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PubMed2005

Selective depletion of macrophages reveals distinct, opposing roles during liver injury and repair.

Macrophages perform both injury-inducing and repair-promoting tasks in different models of inflammation, leading to a model of macrophage function in which distinct patterns of activation have been proposed. We investigated macrophage function mechanistically in a reversible model of liver injury in which the injury and recovery phases are distinct. Carbon tetrachloride---induced liver fibrosis revealed scar-associated macrophages that persisted throughout recovery. A transgenic mouse (CD11b-DTR) was generated in which macrophages could be selectively depleted. Macrophage depletion when liver fibrosis was advanced resulted in reduced scarring and fewer myofibroblasts. Macrophage depletion during recovery, by contrast, led to a failure of matrix degradation. These data provide the first clear evidence that functionally distinct subpopulations of macrophages exist in the same tissue and that these macrophages play critical roles in both the injury and recovery phases of inflammatory scarring.

Animals↗
PubMed2003

[Arrhythmias newly provoked by exercise training in patients who underwent cardiac surgery].

We investigated the incidence and the varieties of arrhythmia during exercise training in patients who underwent cardiac surgery. Subjects were 1293 patients who underwent cardiac surgery and enrolled our cardiac rehabilitation program. According to the charts and cardiac rehabilitation records, we evaluated the incidence and the varieties of arrhythmia provoked by exercise training in patients after cardiac surgery retrospectively. The arrhythmias related to the exercise training were provoked in 12 times, and the incidence was only 0.09% (12/13646). Atrial fibrillation was the most common arrhythmia, and the incidence was 41.6% (5/12) in these patients. Moreover, these arrhythmias occurred within 2 weeks after surgery. Although most patients recovered to the sinus rhythm spontaneously, 3 patients needed medical treatment or cardioversion. We concluded that the arrhythmia provoked by exercise training in patients after cardiac surgery were rare, non-fatal, and common in the early recovery phase after surgery. However, the supervised exercise training was required in those patients, particularly in early recovery phase of cardiac surgery.

Aged↗
PubMed1986

Microelements in the circulation of coccidiosis-infected chicks.

Four-week-old Single Comb White Leghorn male chicks were inoculated with either Eimeria acervulina, E. necatrix, E. brunetti, E. tenella, or left uninfected. On Days 1, 3, 5, 6, 7, 8, 9, 10, 14, 21, 28, and 35 after inoculation, blood was removed from five birds in each group; content of copper, zinc, and iron in plasma and total iron-binding capacity were determined. Copper content in plasma was increased during the acute phase of the infections by lower intestinal tract (E. brunetti, E. tenella) infections but not by upper tract (E. acervulina, E. necatrix) infections. Zinc content in plasma was decreased by E. acervulina and E. necatrix infections on the 7th day and was increased by E. acervulina, E. brunetti, and E. tenella infections on the 9th or 10th days. Iron content in plasma was decreased during the acute phase (Days 5 to 7) of E. acervulina, E. brunetti, and E. tenella infections. Total iron-binding capacity was decreased by acute phase E. acervulina and E. brunetti infections. Eimeria tenella infections increased total iron-binding capacity during both the acute and early recovery phases. Plasma content of all components returned to normal by the latter part of the recovery phase of the infections and remained so thereafter. Plasma trace mineral content appeared to be influenced by mineral absorption effects, by hemorrhaging, and perhaps by invasion of the bloodstream by gut bacteria as a result of mucosal damage.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2001

Coping in spouses of patients with acute myocardial infarction in the early phase of recovery.

The purpose of this study was (1) to determine the coping strategies employed by spouses of patients with AMI in the early phase of the crisis, (2) to define the role of age, gender, health perception, time since infarction, spouses' fears, and negative life events in the choice of coping strategies applied, and (3) to test the effect of coping strategies on physical and psychological strain. Fifty-seven spouses participated in the study, 47 were female and 10 were male. Data were collected by structured questionnaires, which were distributed to the spouses from 2 weeks-4 months after the patient's AMI. The researchers found that age, negative life event during the last 12 months, time since infarction, and the spouse's fears influenced the choice of strategies. In the early stage of the crisis, positive reappraisal seems to be a strategy that increased physical strain. Spouses' need for social support in the early stage of the crisis is a factor for health care providers to bear in mind. Besides giving information, empathy, and understanding, health care personnel can try to assist spouses in their efforts to reappraise their situation.

