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PubMed2006

[Interval and continuous training in cardiovascular rehabilitation].

The objective of the study was to evaluate the physiological effectiveness and the influence of two modifications of aerobic training (interval and continuous) on the physical performance in the patients with coronary heart disease. 38 males with coronary heart disease (age 60 +/- 10.2 years) passed three months training programme of 60 min 3 times a week (10 min of warm up phase, 25 min of aerobic phase, 15 min of resistance training, 10 min of relaxing phase). Patients with coronarographically verified stenosis > 50% luminal diameter and/or left ventricular ejection fraction lower than 40 % (n = 22) had in terms of aerobic phase interval training prescribed (30 second work phases with work load intensity on the level of anaerobic threshold alternating with 60 second recovery phases with intensity of 5 W); other patients (n = 16) passed aerobic phase of the programme with continual work load of intensity on the level of ventilatory anaerobic threshold. After the determination of three month rehabilitation programme the maximal achieved performance as well as aerobic capacity evaluated by spiroergometric examination statistically significantly increased in the group of patients with interval training and also in the group with continuous training. Despite the group with interval training performed 2.5-3 times less work in each training unit (p < 0.01), the performance and aerobic capacity parameters after the termination of three month programme did not statistically significantly differ from the group with continuous training. The advantage of the continuous training is a possibility to achieve an improvement also in the patients with left ventricular dysfunction and chronic coronary heart disease who could have worse tolerance of the continual work load.

Exercise Therapy↗

PubMed1994

Plasma aspirin esterase activity in elderly patients undergoing elective hip replacement and with fractured neck of femur.

Plasma aspirin esterase activity was measured in eight elderly patients undergoing elective hip replacement, and in 11 presenting with femoral-neck fracture. Elective hip surgery was associated with a marked and significant decline in esterase, from 330 +/- 35.9 (SE) (nmol salicylate/ml plasma/min) pre-operatively to 236 +/- 35.6 on the third post-operative day, and returning to normal (359 +/- 24.3) at recovery phase. Patients with fractured neck of femur showed a depressed esterase activity on admission (221 +/- 12.7), rising towards normal (290 +/- 15.4) on recovery. All of these changes were accompanied by a marked acute-phase response, both to injury and surgery. The data suggest that elderly patients experiencing injury or undergoing surgery may have significantly impaired drug metabolism, at least as far as this enzyme is concerned.

Aged↗

PubMed1984

After effects of chronic hypoxia on VO2 kinetics and on O2 deficit and debt.

Single breath O2 consumption (PB = 730, FI02 = 0.21) was measured at rest, during 10 min cycloergometric exercise at 125 W, and in the following recovery phase in seven subjects before, and 12 days after 6 weeks at 5,200 m or above. Peak blood lactate after exercise (Lâb) was measured. O2 deficits and debts and half times (t1/2) of the VO2 on- and off-kinetics were calculated. Before acclimatization, the VO2 on- and off-responses were close to a single exponential with t1/2 = 30 s. After return to sea level, the VO2 on-response curves were less steep in the initial phase, becoming closer to sigmoid. The t1/2, independent of the shape of the underlying function, was approximately 10 s longer. The VO2 off-responses during the initial 4 min of recovery were the same before and after acclimatization. Average O2 deficit was approximately 320 ml larger after acclimatization: the fast component of O2 debt was similar. Since steady state VO2 and Lâb were the same, the O2 deficit difference can be attributed to a greater utilization of O2 stores. Of these, about 1/3 is explained in terms of increased mixed venous blood O2 stores, due to increased [Hb] (16.6 vs 14.9 g X dl-1), while the remainder is ascribed essentially to increased Mb-bound O2. O2 stores utilization and replenishment is presumed to occur when muscle metabolism is low; as a consequence, while it is clearly detectable from the shape of the initial phase of the VO2 on-response, during recovery it is spread throughout, thus becoming more difficult to appreciate.

