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The role of excitation-pattern cues and temporal cues in the frequency and modulation-rate discrimination of amplitude-modulated tones.

These experiments examine the influence of excitation-pattern cues and temporal-fine-structure cues on frequency difference limens (FDLs) measured as a function of duration. In the first three conditions, listeners were required to detect a change in carrier frequency from a baseline of 250 or 2000 Hz, for stimuli with half-amplitude durations ranging from 5 to 320 ms. In the "steady" condition, duration was manipulated by increasing the steady-state portion of the envelope between two 5-ms linear onset and offset ramps. This resulted in spectra and excitation patterns that broadened with decreasing duration. In the "modulated" condition, the carrier was amplitude modulated with a triangle function (period 10 ms) and duration was manipulated by varying the number of cycles of the modulator. In this case, the spectral envelope did not vary with duration, but the width of individual spectral lobes broadened with decreasing duration. The "low-peak-constant" condition was similar to the modulated condition, except that an increase in carrier frequency was accompanied by a decrease in the period of the modulator, so as to hold constant the frequency of the spectral lobe located roughly 100 Hz below the carrier frequency. In this condition, changes in carrier frequency resulted in minimal changes in excitation level on the low-frequency side of the excitation pattern, but changes on the high-frequency side were larger than for the first two conditions. Both the values of the FDLs, and their variation with frequency and duration, were similar in these three conditions. The fourth, "modulator varying," condition differed in that the carrier frequency was held constant and listeners were required to detect a change in modulator frequency. Thresholds were expressed as the change in frequency of the spectral side lobes adjacent to the carrier frequency ("equivalent" FDLs). Excitation-pattern cues in this condition were at least as large as in the first three conditions. However, equivalent FDLs were significantly higher than for the other three conditions. The higher FDLs are attributed to the lack of temporal fine-structure cues related to the carrier frequency. Overall, the results suggest that FDLs in the first three conditions were determined by temporal cues rather than by excitation-pattern cues. The increase of the FDLs with decreasing duration did not arise from increasing spectral splatter.

Auditory Perception↗

Detection of lactate threshold by including haemodynamic and oxygen extraction data.

To date, few attempts have been made to correlate cardiovascular variables to lactate threshold (L(T)). This study was designed to determine the relationship between the accumulation of blood lactate and several haemodynamic variables during exercise. Eight male volunteer cyclists performed an incremental test on an electromagnetically braked cycle-ergometer consisting of a 50 W linear increase in workload every 3 min up to exhaustion. Blood lactate was measured with a portable analyser during each exercise step. Oxygen consumption (VO(2)) and pulmonary ventilation were measured by means of a mass spectrometer while heart rate, stroke volume and cardiac output (CO) were assessed by impedance cardiography. The arterio-venous oxygen difference (A-V O(2) Diff) was obtained by dividing VO(2) by CO. By applying the D(max) mathematical method, L(T) and thresholds of ventilatory and haemodynamic parameters were calculated. The Bland and Altman statistics used to assess agreement between two methods of measurement were applied in order to evaluate the agreement between L(T) and thresholds derived from ventilatory and haemodynamic data. The main result was that most of the haemodynamic variables did not provide thresholds which could be used interchangeably with L(T). Only the threshold of A-V O(2) Diff showed mean values that were no different compared to L(T) together with limits of agreement that were not very wide between thresholds (below +/-25%). Hence of the haemodynamic parameters, A-V O(2) Diff appears to be the one most closely coupled with lactate accumulation and consequently it is also the most suitable for non-invasive calculation of the L(T).

Adult↗

Effect of individual time to peak power output on the expression of peak power output in the 30-s Wingate Anaerobic Test.