Adaptation, Psychological↗
PubMed1999

Force generation upon hydrostatic pressure release in tetanized intact frog muscle fibres.

Single intact muscle fibres isolated from the tibialis anterior muscle of the frog were exposed to hydrostatic pressures of 1-10 MPa, at 2-4 degrees C and sarcomere length of 2.1-2.2 microm. The pressure was rapidly released (ca. 1 ms) to atmospheric level (0.1 MPa) during the plateau of a tetanic contraction (Po) and the resultant tension (= force) transient examined. The pressure release induced tension transient consisted of an initial tension drop coincident with pressure release (ca. 4% Po per MPa, Phase 1), followed by a rapid recovery (Phase 2a) and a slower rise of tension (Phase 2b). Phase 1 was partly due to a length release at fibre ends (ca. 0.1 nm per half-sarcomere per MPa) induced by pressure-release effects on the steel chamber and fibre attachments, and partly due to 'expansion' upon pressure release within muscle fibre (ca. 0.2 nm per half-sarcomere per MPa), probably in the myofilaments and cross-bridges. The rate of tension recovery during phase 2a (ca. 600/s) was comparable to that of the quick tension recovery (T1-T2 transition) reported from moderately fast small length releases; the time course of Phase 2b (rate ca. 40/s) was similar to the late phase of tension rise in a tetanus, and hence compared with Phase 4 (T4) of a length release tension transient. Results are compared with the previously reported findings from analogous experiments on Ca2+ -activated skinned (rabbit) muscle fibres.

Animals↗
PubMed1993

Increased echodensity of transiently asynergic myocardium in humans: a novel echocardiographic sign of myocardial ischemia.

OBJECTIVES: This study was conducted to establish whether changes in myocardial texture can be observed in humans by transthoracic echocardiography during ischemic episodes of different severity and duration induced by various pathogenetic mechanisms. BACKGROUND: Increased echo-reflectivity of ischemic myocardium has been detected in experimental animals by epicardial echocardiography and by backscatter evaluation. METHODS: Transthoracic two-dimensional echocardiographic monitoring with a commercially available electronic sector scanner (2.25- or 3.5-MHz transducer) was performed during 35 episodes of transient myocardial ischemia induced by ergonovine in patients with vasospastic angina (n = 9), by dipyridamole in patients with angiographically assessed coronary artery disease (n = 11) and by balloon occlusion during coronary angioplasty (n = 15). Quantitative texture analysis of gray levels was performed off-line on digitized images during rest conditions, ischemia and the recovery phase in regions showing normal contraction at rest, obvious dyssynergy during ischemia and normal contraction in the recovery phase. In each condition, a control region with normal contraction throughout the study was also evaluated. RESULTS: Chest pain occurred in 23 of the 35 episodes; electrocardiographic (ECG) changes were present in 26 episodes, and consisted of ST segment elevation in 13, ST segment depression in 10 and pseudonormalization of a basally negative T wave in 3. The duration of ischemic episodes was 67 +/- 53 s by symptomatic criteria and 91 +/- 52 s by ECG criteria. The risk region showed an increased end-diastolic mean gray level amplitude in a.u. (arbitrary units) during ischemia (57 +/- 19) compared with rest (38 +/- 15) and recovery (38 +/- 18, p < 0.01). No significant changes were detected in the control region (rest 36 +/- 16 vs. ischemia 34 +/- 18 vs. recovery 31 +/- 13, p = NS). The percent increase in mean gray level was similar in the various types of stress employed (ergonovine, dipyridamole or angioplasty) and was not significantly correlated with either the duration of ST segment shift (r = 0.05, p = NS) or the severity of dyssynergy evaluated semiquantitatively by means of the wall motion score (r = 0.28, p = NS). In the 15 balloon occlusions performed in six patients during coronary angioplasty, the increased echoreflectivity of the risk zone was already evident during echocardiographic sampling performed after 10 +/- 4 s of occlusion (rest 35 +/- 9 vs. 53 +/- 10 a.u., p < 0.01) when no dyssynergy could be detected by quantitative wall motion analysis (percent area change by fixed center of mass reference system 31 +/- 10% at rest vs. 32 +/- 11% after 10 s of occlusion, p = NS). CONCLUSIONS: Transient short-lasting myocardial ischemia is associated with an abrupt increase in myocardial echodensity detectable by videodensitometric analysis applied to standard transthoracic echocardiographic images and is largely independent of the underlying pathogenetic mechanism (reduced blood supply or flow maldistribution with coronary stenosis). During controlled coronary occlusion, increased echodensity precedes the onset of regional dyssynergy.

