Search PubMed⌕ Search

Biomedical subjects

N H Secher

Publications and source records attributed to N H Secher.

At least 217 records · Page 12Linked to original sources

Strength of two- and one-leg extension in man.

Two- and one-leg extension strengths were compared in 155 female and male, untrained and trained (eight bicyclists, 38 weight-lifters) subjects and in a polio patient with almost no strength in one leg. On average two-leg strength was 82 +/- 1.3% (SE) of the sum of the strength of the right and left legs (leg-strength ratio) with no significant difference between the untrained and trained subjects. In the polio patient two-leg strength was lower than the strength of the strongest leg. A similar leg-strength ratio was found when measurements were made with a knee angle of 150 degrees (n = 128) and 90 degrees (n = 25). The ratio did not change when re-determined after 1 year (n = 9). Moderate changes in the subjects' position during measurements did not affect one-leg strength (n = 13). However, familiarization with the experimental apparatus increased the leg-strength ratio from 80 +/- 2.5% to 97 +/- 2.9% (P less than 0.01) (n = 18). In contrast, two-arm extension strength was similar to the sum of the strength of the right and left arms (n = 15). The results demonstrate that two-leg strength in general is lower than the sum of the strength of the right and left legs, and that this phenomenon is found even after intensive endurance or strength training. However, familiarization with the experimental apparatus can increase the relative two-leg strength which suggests that muscle strength in man may be limited by the central nervous systems' ability to activate maximally all synergistic muscles and/or to control antagonistic muscles.

Adult↗

Physical stress and catecholamine release.

In both health and disease, noradrenaline and adrenaline concentrations in plasma increase with intensity and duration of exercise (Figure 1). These changes are only to a minor extent due to decreased catecholamine clearance (Figure 2). The increase in sympathoadrenal activity during exercise is primarily elicited by feed-forward stimulation from motor centres in the brain (Figure 3, Table 1), and by afferent impulses from working muscles (Figure 4). During continued exercise, changes in internal milieu may enhance the catecholamine response. Of particular interest from a metabolic point of view is the fact that during exercise a decrease in plasma glucose causes a relatively large increase in plasma adrenaline (Figure 5). Sympathoadrenal activity is of major importance for exercise capacity. By depressing insulin secretion, as well as by direct effects on target tissues, sympathoadrenal activity enhances mobilization of glycogen as well as triglyceride from both extra- and intramuscular depots. After training, noradrenaline responses to given absolute work loads are reduced, while responses to given relative loads, i.e. work load in percent of individual work capacity, VO2/VO2max%, are unchanged. Prolonged endurance training may increase the size and secretory capacity of the adrenal medulla (Figure 7, Table 2), an adaptation which may improve exercise capacity. Differences in catecholamine levels cannot explain the fact that physically-active individuals have a lower cardiac mortality than inactive ones.

Animals↗

Progressive central hypovolaemia in man--resulting in a vasovagal syncope? Haemodynamic and endocrine variables during venous tourniquets of the thighs.

Hypotensive functional haemorrhage induced by venous pooling of blood in the legs has been reported to be characterized by a vasovagal reaction. In the present study these observations were extended by determination of the hormonal profile developed during progressive central hypovolaemia and an emotionally induced vasovagal syncope. In six subjects venous pooling resulted in normotensive central hypovolaemia, in one subject hypotensive central hypovolaemia was induced, and one subject experienced an emotionally induced vasovagal syncope. During normotensive central hypovolaemia heart rate increased from 58 +/- 4 to 76 +/- 4 beats min-1 (P less than 0.05) and cardiac output fell from 6.1 +/- 0.4 to 4.1 +/- 0.2 1 min-1. Pulse pressure and central venous pressure decreased from 64 +/- 4 to 53 +/- 4 mmHg, and from 8 +/- 2 to 3 +/- 2 mmHg, respectively. Adrenaline and noradrenaline increased from 87 +/- 10 to 120 +/- 20 pg/ml and from 196 +/- 33 to 370 +/- 50 pg/ml, respectively. Angiotensin II increased from 13 +/- 4 to 36 +/- 6 pg/ml and aldosterone from 63 +/- 9 to 180 +/- 27 pg/ml. In hypotensive central hypovolaemia the decrease in mean arterial pressure was accompanied by a decrease in heart rate and increments in the plasma concentrations of pancreatic polypeptide, indicating increased vagal activity and beta-endorphin, while plasma noradrenaline was unchanged. In emotionally induced syncope heart rate decreased to cardiac arrest for 13 s, associated with increments in the plasma concentrations of pancreatic polypeptide and beta-endorphin. It is concluded that normotensive functional haemorrhage in man is associated with increased sympathetic activity and that the qualitatively similar observations obtained during an emotionally and a hypovolaemic-induced hypotensive episode indicate that the hypotensive functional haemorrhage is characterized by a vasovagal reaction.

