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Dynamic and steady-state ventilatory and gas exchange responses to arm exercise.

Previous studies have suggested that, for the same power output, arm exercise requires higher oxygen uptake (VO2), carbon dioxide output (VCO2), and ventilation (VE) than leg exercise and that response kinetics are slower. To evaluate these differences, four healthy subjects performed a total of 95 arm cranking tests. Each subject performed several tests at each of three or four power outputs spaced evenly below the maximum the subject could sustain (average = 53 W). Breath-by-breath responses to identical stimuli were averaged. End-exercise blood lactate was determined at each power output. Responses were compared to leg exercise responses in these subjects (J. Appl. Physiol. 67:547-555, 1989). For power outputs unassociated with lactic acidosis, differences between steady-state VO2, VCO2, and VE responses for arm and leg exercise were not significant. At higher power outputs, the higher VO2, VCO2, and VE during arm exercise were well correlated with higher lactate. For power outputs not engendering lactic acidosis, the time constants (tau) for VO2, VCO2 and VE were not greatly different for arm than for leg exercise. For each variable, at higher power outputs tau became longer by an amount correlated with higher lactate level. Like leg exercise, the slower kinetics of VO2 and VE (but not VCO2) at higher power outputs were well described as a superimposed slower component. We conclude that both dynamic and steady-state responses of VE and gas exchange to arm exercise do not differ substantially from those to leg exercise so long as the power output does not elevate blood lactate.

Adult↗

The use of arm vein conduits during infrageniculate arterial bypass.

To further examine the use of arm vein for bypass to the popliteal or infrapopliteal arteries, we retrospectively reviewed 43 patients undergoing infrageniculate arterial bypass by use of an arm vein as a conduit. Nine grafts were done to the below-knee popliteal artery and 34 to the infrapopliteal arteries. Six grafts were done by use of a single segment of an arm vein, whereas 37 grafts were composites of either multiple segments of arm vein (n = 19) or segments of saphenous and arm vein (n = 18). Mean follow-up time was 15 1/2 months. Initial (30-day) graft patency and limb salvage were 95%. Primary graft patency by life-table analysis was 67% at 1 year and 49% at 3 years. Follow-up examination detected graft stenosis before occlusion in six patients (all of whom were given anticoagulant medication) and three failing grafts were salvaged. This increased overall 3-year secondary graft patency to 64% and 3-year secondary patency for infrapopliteal bypasses to 66%. Eleven of 12 graft occlusions resulted in major amputations (eight were above the knee, and three were below the knee) so that limb salvage paralleled secondary graft patency (63% at 3 years). Thus arm veins provide an excellent alternative venous conduit for infrageniculate arterial bypass, even when composite venous grafts must be used.

Aged↗

Visuomotor transformations underlying arm movements toward visual targets: a neural network model of cerebral cortical operations.

We propose a biologically realistic neural network that computes coordinate transformations for the command of arm reaching movements in 3-D space. This model is consistent with anatomical and physiological data on the cortical areas involved in the command of these movements. Studies of the neuronal activity in the motor (Georgopoulos et al., 1986; Schwartz et al., 1988; Caminiti et al., 1990a) and premotor (Caminiti et al., 1990b, 1991) cortices of behaving monkeys have shown that the activity of individual arm-related neurons is broadly tuned around a preferred direction of movements in 3-D space. Recent data demonstrate that in both frontal areas (Caminiti et al., 1990a,b, 1991) these cell preferred directions rotate with the initial position of the arm. Furthermore, the rotation of the population of preferred directions precisely corresponds to the rotation of the arm in space. The neural network model computes the motor command by combining the visual information about movement trajectory with the kinesthetic information concerning the orientation of the arm in space. The appropriate combination, learned by the network from spontaneous movement, can be approximated by a bilinear operation that can be interpreted as a projection of the visual information on a reference frame that rotates with the arm. This bilinear combination implies that neural circuits converging on a single neuron in the motor and premotor cortices can learn and generalize the appropriate command in a 2-D subspace but not in the whole 3-D space. However, the uniform distribution of cell preferred directions in these frontal areas can explain the computation of the correct solution by a population of cortical neurons. The model is consistent with the existing neurophysiological data and predicts how visual and somatic information can be combined in the different processing steps of the visuomotor transformation subserving visual reaching.