The objective of the present investigation was to examine a proposal which stated that individual power values should be aligned according to peak power output (PPO) before calculating the mean value of PPO. This procedure removes the variation in time it takes for individuals to reach PPO. Participants were forty-one University Rugby Union Football players of mean age 21.7 +/- 2.6 years, height 181.4 +/- 6.9 cm and body mass 88.9 +/- 12.7 kg. Data were collected using a friction-belt cycle ergometer (Monark 864, Varberg, Sweden). A significantly larger mean value for PPO was found when results were calculated from time-aligned rather than cross-sectional data (1154 +/- 246 vs. 1121 +/- 254 W, p < 0.0001); the mean difference was approximately 3 %. Additionally, the average profile of the power output curve was more reflective of individual power curves. The negative correlation between PPO and the time taken to reach PPO was - 0.32 (p < 0.05), confirming the view that the earlier the time taken to reach PPO the larger the PPO. It was concluded that the mean value of PPO and the corresponding profile for power output curves are best represented by the analysis of time-aligned rather than cross-sectional data.

Adult↗

Interstate comparisons of public hospital outputs using DRGs: are they fair?

OBJECTIVE: To assess whether there is variation among Australian States in the reporting and coding of important and relevant secondary diagnoses in public hospital data. Such variation is a potentially important problem because it may invalidate interstate (and other) comparisons of hospital outputs based on Diagnosis Related Groups (DRGs). METHODS: Our outcome measure was the percentage of separations in the lowest-resource split for adjacent DRGs. To reduce potential bias due to interstate differences in the complexity of cases treated in public hospitals, we directly standardised by adjacent-DRG and analysed two subgroups of adjacent-DRGs where there is less discretion about the threshold for admission: obstetrics and major medical conditions. RESULTS: There was important interstate variation in the percentage of separations in the lowest-resource split. The statistically significant differences represent a large number of medical records that might have been documented or coded differently if the separation had occurred in another State. For example, if Queensland had the same standardised percentage as South Australia, then an extra 10,100 separations in Queensland would have been allocated to a DRG with a higher cost weight. CONCLUSIONS: The task of perfecting a national database is never complete and it makes sense to superimpose a permanent cycle of monitoring, followed by more detailed audits. The methods used in this paper could be routinely used to screen administrative hospital data to identify where detailed audits with feedback might be implemented with best effect. Unless interstate variation in the reporting and coding of important additional diagnoses is reduced, measuring public hospital outputs using DRGs will be of limited value at a national level.

Australia↗

The toxicity of benzene and its metabolism and molecular pathology in human risk assessment.

Benzene, a common industrial chemical and a component of gasoline, is radiomimetic and exposure may lead progressively to aplastic anaemia, leukaemia, and multiple myeloma. Although benzene has been shown to cause many types of genetic damage, it has consistently been classified as a non-mutagen in the Ames test, possibly because of the inadequacy of the S9 microsomal activation system. The metabolism of benzene is complex, yielding glucuronide and sulphate conjugates of phenol, quinol, and catechol, L-phenylmercapturic acid, and muconaldehyde and trans, trans-muconic acid by ring scission. Quinol is oxidised to p-benzoquinone, which binds to vital cellular components or undergoes redox cycling to generate oxygen radicals; muconaldehyde, like p-benzoquinone, is toxic through depletion of intracellular glutathione. Exposure to benzene may also induce the microsomal mixed function oxidase, cytochrome P450 IIE1, which is probably responsible for the oxygenation of benzene, but also has a propensity to generate oxygen radicals. The radiomimetic nature of benzene and its ability to induce different sites of neoplasia indicate that formation of oxygen radicals is a major cause of benzene toxicity, which involves multiple mechanisms including synergism between arylating and glutathione-depleting reactive metabolites and oxygen radicals. The occupational exposure limit in the United Kingdom (MEL) and the United States (PEL) was 10 ppm based on the association of benzene exposure with aplastic anaemia, but recently was lowered to 5 ppm and 1 ppm respectively, reflecting a concern for the risk of neoplasia. The American Conference of Governmental Industrial Hygienists (ACGIH) has even more recently recommended that, as benzene is considered an A1 carcinogen, the threshold limit value (TLV) should be decreased to 0.1 ppm. Only one study in man, based on nine cases of benzene associated fatal neoplasia, has been considered suitable for risk assessment. Recent re-evaluation of these data indicated that past assessments may have overestimated the risk, and different authors have considered that lifetime exposure to benzene at 1 ppm would result in an excess of leukaemia deaths of 9.5 to 1.0 per 1000. Although in this study, deaths at low levels of benzene exposure were associated with multiple myeloma and a long latency period, instead of leukaemia, which might justify further lowering of the exposure limit, the risk assessment model has been found to be non-significant for response at low levels of exposure. The paucity of data for man, the complexity of the metabolic activation of benzene, the interactive and synergistic mechanisms of benzene toxicity and carcinogenicity, the different disease endpoints (aplastic anaemia, leukaemia, and multiple myeloma), and different individual susceptibilities, all indicate that in such a complex scenario, regulators should proceed with caution before making further changes to the exposure limit for this chemical.

