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Results for “Recovery phases”

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PubMed1998

A case of poliomyelitis-like syndrome.

The authors report the case of a boy aged 4 years who had sudden abdominal pain and inability to walk on the day before admission to hospital and who developed abdominal distention and difficulty urinating. On admission, the abdominal skin reflexes, knee jerks, cremaster and anal reflexes were absent and power in the lower extremities was reduced. Spinal fluid examination showed a cell count of 383/mm3, with 95% neutrophils and 5% lymphocytes; spinal fluid protein of 44 mg/dl; and glucose 75 mg/dl. Serological studies did not reveal any significant antibodies for polio virus type 1, 2, 3, various ECHO viruses, Coxsackie types A4, A7, A9, B1 or B5. However, the titer of Coxsackie virus antibody type A10 was 128 in the acute phase and only 32 in the recovery phase 4 weeks later. Magnetic resonance scans were performed on the second day; the findings were normal in the brain, but interesting lesions were revealed in the thoracic cord with both T1-weighted images and T2-weighted images. Neurological symptoms improved asymmetrically.

Child, Preschool↗

PubMed2004

Correlation of neutrophil phagocytosis and lymphocyte adhesion molecules in exertional heat stroke.

BACKGROUND: Increased susceptibility to infections has been shown in patients with classic heat stroke. Although immunologic and inflammatory responses may be important factors, the direct role of circulating neutrophil phagocytosis and lymphocyte adhesion molecule expression has yet to be investigated in exertional heat stroke (ExHS). DESIGN: Circulating neutrophil phagocytosis and lymphocyte adhesion molecule CD11a and CD11b expression were examined in 17 patients with ExHS and 17 exertional control subjects (ExC). RESULTS: Patients with ExHS showed significantly increased total leukocyte, neutrophil, and lymphocyte counts, attenuated neutrophil phagocytosis ability, and higher expression of CD11a and CD11b in the acute phase of ExHS, compared with the recovery phase of ExHS and ExC. Although there were no correlations between body temperature and phagocyte function or adhesion molecules, a negative correlation between phagocytosis and CD11a/CD11b was present. CONCLUSION: Increased leukocyte count with decreased circulating neutrophil phagocytic capacity and increased expression of lymphocyte adhesion molecules may in part explain the susceptibility to infections in ExHS.

Adult↗

PubMed2005

Possible pathologenic role of interleukin-5 and eosino cationic protein in Henoch-Schönlein purpura nephritis.

BACKGROUND: The mechanism for the onset of Henoch-Schönlein purpura nephritis is unknown. In order to identify the pathogenesis of nephritis, laboratory findings and serum cytokines between Henoch-Schönlein purpura (HSP) patients without nephritis and with nephritis were investigated. METHODS: We enrolled 32 patients who had been diagnosed with HSP from January 1993 to December 1998. These patients were divided into two groups. Group 1 consisted 12 patients without nephritis and group 2 consisted 20 patients with nephritis. We evaluated laboratory findings such as eosinophil counts, serum IgE, eosino cationic protein (ECP), and serum cytokine (interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, IL-13 interferon-gamma and tumor necrotic factor-alpha) concentrations between both groups. RESULTS: At the acute phase, serum IL-5 and ECP concentrations in group 2 were higher than those in group 1 (59.4 +/- 32.7 pg/mL vs. 10.8 +/- 12.8 pg/mL, P < 0.05, 24.3 +/- 5.1 microg/L vs. 8.9 +/- 4.2 microg/L, P < 0.05, respectively). Serum IL-4 concentrations at the acute phase in group 1 were higher than those in group 2 (40.2 +/- 21.5 pg/mL vs. 10.7 +/- 5.4 pg/mL, P < 0.01). In group 2, serum IL-5 concentrations at the acute phase were higher than those at recovery phase. CONCLUSIONS: These findings suggest that IL-5 and eosinophil activation may be one of the factors involved in the mechanism for onset of nephritis.

Case-Control Studies↗

PubMed1995

Testosterone increases human platelet thromboxane A2 receptor density and aggregation responses.

