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Evaluation of ovarian and adrenal sources of androgens in women with polycystic ovary syndrome. Dexamethasone and GnRH-agonist administration.

Ovarian and adrenal production of androgens was evaluated in 18 patients with polycystic ovary syndrome (PCOS) by administering a combination of short-term dexamethasone (DEX) and long-term gonadotropin-releasing hormone agonist (GnRH-A). At day 6 of the cycle, blood samples were collected at 7 A.M. (basal) and 11 P.M. At midnight, 2 mg DEX was given orally, and blood samples were collected at 7 A.M. the following day (DEX1). Blood samples were obtained for 6 weeks at the same time after administration of a potent GnRH-A (400 micrograms/day given subcutaneously). Eight normal subjects served as controls. The amounts of androgens and 17-hydroxyprogesterone (17-OHP) suppressed by using DEX (adrenal-source suppression) and GnRH-A (ovarian-source suppression) were greater in PCOS patients than in controls. We differentiated PCOS patients as having a normal or an exaggerated response to DEX or GnRH-A administration; threshold values were considered average +2SD of the suppressed androgen amounts of controls. Three patients had an exaggerated response to GnRH-A treatment for androstenedione, testosterone and 17-OHP, while DEX inhibition was similar to controls. The remaining 15 patients had an exaggerated response to DEX for all three androgens; seven also had an exaggerated response to GnRH-A. Thus, the combination of GnRH-A and DEX permitted us to selectively study and identify adrenal and ovarian sources of hyperandrogenemia.

Adrenal Glands↗

Discharge characteristics of medial rectus and abducens motoneurons in the goldfish.

1. The discharge of antidromically identified medial rectus and abducens motoneurons was recorded in restrained unanesthesized goldfish during spontaneous eye movements and in response to vestibular and optokinetic stimulation. 2. All medial rectus and abducens motoneurons exhibited a similar discharge pattern. A burst of spikes accompanied spontaneous saccades and fast phases during vestibular and optokinetic nystagmus in the ON-direction. Firing rate decreased for the same eye movements in the OFF-direction. All units showed a steady firing rate proportional to eye position beyond their recruitment threshold. 3. Motoneuronal position (ks) and velocity (rs) sensitivity for spontaneous eye movements were calculated from the slope of the rate-position and rate-velocity linear regression lines, respectively. The averaged ks and rs values of medial rectus motoneurons were higher than those of abducens motoneurons. The differences in motoneuronal sensitivity coupled with structural variations in the lateral versus the medial rectus muscle suggest that symmetric nasal and temporal eye movements are preserved by different motor unit composition. Although the abducens nucleus consists of distinct rostral and caudal subgroups, mean ks and rs values were not significantly different between the two populations. 4. Every abducens and medial rectus motoneuron fired an intense burst of spikes during its corresponding temporal or nasal activation phase of the "eye blink." This eye movement consisted of a sequential, rather than a synergic, contraction of both vertical and horizontal extraocular muscles. The eye blink could act neither as a protective reflex nor as a goal-directed eye movement because it could not be evoked in response to sensory stimuli. We propose a role for the blink in recentering eye position. 5. Motoneuronal firing rate after ON-directed saccades decreased exponentially before reaching the sustained discharge proportional to the new eye position. Time constants of the exponential decay ranged from 50 to 300 ms. Longer time constants after the saccade were associated with backward drifts of eye position and shorter time constants with onward drifts. These postsaccadic slide signals are suggested to encode the transition of eye position to the new steady level. 6. Motoneurons modulated sinusoidally in response to sinusoidal head rotation in the dark, but for a part of the cycle they went into cutoff, dependent on their eye position recruitment threshold. Eye position (kv) and velocity (rv) sensitivity during vestibular stimulation were measured at frequencies between 1/16 and 2 Hz. Motoneuronal time constants (tau v = rv/kv) decreased on the average by 25% with the frequency of vestibular stimulation.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

[Role of ion channel Na-K-2Cl and alpha2 Na, K-ATPase in cochlear potassium cycling and auditory function].

