Biomedical subjects

E Hultman

Publications and source records attributed to E Hultman.

At least 91 records · Page 5Linked to original sources

PubMed1991

Deficiency of skeletal muscle succinate dehydrogenase and aconitase. Pathophysiology of exercise in a novel human muscle oxidative defect.

We evaluated a 22-yr-old Swedish man with lifelong exercise intolerance marked by premature exertional muscle fatigue, dyspnea, and cardiac palpitations with superimposed episodes lasting days to weeks of increased muscle fatigability and weakness associated with painful muscle swelling and pigmenturia. Cycle exercise testing revealed low maximal oxygen uptake (12 ml/min per kg; healthy sedentary men = 39 +/- 5) with exaggerated increases in venous lactate and pyruvate in relation to oxygen uptake (VO2) but low lactate/pyruvate ratios in maximal exercise. The severe oxidative limitation was characterized by impaired muscle oxygen extraction indicated by subnormal systemic arteriovenous oxygen difference (a-v O2 diff) in maximal exercise (patient = 4.0 ml/dl, normal men = 16.7 +/- 2.1) despite normal oxygen carrying capacity and Hgb-O2 P50. In contrast maximal oxygen delivery (cardiac output, Q) was high compared to sedentary healthy men (Qmax, patient = 303 ml/min per kg, normal men 238 +/- 36) and the slope of increase in Q relative to VO2 (i.e., delta Q/delta VO2) from rest to exercise was exaggerated (delta Q/delta VO2, patient = 29, normal men = 4.7 +/- 0.6) indicating uncoupling of the normal approximately 1:1 relationship between oxygen delivery and utilization in dynamic exercise. Studies of isolated skeletal muscle mitochondria in our patient revealed markedly impaired succinate oxidation with normal glutamate oxidation implying a metabolic defect at the level of complex II of the mitochondrial respiratory chain. A defect in Complex II in skeletal muscle was confirmed by the finding of deficiency of succinate dehydrogenase as determined histochemically and biochemically. Immunoblot analysis showed low amounts of the 30-kD (iron-sulfur) and 13.5-kD proteins with near normal levels of the 70-kD protein of complex II. Deficiency of succinate dehydrogenase was associated with decreased levels of mitochondrial aconitase assessed enzymatically and immunologically whereas activities of other tricarboxylic acid cycle enzymes were increased compared to normal subjects. The exercise findings are consistent with the hypothesis that this defect impairs muscle oxidative metabolism by limiting the rate of NADH production by the tricarboxylic acid cycle.

Aconitate Hydratase↗

PubMed1991

Chronic maxillary sinusitis. Energy metabolism in sinus mucosa and secretion.

The energy metabolism in maxillary sinus mucosa and secretion from 41 patients with, in most cases, recurrent or chronic sinusitis was studied and compared with that in mucosal samples from patients with no previous history of sinus abnormality or infection. In freeze-dried samples, glucose and lactate were measured by enzymatic assays and adenine nucleotides by HPLC. In chronic sinusitis the lactate concentration in the mucosa was increased, probably as a result of increased glycolysis or of impaired diffusion within the mucosa. The lactate concentrations in purulent and non-purulent secretions were 16.3 and 1.1 mmol x kg-1 w.w., respectively. The higher concentration in the purulent secretion was due mainly to leucocyte metabolism. The adenine nucleotide contents in the mucosa were similar in all groups studied. Anaerobic bacteria were isolated only in secretions with a high lactate concentration.

Adenine Nucleotides↗

PubMed1991

Changes in muscle morphology in chronic trapezius myalgia.

