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Surface electromyography activity of trunk muscles during wheelchair propulsion.

BACKGROUND: Trunk instability due to paralysis can have adverse effects on posture and function in a wheelchair. The purpose of this study was to record trunk muscle recruitment patterns using surface electromyography from unimpaired individuals during wheelchair propulsion under various propulsion speed conditions to be able to design trunk muscle stimulation patterns for actual wheelchair users with spinal cord injury. METHODS: Fourteen unimpaired subjects propelled a test wheelchair on a dynamometer system at two steady state speeds of 0.9 m/s and 1.8 m/s and acceleration from rest to their maximum speed. Lower back/abdominal surface electromyography and upper body movements were recorded for each trial. Based on the hand movement during propulsion, the propulsive cycle was further divided into five stages to describe the activation patterns. FINDINGS: Both abdominal and back muscle groups revealed significantly higher activation at early push and pre-push stages when compared to the other three stages of the propulsion phase. With increasing propulsive speed, trunk muscles showed increased activation (P<0.0001). Back muscle activity was significantly higher than abdominal muscle activity across the three speed conditions (P<0.0005), with lower back muscles predominating. INTERPRETATION: Abdominal and back muscle groups cocontracted at late recovery phase and early push phase to provide sufficient trunk stability to meet the demands of propulsion. This study provides an indication of the amount and duration of stimulation needed for a future application of electrical stimulation of the trunk musculature for persons with spinal cord injury.

Abdominal Muscles↗

Ultrastructure of the liver after hypoxia in the postnatal period.

Repeated phases of hypoxia (8 h daily for 2 to 5 days at pO2 11.33 kPa = 5.000 m in altitude) were induced to Sprague-Dawley rats in the postnatal period as well as up to the 64th day of age, and after different recovery phases the ultrastructure of hepatocytes was qualitatively and quantitatively analysed. Major results were as follows: 1. Increases in body and liver weights were delayed but were balanced off after 64 days. 2. Qualitative alterations are reversible spherical transformations of mitochondria, a degradation of lipids and a slight increase in autophagocytosis. 3. The quantitative mitochondrial parameters (volume density, number per unit area, average volume) were not even adjusted to control values after 64 days. Granular endoplasmic reticulum and ribosomes/polysomes were insignificantly reduced in comparison to control animals, structure and arrangement are regular. Lipids and glycogen were differently altered. 4. The findings of the hepatocytes after postnatal hypoxia were reversible, though the majority of parameters had not yet returned to normal after 2 months. An adaptation to repetitive hypoxic conditions is not provable.

Animals↗

Differential regulation of FUS3 MAP kinase by tyrosine-specific phosphatases PTP2/PTP3 and dual-specificity phosphatase MSG5 in Saccharomyces cerevisiae.

The Saccharomyces cerevisiae mating pheromone response is mediated by activation of a MAP kinase (Fus3p and Kss1p) signaling pathway. Pheromone stimulation causes cell cycle arrest. Therefore, inactivation of the Fus3p and Kss1p MAP kinases is required during recovery phase for the resumption of cell growth. We have isolated a novel protein tyrosine phosphatase gene, PTP3, as a negative regulator of this pathway. Ptp3p directly dephosphorylates and inactivates Fus3p MAP kinase in vitro. Multicopy PTP3 represses pheromone-induced transcription and promotes recovery. In contrast, disruption of PTP3 in combination with its homolog PTP2 results in constitutive tyrosine phosphorylation, enhanced kinase activity of Fus3p MAP kinase on stimulation, and delayed recovery from the cell cycle arrest. Both tyrosine phosphorylation and kinase activity of Fus3p are further increased by disruption of PTP3 and PTP2 in combination with MSG5, which encodes a dual-specificity phosphatase. Cells deleted for all three of the phosphatases (ptp2delta ptp3delta msg5delta) are hypersensitive to pheromone and exhibit a severe defect in recovery from pheromone-induced growth arrest. Our data indicate that Ptp3p is the major phosphatase responsible for tyrosine dephosphorylation of Fus3p to maintain a low basal activity; it also has important roles, along with Msg5p, in inactivation of Fus3p following pheromone stimulation. These data present the first evidence for a coordinated regulation of MAP kinase function through differential actions of protein tyrosine phosphatases and a dual-specificity phosphatase.

