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Recovery of maximal insulin responsiveness and insulin sensitivity after induction of insulin resistance in primary cultured adipocytes.

Treatment of primary cultured adipocytes with 50 ng/ml insulin and 20 mM glucose for 0-6 h resulted in a loss of maximal insulin responsiveness (MIR) which was immediate (no lag period), rapid (t1/2 of 3 h), linear, and extensive (80% of that seen at 24 h), whereas loss of insulin sensitivity from 0-24 h was slow (t1/2 = 8 h), extensive (insulin ED50 of 0.3 and 1.45 ng/ml at 2 and 24 h, respectively), and was preceded by an initial 2-h lag. Recovery of MIR and insulin sensitivity was assessed by inducing desensitization for various times from 2-24 h, removing insulin and glucose, and then measuring MIR and insulin sensitivity over a subsequent 1-6-h period. After 2 h, recovery of MIR in desensitized cells was rapid (251 pmol of glucose/3 min/h), whereas after 24 h, recovery was much slower (35 pmol/3 min/h). In contrast, the opposite trend was seen for recovery of insulin sensitivity: at early times recovery of insulin sensitivity was slow (0.05 ng/ml/h) but was rapid after 24 h (0.12 ng/ml/h). Thus, it appears that MIR and insulin sensitivity can be independently regulated since recovery rates for MIR and insulin sensitivity diverged with the progression of insulin resistance. When the effects of insulin and glucose on recovery were examined, we found that insulin alone was unable to block recovery of MIR or insulin sensitivity. Glucose alone, however, was effective in preventing recovery of insulin sensitivity but not recovery of MIR. In the presence of 20 mM glucose, low doses of insulin (treatment EC50 = 0.22-0.46 ng/ml) effectively prevented recovery of both MIR and insulin sensitivity. De novo protein synthesis apparently is not involved in the development of insulin resistance or the reversal of desensitization since inhibition of protein synthesis by cycloheximide had no effect on the loss of MIR and insulin sensitivity or recovery.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue↗

Investigation of menstruation recovery after LH-RH agonist therapy for premenopausal patients with breast cancer.

BACKGROUND: Recently Luteinizing hormone-releasing hormone (LH-RH) agonist has been used for premenopausal patients with breast cancer as endocrine therapy. However, there is no consensus regarding recovery of menstruation after long-term treatment with LH-RH agonist. We investigated recovery of menstruation after this treatment. METHODS: We investigated 28 premenopausal patients with breast cancer who underwent operation at Chiba Cancer Center Hospital in 1995 or 1996. The patients were treated with LH-RH agonist (goserelin) for 24 months as an adjuvant therapy, and were observed for more than 6 months after the last goserelin depot. Ages ranged 31-55 years old from at the time of last treatment. We defined recovery of menstruation as regular menstruation occurring more than three times. RESULTS: There were 22 patients in the recovery group (range: 31-53 years, mean 45.1 years). There were 6 patients in the non-recovery group (range: 50-55 years, mean 52.2 years). The overall recovery rate was 78.6%. Recovery rate was 81.8% for the patients under 50 years, and 66.7% for over 51 years. We separated all patients into groups by age at 5 years intervals, and investigated the distribution of the recovery time. In the recovery group (22 patients), there were 15 patients (68.2%) who confirmed recovery of menstruation within 6 months. CONCLUSION: Our investigation suggested that the recovery of menstruation after this therapy would occur in those less than 50 years old, within 6 months from the last treatment.

Adult↗

Recovery of facial nerve function after repair or grafting: our experience with 24 patients.