BACKGROUND: The incidence of thrombotic cardiovascular disease is greater in men than in premenopausal women. Testosterone has been implicated as a significant risk factor for cardiovascular disease and for acute myocardial infarctions and strokes in young male athletes who abuse anabolic steroids. Thromboxane A2 (TXA2) is a vasoconstrictor and platelet proaggregatory agent that has been implicated in the pathogenesis of cardiovascular disease. We therefore tested the hypothesis that testosterone regulates the expression of human platelet TXA2 receptors. METHODS AND RESULTS: In a double-blind, placebo-controlled, randomized, parallel-group study, we determined the effects of testosterone cypionate 200 mg IM given twice, 2 weeks apart, or saline placebo in 16 healthy men. Platelet TXA2 receptor density (Bmax) and dissociation constant (Kd) were measured by use of the TXA2 mimetic 125I-BOP. Platelet aggregation responses to I-BOP and to thrombin and plasma testosterone concentrations were measured before treatment (pretreatment phase), at 2 and 4 weeks (active phase), and again at 8 weeks (recovery phase). Treatment with testosterone was associated with an increase in the Bmax value from 0.95 +/- 0.13 to 2.10 +/- 0.4 pmol/mg protein (n = 9), with a peak effect at 4 weeks (P = .001), returning to baseline by 8 weeks. There was no significant change in Bmax values in the saline-treated group. The Kd values were unchanged. Testosterone treatment was associated with a significant increase in the maximum platelet aggregation response to I-BOP (P < .001) at 4 weeks and returned to baseline at 8 weeks. The EC50 values were not significantly changed. Platelet TXA2 receptor density was positively correlated (r = .56, P < .001, n = 32 measurements) with pretreatment (endogenous) plasma testosterone levels (range, 215 to 883 ng/dL) but not Kd. CONCLUSIONS: Testosterone regulates the expression of platelet TXA2 receptors in humans. This may contribute to the thrombogenicity of androgenic steroids.

Adult↗

PubMed1999

Lack of evidence of acute ischemic tissue change in transient global amnesia on single-shot echo-planar diffusion-weighted MRI.

BACKGROUND AND PURPOSE: There is uncertainty concerning the etiology of transient global amnesia (TGA). Previous CT and MRI studies have indicated that permanent structural abnormality is rare in TGA. Diffusion-weighted (DW) MRI is very sensitive to early ischemic parenchymal changes and has recently demonstrated embolic infarction in the posterior cerebral artery territory in 2 TGA patients. We report the findings of DW MRI in 8 patients in acute stages of TGA. METHODS: Conventional and echo-planar DW MRI was performed in 2 patients in the active phase and 6 patients in the recovery phase (1 to 8 hours after cessation of anterograde memory dysfunction) of spontaneously occurring TGA. RESULTS: None of the patients showed signs of hyperintensity on DW images or hypointensity on quantitative apparent diffusion coefficient (ADC) maps to suggest regional decreases of water mobility or acute T2 changes on transverse or coronal slices. CONCLUSIONS: We were unable to detect ADC or acute T2 changes with echo-planar DW MRI in patients with TGA, which suggests that mechanisms other than ischemic infarction may cause TGA. We did not identify spreading depression-associated changes of the ADC. Further refinement of MRI sequences may be necessary to detect subtle or transient signal change in brain parenchyma.

Aged↗

PubMed1994

[Echocardiographic evaluation of left ventricular hemodynamics in children with post-streptococcal acute glomerulonephritis].

Left ventricular hemodynamics were studied using M-mode and pulsed doppler echocardiography in 18 cases with post-streptococcal acute glomerulonephritis (PSAGN) during the acute phase. Both the ratio of left atrial to aortic dimension and the end-diastolic volume index increased in the acute phase compared with those in the recovery phase in each case (p < 0.01, p < 0.01). These results indicated that the increase in the preload was due to hypervolemia. End-systolic wall stress increased in the acute phase (p < 0.01), thereby the afterload was considered to have increased as well. But the value of systemic vascular resistance showed no significant difference in either phase. Therefore it seems the increase of the afterload was due to increasing blood pressure, which was mainly due to hypervolemia. The ratio of end-systolic wall stress to the end-systolic volume index (ESWS/ESVI) was significantly higher in the acute phase (p < 0.01). Stroke volume index (SI) was also increased in the acute phase (p < 0.01). The increase in SI was considered to be due to a more prominent increase in both the preload and left ventricular contractility than in the afterload. Left ventricular inflow patterns derived from pulsed doppler echocardiography also suggested a markedly increased preload and an increased afterload in the acute phase. These data showed that in the acute phase of PSAGN, left ventricular preload, contractility and afterload were increased due mainly to hypervolemia.

Acute Disease↗

PubMed2001

Severe, but completely reversible heart failure in an adult with meningococcal sepsis.