Adult↗

Cardiovascular responses at the onset of exercise with partial neuromuscular blockade in cat and man.

1. In decerebrated cats the cardiovascular, heart rate and blood pressure responses to static muscle contractions were followed from the onset of stimulation of the cut L7-S1 ventral roots. Heart rate and blood pressure were also followed during maximal voluntary and electrically induced static muscle contractions in man using one leg. In both cat and man contractions were performed under control conditions and tubocurarine-induced neuromuscular blockade. 2. In the cat, heart rate and blood pressure increased 1.7 s after the onset of the contraction. No cardiovascular responses were seen when the muscle contraction was blocked by tubocurarine. 3. In man, both heart rate and blood pressure increased at the onset of voluntary contractions. Partial curarization reduced strength to 39% of control. The heart rate response was unaffected by tubocurarine while the blood pressure response was reduced from 61 to 32 mmHg. 4. Electrical stimulation of the muscles resulted in 75% of voluntary strength in man. The heart rate response was delayed one R-R interval in the electrocardiogram but was as large as during voluntary contractions. During partial curarization the heart rate response was significantly smaller and the blood pressure response was reduced from 11 to 8 mmHg. 5. In conclusion, processes in active muscles elicit an increase in heart rate and blood pressure which depends on the intensity of the muscle contraction developed. However, the immediate cardiovascular responses at the onset of voluntary muscle contractions cannot be accounted for by reflexes generated in the working muscles alone.

Adolescent↗

Cardiovascular, ventilatory and catecholamine responses to maximal dynamic exercise in partially curarized man.

1. In ten young men the ventilatory, cardiovascular, catecholamine and metabolic responses to maximal dynamic leg exercise on a stationary bicycle were followed during partial neuromuscular blockade with tubocurarine. Maximal exercise was performed when the drug effect was at its maximum as well as during the subsequent reduction in the effect allowing a gradually increasing work intensity. The results were compared with those obtained during submaximal and maximal exercise performed without tubocurarine. Partial neuromuscular blockade decreased hand-grip strength to 41 +/- 1.1% (S.E. of mean) and the maximal work load to 27 +/- 2.4% of control values. Voluntary effort was maximal and the rate of perceived exertion was high at all levels of exercise with tubocurarine indicating a maintained intense central nervous motor command. 2. During maximal action of the drug oxygen uptake was 1.67 +/- 0.11 l/min while only 0.91 +/- 0.13 l/min (P less than 0.01) at the same work intensity without neuromuscular blockade. This difference may reflect a dominant reliance on fast-twitch muscle fibres when work was performed under the influence of tubocurarine. 3. Compared at a given oxygen uptake ventilation was higher during work with tubocurarine than during control exercise (e.g. 55 +/- 4.2 and 40 +/- 2.2 l/min, respectively (P less than 0.01), at a mean oxygen uptake of 1.9 l/min), while heart rate did not differ significantly (146 +/- 4.4 and 139 +/- 3.0 beats/min). With decreasing drug effect both variables increased towards the maximum values of 138 +/- 4.5 l/min and 183 +/- 3.9 beats/min, respectively, achieved in control experiments at an oxygen uptake of 3.8 +/- 0.2 l/min. Like heart rate the mean arterial blood pressure increased with increasing work load and was similar at a given oxygen uptake with and without tubocurarine. 4. During maximal exercise at peak tubocurarine effect plasma adrenaline and noradrenaline concentrations were smaller than during control maximum, 1.6 +/- 0.27 versus 3.4 +/- 0.55 nmol/l (P less than 0.01) and 7.5 +/- 1.3 versus 12.6 +/- 1.8 nmol/l (P less than 0.05), respectively. However, comparisons at identical oxygen uptake rates revealed that catecholamine responses were markedly enhanced during tubocurarine treatment. Also, blood lactate concentrations were smaller at peak tubocurarine action than during control maximum, 1.9 +/- 0.42 mmol/l and 6.1 +/- 0.49 mmol/l (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Role of motor center activity for hormonal changes and substrate mobilization in humans.