OBJECTIVE: The aim of this study was to review the outcomes of facial nerve repair and attempt to identify predictors of recovery time. STUDY DESIGN: A retrospective chart review was conducted. SETTING: The study was done in a single, tertiary care, otologic referral center. PATIENTS AND METHODS: Thirty-one patients underwent facial nerve repair or grafting between 1990 and 2003. Twenty-four patients were found to have complete data sets with at least 11-month follow-up. The following data were noted: patient age and sex, preoperative diagnosis and facial nerve status, administration of radiation, surgical procedure performed (including type and length of graft), proximal and distal sites of anastomosis, time interval to first recovery of clinical facial nerve function, and facial nerve status at most recent follow-up. RESULTS: Nineteen patients had some return of function within 12 months postoperatively. Five patients were lost to follow-up but had no documented facial function at a minimum of 11 months postoperatively. Mean follow-up was 8 months, with a range from 3 to 25 months. Overall mean time to recovery of function was 7 months. Mean times to recovery for each anastomotic site were calculated and found to correlate with recovery times, with an R(2) value of 0.86. A more proximal anastomosis was associated with a longer recovery period. When the data were analyzed individually, no statistical correlation was found between time to recovery of function and patient age, radiation status, length of graft, or site of anastomosis. CONCLUSIONS: Intuitively, because of technical difficulty and the proximity of injury to the cell body, a more proximal repair would seem to result in slower recovery. In our series of patients undergoing repair or grafting, neither the site of injury and repair nor the length of graft were statistically predictive of recovery intervals. A trend toward longer recovery time with a more proximal anastomosis is likely, however, based on the relationship identified between average recovery times and site of injury. A larger series is needed to identify a significant correlation.

Adolescent↗

Recovery of semantic word processing in global aphasia: a functional MRI study.

One important issue concerning the recovery of higher cognitive functions-such as word comprehension in aphasia-is to what extent impairments can be compensated for by intact parts of the network of areas normally involved in a closely related function ("redundancy recovery"). In a previous functional MRI investigation, we were able to show that left hemispheric redundancy recovery within a distributed system of related lexical-semantic functions was the most probable basis of recovery of comprehension from transcortical sensory aphasia. The question remained, however, whether redundancy recovery may play a more general role in the recovery of comprehension after large left hemispheric lesions and severe aphasia. We had the possibility, using the same fMRI paradigm, to study seven cases with left middle cerebral artery (MCA) infarction and partial recovery of comprehension > or =6 months after presentation with global aphasia on acute assessment. Lateralization of activation did not differ significantly between patients and controls. The most consistent regions of activation included the left extrasylvian posterior temporal and the right posterior parietal cortex. Recovery of language comprehension was associated predominantly with activations in regions, which were also activated in several normal subjects. We suggest that a redundancy recovery mechanism within multiple representations of closely related functions was more important than take-over of function by previously unrelated areas (vicariation) as the basis of recovery of word comprehension in our patients in spite of extensive left hemispheric damage. We conclude that redundancy within the lexical-semantic system seems to make an important contribution to recovery of comprehension even in severe aphasia.

Acoustic Stimulation↗

Physical, psychological and social recovery patterns after coronary artery bypass graft surgery: a prospective repeated measures questionnaire survey.

AIM: This study examined the physical, psychological and social recovery patterns of Hong Kong Chinese patients who have undergone CABG surgery over a period of six months. BACKGROUND: Recovery from coronary artery bypass graft (CABG) surgery is a dynamic process and the associated physical, psychological and social effects could lead to failure to recuperate leading to hospital re-admission and morbidity. DESIGN: A prospective repeated measures design was used for this research. Patients were interviewed in person 5 days before surgery and at 1 week after discharge, and by telephone at 3 and 6 months after discharge. Physical recovery dimension was assessed by three categories of the Sickness Impact Profile (ambulation, sleep-rest, body movement and care). Social recovery dimension was assessed by three categories of the Sickness Impact Profile (SIP) (home management, social interaction, and recreation and pastimes). Psychological recovery was assessed using the Centre for Epidemiologic Studies-Depression (CES-D). RESULTS: Sixty-eight patients participated in this research. The mean physical SIP-dimension score and depression level at discharge was the highest then gradually decreased at 6 months after CABG. The SIP-physical and SIP-social and depression level differed significantly across the four-assessment time within-group. There were no gender differences in physical and social recovery and depression levels. Patients who had poorer physical and social recovery had more depression at one week and three months after CABG surgery. CONCLUSION: Patients should be prepared for discharge after CABG surgery. Cultural factors may have influenced the similar recovery patterns between genders. These factors contributing to early recovery must be further examined. RELEVANCE TO CLINICAL PRACTICE: Because of the large number of patients who undergo CABG worldwide, and because of healthcare cost related to this intervention, it is important for both patients and healthcare providers to have realistic expectations about the recovery process and to recognise deviations from the norm. The results provided some insights into the Hong Kong Chinese patients' recovery from CABG surgery that would guide the development of culturally appropriate pre-operative and discharge teaching for this group of patients.

