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PubMed1990

Utility and tolerance of stress testing in geriatric patients.

OBJECTIVES: To determine the sensitivity and specificity of stress testing in geriatric patients and to estimate the tolerance of these patients to exercise. DESIGN: A prospective study done in two populations with different ages. SETTING: Cardiologists and a stress testing laboratory. PATIENTS: Persons with ages above and under 65 years who were admitted in our center and submitted to stress testing and coronary angiography for suspicion of ischemic heart disease. PROCEDURES: All stress tests were performed on a Siemens Elama cicloergometer model 380-B adapted to a Hewlett Packard 1517 A ECG recorder. Our protocol started with an initial work load of 30 Watts with increments of other 30 Watts every three minutes. A 12 lead ECG was registered at rest, at maximum effort and in the recovery phase (approx. eight minutes after maximum effort). Three leads ECG's (V2, aVF, V5) were registered every three minutes. Stress finishing criteria were: symptom's limited, fatigue and maximum heart rate (220-age). Blood pressure was also controlled every three minutes during exercise and every two minutes during the recovery phase. Coronary angiographies were performed on a Siemens Cardoskop U (cine) using the Judkins technique. Left anterior oblique, right anterior oblique and postero anterior projections were used in all the procedures. RESULTS: Stress testing presents high sensitivity and low specificity in geriatric patients. A good tolerance to exercise was observed in this group of patients. CONCLUSIONS: A similar sensitivity was observed in the stress tests performed by patients with ages above and under 65 years. Sensitivity seems to be related to the severity of the coronary lesion. On the other hand stress testing presented a lower specificity in the geriatric patient. Finally, good tolerance to exercise was observed in patients older than 65 years.

Aged↗
PubMed1978

Regulation of glycolysis in intermittent exercise in man.

1. Seven healthy male volunteers performed intermittent exercise (15 sec work--15 sec rest) at a high work load for 60 min and six subjects performed continuous exercise at an equally high load to exhaustion, which occurred after 4--6 min. 2. Muscle biopsies were obtained from the lateral portion of the quadriceps muscle before intermittent exercise and after the end of a work period and the end of the subsequent rest period at 5, 15, 30 and 60 min of exercise, as well as before, immediately after and about 15, 30, 60 and 180 sec after continuous exercise. 3. The reduction in glycogen content was smaller and glucose-6-phosphate, glycerol-1-phosphate, lactate and malate contents were lower after both work and rest periods in intermittent compared with continuous exercise, indicating a lower rate of glycolysis. 4. ATP and CP levels had decreased at the end of work periods in intermittent exercise but increased to slightly below basal in the subsequent rest periods. A still larger decrease in ATP and CP levels was found after continuous exercise to exhaustion and a progressive increase occurred over the 3 min of recovery. 5. In each rest period during intermittent exercise citrate levels increased to reach above basal. They increased also in the recovery phase after continuous exercise, although more slowly. 6. The findings support the assumption that ATP, CP and citrate act as regulatory factors of glycolysis in human muscle by retarding certain rate limiting steps. The increase in G-6-P/F-1-6-P2 ratio in rest periods of intermittent intense exercise and in the recovery phase of continuous intense exercise suggests that glycolysis is retarded at the phosphofructokinase reaction. 7. The factors mentioned may therefore contribute to the relative increase in lipid utilization during intense intermittent compared to continuous exercise.

Adenosine Triphosphate↗
PubMed1983

[Incidence of irritant dermatosis among employees of the shipbuilding industry].

Irritant dermatosis is a non-specific reactive change on the skin. In most cases it represents the summated effects induced by various agents. Not only the shortened recovery phases of the skin but also a dispositional factor are important. Such changes, which are relatively common in some vocations but are usually only slight, cannot, as a rule, be regarded as signs of illness. Nevertheless, attention should be drawn to the necessity of intensive skin care and observation of the recovery phases because the frequency of irritant dermatosis can increase with increasing length of employment.