Analysis of Variance↗
PubMed1992

The onset and recovery from airway hyperresponsiveness: relationship with inflammatory cell infiltrates and release of cytotoxic granule proteins.

Previous studies from our laboratory have demonstrated a temporal relationship between eosinophil influx into the airways and the onset of airway hyperresponsiveness to inhaled methacholine. The purpose of the present study was to extend this observation by evaluating changes in airway cellular composition and measuring the levels of granulocyte-derived mediators recovered in BAL fluid during the onset and recovery from antigen-induced airway hyperresponsiveness. Airway cellular composition, airway responsiveness to inhaled methacholine and the levels of BAL fluid EPO and MPO were monitored over a 32 day study in eight adult male Ascaris suum sensitive cynomolgus monkeys. Repeated Ascaris suum inhalation (nine challenges during days 0-21) resulted in a selective, sustained airway eosinophilia that was temporally related with the onset and maintenance of airway hyperresponsiveness (r = 0.67, P less than 0.001). The level of BAL eosinophil-derived EPO was increased and remained elevated concurrent with the increase in airway eosinophils and airway responsiveness. During the recovery phase (days 22-32) the actual number of eosinophils remained elevated, while BAL EPO levels were significantly decreased. The recovery phase was also associated with a transient increase in the number of BAL neutrophils and MPO concentration. We conclude that the number and state of activation of airway eosinophils directly correlate with the onset and maintenance of airway hyperresponsiveness. Recovery from airway hyperresponsiveness is associated with a decrease in eosinophil activation and a transient increase in the number of activated neutrophils.

Airway Resistance↗
PubMed1995

Changes in immunoreactive insulin, C-peptide immunoreactivity, and immunoreactive glucagon in acute viral hepatitis.

Insulin and glucagon are thought to play important roles as hepatotrophic factors in acute viral hepatitis (AVH); however, few reports have investigated the responses and relationships of each of these hormones to liver damage in detail. We studied insulin and glucagon responses during the acute and recovery phases of AVH. We performed a glucose tolerance test (GTT) and an insulin sensitivity test (IST) in each phase in 11 patients with AVH. In 8 additional patients in the acute phase (total n = 19), were compared immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR) levels with transaminase levels. In the acute phase, IRI concentrations were normal from fasting to 60 min, despite an increased CPR level. In the recovery phase, IRI and CPR levels increased significantly. Immunoreactive glucagon levels in both phases did not differ significantly from those in controls. During the IST, the insulin sensitivity index in both phases was significantly lower than that in the controls. Fasting IRI and sigma IRI showed significant negative correlations with transaminase levels. We found enhanced insulin secretion and a decrease in plasma insulin in the acute phase of AVH. The discrepancy between IRI and CPR responses in the acute phase suggests an increase in the degradation or consumption of insulin in the liver.

Acute Disease↗
PubMed1977

Metabolic effects of intravenous salbutamol in the course of acute severe asthma.

Peak expiratory flow rate and plasma free fatty acids, potassium, insulin, and glucose were measured in 10 patients admitted with acute severe asthma before and at frequent intervals for one hour after an infusion of salbutamol, 4 microgram/kg over 10 minutes. These studies were repeated during the recovery phase and again before discharge. Effective bronchodilatation seen after the infusion was similar in the acute and recovery phases. Baseline plasma free fatty acids were elevated but rose significantly after the infusion. There was also a significant fall in plasma potassium. These changes occurred in all individuals. There were no significant differences in mean baseline or peak changes of plasma free fatty acids, potassium or insulin on any of the study days. There was no evidence of beta receptor blockade in the acute phase in any patient.

Acute Disease↗
PubMed1994

Positioning of cell growth and division after osmotic stress requires a MAP kinase pathway.