Adaptation, Psychological↗

Social precursors to onset and recovery from episodes of common mental illness.

BACKGROUND: Social disadvantage and lack of social support have been identified as important risk factors for the onset and continuance of episodes of common mental illness. This study aimed to identify the social precursors to episodes of and recovery from common mental illness in a large, general population sample over eight yearly intervals. METHOD: The analytical samples were drawn from those aged > or = 16 in the British Household Panel Survey from 1991 to 1998. The samples were: (1) onset--over 42,000 paired years from 10,204 persons; (2) recovery--over 10,000 paired years from 4878 persons; and (3) 1812 spells with observed onset and recovery. Markov and discrete-time complementary log-log models were used. Common mental illness was measured using the 12-item General Health Questionnaire. RESULTS: Sex, age, changes in marital and employment status, physical health, family care and social support were all associated with differential rates of onset and recovery. Severity of disorder was associated with less likelihood of recovery and longer time to recovery. CONCLUSIONS: The study confirms many previous findings concerning social factors associated with onset and recovery. Low social support acted as expected by increasing chances of onset and decreasing chances of recovery. Other social factors such as separation or divorce, becoming and remaining unemployed, health limiting daily activities, caring for a sick relative all decreased chances of recovery. The chances of observing a change in state (either onset or recovery) decreased with the number of prior observations in that state. Reduced rates of recovery with increasing degrees of severity of distress was expected, but not previously demonstrated.

Adult↗

[Neuromuscular recovery following mivacurium is predictable in patients with severe systemic disease prognoses].

OBJECTIVES: Fast recovery from mivacurium-induced neuromuscular blockade is impaired in patients with decreased plasma cholinesterase activity which is often associated with dysfunction of different organs. Nevertheless, predictability of neuromuscular recovery may be given. Thus, this study evaluates parameters to predict individual neuromuscular recovery in patients with uncommon diseases. METHODS: 84 male or female patients (18-70 years of age) were allocated to one of two groups according to their ASA risk profile (without severe systemic diseases: ASA 1 and 2; with severe systemic diseases: ASA 3 and 4). Plasma cholinesterase activity (PChE) had been determined preoperatively. Anaesthesia was performed with propofol and fentanyl. Neuromuscular transmission was monitored by electromyography. The ulnar nerve was stimulated by train-of four stimuli and neuromuscular transmission was measured at the hypothenar. After mivacurium 0.1 mu mg/kg, an infusion of mivacurium was adjusted to maintain T1/T0 at approximately 5% for at least 60 min. Duration from application of the initial bolus until recovery to T1/T0 = 5% (dur 5), the mean mivacurium infusion rate (IR), infusion time, the early recovery time from cessation of infusion to T1/T0 = 25% (rec 25) and the final recovery time from T1/T0 = 25% to T4/T1 = 75% (final rec) was measured. Statistical analysis of data was performed using t-tests. (alpha = 0.05). Predictability of the recovery times (rec 25 and final rec) was tested by multiple linear least-squares regressions. Dependent variables were PChE, dur 5, IR, infusion time, and rec 25, respectively. To test for predictability of neuromuscular blockade by mivacurium with respect to severe systemic diseases, the ASA risk score was defined to be the second independent variable at each regression, the respective interaction was defined to be the third independent variable (variable 1 x group). Variables entered multiple regression analysis in a forward stepwise manner (F > 4.0). RESULTS: PChE was significantly lower in patients with severe systemic diseases (3.7 +/- 1.2 kU/l vs. 4.5 +/- 0.9 kU/l), dur 5 significantly prolonged (17.3 +/- 7.3 min vs. 11.0 +/- 3.0 min), IR significantly lower (4.6 +/- 2.6 micrograms/kg/min vs. 6.5 +/- 2.8 micrograms/kg/min), and rec 25 (8.7 +/- 4.0 min vs. 6.0 +/- 1.7 min) as well as final rec (23.0 +/- 16.3 min vs. 13.0 +/- 3.7 min) significantly prolonged compared to patients without severe systemic diseases. Both recovery intervals correlated significantly with PChE, dur 5, or IR, but not with the ASA risk score. Multiple regression analysis revealed a close correlation between rec 25 and final rec very closely (R2 = 0.875). Prolonged mivacurium infusion time and additionally high ASA risk score were correlated with a prolonged neuromuscular recovery (R2 = 0.130). DISCUSSION: Prolonged neuromuscular recovery could be predicted from a reduced PChE, a prolonged duration of action of the initial mivacurium bolus and a decreased mivacurium-infusion rate required to maintain a 95% neuromuscular blockade. Measurement of plasma cholinesterase and monitoring of mivacurium induced neuromuscular blockade can avoid resting neuromuscular blockade postoperatively despite of prolonged neuromuscular recovery.

