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PubMed1998

Comparison of left ventricular function during interval versus steady-state exercise training in patients with chronic congestive heart failure.

This study sought to assess the safety of interval exercise training in patients with chronic congestive heart failure (CHF) with respect to left ventricular (LV) function. For effective rehabilitation in CHF, both aerobic capacity and muscle strength need to be improved. We have previously demonstrated in both coronary artery bypass surgery and patients with CHF that interval exercise training (IET) offers advantages over steady-state exercise training (SSET). However, because LV function during IET has not yet been studied, the safety of this method in CHF remains unclear. To assess LV function during IET and SSET, at the same average power output, 11 patients with stable CHF were compared with 9 stable coronary patients with minimal LV dysfunction (control group). Using first-pass radionuclide ventriculography, changes in LV function were assessed during work versus recovery phases, at temporally matched times between the fifth and sixteenth minute of IET and SSET. In CHF during IET, there were no significant variations in the parameters measured during work and/or recovery phases. During the course of both IET and SSET, there was a significant increase in LV ejection fraction (5 vs 4 U; p <0.05 each), accompanied by increased heart rate (6 vs 8 beats/min; p <0.05 each) and cardiac output (2.4 vs 1.8 L/min; p <0.01 and p <0.05). In CHF, the magnitude of change in LV ejection fraction during IET was similar to that seen in controls. Both LV ejection fraction and the clinical status in patients with CHF remained stable during IET. Because IET appears to be as safe as SSET with respect to LV function, IET can be recommended for exercise training in CHF to apply higher peripheral exercise stimuli and with no greater LV stress than during SSET.

Exercise Therapy↗
PubMed1983

Time course of the bronchoconstriction induced by inhaled histamine and methacholine.

Eleven asthmatic subjects inhaled doubling concentrations of histamine until a near sixfold increase in total pulmonary flow resistance had been reached. This last concentration (C6) of histamine and methacholine was administered on two subsequent separate visits. Specific lung conductance (sGL) dropped to 18.6 +/- 7.9 (SD) and 19.1 +/- 10.3% of initial value after histamine and methacholine, respectively (NS). Whereas the peak action occurred in a similar interval (1-4 min), the mean duration of the subsequent plateau, defined as values of sGL within 20% of the maximum fall was 16.8 +/- 9.8 min for histamine and 74.6 +/- 53.7 min for methacholine (P less than 0.01). The recovery phase from the end of the plateau to base line lasted 25.5 +/- 14.4 min for histamine and 56.7 +/- 38.3 min for methacholine (P less than 0.01). The duration of plateau and recovery phases were not linked with base-line sGL, maximum fall in sGL, or C6. We conclude that for the same induced bronchoconstriction methacholine has a more prolonged action than histamine.

Adolescent↗
PubMed1989

[Study on intracardiac blood flow with color flow mapping in human fetus--the reverse flow at tricuspid valve in human fetus during labor].

This study was performed to determine the relation among the reverse flow signal of tricuspid valve, fetal heart rate pattern and uterine contraction. The blood flow signal through the tricuspid valve was continuously recorded with color flow mapping and direct fetal electrocardiogram as well as uterine contraction in 17 human fetuses during labor. Gestational ages ranged from 36 to 41 weeks. No fetus had a congenital heart anomaly. The detection rate of the reverse flow signal at the tricuspid valve was 100% in variable deceleration, 33% in late deceleration, 5% in normocardia and none in early deceleration. In investigation of the time relation between the reverse flow signal and variable deceleration, the reverse flow signal started after the onset of the recovery phase of deceleration. The tricuspid reverse flow, which was observed in variable deceleration, was caused by an increase in the venous return when cord compression disappeared at the onset of the recovery phase of variable deceleration.

Echocardiography, Doppler↗
PubMed1976

Electrical properties of the rod syncytium in the retina of the turtle.

