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Biomedical subjects

E Jansson

Publications and source records attributed to E Jansson.

At least 37 records · Page 2Linked to original sources

Comprehensive local muscle training increases aerobic working capacity and quality of life and decreases neurohormonal activation in patients with chronic heart failure.

BACKGROUND: Beneficial training outcomes have been reported in patients with chronic heart failure (CHF) following leg exercise training. However, data from more comprehensive training programs are limited. The aim of this study was to test the hypothesis that exercise training applying the concept of comprehensive local muscle training can improve aerobic and functional working capacity as well as quality of life in patients with CHF. METHODS: Twenty-four men and women [age 63+/-9 years (mean+/-S.D.)] with stable, moderate chronic heart failure (left ventricular ejection fraction 30+/-10%), were investigated in a randomized controlled study with a training group of 16 patients and a control group of 8 patients. The training was performed as an aerobic resistance training by activating all the main muscle groups, one at a time. The patients exercised for 1 h, three times per week for 8 weeks. RESULTS: Patient groups did not differ at baseline. Peak oxygen uptake (8%, P<0.03), the distance walked in a 6-min walking test (11%, P<0.002), the health-related quality of life (P<0.001) and plasma norepinephrine levels at rest (32%, P<0.003) and at submaximal intensities (P<0.03) improved after training. No changes were found in the control group, except for decreased peak oxygen uptake (P<0.02) and quality of life scores (P<0.03). CONCLUSIONS: Since comprehensive physical training activating a minor muscle mass at a time markedly improves exercise capacity and quality of life and reduces catecholamine levels, it can be recommended for the rehabilitation of patients with CHF under supervision of a physical therapist.

Analysis of Variance↗

Increased expression of VEGF following exercise training in patients with heart failure.

BACKGROUND AND AIMS: During the last decades several angiogenic factors have been characterized but so far it is unknown whether local muscle exercise training increases the expression of these factors in patients with moderate heart failure. Expression of the major putative angiogenic factor vascular endothelial growth factor (VEGF) at the level of messenger RNA (mRNA) and/or protein was therefore studied before and after 8 weeks of training in patient with chronic heart failure. METHODS: VEGF mRNA and protein concentrations were determined in skeletal muscle biopsies before and after 8 weeks of one-legged knee extension training in patients with chronic heart failure (New York Heart Association II-III). RESULTS: Exercise training increased the citrate synthase activity and peripheral exercise capacity by 46% and 36%, respectively, in parallel with a two-fold increase in VEGF at both the mRNA (P = 0.03) and protein (P = 0.02) levels CONCLUSION: The increase in VEGF gene expression in response to exercise training indicates VEGF to be one possible mediator in exercise-induced angiogenesis and may therefore regulate an important and early step in adaptation to increased muscle activity in patient with chronic heart failure.

Aged↗

Regulation of skeletal muscle ATP catabolism by AMPD1 genotype during sprint exercise in asymptomatic subjects.

Deficiency of myoadenylate deaminase, the muscle isoform of AMP deaminase encoded by the AMPD1 gene, is a common myopathic condition associated with alterations in skeletal muscle energy metabolism. However, recent studies have demonstrated that most individuals harboring this genetic abnormality are asymptomatic. Therefore, 18 healthy subjects with different AMPD1 genotypes were studied during a 30-s Wingate test in order to evaluate the influence of this inherited defect in AMPD1 expression on skeletal muscle energy metabolism and exercise performance in the asymptomatic population. Exercise performances were similar across the AMPD1 genotypes, whereas significant differences in several descriptors of energy metabolism were observed. Normal homozygotes (NN) exhibited the highest levels of AMP deaminase activities, net ATP catabolism, and IMP accumulation, whereas intermediate values were observed in heterozygotes (MN). Conversely, mutant homozygotes (MM) had very low AMP deaminase activities and showed no significant net catabolism of ATP or IMP accumulation. Accordingly, MM also did not show any postexercise increase in plasma ammonia. Unexpectedly, MN consistently exhibited greater increases in plasma ammonia compared with NN despite the relatively lower accumulation of IMP in skeletal muscle. Moreover, time course profiles of postexercise plasma ammonia and blood lactate accumulation also differed across AMPD1 genotypes. Finally, analysis of adenosine in leftover biopsy material revealed a modest twofold increase in MN and a dramatic 25-fold increase in MM.

