Background. Counseling sedentary primary care patients can increase physical activity, but whether this approach will increase exercise and fitness in elderly adults with chronic diseases remains to be determined. Methods. After receiving individualized nurse counseling to begin a program of walking for health, 60- to 80-year-old primary care patients were randomized to one of three levels of telephone contacts over 10 months: (i) 20 nurse-initiated calls, (ii) 10 nurse-initiated calls plus 10 motivational calls programmed through an automated phone calling system, or (iii) no program-initiated phone contacts. Self-reported (diary) walking adherence was the primary outcome; other activity, social support, health quality of life, and measured walking performance, mobility, and body mass index and girths were also assessed during the initiation (months 1-6) and maintenance (months 7-10) phases of the trial. Results. Average adherence for the 181 participants to the goal of walking at least 20 minutes on 3 or more days per week was 44% for initiation and 42% for maintenance. Participants receiving the combination of nurse-initiated personal and automated phone calls walked significantly more frequently than those with no phone contacts. Fitness improved in all three groups; changes were generally correlated with self-reported walking. Having a companion was associated with more frequent walking. Perceived quality of physical and mental health did not change. Conclusions. Simple and relatively inexpensive nurse contacts can motivate elderly primary care patients to walk for exercise, and this activity is associated with measurable health benefits.

Although obesity is a major risk factor for morbidity and mortality, the mechanisms mediating cardiovascular abnormalities in response to weight gain are unclear. One reason for the paucity of information in this area is the lack of appropriate animal models for the study of human obesity. Therefore, the goal of the present study was to develop a small animal model of dietary-induced obesity that mimics many of the characteristics of human obesity. We studied female New Zealand White rabbits fed either a normal (n = 17) or high-fat diet (n = 15) and examined the cardiovascular consequences of obesity, including changes in blood pressure, humoral activation, and end-organ effects such as cardiac hypertrophy. After 12 wk, rabbits on the high-fat diet were 46% heavier than their lean counterparts (5.49 +/- 0.09 vs. 3.77 +/- 0.06 kg, respectively; P = 0.0001). Obese rabbits had higher resting heart rates than lean rabbits (220 +/- 7 vs. 177 +/- 6 beats/min; P = 0.0001) and developed hypertension (96 +/- 2 vs. 85 +/- 1 mmHg; P = 0.0001), hyperinsulinemia (32.5 +/- 3.4 vs. 15.5 +/- 1.0 microU/ml; P = 0.0001), hyperglycemia (162.4 +/- 2.9 vs. 141.9 +/- 2.7 mg/dl; P = 0.0001), and elevated triglycerides (102.3 +/- 9.1 vs. 48.5 +/- 4.0 mg/dl; P = 0.0001). Obese rabbits also developed cardiac hypertrophy, as evidenced by left ventricular (LV) dry weights that were 52% greater in obese than in lean rabbits (P = 0.0003). In addition, LV total protein was increased in proportion to the increase in LV weight. The results of this study suggest that rabbits fed a high-fat diet for a period of 12 wk develop many of the characteristics of human obesity. The obese rabbit should provide a small and relatively inexpensive animal model to investigate mechanisms of obesity-related cardiovascular abnormalities.

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Pearl millet [Pennisetum millet (L.) leeke] is the main source of food energy for the rural poor in many areas of the semiarid tropics. Epidemiological evidence suggests that millet may play a role in the genesis of endemic goiter in these areas, and sparse experimental data in rats support this suspicion. This study was undertaken to determine in vivo in rats and in vitro using porcine thyroid slices and a thyroid peroxidase (TPO) assay the goitrogenic and antithyroid effects of millet diets, extracts of millet, and certain pure compounds contained therein. For use in these studies, whole grain millet was progressively dehulled to yield successively four bran and four flour fractions in which direct analyses revealed progressively lower concentrations of C-glycosylflavones. In vivo feeding of bran fraction 1, that richest in C-glycosylflavones, led to a significant increase in thyroid weight and antithyroid effects. Feeding of bran fraction 2, the next richest in C-glycosylflavones, produced similar, but less marked, changes. In vitro studies of 125I metabolism using porcine thyroid slices indicated that extracts of bran fractions 1 and 2 were most potent, producing changes similar to those produced by methimazole (MMI). At a concentration of 60 mumol/L, glucosylvitexin, the major C-glycosylflavone present in millet, had effects comparable to those of 1 mumol/L MMI. Similarly, in studies of porcine TPO, extracts of bran fraction 1 caused pronounced (85%) inhibition of enzyme activity, and progressively less inhibition was induced by extracts of bran fractions 2, 3, and 4. Overall, the TPO-inhibiting activities of the various millet fractions closely correlated with their C-glycosylflavone concentrations. Three C-glycosylflavones present concentrations. Three C-glycosylflavones present in millet, glucosylvitexin, glycosylorientin, and vitexin, also inhibited TPO activity. Thus, in vivo and in vitro studies revealed that millet diets rich in C-glycosylflavones produce goitrogenic and antithyroid effects similar to those of certain other antithyroid agents and small doses of MMI. We conclude that in areas of iodine deficiency in which millet is a major component of the diet, its ingestion may contribute to the genesis of endemic goiter.