Animals↗

Mid-arm circumference: an alternative measure for screening low birth weight babies.

Birth weight is a reliable and sensitive indicator for predicting the immediate or later outcome of a newborn child. In a developing country like Bangladesh, where more than 75% of deliveries occur in rural community and are mostly attended by Traditional Birth Attendants (TBA) or relatives, birth weight cannot be recorded mainly due to paucity of suitable weighing scale. To overcome the problem associated with weighing the newborn, it was considered justified to find out other simpler measurements that could be used as substitute of weighing, in order to identify low birth weight babies. A cross sectional, analytical, hospital based study was conducted at Dhaka city on 560 newborn babies born during a period of 18 months in 2000-2001 to examine relative validity of mid-arm circumference as a screening measure of low birth weight babies. Mid-arm circumference, length, head circumference, chest circumference, abdominal girth, and calf circumference were considered. The study showed a strong correlation (p < 0.001) between mid-arm circumference (r = 0.956) and birth weight, followed by calf circumference (r = 0.946) and birth weight. Other parameters were also strongly correlated (p < 0.001). The study showed that in identifying newborns of <2500 gm a mid-arm circumference of <9 cm had the best sensitivity (96.2%) and specificity (97.3%). A value of <8 cm and <6.8 cm for mid-arm circumference showed highest validity for picking up newborns weighing <2000 gm and <1500 gm respectively. Measurement of arm circumference is easier, convenient and statistically superior to other anthropometrical parameters in this work. The researchers recommend designing of simple 'Tri-colored tape' for early detection of 'At Risk' newborns in rural community for their timely management.

Anthropometry↗

Making arm movements within different parts of space: the premotor and motor cortical representation of a coordinate system for reaching to visual targets.

The activity of 156 individual arm-related neurons was studied in the premotor cortex (area 6) while monkeys made arm movements of similar directions within different parts of 3-dimensional space. This study was aimed at describing the relationship between premotor cortical cell activity and direction of arm movement and assessing the coordinate system underlying this relationship. We found that the activity of 152 (97.4%) cells varied in an orderly fashion with the direction of movement, in at least some region of the work space. Premotor cortical cells fired most for a given preferred direction and less for other directions of movement. These preferred directions covered the directional continuum in a uniform fashion across the work space. It was found that, as movements of similar directions were made within different parts of the work space, the cells' preferred directions changed their orientation. Although these changes had different magnitudes for different cells, at the population level, they followed closely the changes in orientation of the arm necessary to move the hand from one to another part of the work space. This shift of cells' preferred direction with the orientation of the arm in space has been observed with similar characteristics in the motor cortex (see Caminiti et al., 1990). In both premotor and motor cortices, neuronal movement population vectors provide a good description of movement direction. Unlike the individual cell preferred directions upon which they are based, movement population vectors did not change their spatial orientation across the work space, suggesting that they remain good predictors of movement direction regardless of the region of space in which movements are made. The firing frequency of both premotor and motor cortical neurons varied significantly with the position occupied by the hand in space. These static positional effects were observed in 88.5% of premotor and 91.8% of motor cortical cells. In a second task, monkeys made movements from differing origins to a common end point. This task was performed within 3 different parts of space and was aimed at dissociating movement direction from movement end point. It was found that in both premotor and motor cortices virtually all cells were related to the direction and not to the end point of movement. These data suggest that premotor and motor cortices use common mechanisms for coding arm movement direction. They also provide a basis for understanding the coordinate transformation required to move the hand toward visual targets in space.

Analysis of Variance↗

[Nutritional status of Indian children of Alto Xingu and evaluation of the use of arm perimeter in the diagnosis of protein-calorie malnutrition].