1. Intracellular responses were recorded from rods in isolated eye-cups of the snapping turtle. Chelydra serpentina. Responses to flashes of small (less than 100 mum diameter) and large (1000 mum diameter) spots of 500 nm light were studied. 2. Responses produced by small and large diameter spots which delivered less than 0-3 photons mum-2 had the same shape. The responses produced by large spots were, however, nearly ten times greater in amplitude. The difference in amplitude is termed enhancement. 3. Perfusing an eye-cup with a Co2+-containing medium blocked synaptic transmission from receptors to horizontal cells but did not affect the responses of rods. 4. The membrane conductance of a single rod, estimated by three independent methods, was approximately 1-2 X 10(-9) MHo. 5. Enhancement can be predicted by a mathematical model which treats rods as an electrical syncytium. The space coefficient describing the spread of current is approximately 65 mum indicating that the coupling conductance between rods was relatively high. 6. When the intensity of a small spot was increased from 0-3 photons mum-2 up to 6 photons mum-2, the shape of the response was unchanged. When the intensity of a large spot was increased to more than 0-3 photons mum-2, the voltage during the recovery phase was decreased. This decrease is termed disenhancement. 7. The voltages produced by bright, large and small diameter spots which delivered the same quantity of light to the impaled rod were compared. The voltage produced by a large diameter spot became for a short period during the recovery phase less than the voltage produced by a small diameter spot. This observation indicates that the response to a large spot included during recovery an active process which is not apparent in the response to a small spot.

Animals↗
PubMed1996

Electromyographic activity of shoulder muscles during wheelchair propulsion by paraplegic persons.

OBJECTIVE: Phasing and intensity of shoulder muscle activity during wheelchair propulsion were documented to identify muscles at risk for fatigue and overuse. DESIGN AND PARTICIPANTS: Electromyographic (EMG) activity of 12 muscles was recorded with wire electrodes in 17 paraplegic men during propulsion on a stationary ergometer. MAIN OUTCOME MEASURES: Push and recovery phases of the propulsion cycle were determined with an instrumented pushrim. Onset and cessation of EMG were compared between muscles with a repeated measures ANOVA. Average and peak EMG intensity also were identified. RESULTS: All muscles functioned either in push or recovery phases, except supraspinatus, which displayed both patterns, and latissimus dorsi, which was inconsistent. The 6 push phase muscles--anterior deltoid, sternal pectoralis major, supraspinatus, infraspinatus, serratus anterior, and long head of biceps brachii--had onsets in late recovery (78% to 93% cycle) with peak EMG in the first 10% of the cycle. Pectoralis major and supraspinatus had the highest peak (58% and 67%MAX) and average (35% and 27%MAX) EMG intensities in this group. Cessation occurred in late push (17% to 23% cycle) except in biceps brachii (8% cycle) (p < .01). The 5 recovery muscles--middle and posterior deltoid, subscapularis, supraspinatus, and middle trapezius--had EMG onsets in late push (17% to 26% cycle) with moderate average intensities (21% to 32%MAX). These muscles had two EMG peaks (end of push and mid-recovery). Cessation was in late recovery (82% to 91% cycle). CONCLUSIONS: Muscles most vulnerable for fatigue were pectoralis major, supraspinatus, and recovery muscles. Endurance training was recommended.

Adult↗
PubMed2003

Reflux of nasopharyngeal content into middle ear through the eustachian tube.

Whether nasopharyngeal content passes into the middle ear in patients without any head and neck pathology during the recovery phase of anesthesia is shown with an objective and prospective method. Thirty-eight patients, 21 female and 17 male, aged between 17 and 76, were included in the study. During the recovery phase of general anesthesia, 10 ml of 5 mCi Tc-99m-MAA was administered intranasally to the patients with a 10-F catheter. A manometer-adapted cuffed intubation tube was placed in the nasal passage so that the cuff was located at the choana. The pressure changes reflecting to the nasopharynx were recorded. The patients were extubated 10 min after the radionuclide was applied. The scintigraphic evaluation was done at the end of the 1st hour of the application of radionuclide. Transmission and emission views were taken with a gamma camera. Passage of nasopharyngeal content into the middle ear via the eustachian tube was not a statistically significant observation. The mean value of maximum pressure reflecting from the nasopharynx did not differ significantly between patients. Our study does not support the hypothesis that nasopharyngeal content passes directly through the eustachian tube into the middle ear and causes deleterious effects.

Adolescent↗
PubMed1996

Increased nitric oxide formation in recurrent thrombotic microangiopathies: a possible mediator of microvascular injury.