Acclimatization↗

PubMed1993

Persistent mechanical effects of decreasing length during isometric contraction of ovarian ligament smooth muscle.

When isometrically-contracting strips of ovarian ligament smooth muscle were suddenly shortened by 10-20% of their length, force fell rapidly and then redeveloped along an exponential time course. The amount of force recovered fell short of that expected in an isometric contraction at the new length, and this force deficit was proportional to the magnitude of the length step (approximately 80% of force was recovered after a 10% shortening). A sudden imposed decrease in length was more effective in reducing subsequent force than was isotonic shortening. Early in the recovery phase the stiffness of the muscle was decreased to less than its expected value; stiffness recovered to expected levels on an exponential time course approximately three to four times faster than force recovery itself. Force-velocity curves made during the redevelopment phase showed a reduced maximal force (Fmax) and an increased maximal shortening velocity (Vmax) when compared with control contractions matched in force, time and length. The curves crossed at approximately 10% of Fmax. During isometric relaxation the muscles showed an increase in their expected stiffness; prior imposed shortening (as above) reduced the relaxation stiffness increase in proportion to the prior force deficit. The persistent effects of early events on the later phases of the contraction, as well as the increase in shortening velocity with very light loads, are consistent with the hypothesis that the sudden shortening detaches crossbridges and that same fail to reattach during force recovery. During isotonic shortening of unperturbed muscle some slowly-cycling crossbridges may act as an internal load and reduce shortening velocity.

Animals↗

PubMed2006

Choroidal dye filling velocity in patients with Vogt-Koyanagi-Harada disease.

PURPOSE: To evaluate quantitative choroidal dye filling velocity in patients with Vogt-Koyanagi-Harada disease (VKH) before and after corticosteroid treatment using indocyanine green (ICG) angiography. METHODS: ICG angiography was performed in seven VKH patients before and after systemic corticosteroid treatment. Choroidal dye curves were obtained by image analysis software and analyzed using an exponential model. The model's time constant (tau) was used to evaluate choroidal dye filling velocity. RESULTS: Compared with controls, acute phase choroidal tau values in VKH patients were significantly longer, suggesting choroidal circulation disturbance. During the recovery phase, choroidal tau values were significantly shortened, suggesting choroidal circulatory disturbance improvement. CONCLUSION: Choroidal dye filling velocity may be useful for VKH diagnosis and verification of corticosteroid treatment effectiveness.

Adult↗

PubMed1988

Effect of total parenteral nutrition enriched in branched-chain amino acids on metabolite levels in septic rats.

This study examined the effects of total parenteral nutrition (TPN) enriched with branched-chain amino acids (BCAAs) on metabolite levels of carbohydrate and protein metabolism in septic rats. Results also were obtained for standard amino acid hyperalimentation (conventional TPN). Septic peritonitis was induced in rats by cecal ligation and puncture. Two different experimental models were tested. In one, the two kinds of TPN were administered to the operated rats during the progress of sepsis (the septic phase). In the other, TPN was started immediately after surgical removal of the focal cecum (the recovery phase). The conventional and BCAA-enriched TPN solutions were isocaloric and isonitrogenous except that the percentage of BCAAs in the total amino acids by weight was 35.8% in BCAA-enriched TPN and 20.9% in conventional TPN. On the fifth postoperative day, TPN was discontinued, the animals were killed, and samples of arterial blood, liver, and rectus abdominis muscle were taken. BCAA-enriched TPN had a significant effect on nitrogen balance and survival rate in the septic phase model, and on muscle adenine nucleotide content in both models. Other metabolites showed similar changes in the two TPN groups. These results indicate that BCAA supplement in TPN improves nitrogen balance and peripheral cellular energy status and is thus clinically beneficial in preventive therapy for increased catabolism.

Amino Acids↗

PubMed1987

Changes in cerebrospinal fluid cells, IgG and IgA during herpes simplex virus encephalitis in rabbits.