STUDY OBJECTIVE: The purpose of this study was to determine the presence of malnutrition in indian children of Alto Xingu region in Brazil, and to evaluate the usefulness of arm circumference and QUAC index in the diagnosis of protein-energy malnutrition (PEM). SITE: The indian population of Alto Xingu maintains most of its traditional customs. PATIENTS: 335 children were studied prospectively in at least one of seven consecutive years between 1974 and 1980, and 1278 measurements were obtained of weight, height, and arm circumference. MEASUREMENTS AND RESULTS: The annual prevalence of PEM (weight-for-height) less than 90% according to Brazilian reference tables was 4.1% in children aged under 1 year, 7.3% in children from 1 to 5 years of age, and 7.5% in children older than 5. According NCHS tables, however, values of 1.0%, 2.8%, and 1.1% were obtained for the respective age groups. The sensitivity and specificity of arm circumference and QUAC index were calculated in relation to the weight-for-height relation. According to Brazilian reference tables, arm circumference had a sensitivity of 8.9% and specificity of 99.3%, whereas the QUAC index had a sensitivity of 11.1% and specificity of 98.3%. However, according to NCHS tables, slightly different values were obtained. The sensitivity and specificity in this case were 23.5% and 99.3%, respectively, for arm circumference and 35.3% and 98.3%, respectively, for the QUAC index. CONCLUSIONS: The authors concluded that the prevalence of PEM was low in the Alto Xingu and that arm circumference and the QUAC index should only be used in situations suited to their sensitivity and specificity.

Anthropometry↗

Arm vein uptake of thallium-201 during exercise: incidence and clinical significance.

We prospectively analyzed several clinical and technical variables that might be associated with arm vein uptake of 201Tl during stress thallium scintigraphy in 63 patients. The influence of site (medial antecubital vs. other vein) and technique (with or without a 15-cc saline flush) were examined. Arm vein uptake was not seen after medial antecubital injections except in one case injected through a 24-hr-old indwelling catheter. Arm vein uptake was seen in 24/45 (53%) of cases injected into veins other than the medial antecubital. A saline flush did not reduce the incidence of arm uptake. In patients with normal myocardial studies, those with positive arm uptake had 33% lower net myocardial counts on the postexercise images (p = 0.00008) and 20% lower net myocardial counts on the delayed images (p = 0.04). Myocardial washout of thallium was significantly (p = 0.009) slower in those with arm uptake.

Adult↗

The fate of arm veins used for aorta-coronary bypass grafts.

Arm veins have been a common second choice conduit for those patients having insufficient saphenous veins for coronary bypass operations. To define the patency and durability of arm vein grafts, we reviewed our patients with one or more arm vein grafts used for coronary revascularization between 1974 and 1982. A total of 59 patients required at least one arm vein graft and 51 are presently alive. Postoperative arteriograms were obtained in 28 patients. Of 56 arm vein grafts used, 32 (57%) were patent and 24 (43%) had failed at 2 years. Seven of the patent grafts had a localized area of stenosis. Sixteen internal mammary artery grafts also had been used in this group of patients, and 15 (93%) were patent. We conclude that arm vein grafts have a high failure rate and are not as dependable as saphenous vein grafts or internal mammary artery grafts.

Adult↗

The influence of biodynamic factors on the absorption of vibration energy in the human hand and arm.

A possible basis for risk assessment for hand-transmitted vibration may be to determine the quantity of energy absorbed in the human hand and arm. In the present study the mechanical energy absorption in the hand-arm system has been measured on 10 healthy subjects during exposure to random vibration with constant velocity spectrum. In the study, the influence of various conditions, such as vibration direction (Xh, Yh, Zh), grip force (25-75 N), feed force (20-60 N), frequency weighted acceleration level (3, 6, 9, 12 m/s2) and hand and arm posture (5 flexions, 2 abductions) were studied. The outcome showed that the energy absorption in the human hand and arm depended mainly on the frequency and direction of the vibration stimuli. Higher vibration levels, as well as firmer hand grips and higher feed forces, resulted in a significantly higher absorption. As concerns the hand and arm posture the results show that the flexion had a significant contribution to the vibration absorption but the abduction had no influence on the quantity of absorbed energy. Furthermore, the influence of some of the studied variables had a non-linear effect on the absorption but also differed between different exposure directions. Moreover, it was concluded that the frequency-weighting routine in the international standard ISO 5349 do not reflect the energy absorbing properties of the human hand and arm.