The yeast Saccharomyces cerevisiae has a genetic program for selecting and assembling a bud site on the cell cortex. Yeast cells confine their growth to the emerging bud, a process directed by cortical patches of actin filaments within the bud. We have investigated how cells regulate budding in response to osmotic stress, focusing on the role of the high osmolarity glycerol response (HOG) pathway in mediating this regulation. An increase in external osmolarity induces a growth arrest in which actin filaments are lost from the bud. This is followed by a recovery phase in which actin filaments return to their original locations and growth of the original bud resumes. After recovery from osmotic stress, haploid cells retain an axial pattern of bud site selection while diploids change their bipolar budding pattern to an increased bias for forming a bud on the opposite side of the cell from the previous bud site. Mutants lacking the mitogen-activated protein (MAP) kinase encoded by HOG1 or the MAP kinase kinase encoded by PBS2 (previously HOG4) show a similar growth arrest after osmotic stress. However, in the recovery phase, the mutant cells (a) do not restart growth of the original bud but rather start a new bud, (b) fail to restore actin filaments to the original bud but move them to the new one, and (c) show a more random budding pattern. These defects are elicited by an increase in osmolarity and not by other environmental stresses (e.g., heat shock or change in carbon source) that also cause a temporary growth arrest and shift in actin distribution. Thus, the HOG pathway is required for repositioning of the actin cytoskeleton and the normal spatial patterns of cell growth after recovery from osmotic stress.

Actins↗
PubMed1981

Reversible changes of the histological abnormalities of the thyroid in patients with painless thyroiditis.

The histological abnormalities on percutaneous needle biopsy of the thyroid were investigated in two patients (cases 1 and 2) with transient thyrotoxicosis and low radioactive iodine uptake by the thyroid and in a patient (case 3) with transient hypothyroidism which might be the consequence of transient thyrotoxicosis. The most characteristic findings of lymphocytic thyroiditis, such as extensive lymphocyte infiltration with collapsed follicles and degeneration of follicular cells of the thyroid, were found in case 1, in whom the thyroid biopsy was performed in the thyrotoxic phase. Ashkanazy cells were not present and fibrosis was not observed in this specimen. Histological examination of the thyroid biopsy specimen, which was obtained in the recovery phase in case 1, revealed well preserved thyroid follicles and slight lymphocytic infiltration. In addition, papillary infoldings of cuboidal epithelium were found in cases 2 and 3, in whom the thyroid biopsy was done in the hypothyroid phase. The follow-up biopsy of the thyroid was performed in the recovery phase in case 3. The biopsy specimen showed focal lymphocytic infiltration and the follicles lined by low cuboidal cells without papillary infoldings. In all biopsy specimens, there was no evidence of subacute thyroiditis, as characterized by granulomatous changes and breakdown of colloid follicles with foreign body giant cell reaction. The present findings revealed that the histological abnormalities, such as lymphocytic infiltration and follicular epithelial changes of the thyroid, observed in the patients with painless thyroiditis, can improve spontaneously during the course of several months.

Adult↗
PubMed1990

The influence of immunosuppressive acidic protein on the activity of peripheral K-lymphocytes in subacute thyroiditis.

We previously reported that immunosuppressive acidic protein (IAP), an alpha 1-acid glycoprotein, is increased during the acute phase of subacute thyroiditis (SAT). In this study we measured the percentage and absolute number of peripheral K-cells using a plaque-forming cell technique to investigate immunological abnormalities associated with SAT. Additionally, we investigated the relationship between IAP and peripheral K-cell activity. In normal controls, a sex-related difference in the percentage of K-cells among total lymphocytes was present; the percentage was significantly lower in women (mean +/- SD, 5.0 +/- 2.0%; n = 12; P less than 0.01) than in men (8.4 +/- 2.9%; n = 13). However, there was no difference (0.153 +/- 0.073 x 10(9)/L in five females; 0.173 +/- 0.054 x 10(9)/L in seven males) in the absolute number of peripheral K-cells. During the acute phase of SAT, the percentage (2.4 +/- 1.9% in 16 females; 2.7 +/- 1.0% in 3 males) and absolute number (0.058 +/- 0.048 x 10(9)/L in 11 females) of K-cells were significantly lower than those in normal controls. These values returned to normal during the recovery phase, although their mean values were still lower than those in normal controls. In female patients with Graves' disease, the percentage (2.2 +/- 1.8% in 11 females) and absolute number (0.038 +/- 0.033 x 10(9)/L in 11 females) of K-cells were significantly lower than those in normal controls; in male patients, the percentage (4.2 +/- 2.7% in 5 males) was lower than that in normal controls, but the absolute number (0.136 +/- 0.114 x 10(9)/L) of K-cells was not significantly different. Serum IAP values during the acute phase of SAT showed a significant negative correlation with the percentage of K-cells (r = -0.66; P less than 0.01). The number of K-cells from a normal subject decreased significantly when these lymphocytes were incubated with sera from patients with SAT, and the mean inhibition rate of K-cells by serum samples from 13 SAT patients during the acute phase was higher than that during the recovery phase (68.0 +/- 21.0 vs. 38.0 +/- 23.0%; P less than 0.01). Purified IAP inhibited the activity of K-cells from normal subjects dose dependently. These results suggest that 1) there may be inhibitory factors for the antibody-dependent cell-mediated cytotoxicity of peripheral K-cells in the serum of patients with SAT, and 2) IAP may be one of these inhibitory factors.