Adolescent↗
PubMed1993

Inversion of Ca2+ current modulation during recovery of neuroblastoma cells from pertussis toxin pretreatment.

Human neuroblastoma cells (SH-SY5Y) differentiated by retinoic acid exhibited high threshold-activated N-type Ca2+ currents, which were largely inhibited by the two enkephalins, DAGO and DPDPE, as well as by dopamine and somatostatin. The inhibitory effects were fully abolished after pretreatment of cells with pertussis toxin. After washing out the toxin, the inhibitory effects re-established with a time constant of about 16 h. The recovery of Ca2+ current inhibition was similar for all tested agonists. Unexpectedly, we observed a neurotransmitter-induced stimulation of Ca2+ currents in approximately 10% of all investigated cells during the recovery phase. Such a stimulatory effect by otherwise inhibitory receptors was never seen in control cells. It did also not occur when exogenous purified G-proteins of the Gi family were reconstituted via the patch pipette, suggesting that additional mechanisms may play a role in the appearance of stimulatory effects during the recovery phase after pertussis toxin pretreatment.

Calcium↗
PubMed1999

Unsuitability of corrected QT dispersion as a marker for ventricular arrhythmias and cardiac sudden death after acute myocardial infarction.

The present study investigated whether corrected QT (QTc) dispersion could play a role as a marker of ventricular arrhythmias and sudden cardiac death after acute myocardial infarction (MI). The study included 76 males and 24 females with a mean age of 60+/-11 years. Standard 12-lead ECGs were recorded during the recovery phase (15+/-9 days) after the onset of MI. The QTc was calculated according to Bazett's formula and QTc dispersion was calculated as the difference between the maximum and minimum QTc intervals. Patients were divided into 2 groups: 21 patients (group A) had a QTc dispersion of > or =80ms, and the other 79 patients (group B) had a QTc dispersion of <80ms in the recovery stage (15+/-9 days). Clinical, angiographical, and Holter monitoring data, and prognosis (mean follow-up period 29+/-18 months) were compared between these 2 groups. The frequencies of early coronary reperfusion and recanalization of infarct-related vessels during the recovery phase were significantly higher in group B than group A. The left ventricular ejection fraction was also higher in group B than group A (51+/-12 vs 43+/-12%, p=0.0029). There were no significant differences in the number of premature ventricular contractions, the percentage of patients with repetitive ventricular arrhythmias, or in the frequency of sudden cardiac death during the follow-up period between the 2 groups. In summary, QTc dispersion in the recovery stage is not a useful marker for ventricular arrhythmias or sudden cardiac death after acute MI, although increased QTc dispersion may correlate with an ineffective early coronary reperfusion and with the degree of depressed left ventricular function.

Adult↗
PubMed1990

Ability of calcium-entry blockade by felodipine to disclose different pathogenetic mechanisms behind hyperventilation-induced myocardial ischemia in men.

To verify that myocardial ischemia occurring during either the overbreathing or recovery phase of the hyperventilation test is based on different pathogenetic mechanisms, 2 consecutive series of patients, selected on the basis of their response to a run-in hyperventilation test, were studied. Group I comprised 15 patients who developed ST-segment depression early during overbreathing, whereas group II consisted of 12 patients showing ST-segment depression late during the recovery phase. A single oral dose of felodipine 10 mg or of placebo was administered on 2 consecutive days according to a randomized, double-blind, crossover design, and the hyperventilation test was repeated, on both days of the study, 3 to 5 hours after drug intake. In group I, ST-segment depression occurred after placebo in all patients during overbreathing, with an increase in rate pressure product (from 112 +/- 31 at baseline to 168 +/- 55 mm Hg x beats/min/100 at the onset of ST-segment depression; p less than 0.01). After felodipine, 13 patients continued to show ST-segment depression during overbreathing, together with an increase in rate pressure product (from 107 +/- 24 at baseline to 158 +/- 46 mm Hg x beats/min/100 at the onset of electrocardiographic changes; p less than 0.01). In group II, all 12 patients showed ST-segment depression during recovery after placebo, with a rate pressure product comparable to baseline conditions (112 +/- 35 at baseline vs 102 +/- 27 mm Hg x beats/min/100 at the onset of ST-segment depression; difference not significant). After felodipine, no patient developed ST-segment depression or chest pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Angiography↗
PubMed1987

The effect of lanthanum, quercetin and dinitrophenol on calcium-evoked electrical responses in hamster eggs.