Anemia, Aplastic↗

Effect of low and high intensity exercise on circulating growth hormone in men.

We hypothesized that circulating GH would increase only if a threshold of work intensity [corresponding to the anaerobic or lactate threshold (LT)] was exceeded. Ten healthy male volunteers (18-35 yr) first performed ramp-type progressive cycle-ergometer exercise to determine the LT and the maximal oxygen uptake. On subsequent mornings after an overnight fast, each subject performed bouts of 1, 5, and 10 min constant work rate exercise of either high intensity (above LT) or low intensity (below LT). A 1-h interval separated exercise bouts. Gas exchange (breath-by-breath), GH, immunoreactive insulin, glucose, lactate, pyruvate, and epinephrine and norepinephrine were measured at regular intervals. After the 10-min bouts of high compared with low intensity exercise, lactate was 7.2 +/- 3.7 mmol/L vs. 1.4 +/- 1.3, P less than 0.05; epinephrine was 1,113 +/- 519 pmol/L vs. 496 +/- 273, P less than 0.05; and norepinephrine was 7.89 +/- 3.45 nmole/L vs. 2.83 +/- 1.34, P less than 0.05. GH did not increase significantly from preexercise baseline during low intensity exercise (e.g., GH after 10-min low intensity exercise changed from baseline values by 1.5 +/- 2.0 micrograms/L, NS). Although lactate was elevated after 5-min of high intensity exercise, peak GH was significantly elevated (mean increase above baseline of 7.7 +/- 2.4 micrograms/L, P less than 0.05) only after 10 min of high intensity exercise (increases in 9 of 10 subjects). The GH increase occurred despite simultaneous increases in both IRI and glucose. A minimum duration of 10 min, high intensity exercise consistently increased circulating GH in adult males.

Adolescent↗

The influence of menstrual cycle phase upon postexercise hypotension.

PURPOSE: Postexercise hypotension (PEH) has been observed in males and females; however, the impact of menstrual cycle phase upon PEH has not been evaluated. We examined the pattern of PEH in the early follicular (EF), late follicular (LF), and midluteal (ML) phases of the menstrual cycle in eight eumenorrheic women following 30 min of exercise at 80% lactate threshold. METHODS: Supine hemodynamic measurements were assessed at rest and then for 45 min following exercise. Blood pressure was measured with manual sphygmomanometry, calf vascular resistance (CVR) via venous occlusion plethysmography, and central hemodynamics with echocardiography. RESULTS: Cardiovascular parameters did not differ between menstrual phases at rest (P > 0.05). The pattern of PEH was unaffected by menstrual phase, but mean arterial and diastolic (DBP) pressures dropped to significantly lower levels across the recovery period in the EF phase than in the LF and ML phases (mean DBP EF: 69 +/- 4; LF 74 +/- 3; ML 72 +/- 5; P < 0.05). Postexercise cardiac output, stroke volume, ejection fraction, left ventricular dimensions, and heart rate did not differ across menstrual phases (P > 0.05). These parameters, except for left ventricular dimensions in systole and heart rate, varied with recovery time, increasing to a peak between 5 and 10 min postexercise (P < 0.05). CVR displayed a significant interaction between cycle phase and recovery time as resistance increased to greater values in the ML phase compared with the EF and LF phases following 30 min of postexercise recovery (P < 0.05). CONCLUSION: Buffering of PEH appears to be enhanced in the LF and ML phases of the cycle where estrogen concentrations are known to be elevated.

Adult↗

Altered exercise gas exchange as related to microalbuminuria in type 2 diabetic patients.