Muscle biopsies of the descending portion of the trapezius muscle from female patients with chronic trapezius myalgia and from healthy women were analyzed with enzyme histochemical and immunohistochemical methods. Frequency, area, and capillarization of the muscle fiber types were determined. A biochemical analysis determined the lactate concentration of mixed muscle samples and the adenosine triphosphate (ATP) and phosphocreatine levels in single muscle fibers. The patients had larger type I fibers and a lower capillary:fiber area ratio for type I and type IIA fibers. The patients also exhibited lower levels of ATP and phosphocreatine in both type I and type II fibers. It is suggested that there might have been an imbalance between the capillary supply and the cross-sectional fiber area of type I and type IIA fibers in the patients. This imbalance might be of significance in the development of muscular fatigue and pain.

Adult↗

PubMed1991

Skeletal muscle energy metabolism and fatigue during intense exercise in man.

Adenosine triphosphate (ATP) is the sole fuel for muscle contraction. During near maximal intense exercise the muscle store of ATP will be depleted in < 1s, therefore, to maintain normal contractile function ATP must be continually resynthesized. During intense exercise (from approximately 75% VO2 max to near maximal workloads) this is achieved principally by the oxidation of carbohydrate and the anaerobic utilisation of phosphocreatine (PCr) and carbohydrate. The relative contribution of carbohydrate oxidation to total energy provision decreases, while that from anaerobic utilization increases. During prolonged intense exercise (approximately 75% VO2 max), the oxidation of glucose derived from skeletal muscle and liver glycogen stores is the primary pathway for ATP resynthesis. It is widely accepted that the availability of carbohydrate limits performance during this type of exercise as the point of exhaustion has been shown to be closely related to the depletion of muscle and liver glycogen stores. It is probable that carbohydrate depletion results in the inability of skeletal muscle to maintain the required rate of ATP resynthesis and therefore, the work intensity must be reduced for exercise to continue. During short lasting near maximal exercise (0-30 s), the anaerobic utilization of muscle PCr and glycogen will fuel muscle contraction. Evidence is available to indicate that fatigue during this type of exercise is related to the inability of type II fibres to maintain the required very high rate of ATP resynthesis. This has been suggested to result from a rapid depletion of type II fibre PCr stores and an insufficiency of the glycogenolytic rate to compensate for the fall in ATP production when the PCr store is depleted. In this situation the force generation has to decrease due to insufficient energy supplies.

Adenosine Triphosphate↗

PubMed1991

Nutritional assessment in anemic hemodialysis patients treated with recombinant human erythropoietin.

Nutritional status was assessed in 25 anemic hemodialysis patients before and during erythropoietin treatment. Nutritional assessment included regular blood chemistry determinations, anthropometric measurements, analysis of protein content in skeletal muscle, and estimation of daily protein intake from protein catabolic rate determinations (using urea kinetic modelling) and dialysis efficiency for urea. These measurements were done immediately prior to erythropoietin treatment, after anemia correction and after one year of maintenance erythropoietin treatment. Both relative body weights and subcutaneous fat stores were low at the start, but increased significantly (p less than 0.05) during the study. Sixteen of the 25 patients gained weight and eight patients lost weight. The patients with weight gain had at the start of the study low weight indices (body weight 89.9 +/- 7.6% of ideal body weight, body mass index 20.6 +/- 1.6), significantly (p less than 0.005) lower than the patients with weight loss. Although protein malnutrition was not obvious from arm anthropometrics, alkali soluble protein/DNA ratio or from serum albumin determinations, ASP/DNA ratio, increased in three of five patients investigated after one year on erythropoietin treatment. Neither protein catabolic rate nor dialysis efficiency changed significantly during the study. We conclude that anemia correction with erythropoietin has a positive effect on malnutrition in hemodialysis patients. In patients with underweight, an adjustment of fat stores was initially observed, followed possibly by an improvement in muscle protein content.

Adult↗

PubMed1990

Contraction characteristics of the human quadriceps muscle during percutaneous electrical stimulation.

