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Biomedical subjects

Alan R Hargens

Publications and source records attributed to Alan R Hargens.

34 records · Page 2Linked to original sources

Ischemic-preconditioning does not prevent neuromuscular dysfunction after ischemia-reperfusion injury.

The primary purpose of this study was to evaluate ischemic-preconditioning (IPC) as a means of improving tolerance to ischemia-reperfusion (IR) stress on neuromuscular function. A secondary objective was to isolate the area of injury within the neuromuscular unit responsible for contractile dysfunction after IR injury. Twenty-eight male rabbits were randomly assigned to four groups (sham, IPC only, sustained ischemia only, IPC and sustained ischemia). The IPC protocol consisted of three cycles of 10 min of tourniquet-induced ischemia (125 mmHg) followed by 10 min of reperfusion. Sustained ischemia was induced by 350 mmHg external compression for 2 h. Peak tetanic tension of the tibialis anterior (TA) muscle was evaluated 48 h after the tourniquet protocol by both peroneal nerve and direct muscle stimulation, with and without pharmacologic neuromuscular junction blockade. Animals subjected to combined IPC and sustained ischemia had an equivalent loss of contractile force to those undergoing sustained ischemia alone. Two hours of tourniquet-induced ischemia resulted in marked dysfunction of the TA neuromuscular unit when evaluated by peroneal nerve stimulation (p < 0.0001). Isolation of the TA muscle from the peroneal nerve with direct muscle stimulation and neuromuscular junction blockade preserved muscle function after 3 h of ischemia. In our model, these results clearly demonstrate that IPC provides no significant protective effect from IR injury to either nerve or muscle function in our model. In addition, nerve or neuromuscular junction injury, rather than muscle damage, is identified as primarily responsible for IR-related muscle dysfunction.

Algorithms↗

Ultrasonic device for the noninvasive diagnosis of compartment syndrome.

An ultrasonic device for the diagnosis of acute compartment syndrome is described and results on six human cadaveric legs are presented. The ultrasonic device uses a pulsed phase locked loop (PPLL) to measure sub-micrometer displacements of the fascia wall. These displacements occur as a result of volume expansion of the muscle compartment of the lower leg and are related to changes in intramuscular pressure (IMP). In the cadaveric tests, the PPLL detected changes in compartment diameter resulting from IMP changes of 1 mmHg and from infusions of 0.25 ml saline increments. Based on these results, the ultrasonic PPLL appears to have the potential to become a low-cost, portable and noninvasive alternative to current methods for diagnosing acute compartment syndrome.

Acute Disease↗

The ratio of animal protein intake to potassium intake is a predictor of bone resorption in space flight analogues and in ambulatory subjects.

BACKGROUND: Bone loss is a critical concern for space travelers, and a dietary countermeasure would be of great benefit. Dietary protein and potassium-associated bicarbonate precursors may have opposing effects on the acid-base balance in the body and therefore on bone loss. OBJECTIVE: In 2 studies, we examined the ability of dietary protein and potassium to predict markers of bone metabolism. DESIGN: In the first study, 8 pairs of male identical twins were assigned to 1 of 2 groups: bed rest (sedentary, or SED, group) or bed rest with supine treadmill exercise in a lower-body negative pressure chamber (EX group). In a second study, groups of 4 subjects lived in a closed chamber for 60 or 91 d, and dietary data were collected for two or three 5-d sessions. Urinary calcium, N-telopeptide, and pyridinium cross-links were measured before bed rest; on bed rest days 5-6, 12-13, 19-20, and 26-27; and daily during the chamber studies. Data were analyzed by Pearson's correlation (P < 0.05). RESULTS: The ratio of animal protein intake to potassium intake was significantly correlated with N-telopeptide in the SED group during bed rest weeks 3 and 4 (r = 0.77 and 0.80) and during the 91-d chamber study (r = 0.75). The ratio of animal protein intake to potassium intake was positively correlated with pyridinium cross-links before bed rest in the EX group (r = 0.83), in the EX group during bed rest week 1 (r = 0.84), and in the SED group during bed rest week 2 (r = 0.72) but not during either chamber study. In both studies, these relations were not significant with the ratio of vegetable protein intake to potassium intake. CONCLUSIONS: The ratio of animal protein intake to potassium intake may affect bone in ambulatory and bed-rest subjects. Changing this ratio may help to prevent bone loss on Earth and during space flight.