At room temperature micro-injections of calcium or strontium produced transient hyperpolarizations with an associated rise in input conductance. By contrast micro-injections of potassium, barium, magnesium, cobalt or lanthanum did not produce hyperpolarizations. The reversal potential for the hyperpolarizing response was about -80 mV. Some responses to calcium injections appeared to suffer from an additional transient leak conductance generated by the injected current. In these cases the recovery of the potential and the conductance to normal values was prolonged. The reversal potential of this additional leak pathway was about -10 mV. Experiments designed to investigate the role of active calcium extrusion from the cells showed that extracellular lanthanum or quercetin caused a pronounced slowing of the recovery phase of the potential and conductance response to calcium injection. The metabolic uncoupler dinitrophenol also prolonged the calcium-evoked responses. The replacement of extracellular sodium by lithium or choline produced no alteration in the time course of the calcium-evoked responses, thus suggesting that sodium-calcium exchange exerts no rate control on the recovery phase of those responses.

Animals↗
PubMed2006

Influence of swimsuit design and fabric surface properties on the butterfly kinematics.

This study investigated the influence of the covering swimsuit and the fabric surface properties on the butterfly stroke kinematics. Surface properties were evaluated by wetting measurements of two fabric samples: one for training suits and one for competition suits. The surface of the second one was coated by mechanochemical treatment in order to modify its surface properties. Nine national level swimmers performed a 50-m butterfly at submaximal velocity in three swimsuit conditions: conventional, long, and coated long swimsuits. From video recording, the hip was digitized at the entry and exit of the swimmer's hand in order to calculate the duration, hip displacement, and hip linear velocity during underwater and recovery phases and during stroke. The results for wetting show that competition fabric was more water-repellent than training fabric, but both were isotropic. Moreover, the mechanochemical treatment increased water repellency and anisotropy. The swimming results indicated that, when compared to a conventional swimsuit, wearing a coated long swimsuit increased hip linear velocity during stroke, and particularly during the recovery phase which had a shorter duration. These results suggest that the covering swimsuit should be coupled with the water repellent and anisotropic properties of the fabric surface in order to improve swimming performance.

Biomechanical Phenomena↗
PubMed1994

Recovery from acute glucagon challenge in isolated rat hepatocytes: is protein dephosphorylation synchronous or asynchronous?

One-dimensional SDS-PAGE of cytosolic phosphopeptides confirms that glucagon promotes the phosphorylation of 11 phosphopeptides in isolated rat hepatocytes pre-equilibrated with 32PO4(3-). Nine of these phosphopeptides are tentatively identified, whereas two phosphopeptides (48 kDa and 46 kDa) remain unidentified. Transfer of the glucagon-challenged hepatocytes to medium free of 32PO4(3-) and glucagon led to the rapid net dephosphorylation of the phosphopeptides and to a rapid decline in the specific radioactivity of the [32P]ATP pool. There were profound differences between the post-glucagon rates of net dephosphorylation of the different hepatic phosphopeptides, consistent with net dephosphorylation being asynchronous during the recovery phase from acute glucagon challenge. On the basis of descending rates of dephosphorylation, four major groups of phosphopeptides were delineated. Okadaic acid, a potent inhibitor of protein phosphatase 2A and to a lesser extent protein phosphatase 1, inhibited the dephosphorylation of all of the phosphopeptides. A role for protein phosphatase 2A in protein dephosphorylation may be indicated by the observation that spermine, a specific activator of protein phosphatase 2A, stimulates the dephosphorylation of some, but not all, of the glucagon-stimulated phosphopeptides. Although phosphorylation during the recovery phase from glucagon challenge may be a complicating factor, the results suggest that post-glucagon dephosphorylation is a complex asynchronous process. The physiological consequences of this asynchrony may be that the suppression of glycogenolysis and gluconeogenesis and the activation of glycolysis are early events in the recovery process.