The term thrombotic microangiopathy (TMA) has been used extensively to encompass hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, two syndromes of hemolytic anemia, and thrombocytopenia associated with renal or brain involvement or both. There is evidence that endothelial damage is a crucial feature in the sequence of events that precedes the development of microvascular lesions. More recent studies would suggest that endothelial dysfunction could be a consequence of neutrophil activation. Activated neutrophils generate superoxide anions (O2-) that, combining with endothelial-derived nitric oxide (NO), form the highly cytotoxic hydroxyl radical. Seven patients with recurrent forms of TMA and seven healthy volunteers were studied. Plasma concentrations of the NO metabolites, nitrites/nitrates, were elevated in the acute phase of TMA, indicating an increased NO synthesis in vivo. In addition, elevated serum concentrations of tumor necrosis factor, a potent inducer of endothelial NO synthase, were found in acute TMA. Serum from patients with acute TMA induced NO synthesis in cultured endothelial cells more than normal serum. Enhanced stimulatory activity was no longer found in the recovery phase. Release of O2- by neutrophils ex vivo was higher than normal in patients with acute TMA, but decreased in the recovery phase. Exactly the same trend was observed for plasma malondialdehyde and conjugated dienes, indicating that excessive oxygen radical formation in acute TMA is associated with increased lipid peroxidation. Thus, in recurrent forms of TMA, NO formation was increased as compared with controls. This was associated with signs of lipid peroxidation, likely the consequence of the interaction of NO with neutrophil-derived oxygen products.

3,4-Methylenedioxyamphetamine↗
PubMed1979

Chemotherapeutic alteration of small intestinal morphology and function: a progress report.

Nine patients with malignancy requiring chemotherapy were evaluated before, during, and in the recovery phase of their antineoplastic regimen with selected absorptive studies and jejunal biopsies. Depression of the crypt mitoses occurred without change in the indices of absorption. The mitotic indices returned to pretreatment counts on the recovery phase biopsies. Even after prolonged therapy, restudy in three of the patients failed to demonstrate clinical malabsorption. We conclude that chemotherapy-related malabsorption does not contribute to overall malnutrition of cancer patients during the first months of treatment.

Antineoplastic Agents↗
PubMed2006

Incidence, time course, and determinants of menstrual bleeding after breast cancer treatment: a prospective study.

PURPOSE: To assess ovarian function using the surrogate of monthly bleeding after breast cancer treatment in premenopausal women. PATIENTS AND METHODS: Five hundred ninety-five US women age 20 to 45 years were accrued from January 1998 to July 2002 within 8 months of diagnosis with stages I to III breast cancer (median follow-up 45 months). Daily bleeding records were obtained prospectively, as well as extensive clinical, demographic, quality of life, and treatment data. Repeated measures logistic regression was used to assess which variables were predictive of monthly bleeding. RESULTS: Significantly different proportions of women had monthly bleeding depending on their age (P < .001), chemotherapy program (P < .001), and time since treatment regimen. In the month after the standard course of doxorubicin and cyclophosphamide (AC), whether or not followed by paclitaxel or docetaxel, approximately 16% had monthly bleeding compared with the cyclophosphamide, methotrexate, fluorouracil (CMF) group, in which 48% bled (P < .001). Following any AC regimen, there was a slow recovery phase of about 9 months followed by a plateau, during which almost half continued monthly bleeding for the remainder of the follow-up period compared with after CMF in which there was no recovery phase and a continual decline in monthly bleeding to approximately 18% of women at study end (P < .001). Tamoxifen use decreased bleeding between months 12 and 24 after chemotherapy with 15% fewer women having bleeding. CONCLUSION: Using daily menstrual bleeding records, it is demonstrated that age, the specific chemotherapy regimen received, and tamoxifen use impact ovarian function.

Adult↗
PubMed2005

Aquatic wing flapping at low Reynolds numbers: swimming kinematics of the Antarctic pteropod, Clione antarctica.