Acid-Base Equilibrium↗

Intramuscular pressure and EMG relate during static contractions but dissociate with movement and fatigue.

Intramuscular pressure (IMP) and electromyography (EMG) mirror muscle force in the nonfatigued muscle during static contractions. The present study explores whether the constant IMP-EMG relationship with increased force may be extended to dynamic contractions and to fatigued muscle. IMP and EMG were recorded from shoulder muscles in three sessions: 1). brief static arm abductions at angles from 0 to 90 degrees, with and without 1 kg in the hands; 2). dynamic arm abductions at angular velocities from 9 to 90 degrees /s, with and without 1 kg in the hands; and 3). prolonged static arm abduction at 30 degrees for 30 min followed by recovery. IMP and EMG increased in parallel with increasing shoulder torque during brief static tasks. During dynamic contractions, peak IMP and EMG increased to values higher than those during static contractions, and EMG, but not IMP, increased significantly with speed of abduction. In the nonfatigued supraspinatus muscle, a linear relationship was found between IMP and EMG; in contrast, during fatigue and recovery, significant timewise changes of the IMP-to-EMG ratio occurred. The results indicate that IMP should be included along with EMG when mechanical load sharing between muscles is evaluated during dynamic and fatiguing contractions.

Adult↗

EMG power spectra of intercollegiate athletes and anterior cruciate ligament injury risk in females.

PURPOSE: Females have a disproportionately high incidence of anterior cruciate ligament (ACL) injuries compared with males in analogous sports. Although the pathogenesis of this higher frequency has not been elucidated, gender differences in neuromuscular control of the knee may play an important role. This study evaluates EMG power spectra of the quadriceps and hamstring muscles during dynamic, fatiguing exercise to examine differences between male and female intercollegiate athletes. METHODS: Fifty-one collegiate basketball and soccer players (25 female, 26 male) were studied. Maximum voluntary contraction (MVC) was determined for knee flexion and extension. Three consecutive 2-min bouts of isokinetic knee flexion and extension exercise were performed at 40% MVC. EMG activity in the biceps femoris and vastus medialis obliquus was recorded using bipolar surface electrodes. RESULTS: MVC normalized to body weight was significantly greater in males than in females for the quadriceps (P< 0.01). Quadriceps coactivation ratios were significantly higher in females than in males during knee flexion exercises (P< 0.01). CONCLUSIONS: This study demonstrates differences in the EMG power spectra for females when compared with a matched group of males. Increased quadriceps coactivation in females may increase anterior tibial loads under dynamic conditions, thus placing the ACL at higher risk for injury in the female athlete.

Adolescent↗

Evaluation of treadmill exercise in a lower body negative pressure chamber as a countermeasure for weightlessness-induced bone loss: a bed rest study with identical twins.

UNLABELLED: Counteracting bone loss is required for future space exploration. We evaluated the ability of treadmill exercise in a LBNP chamber to counteract bone loss in a 30-day bed rest study. Eight pairs of identical twins were randomly assigned to sedentary control or exercise groups. Exercise within LBNP decreased the bone resorption caused by bed rest and may provide a countermeasure for spaceflight. INTRODUCTION: Bone loss is one of the greatest physiological challenges for extended-duration space missions. The ability of exercise to counteract weightlessness-induced bone loss has been studied extensively, but to date, it has proven ineffective. We evaluated the effectiveness of a combination of two countermeasures-treadmill exercise while inside a lower body negative pressure (LBNP) chamber-on bone loss during a 30-day bed rest study. MATERIALS AND METHODS: Eight pairs of identical twins were randomized into sedentary (SED) or exercise/LBNP (EX/LBNP) groups. Blood and urine samples were collected before, several times during, and after the 30-day bed rest period. These samples were analyzed for markers of bone and calcium metabolism. Repeated measures ANOVA was used to determine statistical significance. Because identical twins were used, both time and group were treated as repeated variables. RESULTS: Markers of bone resorption were increased during bed rest in samples from sedentary subjects, including the collagen cross-links and serum and urinary calcium concentrations. For N-telopeptide and deoxypyridinoline, there were significant (p < 0.05) interactions between group (SED versus EX/LBNP) and phase of the study (sample collection point). Pyridinium cross-links were increased above pre-bed rest levels in both groups, but the EX/LBNP group had a smaller increase than the SED group. Markers of bone formation were unchanged by bed rest in both groups. CONCLUSIONS: These data show that this weight-bearing exercise combined with LBNP ameliorates some of the negative effects of simulated weightlessness on bone metabolism. This protocol may pave the way to counteracting bone loss during spaceflight and may provide valuable information about normal and abnormal bone physiology here on Earth.