Animals↗
PubMed1996

Mobilisation kinetics of primitive haemopoietic cells following G-CSF with or without chemotherapy for advanced breast cancer.

BACKGROUND: The objective of this study was to determine the optimal conditions for blood progenitor cell harvest for transplantation, with main emphasis on the mobilisation kinetics of primitive, marrow repopulating cells. PATIENTS AND METHODS: Sixteen patients with advanced breast cancer were treated with 4 cycles of dose escalating FAC chemotherapy (5-fluorouracil, adriamycin, cyclophosphamide) each followed by 10 micrograms/kg/d G-CSF for 13 days. We assessed the number of colony-forming cells (CFC), and estimated the long-term culture initiating cells (LTC-IC) and CD34+ cells during the recovery phase of cycle 1 and 4 of chemotherapy, and during additional periods of G-CSF administration either preceding or following the full course of chemotherapy. RESULTS: The highest peak numbers of CFC per ml of blood (median 10489, range 860-39282) were mobilised after the first cycle of chemotherapy. The lowest peak numbers of CFC were obtained during the recovery phase from cycle 4 (median 4739, range 40-26789). In contrast, the numbers of CD34+ cells per ml of blood were significantly higher in cycle 4 (median 650, range 30-2600 x 10(2)) compared to those of cycle 1 (median 240, range 20-770 x 10(2)). The peak numbers of CFC mobilised by G-CSF before commencement and after the cessation of chemotherapy were equivalent, with a median of 5470 (range 1056-25669) and 5948 (range 2710-38975) per ml of blood, respectively. However, while mononuclear cells (MNC) collected at the days of maximal CFC mobilization following G-CSF administration before or after cycle 1 were similar to normal bone marrow MNCs in their ability to generate haemopoiesis when seeded onto performed irradiated stroma, those collected after cycle 4 or during G-CSF administration after the cessation of chemotherapy were markedly compromised in this respect. CONCLUSIONS: Our results indicate that repeated cycles of FAC chemotherapy followed by G-CSF result in a far lower number of LTC-IC than of CFC mobilised into the circulation. Furthermore although the combination of chemotherapy and G-CSF mobilised the highest numbers if CFC, G-CSF alone pre-chemotherapy was more effective at mobilising LTC-IC. These data indicate that neither the numbers of CFC mobilised nor the numbers of CD34+ cells are necessarily a reliable indicator for the putative marrow repopulating capability of the blood cells mobilised with chemotherapy plus G-CSF.

Adult↗
PubMed1993

Mechanisms for hypothermia-induced increase in contractile force studied by mechanical restitution and post-rest contractions in guinea-pig papillary muscle.

Lowering myocardial temperature increases contractile force, presumably by increasing intracellular calcium content. To study the mechanisms behind this, we compared the effects of some known inotropic interventions with hypothermia on mechanical restitution and post-rest contractile force in isolated guinea-pig papillary muscles. In four groups (n = 6 per group), the effects of: (1) reducing the ability for Na/Ca exchange to extrude Ca2+ (a) by increasing [Na+]i with ouabain or (b) by increasing [Ca2+]o; and (2) activation of calcium channels with Bay-K 8644, were compared with lowering temperature from 37 to 27 degrees C. Normally (at 37 degrees C and 2 mM CaCl2), mechanical restitution could be described by a rapid recovery phase with a time constant between 180 and 220 ms, followed by a slowly decaying phase with a time constant between 5000 and 8000 ms and post-rest contractions (1-10 min rest) were markedly depressed compared to steady-state contractions. Steady-state developed force was markedly increased at 27 degrees C, after 1 microM ouabain, 6 mM CaCl2 or 0.1 microM Bay-K 8644. At 27 degrees C the rapid recovery phase of restitution was delayed while the slowly decaying phase was not affected. Ouabain and increased [Ca2+]o caused elevation of the slowly decaying phase of restitution and markedly attenuated the post-rest depression of developed force, which may be attributed to a reduced diastolic extrusion of Ca2+ via the Na/Ca exchanger. Hypothermia and Bay-K 8644 on the other hand, augmented this post-rest depression. Hence, this study suggests that increased Ca2+ influx due to delayed inactivation of calcium channels may account for the increased developed force during hypothermia rather than reduced diastolic extrusion of Ca2+ via the Na/Ca exchanger.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗
PubMed1990