Adolescent↗

Early recovery after closed traumatic head injury: somatosensory evoked potentials and clinical findings.

OBJECTIVE: To determine the ability of somatosensory evoked potentials (SEP) compared with clinical findings to monitor and predict recovery in patients suffering from closed head injury with predominantly diffuse axonal injury (DAI). DESIGN: Prospective cohort study. SETTING: Neurologic intensive care unit (ICU) of a university hospital. PATIENTS: Serial SEP recordings were obtained from 31 consecutive patients with closed head injury. The first SEP was recorded within 48 hrs after trauma, followed by recordings after another 2 days, after which the time interval for each consecutive recording was doubled. Clinical examinations were performed every 6 hrs during the ICU stay and daily after transfer to a general neurologic ward. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Twenty-three of 31 patients demonstrated pathologic SEP findings at initial examination. Of these patients, 11 recovered clinically, two remained vegetative, and ten died. In all 11 patients with clinical recovery, SEP also recovered. In 8 of 31 patients, initial SEPs were normal and remained normal until discharge, all eight had a good outcome. Initial SEP findings were related with outcome at 6 months (p = .02), and follow-up studies increased the predictive value of SEP studies (p = .009). Other factors related to outcome included age, severity of DAI, and length of ICU/hospital stay. In the 11 patients with SEP and clinical recovery, early (day 2) and late (>or=2 months) recovery was documented. Early and reliable SEP indicators of improvement included N20-P25-Amplitudes (mean recovery, 8.5 days) and central conduction time (9.6 days). Pupillary light reaction (6.4 days), Babinski reflex (12.4 days), and Glasgow Coma Score (9.6 days) were the most valuable clinical findings. Recovery of the Glasgow Coma Score frequently coincided with reduction of sedatives. In most patients, recovery was detected with SEP before clinical recovery (7/11 patients, time difference 1 wk). CONCLUSIONS: Initial SEP findings correlate with long-term outcome in patients with closed head injury with DAI. Initial bilaterally absent cortical responses in the SEP reliably predicted death, whereas completely normal SEP findings predicted good long-term outcome. Early recovery after DAI can be detected with serial SEP recordings despite sedative medications. Electrophysiologic recovery frequently precedes clinical recovery.

Adult↗

Longitudinal quantitative measures of the natural course of low back pain recovery.

STUDY DESIGN: A prospective study was developed to quantify acute low back pain recovery. OBJECTIVE: To compare traditional self-report measures of low back pain recovery with a quantitative measure of recovery. SUMMARY OF BACKGROUND DATA: The magnitude of low back disorders in society continues to be a problem. To prevent secondary injuries, an understanding of recovery must be gained by comparing the natural course of recovery using several outcome measures. METHODS: For this study, 16 occupational and 16 nonoccupational patients with low back pain were recruited. Recovery was monitored prospectively every 2 weeks for 3 to 6 months, using subjective work status, pain symptoms, activities of daily living, and objective functional performance probability (trunk kinematics). RESULTS: Return to work underestimated the percentage of subjects impaired, as compared with all other outcome measures. Symptoms, activities of daily living, and functional performance probability all showed similar patterns of recovery for 0 to 12 weeks. At 14 weeks, there was a lag in functional performance recovery. Both symptoms and activities of daily living indicated that 80% of the population was recovered, whereas functional performance indicated the figure to be 68%. CONCLUSION: This prospective study demonstrates the natural course of recovery using several outcome measures. The objective kinematic functional performance measure of recovery quantifies a different aspect of impairment not evaluated by traditional subjective measures. Use of several outcome measures may lead to a better understanding of low back pain recovery or residual impairment, which may minimize the risk of recurrent injury.