Amino Acid Sequence↗

Analysis of high frequency QRS potential during exercise testing in patients with coronary artery disease and in healthy subjects.

High resolution ECG waveforms from leads V3, V4, V5, and V6 were analyzed in two groups of male subjects before, during, and following treadmill exercise testing. Group A included 32 coronary artery disease (CAD) patients, with arteriographically proven > 75% obstruction of at least two main coronary arteries, and group B included 30 healthy subjects, without history or symptoms of CAD. Signal averaging and filtering techniques were used in order to enhance the signal-to-noise ratio of the recorded ECG. The averaged QRS waveforms were filtered between 150 and 250 Hz. QRS complexes of the four leads were combined to form a "precordial average complex" (PAC). The PAC signals were examined for each subject at different stages of the exercise test and two parameters were computed: the root mean square (RMS) voltage; and the peak amplitude. The values of RMS and peak amplitudes measured at each stage of the exercise test were normalized to the values at rest. Normalized RMS (NRMS) values at peak exercise, immediately after peak exercise, and during the recovery phase were found to be higher for the healthy subjects than for the CAD group (1.17 +/- 0.31 vs 0.94 +/- 0.26, P < 0.008 at peak exercise, 1.13 +/- 0.24 vs 0.84 +/- 0.19, P < 0.001 after peak exercise, 1.08 +/- 0.22 vs 0.94 +/- 0.17, P < 0.007 during recovery). Cut-off NRMS value of one had a sensitivity of 81.3% and a specificity of 70.0% in differentiating CAD patients from healthy subjects in the examined groups. Normalized peak amplitude (NAMP) values exhibited similar behavior, with higher values for the healthy subjects than for the CAD group (1.23 +/- 0.48 vs 0.94 +/- 0.36, P < 0.03 at peak exercise, 1.20 +/- 0.34 vs 0.83 +/- 0.28, P < 0.001 after peak exercise, 1.10 +/- 0.29 vs 0.94 +/- 0.23, P < 0.02 during recovery). Specificity of 73.3% and sensitivity of 71.8% were found using a postpeak NAMP cut-off value of 1. In conclusion, the present study shows that using high frequency ECG may contribute to identifying patients with CAD. Further studies in larger groups of patients are required to better define the true predictive value of the method described for the diagnosis of CAD.

Adult↗

Plasma C3c in immune-mediated neurological diseases: a preliminary report.

Plasma C3c levels were examined in 56 patients with immune (27) and non-immune (29) mediated neurological diseases by crossed immunoelectrophoresis. Plasma samples were collected during the active phase of illness in both groups, usually within 7 days of admission. 11 patients (4 Guillain-Barré Syndrome-GBS, 3 chronic inflammatory demyelinating polyneuropathy-CIDP, 4 myasthenia gravis-MG) had their plasma saved sequentially during the active and the recovery phase. Plasma C3c levels were elevated in the group with immune mediated diseases when compared with those of non-immune mediated diseases. The sensitivity and specificity of C3c as a diagnostic test for immune mediated neurological diseases were 61.4 and 100% respectively with a positive and negative predictive value of 100 and 41%. the C3c levels in plasma correlated well with disease severity in MG and GBS patients. Such a correlation was also evident in all CIDP patients except one that had persistent elevation in the presence of clinical improvement. Results suggest that the plasma C3c level may be useful for differentiating immune from non-immune mediated neurological diseases. Plasma C3c may also be used for monitoring disease severity, particularly in myasthenia gravis.

Autoimmune Diseases↗

Training and electrocardiographic abnormalities in the elderly.