A 25-year-old woman developed meningococcal septicaemia, among others complicated by a combination of cardiogenic and distributive shock requiring full haemodynamic support in the acute phase. Besides clinical course and treatment in the acute phase, we describe treatment in the recovery phase and make some comments concerning the pathophysiology. This case demonstrates the importance of intensive treatment for cardiac failure in the initial period and long-term therapy afterwards because myocardial function can be fully restored.

Adult↗

PubMed1996

Mild mental stress increases insulin sensitivity in healthy young men.

We examined if mental stress alters insulin sensitivity and renal sodium handling in 11 normotensive young men. Following a 60-minute period of equilibration, we performed euglycemic hyperinsulinemic glucose clamp for 150 minutes. The clamp period was divided into three phases; control phase for 90 minutes (I), mental arithmetic phase for 30 minutes (II), and recovery phase for 30 minutes (III). Blood pressure, heart rate and glucose disposal rate (M value) significantly elevated during phase II of the stress study. In a time control study, in which mental arithmetic was not loaded during phase II, blood pressure was kept constant and the changes in M value from phase I to phase II were significantly smaller than those in the stress study. In both studies, fractional excretion of sodium did not significantly change throughout the study period. Thus, insulin sensitivity concerning glucose metabolism increased in response to mild mental stress. However, the effect of insulin on sodium handling was not altered by the stress.

Adult↗

PubMedDate not supplied

Comparison of cycling kinetics during recumbent bicycling in subjects with and without diabetes.

We compared recumbent bicycle kinetics in diabetic peripheral neuropathy and nondiabetic men (nine per group). 3D kinematic and force pedal data in a linked-segment model were used. The generalized muscle moment (GMM) patterns were similar between the two groups except for (1) decreased maximum knee flexor moment, (2) increased minimum knee flexor GMM, and (3) maximum hip extensor GMM by the diabetic subjects. Similar to the walking support moment, a summation moment immutable pattern was observed, although the groups accomplished it differently. The diabetic group utilized the hip during the power phase and the knee during the recovery phase. The nondiabetic group utilized both joints together during both phases. Differences in ankle GMM were not observed, suggesting further research using the recumbent bicycle as an exercise modality for diabetic peripheral neuropathy patients to enhance ankle range of motion and strength, commonly observed walking deficits.

Aged↗

PubMed1985

Cerebral edema caused by perinatal asphyxia. Detection and follow-up.

Cerebral edema due to perinatal asphyxia in 2 full-term newborns was detected and monitored with a combination of real time ultrasound, computed tomography, and serial pulsatility-index determinations of the cerebral arteries using Doppler ultrasound. In both babies, real time ultrasound showed small or slitlike lateral ventricles, an increase in diffuse echogenicity and obliteration of normally visible structures in the acute phase suggesting cerebral edema. In the recovery phase a remarkable widening of the ventricles was seen. We also found a relationship between disturbances of consciousness (probably due to cerebral edema) and the pulsatility index. The combination of serial pulsatility-index determinations of the anterior cerebral arteries and real time ultrasound of the brain may in the future be a useful "bedside" method for early detection and follow-up of the cerebral edema.

Asphyxia Neonatorum↗

PubMed1984

Assay of cerebral catecholamines, serotonin and their metabolites in experimental hemorrhagic shock in rats.

Rats were subjected to standard conditions of hemorrhagic shock. Animals were sacrificed 5 minutes and two hours after reinjection of blood which had effused into a syringe. The extent of shock was determined by measuring the acid base balance of the serum. Cerebral concentrations of NE, DA, DOPAC, HVA, 5-HT and 5-HIAA were measured and compared to controls. There was a significant decrease of the NE concentration and a highly significant increase of that of DA. Although the DOPAC concentration varied to a slight extent, that of HVA was significantly depressed 5 min after reinjection and exceeded initial values two hours later. It is consistent to interpret these results as a synaptic quiescence of DA utilization, which is no longer methylated by COMT. After two hours, however, extraneuronal DA metabolism was greatly increased, as indicated by the decreased DA concentration and the considerable increase of HVA levels. 5-HT turnover seemed to follow the same temporal variations, decreasing in the acute phase and then increasing during the recovery phase.

Animals↗

PubMedDate not supplied

Disaster medicine.

The American College of Emergency Physicians defines a medical disaster as occurring when the destructive effects of natural or man-made forces overwhelm the ability of a particular region to meet the demand for health care. The science of disaster medicine is continually improving, and significant progress has been made in defining how to provide a comprehensive response to disaster sites. The management of a disaster involves an activation phase, followed by the implementation and recovery phases. The success of each phase depends on coordinated on-site and off-site communication systems. This paper presents an overview of this new subspecialty and discusses the fundamental components of an effective disaster response.