Activities of Daily Living↗

Effects of alpha-2 adrenoceptor agonists during recovery from isoflurane anaesthesia in horses.

REASONS FOR PERFORMING STUDY: Recovery from inhalant anaesthesia in the horse is a critical and difficult period to manage; however, several factors could help to obtain a calm recovery period including choice of anaesthetic and analgesic procedure used and the conditions under which anaesthetic maintenance and recovery occur. OBJECTIVES: The objective of this study was to evaluate and compare the quality of recovery in horses administered saline, xylazine, detomidine or romifidine during recovery from isoflurane anaesthesia. METHODS: Six mature and healthy horses were premedicated with i.v. xylazine and butorphanol, and anaesthesia induced using ketamine. After 2 h of inhalant anaesthesia with isoflurane vaporised in oxygen, saline solution, xylazine (0.1 mg/kg bwt), detomidine (2 microg/kg bwt) or romifidine (8 pg/kg bwt) were administered. The quality of recovery of each horse and the degree of sedation and ataxia were evaluated. Cardiovascular and respiratory parameters were recorded, and arterial blood samples obtained and analysed for pH, PO2 and PCO2 during recovery. RESULTS: Quality of recovery was better in groups treated with alpha-2 adrenergic receptors agonists, showing less ataxia. Degree of sedation was greater in the romifidine group. CONCLUSIONS: We concluded that the administration of alpha-2 adrenoceptor agonists during recovery from isoflurane anaesthesia in horses prolonged and improved the quality of recovery without producing significant cardiorespiratory effects. POTENTIAL CLINICAL RELEVANCE: Administration of alpha-2 adrenoceptor agonists after inhalent anaesthesia could prevent complications during the recovery period.

Adrenergic alpha-2 Receptor Agonists↗

Cortical reorganization in patients with subcortical hemiparesis: neural mechanisms of functional recovery and prognostic implication.

OBJECT: A systematic investigation on cortical reorganization in patients with hemiparesis of a subcortical origin, with special emphasis on functional correlates, was conducted using functional magnetic resonance (fMR) imaging performed on a 3-tesla system specifically optimized for fMR imaging investigation. METHODS: The study group included 46 patients with hemiparesis (25 with right and 21 with left hemiparesis) and 30 age-matched healthy volunteers as controls. All study participants were originally right handed. The characteristics of the lesion were putaminal hemorrhage in 19 patients, thalamic hemorrhage in 10 patients, and striatocapsular bland infarction in 17 patients. Functional recovery in subcortical hemiparesis showed two distinct phases of the recovery process involving entirely different neural mechanisms. Phase I is characterized by the process of recovery and/or reorganization of the primary system. Successful recovery of this system is typically reached within 1 month after stroke onset. Its clinical correlate is a rapid recovery course and significant recovery of function within 1 month of stroke onset. Failure of recovery of the primary system shifts the recovery process to Phase II, during which reorganization involving the ipsilateral pathway takes place. The clinical correlate of Phase II is a slow recovery course with variable functional outcome. CONCLUSIONS: Effective functional organization of the ipsilateral pathway, as identified by linked activation of the ipsilateral primary sensorimotor cortex and contralateral anterior lobe of the cerebellum, is correlated with a good prognostic outcome for patients in the slow recovery group. A high degree of connectivity between supplementary motor areas, bilaterally, appears to influence functional recovery adversely.

Aged↗

Modeling in vivo recovery of intracellular pH in muscle to provide a novel index of proton handling: application to the diagnosis of mitochondrial myopathy.