OBJECTIVE: To investigate the auditory function and the role of NKCC1 and alpha2 Na, K-ATPase in the potassium recycling of cochlea. METHODS: NKCC1(+/-) / alpha2 Na, K-ATPase(+/-) mice model was established from NKCC1(+/-) and alpha2 Na, K-ATPase(+/-) mice. The auditory function of all strain mice were detected by auditory brainstem response (ABR) and endocochlear potential (EP) to investigate the role of NKCC1 and alpha2 Na, K-ATPase in the potassium recycling of cochlea. Furosemide and ouabain were applied to block the two channels in Castel mice line which can long-time maintain normal auditory function and then their auditory function was detected by ABR to authenticate the mode of potassium recycling in vivo and the relationship between cochlear potassium recycling and NKCC1(+/-) and alpha2 Na, K-ATPase. RESULTS: The mean value for ABR thresholds in response to stimulus was elevated in NKCC1(+/-) and alpha2 Na, K-ATPase (+/-) mice [(38.49 +/- 12.29) dB and (53.32 +/- 7.62) dB) ] respectively, which was significantly increased compared with that observed in wild type mice [(23.13 +/- 3.78) dB, P < 0.05) ]; The EP value of NKCC1(+/-) [(78 +/- 7) mV] and alpha2 Na, K-ATPase(+/-) mice [(71 +/- 14) mV] was decreased compared with that of NKCC1(+/-) / alpha2 Na, K-ATPase(+/-) mice [( 86 +/- 11) mV]. The auditory function of NKCC1(+/-) / alpha2 Na, K-ATPase(+/-) mice could simulate the model of cochlear potassium recycling well. NKCC1 and Na, K-ATPase were great of importance in the potassium recycling, while the two ion channels were in restrict dynamic equilibrium. Castel mice line after administration with furosemide developed significant ABR threshold shifts (P < 0.05) compared with control group. Castel mice line after administration with ouabain also developed greatly significant ABR threshold shifts (P < 0.05) compared with control group. ABR threshold shifts in mice after administration both furosemide and ouabain was attenuated compared with only administration with furosemide (P < 0.01). CONCLUSIONS: Ion channel NKCC1 and alpha2 Na, K-ATPase played important roles in the inner ear potassium recycling. Dysfunction of either of them could influence potassium concentration in the endolymph and lead to hearing loss subsequently. The role of NKCC1 and alpha2 Na, K-ATPase in cochlear potassium recycling was authenticated in vivo. The two ion channels contribute the key role for dynamic equilibrium in cochlear potassium recycling and are of great importance for the metabolism of potassium in the inner ear to maintain the normal auditory function.

Animals↗

Effects of lidocaine on relation between defibrillation threshold and upper limit of vulnerability in open-chest dogs.

BACKGROUND: The purpose of the present study was to test the effects of lidocaine on the relation between the defibrillation threshold and the upper limit of vulnerability. METHODS AND RESULTS: The shock strength associated with a 50% probability of successful defibrillation (DFT50) and the shock strength associated with a 50% probability of reaching the upper limit of vulnerability (ULV50) were determined in 11 open-chest dogs by using the delayed up-down method before and during lidocaine (seven dogs) or normal saline (four dogs) infusion. The ventricles were paced at a cycle length of 300 msec. Shocks of various strengths were then given via a patch-patch electrode configuration on the anterior and posterior surfaces of the ventricle to determine the ULV50. Once ventricular fibrillation was induced, shocks were given 15-20 seconds later via the same electrode configuration to determine the DFT50. Lidocaine infusion resulted in a serum level of 15 +/- 4 micrograms/ml. This was associated with a lengthening of the QT interval but not with the widening of the QRS complex. In all dogs, both the ULV50 and the DFT50 increased significantly when tested during lidocaine infusion. Mean ULV50 during lidocaine infusion was 496 +/- 70 V or 13.1 +/- 4.3 J, which were significantly higher than the baseline values of 333 +/- 67 V or 5.3 +/- 2.2 J (p less than 0.001 for both voltage and energy). Mean DFT50 during lidocaine infusion was 407 +/- 41 V or 8.7 +/- 1.7 J, which were significantly higher than the baseline values of 300 +/- 38 V and 4.4 +/- 1.1 J (p = 0.004 for voltage and p = 0.013 for energy). The r values between the ULV50 and the DFT50 were 0.79 (p = 0.037) for voltage and 0.80 (p = 0.030) for energy at baseline and 0.85 (p = 0.016) for voltage and 0.88 (p = 0.009) for energy during the lidocaine infusion. However, the increments of the ULV50 (163 +/- 88 V or 7.8 +/- 4.6 J) were significantly greater than the increments of the DFT50 (107 +/- 51 V or 4.4 +/- 1.9 J, p = 0.035 for voltage and p = 0.023 for energy). Normal saline infusion did not alter DFT50 or ULV50. CONCLUSIONS: Lidocaine infusion significantly increases both ULV50 and DFT50. These results are compatible with the upper limit of vulnerability hypothesis of defibrillation. However, the greater increase of the upper limit of vulnerability than the defibrillation threshold with lidocaine infusion indicates that other factors may also need to be considered to explain the results.