Absorption↗

Arm vein reconstruction for limb salvage: long-term outcome.

A series of 42 consecutive patients undergoing infrainguinal vascular reconstruction for limb salvage using vein harvested from the arm were followed prospectively to determine the long-term graft patency and stenosis rates. Vein harvested from the arm ('arm vein') was used for secondary or tertiary reconstruction in 22 patients (52.4%). The outflow was to a single calf vessel in 37 grafts (88.1%). The cumulative primary, primary assisted and secondary graft patency rates were 35.6%, 49.6% and 59.5% at 2 years, respectively, and the limb salvage rate was 69.0% at 2 years. Eight grafts developed stenoses detected by a graft surveillance programme. Six stenoses were dilated successfully with percutaneous transluminal angioplasty (PTA) and one was treated with an interposition vein graft. Bypass using arm vein is time-consuming and technically demanding as multiple anastomoses are often required. Arm vein grafts, however, have no greater incidence of stenosis than long saphenous vein grafts and these stenoses may be dilated with PTA with good results. The long-term outcome suggests that an arm vein graft is an important treatment option in the absence of the long saphenous vein.

Adult↗

Arm pain among Swedish fighter pilots during +Gz flight and centrifuge exposures.

BACKGROUND: The purpose was to survey the occurrence of arm pain among Swedish fighter or test pilots in connection with exposures to high +Gz load when flying or performing centrifuge tests. HYPOTHESIS: +Gz induced arm pain occurs in connection with high +Gz loads in flight as well as in centrifuge tests of high performance fighter pilots. METHODS: A questionnaire was used for data collection regarding +Gz induced arm pain. Respondents were 35 Swedish Air Force Viggen and Gripen fighter pilots who had previously participated as subjects in centrifuge tests between 1990 and 1995 at Brooks Air Force Base, TX, either with the standard anti-G suit or with extended coverage anti-G suit with pressure breathing during +Gz. RESULTS: Of the respondents, 55% reported that they had experienced arm pain during flight at least once and 42% experienced it more than three times. However, arm pain was more common in the centrifuge tests (82% once; and 42% more than 3 times). CONCLUSIONS: Presence of arm pain during high performance fighter aircraft flights is a phenomenon that should be taken into consideration when designing high performance aircraft or +Gz protective equipment.

Adult↗

The effect of head-to-trunk position on the direction of arm movements before, during, and after space flight.

This contribution deals with the examination of the consequences of different head-to-trunk positions on arm movements under normal gravity and during prolonged space flight. One of the objectives of this study was to investigate the influence of weightlessness on the condition of the spatial analysis system. Aimed arm movements in the horizontal plane (pointings towards two visual targets) were recorded, first with eyes open, head straight (learning part), then with eyes closed, head straight and during yaw or roll position of the head (performance part). Measurements related to these different head-to-trunk-positions were taken in one short-term and nine long-term cosmonauts preflight, inflight, and postflight. Terrestrial control experiments were carried out with an extended experimental design in 14 healthy volunteers. The analysis of these experiments revealed that, with eyes closed and the head in yaw position, cosmonauts before flight and control subjects exhibit significant slants of the movement plane of the arm. Contrary to terrestrial measurements, in space experiments roll tilt of the head to the right is correlated with considerable counterclockwise slant of the movement plane. This slant of the movement plane of the arm was interpreted as tilt of the internal representation of the horizontal coordinate. The effect is larger with greater distortion induced by the changed head position and with larger muscular involvement to keep this position. This effect is also increased by the reduction of information (for example, in microgravity). The amount and the direction of the horizontal offset of the arm movements are shown to be dependent on the head-to-trunk position, too. Additionally, we have found changes in the amplitude and in the duration of the arm movement, in the vertical offset, and in the curvature of the movement paths, depending on the experimental conditions.

Adult↗

Liposuction reduces arm lymphedema without significantly altering the already impaired lymph transport.