Adenosine Diphosphate↗

Adolescent determinants of cardiovascular risk factors in adult men and women.

AIMS: To investigate how physical activity, physical performance and sociodemographic characteristics at the age of 16 are related to adult health habits (physical activity, dietary intake, smoking) and biological risk factors for cardiovascular diseases (being overweight, low aerobic fitness, unfavorable levels of serum lipids, high blood pressure). METHODS: A randomly selected group of 220 male and 205 female students at 16 years of age was tested in 1974, and reinvestigated 18 years later. RESULTS: The predictive health profiles for adult lifestyle and biological risk factors were different in men and women. Leisure sports activity along with high performance in the nine-minute run among the boys and in the two-hand lift test among the girls were significant predictors of adult physical activity. A positive attitude to aerobic exercise and high performance in the nine-minute run test among the boys and high marks in physical education among the girls decreased the risk of smoking. Leisure sports activities together with body mass index at young ages were the most powerful predictors of adult biological risk factors, but attitudes to sports and educational level were also significant determinants. CONCLUSION: These results contribute to the knowledge of which factors at young ages may promote adult healthy habits in particular physical activities.

Adolescent↗

Effects of dynamic ischaemic training on human skeletal muscle dimensions.

The effect of training under conditions of local leg ischaemia on muscle area and fibre dimensions was studied in nine males. Leg ischaemia was induced by enclosing the legs in a pressure chamber and sealing the opening with a rubber membrane at the level of the crotch. Air pressure over the legs was 50 mmHg. The subjects performed 16 sessions (45 min) of one-legged supine strenuous ischaemic training during 4 weeks. Exercise intensity was maintained as high as possible during the whole session. The contralateral leg served as a control leg and remained passive during exercise. Before and after the training period, muscle fibre dimensions were determined from biopsy samples taken from the m. vastus lateralis, and leg muscle dimensions were assessed by magnetic resonance imaging (MRI). In the trained leg, mean fibre area increased by 12% (P < 0.05). The MRI-assessed cross-sectional area of the vastus group increased by 4% (P = 0.01). In the control leg, mean fibre area and the cross-sectional area of the vastus group were unchanged, while those of the adductor muscle group decreased by 4% (P < 0.05). It is concluded that a short period of strenuous ischaemic endurance training increases the cross-sectional area of the ischaemically trained muscle group, as measured both by MRI and from muscle biopsy samples. In contrast, the adductor muscles in the contralateral thigh showed a decreased cross-sectional area (as assessed by MRI), possibly due to the effects of the strenuous contralateral training, by mechanisms that have yet to be identified.

Adult↗

Insulin treatment increases skeletal muscle fibre area in patients with diabetes mellitus type 2.

The effects of insulin treatment on skeletal muscle characteristics were studied in 18 patients (62 +/- 11 years) with poorly controlled diabetes mellitus type 2 (mean duration 7.5 +/- 6 years). Skeletal muscle biopsy samples were taken from the lateral portion of the quadriceps muscle before and after a period of insulin treatment of 40 +/- 14 days. Enzyme activities (phosphofructokinase, 3-hydroxyacyl-CoA dehydrogenase, citrate synthase, lactate dehydrogenase and creatine kinase) and myoglobin content were assessed. In a subgroup of 11 patients (60 +/- 11 years), skeletal muscle fibre type composition (type I, IIA, IIB and IIC) and fibre type cross-sectional area were also analysed. Following insulin treatment there were 32 and 38% increases, respectively, in the cross-sectional areas of type IIA and IIB fast-twitch fibres (P<0. 02). The fibre type distribution did not change. The myoglobin content in muscle decreased by 20% (P<0.01). Of the enzymes tested, the 3-hydroxyacyl-CoA dehydrogenase activity decreased by 10% (P<0. 04). Serum glucose, HbA1C and serum triglyceride levels decreased (P<0.001) and body weight and arm muscle circumference increased (P<0.02). In conclusion, insulin treatment of patients with poorly controlled non-insulin-dependent diabetes mellitus increased the fast-twitch fibre area, reduced myoglobin levels and decreased muscle enzyme activity related to fatty acid oxidation.