STUDY OBJECTIVE: Microalbuminuria in diabetes mellitus is a risk factor for cardiovascular disease. We hypothesized that microalbuminuria in type 2 diabetic patients is related to impaired cardiopulmonary function during exercise, and that the severity of impairment is correlated with the degree of microalbuminuria. DESIGN: Twenty of each of the following categories of subjects performed symptom-limited cardiopulmonary exercise testing on a cycle ergometer: (1) type 2 diabetic patients with normoalbuminuria (daily urinary albumin excretion [UAE] < 30 mg/d); (2) type 2 diabetic patients with microalbuminuria (daily UAE, 30 to 300 mg/d); and (3) normal control subjects. MEASUREMENTS AND RESULTS: Oxygen consumption (VO(2)) of patients with microalbuminuria was lower than that of control subjects at anaerobic threshold (AT) [p < 0.001], and was lower than both control subjects (p < 0.001) and patients with normoalbuminuria (p = 0.015) at peak exercise. There was a progressive worsening in gas exchange efficiency at the lungs, as measured by minute ventilation (VE)/carbon dioxide production (VCO(2)) at AT or DeltaVE/DeltaVCO(2) slope, (p = 0.006 and p = 0.019, respectively) going from control subjects to patients with normoalbuminuria and then to patients with microalbuminuria. Left ventricular ejection fractions and BP were similar in patients with normoalbuminuria and microalbuminuria. More patients with microalbuminuria (n = 9) than with normoalbuminuria (n = 2) demonstrated diastolic dysfunction (p = 0.013). These 11 patients had lower peak VO(2) values (p = 0.001) and higher daily UAE (p = 0.028). An inverse linear relationship was found between peak VO(2) and log(10) daily UAE (r = - 0.57, r(2) = 0.29, p < 0.001). CONCLUSIONS: Abnormalities reflecting reduced oxygen transport and impaired gas exchange efficiency were found during exercise, and were especially profound in patients with microalbuminuria. These changes could be secondary to pulmonary microangiopathy and myocardial interstitial changes. Increases in capillary permeability to proteins may take place in the myocardium as they do in the kidneys, and contribute to impaired myocardial distensibility and hence diastolic dysfunction.

Albuminuria↗

Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency.

PURPOSE: To define the range of normal contrast medium enhancement, the variability in contrast medium enhancement patterns in healthy premenopausal breast parenchyma, and the implications for management strategies in cases with incidental contrast medium-enhancing foci on breast magnetic resonance (MR) images. MATERIALS AND METHODS: Twenty healthy volunteers (aged 21-41 years) were examined on a 1.5-T system (dynamic two-dimensional gradient-echo protocol with subtraction postprocessing) during each week of a menstrual cycle (group 1) or over 4 months (group 2). The authors evaluated changes in the number of enhancing foci and the respective enhancement patterns within a cycle and between cycles. RESULTS: Both diffuse and nodular enhancement of breast parenchyma occurred during all phases of the menstrual cycle, especially in weeks 1 and 4. Enhancement was lowest in week 2. A total of 60 enhancing foci (73% of which resolved completely during follow-up) were found in 16 of 20 volunteers. Twenty-six foci demonstrated enhancement velocities beyond the malignancy threshold (>80% increase in the 1st minute). CONCLUSION: Contrast-enhancing foci are normal in healthy premenopausal breasts, even when formal malignancy criteria of enhancement velocity are met. This has to be kept in mind to avoid false-positive results, especially in younger patients.

Adult↗

A model for a network of phosphorylation-dephosphorylation cycles displaying the dynamics of dominoes and clocks.