Rabbits were infected with herpes simplex-type 1 virus either by corneal scarification or intrathecal inoculation. Encephalitis was induced predictably by either route but was most severe after intrathecal inoculation. Serial examination of the cerebrospinal fluid (CSF) demonstrated abnormalities reflecting two distinct phases of the immune response to this central nervous system infection. The acute phase was manifested by a mononuclear pleocytosis and transudation of serum proteins into the CSF. The recovery phase was manifested by increased amounts of IgG, IgA and antibody specific for herpes simplex virus in the CSF. These studies demonstrate that IgA is a significant component of the local immune response to viral encephalitis in the rabbit as well as in mice and man.

Albumins↗

PubMed1998

Myelin basic protein reactive Th2 T cells are found in acute disseminated encephalomyelitis.

Acute disseminated encephalomyelitis (ADEM), a postinfectious illness of the central nervous system (CNS), is thought to be an autoimmune disease. Here, we characterized the cytokines secreted by myelin-reactive T cells generated from patients with ADEM. The frequency of MBP-reactive T cell lines was ten-fold higher in patients with ADEM compared to patients with encephalitis and normal subjects. Whereas there was no significant IFN-gamma secretion, the predominant cytokine secreted by MBP-reactive T cell lines was IL-4 in patients with ADEM. In contrast, IL-4 secretion was only rarely detected in the controls. The presence of high frequencies of MBP-reactive IL-4 secreting T cells in subjects with ADEM during their recovery phase may be similar to myelin reactive IL-4 secreting T cells observed during the spontaneous recovery of animals with EAE.

Antibodies, Viral↗

PubMed2003

Vasoactive mediators and renal haemodynamics in exertional heat stroke complicated by acute renal failure.

BACKGROUND: Although vasoactive substances may be important in the pathogenesis of some types of acute renal failure (ARF), their potential role in exertional heat stroke (ExHS) with ARF has not been explored. AIM: To evaluate whether changes in concentration of individual vasoactive mediators correlated with alterations in renal function and haemodynamics in patients with ExHS and ARF. DESIGN: Prospective case-control study. METHODS: Systemic and renal haemodynamics, circulating vasoactive hormones and urinary vasodilator metabolites were determined in 12 military recruits who developed ExHS with ARF but without other organ failure during a three-year period. The control group consisted of 12 recruits who performed similar exercise under the same conditions without developing ExHS. RESULTS: There were significant elevations in circulating pressor hormones (catecholamines, renin, aldosterone and endothelin-1 (ET-1)) and significant decreases in the vasodilatory hormone prostaglandin E(2) (PGE(2)) in the acute phase of ExHS with ARF when compared to ExC. There was also a significant rise in nitric oxide metabolites (NOx) in the acute phase of ExHS. All of these abnormalities in circulating hormones returned to normal range during the recovery phase of ExHS. The ERPF correlated positively with GFR and urinary PGE(2) and negatively with plasma catecholamines, renin, ET-1 and NOx. DISCUSSION: The changes in the plasma levels of these hormones, together with enhanced NO production, may both contribute to the pathophysiology of ARF in ExHS.

Acute Kidney Injury↗

PubMed1991

Detection of IgM, IgA, and IgG antibodies to preS2 antigen in hepatitis B virus infection.

Antibodies to the preS2 antigen (anti-preS2) of the hepatitis B virus (HBV), including IgA, IgM and IgG classes, were observed in patients with acute and persistent HBV infection. In acute HBV infection, rapid and marked serum IgM and IgA anti-preS2 responses were observed. Antibodies reached a peak of serum activity at about 1-2 months after the onset of clinical symptoms, and both antibodies disappeared from serum at 4 months after. IgG anti-preS2 was detected in the early phase of the illness, then the level of IgG anti-preS2 gradually rose during the recovery phase. In persistent HBV infection, IgG and IgM anti-preS2 were detected in sera where the preS2 antigen was present, and IgM anti-preS2 was significantly higher (p less than 0.05) in HBeAg-positive than in HBeAg-negative patients. These results indicate that an adequate humoral immune response to the preS2 antigen is induced during acute and persistent HBV infection.

