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Effect of exercise training on myocardial remodeling in patients with reduced left ventricular function after myocardial infarction: application of magnetic resonance imaging.

BACKGROUND: There are conflicting reports on the effects of training on the remodeling process in post-myocardial infarction patients with ventricular damage. METHODS AND RESULTS: Twenty-five patients with reduced ventricular function (mean ejection fraction, 32.3+/-6%) after an anteroseptal or inferolateral myocardial infarction were randomized to an exercise group (n=12) or a control group (n=13). Patients in the exercise group resided in a rehabilitation center for 2 months and underwent a training program consisting of two 1-hour sessions of walking daily, along with four monitored 45-minute sessions of stationary cycling weekly. Before and after the study period, maximal exercise testing and cardiac MRI were performed. Oxygen uptake increased 26% at maximal exercise (19.7+/-3 to 23.9+/-5, P<.05) and 39% at the lactate threshold (P<.01) in the exercise group, whereas control values did not change. No differences were observed within or between groups in MRI measures of end-diastolic (187+/-47 pre versus 196+/-35 mL post in the exercise group and 179+/-52 pre versus 180+/-51 mL post in the control group), end-systolic volume (118+/-41 pre versus 121+/-33 mL post in the exercise group and 119+/-54 pre versus 116+/-56 mL post in the control group), or ejection fraction (38.0+/-9 pre versus 38.2+/-10% post in the exercise group and 37.0+/-10 pre versus 38.3+/-13% post in the control group). Myocardial wall thickness measurements at end diastole and end systole and their difference in 80 myocardial segments determined by MRI yielded no significant interactions between groups. When myocardial wall thickness measurements were classified by infarct or noninfarct areas, no differences were observed between groups over the study period. CONCLUSIONS: A high-intensity, 2-month residential cardiac rehabilitation program resulted in substantial increases in exercise capacity among patients with reduced left ventricular function. In contrast to some recent reports, the training program had no deleterious effects on left ventricular volume, function, or wall thickness regardless of infarct area.

Exercise Test↗

[Risks and benefits of polymeric inlays].

Class I inlays were produced according to the direct method using six white light-cured composite, one inlay material and one veneer acrylic. They were subjected to extraoral heat treatment at 125 degrees C for 150 s. In addition, heat-cured inlays were produced according to the indirect method. In all cases heat treatment resulted in a considerable increase in transverse strength and modulus of elasticity as well as a material specific decrease in the specimen volume between 0.15% and 1.05%, and it facilitated finishing. With one exception heat-treated and heat-cured inlays could be inserted without open margins; even 5000 threshold load cycles of 500 N failed to cause marginal defects. However, these inlays also had no open margins when inserted without previous heat treatment. While in the case of four materials this resulted in no measurable reduction in fatigue strength, it reduced this value to a maximum of 100 N in three materials. Swelling of the polymeric inlays due to high water absorption resulted in extensive enamel cracks with one of the materials tested.

Acrylic Resins↗

Effect of ultramarathon cycling on the heart rate in elite cyclists.

OBJECTIVES: To analyse the heart rate (HR) response and estimate the ultraendurance threshold-the optimum maintainable exercise intensity of ultraendurance cycling-in ultraendurance elite cyclists competing in the Race across the Alps. METHODS: HR monitoring was performed in 10 male elite cyclists during the first Race across the Alps in 2001 (distance: 525 km; cumulative altitude difference: 12 600 m) to investigate the exercise intensity of a cycle ultramarathon and the cardiopulmonary strains involved. Four different exercise intensities were defined as percentages of maximal HR (HR(max)) as follows: recovery HR (HR(re)), <70% of HR(max); moderate aerobic HR (HR(ma)), 70-80%; intense aerobic HR (HR(ia)), 80-90%; and high intensity HR (HR(hi)), >90%. RESULTS: All athletes investigated finished the competition. The mean racing time was 27 hours and 25 minutes, and the average speed was 18.6 km/h. The mean HR(max) was 186 beats/min, and the average value of measured HRs (HR(average)) was 126 beats/min resulting in a mean HR(average)/HR(max) ratio of 0.68, which probably corresponds to the ultraendurance threshold. The athletes spent 53% (14 hours 32 minutes) of total race time within HR(re), 25% (6 hours 51 minutes) within HR(ma), 19% (5 hours 13 minutes) within HR(ia), and only 3% (49 minutes) within HR(hi), which shows the exercise intensity to be predominantly moderate (HR(re) + HR(ma) = 78% or 21 hours 23 minutes). The HR response was influenced by the course profile as well as the duration. In all subjects, exercise intensity declined significantly during the race, as indicated by a decrease in HR(average)/HR(max) of 23% from 0.86 at the start to 0.66 at the end. CONCLUSIONS: A substantial decrease (10% every 10 hours) in the HR response is a general cardiovascular feature of ultramarathon cycling, suggesting that the ultraendurance threshold lies at about 70% of HR(max) in elite ultramarathon cyclists.