Percutaneous electrical stimulation was used to study the force response of the quadriceps muscle. The normal frequency dependence of force was investigated in muscles at rest and after fatiguing contractions. A comparison between force response during fatigue induced by electrical stimulation at different frequencies and by voluntary work suggested equal changes in contractility, irrespective of the fatigue-inducing procedure. In fresh muscle we found a linear relation between stimulation period (10-100 ms) and force. At fatigue the relation changes with maximal deviation from linearity at a 50-ms period (20 Hz). There is a rapid recovery of high frequency force whereas the low frequency response remains low even after 30 min rest. At very low frequencies there is initially unexpectedly high force in fatigued muscle. This could be a result of increased fusion of twitches with initially prolonged relaxation time. To study the twitch summation we compared experimental results in a wide frequency range with computer-simulated twitch summations and present the frequency dependence of summation processes in human quadriceps muscle.

Adult↗

PubMed1990

Radioisotopic assays of CoASH and carnitine and their acetylated forms in human skeletal muscle.

Radioisotopic assays for the determination of acetyl-CoA, CoASH, and acetylcarnitine have been modified for application to the amount of human muscle tissue that can be obtained by needle biopsy. In the last step common to all three methods, acetyl-CoA is condensed with [14C]oxaloacetate by citrate synthase to give [14C]-citrate. For determination of CoASH, CoASH is reacted with acetylphosphate in a reaction catalyzed by phosphotransacetylase to yield acetyl-CoA. In the assay for acetylcarnitine, acetylcarnitine is reacted with CoASH in a reaction catalyzed by carnitine acetyltransferase to form acetyl-CoA. Inclusion of new simple steps in the acetylcarnitine assay and conditions affecting the reliability of all three methods are also described. Acetylcarnitine and free carnitine levels in human rectus abdominis muscle were 3.0 +/- 1.5 (SD) and 13.5 +/- 4.0 mumol/g dry wt, respectively. Values for acetyl-CoA and CoASH were about 500-fold lower, 6.7 +/- 1.8 and 21 +/- 8.9 nmol/g dry wt, respectively. A strong correlation between acetylcarnitine (y) and short-chain acylcarnitine (x), determined as the difference between total and free carnitine, was found in biopsies from the vastus lateralis muscle obtained during intense muscular effort, y = 1.0x + 0.5; r = 0.976.

Acetyl Coenzyme A↗

PubMed1990

Muscle buffering capacity and dipeptide content in the thoroughbred horse, greyhound dog and man.

1. Muscle buffering capacity (beta m) and dipeptide content were measured in locomotory muscles of the Thoroughbred horse, Greyhound dog and Man. 2. Beta m and carnosine contents were highest in the horse. Anserine was only found in dog muscle. 3. The higher beta m in horse and dog muscle, compared with man, appears to be predominantly due to higher muscle contents of histidine containing dipeptides in these species.

Animals↗

PubMed1990

Epidural versus intrathecal morphine-bupivacaine: assessment of consecutive treatments in advanced cancer pain.

Twenty-five patients with multifocal and multitype (somatic, visceral, and neurogenic) advanced cancer pain who experienced severe pain despite extradural (ED) morphine and bupivacaine were converted to intrathecal (IT) morphine and bupivacaine. The consecutive ED and IT periods (2-174 days, median = 50 days, and 1-305 days, median = 37 days, respectively) were assessed in clinical terms (daily analgesic dosages giving acceptable pain relief and quality of life expressed as sleeping hours and walking/daily activities). With the IT treatment, the total (all routes) opiate consumption and the daily doses of spinal morphine and spinal bupivacaine decreased significantly at the beginning of the treatment compared to the ED period, and continued to be significantly reduced for up to 1 wk for spinal opiate and bupivacaine and 6 mo for total opiate. The spinal opiate and bupivacaine doses were still lower in 50% of the patients at the end of the IT treatment compared to the end of the ED period. When final ED versus initial (2nd day) IT doses were assessed, the daily median dose ratios were 7.5 for total opiate and 4 for both spinal opiate and bupivacaine. Subsequently, lower daily volumes and higher concentrations were needed for IT administration of the drugs. During the first month of the IT treatment, sleeping and walking scores improved compared to ED treatment. Thus, the IT treatment gave more satisfactory pain relief, and--because of lower daily doses and volume--proved to be more suitable for treatment at home (continuous infusion from external pumps) than the ED treatment.