Disaster Planning↗

PubMed1999

Endothermic force generation in skinned cardiac muscle from rat.

Isometric tension responses to rapid temperature jumps (T-jumps) of 2-6 degrees C were examined in skinned muscle fibre bundles isolated from papillary muscles of the rat heart. T-jumps were induced by an infra-red laser pulse (wave length 1.32 microm, pulse duration 0.2 ms) obtained from a Nd-YAG laser, which heated the fibres and bathing buffer solution in a 50 microl trough; the increased temperature by laser pulse was clamped at the high temperature by a Peltier system (see Ranatunga, 1996). In maximally Ca2+ -activated (pCa ca. 4.5) fibres, the relationship between tension and temperature was non-linear, the increase of active tension with temperature being more pronounced at lower temperatures (below ca. 20 degrees C). A T-jump at any temperature (range 3-35 degrees C) induced an initial step decrease of tension of variable amplitude (Phase 1), probably due to thermal expansion, and it was followed by a tension transient which resulted in a net rise of tension above the pre-T-jump level. The rate of net rise of tension (Phase 2b or endothermic force generation) was 7-10/s at ca. 12 degrees C and its Q10 was 6.3 (below 25 degrees C). In cases where the step decrease of tension in Phase 1 was prominent, an initial quick tension recovery phase (Phase 2a, 70-100/s at 12 degrees C) that did not contribute to a rise of tension above the pre-T-jump level, was also seen. This phase (Phase 2a) appeared to be similar to the quick tension recovery induced by a small length release and its rate increased with temperature with a Q10 of 1.8. In some cases where Phase 2a was present, a slower tension rise (Phase 3) was seen; its rate (ca. 5/s) was temperature-insensitive. The results show that the rate of endothermic force generation in cardiac fibres is clearly different from that of either fast-twitch or slow-twitch mammalian skeletal muscle fibres; implication of such fibre type-specific differences is discussed in relation to the difficulty in identifying the biochemical step underlying endothermic cross-bridge force generation.

Adenosine Triphosphate↗

PubMed2003

Acute transverse myelitis in children: clinical course and prognostic factors.

The objective of this study was to describe the clinical course of acute transverse myelitis in children, to identify prognostic factors, and to compare our findings with published data Twenty-four children, aged 2 to 14 years and admitted with a diagnosis of acute transverse myelitis, were studied. Clinical features and results of investigations were collected at admission and during the course of the disease. Motor, sphincter, and global outcomes were compared with those in the main adult and pediatric series. During the initial phase, the most common presenting symptoms were pain (88%) and fever (58%). Motor loss preceded sphincter dysfunction in two thirds of patients and became bilateral in half of the patients. When maximal deficit was achieved (plateau), the patients presented a combination of sensory, motor, and sphincter dysfunctions without radicular involvement The motor loss consistently involved the lower limbs but was inconsistent and moderate in the upper limbs. The mean duration of the plateau was 1 week. The recovery phase was characterized by a progressive improvement of all deficits. Sphincter dysfunction improved more slowly than did the other deficits. A full recovery was achieved by 31% of the patients; minimal sequelae were present in 25% and mild to severe sequelae in 44%. An unfavorable outcome was associated with complete paraplegia (P = .03) and/or a time to maximal deficit shorter than 24 hours (P = .005). A favorable outcome was associated with a plateau shorter than 8 days (P = .03), the presence of supraspinal symptoms (P = .01), and a time to independent walking shorter than 1 month (P = .01). The course of acute transverse myelitis in children proceeds through three stages, an initial phase, a plateau, and a recovery phase, each characterized by specific clinical features. The global outcome was favorable in 56% of patients. Several prognostic factors were identified.

Adolescent↗

PubMed1985

Alteration in murine epidermal Langerhans cell population by various UV irradiations: quantitative and morphologic studies on the effects of various wavelengths of monochromatic radiation on Ia-bearing cells.