Adult↗

The relation between cycling time to exhaustion and anaerobic threshold.

This study investigated whether the anaerobic threshold (AnT) could be used to predict prolonged work capacity measured as cycling time to exhaustion (= endurance time) and which factors, in addition to relative exercise intensity, could explain variation in endurance time. Theoretical exercise intensities corresponding to certain endurance times were also calculated. The hyperbolic and exponential functions between cycling time and relative work rate (WR[%]), as well as between cycling time and relative oxygen uptake (VO2[%]) were fitted to the pooled data (n = 45) of 17 subjects. The WR(%) and VO2(%) were expressed as a percentage of the subject's own AnT- and maximum-values. At WR corresponding to AnT (i.e., 70% of WRmax) an average subject could cycle 60 min according to both AnT- or maximum-related exponential function. When prediction was done for an endurance time of 4 h, the AnT-related exponential function gave 2.9%-units (= 11 W or approximately 0.15 O2 l.min-1) lower intensity level (51% of WRmax) than the maximum-related function (54% of WRmax). The WR(%) alone explained 54% and 70% of the variation in endurance time of the AnT-related and maximum-related exponential functions, respectively. Muscle fibre composition and initial blood lactate or relative muscle glycogen depletion (change in muscle glycogen as percentage) increased significantly the explanatory power of these models. The differences between the observed and expected exercise times correlated with blood lactate accumulation (r = -0.42; p less than 0.01), muscle fibre composition (r = 0.33; p less than 0.05) and relative muscle glycogen depletion (r = 0.67; p less than 0.01). It was concluded that the capacity for prolonged work measured as cycling time to exhaustion can be estimated by AnT-related power output, and that the exponential function model is the most suitable. Prediction power of the model can be improved by multiple regressions including muscle fibre composition, initial blood lactate level and relative muscle glycogen depletion.

Adult↗

The accuracy of the ACSM and a new cycle ergometry equation for young women.

The purpose of this study was to determine the accuracy of the American College of Sports Medicine's (ACSM) equation for estimating the oxygen cost of exercise performed by women on a cycle ergometer. Sixty healthy, young females performed a five-stage submaximal cycle ergometry test. Results indicated the SEE for the predicted oxygen values ranged from 79-156 ml.min-1, with total errors (E) ranging from 107-275 ml.min-1. Correlations between the actual and predicted values ranged from r = -0.22 to r = 0.38. The r, SEE, and E were 0.96, 118, and 172, respectively for all of the power loads combined. A revised equation was developed based upon the actual VO2-power relationship. This equation appears as: VO2 (ml.min-1) = kgm.min-1 x 1.6 ml.min-1 + ((3.5 ml.kg-1.min-1 x kg body weight) + 205 ml.min-1). Cross validation was performed on an independent sample of 40 subjects. All of the SEE and E were lower and all of the correlations were higher at each power load in the validation sample. Since the revised equation is based on an actual VO2-power relationship, it would appear that it provides a more accurate depiction of the cycle ergometry VO2-power relationship for women. These facts support its use.

Adult↗

The effects of exercise intensity on thermoregulatory responses to exercise in women.