Acute-Phase Reaction↗
PubMed1994

Recovery positive exercise stress test: an indication for coronary artery disease.

UNLABELLED: The significance of ST depression occurring during exercise treadmill stress test has been well established. However, at times there may be no ST segment changes during exercise with changes occurring during the recovery phase. Out of the 1234 patients who underwent exercise stress test, 17 patients had ST segment changes confined to recovery phase. Coronary angiography performed in these 17 patients showed 11 patients had significant coronary artery disease (CAD), with nine patients having triple vessel disease and 2 having double vessel disease. Analysis showed there was no significant difference in the two groups of CAD and no CAD with respect to sex ratio, mean duration of exercise, maximal heart rate and double product achieved. CONCLUSION: Although, patients with recovery positive stress test may have normal coronary angiography, a large number of patients (64.7%) in our study had significant CAD. Hence, such patients should be subjected to another noninvasive test such as thallium perfusion scan or coronary angiography.

Adult↗
PubMed1994

Wheelchair propulsion efficiency: movement pattern adaptations to speed changes.

Low mechanical efficiency values in wheelchair propulsion are usually explained on the basis of the supply of force and power generated during the push phase. The purpose of this study is to analyze the movement and muscular activity pattern in handrim wheelchair propulsion, focusing on both the push and recovery phases. Data on cardiorespiratory and propulsion technique parameters were obtained from 40 wheelchair basketball players with extensive experience in wheelchair propulsion in six situations: two exercise levels (60% and 80% of individual VO2peak), and three velocities (1.11, 1.67, and 2.22 m.s-1) with constant power output on a treadmill. A two-factor analysis of variance with repeated measurements was applied with "exercise level" and "speed" as the main factors. A significant effect on gross mechanical efficiency was found when the velocity was increased from 1.67 to 2.22 m.s-1. Decreased mechanical efficiency could be explained by a significant change in the acceleration of the wheelchair-user system during recovery, caused by arm and trunk movements, inducing inertial forces to act on the wheelchair. Consequently, mechanical work increased significantly during the recovery phase. These findings indicate that studies on mechanical efficiency in wheelchair propulsion should not only be focussed on power supply during the push phase, but also on the movement pattern during recovery.

Adaptation, Physiological↗
PubMed1996

Case report: delayed hypercalcemia after rhabdomyolysis-induced acute renal failure.

Abnormal calcium metabolism is a common complication of rhabdomyolysis -induced acute renal failure. During the oliguric phase, patients are frequently hypocalcemic. Hyperphosphatemia and skeletal resistance to parathyroid hormone are believed to be possible underlying mechanisms. In addition, there have been reports of hypercalcemia during the diuretic recovery phase after rhabdomyolysis. The pathophysiology of the hypercalcemia observed in the recovery phase is a subject of debate. Several mechanisms have been proposed, including mobilization of calcium from muscle deposits, secondary hyperparathyroidism, and elevated levels of 1,25 dihydroxyvitamin D. The authors report the case of a 30-year-old man admitted for evaluation of marked hypercalcemia (18.3 mg/dL) who was hospitalized 3 weeks earlier for acute renal failure secondary to rhabdomyolysis. Plasma parathyroid hormone and 1,25 dihydroxyvitamin D levels were suppressed during the period of maximal hypercalcemia. A technetium pyrophosphate scan demonstrated extensive deposition of calcium throughout the pelvic and lower extremity muscles. This case of delayed hypercalcemia after rhabdomyolysis supports the hypothesis that mobilization of calcium deposits from soft tissue, including muscle, is central to the pathogenesis of this syndrome.