Algorithms↗

Mathematical analysis of the changes in the parameters of the action potentials, membrane and ionic currents of frog muscle fibre during the recovery cycle.

The method of mathematical modelling was used to study the excitability changes of the membrane of a frog skeletal muscle fibre and the parameters of the action potentials, membrane and ionic currents during the first 30 ms of the recovery cycle. The threshold current for a fibre at rest was found to be 0.32 microA and the durations of the absolute and relative refractory periods were respectively 4 ms and 5.2 ms. With increasing interpulse interval, the subnormality of the membrane excitability is followed by supernormality. Under the same condition the supernormality in the velocity recovery cycle is not obtained. In the recovery cycle, the shape (polarity, sequence and number of phases) of the action potentials, of the membrane and ionic currents and their conductances, are unchanged. Only the time and amplitude parameters of the quantities listed above are known to vary. With increasing the interpulse interval, the amplitudes of the quantities increase and their durations are shortened attaining the values of the corresponding quantities of the initial action potential. The membrane properties are recovered 30 ms after application of the initial pulse, but the supernormality of the excitability is still preserved.

Action Potentials↗

Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shock.

STUDY OBJECTIVE: To investigate whether the respiratory changes in peak velocity (Vpeak) of aortic blood flow could be related to the effects of volume expansion on cardiac index. DESIGN: Prospective clinical study. SETTING: Medical ICUs of a university hospital (20 beds) and of a nonuniversity hospital (15 beds). PATIENTS: Nineteen sedated septic shock patients who were receiving mechanical ventilation and who had preserved left ventricular (LV) systolic function. INTERVENTION: Volume expansion. MEASUREMENTS AND RESULTS: Analysis of aortic blood flow by transesophageal echocardiography allowed beat-to-beat measurement of Vpeak before and after volume expansion. Maximum values of Vpeak (Vpeakmax) and minimum values of Vpeak (Vpeakmin) were determined over one respiratory cycle. The respiratory changes in Vpeak (Delta Vpeak) were calculated as the difference between Vpeakmax and Vpeakmin divided by the mean of the two values and were expressed as a percentage. The indexed LV end-diastolic area (EDAI) and cardiac index were obtained at the end of the expiratory period. The volume expansion-induced increase in cardiac index was > or = 15% in 10 patients (responders) and < 15% in 9 patients (nonresponders). Before volume expansion, Delta Vpeak was higher in responders than in nonresponders (20 +/- 6% vs 10 +/- 3%; p < 0.01), while EDAI was not significantly different between the two groups (9.7 +/- 3.7 vs 9.7 +/- 2.4 cm(2)/m(2)). Before volume expansion, a Delta Vpeak threshold value of 12% allowed discrimination between responders and nonresponders with a sensitivity of 100% and a specificity of 89%. Volume expansion-induced changes in cardiac index closely correlated with the Delta Vpeak before volume expansion (r(2) = 0.83; p < 0.001). CONCLUSION: Analysis of respiratory changes in aortic blood velocity is an accurate method for predicting the hemodynamic effects of volume expansion in septic shock patients receiving mechanical ventilation who have preserved LV systolic function.