Acute Disease↗

PubMed2004

Muscle forces analysis in the shoulder mechanism during wheelchair propulsion.

This study combines an ergometric wheelchair, a six-camera video motion capture system and a prototype computer graphics based musculoskeletal model (CGMM) to predict shoulder joint loading, muscle contraction force per muscle and the sequence of muscular actions during wheelchair propulsion, and also to provide an animated computer graphics model of the relative interactions. Five healthy male subjects with no history of upper extremity injury participated. A conventional manual wheelchair was equipped with a six-component load cell to collect three-dimensional forces and moments experienced by the wheel, allowing real-time measurement of hand/rim force applied by subjects during normal wheelchair operation. An ExpertVision six-camera video motion capture system collected trajectory data of markers attached on anatomical positions. The CGMM was used to simulate and animate muscle action by using an optimization technique combining observed muscular motions with physiological constraints to estimate muscle contraction forces during wheelchair propulsion. The CGMM provides results that satisfactorily match the predictions of previous work, disregarding minor differences which presumably result from differing experimental conditions, measurement technologies and subjects. Specifically, the CGMM shows that the supraspinatus, infraspinatus, anterior deltoid, pectoralis major and biceps long head are the prime movers during the propulsion phase. The middle and posterior deltoid and supraspinatus muscles are responsible for arm return during the recovery phase. CGMM modelling shows that the rotator cuff and pectoralis major play an important role during wheelchair propulsion, confirming the known risk of injury for these muscles during wheelchair propulsion. The CGMM successfully transforms six-camera video motion capture data into a technically useful and visually interesting animated video model of the shoulder musculoskeletal system. The CGMM further yields accurate estimates of muscular forces during motion, indicating that this prototype modelling and analysis technique will aid in study, analysis and therapy of the mechanics and underlying pathomechanics involved in various musculoskeletal overuse syndromes.

Adult↗

PubMed2004

[Clinical significance of detecting RNA and anti HEV antibody in convalesent sera in patients with acute HEV hepatitis].

OBJECTIVE: To investigate the anti hepatitis E virus (HEV) and HEV RNA in acute and convalescent sera of patients with NonA-E acute hepatitis. METHODS: The serum samples were taken from 95 patients who were diagnosed as acute NonA-E hepatitis. Enzyme immunoassay (EIA) was used for detecting anti-HEV Immunoglobulin G (IgG, Genolable and Wantai EIA anti-HEV kits). RT-PCR amplification of HEV RNA was based on the open reading frame 2 region of HEV and the PCR products were sequenced. RESULTS: Sera from 95 patients who were negative for anti-HEV in acute phase were followed up for 11-35 days to detect the anti-HEV antibody in recovery phase, 16/95 (16.84%) were positive for anti-HEV (wantai EIA anti-HEV kits). Ten (62.50%) were positive for HEV RNA in acute phase. Sequence analysis showed that 4 were HEV genotype. 6 were HEV genotype; 12/95 (12.50%) were positive for anti-HEV (Genolable EIA anti-HEV kits). Seven were positive for HEV RNA; 4 belonged to HEV genotype, 3 were HEV genotype. CONCLUSION: It is significant and necessary to detect anti HEV antibody and HEV RNA in patients with HEV infection during acute phase and convalesent phase.

Acute Disease↗

PubMed1973

[The effect of rastinon on the beta cells of the rat and guinea pig pancreas].