[Value of transcutaneous staged dynamic oximetry of stage II arteritis of the leg].

The clinical and prognostic value of transcutaneous oxygen pressure measurements at rest has been established in Leriche Stage III and IV occlusive peripheral arterial disease but is controversial in Stage II because there is an overlap of transcutaneous pO2 (Tc pO2) values with those of normal subjects. The authors report the results of Tc pO2 measurements during exercise testing in a group of patients with Stage II occlusive arterial disease of the lower limbs. Seventy-eight patients with an average age of 53 years (range 40 to 65 years) whose claudication perimeter and site of pain had been carefully assessed and who had also recently undergone Doppler arterial examination and arteriography and 35 control subjects with an average age of 54 years (range 45 to 70 years) were studied. The Tc pO2 was continuously measured with a multimodular Kontron Supermon at 4 different sites simultaneously: precordium (reference probe), thigh, calf and foot in the dorsal recumbent position after 30 minutes rest, during a standardised exercise stress test at 50 watts and during the recovery phase. The results were expressed as ratio of tissue oxygenation (RTO): thigh, calf or foot Tc pO2/precordial Tc pO2 X 100 in order to take into account the patients cardiorespiratory status and adaptation to exercise. The RTO in normal subjects remained at the upper limits of the resting value throughout exercise and then returned slowly to basal values during the recovery phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Mechanism of the depressor action of LY171555, a selective dopamine D2 receptor agonist, in the anesthetized rat.

Administration of LY171555 (1 mg/kg i.v.) decreased mean arterial pressure (MAP) and heart rate in both pentobarbital- and urethane-anesthesized Sprague-Dawley rats. The depressor response to LY171555 in pentobarbital-anesthetized rats was sustained for at least 30 min, but in urethane-anesthetized rats lasted only approximately 3 min after LY171555 injection. In pentobarbital-anesthetized rats, pretreatment with domperidone (0.5 mg/kg) or metoclopramide (5 mg/kg) attenuated the depressor action of LY171555, whereas pretreatment with d(CH2)5Tyr(Me)arginine vasopressin (AVP) (10 micrograms/kg) only delayed the recovery phase of the depressor response to LY171555. In contrast, LY171555 administered to urethane-anesthetized rats after domperidone pretreatment induced a pressor response which was blocked completely by d(CH2)5Tyr(Me)AVP. Metoclopramide pretreatment in urethane-anesthetized rats prevented the decreases in MAP and heart rate induced by LY171555, whereas pretreatment with d(CH2)5Tyr(Me)AVP delayed the recovery phase of the depressor response. Pretreatment with d(CH2)5Tyr(Me)AVP per se decreased basal MAP in the urethane-anesthetized group, but not in pentobarbital-anesthetized rats. Basal plasma norepinephrine, epinephrine and AVP levels were higher in urethane-anesthetized rats than in the pentobarbital-anesthetized group. LY171555 administration decreased plasma norepinephrine without altering plasma epinephrine in both groups and induced a significant increase in plasma AVP which was greater in the urethane-anesthetized rats than in pentobarbital-anesthetized animals. These results suggest that LY171555 decreases MAP and heart rate in anesthetized rats by inhibiting norepinephrine release from nerve endings through the peripheral dopamine D2 receptor and that the time course of the depressor response may be altered by LY171555-induced AVP release, the magnitude of which appears to be dependent on the anesthetic agent.