We consider a model for a network of phosphorylation-dephosphorylation cycles coupled through forward and backward regulatory interactions, such that a protein phosphorylated in a given cycle activates the phosphorylation of a protein by a kinase in the next cycle as well as the dephosphorylation of a protein by a phosphatase in a preceding cycle. The network is cyclically organized in such a way that the protein phosphorylated in the last cycle activates the kinase in the first cycle. We study the dynamics of the network in the presence of both forward and backward coupling, in conditions where a threshold exists in each cycle in the amount of protein phosphorylated as a function of the ratio of kinase to phosphatase maximum rates. We show that this system can display sustained (limit-cycle) oscillations in which each cycle in the pathway is successively turned on and off, in a sequence resembling the fall of a series of dominoes. The model thus provides an example of a biochemical system displaying the dynamics of dominoes and clocks (Murray & Kirschner, 1989). It also shows that a continuum of clock waveforms exists of which the fall of dominoes represents a limit. When the cycles in the network are linked through only forward (positive) coupling, bistability is observed, while in the presence of only backward (negative) coupling, the system can display multistability or oscillations, depending on the number of cycles in the network. Inhibition or activation of any kinase or phosphatase in the network immediately stops the oscillations by bringing the system into a stable steady state; oscillations resume when the initial value of the kinase or phosphatase rate is restored. The progression of the system on the limit cycle can thus be temporarily halted as long as an inhibitor is present, much as when a domino is held in place. These results suggest that the eukaryotic cell cycle, governed by a network of phosphorylation-dephosphorylation reactions in which the negative control of cyclin-dependent kinases plays a prominent role, behaves as a limit-cycle oscillator impeded in the presence of inhibitors. We contrast the case where the sequence of domino-like transitions constitutes the clock with the case where the sequence of transitions is passively coupled to a biochemical oscillator operating as an independent clock.

Animals↗

Prolonged stage duration during incremental cycle exercise: effects on the lactate threshold and onset of blood lactate accumulation.

The aim of this study was to investigate whether increasing the duration of workloads from 3 min to 8 min during incremental exercise would influence workload (W), oxygen consumption (VO2) and heart rate (HR) at the lactate threshold (LT) and the onset of blood lactate accumulation (OBLA). Two groups of six male cyclists were assigned to a well-trained (WT) and recreational (REC) group on the basis of their performance in a maximal incremental ramp test. Each subject then performed two incremental lactate tests (EXT) consisting of six workloads of either 3 min (EXT3-min) or 8 min (EXT8-min) duration. At the completion of each workload whole capillary blood samples were obtained for the determination of blood lactate (BLa) concentration (mM). Power output (Watts, W), HR and VO2 were averaged in the final minute of each workload as well as in the third minute of the EXT8-min. The workload, HR and VO2 at the LT and OBLA were subsequently determined from the data of EXT3-min and EXT8-min. The results demonstrate that workload and VO2, but not HR, at the LT and OBLA were higher in the WT cyclists. At the same time, the workload at the LT obtained from the results of the EXT3-min was significantly (P < 0.05) higher then the value obtained in the EXT8-min in the WT subjects but not the REC subjects. However, the workload, VO2 and HR at the OBLA, together with the VO2 and HR at the LT were not significantly different when calculated from data obtained from EXT3-min or EXT8-min. The data obtained in this study suggest that incremental exercise protocols using workloads of duration longer than 3 min have the effect of increasing the workload at the LT in well-trained cyclists. However, the OBLA determined in exercise tests using stage increments of either 3 min or 8 min is similar in cyclists of different training status.

Adaptation, Physiological↗

Auxin efflux carrier activity and auxin accumulation regulate cell division and polarity in tobacco cells.

Division and growth of most types of in vitro-cultured plant cells require an external source of auxin. In such cultures, the ratio of external to internal auxin concentration is crucial for the regulation of the phases of the standard growth cycle. In this report the internal concentration of auxin in suspension-cultured cells of Nicotiana tabacum L., strain VBI-0, was manipulated either (i) by increasing 10-fold the normal concentration of 1-naphthaleneacetic acid (NAA) and 2,4-dichlorophenoxyacetic acid in the external medium; or (ii) by addition 1-N-naphthylphthalamic acid (NPA; an inhibitor of auxin efflux and of auxin efflux carrier traffic). Both treatments delayed the onset of cell division for 6-7 days without loss of cell viability. In both cases, cell division activity subsequently resumed coincident with a reduction in the ability of cells to accumulate [(3)H]NAA from an external medium. Following renewed cell division, a significant proportion of the NPA-treated cells but not those grown at high auxin concentration, exhibited changes in the orientation of new cell divisions and loss of polarity. We conclude that cell division, but not cell elongation, is prevented when the internal auxin concentration rises above a critical threshold value and that the directed traffic of auxin efflux carriers to the plasma membrane may regulate the orientation of cell divisions.