Immunologic graft loss in our population is related to noncompliance with transplant medications, which occurred primarily in recipients with a pretransplantation history of substance abuse and is not related to an inability to pay for medications at the time of graft loss. A change in criteria for acceptance of transplant candidates with a prior history of substance abuse might significantly improve graft survival in this patient population.

CCI, is a hepatotoxic haloalkane, capable of producing hepatocellular fatty degenention and centrilobular necrosis. Previous reports indicate induction of liver regeneration after 3 6 4 8 hr of CCI, treatment, which is considered as a secondary effect. The present investigation was undertaken to evaluate the primary effects of CCI, on hepatic DNA synthesis and to correlate liver regeneration with CCI, toxicity. These studies were conducted in normal and actively regenerating livers using male Spngue-Dawley rats undergoing sham operation (SH), or partial (70%) hepatectomy (PH). Incorporation of 'H-thymidine ('H-T) in hepatocellular nuclear DNA and autoradiographic analyses of liver sections served as indices for hepatocellular regeneration. Initial experiments established that peak regeneration occurs at 2 days post-PH (PH,) and liver regeneration phases out by 7 days post-PH (PH,). SH and PH rats were challenged with a single ip dose of either corn oil vehicle or CCI, at either 0.1 mVkg (to represent subtoxic dose) or 2.5 mVkg (to represent toxic dose). The low dose of CCI, was not toxic and did not alter 'H-T incorporation and percentage labelled cells at 6 or 24 hours after administration to SH, PH, or PH, groups, indicating that there was no interference with PHstimulated hepatocellular regeneration. The high dose of CCI, was significantly hepatotoxic and lethal in SH rats, while in PH, rats both hepatotoxic and lethal effects were significantly decreased. 'H-T incorporation as well as percentage labelled cells, highly stimulated by PH, were significantly decreased by high dose of CCI,. However, hepatocellular regeneration in PH2 rats treated with high dose of CCI, was still significantly higher than SH or PH, groups by virtue of the stronger stimulatory effect of PH. In PH, nts, where hepatocellular regeneration had returned to the SH level, the hepatotoxic and lethal effects of the large dose of CCI, were also restored. These findings show that the progressive phase of a single high dose of CCI, injury which normally culminates in hepatotoxic and lethal eKects is significantly mitigated by previously stimulated hepatocellular regeneration. High dose of CCI, suppresses hepatocellular regeneration at early time points after administration in contrast to the smaller subtoxicdose ofCCI,. By virtue ofthe much stronger stimulatory effect, PH results in the protection against the hepatotoxic and lethal effects of CCI, despite the obtunding effects of the high dose on hepatocellular regeneration.

Background: We evaluated the effects of counseling linked with primary care visits on walking and "strength exercise" (the combination of strength-building and flexibility exercise) in aging veterans. Methods: Male veterans aged 60 to 85 years (N=224) with physical function limitations were randomized to either counseling for home-based walking and strength exercise (EXC) or discussion of their choice of health education topics (EDUC) with a nurse at baseline, 1 month, and 5 months. The EXC participants recorded exercise on monthly calendars and received brief follow-up calls from the nurse; all participants received bimonthly newsletters throughout the 10-month trial. Results: Retention was 83% in the EXC group and 97% in the EDUC group (P Ͻ.001). With analyses using the last observation carried forward approach, the EXC participants reported more walking time per week at 5 and 10 months (64.5 and 60.6 min/wk, respectively, for the EXC group vs 50.5 and 45.7 min/wk, respectively, for the EDUC group; 2.4 d/wk and 2.3 d/wk, respectively, for the EXC group vs 1.8 and 1.7 d/wk, respectively, for the EDUC group) (P Ͻ.001). The EXC participants also reported more strength exercise at 5 and 10 months (44.6 and 41.2 min/wk, respectively, for the EXC group vs 19.8 and 14.7 min/wk, respectively, for the EDUC group; 2.1 and 2.0 d/wk, respectively, for the EXC group vs 0.8 and 0.8 d/wk, respectively, for the EDUC group) (P Ͻ.001). The EXC participants reported more frequent moderate-or higher-intensity physical activity (7.1 vs 5.1 sessions/wk) (P Ͻ .001). Findings from accelerometermeasured physical activity indicated more EXC than EDUC participants (64% vs 46%), who averaged 30 min/d or more of moderate-or higher-intensity physical activity (P =.03). Participants engaging in strength exercise improved physical performance and reported positive changes in quality of life. Conclusion: Relatively brief counseling linked with primary care visits can increase home-based walking and strength exercise in aging male veterans.

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