Post-exercise recovery of intracellular pH (pH(i)) assessed using phosphorus magnetic resonance spectroscopy has not been previously evaluated in its entirety due to its complex time-course and missing data points resulting from a transient loss of inorganic phosphate signal. By considering the transition from exercise to recovery as a step function input, pH(i) recovery was modeled based on the creatine-kinase equilibrium, and the entire pH(i) recovery was characterized by calculating the time required for pH(i) recovery (t(pHrec)). Applying this methodology, normal subjects showed a strong linear correlation between phosphocreatine (PCr) half-time and t(pHrec) (r = 0.90, P < 0.001). In mitochondrial myopathy (MM) patients with weakness in the limb examined, 9/10 had faster pH(i) recovery relative to PCr recovery; wide normal ranges from a control group which included deconditioned subjects resulted in 7 of those 10 patients having otherwise normal recovery indices. Therefore, modeling pH(i) recovery allows characterization of the entire pH(i) recovery and detects altered proton handling in MM patients, including those with otherwise normal recovery indices.

Adult↗

Long term model for evaluation of myocardial metabolic recovery following global ischemia.

Myocardial ATP levels remain depressed following significant periods of ischemia (Isc) despite reperfusion (Rpf). Neither the rate of in vivo ATP return following global Isc nor the factors which influence recovery have been defined. In order to determine the time course to complete the return of ATP levels and evaluate methods of enhancing recovery of ATP levels, we have devised a chronic canine model of global Isc. In this model serial ventricular biopsies can be taken in the awake animal over several days without reoperation which allows an investigation of the recovery of the myocardium following a uniform global insult to be performed. Recovery of ATP levels has been shown to depend, at least in part, on the availability of precursors and the activity of the ATP regenerating enzymes. Because complete recovery of ATP levels takes days, short term (hours) models have limitations. Previous attempts at enhancing ATP recovery following Isc have been only partially successful because either the degree of depression was not great or the period of observation was short, resulting in incomplete return. To identify the best precursor choice, we previously measured the activity of the AMP regenerating enzymes, adenosine kinase (AdK) (adenosine----AMP) and adenine phosphoribosyl transferase (APRT) (adenine----AMP). Because APRT activity was 20 fold higher than AdK with similar Km values for substrates, it appeared that adenine (A) is preferred to adenosine for AMP regeneration in the dog's myocardium. The formation of 5-phosphoribosyl 1-pyrophosphate (PRPP) may also be rate limiting and, therefore, the effect of ribose (R) on ATP recovery was also evaluated. Recovery of ATP levels was assessed in three groups: (1) normal saline (NS), (2) A (20 mM) in normal saline (A/NS) or (3) A with R (80 mM) in normal saline (A/R) were infused (1.0 ml/min) into the right atrium of dogs for 48 hours following Isc. In all groups, ATP levels fell to between 46-60% of pre-Isc levels during Isc. In the NS dogs, ATP levels continued to fall slightly to 46% pre-Isc levels during the first four hours of Rpf after Isc. By 24 hours no appreciable recovery had occurred and the measured ATP was only 51% of the pre-Isc value. Even by seven days, ATP had not returned fully, and by extrapolation, complete recovery required 9.9 +/- 1.4 days. Treated dogs showed, however, that ATP recovery could be significantly enhanced.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenine Nucleotides↗

The relationship between plasma potassium concentration and muscle torque during recovery following intense exercise.