2,4-Dichlorophenoxyacetic Acid↗

The effect of a one-piece competition speedsuit on swimming performance and thermoregulation during a swim-cycle trial in triathletes.

This study investigated the thermoregulatory response to wearing a one-piece competition speedsuit during the swim-cycle aspect of a sprint-distance triathlon. Eight highly trained, male triathletes completed a graded-exercise test, and two swim-cycle trials including a 750 m swimming time trial followed by 30 min of cycling at 95% lactate threshold. Cycling was conducted inside a climate regulated chamber set to 30.0+/-0.3 degrees C and 60.3+/-0.3% humidity. Throughout each swim-cycle testing session, the athletes wore either standard swimming bathers only (BATHERS), or a competition speedsuit (SPEEDSUIT). During the swim-cycle trial, the athletes core temperature (T(c)) and skin temperature (T(sk)) were recorded via a telemetric temperature pill and a series of skin thermistors, respectively. Blood lactate concentration (BLa), heart rate (HR) and ratings of perceived thermal sensation (RPTS) were collected at the conclusion of the swim and during cycling. The SPEEDSUIT swim time (590+/-20s) was significantly faster (3.2%, p<0.01) than the BATHERS trial (609+/-24s). This time improvement incurred no between group differences in T(c), BLa or RPTS (SPEEDSUIT: 38.4+/-0.2 degrees C, 8.3+/-0.9 mmol L(-1), 15+/-1, BATHERS: 38.2+/-0.1 degrees C, 8.4+/-1.1 mmol(-1), 15+/-1, respectively) (p>0.05). During the 30 min cycle, there were not significant differences between the mean values for power output, T(c), T(sk), HR, BLa or RPTS (SPEEDSUIT: 289+/-13W, 38.65+/-0.27 degrees C, 34.30+/-0.71 degrees C, 7.8+/-1.1 mmol L(-1), 17+/-1, BATHERS: 288+/-14W, 38.35+/-0.10 degrees C, 33.50+/-0.57 degrees C, 7.1+/-0.9 mmol L(-1), 17+/-1, respectively) (p>0.05). The use of a competition speedsuit improved the triathletes' swim time without effecting temperature regulation during a laboratory-based swim-cycle trial.

Adult↗

Dual effects of dichloroacetate on cardiac ischaemic preconditioning in the rat isolated perfused heart.

1. Ischaemic cardiac preconditioning represents an important cardioprotective mechanism which limits myocardial ischaemic damage. The aim of this investigation was to assess the impact of dichloroacetate (DCA), a pyruvate dehydrogenase complex activator, on preconditioning. 2. Rat isolated hearts were perfused by use of the Langendorff technique, and were subjected to either preconditioning (3 x 4 or 3 x 6 min ischaemia) or continuous perfusion, followed by 30 min global ischaemia and 60 min reperfusion. DCA (3 mM) was either given throughout the protocol (pretreatment), during reperfusion only (post-treatment), or not at all. Throughout reperfusion mechanical performance was assessed as the rate-pressure product (RPP: left ventricular developed pressure x heart rate). 3. In non-preconditioned control hearts, mechanical performance was substantially (P < 0.001) depressed on reperfusion (the RPP after 60 min of reperfusion (RPP(t=60)) was 4,246+/-974 mmHg beats min(-1) compared to baseline value of 21,297+/-1,728 mmHg beats min(-1)). Preconditioning with either 3 x 4 min or 3 x 6 min cycles caused significant protection, as shown by enhanced recovery (RPP(t=60) = 7,818+/-1,138, P < 0.05, and 11,123+/-587 mmHg beats min(-1), P < 0.001, respectively). 4. Addition of DCA (3 mM) to hearts under baseline conditions significantly (P < 0.001) enhanced systolic function with an increased left ventricular developed pressure of 108+/-5 mmHg compared to 88.3+/-3.0 mmHg in the controls. 5. Pretreatment with 3 mM DCA had no effect on recovery of mechanical performance in the non-preconditioned hearts (RPP(t=60) = 3,640+/-1,235 mmHg beats min(-1)) while the beneficial effects of preconditioning were reduced in the preconditioned hearts (3 x 4 min: RPP(t=60) = 2,919+/-1,060 mmHg beats min(-1); 3 x 6 min: RPP(t=60) = 8,032+/-1,367 mmHg beats min(-1)). Therefore, DCA had increased the threshold for preconditioning. 6. By contrast, post-treatment of hearts with 3 mM DCA substantially improved recovery on reperfusion in all groups (RPP(t=60) = 5,827+/-1,328 (non-preconditioned), 14,022+/-3,743 (3 x 4 min; P < 0.01) and 23,219+/-1,374 (3 x 6 min; P < 0.001) mmHg beats min(-1)). 7. The results of the present investigation clearly show that pretreatment with DCA enhances baseline cardiac mechanical performance but increases the threshold for cardiac preconditioning. However, post-treatment with DCA substantially augments the beneficial effects of preconditioning.