Adult↗

PubMed1990

Restoration of anabolic deficit and muscle glycogen consumption in competitive orienteering.

Consumption and restoration of muscle glycogen and changes in anabolic and catabolic steroid hormones were analyzed in five male elite orienteers during and after an orienteering competition. The magnitude of glycogen consumption and pronounced increase in serum-cortisol during the orienteering race reflect the great muscular output demands during forest running. The free testosterone/cortisol ratio was normalized to the initial level within four hours post-exercise. Synchronously, only 25% of the muscle glycogen loss was restored. Within 24 hours post-exercise all runners showed normalized levels of testosterone, cortisol and free testosterone/cortisol ratio. The glycogen content was also restored except in one of the runners. We conclude that daily orienteering competitions per se do not seem to create risks for developing a state of hormonal imbalance or significant decrease in glycogen when the carbohydrate supply is appropriate.

Adult↗

PubMed1990

A sensitive method for measuring ATP-formation in rat muscle mitochondria.

A sensitive method for the measurement of the ATP production rate in isolated skeletal muscle mitochondria is presented. Mitochondrial suspensions were prepared by differential centrifugation from approximately 80 mg of soleus muscle. ATP production rates were measured luminometrically, utilizing a reagent based upon firefly luciferase, which emits light proportional to the ATP concentration. In a group of 10 rats the ATP production rates were measured with the following substrate combinations: pyruvate + malate, palmitoyl-L-carnitine + malate, alpha-ketoglutarate, succinate + rotenone and succinate alone. The variance of the method including tissue preparation, protein determination and the luminometric determination of ATP production was estimated to be 10-14% for the various substrates. Compared to values in the literature, the present results show a good agreement for the substrates pyruvate + malate and palmitoyl-L-carnitine + malate, but lower rates were obtained in our study for alpha-ketoglutarate and succinate + rotenone. The advantage of the luminometric method is its high sensitivity. Only 30-40 mg of tissue is required for a complete determination, compared to 1-2 g for a similar assay of oxygen consumption. The method is intended for use in human subjects and will facilitate studies of mitochondrial respiration both in patients of different age groups and in healthy subjects.

Adenosine Triphosphate↗

PubMed1990

ATP content in single fibres from human skeletal muscle after electrical stimulation and during recovery.

The ATP content was measured in type I and type II fibres from human vastus lateralis muscle at rest, after electrical stimulation and during recovery. At rest the mean values were 25.2 +/- 4.02 and 25.9 +/- 3.62 mmol kg-1 dry muscle (mean +/- SD) for type I and type II fibres respectively. Normal distribution curves were found for both types I and II fibres. After intermittent electrical stimulation for 83 s (1.6 s stimulation, 1.6 s pause) with occluded blood flow, the force generation decreased to 22% of the initial value and the muscle tissue showed a mean decrease in ATP to 14.8 and in phosphocreatine to 5.44 mmol kg-1 dry muscle; lactate increased to 128.9 mmol kg-1 dry muscle. The ATP content in isolated fibres was equally decreased in both fibre types to 16 mmol kg-1 dry muscle. In 11% of the fibres the ATP content was lower than 10 mmol kg-1 dry muscle. After 15 min rest with intact blood circulation ATP was completely resynthesized in type I fibres and to 91% in type II fibres.

Adenosine Triphosphate↗

PubMed1990

Influence of reduced glycogen level on glycogenolysis during short-term stimulation in man.