We investigated the influence of altering exercise intensity (150, 300, and 450 kpm/min) on the resetting of the core temperature threshold for the onset of the sweating rate (M(sw)) and the alteration of sweating sensitivity during the menstrual cycle in women. Five women underwent cycling exercise for 30 min in both the luteal and follicular phases under controlled neutral environmental conditions (T: 25 degrees C, RH: 55%). A significantly higher rectal temperature (T(re)) was seen in the luteal phase at all exercise intensities, and the same time course of the T(re) response with a constant difference of approximately 0.2 degrees C was shown between the follicular phase and the luteal phase. The T(re) threshold for M(sw) was also apparently shifted rightward a constant value of 0.2 degrees C from the follicular phase to the luteal phase, independent of the alteration of exercise intensity. The slope of the M(sw)-T(re) relationship in the follicular phase did not differ from that in the luteal phase. These results indicate that (1) a rightward shift in the T(re) threshold from the follicular phase to the luteal phase can be observed independent of any alteration of the exercise intensity; and (2) the sensitivity of M(sw) is also not physiologically influenced by exercise intensity. Thus, alterative thermoregulation during the menstrual cycle was fundamentally unaffected by the change of exercise intensity.

Adult↗

Effect of temperature on the potential and current thresholds of axon membrane.

The effect of temperature on the potential and current thresholds of the squid giant axon membrane was measured with gross external electrodes. A central segment of the axon, 0.8 mm long and in sea water, was isolated by flowing low conductance, isoosmotic sucrose solution on each side; both ends were depolarized in isoosmotic KCl. Measured biphasic square wave currents at five cycles per second were applied between one end of the nerve and the membrane of the central segment. The membrane potential was recorded between the central sea water and the other depolarized end. The recorded potentials are developed only across the membrane impedance. Threshold current values ranged from 3.2 microa at 267deg;C to 1 microa at 7.5 degrees C. Threshold potential values ranged from 50 mv at 26 degrees C to 6 mv at 7.5 degrees C. The mean Q(10) of threshold current was 2.3 (SD = 0.2), while the Q(10) for threshold potentials was 2.0 (SD = 0.1).

Axons↗

Rapid detection of trisomy 21 by gene dosage analysis using quantitative real-time polymerase chain reaction.

AIM: Rapid detection of fetal aneuploidy helps inform a mother's choice about the course of her pregnancy. Obtaining results by fluorescent in situ hybridization (FISH) requires more than 24 h, and thus a more rapid method is needed. METHODS: Conventional G-banding and FISH for chromosome 21 were performed for cultured amniocytes. Genomic DNA was extracted from uncultured amniocytes obtained from 23 patients. TaqMan polymerase chain reaction (PCR) primers were designed to amplify the potassium voltage gated channel gene on chromosome 21q22.12 and the ribosomal phosphoprotein gene on 18q21.1. Quantitative real-time PCR was performed for these two gene fragments and the differences of the threshold cycle (Ct) of the two genes (Ct 18-Ct 21) were calculated for each sample. RESULTS: G-banding revealed that 19 patients had a normal karyotype and four had trisomy 21. FISH resulted in one case of a false positive. The Delta Ct values (Ct 18-Ct 21) of trisomy 21 patients were significantly higher than the values of individuals with normal karyotypes (P < 0.001) and there was no overlapping. CONCLUSIONS: Fetal trisomy 21 is rapidly detectable by gene dosage analysis from amniocytes using quantitative real-time PCR.

Amniotic Fluid↗

Visual processing during high frequency head oscillation.

There is a discrepancy between the averaged amount of retinal slip measured during head movement and the expected level of visual performance. This study offers an explanation based on the sinusoidal velocity profile of the retinal image motion during head oscillation. Contrast thresholds were measured for stationary and moving 0.5 and 6 cycles per degree (c.deg-1) gratings with both passive oscillation (2-6 Hz) and fixation of the head. Eye and head movements were recorded with a magnetic induction coil technique. When expressed in terms of averaged retinal image motion, threshold contrast for the 0.5 c.deg-1 grating remained suboptimal, whereas the blurring of the 6 c.deg-1 grating appeared to be less during the head movement. The data obtained from head movement versus non-head movement conditions could, however, be matched when the oscillatory character of the retinal image motion was taken in to account. The amplitude of gaze movement was small relative to the size of the individual cycles in the 0.5 c.deg-1 grating. This reduced spatiotemporal interaction which rendered their visibility sub-optimal. Contrast thresholds for the 6 c.deg-1 grating were highly correlated to the duration of the time intervals in which the retinal slip was below the critical value of 2 deg.s-1. Intermittent exposure to quasi-stable retinal images explained the relatively high level of contrast sensitivity for the 6 c.deg-1 grating during head oscillations.