Electrocardiograms (CM5 lead, where one lead is attached in the V5 position and one at the manubrium sterni, with the neutral lead on the back of the neck) have been recorded from 14 men and 25 women aged 60 to 75 years, at rest, during progressive bicycle ergometer exercise to 75 to 85 per cent maximum oxygen intake, and during the subsequent recovery phase. Earlier studies showing a high frequency of ischaemic electrocardiographic abnormalities in women are confirmed; it is suggested that this may reflect a high work load per unit mass of myocardium. Training induces an elevation of the ST segment at rest and during recovery, with a reduction in ST depression during work at a given heart rate, the exercise changes being related to the intensity and frequency of training selected by the subject. Possible explanations of the response to regular exercise include not only the development of the collateral circulation, but also a lessening of the hyperkalaemia of effort and a reduction in the work load per unit mass of myocardium secondary to hypertrophy or a change in the average dimensions of the heart.

Aged↗

Peritonitis increases MMP-9 activity in peritoneal effluent from CAPD patients.

Patients undergoing long-term continuous ambulatory peritoneal dialysis (CAPD) sometimes experience ultrafiltration failure. Mesothelial basement membrane thickening and the accumulation of submesothelial fibrotic tissue are common features of the diseased peritoneum. Peritonitis can lead to ultrafiltration failure, but the precise mechanism is not clear. The key enzymes in extracellular matrix (ECM) remodeling, namely matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), are produced by human peritoneal mesothelial cells. Using peritoneal effluent from 13 CAPD patients with peritonitis and 7 noninfected CAPD control individuals, we examined MMP and TIMP activities by gelatin and reverse zymography. Latent and activated types of MMP-2 and -9, and TIMP-1 and -2 were identified in peritoneal effluent (from all CAPD patients). Levels of latent and activated type MMP-9, as well as of TIMP-1 activities were higher at the onset of peritonitis than either during the recovery phase of peritonitis and/ or in control individuals. Activated MMP-9 activity positively correlated with leukocyte numbers and IL-6 levels in peritoneal effluent. Activities of MMP-2 and TIMP-2 in peritoneal effluent did not change between the onset of peritonitis and recovery. We concluded that increased MMP-9 and TIMP-1 levels might be associated with peritoneal ECM remodeling during peritonitis.

Adult↗

Anomalous origin of the left coronary artery from the pulmonary artery: diagnosis and postoperative follow up.

BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital malformation that presents a diagnostic challenge to the pediatrician and pediatric cardiologist. Although surgical repair is always indicated, the optimal technique has yet to be determined. OBJECTIVES: To review our experience with the diagnosis of children with ALCAPA and to assess short to midterm surgical results. METHODS: Between 1992 and 1998, 13 infants and children (2 months to 15 years) were treated for ALCAPA at our medical center. Eight were diagnosed during the first year of life; all were symptomatic and had severe dysfunction of the left ventricle. The five patients diagnosed at an older age had normal myocardial function. Diagnosis was established by echocardiography alone in seven patients; six required catheterization (one infant and all older patients). Surgery was performed in 12 patients to establish dual coronary artery system: 7 underwent the Takeuchi procedure and 5 had re-implantation of the anomalous left coronary artery. RESULTS: One infant died shortly after diagnosis before surgical repair was attempted, and one died postoperatively. Four patients required additional surgery: three for late complications of the Takeuchi procedure and one valve replacement for mitral insufficiency. Recent evaluation revealed good global left ventricle function in all patients except for one, who is still within the recovery phase and shows gradual improvement. However, most patients who presented with severe myocardial dysfunction upon diagnosis still display abnormal features such as echo-dense papillary muscles or evidence of small akinetic segments. In this group, early repair was associated with faster myocardial recovery. CONCLUSIONS: The diagnosis of ALCAPA remains a clinical challenge to the pediatrician and cardiologist. Diagnosis can be established echocardiographically, and early diagnosis and treatment may lead to faster myocardial recovery. The preferred surgical method appears to be re-implantation of the ALCA. The chance for good recovery of global ventricular function is high even in the sickest patients, nonetheless abnormal myocardial features can be identified even years after surgery.

Adolescent↗

Intravenous atropine relieves coronary arterial spasm and hemodynamic decompensation during recovery after exercise.