The relationship between muscle glycogen concentration and the rate of glycogen breakdown during short, intense contraction has been investigated in man. Prior to the experiment, muscle glycogen content was manipulated by a combination of exercise and diet, and varied from 155 +/- 19 to 350 +/- 25 mmol kg-1 dry muscle (36-81 mmol kg-1 wet wt). The quadriceps femoris muscle was stimulated electrically at a frequency of 20 Hz for 1 min. The blood flow to the leg was occluded during the experiment and muscle biopsies were taken before and after 10, 30 and 60 s stimulation. Force development and glycogenolytic rate were maintained constant during electrical stimulation and similar in all conditions, irrespective of the initial glycogen concentration. The phosphorylase a fraction was increased after 10 s stimulation, but returned to the initial values at the end of the stimulation. Muscle ATP was unaltered during the first 30 s stimulation, but decreased thereafter. The decrease in ATP was accompanied by a stoichiometric increase in inosine monophosphate. Phosphocreatine decreased during stimulation and was almost depleted at the end of stimulation. Muscle lactate and glucose 6-phosphate (Glu 6-P) increased during stimulation. None of these changes was significantly affected by the reduced glycogen contents. It is concluded that the rate of muscle glycogen breakdown is not affected by the initial glycogen level in the range of 155 +/- 19 to 350 +/- 25 mmol kg-1 dry muscle.

Adenosine Triphosphate↗

PubMed1990

ATP production rate in mitochondria isolated from microsamples of human muscle.

Mitochondrial ATP production (MAPR) was determined using a bioluminescence method in mitochondrial preparations of human skeletal muscle. We obtained muscle samples from 21 healthy subjects using the percutaneous muscle biopsy technique. The subjects were grouped according to their degree of physical activity, i.e., from sedentary to highly active. The MAPR for each subject was related to the mitochondrial protein content and to the activity of glutamate dehydrogenase (GDH) estimated in muscle homogenates and in isolated mitochondria. With the use of GDH as a reference base, the MAPR could be expressed per muscle mass. MAPR was determined for different individual substrates and also for the combination of pyruvate, palmitoyl-carnitine, alpha-ketoglutarate, and malate (MAPRPPKM). The MAPR observed was higher for the combination of substrates than for any individual substrate tested. The relation between mitochondrial ATP production rate and GDH activity was the same for all subjects irrespective of physical activity status, but MAPRPPKM/kg muscle varied from 6.6 +/- 1.3 mmol.min-1.kg-1 in sedentary subjects to 11.0 +/- 2.2 in highly active subjects. The present method, which uses 50 mg of muscle tissue, enables mitochondrial function to be estimated in healthy subjects or patients with mitochondrial disorders.

Adenosine Triphosphate↗

PubMed1990

Association between muscle acetyl-CoA and acetylcarnitine levels in the exercising horse.

Treadmill exercise of 2-min duration and increasing intensity resulted in increased formation of acetyl-CoA and acetylcarnitine in working muscle of Thoroughbred horses. At high work intensities a plateau was reached for both acetyl-CoA (approximately 50 mumols/kg dry muscle) and acetylcarnitine (approximately 20 mmol/kg dry muscle). Postexercise concentrations were significantly (P less than 0.001) correlated; [acetylcarnitine] = 349.[acetyl-CoA] + 2.4. The results indicate that approximately 350 mumols acetylcarnitine were accumulated for every 1 mumol acetyl-CoA. Under the conditions of exercise used it is probable that most of the acetyl-CoA formed is generated through the intramitochondrial decarboxylation of pyruvate. The acetyl groups of acetyl-CoA are apparently redistributed throughout the whole cell through formation of acetylcarnitine, which readily transverses the mitochondrial membrane. Despite the redistribution, however, the close correlation between acetylcarnitine and acetyl-CoA would indicate that equilibrium was maintained and that neither acetylcarnitine transferase nor carnitine/acetylcarnitine translocase were rate limiting. There is some question as to whether the changes observed relate directly to exercise itself or to the state in muscle 10 s or more after exercise.