Acute Kidney Injury↗
PubMed2006

The requirements of protein & amino acid during acute & chronic infections.

Nutrition and infection interact with each other in a synergistic vicious cycle, leading to an adverse nutritional status and increased susceptibility to infection. Infectious episodes result in hypermetabolism and a negative nitrogen balance which is modulated by hormones, cytokines and other pro-inflammatory mediators, and is compounded by a reduced food intake. The extent of the negative nitrogen balance varies with the type of infection and its duration; however, it is reasonable to suggest that the loss of body protein could be minimized by the provision of dietary nitrogen, although anorexia will limit this. Further, distinctions need to be made about the provision of nutrients or protein during the catabolic and anabolic or recovery phase of the infection, since the capacity of the body to retain protein is enhanced in the anabolic recovery phase. Meeting the increased requirement for protein (and other nutrients) in infection does not imply a complete therapeutic strategy. Infections need to be treated appropriately, with nutrition as an adjunct to the treatment. Prior undernutrition could also impair the body's response to infection, although the weight of the evidence would suggest that this happens more particularly in oedematous undernutrition. In general, the amount of extra protein that would appear to be needed is of the order of 20-25 per cent of the recommended intake, for most infections. In acute infections, this is particularly relevant during the convalescence period. Community trials have suggested that lysine supplementation to the level required for normal daily nutriture, in predominantly wheat eating or potentially lysine deficient communities, improves immune function among other functional nutritional parameters; however, there is as yet insufficient evidence to suggest a specific requirement for amino acids in infections over and above the normal daily requirement as based on recent evidence. Some clinical studies that have showed benefits with specific amino acids through selected clinical outcomes, however, these do not provide enough evidence for a firm recommendation.

Amino Acids↗
PubMedDate not supplied

Regulation of pyrimidine nucleotide synthesis in rat hematopoiesis.

In an attempt to define a regulation of pyrimidine nucleotide synthesis in hematopoietic cells, we investigated the activities of thymidylate synthetase and thymidine kinase, and the cell cycle by flow cytometric DNA analysis and bromodeoxyuridine-immunohistochemistry during the recovery phase of hematopoietic cells in bone marrow after the hypoplastic period induced by cyclophosphamide treatment in rats. The hematopoietic cells first entered into cell cycle via the de novo pathway in pyrimidine nucleotide synthesis, and were secondly proliferated and differentiated via the salvage pathway. S-phase cells associated with a myeloid hematopoiesis increased earlier than those associated with an erythroid hematopoiesis in the recovery phase of in rat bone marrow.

Animals↗
PubMed2006

Epimorphin expression and stellate cell status in mouse liver injury.

Epimorphin, a mesenchymal morphogenic protein expressed by hepatic stellate cells, is considered important to liver morphogenesis in both healthy and pathologic conditions. However, the stellate cell phenotype, quiescent versus activated, that expresses epimorphin is unknown. We studied the relationship between epimorphin expression and stellate cell status in carbon tetrachloride-induced acute and chronic injury to mouse liver and in mouse liver regeneration following 70% partial hepatectomy. Epimorphin-positive cells in sinusoids expressed desmin, indicating that they are stellate cells. Epimorphin-positive cells were more numerous and larger in pericentral than periportal sinusoids in normal liver. In early-phase acute liver injury and liver regeneration, epimorphin expression transiently decreased while alphaSMA-positive stellate cells increased. In the recovery phase of acute and chronic injury as well as the late phase of liver regeneration, epimorphin expression was strikingly enhanced while alphaSMA-positive stellate cells decreased. This expression pattern was seen in both Balb/c and C57BL6 mouse strains irrespective of their differences in response to the hepatotoxin. In conclusion, stellate cells express epimorphin in their quiescent state and in the recovery phase, respectively associated with maintenance and reconstruction of microscopic liver structure.

Journal Article↗