3-Hydroxyacyl CoA Dehydrogenases↗

On operating deflection shapes of the violin body including in-plane motions.

Earlier investigations have assumed only "out-of-plane" vibrations of the plates of the violin. The violin body can, however, be described as a thin-walled, double-arched shell structure and as such it may very well elongate in one direction as it contracts in another. Therefore, at least two orthogonal vibration components have to be included to describe the vibrations. The operating deflection shapes (ODSs) of a good, professionally made and carefully selected violin were therefore measured in several directions by TV holography to determine both "in-plane" and out-of-plane vibration components of the ODSs. The observations were limited to the frequency range 400-600 Hz, as this interval includes two most-prominent resonance peaks of bridge mobility and sound radiation as well as a third poorly radiating resonance. These three peaks clearly showed orthogonal vibration components in the ODSs. The vibration behavior of the violin body, sectioned in the bridge plane, was interpreted as the vibrations of an "elliptical tube" with nodal diameters. The number of nodal diameters increases from two to three in the selected frequency range. The TV holography measurements were supported by electrodynamical point measurements of bridge mobility, of air volume resonances, and by reciprocity, of radiation properties. Furthermore, a fourth mode, the air mode, A1, is involved indirectly in the sound radiation via influence on the body vibrations.

Acoustics↗

Red blood cell trauma during cardiopulmonary bypass: narrow pore filterability versus free haemoglobin.

Ten patients admitted for coronary artery bypass grafting were investigated with respect to the influence of cardiopulmonary bypass (CPB) on red blood cell (RBC) trauma. Blood samples were collected prior to, at the start of, and at 30 and 60 min of CPB. RBC deformability was assessed by filtering re-suspended RBCs through a polycarbonate membrane using a computer-controlled filtrometer. Multiple regression analysis was employed to evaluate RBC flow-curve characteristics denoted by the initial filtration rate (IFR) and clogging slope (CS). Release of free haemoglobin was determined concomitantly. IFR was estimated at 90.39 microl/s and CS at -5.32 microl/s2 prior to CPB. During 60 min of CPB, neither IFR nor CS deviated significantly (p > 0.05) from these reference values. However, release of free haemoglobin increased significantly (p < 0.018) from the start of CPB to the 60-min determination. In conclusion, 60 min of CPB seems not to alter significantly RBC deformability in a 5 microm pore filtration model, despite a significant release of haemoglobin.

Aged↗

Impaired exercise performance but normal skeletal muscle characteristics in female syndrome X patients.