Investigations are carried out with light and electron microsckope on the islands of Langerhans in rats and guinea pigs following Rastinon treatment over variable time intervals. The beta cells were strongly activied: with expanded ergastoplasm (archiplasm), enlarged and elongated mitochondria, Golgi's complex of a multiple vesiculose type, abudance of coated vesicles, marginization of secreting B-granules along the cellular membranes and perforated sacs. In addition, mixed island-acinous cells and bright degranulated and agranulated cells, which represent beta cells in different phases of insulin secretion, were observed. The bright agranulated cells are assumed as demontrating a refrangible recovery phase of the beta cells.

Animals↗

PubMedDate not supplied

[Plasma vitamin A levels in deprived children with pneumonia during the acute phase and after recovery].

OBJECTIVE: The aim of this study was to examine the plasma retinol of children in the acute phase of pneumonia and after recovery and to investigate the association between plasma levels of retinol after recovery with socioeconomic variables, nutritional status and severity of pneumonia. METHODS: A prospective cohort study which included 40 low-income hospitalized children with pneumonia, aged 6 months to 5 years. We evaluated: plasma retinol level during the acute phase and after recovery, years of schooling of the head of the family, per capita income, birth weight, nutritional status, hemoglobin levels and severity of pneumonia. RESULTS: Mean plasma retinol levels were significantly higher after recovery than during the acute phase of infection (1.4+/-0.6 vs. 1.7+/-0.6 micromol/l, p = 0.03). The frequency of inadequate plasma retinol levels (< 1.05 micromol/l) was 32.5 and 17.5% for the acute phase and after recovery, respectively. There were no statistically significant associations between plasma retinol deficiency and the clinical and epidemiological variables studied. More severe pneumonia was observed in 30/40 (75%) of the patients. There was no statistically significant association between plasma retinol inadequacy after recovery and severity of pneumonia (4/30 - 13.3% vs. 3/10 - 30.0%, p = 0.34). CONCLUSION: Serum retinol levels were significantly higher after recovery than during the acute phase of pneumonia. There was no statistically significant association between the deficiency of serum retinol and the clinical and epidemiological variables studied.

Acute Disease↗

PubMed1984

The effect of calcium ions on the glutamate response and its desensitization in crayfish muscle fibres.

The responses of crayfish muscle fibres to bath application or long ionophoresis of L-glutamate were studied in normal and low Ca2+ solutions. The smaller responses recorded in low Ca2+ solutions have characteristics suggesting a faster desensitization. Desensitization and recovery have complex kinetics. Desensitization is faster and recovery slower when external Ca2+ concentration is reduced. Both components of the recovery phase, which can be fitted by the sum of two exponentials, are affected by the external Ca2+ concentration. Recovery can be accelerated by external Ca2+ ionophoresis onto desensitized glutamate receptors. Responses to brief glutamate pulses of low intensity are not affected by Ca2+ reduction. For higher intensities, signs of desensitization are detectable early in the rising phase of the response. Concanavalin A (Con A) blocks both desensitization and Ca2+ dependence with similar time courses. Whether or not the preparation has been treated with Con A, the slowly rising responses recorded in isotonic Ca2+ do not show signs of desensitization. Con A causes a partial blockade of the glutamate response. The Ca2+ dependence of the glutamate response can be explained by the Ca2+ dependence of the desensitization process, the cation acting at ectocellular sites of the muscle membrane.

Animals↗

PubMed2006

Major depressive episodes and random mood.