The study evaluated the hypothesis that during exercise autonomic neuroendocrine activity and, in turn, substrate mobilization, is subjected to feed-forward stimulation from motor centers. Eight young healthy men bicycled for two 20-min periods without (control, C) as well as during partial neuromuscular blockade with tubocurarine (Cu). 3-[3H]glucose was infused, and arterialized hand vein blood was sampled. In period 1 O2 consumption (VO2) (56% VO2 max), heart rate, and blood lactate were identical in Cu compared with C experiments, whereas hand grip strength was lower and perceived exertion [14.0 +/- 1.5 vs. 9.1 +/- 1.2 (SE) points, P less than 0.01] higher in Cu experiments, indicating higher motor center activity. Concentrations of norepinephrine [7.39 +/- 1.18 (Cu) vs. 5.14 +/- 1.06 (C) nmol/l], epinephrine (1.69 +/- 0.33 vs 0.87 +/- 0.16 nmol/l), growth hormone (25.9 +/- 7.3 vs. 11.5 +/- 4.7 mU/l), and adrenocorticotropin hormone (11.3 +/- 1.3 vs. 5.5 +/- 0.7 pmol/l) attained higher values in Cu than in C experiments (P less than 0.05). The initial increase in glucose production was enhanced in Cu (8.1 +/- 1.6 mumol.min-1.kg-1) compared with C experiments (3.9 +/- 1.9, P less than 0.05), and plasma glucose only increased in Cu experiments. Free fatty acid (P less than 0.05) and glycerol (P less than 0.1) concentrations were higher in Cu than in C experiments. In period 2 identical perceived exertion was achieved in the two experiments by reducing work load in Cu experiments. In this period hormonal responses were similar in the two experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗

Vagal slowing of the heart during haemorrhage: observations from 20 consecutive hypotensive patients.

Heart rate and arterial blood pressure were monitored in 20 consecutive patients during resuscitation from haemorrhagic shock. The mean blood loss (2.3 (SEM 0.3) 1) corresponded to 36(4)% of their estimated mean blood volume. During shock the mean blood pressure was 81/55 (3/2) mm Hg and heart rate 73 (3) beats/min. Administration of blood and crystalloids resulted in immediate increases to 111/72 (2/2) mm Hg and 102 (3) beats/min followed by steady state values of 131/79 (6/3) mm Hg and 82 (2) beats/min. In three otherwise healthy patients plasma concentrations of the vagally regulated hormone pancreatic polypeptide rose from resting values of 64-77 pmol/l (272-327 pg/ml) to 198-280 pmol/l (842-1190 pg/ml). These findings suggest that reversible hypotensive hypovolaemic shock is characterised by a decrease in heart rate conceivably reflecting an increase in vagal tone.

Adult↗

Sympathoadrenal and parasympathetic responses to exercise.

Exhaustive exercise is associated with a persistent sensation of weakness and sometimes nausea suggesting abdominal vagal activity. We measured plasma indices of sympathoadrenal (adrenaline, noradrenaline, dopamine) and vagal (pancreatic polypeptide) activity before, during and after submaximal and maximal exercise in healthy young subjects. Plasma adrenaline, noradrenaline and dopamine increased to 8.5 (range 7.4-40.5), 48.0 (32.3-100.5) and 1.8 (1.2-6.6) nmol 1-1 respectively (n = 5), during maximal exercise and decreased towards control values within 15 min of rest. Pancreatic polypeptide (n = 10) increased only during maximal exercise and reached its highest value, 48 (21-145) pmol 1-1, after exertion. The results conform to an increase in sympathetic activity during exercise and a persistent vagal activity after intense exercise which could contribute to the sensation of weakness.

Adult↗

Decrease in pulmonary diffusion capacity after maximal exercise.

Oppression of the chest, cough and orthopnea are well known to occur in some athletes after competitions, maybe reflecting an increase in lung water. In order to indicate if lung water increases after maximal exercise we measured pulmonary diffusion capacity before and 2.1 h after a short maximal arm exercise bout in 11 canoeists and showed a decrease of 6.7%. The result may be explained by a calculated 17% increase in alveolar interstitial volume.