Aorta, Thoracic↗

Plasma levels on nociceptin in female fibromyalgia syndrome patients.

Fibromyalgia syndrome (FMS) is a frequent pain disorder in women. The pathophysiologic mechanism behind this disorder is still unexplained; however, alterations in both monoamines, neuropeptides and in the stress axis have been found. This study was designed to determine the levels of the newly discovered neuropeptide nociceptin in hormonally different FMS patients and corresponding controls. The results showed that the nociceptin concentrations of the patients were lower than in controls. It also showed decreased levels with significant differences between the cyclic patients in the luteal phase of the menstrual cycle, compared to the corresponding controls. Our results suggest that the perturbed nociceptin concentrations of the FMS patients may be linked to both the sex hormones and to the stress system and that these changes might be one of several possible pathophysiologic mechanisms involved in the FMS.

Adult↗

Higher CD4+ T cell counts associated with low viral pol replication capacity among treatment-naive adults in early HIV-1 infection.

BACKGROUND: Infection with primary drug-resistant human immunodeficiency virus type 1 (HIV-1) has been associated with higher CD4(+) T cell counts in drug-naive patients, suggesting that altered viral pol replication capacity (RC) associated with drug resistance diminishes immune injury in vivo, independent of exposure to drugs. METHODS: Virus replication over a single cycle was measured by use of a viral test vector containing patient-derived HIV-1 protease and reverse transcriptase gene segments. RESULTS: Among 191 recently infected patients, pol RC ranged widely, with only 6% of the variance explained by drug-resistance mutations. Patients infected with a virus with a low pol RC (</=43% of the reference virus) had significantly higher CD4(+) T cell counts at study entry, independent of drug resistance and plasma HIV-1 RNA level, and over time, both before and during combination antiretroviral therapy. CONCLUSIONS: Viral pol RC may influence HIV-1 disease progression by affecting the amount and tissue distribution of viral replication. The pol RC value of 43% may represent a threshold below which HIV-1 has lowered virulence and is less able to deplete CD4(+) T cell counts.

Adult↗

Estimation of the lactate threshold from heart rate response to submaximal exercise: the pulse deficit.

In this study, we evaluated the validity of a sharp increase in pulse deficit (PD) as a noninvasive index for estimation of the first lactate threshold (LT (1)) in healthy individuals with various levels of aerobic fitness. Three groups of healthy male subjects participated in the study: 15 sedentary individuals, 14 students of physical education, and 13 competitive athletes. Each subject performed a maximal incremental exercise test on the cycle ergometer for the determination of the LT (1), the second lactate threshold, and peak power output. On different days, subjects performed several 8-min bouts of constant-load exercise on the cycle ergometer, corresponding to each of the power outputs of the maximal test, to evaluate PD, which was calculated as the total number of heart beats of the last 4 min minus the total number of heart beats in the first 4 min of exercise. The three groups presented similar blood lactate, heart rate and pulse deficit responses to exercise. For the first power output up to the LT (1), PD showed no significant changes. For the three groups, a sharp increase in PD was seen at the intensity immediately above LT (1). There was a significant correlation between PD and blood lactate changes from the rest to 4th min of submaximal exercise (r = 0.83, p < 0.05). The power output before a sharp increase in PD detected during constant-load exercise (112 +/- 38 W) and the power output corresponding to the LT (1) detected during the incremental test (111 +/- 37 W, p = 0.323) were similar and strongly correlated (r = 0.99, p = 0.0001). The absolute cut-point value of 25 beats for PD had a sensitivity of 100 %, a specificity of 95 %, and a positive predictive value of 90 % for the detection of LT (1). The determination of PD provides an accurate noninvasive estimate of the LT (1) in healthy young men with different levels of fitness. One 8-min submaximal exercise bout can establish if an individual is exercising above or below the LT (1).

Adult↗

Dynamic behavior of a neural network model of locomotor control in the lamprey.