Alkaline Phosphatase↗

Lumbar spine disc heights and curvature: upright posture vs. supine compression harness.

INTRODUCTION: Spinal lengthening in microgravity is thought to cause back pain in astronauts. A spinal compression harness can compress the spine to eliminate lengthening but the loading condition with harness is different than physiologic conditions. Our purpose was to compare the effect of spine compression with a harness in supine position on disk height and spinal curvature in the lumbar spine to that of upright position as measured using a vertically open magnetic resonance imaging system. METHODS: Fifteen healthy subjects volunteered. On day 1, each subject lay supine for an hour and a baseline scan of the lumbar spine was performed. After applying a load of fifty percent of body weight with the harness for thirty minutes, the lumbar spine was scanned again. On day 2, after a baseline scan, a follow up scan was performed after kneeling for thirty minutes within the gap between two vertically oriented magnetic coils. Anterior and posterior disk heights, posterior disk bulging, and spinal curvature were measured from the baseline and follow up scans. RESULTS: Anterior disk heights increased and posterior disk heights decreased compared with baseline scans both after spinal compression with harness and upright posture. The spinal curvature increased by both loading conditions of the spine. DISCUSSION: The spinal compression with specially designed harness has the same effect as the physiologic loading of the spine in the kneeling upright position. The harness shows some promise as a tool to increase the diagnostic capabilities of a conventional MR system.

Adult↗

Mechanical counter pressure on the arm counteracts adverse effects of hypobaric exposures.

INTRODUCTION: Current space suits have limited movement due to gas pressurization during exposure to the vacuum of space. Alternatively, if pressure is applied by an elastic garment vs. pneumatic garment to produce mechanical counter pressure (MCP), several advantages are possible. In this study, we investigate local microcirculatory and other effects produced with and without a prototype MCP glove and sleeve during exposure to varying levels of vacuum. METHODS: The entire arms of eight male volunteers were studied at normal ambient pressure and during 5 min exposures to -50, -100, and -150 mm Hg with and without the MCP glove and sleeve. Pressure distribution, skin microvascular flow, and temperature were measured. RESULTS: The MCP glove and sleeve generated over 200 mm Hg on the middle finger, dorsum of the hand, and the wrist. However, pressure was significantly lower on the forearm and the upper arm. Without the glove and sleeve, only two of eight subjects tolerated -100 mm Hg. Also, no subject tolerated -150 mm Hg. However, subjects tolerated all vacuum pressures wearing the glove and sleeve. Skin microvascular flow and temperature remained within control values with the glove and sleeve at a chamber pressure of -150 mm Hg. DISCUSSION: The MCP glove and sleeve counteracts adverse effects of vacuum exposures due to lower pressure differentials. Pressure levels over the hand and wrist are similar to those of the current U.S. space suit glove and sleeve, but additional development is required to increase MCP over the forearm and upper arm.

Adult↗

Cranial diameter pulsations measured by non-invasive ultrasound decrease with tilt.

INTRODUCTION: Intracranial pressure (ICP) may play a significant role in physiological responses to microgravity by contributing to the nausea associated with microgravity exposure. However, effects of altered gravity on ICP in astronauts have not been investigated, primarily due to the invasiveness of currently available techniques. We have developed an ultrasonic device that monitors changes in cranial diameter pulsation non-invasively so that we can evaluate ICP dynamics in astronauts during spaceflight. This study was designed to demonstrate the feasibility of our ultrasound technique under the physiological condition in which ICP dynamics are changed due to altered gravitational force. METHODS: Six healthy volunteers were placed at 60 degrees head-up, 30 degrees headup, supine, and 15 degrees head-down positions for 3 min at each angle. We measured arterial blood pressure (ABP) with a finger pressure cuff, and cranial diameter pulsation with a pulsed phase lock loop device (PPLL). RESULTS: Analysis of covariance demonstrated that amplitudes of cranial diameter pulsations were significantly altered with the angle of tilt (p < 0.001). The 95% confidence interval for linear regression coefficients of the cranial diameter pulsation amplitudes with tilt angle was 0.862 to 0.968. However, ABP amplitudes did not show this relationship. DISCUSSION: Our noninvasive ultrasonic technique reveals that the amplitude of cranial diameter pulsation decreases as a function of tilt angle, suggesting that ICP pulsation follows the same relationship. It is demonstrated that the PPLL device has a sufficient sensitivity to detect changes non-invasively in ICP pulsation caused by altered gravity.