Contrast Sensitivity↗

The release of prostaglandins and progestin into the utero-ovarian venous blood of guinea-pigs during the oestrous cycle and following oestrogen treatment.

1. Blood was collected from the utero-ovarian vein of guinea-pigs on days 3, 9, 10, 11, 12, 13, 14 and 15 of the oestrous cycle, and from animals injected with oestrogen over days 4-6 and used on day 7. The content of prostaglandin F(2alpha) and E(2) was determined by bio-assay and gas chromatography-mass spectrometry, and of progestin by competitive protein binding assay.2. The concentration of prostaglandin F(2alpha) on day 3 was 14.1 ng/ml.; it fell below detectable limits on day 7, but after day 11 the concentration rose to between 15.7-17.2 ng/ml. A value of 60.7 ng/ml. was recorded on day 15.3. The release of prostaglandin F(2alpha) was increased in animals pre-treated with oestrogen but was below threshold levels in similarly treated hysterectomized females.4. Prostaglandin E(2) was not detectable in blood collected on days 3, 9, 10, 11 and 12. From a threshold value of 1.1 ng/ml. on day 13, the concentration rose to 5.4 ng/ml. on day 14 and to 54.9 ng/ml. on day 15.5. The progestin concentration rose from 66 ng/ml. on day 3 to values of 80-180 ng/ml. between days 9-14. It fell to 45 ng/ml. between days 14 and 15.6. This work establishes that prostaglandin F(2alpha) is released into the utero-ovarian venous blood, and that its concentration fluctuates in the course of the oestrous cycle and can be related to changes in luteal function.

Animals↗

Variable power output during cycling improves subsequent treadmill run time to exhaustion.

The aim of this study was to investigate the effect of constant versus variable power output cycling exercise on subsequent high-intensity, running performance. Eight triathletes completed two testing sessions (in a random order), which required the subjects to perform 30 min of cycling at either, a constant power output (90% of the lactate threshold), or a variable power output with power output alternating every 5 min (+/-20% of the constant workload). Each cycling bout was immediately followed by a high-intensity treadmill run (16.7+/-0.7 km h(-1)) to exhaustion. No significant differences were found for mean metabolic values or power output between cycling conditions. However, a significant (P<0.05) improvement in run time to exhaustion was reported after 30 min of variable cycling (15:09+/-4:43 min) compared to constant cycling (10:51+/-3:32 min). The results of this study demonstrate that, despite similar average physiological responses during 30 min of cycling, variable-intensity cycling results in an improved running performance compared to constant-intensity cycling. It is hypothesised that the reduced power output in the final 5 min of variable cycling protocol may allow recovery before transition, however the mechanisms involved cannot be determined from the current study.

Adult↗

Reproductive toxicity of occupational mercury. A review of the literature.

OBJECTIVES: This paper aims to give the dental practitioner insight into the potential reproductive effects of handling dental silver amalgam, c.q. mercury. DATA SOURCES: Experimental studies on animals, case reports and epidemiologic studies. STUDY SELECTION: Experimental animal studies show high doses/concentrations of mercury to increase the risk of reproductive disorders, e.g. infertility, spontaneous abortion, stillbirth and congenital malformations. Some case reports suggest an association between the disorders in humans and high levels of mercury. Therefore, the present article reviews epidemiological studies on the relationship between occupational exposure to mercury, mainly as vapour in the dental practice, and females' procreative ability. Studies concerning the reproductive effects of males' occupational mercury body burden are scarce. The reproductive risk of patients' mercury uptake from silver amalgam fillings is assessed. CONCLUSIONS: It seems warranted to conclude that negative reproductive effects from exposure to mercury in the dental office are unproven, but safe levels have not been established. Seemingly problems are unlikely to occur, unless a poor hygiene causes the mercury concentration in the air to exceed females' time-weighted long-term Threshold Limit Value (TLV). Consequently, in view of the in general low amounts of mercury stemming from dental amalgam fillings, the population at large is at even less risk than dental staff. The effects of occupational elemental mercury concentrations lower than the TLV on the menstrual cycle, conception, male fertility and children's behaviour need, however, more research.