CONTEXT: Mathematical models describing changes in mood in affective disorders may assist in the identification of underlying pathologic and neurobiologic mechanisms and in differentiating between alternative interpretations of psychiatric data. OBJECTIVE: Using time-to-event data from a large epidemiologic survey on recovery from major depression, to model the survival probability, in terms of an underlying process, with parameters which might be recognized and influenced in clinical practice. DESIGN: We present a sequential-phase model for survival analysis, which describes depression as a state with or without an additional incubation phase. Recovery is seen as the transition to a nondepressive state. We show that this sequential-phase model finds a microscopic realization in a dynamic description, the random-mood model, which depicts mood as governed by an Ornstein-Uhlenbeck type of stochastic process, driven by intermittent gaussian noise. RESULTS: For reversible depression (80%), the fractional probability of recovery is remarkably independent of the history of the depression. Analysis with the sequential-phase model suggests single exponential decay in this group, possibly with a short incubation phase. Within the random-mood model, the data for this reversibly depressed cohort are compatible with an intermittent noise pattern of stimuli with average spacing of 4 months and incompatible with nonintermittent noise. CONCLUSIONS: Time-to-event data from psychiatric epidemiologic studies can be conceptualized through modeling as intrasubject processes. The proposed random-mood model reproduces the time-to-event data and explains the incubation phase as an artifact due to the inclusion criterion of 14 days in most current psychiatric diagnostic systems. Depression is found to result more often from pileup of negative stimuli than from single life events. Time sequences, generated using the random-mood model, produce power plots, phase-space trajectories, and pair-correlation sums, similar to recent results for individual patients. This suggests possible clinical relevance along with the model's use as a tool in survival analysis.

Affect↗

PubMed1980

Fusiform erythrocytes resembling sickle cells in angora goats: observations on osmotic and mechanical fragilities and reversal of cell shape during anaemia.

Osmotic and mechanical fragilities of erythrocytes were determined for seven goats having 3.4-71 per cent fusiform erythrocytes. The osmotic fragility was related to the erythrocyte shape in that the osmotic resistance was considerably higher for bloods containing more than 26 per cent fusiform erythrocytes. A decrease in the proportion of fusiform erythrocytes in the same goats was related to an increase in the osmotic fragility. Anaemia was induced in two goats by removal of 200-400 ml of blood at three or four day intervals for eight weeks. Red cell values decreased by 28-43 per cent within three weeks, but further bleeding produced either no or less (0-21 per cent) reductions in these values. Slight reticulocytosis was seen during the anaemic phase and there was a concomitant increase in the mean corpuscular volume and mean corpuscular haemoglobin values. Reticulocytosis diminished before the start of recovery from anaemia and disappeared during the recovery phase. The most significant finding was the change in the erythrocyte morphology during production of and recovery from anaemia. The development of anaemia was associated with a gradual reduction in the proportion of fusiform erythrocytes or discoid cells and simultaneous increase in the proportion of erythrocytes exhibiting distinct poikilocytosis. Recovery from the anaemia was rapid (within five weeks), but reversal of the erythrocyte shape took several months. Severe blood loss anaemia in the goat is known to induce synthesis of haemoglobin C, and in these anaemic goats formation of a new haemoglobin, most likely haemoglobin C, was demonstrated by electrophoretic and column chromatographic analyses. It was concluded that the formation of haemoglobin C was responsible for the morphological changes in the erythrocytes.

Anemia↗

PubMed1993

Anti-peripheral nerve myelin antibodies and terminal activation products of complement in serum of patients with acute brachial plexus neuropathy.

OBJECTIVE: To determine if complement-fixing antibodies to peripheral nerve myelin (anti-PNM antibodies) and terminal complement activation products were increased in serum of patients with brachial plexus neuropathy compared with normal controls. DESIGN: Case series. SETTING: University medical center. PATIENTS: Three patients (aged 6, 39, and 51 years) with acute brachial plexus neuropathy were studied during the acute and recovery phase of their disease. METHODS: Anti-PNM antibodies were measured in serum samples obtained from three patients and 25 normal controls with the C1 fixation and transfer assay. Soluble terminal complement activation products, SC5b-9, were measured by enzyme-linked immunosorbent assay (ELISA) in serum samples of one patient with brachial plexus neuropathy and of five normal controls. RESULTS: Both serum anti-PNM antibodies and soluble terminal complement activation products were increased in the acute phase of brachial plexus neuropathy compared with normal control values and decreased several months later during clinical recovery. CONCLUSION: Complement dependent, antibody-mediated demyelination may participate in the peripheral nerve damage of brachial plexus neuropathy.

Acute Disease↗