The present study was undertaken in order to clarify the exact mode of the Langerhans cell (LC) depleting process caused by UV irradiation. Following irradiation with a single dose of various wavelengths of monochromatic UV radiation (UVR), we studied the number of Ia-positive cells in mouse epidermal sheets quantitatively, particularly with regard to dose-response relationship, action spectrum, and time course change. In addition, we studied morphologic alterations of these cells using electron- and immunoelectron microscopy (EM and IEM). We obtained the following results after a single dose of UVB radiation (200 mJ/cm2 of 300 nm) or PUVA (1% of 8-methoxypsoralen (8-MOP) 20 microliter and 1 J/cm2 of 360 nm): (1) EM and IEM showed that while some LCs simply lost their Ia marker without any structural alterations, the majority of the LCs disappeared due to actual cell damage. (2) During an "injury phase," the initial 48 h, and a "recovery phase," lasting from 4-14 days after irradiation, enlargement of the size of remaining Ia-positive LCs occurred. The degree of enlargement was closely related to the degree of reduction in number, suggesting a process compensating for the loss of the LC population. (3) It was found that the recovery rate of LCs after irradiation damage was slower than that of keratinocytes, indicating different cell kinetics between these distinct cell populations in the epidermis, i.e., restoration of LCs after irradiation seems to be achieved at least partially through a repopulation process originating in the bone marrow. Studies with irradiation of various monochromatic wavebands, with or without topical 8-MOP, showed that the action spectrum for Ia-positive cell depletion activity lay within the spectrum shorter than 300 nm for UVR alone, and between 320-380 nm for 8-MOP plus UVR. Since the action spectra were similar to those for keratinocyte damage, i.e., sunburn cell formation, induction of unscheduled DNA synthesis, and to those for UVR-induced erythema, we conclude that common mechanisms underlie these types of tissue damage.

Animals↗

PubMed1985

Differential effect of botulinal toxin on esophageal motor function in infants.

The effect of Clostridium botulinum toxin on esophageal motor function was studied in four infants (ages 5-9 months) with confirmed infant botulism. Esophageal motility studies using a perfused catheter assembly were performed during the acute phase in all patients, and during the recovery phase in one patient. Motor function of the proximal esophagus and upper esophageal sphincter was abnormal in each, while motor function of the distal esophagus and lower esophageal sphincter was normal. Mean lower esophageal sphincter pressure was 24 mm Hg for the group (normal: 15-30 mm Hg). Sequential studies of proximal esophageal motility in one infant revealed a return of normal motor function which correlated with recovery of peripheral muscle strength and gag reflexes. C. botulinum toxin impairs proximal, but not distal, esophageal motor function in the infant botulism model. This effect appears to be consistent with the known action of the toxin on synaptic acetylcholine release and current concepts regarding distribution of cholinergic and noncholinergic neurotransmitter receptors in the esophagus.

Botulinum Toxins↗

PubMed1981

Plasma exchange in five patients with acute Guillain Barré syndrome.

During the last 3 years plasma exchanges were undertaken in 5 patients with acute Guillain Barré syndrome (G.B.S.). All the patients were admitted in the intensive respiratory care unit and had received six plasma exchange procedures over two weeks (each procedure consists of 2-3 L exchange). The first patient improved dramatically after the second exchange. Moderate success was obtained in two patients. One patient did not show any effect. The fifth patient received plasma exchange one day after her recovery phase had begun but the course of recovery remained uneffected. The effect of plasma exchange was analysed as the patients' response to motor activity, and compared with a historical control group consisting of 50 acute G.B.S. patients admitted in the intensive respiratory care area over the last 25 years. Plasma exchange does not seem to have exerted any significant effect although at any given time the plasma exchange group had higher motor activity than that of the control group. A controlled clinical trial especially in the early phase of the disease is emphasized.

Adult↗

PubMedDate not supplied

Simulations of postvagal tachycardia at the single cell pacemaker level: a new hypothesis.

Simulations performed on a single cell model of rabbit sinoatrial node activity after prolonged vagal stimulation have been able to reproduce the known characteristics of cycle length recovery, including the presence of rapid and slow recovery phases and the transient undershoot phenomenon known as postvagal tachycardia (PVT). In the model, the PVT component has been hypothesized to result from the recovery of background levels of the muscarinic K+ current iK,ACh from desensitization due to prolonged exposure to acetylcholine (ACh) neurotransmitter. Other components of the recovery were found to be due to the inactivation of iK,ACh after the hydrolysis of ACh (rapid phase) and the recovery of the hyperpolarizing-activated current i(f) from its ACh-induced inhibition (slow phase). The magnitudes of both the rapid component and the PVT were found to increase linearly with preceding vagally mediated increase in cycle length, whereas the gain of the slow component was found to saturate, reflecting the limited contribution of i(f) inhibition to cycle prolongation.

Acetylcholine↗