Anesthesia↗
PubMed1996

[Changes of peripheral blood stem cells of patients with malignant hematopoietic tumor after chemotherapy].

To investigate the most appropriate condition for collecting stem cells during peripheral blood stem cells transplantation (PBSCT), we used colony forming unit-granulocyte, macrophage (CFU-GM) as index to observe the change of PBSC after chemotherapy in 12 patients with malignant hematopoietic tumor. The results showed that it was more suitable to collect PBSC when the number of leucocytes was 2 x 10(9)/L, neutrophils 0.8 x 10(9)/L and platelets 110 x 10(9)/L after chemotherapy for 2 weeks. After chemotherapy, the number of leucocytes were suppressed evidently. On the contrary, a lot of CFU-GM appeared during the recovery phase of peripheral hemogram. At the nadir of peripheral hemogram, the number of leucocytes correlated negatively with the number of CFU-GM (P < 0.05). The longer the time of chemotherapy, the less the CFU-GM that in the same patients. After chemotherapy the CD34+ cells which appeared early might not form CFU-GM, but the CD34+ cells at the recovery phase of peripheral hemogram had the same trend of change with CFU-GM.

Adolescent↗
PubMed2000

The influence of maternal exercise on placental blood flow measured by Simultaneous Multigate Spectral Doppler Imaging (SM-SDI)

OBJECTIVE: To evaluate the effect of maternal isometric exercise on the placental blood flow as reflected by the velocimetric indices PI and RI derived from placental arteries. SUBJECTS: Thirty-four healthy women with normal singleton pregnancies between 22 and 35 weeks of gestation. METHODS: All subjects underwent an isometric handgrip exercise test. Maternal blood pressure and heart rate together with placental PI and RI were measured at rest, during the exercise and in the post-exercise recovery phase. All Doppler measurements were obtained using the Simultaneous Multigate Spectral Doppler Imaging (SM-SDI) technique, a new ultrasound modality that enables a Doppler study of multiple locations to take place within a very short time. RESULTS: There was a significant increase in the mean values of the maternal blood pressure and heart rate during the exercise and a significant decline in the recovery phase. There was no significant change in the mean values of the Doppler indices throughout the examination. CONCLUSION: Isometric handgrip exercise test during pregnancy does not affect the impedance of the placental circulation.

Adult↗
PubMed1994

Transient erythroblastopenia of childhood. Prospective study of fifty patients.

PURPOSE: To prospectively evaluate 50 patients with transient erythroblastopenia of childhood (TEC) at a single institution in order to compare those patients presenting with reticulocytopenia (group I) with those presenting in the recovery phase with reticulocytosis (group II); to further describe the clinical course of this common pediatric hematological disorder in a large number of patients, particularly the effect on the neutrophils; and to review the available literature regarding this disorder. PATIENTS AND METHODS: Fifty patients presenting to the Children's Hospital from September 1983 to September 1991 were prospectively evaluated. Those patients with a reticulocytosis and in recovery at the time of diagnosis were included and compared with those with reticulocytopenia. All patients were followed through complete recovery. RESULTS: Thirty-six patients were reticulocytopenic (group I) and 14 had a reticulocytosis (group II). There was a high incidence of neutropenia (64%) in both groups and the resolution of this neutropenia was variable in relation to the resolution of the anemia, with 44% having the lowest ANC before, 9% simultaneous with, and 47% after the peak reticulocyte count. CONCLUSIONS: Our experience with a large group of patients with TEC suggests that neutropenia is an integral part of this disorder, and its recovery has no relation to the recovery of the anemia. A significant number of patients are described in the recovery phase for the first time, and this clarifies this group of patients in order to aid in their diagnosis, particularly in the differentiation from a hemolytic process. Some previously described associations of TEC are not supported in this study of a large number of patients.

Child, Preschool↗
PubMed1996

Role of endogenous and exogenous cholecystokinin in experimental acute pancreatitis induced in rats by the duodenal loop technique.