The present study investigated the relationship between plasma potassium ion concentration ([K+]) and skeletal muscle torque during three different 15-min recovery periods after fatigue induced by four 30-s sprints. Four males and one female completed the multiple sprint exercise on three separate days; recovery was passive, i.e. no cycling exercise (PRec), active cycling at 30% peak oxygen consumption. VO2peak (30% Rec) and active cycling at 60% VO2peak (60% Rec). Plasma [K+] was measured from blood sampled from an antecubital vein of subjects at rest and at 0, 3, 5, 10 and 15 min into each recovery. Isokinetic leg strength was measured at rest and at 1, 6, 11 and 16 min during each recovery. Following the exhaustive sprints, [K+] increased significantly from an average mean (SEM) resting value of 3.81 (0.07) mmol.l-1 to 4.48 (0.19) mmol.l-1 (P < 0.01). In all recovery conditions, plasma [K+] returned to resting levels within 3 min following the fourth sprint. However, in the two active recovery conditions plasma [K+] increased over the remainder of the recovery periods to 4.36 (0.12) mmol.l-1 in the 30% Rec condition and 4.62 (0.12) mmol.l-1 in the 60% Rec condition, the latter being significantly higher than the former (P < 0.01). The maximum torque measured following the sprints decreased significantly, on average, to 61.1 (8.36)% of peak levels (P < 0.01). After 15 min of recovery, maximum torque was highest in the 30% Rec condition at 92.13 (3.06)% of peak levels (P < 0.01), compared to 85.23 (3.64)% and 85.71 (0.82)% for the PRec and 60% Rec conditions, respectively. In contrast to the significant differences in plasma [K+] across all three recovery conditions, muscle torque recovery was significantly different in only the 30% Rec condition. In summary, recovery of peak levels of muscle torque following fatiguing exercise does not appear to follow changes in plasma [K+].

Adult↗

Significance of pacemaker recovery time after the Mustard operation for transposition of the great arteries.

Pacemaker recovery time corrected for cycle length was measured in 24 patients 6 months to 3 years after the Mustard operation for transposition of the great arteries. This index of sinoatrial (S-A) nodal function was obtained by subtracting the control R-R interval from the first R-R interval recorded after 3 minutes of rapid atrial pacing at the superior vena caval-right atrial junction. Recovery times were compared with those of a control group of 54 children with various forms of congenital heart disease who had not had cardiac surgery and whose electrocardiogram revealed normal sinus rhythm. The longest corrected pacemaker recovery time in the control group was 250 msec. Recovery time was normal (mean 115 msec) in 13 of the 24 patients who had undergone the Mustard procedure and prolonged (mean 472 msec) in the other 11. In 4 of these 11 a junctional escape complex was recorded before recovery of the S-A node. The configuration of the P wave and the development of dysrhythmias in the postoperative follow-up period were compared in patients with a normal and a prolonged corrected pacemaker recovery time. The incidence of dysrhythmias was much smaller in the former group. Normal sinus rhythm after the first postoperative week was noted in 10 (76 percent) of patients with a normal corrected pacemaker recovery time but in only 2 (18 percent) of those with an abnormal recovery time. One patient with an abnormal recovery time died suddenly 26 months after operation in spite of good hemodynamic repair. A prolonged pacemaker recovery time after the Mustard operation for transposition of the great arteries indicated that rhythm abnormalities were likely to develop, but a normal recovery time did not exclude abnormal sinus nodal function.

Adolescent↗

Putative stimulants for functional recovery after neural trauma: only spermine was effective.

The motor functional recovery after sciatic nerve crush was measured in rats treated with daily injections of (a) thyrotropin-releasing hormone (2.0 mg/kg, (b) alpha-melanocyte-stimulating hormone (0.07 mg/kg/48 h), or (c) testosterone propionate (4.4 mg/kg). The recovery of the motor function of the sciatic nerve was indicated by using the return of the toe-spreading response. None of the treatments differed significantly from saline controls in the time needed for recovery. The same procedure (without injections) was carried out with castrated and noncastrated male rats in order to test the effect of the lack of testosterone on recovery time after sciatic crush. The groups did not differ significantly as to their recovery times. The same method was used to study the effect of spermine (10.0 mg/kg/day) on the recovery of motor function. Spermine seemed to reduce the time needed for recovery from a mean value of 15.7 to 11.0 days (P less than 0.01). We also studied the effect of daily injections of spermine (13.0 mg/kg) on the sensory division of the peripheral nerve using the foot-flick test. The time needed for recovery after crush in the sciatic notch was reduced from 13.7 to 7.7 days (P less than 0.005). These results do not support the hypothesis that alpha-melantocyte-stimulating hormone, thyrotropin-releasing hormone, or testosterone enhance functional recovery of severed motor axons. Our results confirm a previous observation that spermine reduces the time needed for recovery after trauma in peripheral motor neurons. The result of the foot-flick test suggests that spermine enhances both motor and sensory recovery.