Adult↗

R-R interval variability with lower body positive pressure assessed by wavelet packet transform.

Lower body positive pressure (LBPP) is used for simulation of microgravity due to central fluid shift. In the present study, we evaluate R-R interval variability, which is sometimes considered as an index of human cardiovascular autonomic nerve status. 10 healthy male subjects were set in a chamber with standing position. Chamber pressure was raised 10 mmHg each for every 3 minutes, up to +40 mmHg. Wavelet packet transform (WPT) followed by Hilbert transform was employed to analyze time-dependent changes in low frequency component (LF) and high frequency component (HF) of R-R interval variability. Calf circumference lowered according to chamber pressure. ABP was maintained throughout measurements. R-R interval was significantly higher at +30 and +40 mmHg compared to that of control. Standing LBPP causes higher HF and lower L/H probably due to central fluid shift, and WPT followed by Hilbert transform shows time-dependent changes in R-R interval variability.

Atmosphere Exposure Chambers↗

Skin blood flow with elastic compressive extravehicular activity space suit.

During extravehicular activity (EVA), current space suits are pressurized with 100% oxygen at approximately 222 mmHg. A tight elastic garment, or mechanical counter pressure (MCP) suit that generates pressure by compression, may have several advantages over current space suit technology. In this study, we investigated local microcirculatory effects produced with negative ambient pressure with an MCP sleeve. The MCP glove and sleeve generated pressures similar to the current space suit. MCP remained constant during negative pressure due to unchanged elasticity of the material. Decreased skin capillary blood flow and temperature during MCP compression was counteracted by greater negative pressure or a smaller pressure differential.

Adult↗

Lower-body negative-pressure exercise and bed-rest-mediated orthostatic intolerance.

PURPOSE: Supine, moderate exercise is ineffective in maintaining orthostatic tolerance after bed rest (BR). Our purpose was to test the hypothesis that adding an orthostatic stress during exercise would maintain orthostatic function after BR. METHODS: Seven healthy men completed duplicate 15-d 6 degrees head-down tilt BR using a crossover design. During one BR, subjects did not exercise (CON). During another BR, subjects exercised for 40 min.d(-1) on a supine treadmill against 50-60 mm Hg LBNP (EX). Exercise training consisted of an interval exercise protocol of 2- to 3-min intervals alternating between 41 and 65% (.)VO(2max). Before and after BR, an LBNP tolerance test was performed in which the LBNP chamber was decompressed in 10-mm Hg stages every 3 min until presyncope. RESULTS: LBNP tolerance, as assessed by the cumulative stress index (CSI) decreased after BR in both the CON (830 +/- 144, pre-BR vs 524 +/- 56 mm Hg.min, post-BR) and the EX (949 +/- 118 pre-BR vs 560 +/- 44 mm Hg.min, post-BR) conditions. However, subtolerance (0 to -50 mm Hg LBNP) heart rates were lower and systolic blood pressures were better maintained after BR in the EX condition compared with CON. CONCLUSION: Moderate exercise performed against LBNP simulating an upright 1-g environment failed to protect orthostatic tolerance after 15 d of BR.

Adult↗

Intramuscular and blood pressures in legs positioned in the hemilithotomy position : clarification of risk factors for well-leg acute compartment syndrome.