The role of endogenous cholecystokinin (CCK) release and exogenous CCK-8 administration in the development and progression of acute pancreatitis and in the early recovery phase of acute pancreatitis were investigated in rats with closed duodenal loop (CDL)-induced pancreatitis. The subcutaneous injection of CCK-8 (2 micrograms/kg) stimulated a physiological level of pancreatic enzyme secretion in normal control rats, but did not lead to any biochemical or histological evidence of acute pancreatitis. A higher dose of CCK-8 (8 micrograms/kg), however, did produce both biochemical and histological evidence of acute pancreatitis in the normal control rats. When 2 micrograms/kg of CCK-8 was injected subcutaneously in rats 6 and 12 h after the creation of the CDL, neither the biochemical nor the histological findings of acute pancreatitis showed any progression compared with the changes in controls given no CCK-8. Serum CCK levels, measured by radio-immunoassay, increased significantly from mean levels of 5.39 pg/ml (+/- 0.95 SD) before creation of the CDL to 42.06 pg/ml (+/- 2.27 SD) 6 h after, and 41.95 pg/ml (+/- 1.88 SD) 12 h after its creation (P < 0.01). The difference between serum CCK levels at 6 and 12 h was not statistically significant. Following the release of the loop, serum CCK levels decreased gradually, especially in rats in which the loop was released 6 h after being created. Although no marked biochemical and histological changes of acute pancreatitis were observed following the administration of 2 micrograms/kg of CCK-8 to rats upon release of the loop 6 h and 12 h after its creation, a higher dose of CCK-8 (8 micrograms/kg) in these rats adversely affected both the biochemical and histological findings of acute pancreatitis. Based on these findings, it was concluded that neither endogenous CCK release, as a result of the CDL, nor physiological stimulation of the pancreas by exogenous CCK-8 administration, caused progression from edematous to hemorrhagic acute pancreatitis, and neither CCK treatment had any adverse effect on the early recovery phase of CDL-induced acute pancreatitis. A pharmacological dose of CCK, however, exacerbated the acute pancreatitis, even in the early recovery stage.

Acute Disease↗
PubMed1999

Hyperreflexia in Guillain-Barré syndrome: relation with acute motor axonal neuropathy and anti-GM1 antibody.

OBJECTIVES: To investigate the incidence of hyperreflexia in patients with Guillain-Barré syndrome (GBS), and its relation with electrodiagnosis of acute motor axonal neuropathy (AMAN), antiganglioside GM1 antibody, and Campylobacter jejuni infection. It was reported that patients with AMAN in northern China often had hyperreflexia in the recovery phase. METHODS: In 54 consecutive Japanese patients with GBS, sequential findings of tendon reflexes were reviewed. By electrodiagnostic criteria, patients were classified as having AMAN or acute inflammatory demyelinating polyneuropathy (AIDP). Anti-GM1 and anti-C jejuni antibodies were measured by enzyme linked immunosorbent assays. RESULTS: Seven (13%) patients developed hyperreflexia with the spread of the myotatic reflex to other segments in the early recovery phase, one of whom already had hyperreflexia in the acute progressive phase. Of the seven patients, six had AMAN and all seven had anti-GM1 antibodies, whereas only two had anti-C jejuni antibodies. Hyperreflexia was more often found in patients with AMAN than AIDP (6/23 v 1/18, p=0. 002), and in patients with anti-GM1 antibodies than without them (7/26 v 0/28, p=0.01). Hyperreflexic patients had milder peak disabilities than patients without hyperreflexia (p=0.03). Increased motor neuron excitability in the hyperreflexic patients was supported by increased soleus H-reflex amplitudes and the appearance of H-reflexes in the small hand or foot muscles. CONCLUSIONS: Hyperreflexia often occurs in patients with GBS especially with AMAN, anti-GM1 antibodies, and milder disease. Increased motor neuron excitability further characterises the subgroup of patients with GBS with AMAN and anti-GM1 antibodies.

Acute Disease↗