Acetyl Coenzyme A↗

PubMed1990

Regulation of phosphorylase a activity in human skeletal muscle.

The control mechanism of glycogenolysis by phosphorylase a in contracting muscle has been investigated. The quadriceps femoris muscles of six subjects were intermittently stimulated at 15 and 50 Hz. The stimulation lasted 9.6 s and was performed twice at 15 Hz and once at 50 Hz. Epinephrine was infused continuously during the experiment. The force generation and ATP turnover rate were nearly twofold higher at 50 Hz than at 15 Hz. Calculated mean Pi was 5.7 and 10.0 mM during the two 15-Hz stimulations and 8.1 mM during the 50-Hz stimulation. Phosphorylase a varied between 85.5 and 91.5% without significant differences between periods. However, the rate of glycogenolysis was twofold higher during the stimulation at 50 Hz than it was at 15 Hz (P less than 0.05) and was related to the ATP turnover rate (r = 0.992). These results demonstrate that rapid glycogen breakdown during muscle contraction cannot be solely explained by transformation of phosphorylase b to a and increased Pi concentration. The contraction intensity may determine the glycogenolytic rate through a transient increase in free AMP level related to the ATP turnover rate.

Adenosine Monophosphate↗

PubMed1990

The effect of cobalt on mitochondrial ATP-production in the rat myocardium and skeletal muscle.

Cobalt has been shown to accumulate in the myocardium of uraemic patients and has been suggested as a myocardial toxin inhibiting mitochondrial respiration. In order to study the cellular effects of cobalt exposure three groups of rats (n = 12 per group) were fed a diet containing 12% protein without supplementation or with 20 mg and 40 mg CoSO4 7 H2O/kg body weight/day respectively. After 8 weeks the hearts and soleus muscles were removed. Cobalt in tissues and in four cell fractions were analysed with neutron-activation analysis (ng/g wet weight and ng/mg protein respectively). Mitochondrial respiration was analysed as ATP-production rate using pyruvate + malate and palmitoyl-carnitine + malate as substrate. The ATP-production from pyruvate + malate was unchanged in both heart and skeletal muscle in the exposed animals. With palmitate as substrate, the heart muscle showed a slightly lower ATP-production rate (p less than 0.05) after the 20 mg cobalt dose, but the rate was unchanged in the group with higher cobalt intake. No changes in ATP-production rate from palmitate was observed in soleus muscle. The microsomal (100,000 g) fraction in the myocardial cells contained significantly higher cobalt concentrations compared to the mitochondrial fraction in both the unexposed (1.4 ng/mg protein vs 0.19, p less than 0.05) and exposed rats (53.4 ng/mg protein vs 13.2, p less than 0.005). In conclusion, cobalt showed a large accumulation in myocardial cells, without significant effects on mitochondrial ATP-formation rate from oxidation of pyruvate or palmitate and with the highest cobalt content contained in the microsomal (100,000 g) fraction.

Adenosine Triphosphate↗

PubMed1990

The intracellular distribution of cobalt in exposed and unexposed rat myocardium.

The intracellular distribution of cobalt was analysed in the myocardium of exposed and unexposed rats. The exposed rats were given a dietary cobalt supplementation of 40 mg CoSO4.7 H2O/kg body weight for 8 weeks. The mitochondrial fraction showed the greatest relative increase in cobalt: 0.09 ng/mg protein in the unexposed rats to 8.43 ng/mg protein in the exposed rats. In the exposed rats the submitochondrial particles had the highest levels of cobalt: 19.43 ng/mg protein, followed by the sarcoplasmatic reticulum: 12.3 ng/mg protein. The microsomal 44,000 g supernatant also showed an increase, although the levels remained low (0.51 ng/mg protein in the exposed animals). Apparently the calcium-storing organelles had the highest levels of cobalt. This could affect calcium flux in myocardial cells and, secondarily, tension development in cardiac muscle.

Animals↗