In a prospective study, 20 patients with arm lymphedema after breast cancer treatment underwent liposuction combined with Controlled Compression Therapy (CCT) or CCT alone. Indirect lymphoscintigraphy (ILS) was used to study lymph kinetics before and after intervention. Lymphoscintigrams from the contralateral, non-edematous arm were characterized by prompt transit of the radiotracer (99mTc-albumin nanocolloid) to the axillary nodes, whereas tracer accumulation as dermal backflow characterized tracer transport in the lymphedematous arm. Neither liposuction with CCT nor CCT alone, changed this ILS profile. Liposuction combined with CCT reduced arm edema volume by (median) 115% (range 92-179%), whereas CCT alone decreased arm edema volume by only 54% (range 7-81%) (p = 0.008). Because liposuction in conjunction with CCT was not associated with further impairment to an already restricted lymph transport, we recommend this therapy (liposuction with external compression) for chronic arm lymphedema, as it reduces edema volume safely, rapidly, and more efficiently than external compression alone. Moreover, it does not worsen an already impaired lymph transport in the lymphedematous upper extremity.

Adult↗

Exposing rats to a predator impairs spatial working memory in the radial arm water maze.

This series of studies investigated the effects of predator exposure on working memory in rats trained on the radial arm water maze (RAWM). The RAWM is a modified Morris water maze that contains four or six swim paths (arms) radiating out of an open central area, with a hidden platform located at the end of one of the arms. The hidden platform was located in the same arm on each trial within a day and was in a different arm across days. Each day rats learned the location of the hidden platform during acquisition trials, and then the rats were removed from the maze for a 30-min delay period. During the delay period, the rats were placed either in their home cage (nonstress condition) or in close proximity to a cat (stress condition). At the end of the delay period, the rats were run on a retention trial, which tested their ability to remember which arm contained the platform that day. The first experiment confirmed that the RAWM is a hippocampal-dependent task. Rats with hippocampal damage were impaired at learning the location of the hidden platform in the easiest RAWM under control (non-stress) conditions. The next three experiments showed that stress had no effect on memory in the easiest RAWM, but stress did impair memory in more difficult versions of the RAWM. These findings indicate that the capacity for stress to impair memory is influenced not only by the brain memory system involved in solving the task (hippocampal versus nonhippocampal), but also by the difficulty of the task. This work should help to resolve some of the confusion in the literature regarding the heterogeneous effects of stress on hippocampal-dependent learning and memory.

Analysis of Variance↗

Is the blood pressure the same in both arms?

It is generally believed that there are blood pressure differences between the right and left arms, but most of the validation studies have used nonsimultaneous measurements. It is important to know whether there is a difference, as methodological comparisons are often made using a different technique on each arm. We have measured the blood pressure simultaneously in both arms in 91 patients, using two observers and two cuffs to provide eight measurements in a fully balanced design. The mean difference in blood pressure between the arms (left/right) was -1.3 (SE 0.4)/1.1 (SE 0.3) mmHg. Mean differences of the same magnitude were found between the two observers, and between the cuffs. Thus, no systematic difference of any consequence was found, although individual patients had mean between-arm differences in blood pressure of up to 10 mmHg. These results suggest that no significant bias is introduced in methodological comparisons that use both arms.

Adult↗

Molecular structure of dynein and motility of a giant sperm axoneme provided with only the outer dynein arm.