Pathophysiologic mechanisms in syndrome X (anginal chest pain, positive exercise stress test, and angiographically normal coronary arteries) have been extensively studied. Recent reports suggest an ischemic origin of the pain to be less probable. Other contributing mechanisms that have been hypothesized are enhanced sympathetic drive or sensitivity or an abnormal muscle metabolism. Our aim in this study was to characterize exercise performance, skeletal muscle characteristics, and sympathetic control of blood flow in patients with syndrome X. Seven female patients aged 50 to 65 years and 5 matched controls were tested. Exercise test was performed according to clinical routine. Plasma catecholamine and blood lactate levels were measured before, during, and after exercise. Autonomic blood flow control was measured plethysmographically in the resting contralateral forearm during isometric handgrip. Muscle biopsy specimens were obtained at rest from the lateral part of Musculus vastus at midthigh. The biopsy samples were investigated for the relative number of different fiber types, phosphagen content, and energy charge, calculated as (adenosine triphosphate +/- 1/2 adenosine diphosphate)/[adenosine triphosphate +/- adenosine diphosphate +/- adenosine monophosphate]). Exercise capacity was markedly decreased in syndrome X compared with controls (85 +/- 14 vs 156 +/- 11 W, p <0.0005) and all patients discontinued exercise because of chest pain (Borg CR-10, 5 +/- 3). Peak heart rate was lower in syndrome X (150 +/- 18 vs 176 +/- 7 beats/min, p <0.01), whereas systolic blood pressure and double product did not differ. Peak norepinephrine plasma levels were lower than in controls (11 +/- 6 vs 24 +/- 13 nmol/L, p <0.04), whereas peak blood lactate levels did not differ. Blood flow increase in the resting forearm during isometric handgrip was similar to that in controls. The proportion of different fiber types, phosphagen content, and energy charge were normal. Thus, patients with syndrome X have a reduced physical exercise capacity but no skeletal muscle abnormalities. Catecholamine hypersensitivity may contribute to their condition.

Aged↗

Sex difference in plasma ammonia but not in muscle inosine monophosphate accumulation following sprint exercise in humans.

Since accumulation of ammonia in plasma has been shown to be lower in females than in males following sprint exercise, we hypothesised that muscle inosine monophosphate (IMP) accumulation would also be smaller in females, especially in type II fibres. A relationship between plasma ammonia and muscle IMP accumulation was expected, since ammonia and IMP are formed in equimolar amounts during the net breakdown of adenine nucleotides. The sprint-exercise-induced IMP accumulation, measured in biopsies from vastus lateralis muscle, did not differ between males (n = 16) and females (n = 16) either in type I fibres [males 4.6 (SD 3), females 5.7 (SD 2) mmol x kg(-1) dry muscle], type II fibres [males 13.2 (SD 4), females 12.6 (SD 4) mmol x kg(-1) dry muscle] or in mixed muscle [males 8.4 (SD 3), females 8.2 (SD 3) mmol x kg(-1) dry muscle]. The accumulation of plasma ammonia following the sprint was 35% lower in the females than in the males. The inter-individual variation in plasma ammonia accumulation was explained by the sex but not by the muscle IMP accumulation as tested in a multiple regression analysis. In conclusion, the smaller plasma ammonia accumulation following sprint exercise in females than in males would seem not to be explained by a smaller muscle IMP accumulation per unit muscle during sprint exercise.

Adult↗

Female-related skeletal muscle phenotype in patients with moderate chronic heart failure before and after dynamic exercise training.

UNLABELLED: This study hypothesized that female patients with chronic heart failure (CHF), similarly as previously reported for male patients, have a decreased proportion of type I (slow twitch) muscle fibers combined with fiber atrophy, and respond to exercise training with an increased muscular fiber area and performance, and with an unaltered fiber type distribution. METHODS: Sixteen women [age 62 +/- 10 years (mean +/- SD)] with stable, moderate CHF (left ventricular ejection fraction 28 +/- 8%) underwent percutaneous needle biopsies of the lateral vastus muscle, and assessments of isokinetic muscle strength and exercise tests with respiratory gas and blood lactate analyses, before and after 8 weeks of intensive knee extensor endurance training. RESULTS: When compared to healthy age-matched women, the women with CHF unexpectedly had a normal proportion of type I fibers (51 +/- 15%), but a decreased cross-sectional area in both type I and II fibers. Exercise training increased the cross-sectional area of muscle fibers up to the reference range (21%, p < 0.04), while the relative number of type I fibers decreased (12%, p < 0.03). Training also increased muscle strength (16%, p < 0.0001) and peak oxygen uptake (20%, p < 0.0001). The increase in peak oxygen uptake was directly related to the training-induced increase in fiber areas (r = 0.63; p < 0.03), and decrease in lactate accumulation was inversely related to the training-induced decrease in the relative number of type I fibers (r = -0.62; p < 0.02). CONCLUSIONS: As for men with CHF, a skeletal muscle atrophy was found in women, but contrary to the hypothesis, the proportion of type I muscle fibers was normal. Exercise training counteracted the atrophy suggesting skeletal muscle trainability in female CHF patients.