1. Experimental studies have shown that a central pattern generator in the spinal cord of the lamprey can produce the basic rhythm for locomotion. This pattern generator interacts with the reticular neurons forming a spinoreticulospinal loop. To better understand and investigate the mechanisms for locomotor pattern generation in the lamprey, we examine the dynamic behavior of a simplified neural network model representing a unit spinal pattern generator (uPG) and its interaction with the reticular system. We use the techniques of bifurcation analysis and specifically examine the effects on the dynamic behavior of the system of 1) changing tonic drives to the different neurons of the uPG; 2) altering inhibitory and excitatory interconnection strengths among the uPG neurons; and 3) feedforward-feedback interactions between the uPG and the reticular neurons. 2. The model analyzed is a qualitative left-right symmetric network based on proposed functional architecture with one class of phasic reticular neurons and three classes of uPG neurons: excitatory (E), lateral (L), and crossed (C) interneurons. In the model each class is represented by one left and one right neuron. Each neuron has basic passive properties akin to biophysical neurons and receives tonic synaptic drive and weighted synaptic input from other connecting neurons. The neuron's output as a function of voltage is given by a nonlinear function with a strict threshold and saturation. 3. With an appropriate set of parameter values, the voltage of each neuron can oscillate periodically with phase relationships among the different neurons that are qualitatively similar to those observed experimentally. The uPG alone can also oscillate, as observed experimentally in isolated lamprey spinal cords. Varying the parameters can, however, profoundly change the state of the system via different kinds of bifurcations. Change in a single parameter can move the system from nonoscillatory to oscillatory states via different kinds of bifurcations. For some parameter values the system can also exhibit multistable behavior (e.g., an oscillatory state and a nonoscillatory state). The analysis also shows us how the amplitudes of the oscillations vary and the periods of limit cycles change as different bifurcation points are approached. 4. Altering tonic drive to just one class of uPG neurons (without altering the interconnections) can change the state of the system by altering the stability of fixed points, converting fixed points to oscillations, single oscillations to two stable oscillations, etc. Two-parameter bifurcation diagrams show the critical regions in which a balance between the tonic drives is necessary to maintain stable oscillations. A minimum tonic drive is necessary to obtain stable oscillatory output. With appropriate changes in the tonic drives to the L and C neurons, stable oscillatory output can be obtained even after eliminating the E neurons. Indeed, the presence of active E neurons in the biological system does not prove they play a functional role in the system, because tonic drive from other sources can substitute for them. On the other hand, very high excitation of any one class of neurons can terminate oscillations. Appropriate balance of tonic drives to different neuron classes can help sustain stable oscillations for larger tonic drives. Published experimental results concerning changes in amplitude and swimming frequency with increased tonic drives are mimicked by the model's responses to increased tonic drive. 5. Interconnectivity among the neurons plays a crucial role. The analysis indicates that the C and L classes of neurons are essential components of the model network. Sufficient inhibition from the L to C neurons as well as mutual inhibition between the left and right halves is necessary to obtain stable oscillatory output. When the E neurons are present in the model network, they must receive appropriate tonic drive and provide appropriate excitation

Animals↗

Gustatory and food habit changes during the menstrual cycle.

Gustatory and food habit changes during the menstrual cycle were studied in 8 women, 6 smokers and 2 non-smokers, aged 23-37 years. The following parameters were evaluated during three consecutive menstrual cycles: blood oestradiol and progesterone levels on the 7th, 14th and 21st day of each cycle (radioimmunoassay); detection and recognition thresholds and concentration preferences for sucrose, sodium chloride, citric acid and quinine sulphate on the 1st, 7th, 14th and 21st day of each cycle; food consumption (weighed record) on days 1 and 2, 6-8, 13-15 and 20-22 each cycle. The four basic tastes were influenced differently by blood hormone levels during the menstrual cycle. Sensitivity to sweet taste increased with an increase of oestradiol, while sensitivity to bitter taste increased with an increase of progesterone. No correlations between hormone levels and acid taste, and only a few correlations for salt taste were found. Food habits changed during the cycle particularly for meat and fruit. Vegetables and cereals showed only a tendency to vary. In correspondence with the highest oestradiol values there was a tendency towards lower energy intake, -122 kcal (-0.51 MJ) = 8%, predominantly provided by carbohydrates (as bread).