BACKGROUND: Acute compartment syndrome has been widely reported in legs positioned in the lithotomy position for prolonged general surgical, urologic, and gynecologic procedures. The orthopaedic literature also contains reports of this complication in legs positioned on a fracture table in the hemilithotomy position. The purpose of this study was to identify the risk factors for development of acute compartment syndrome resulting from this type of leg positioning. METHODS: Eight healthy volunteers were positioned on a fracture table. Intramuscular pressures were continuously measured with a slit catheter in all four compartments of the left leg with the subject supine, in the hemilithotomy position with the calf supported, and in the hemilithotomy position with the heel supported but the calf free. Blood pressure was measured intermittently with use of automated pressure cuffs. RESULTS: Changing from the supine to the calf-supported position significantly increased the intramuscular pressure in the anterior compartment (from 11.6 to 19.4 mm Hg) and in the lateral compartment (from 13.0 to 25.8 mm Hg). Changing from the calf-supported to the heel-supported position significantly decreased intramuscular pressure in the anterior, lateral, and posterior compartments (to 2.8, 3.4, and 1.9 mm Hg, respectively). The mean diastolic blood pressure in the ankle averaged 63.9 mm Hg in the supine position, which significantly decreased to 34.6 mm Hg in the calf-supported position. Changing to the heel-supported position had no significant effect on the diastolic blood pressure in the ankle (mean, 32.8 mm Hg). The mean difference between intramuscular pressure and diastolic blood pressure in the supine position was approximately 50 mm Hg in each of the four compartments. This mean difference significantly decreased to <20 mm Hg in the calf-supported position and then, when the leg was moved into the heel-supported position, significantly increased to approximately 30 mm Hg in all compartments. CONCLUSIONS: The combination of increased intramuscular pressure due to external compression from the calf support and decreased perfusion pressure due to the elevated position causes a significant decrease in the difference between the diastolic blood pressure and the intramuscular pressure when the leg is placed in the hemilithotomy position in a well-leg holder on a fracture table. Combined with a prolonged surgical time, this position may cause an acute compartment syndrome of the well leg. Leaving the calf free, instead of using a standard well-leg holder, increases the difference between the diastolic blood pressure and the intramuscular pressure and may decrease the risk of acute compartment syndrome.

Adult↗

Skin microvascular flow during hypobaric exposure with and without a mechanical counter-pressure space suit glove.

INTRODUCTION: Current space suits are rigid, gas-pressurized shells that protect astronauts from the vacuum of space. A tight elastic garment or mechanical-counter-pressure (MCP) suit generates pressure by compression and may have several advantages over current space suit technology. In this study, we investigated local microcirculatory effects produced with and without a prototype MCP glove. METHODS: The right hand of eight normal volunteers was studied at normal ambient pressure and during exposure to -50, -100 and -150 mm Hg with and without the MCP glove. Measurements included the pressure against the hand, skin microvascular flow, temperature on the dorsum of the hand, and middle finger girth. RESULTS: Without the glove, skin microvascular flow and finger girth significantly increased with negative pressure, and the skin temperature decreased compared with the control condition. The MCP glove generated approximately 200 mm Hg at the skin surface; all measured values remained at control levels during exposure to negative pressure. DISCUSSION: Without the glove, skin microvascular flow and finger girth increased with negative pressure, probably due to a blood shift toward the hand. The elastic compression of the material of the MCP glove generated pressure on the hand similar to that in current gas-pressurized space suit gloves. The MCP glove prevented the apparent blood shift and thus maintained baseline values of the measured variables despite exposure of the hand to negative pressure.

Adult↗

Compression under a mechanical counter pressure space suit glove.

BACKGROUND: Current gas-pressurized space suits are bulky stiff shells severely limiting astronaut function and capability. A mechanical counter pressure (MCP) space suit in the form of a tight elastic garment could dramatically improve extravehicular activity (EVA) dexterity, but also be advantageous in safety, cost, mass and volume. The purpose of this study was to verify that a prototype MCP glove exerts the design compression of 200 mmHg, a pressure similar to the current NASA EVA suit. METHODS: Seven male subjects donned a pressure measurement array and MCP glove on the right hand, which was placed into a partial vacuum chamber. Average compression was recorded on the palm, the bottom of the middle finger, the top of the middle finger and the dorsum of the hand at pressures of 760 (ambient), 660 and 580 mmHg. The vacuum chamber was used to simulate the pressure difference between the low breathing pressure of the current NASA space suits (approximately 200 mmHg) and an unprotected hand in space. RESULTS: At ambient conditions, the MCP glove compressed the dorsum of the hand at 203.5 +/- 22.7 mmHg, the bottom of the middle finger at 179.4 +/- 16.0 mmHg, and the top of the middle finger at 183.8 +/- 22.6 mmHg. The palm compression was significantly lower (59.6 +/- 18.8 mmHg, p<0.001). There was no significant change in glove compression with the chamber pressure reductions. CONCLUSIONS: The MCP glove compressed the dorsum of the hand and middle finger at the design pressure.

Adult↗