Animals↗

Inertial cavitation dose and hemolysis produced in vitro with or without Optison.

Gas-based contrast agents (CAs) increase ultrasound (US)-induced bioeffects, presumably via an inertial cavitation (IC) mechanism. The relationship between IC dose (ICD) (cumulated root mean squared [RMS] broadband noise amplitude; frequency domain) and 1.1-MHz US-induced hemolysis in whole human blood was explored with Optison; the hypothesis was that hemolysis would correlate with ICD. Four experimental series were conducted, with variable: 1. peak negative acoustic pressure (P-), 2. Optison concentration, 3. pulse duration and 4. total exposure duration and Optison concentration. P- thresholds for hemolysis and ICD were approximately 0.5 MPa. ICD and hemolysis were detected at Optison concentrations >/= 0.01 V%, and with pulse durations as low as four or two cycles, respectively. Hemolysis and ICD evolved as functions of time and Optison concentration; final hemolysis and ICD values depended on initial Optison concentration, but initial rates of change did not. Within series, hemolysis was significantly correlated with ICD; across series, the correlation was significant at p < 0.001.

Albumins↗

Alteration in the lactate threshold with changes in substrate availability.

The lactate threshold (LT) was studied (N=9) during ergometer cycling under control (C), high blood glucose (G), and high blood free fatty acid (F) conditions. During the G trial blood lactate (HLa) was greater than C at all work loads (P less than 0.05) Adjusted blood HLa values (HLa - pre-exercise value = delta HLa), however, were essentially the same for the C and G trials. Determination of the LT disclosed that there was no difference between the two treatments (C = 53.9 +/- 2.6% VO2 max; G=52.7 +/- 3.1% VO2max). Elevation of blood FFA levels, however, reduced both the HLa and deltaHLa at all work loads from 150-250 W (P less than 0.05) although VO2 was the same as C. In addition, a significant increase in the LT (F = 59.8 +/- 2.6% VO2max) was found for the F treatment. These data suggest that (1) the LT can be altered by substrate availability and (2) that muscle tissue anoxia may not be solely responsible for lactate production during submaximal work.

Adult↗

How accurately does wrist actigraphy identify the states of sleep and wakefulness?

STUDY OBJECTIVES: Because sleep and wakefulness differ from each other by the amount of body movement, it has been claimed that the two states can be accurately distinguished by wrist actigraphy. Our objective was to test this claim in lengthy polysomnographic (psg) and actigraphic (acf) samples that included night and day components. DESIGN: Fourteen healthy young (21-35 years) and old (70-72 years) men and women lived in a laboratory without temporal cues for 7 days. Each subject continuously wore sleep-recording electrodes as well as 2 wrist-movement recorders. Act measurements were converted to predictions of sleep and wakefulness by simple-threshold and multiple-regression methods. Psg served as the gold standard for calculation of predictive values (PV, the probability that an act prediction is correct by psg criteria). SETTING: N/A. PARTICIPANTS: N/A. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The 7-day act recordings showed clear circadian cycles of high and low activity that respectively corresponded to subjective days, when subjects were wakeful, and subjective nights when they slept. Lower act levels corresponded to deeper states of psg sleep. Logistic regression on a 20-minute moving average of act gave the highest overall PV's. Nevertheless, the mean PV for sleep (PVS) was only 62.2% in complete, day + night samples. PVS was 86.6% in night samples. Act successfully predicted wakefulness during subjective nights (PVW = 89.6) and accurately measured circadian period length and the extent of sleep-wake consolidation, but it overestimated sleep rate and sleep efficiency. Act systematically decreased before sleep onset and increased before awakening, but reliable transitions among joint psg/act states (the Markov-1 property) were not demonstrated. CONCLUSIONS: Low PV's and overestimation of sleep currently disqualify actigraphy as an accurate sleep-wake indicator. Actigraphy may, however, by useful for measuring circadian period and sleep-wake consolidation and has face validity as a measure of rest/activity.