Adult↗

Bilateral deficit during short-term, high-intensity cycle ergometry in girls and boys.

Peak torque during an isokinetic bilateral knee extension or flexion is usually lower than the summed peak torque of two unilateral contractions, and this phenomenon is designated as bilateral deficit (BD). The objectives of this study were to determine whether a BD also exists for more complex, alternating movements (e.g., short-term, high-intensity cycling), and to assess the possible effects of gender and maturity. Forty children and adolescents performed two unilateral (ULWAnT) and one bilateral Wingate anaerobic test (BLWAnT). The highest power reached in any 3-s interval (peak power; PP), and the total mechanical work (TMW) performed during the test was determined. Individual BD for PP (BDpp, %) was calculated by dividing the PP in the BLWAnT by the sum of the PP values of both ULWAnTs. The BD for TMW (BDTMw) was calculated in the same way. The sum of PP generated during the two ULWAnTs was larger than the PP measured in the BLWAnT (P<0.000001). The same difference was observed for TMW (P<0.0001). Maturity did not affect the BDpp or BDTMW (P=0.34). However, the BD was more pronounced in females compared to males (P= 0.03). In conclusion, a BD is evident during cycling exercise.

Adolescent↗

Relationship between inner-ear fluid pressure and semicircular canal afferent nerve discharge.

The present study was designed to determine (1) the transcupular fluid pressure (deltaP) generated across the semicircular canal cupula in response to sinusoidal head rotation, (2) the translabyrinthine dilational pressure (P0) generated across the membranous labyrinth in response to an increase in endolymph fluid volume (hydrops), (3) afferent nerve discharge patterns generated by these distinct pressure stimuli and, (4) threshold values of deltaP and P0 required to elicit afferent neural responses. The experimental model was the oyster toadfish, Opsanus tau. Micromechanical indentation of the horizontal canal (HC) duct and utricular vestibule was used to simulate sinusoidal head rotation and fluid volume injection. Single-unit neural spike trains and endolymph pressure within the ampulla, on both sides of the cupula, were recorded simultaneously. deltaP averaged 0.013 Pa per 1 degrees/s of sinusoidal angular head velocity and P0 averaged 0.2 Pa per 1 nL of endolymph volume injection. The most responsive afferents had a threshold sensitivity to deltaP of 10(-3) Pa and to P0 of 5 x 10(-2) Pa based on a discharge modulation criterion of 1 impulse/s per cycle for 2 Hz pressure stimuli. Neural sensitivity to AP was expected on the basis of transverse cupular and hair bundle deflections. Analysis of mechanics of the end organ, neuronal projections into the crista, and individual neural firing patterns indicates that P0 sensitivity resulted from pressure-induced distension of the ampulla that led to a nonuniform cupular deformation pattern and hair bundle deflections. This explanation is consistent with predictions of a finite element model of the end organ. Results have implications regarding the role of deltaP in angular motion transduction and the role of P0 under transient hydropic conditions.

Action Potentials↗

Evidence for an intramuscular ventilatory stimulus during dynamic exercise in man.

During incremental work rate exercise, ventilation (VE) typically increases in proportion to the metabolic rate until the onset of a progressive metabolic acidemia induces an additional compensatory hyperpnea. We examined the control characteristics of this compensatory mechanism in seven healthy subjects performing incremental cycle ergometry to their limit of tolerance at different levels of lower-body positive pressure (LBPP) at 0, 15, 30, and 45 Torr in order to determine if LBPP could alter the occurrence of the ventilatory threshold. Ventilatory responses and pulmonary gas exchange variables were measured breath-by-breath while 'arterialized'-venous blood was sampled from the dorsum of the heated hand for determination of [lactate], pH, and [K+]. The ventilatory threshold was progressively reduced with increasing levels of LBPP: Ventilatory threshold = 2.33-(0.0173.LBPP); (r2 = 0.59, P < 0.001). Ventilatory equivalents for oxygen (VE/VO2) and carbon dioxide (VE/VCO2) were systematically elevated at work rates above 50 W by increases in respiratory frequency which also resulted in lower PETCO2 and higher PETO2 values. As [lactate] was only slightly elevated above control (delta lactate < 1 mEq.L-1) while pH and [K+] were unchanged, it seems unlikely that the LBPP-induced hyperpnea can be attributed to activation of peripheral arterial or central chemoreceptors. These findings suggest a ventilatory stimulus may be generated by an LBPP-induced reduction in perfusion with the subsequent accumulation of intramuscular metabolites at the working limb and/or a direct effect of increased intramuscular tissue pressure.