Animals↗

[Computerized processing of two-dimensional echo-cardiograms: its application for quantitating left ventricular regional contractility and three-dimensional echocardiography].

This study assessed the computerized processing of two-dimensional echocardiograms for quantitating left ventricular regional contractility and for computer reconstruction of the left ventricle; so-called three-dimensional echocardiography. Computer analysis of two-dimensional echocardiograms for quantitative evaluations of the left ventricular regional contractility in myocardial infarction: A new practical method for computer digital image processing of two-dimensional echocardiograms was developed for quantitating left ventricular regional contractility. Short-axis cross-sectional images of the left ventricle at the levels of the mitral valve (MV), papillary muscles (PM) and the apex (AP) were recorded using a phased array sector scanner in thirty patients with healed myocardial infarction and fifteen normal control subjects. The echocardiographic data were recorded on the video tape and transferred to a minicomputer via interface circuits, digitized, and processed automatically. Each digitized image consisted of 256 X 256 pixels with a gray scale of 256 values. The edges of the endocardial and epicardial walls were detected by applying sequential steps including smoothing, dynamic thresholding, region growing, and filling of small holes. The rationale of edge detection depended on assuming that abrupt changes in gray levels occurred at the boundary, and that the points with maximum gradient values were boundaries of the left ventricular wall. Best-fit contours of endocardial and epicardial edges were drawn by fitting a spline. Besides this automatic edge tracing, endocardial and epicardial edges were also manually traced using a digi-pen system, whose results coincided well with automatic tracings. After detection of edges of endocardial and epicardial walls, the short-axis cross sectional left ventricular wall at each level was divided into eight segments. The geometric center of the end-diastolic left ventricular cavity and the axis connecting this with the posterior end of the right side of the septum was used as the reference point and line (fixed reference system). End-diastolic and end-systolic segmental hemiaxes, segmental area, segmental wall thickness and changes during the cardiac cycle were measured and calculated automatically in each segment using a computer. Regional contractility of the left ventricle was evaluated by percent systolic changes of the segmental hemiaxis, area and wall thickness. These values were significantly reduced in the infarcted left ventricular wall as defined by left ventriculography and coronary angiography.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

A comparison of methods of estimating anaerobic work capacity.

The hyperbolic relationship between power output (P) and time to exhaustion (t) is described as: (P-theta PA).t = W', where theta PA is the power asymptote (or 'critical power'), which theoretically represents the highest sustainable power output, and W' is a constant which represents a limited amount of work which can be performed above theta PA (or 'anaerobic capacity'). The purpose of this study was to determine the validity of W' as anaerobic capacity, using maximal oxygen deficit as the criterion measure. Thirteen women (mean (+/- SD) age 23 +/- 2 years, height 1.67 +/- 0.07 m and mass 60.8 +/- 8 kg) and 13 men (mean age 23 +/- 2 years, height 1.74 +/- 0.1 m and mass 71.3 +/- 14 kg) performed two sets of five bouts of high-intensity cycling exercise to exhaustion, each bout on a separate day and at a different relative power. Individual W' were calculated by nonlinear regression of time with power, with time as the dependent variable. Oxygen deficit was determined during each bout, and the mean of the values obtained from the power output which elicited the highest values was used as the criterion for anaerobic capacity. Mean (+/- SE) values for anaerobic capacity for women were 179 +/- 10 J.kg-1 (W') and 177 +/- 10 J.kg-1 (oxygen deficit) and for men, 224 +/- 10 J.kg-1 (W') and 235 +/- 9 J.kg-1 (oxygen deficit). The W' estimates and criterion measures were the same (F1,24 = 0.61, p = 0.44), and there was no method-gender interaction (F1,24 = 0.26, p = 0.62).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Pulmonary function at peak exercise in patients with chronic heart failure.