Adult↗

Hemodynamic responses during aerobic and resistance exercise.

PURPOSE: Resistance training has become an accepted part of cardiac rehabilitation programs. Because of the potential for a high afterload to have a negative impact on left ventricular function, there has been concern regarding the safety of resistance training for patients with congestive heart failure. METHODS: This study addressed this concern by studying 12 healthy volunteers, 12 patients with stable coronary artery disease, and 12 patients with stable congestive heart failure during upright cycling at 90% of ventilatory threshold, and during one set of 10 repeated leg presses, shoulder presses, and biceps curls at 60% to 70% of 1-repetition maximum. Left ventricular function was measured by echocardiography. RESULTS: The pattern of changes in heart rate, blood pressure, left ventricular ejection fraction, wall thickness, and left ventricular internal diameters was similar across all three groups of subjects, although there were large differences in absolute values. Despite elevations in diastolic and mean arterial pressures during resistance exercise, there was no evidence of significant rest-to-exercise deterioration in left ventricular function during leg press (ejection fraction, 60%-59%, 56%-55%, and 38%-37%), shoulder press (66%-65%, 59%-53%, and 38%-35%), or biceps curls (63%-58%, 53%-54%, and 35%-36%), as compared with cycle ergometry (63%-69%, 51%-57%, and 35%-42%) in the healthy control subjects, the patients with coronary artery disease, and the patients with congestive heart failure, respectively. CONCLUSIONS: Left ventricular function remains stable during moderate-intensity resistance exercise, even in patients with congestive heart failure, suggesting that this form of exercise therapy can be used safely in rehabilitation programs.

Aged↗

Photocontrol of Hypocotyl Elongation in Light-Grown Cucumis sativus L. : Responses to Phytochrome Photostationary State and Fluence Rate.

The effects of the calculated photostationary state of phytochrome (phi(c)) and the photon fluence rate on the elongation growth of the hypocotyl of light-grown seedlings of Cucumis sativus L. are examined. Two threshold responses to phi(c) are found at values of 0.06 and 0.43. At phi(c) = 0.06, there is no response at any fluence rate. In the phi(c) range 0.1 to 0.43, elongation growth does not respond to changes in phi(c). Above the second threshold (phi(c) = 0.43), there is a strong response to changes in phi(c). At all values of phi(c) at and above 0.1, there is a response to fluence rate. A linear relationship can be demonstrated between a factor comprised of the logarithm of phytochrome cycling rate (a fluence-rate-dependent process) and phi(c), and the growth response.

Journal Article↗

Swallowing function and upper airway sensation in obstructive sleep apnea.

The objective of this study was to determine whether impaired upper airway (UA) mucosal sensation contributes to altered swallowing function in obstructive sleep apnea (OSA). We determined UA two-point discrimination threshold (2PDT) and vibratory sensation threshold (VST) in 15 men with untreated OSA and 9 nonapneic controls (CL). We then assessed swallowing responses to oropharyngeal fluid boluses delivered via a catheter. The threshold volume required to provoke swallowing and the mean latency to swallowing were determined, as was the phase of the respiratory cycle in which swallowing occurred [expressed as percentage of control cycle duration (%CCD)] and the extent of prolongation of the respiratory cycle after swallowing [inspiratory suppression time (IST)]. 2PDT and VST were significantly impaired in OSA patients compared with CL subjects. 2PDT was positively correlated with swallowing latency and threshold volume in CL subjects, but not in OSA patients. Threshold volume did not differ between the groups [median value = 0.1 ml (95% confidence interval = 0.1-0.2) for OSA and 0.15 ml (95% confidence interval = 0.1-0.16) for CL], whereas swallowing latency was shorter for OSA patients [3.3 (SD 0.7) vs. 3.9 (SD 0.8) s, P = 0.04]. %CCD and IST were similar for OSA patients and CL subjects. However, among OSA patients there was a significant inverse relation between VST and IST. These findings suggest that oropharyngeal sensory impairment in OSA is associated with an attenuation of inhibitory modulating inputs to reflex and central control of UA swallowing function.

Adult↗