Adult↗

Central regulation of motor cortex neuronal responses to forelimb nerve inputs during precision walking in the cat.

1. The responses of neurones in forelimb motor cortex to impulse volleys evoked by single pulse electrical stimulation (at 1.5 or 2 times the threshold for most excitable nerve fibres) of the superficial radial (SR) and ulnar (UL) nerves of the contralateral forelimb were studied in awake cats both resting quietly and walking on a horizontal ladder. Nerve volley amplitude was monitored by recording the compound action potential elicited by the stimulus. 2. In the resting animal 34/82 (41%) cells yielded statistically significant responses to SR stimulation, and 20/72 (28%) responded to UL stimulation. Some responses were confined to or began with an increase in firing probability ('excitatory' responses) and others with a decrease in firing ('inhibitory' responses), typically including a brief interruption of the spike train (zero rate). Cells responding to both nerves usually yielded responses similar in type. Most (78%) response onset latencies were less than 30 ms. Responses involved the addition or subtraction of from 3.4 to 0.1 impulses stimulus-1 (most <1 impulse stimulus-1). The distribution of response sizes was continuous down to the smallest values, i.e. there was no 'gap' which would represent a clear separation into 'responsive' and 'unresponsive' categories. Responses were commonest in the lateral part of the pericruciate cortex, and commoner among pyramidal tract neurones (PTNs) than non-PTNs. 3. During ladder walking most cells generated a rhythmic step-related discharge; in assessing the size of responses to nerve stimulation (20 studied, from 13 cells) this activity was first subtracted. Response onset latencies (90% <30 ms) and durations showed little or no change. Although most cells were overall more active than during rest both 'excitatory' and 'inhibitory' responses in both PTNs and non-PTNs were often markedly reduced in large parts of the step cycle; over some (usually brief) parts responses approached or exceeded their size during rest, i.e. response size was step phase dependent. Such variations occurred without parallel change in the nerve compound action potential, nor were they correlated with the level of background firing at the time that the response was evoked. When responses to both nerves were studied in the same neurone they differed in their patterns of phase dependence. 4. The findings are interpreted as evidence for central mechanisms that, during 'skilled', cortically controlled walking, powerfully regulate the excitability of the somatic afferent paths from forelimb mechanoreceptors (including low threshold cutaneous receptors) to motor cortex. Retention (or enhancement) of responsiveness often occurred (especially for ulnar nerve) around footfall, perhaps reflecting a behavioural requirement for sensory input signalling the quality of the contact established with the restricted surface available for support.

Animals↗

Gas exchange responses to continuous incremental cycle ergometry exercise in primary pulmonary hypertension in humans.