Animals↗

DNA-replication recovery inhibition and subsequent reinitiation in UV-radiation-damaged E. coli: a strategy for survival.

Using the incorporation of [14C]thymine to measure DNA accumulation, it was shown that exposure of the B/r strain of Escherichia coli to 10 J/m2 of ultraviolet radiation (UV) inhibits replication for about 20 min, but then resumption of replication occurs. Pulse-labelling with [3H]thymidine after exposure of the WT strain to this fluence confirmed the transient inhibition and recovery of DNA replication. After recovery, the rate of accumulation of DNA in the culture increases, to exceed that of the exponentially growing culture, so that eventually the amount of DNA almost equals that of the unirradiated culture. After a higher fluence (20 J/m2), an inhibition of replication recovery was revealed. This fluence delays the reinitiation of DNA accumulation in the culture, measured by [14C]thymine incorporation, for 25 min more, in addition to the 20-min recovery period. This finding was confirmed with pulse-labelling studies, which revealed that the higher exposure represses the rates of replication for 45 min before replication at the normal rate reinitiates in the culture. It was proposed that the inhibition of recovery revealed by these investigations is effected by the UV-induction of an active DNA-replication recovery-inhibition process. With the uvrA strain, rate studies revealed that 1.5 J/m2 of UV (a reduced fluence necessary because of the greater sensitivity of the strain) induces a transient inhibition of DNA replication, with considerable recovery following. Exposure to 3.0 J/m2 induces the transient inhibition of replication, followed by massive recovery inhibition after 20 min of incubation. With uvrA recA, both the lower and the higher fluence resulted in an immediate block of replication with no recovery, confirming the recA gene dependency of the recovery process. The decrease in rate of replication comparable to that seen in the uvrA strain after 20 min, and taken as evidence of the function of the recovery-inhibition process, was not seen. The evidence supports the concept that a process somehow triggered by higher UV fluences functions to repress replication temporarily, presumably allowing time for repair processes to take place before replication overruns closely linked pyrimidine dimers on opposite strands to create lethal lesions.

DNA Replication↗

Long latency inhibition of H-reflex recovery by cutaneous tactile stimulation in man: a cutaneous transcortical reflex.

The effect of cutaneous tactile stimulation on motoneuron excitability was studied in 20 normal subjects and in patients of hemiplegia (n = 14) and paraplegia (n = 15) by plotting H-reflex recovery curves during application of twin pulses alone ("basal" H-reflex recovery curve), and twin pulses synchronized with electrical stimuli evoking tactile sensation in skin over the lateral border of the small toe. The "basal" H-reflex recovery curves from normal subjects showed a significant lateral asymmetry of motoneuron excitability, with an even distribution of subjects showing greater excitability on the left and right sides. However, there was no relation between handedness and the side with greater excitability. The cutaneous stimulation produced a highly significant inhibition of the H-reflex recovery between 600 and 6000 ms, with the maximum inhibition recorded at 1000 and 2000 ms, at which time even a complete inhibition of the test H-reflex was observed in some instances. The effect of cutaneous stimulation before 600 ms was statistically insignificant. The amount of cutaneous inhibition of H-reflex recovery showed a lateral asymmetry. The side with greater motoneuron excitability showed more cutaneous inhibition of the H-reflex recovery. A comparison of the H-reflex recovery at higher frequencies of cutaneous stimulation with that at basal frequency showed a slight but statistically insignificant difference in the amount of cutaneous inhibition of the H-reflex recovery. In hemiplegics, the "basal" H-reflex recovery curves showed greater motoneuron excitability on the affected side as compared to those of the unaffected side or controls, with the late inhibitory phase being completely obliterated. A similar pattern was also observed in paraplegics. Significantly, the lateral asymmetry of motoneuron excitability observed in the control group was absent in paraplegics. The cutaneous stimulation failed to produce any significant effect on the H-reflex recovery curves either in the affected side of hemiplegics or in both sides of paraplegics. The significant long latency inhibition of the H-reflex recovery curve produced by cutaneous tactile stimulation is a new finding.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