The peculiar sperm axoneme of the dipteran Asphondylia ruebsaameni is characterized by an extraordinarily high number of microtubule doublets (up to 2,500) arranged in double parallel spirals. Doublets of the inner row of each spiral are tilted, so that their outer arms point towards the B-tubule of the next doublet in the outer row. Doublets are provided with only the outer arm, and no structure related to the central pair/radial spoke complex is present. When analyzed by quick-freeze, deep-etch electron microscopy, the structure of the dynein arms was shown to share the same organization described in other organisms; however, it appears to be somewhat more complex than that previously found in a related dipteran species, Monarthropalpus flavus, since the foot region of the arms displays a globular extra-domain that is intercalated between adjacent arms. Treatment of demembranated sperm with ATP and vanadate induced conformational changes in the dynein arms. SDS-page suggested the presence of a single dynein high molecular weight band or, in the gels with the best electrophoretic resolution, of two very closely spaced bands. This polypeptide positively reacted with a polyclonal antibody raised against a specific amino acid sequence located in the phosphate-binding loop of the dynein catalytic site. Dynein heavy chain-related DNA sequences corresponding to the catalytic phosphate-binding region were amplified by RT-PCR. Two distinct fragments (Asph-ax1 and Asph-ax2) encoding axonemal dynein sequences were identified. Southern blot analysis performed on genomic DNA using these sequences as a probe showed that they are part of different genes. An intron was identified in the Asph-ax1 fragment at a position corresponding to the site of a nucleotide deletion in the putative pseudogene of Monarthropalpus. Asphondylia spermatozoa exhibited in vivo a whirling movement both in the deferent duct and in the spermatheca, but they were unable to undergo processive movement in vitro. They propagated a three-dimensional wave only when constrained in a bent configuration by some mechanical means. The phylogenetic relationships between the two dipteran species, Monarthopalpus and Asphondylia, based on these biochemical and molecular data are also discussed.

Amino Acid Sequence↗

Effect of radial shortening on muscle length and moment arms of the wrist flexors and extensors.

The purpose of this study was to determine the effect of distal radial shortening on muscle length and moment arm of the wrist flexors and extensors. In eight cadaveric upper extremities, distal radius fractures were simulated by an ostectomy. The distal radius was progressively shortened by 2.5, 5.0, 7.5, and 10 mm. Changes in the resting length of the flexor carpi radialis and ulnaris, extensor carpi radialis longus and brevis, and extensor carpi ulnaris muscles were measured with rotary potentiometers at neutral position, flexion, extension, and radial and ulnar deviation of the wrists. The wrists were passively moved through flexion-extension and radioulnar deviation, and tendon excursions and wrist joint angulation were recorded simultaneously. Tendon moment arms were derived from tendon excursions and joint motion. The results showed that either muscle length or moment arm of the principal wrist flexors and extensors was significantly affected by the radial shortening. Muscle length decreased significantly after radial shortening in all the wrist flexors and extensors except for the extensor carpi ulnaris. The moment arm of the extensor carpi ulnaris tendon decreased significantly during either wrist flexion-extension or radioulnar deviation. The extensor carpi radialis brevis and flexor carpi ulnaris tendons also showed a significant decrease in their moment arms during radioulnar deviation of the wrist. Radial shortening of only 2.5 mm caused statistically significant changes in muscle length and moment arm of the wrist flexors and extensors. Increasing the extent of radial shortening exaggerated the biomechanical changes in the wrist motors. These results validate the importance of normal radial length for wrist kinetics and, from a biomechanical perspective, support complete correction of radial shortening after distal radius fractures.

Aged↗

Theoretical study of the conformation of the lipoamide arm in a mutant H protein.

The lipoamide arm of the H protein plays a pivotal role in the catalytic cycle of the glycine decarboxylase complex (GDC) by being successively methylamine loaded (Hmet), reduced (Hred), and oxidized (Hox). In a previous study, we calculated free-energy surfaces as a function of the lipoamide arm position of the three forms of the wild-type protein and found close agreement with the available experimental data. Our simulations, together with crystallographic and NMR data, showed that the methylamine-loaded arm is locked in a cavity by interaction with Ser12, Glu14, and Asp67. In this work, we investigate the behavior of the methylamine-loaded form of a mutant H protein (HEA) where Glu14 has been replaced by Ala. We find that the arm can still be held in the cavity but that the energy barrier to release of the arm is halved from approximately 40 kcal mol(-1) for Hmet to approximately 12 kcal mol(-1) for HEA. To compensate for the loss of Glu14, the methylamine group shifts toward Ser66 in the mutant form. These results provide a structural basis for the equilibrium between the loaded and the unloaded forms of the arm observed by Gueguen et al. (Gueguen et al., J Biol Chem 1999;274:26344-26352) in HEA.

Alanine↗