We studied swimming kinematics of the Antarctic pteropod, Clione antarctica, to investigate how propulsive forces are generated by flexible oscillating appendages operating at low Reynolds numbers (10 25) exhibited gliding during the recovery phase of each half-stroke. Maximum translational and rotational accelerations of the body occurred at the initiation of each power phase, suggesting that rotational circulation, the acceleration reaction, and wake recapture may all potentially contribute to vertical force production. Individual contributions of these mechanisms cannot, however, be assessed from these kinematic data alone. During recovery phases of each half-stroke, C. antarctica minimized adverse drag forces by orienting the wings parallel to flow and by moving them along the body surface, possibly taking advantage of boundary layer effects. Vertical force production was altered through changes in the hydrodynamic angle of attack of the wing that augmented drag during the power phase of each half-stroke. At higher translational velocities of the body, the inclination of the power phase also became more nearly vertical. These results indicate that, in addition to serotonin-mediated modulation of wingbeat frequency reported previously in Clione, geometric alteration of wingbeat kinematics offers a precise means of controlling swimming forces.

Acceleration↗
PubMed1987

Superoxide Dismutase as an Anaerobic Polypeptide : A Key Factor in Recovery from Oxygen Deprivation in Iris pseudacorus?

The perennating organ, the rhizome, was chosen for examination of response to anoxia in the species Iris pseudacorus L., Iris germanica L. var Quechei, and Glyceria maxima (Hartm.) Holmberg. These monocots are known to differ in their tolerance of anoxia. Intact rhizomes were subjected to periods of prolonged anoxia of up to 28 days and superoxide dismutase (SOD) activity was determined in a 48 hour postanoxic recovery phase. Tests were performed to ensure the accuracy of the measured enzyme activities. In the most anoxia tolerant species, I. pseudacorus, SOD activity rose continuously during the period of imposed anoxia, and levels were maintained in the postanoxic recovery phases: 28 days brought about a 13-fold increase to 1576 U SOD per milligram protein. Small increases were found in the less anoxia tolerant I. germanica during anoxic/postanoxic phases, while a drop in activity was recorded in the least anoxia tolerant G. maxima. However, initial levels in G. maxima were more than twice as high as in the other two species. Experiments applying cycloheximide to anoxic rhizome slices of I. pseudacorus inhibited the increase in SOD activity. This indicates that SOD is, paradoxically, induced under anoxia and we suggest that in this species SOD is one of the enzymes identified as anaerobic polypeptides. The significance of the induction of an ;oxygen-protecting' enzyme during complete oxygen deprivation is discussed with regard to a possible critical role during recovery from anoxic stress.

Journal Article↗
PubMed1981

Effects of heavy ions on rabbit tissues: alopecia.

During extended investigations of the radiation responses of optic and proximate tissues of New Zealand white rabbits (Oryctolagus cuniculus), the skin surrounding the eyes was exposed to the Bragg plateau regions of 530 MeV/amu Ar ions and 365 MeV/amu Ne ions, and also to 60Co gamma rays. The linear energy transfers (LET infinity s) for the radiations were 90 +/- 5, 35 +/- 3, and 0.3 keV/micron, respectively. Alopecia was measured after irradiation with subjective indices of baldness (0-5) that were calibrated against hair loss in other rabbits irradiated with Ne and Ar ions at the central region of the ear. The patterns of post-irradiation alopecia, which conformed to the model proposed by Casarett (1963) for the long-term expression of radiation damage in proliferating animal tissues, were modified by radiation quality in the following ways: (1) For acute (early) losses, the magnitude of the recovery phase decreased as the LET infinity of the incident radiation increased; (2) In the intermediate or plateau phase of radiation response, the values of relative biological effectiveness (r.b.e) approached those reported for proliferating cells in culture, but differences were found that may be related to the changes in the magnitude of the recovery phase; (3) For a given level of intermediate damage, the onset of the late degenerative phase of radiation response, which was expressed years after irradiation, occurred earlier the higher the LET infinity of the incident radiation. Taken overall, the most important finding of these experiments was that the r.b.e.s for alopecia varied with post-irradiation time.

Alopecia↗
PubMed2003

[Roentgenography and CT appearance in patients with severe acute respiratory syndrome].