Adolescent↗

Slowing of the heart during hypotension in major abdominal surgery.

Heart rate (HR) and mean arterial blood pressure (MBP) were studied during abdomino-perineal resections of the rectum under neurolept anesthesia in order to observe HR deviations due to hypovolemic hypotension. Of the 65 patients followed, 18 developed a systolic BP under 100 mmHg. Their blood loss (37 +/- 9 ml/kg, mean +/- s.e. mean) was higher than that of the normotensive control group (20 +/- 2 ml/kg, P less than 0.01), the urine production lower (8 +/- 1 versus 10 +/- 3 ml/kg, P less than 0.01) and blood transfusions amounted to 40 +/- 8 versus 24 +/- 2 ml/kg (P less than 0.01). In the hypotensive patients a decrease in MBP from 108 +/- 3 to 94 +/- 3 mmHg was accompanied by a simultaneous increase in HR from 81 +/- 3 to 91 +/- 3 beats/min (P less than 0.05). However, during the hypotensive incident where the MBP averaged 69 +/- 4 mmHg, HR decreased temporarily to 75 +/- 3 beats/min (P less than 0.001). After MBP was restored to 94 +/- 3 mmHg using volume repletion, HR increased to 95 +/- 3 beats/min (P less than 0.001). The results demonstrated a temporary slowing of HR in anesthetized, bleeding and hypotensive patients.

Aged↗

Bradycardia during hypotension following release of a tourniquet in orthopaedic surgery.

Heart rate (HR) and mean arterial blood pressure (MBP) were followed in 39 consecutive patients during orthopaedic surgery with the leg exsanguinated by an inflatable tourniquet around the thigh. The circulation was stable in all patients until release of the tourniquet. Following release of the tourniquet MBP decreased from 94 +/- 5 (s.e. mean) to 45 +/- 12 mmHg (12.5 +/- 0.7 to 6.0 +/- 1.6 kPa) (P less than 0.005) in 10 patients, while it remained stable in the others. At the same time the hypotensive group showed a decrease in HR from 83 +/- 6 to 67 +/- 3 beats min-1 (P less than 0.005) while no significant change in HR was seen in the normotensive group. The hypotensive group was older (57 +/- 8 versus 50 +/- 4 years (P less than 0.05)), had a larger blood loss during surgery (2.9 +/- 1.2 versus 0.7 +/- 0.3 ml kg-1 (P less than 0.005)), and the duration of the operation was longer in this group (120 +/- 14 versus 60 +/- 27 min (P less than 0.001). It is suggested that the characteristic deviation of HR in conjunction with hypotension following release of a tourniquet is bradycardia.

Anesthesia, General↗

Cardiovascular and endocrine responses to head-up tilt and vasopressin infusion in humans.

The effects of passive tilt on arterial and central venous pressures (MAP and CVP), heart rate (HR), arterial concentrations of vasopressin (AVP) and aldosterone (ALDO), osmolality, and hematocrit were studied in eight healthy young men. Tilting was performed at 30 degrees/min to 20 or 40 degrees and maintained for 45 min. The 20 degrees tilt did not change MAP while CVP fell by 5.9 mmHg (P less than 0.01) and HR increased by 5 beats/min (51-56 beats/min, P less than 0.05). AVP and ALDO concentrations were unchanged. At 40 degrees, MAP increased by 5.7 mmHg (86.0-91.7 mmHg, P less than 0.01), CVP decreased by 7.4 mmHg (P less than 0.01), HR rose by 8 beats/min (55-63 beats/min, P less than 0.01), and pulse pressure fell by 6 mmHg (P less than 0.05). ALDO increased fivefold (P less than 0.05), but AVP did not change. Infusions of AVP at 0.25 or 1.0 ng X min-1 X kg body wt-1 elevated plasma AVP to 11 +/- 1 and 52 +/- 8 pg/ml. Only the larger dose caused a small increase in MAP while CVP and HR remained unchanged; however, washout of a subcutaneous depot of Xe was reduced greater than 60% even by the lower dose. It is concluded that small-angle nonhypotensive passive tilt does not affect AVP measurably despite substantial reductions of CVP and a marked increase in ALDO. Elevations of AVP elicit marked subcutaneous vasoconstriction also in the absence of changes in CVP, HR, and MAP.