Adult↗

Aerobic training involving a minor muscle mass shows greater efficiency than training involving a major muscle mass in chronic heart failure patients.

BACKGROUND: Beneficial training outcomes have been reported in sedentary patients with chronic heart failure (CHF) after exercise training. However, data on training effects in previously trained patients, as well as comparisons of different exercise modes, are lacking. The aim of this study is to compare exercise training on a cycle ergometer (major muscle mass) and aerobic knee-extensor training (minor muscle mass) in previously trained patients with CHF. METHODS AND RESULTS: Twenty-four men and women (age, 63 +/- 10 years [mean +/- SD]) with stable, moderate CHF (left ventricular ejection fraction, 30% +/- 11%) who had completed their first exercise training period more than 1 year ago were allocated to either the exercise or control group. After stratification for sex, age, ejection fraction, and cardiac output response, the training group was further randomized to either cycle ergometer or knee-extensor training for 8 weeks. The control and training patients did not differ at baseline, and the measured variables did not change in the control group during the 8 weeks. Citrate synthase activity in skeletal muscle increased after cycle training (23%; P < .02) and knee-extensor training (45%; P < .008), and blood lactate concentration at submaximal intensities decreased (P < .04) in both groups. However, only after knee-extensor training did the peak oxygen uptake increase (19%; P < .01) and sympathetic nervous system activity, measured as plasma norepinephrine concentration at rest (P < .05) and during exercise (P < .008), decrease. Minnesota Living with Heart Failure questionnaire scores also showed improvement in the health-related quality of life (P < .05) only after knee-extensor training. CONCLUSION: Physical training is beneficial in previously trained patients with CHF. Aerobic training involving a minor muscle mass shows greater efficiency than training involving a major muscle mass.

Aged↗

Beneficial effects of exercise training in heart failure patients with low cardiac output response to exercise - a comparison of two training models.

BACKGROUND: Exercise capacity of patients with chronic heart failure (CHF) correlates poorly with estimates of cardiac function. Yet, it has been suggested that only patients without severely impaired cardiac output (CO) benefit from exercise training. Comparisons of different training models have not been made in the same study. AIMS: To evaluate whether the response to different training models diverges according to the cardiac output response to exercise in patients with chronic heart failure. METHODS: Sixteen CHF patients (63 +/- 11 years) with an ejection fraction of 30 +/- 11% underwent a baseline cardiopulmonary exercise test, right heart catheterization and leg muscle biopsy. Cardiac output (CO) response to exercise was defined as the ratio between CO increase and the increase in oxygen uptake (CO response index) during exercise. Patients were randomized into two training regimens, differing with regard to active muscle mass, i.e. whole body and one-legged exercise. RESULTS: Baseline exercise capacity expressed as W kg-1 correlated with the CO response index (r = 0.51, P < 0.05). Exercise capacity on the cycle ergometer increased in both groups but more in the one-legged than in the two-legged training group (P < 0.05). The improvement in exercise capacity did not correlate with base-line exercise capacity. It correlated with CO response index in the one-legged (r = 0.75, P < 0.01) but not in the two-legged training group. CO response index correlated negatively with the pulmonary capillary wedge pressure at peak exercise (r = - 0.60, P < 0.05). The increase in leg muscle citrate synthase activity after training correlated negatively with the baseline CO response index (r = - 0. 50, P < 0.05). CONCLUSIONS: The improvement of exercise capacity after one-legged training correlates with the CO increase in relation to the O2 uptake before training. In patients with low CO response, individualization of the exercise regimen is needed and the benefits of training a limited muscle mass at a time deserve further study.

Adult↗

Diaphragmatic activity after laparoscopic cholecystectomy.