OBJECTIVE: To evaluate the appearance and dynamic change of chest roentgenography and CT in patients with severe acute respiratory syndrome (SARS). METHODS: Serial roentgenography and CT of 61 confirmed SARS patients were analyzed. RESULTS: The onset symptom was fever in all patients. In the early phase of SARS, the main abnormal appearance was single or bilateral localized patchy clouding opacity on roentgenography, which progressed rapidly. The area of opacity peaked at about 2 weeks, involving the majority area of the lung in 57% of the patients. The area involved was correlated with the severity of clinical symptoms. The opacity disappeared gradually in 5 weeks in 84% of the patients. Lungs complicated infection were found in 6 patients with a prolonged duration of the illness. Among the 61 patients, 4 died. CT scan was performed in 16 SARS patients in the recovery phase, of whom 13 showed lung fibrosis. CONCLUSIONS: Lung infiltration in early phase develops rapidly and involves most area of the lung in advanced phase in most SARS patients. Lungs fibrosis was found in some patients in the recovery phase.

Adult↗
PubMed2004

Serum testosterone and corticosterone levels in acute experimental autoimmune encephalomyelitis (EAE) in male Wistar rats.

OBJECTIVES: Experimental autoimmune encephalomyelitis (EAE) was induced to investigate the levels of circulating total testosterone (TT) and the possible association of corticosterone with the steroid-producing capacity of the testes. SETTING AND DESIGN: We determined gonad weights, serum TT and corticosterone levels during the development of EAE in male rats. METHODS: Active EAE was induced in young male Wistar rats by injection of whole myelin in complete Freund's adjuvant. All the rats were weighted and monitored daily for clinical signs and blooded during different phases of the disease. Serum TT was measured by radioimmunoassay and circulating corticosterone was determined using a competitive enzyme immunoassay. Also testes and seminal vesicles were removed to determine their weights. RESULTS: Seminal vesicle weights and serum TT levels diminished during the acute stage of the disease in all EAE rats and then they began gradually to increase, reaching the normal values at the post-recovery phase. Concomitantly a significant increase in serum corticosterone levels was observed during the acute EAE and the post-recovery phase was accompanied by a decline in corticosterone levels. MAIN FINDING: Our results indicated an inverse correlation between serum TT and corticosterone levels during the acute EAE. Moreover, the diminution of TT was not a consequence of an alteration of the testes induced by anti-myelin antibodies neither contributed by apoptosis of testis cells by exposure to corticosterone. CONCLUSIONS: The negative correlation between corticosterone and TT levels associated to EAE may be relevant in understanding the association of the endocrine system and the development of autoimmune demyelinating diseases.

Acute Disease↗
PubMed1996

A computer program for comprehensive ST-segment depression/heart rate analysis of the exercise ECG test.

The ST-segment depression/heart rate (ST/HR) analysis has been found to improve the diagnostic accuracy of the exercise ECG test in detecting myocardial ischemia. Recently, three different continuous diagnostic variables based on the ST/HR analysis have been introduced; the ST/HR slope, the ST/HR index and the ST/HR hysteresis. The latter utilises both the exercise and recovery phases of the exercise ECG test, whereas the two former are based on the exercise phase only. This present article presents a computer program which not only calculates the above three diagnostic variables but also plots the full diagrams of ST-segment depression against heart rate during both exercise and recovery phases for each ECG lead from given ST/HR data. The program can be used in the exercise ECG diagnosis of daily clinical practice provided that the ST/HR data from the ECG measurement system can be linked to the program. At present, the main purpose of the program is to provide clinical and medical researchers with a practical tool for comprehensive clinical evaluation and development of the ST/HR analysis.

Exercise Test↗
PubMed1989

[Local muscle work and noise and their effect on the amplitude of the finger pulse].

The finger pulse amplitude of 10 healthy men (aged 20 to 30 years) was measured during noise (70, 80 and 90 dBA) and combined exposure (local muscular work with 30% MVC and noise with 70, 80 or 90 dBA) and during a recovery phase of 60 min. The finger pulse amplitude was reduced only during noise exposure with 90 dBA and was increased during the combined exposures. A continuous decrease of the finger pulse amplitude was observed during the recovery phases. Differences between noise exposure and combined exposure do not exist. The findings were discussed as the risk of hypertension in workers exposed to noise.