BACKGROUND: Various respiratory abnormalities are associated with chronic heart failure (CHF). However, changes in inspiratory capacity (IC) and breathing pattern from rest to exercise in patients with CHF have not been thoroughly investigated in these patients. MATERIALS AND METHODS: Seventy seven (66 male/11 female) patients with clinical stable CHF (age: 52+/-11 years) were studied. All the patients underwent pulmonary function tests, including measurements of IC and maximal inspiratory pressure (Pimax) at rest and then a maximal cardiopulmonary exercise testing (CPET) on a treadmill. During the CPET, IC was measured every 2 min. Pimax was measured again after the end of CPET. RESULTS: Percent predicted forced expiratory volume in 1 s (FEV1) was 91+/-12, %predicted forced vital capacity (FVC) was 92+/-13, %FEV1/FVC was 81+/-4, and %predicted IC was 85+/-18. Peak exercise IC was lower than resting (2.4+/-0.6 vs. 2.6+/-0.6 l, p<0.001). Analysis of variance between Weber's groups revealed statistically significant differences in peak exercise IC (p<0.001), VE/VCO2slope (p<0.001), resting Pimax (p=0.005) and post-exercise Pimax (p<0.001). At rest, there was a statistically significant difference in end-tidal CO2 (P(ETCO2)) (p=0.002), in breathing frequency (p=0.004), in inspiratory time (Ti) (p=0.04) and in total respiratory time (T(Tot)) (p=0.004) among Weber's groups. At peak exercise there was a statistically significant decrease in minute ventilation (VE) (p<0.001), tidal volume (VT) (p<0.001), respiratory cycle (VT/TI) (p<0.001) and P(ETCO2) (p<0.001). Peak IC was correlated with peak VO2 (r=0.72, p<0.001), anaerobic threshold (r=0.71, p<0.001), VO2/t slope (r=0.54, p<0.0001), and post-exercise Pimax (r=0.62, p<0.001). CONCLUSIONS: In patients with CHF, peak exercise IC is reduced in parallel with disease severity, which is probably due to respiratory muscle dysfunction.

Anaerobic Threshold↗

Predictive usefulness of cycle day 10 follicle-stimulating hormone level in a clomiphene citrate challenge test for in vitro fertilization outcome in women younger than 40 years of age.

OBJECTIVE: To determine the usefulness of the day 10 FSH level of a clomiphene citrate challenge test in predicting IVF outcome in women younger than 40 years of age. DESIGN: Retrospective chart review. SETTING: Academic fertility center. PATIENT(S): Three hundred fifty-three women younger than 40 years of age undergoing 483 IVF cycles. MAIN OUTCOME MEASURE(S): Delivery rates. RESULT(S): An inverse relationship was observed between the likelihood of successful pregnancy and both cycle day 3 and cycle day 10 FSH levels. In women with a normal day 3 FSH level, elevated day 10 FSH levels predicted similarly poor IVF outcomes as for women with an abnormal day 3 FSH level. There was no specific threshold FSH level beyond which pregnancies failed to occur. Successful pregnancies were achieved with aggressive stimulation even in women with FSH levels greater than 20 mIU/mL. CONCLUSION(S): The clomiphene citrate challenge test (CCCT) correlates with IVF outcomes in women younger than 40 years of age. Stimulated day 10 FSH levels are strongly predictive of decreased IVF success even when day 3 FSH levels are normal. Results of the CCCT are useful for patient counseling before the IVF cycle and for choosing the optimal gonadotropin regimen.

Adult↗