BACKGROUND: Laparoscopic cholecystectomy is presumed to induce a reduction in diaphragmatic activity. Indirect indices of diaphragmatic function based on tidal changes in pressures and cross-section area measurements can be unreliable in the postoperative phase. The present study evaluates diaphragmatic activity by directly recording diaphragmatic EMG (EMGdia) data, along with indirect indices. METHODS: Thirteen adult patients (American Society of Anesthesiologists physical status I or II) undergoing laparoscopic cholecystectomy were examined preoperatively for inspiratory tidal changes in gastric (Pgas-insp) and esophageal (Peso-insp) pressures, and tidal changes in ribcage (Vthor) and abdominal (Vabd) cross-section areas and then again at 1, 6, and 24 h postoperatively combined with EMGdia recordings. Variations in inspiratory gastric (deltaPgas-insp) and inspiratory transdiaphragmatic (deltaPdi-insp) pressures were derived from the above. RESULTS: Laparoscopic cholecystectomy induced a significant reduction in mean deltaPgas-insp, mean deltaPdi-insp, and mean Vabd indicating a reduction of diaphragmatic activity postoperatively. DeltaPdi-insp decreased from 11.8+/-4.0 cm H2O preoperatively to 5.7+/-5.7 cm H2O at 1 h and 6.6+/-5.1 cm H2O at 6 h postoperatively (mean +/- SD; P < 0.05). Vabd decreased from 327.0+/-113.0 ml preoperatively to 174.0+/-65.0 ml at 1 h and 175.0+/-98.0 ml at 6 h postoperatively (mean +/- SD; P < 0.05). These values had partially recovered at 24 h. CONCLUSION: The direct and indirect indices of diaphragmatic activity taken together confirm the presence of reduction in diaphragmatic activity after laparoscopic cholecystectomy followed by its partial recovery at 24 h.

Adult↗

Reactivation of mutant p53 through interaction of a C-terminal peptide with the core domain.

A synthetic 22-mer peptide (peptide 46) derived from the p53 C-terminal domain can restore the growth suppressor function of mutant p53 proteins in human tumor cells (G. Selivanova et al., Nat. Med. 3:632-638, 1997). Here we demonstrate that peptide 46 binds mutant p53. Peptide 46 binding sites were found within both the core and C-terminal domains of p53. Lys residues within the peptide were critical for both p53 activation and core domain binding. The sequence-specific DNA binding of isolated tumor-derived mutant p53 core domains was restored by a C-terminal polypeptide. Our results indicate that C-terminal peptide binding to the core domain activates p53 through displacement of the negative regulatory C-terminal domain. Furthermore, stabilization of the core domain structure and/or establishment of novel DNA contacts may contribute to the reactivation of mutant p53. These findings should facilitate the design of p53-reactivating drugs for cancer therapy.

Amino Acid Sequence↗

Exercise-induced expression of angiogenesis-related transcription and growth factors in human skeletal muscle.

mRNA expression of vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF-2), and hypoxia-inducible factor (HIF) subunits HIF-1alpha and HIF-1beta in human skeletal muscle was studied during endurance exercise at different degrees of oxygen delivery. Muscle biopsies were taken before and after 45 min of one-legged knee-extension exercise performed under conditions of nonrestricted or restricted blood flow (approximately 15-20% lower) at the same absolute workload. Exercise increased VEGF mRNA expression by 178% and HIF-1beta by 340%, but not HIF-1alpha and FGF-2. No significant differences between the restricted and nonrestricted groups were observed. The exercise-induced increase in VEGF mRNA was correlated to the exercise changes in HIF-1alpha and HIF-1beta mRNA. The changes in VEGF, HIF-1alpha, and HIF-1beta mRNAs were correlated to the exercise-induced increase in femoral venous plasma lactate concentration. It is concluded that 1) VEGF but not FGF-2 gene expression is upregulated in human skeletal muscle by a single bout of dynamic exercise and that there is a graded response in VEGF mRNA expression related to the metabolic stress and 2) the increase in VEGF mRNA expression correlates to the changes in both HIF-1alpha and HIF-1beta mRNA.

Adult↗