Adult↗
PubMed1982

Dynamics of apolipoprotein E metabolism in humans.

The dynamics of human apoE metabolism were explored by examining the effects of alimentary lipemia and postheparin lipolysis on the plasma level and lipoprotein distribution of apoE. In the studies of alimentary lipemia, fasting and postprandial plasma samples were obtained from five normal adult males, each of whom drank 100 g of corn oil. Although no change in the plasma concentration of apoE accompanied alimentary lipemia, a major redistribution of apoE among lipoproteins occurred. The portion of apoE associated with triglyceride-rich lipoproteins as assessed by agarose column chromatography increased by a mean of 44%. Furthermore, in the two subjects in whom multiple postprandial samples were taken, there were striking linear correlations between plasma triglyceride concentrations and the fraction of apoE in triglyceride-rich lipoproteins (r = 0.96 and 0.73). In contrast, the plasma concentration of apoE fell in each of the seven studies of postheparin lipolysis. The fall averaged 17% of the control plasma apoE level. In hypertriglyceridemic patients, the decline in plasma triglyceride concentration preceded the decline in apoE concentration, suggesting that the decline in apoE was due to removal of remnants of triglyceride-rich lipoproteins. Lipoprotein fractionation demonstrated substantial loss of apoE from triglyceride-rich lipoproteins; the data suggested that this loss of apoE from triglyceride-rich lipoproteins was due both to removal of apoE from plasma and to transfer of apoE to an HDL fraction. During the recovery phase, as plasma triglyceride levels rose, opposite changes occurred: the plasma apoE level rose, apoE in triglyceride-rich lipoproteins increased in concentration, and apoE in HDL decreased in concentration. Furthermore, it became apparent during the recovery phase that apoE in triglyceride-rich lipoproteins was composed of two discrete subfractions. The first subfraction consisted of apoE on larger, probably recently synthesized lipoproteins; the second consisted of apoE on much smaller lipoproteins. These studies provide evidence in intact humans for a dynamic traffic of apoE between triglyceride-rich lipoproteins and high density lipoprotein. This traffic is a prominent phenomenon of normal alimentary lipemia and of lipolysis. By modulating the lipoprotein distribution of apoE, it probably plays a key functional role in lipoprotein metabolism.-Blum, C. B. Dynamics of apolipoprotein E metabolism in humans.

Adult↗
PubMed2006

Can remifentanil be a better choice than propofol for colonoscopy during monitored anesthesia care?

BACKGROUND AND OBJECTIVE: This prospective, randomized trial was designed to test the hypothesis that continuous infusion of low-dose remifentanil can provide effective analgesia, sedation, amnesia, patient comfort and stable recovery profile without respiratory depression when compared with propofol infusion during colonoscopy. METHODS: One hundred patients were randomly assigned to receive either remifentanil (group R, 0.5 microg/kg followed by 0.05 microg/kg/min, n = 50) or propofol (group P, 0.5 mg/kg followed by 50 microg/kg/min, n = 50). Supplemental doses of remifentanil 12.5 microg in group R and propofol 10 mg in group P were given to treat complaints of moderate to severe pain and discomfort. Hemodynamic and respiratory data, pain, discomfort and sedation scores, patient and gastroenterologist satisfaction and recovery profiles were recorded. RESULTS: The duration of colonoscopy was longer in group P. The mean arterial pressure, heart rate and end-tidal CO2 remained stable during the procedure and were comparable between the groups. After bolus injection of the study drugs, the respiratory rate and oxygen saturation values were lower in group R than in group P. Only one patient in group R required airway support. Pain and discomfort scores were better in group R than in group P. Sedation levels were higher in group P than in group R. Group P needed more supplemental doses than group R. The time to reach an Aldrete score of nine or more was shorter in group R, but discharge times were similar in the two groups. Amnesia was better in group P. Nausea and vomiting were more frequent in group R during the recovery phase. CONCLUSION: Low-dose remifentanil infusion with intermittent bolus injections can provide adequate sedation, amnesia and better analgesia than propofol infusion during colonoscopy. However, remifentanil-induced nausea and vomiting may be a problem during the recovery phase.

Adolescent↗