In patients suffering from primary pulmonary hypertension (PPH), a raised pulmonary vascular resistance may limit the ability to increase pulmonary blood flow as work rate increases. We hypothesised that oxygen uptake (VO2) may not rise appropriately with increasing work rate during incremental cardiopulmonary exercise tests. Nine PPH patients and nine normal subjects performed symptom-limited maximal continuous incremental cycle ergometry exercise. Mean peak VO2 [1.00 (SD 0.22) compared to 2.58 (SD 0.64) l x min(-1)] and mean VO2 at lactic acidosis threshold [LAT, 0.73 (SD 0.17) compared to 1.46 (SD 0.21 x 1) ml x min(-1)] were much lower in patients than in normal subjects (both P<0.01, two-way ANOVA with Tukey test). The mean rate of change of VO2 with increasing work rate above the LAT [5.9 (SD 2.1) compared to 9.4 (SD 1.3) ml x min(-1) x W(-1), p<0.01)] was also much lower in patients than in normal subjects [apparent delta efficiency 60.3 (SD 38.8)% in patients compared to 31.0 (SD 4.9)% in normal subjects]. The patients displayed lower mean values of end-tidal partial pressure of carbon dioxide than the normal subjects at peak exercise [29.7 (SD 6.8) compared to 42.4 (SD 5.8) mm Hg, P<0.01] and mean oxyhaemoglobin saturation [89.1 (SD 4.1) compared to 93.6 (SD 1.8)%, P<0.05]. Mean ventilatory equivalents for CO2 [49.3 (SD 11.4) compared to 35.0 (SD 7.3), P<0.05] and O2 [44.2 (SD 10.7) compared to 29.9 (SD 5.1), P<0.05] were greater in patients than normal subjects. The sub-normal slopes for the VO2-work-rate relationship above the LAT indicated severe impairment of the circulatory response to exercise in patients with PPH. The ventilatory abnormalities in PPH suggested that the lung had become an inefficient gas exchange organ because of impaired perfusion of the ventilated lung.

Acidosis, Lactic↗

Comprehensive algorithm for quantitative real-time polymerase chain reaction.

Quantitative real-time polymerase chain reactions (qRT-PCR) have become the method of choice for rapid, sensitive, quantitative comparison of RNA transcript abundance. Useful data from this method depend on fitting data to theoretical curves that allow computation of mRNA levels. Calculating accurate mRNA levels requires important parameters such as reaction efficiency and the fractional cycle number at threshold (CT) to be used; however, many algorithms currently in use estimate these important parameters. Here we describe an objective method for quantifying qRT-PCR results using calculations based on the kinetics of individual PCR reactions without the need of the standard curve, independent of any assumptions or subjective judgments which allow direct calculation of efficiency and CT. We use a four-parameter logistic model to fit the raw fluorescence data as a function of PCR cycles to identify the exponential phase of the reaction. Next, we use a three-parameter simple exponent model to fit the exponential phase using an iterative nonlinear regression algorithm. Within the exponential portion of the curve, our technique automatically identifies candidate regression values using the P-value of regression and then uses a weighted average to compute a final efficiency for quantification. For CT determination, we chose the first positive second derivative maximum from the logistic model. This algorithm provides an objective and noise-resistant method for quantification of qRT-PCR results that is independent of the specific equipment used to perform PCR reactions.

Algorithms↗

A dual electrophysiologic test for atrial antireentry and ventricular antifibrillatory studies. Effects of bethanidine, procainamide, and WY-48986.

We have developed a dual electrophysiologic test that allows measurement of both antireentry and antifibrillatory activities of potential antiarrhythmics in the same anesthetized dog. The reentry portion of the model was created surgically by a Y-shaped crushing around the tissue between the superior and inferior vena cava and tissue parallel to the AV groove. The pacing-induced tachycardia that results from circus movements around the tricuspid ring is very persistent in duration and regular in cycle length. The antifibrillatory activities were assessed by determination of the ventricular fibrillation threshold (VFT) using train-stimuli method. Control VFT was measured every 15-20 min in duplicate and followed by induction of atrial reentry. A drug was infused to intervene the atrial tachycardia. After the conversion of the arrhythmia (either by drug regimens or pacing), postdrug VFT was measured, again in duplicate. Bethanidine (20 mg/kg), procainamide (30 mg/kg), and WY-48986 (10 mg/kg), a Class III antiarrhythmic, were evaluated in this dual test. Bethanidine and procainamide prolonged the cycle length of atrial reentry to a greater extent than WY-48986. The atrial arrhythmias were consistently terminated by procainamide and WY-48986 whereas bethanidine converted the tachycardias in one of the five dogs studied. All three agents elevated VFT with bethanidine producing higher values than procainamide and WY-48986. In conclusion, the dual electrophysiologic testing system offers both economic and scientific advantages for the study of modes of action of antiarrhythmic agents.

Animals↗