Adult↗

Hypotension induced by passive head-up tilt: endocrine and circulatory mechanisms.

Circulatory changes and arterial plasma hormone concentrations were measured in seven healthy young adults during 30 and 60 degrees passive head-up tilt with the subjects supported by a saddle. The 30 degrees tilt induced a decrease in pulse pressure (Pp) from 45 +/- 2 to 35 +/- 4 (mean +/- SE) mmHg concomitant with an increase in heart rate (HR) from 58 +/- 4 to 78 +/- 8 beats/min and a marginal increase in mean arterial pressure (MAP). Norepinephrine increased from 180 +/- 20 to 310 +/- 40 pg/ml, aldosterone increased fivefold, and angiotensin II increased from 8 +/- 2 to 22 +/- 7 pg/ml. The 60 degrees tilt initially produced changes, which were qualitatively similar to the 30 degrees tilt. However, after 19 +/- 3 min sudden decreases were seen in MAP (94 +/- 3 to 50 +/- 8 mmHg), in Pp (38 +/- 5 to 18 +/- 4 mmHg), and in HR (90 +/- 7 to 57 +/- 6 beats/min). Concomitantly, epinephrine doubled while norepinephrine remained unchanged; the vagally controlled hormone pancreatic polypeptide increased from 29 +/- 3 to 51 +/- 8 pmol/l, vasopressin from 4 +/- 1 to 126 +/- 58 pg/ml, and angiotensin II from 23 +/- 9 to 35 +/- 12 pg/ml. The hypotensive bradycardiac episode was immediately reversible on termination of the head-up tilt.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Fibre types, capillary supply and enzyme activities in human intercostal muscles.

The relative occurrence of slow twitch (ST) and fast twitch (FTa and FTb) fibres, fibre size, capillary supply, and glycolytic and oxidative enzyme activities in external (EXT) and internal (INT) intercostal muscles was determined on biopsies obtained during thoracotomy from the mid-axillary line in six patients with normal lung function. EXT and INT showed a similar occurrence of ST fibres. Both FTa and FTb fibres were seen in EXT while only FTa fibres were seen in INT. The size of the three fibre types in EXT was similar. In INT the fibre size was larger for FTa than for ST (P less than 0.05). INT appeared to have a larger number of capillaries per fibre than EXT (P less than 0.05). A positive correlation was demonstrated between variables measured during spirometry and fibre size in INT only. No difference in glycolytic and oxidative enzyme activities between EXT and INT was observed. The histochemical characteristics suggest that, in the mid-axillary line, INT are more used than EXT, though this conclusion did not appear to be confirmed by the enzyme activities determined.

3-Hydroxyacyl CoA Dehydrogenases↗

Partial neuromuscular blockade and cardiovascular responses to static exercise in man.

In human subjects sustained static contractions of the quadriceps femoris in one leg were performed with the same absolute and the same relative intensity before and after partial neuromuscular blockade with either decamethonium or tubocurarine which reduced strength to about 50% of the control value. During the contractions performed with the same absolute force, the magnitude of the cardiovascular responses (heart rate and blood pressure) was greater during neuromuscular blockade than during control contractions. During the contractions involving the same relative force the magnitude of the cardiovascular responses was almost the same with and without neuromuscular blockade. These findings were independent of the drug used. The metabolic part of the exercise pressor reflex was assessed by the application of an arterial cuff 1/2 min before cessation of exercise and for the following 3 min of rest. Although heart rate and blood pressure decreased after cessation of exercise, application of the tourniquet resulted in higher post-exercise values and this effect was seen both with and without neuromuscular blockade. Muscle biopsies from the subjects' m. vastus lateralis were analysed for fast- and slow-twitch fibre composition showing 27-66% slow-twitch fibres. No correlation was found between cardiovascular responses to static exercise, with or without neuromuscular blockade, and fibre type predominance. The results suggest that the involvement of fast- or slow-twitch muscle fibres does not play a dominant role in the cardiovascular responses to static exercise in man. Both central command and reflex neural mechanisms are of importance, and it appears that these two control mechanisms are redundant and that neural occlusion may be operative. However, when partial neuromuscular blockade induces a disproportion between an increase in central command and a constant or decreasing muscle tension and metabolism, the larger signal arising from central command determines the magnitude of the cardiovascular responses.

Adult↗