A 66-year-old man developed right coronary arterial spasm and hemodynamic decompensation during the early recovery phase of a treadmill exercise test. The unstable condition was corrected immediately after intravenous administration of atropine. A subsequent coronary angiographic study revealed insignificant right coronary artery stenosis. The pathophysiology of this response may be related to rapid alterations in autonomic balance during recovery after exercise. To our knowledge, this is the 1st reported case in which atropine effected immediate reversal of coronary arterial spasm and hemodynamic decompensation that were induced by exercise, rather than by pharmacologic agents. Atropine might be an effective treatment in patients who experience exercise-induced coronary arterial spasm and hemodynamic decompensation, but further investigation is warranted.

Aged↗

Modifications in the brush border enzymes of the small intestine after irradiation at different times of the day.

The behaviour of the brush border enzyme activity of the intestinal epithelium after the same sublethal radiation dose to the abdomen at different times of the day was investigated. Three previously observed post-irradiation phases (initial increase of activity, reduction and the return to control values) were confirmed, although with some differences. A later return to normal of lactase was also confirmed. The same dose produced different behaviour of the enzyme activities both during the initial and the recovery phase, depending on the time of the day when irradiation was performed, i.e. on the functional condition of the epithelial cells.

Animals↗

Activation of p38 mitogen-activated protein kinase in the early and peak phases of autoimmune neuritis in rat sciatic nerves.

To examine the involvement of p38 mitogen-activated protein kinase (MAPK) in autoimmune disorders of the peripheral nerve system, we analyzed the phosphorylation of p38 MAPK protein in the sciatic nerves of Lewis rats with experimental autoimmune neuritis (EAN). Western blot analysis showed that phosphorylated p38 (p-p38) MAPK protein was significantly increased in the sciatic nerves of rats in the early and peak phases of EAN, and declined gradually thereafter. Immunohistochemistry showed that p-p38 MAPK levels were increased in the infiltrating inflammatory cells, including T cells and macrophages, as well as in blood vessels and some Schwann cells in EAN-affected sciatic nerves, as compared to the sciatic nerves of controls. Some inflammatory cells and a few Schwann cells were also positive for TUNEL reaction at the peak and recovery phases of EAN. In conclusion, we postulate that the phosphorylation of p38 MAPK is involved in the elimination of infiltrating inflammatory cells during the course of EAN and may possibly modulate recovery in autoimmune disorders of the peripheral nervous system.

Animals↗

Lactate kinetics during passive and partially active recovery in endurance and sprint athletes.

We investigated the effects of passive and partially active recovery on lactate removal after exhausting cycle ergometer exercise in endurance and sprint athletes. A group of 14 men, 7 endurance-trained (ET) and 7 sprint-trained (ST), performed two maximal incremental exercise tests followed by either passive recovery (20 min seated on cycle ergometer followed by 40 min more of seated rest) or partially active recovery [20 min of pedalling at 40% maximal oxygen uptake (VO2max) followed by 40 min of seated rest]. Venous blood samples were drawn at 5 min and 1 min prior to exercise, at the end of exercise, and during recovery at 1, 2, 3, 4, 5, 6, 8, 10, 15, 20, 30, 40, 50, 60 min post-exercise. The time course of changes in lactate concentration during the recovery phases were fitted by a bi-exponential time function to assess the velocity constant of the slowly decreasing component (tau 2) expressing the rate of blood lactate removal. The results showed that at the end of maximal exercise and during the 1st min of recovery, ET showed higher blood lactate concentrations than ST. Furthermore, ET reached significantly higher maximal exercise intensities [5.1 (SEM 0.5) W.kg-1 vs 4.0 (SEM 0.3) W.kg-1, P < 0.05] and VO2max [68.4 (SEM 1.1) ml.kg-1.min-1 vs 55.5 (SEM 5.1) ml.kg-1.min-1, P < 0.01]. There was no significant difference between the two groups during passive recovery for tau 2. During partially active recovery, tau 2 was higher than during passive recovery for both groups (P < 0.001), but ET recovered faster and sooner than ST (P < 0.05). Compared to passive recovery, the tau 2 measured during partially active recovery was increased threefold in ET and only 1.5-fold in ST. We concluded that partially active recovery potentiates the enhanced ability to remove blood lactate induced by endurance training.

Adult↗

Development of the diagnostic immunoassay to detect anti-PreS1(21-47aa) antibody--a marker suggesting the health improvement of hepatitis B patients.

BACKGROUND: A new immunoassay has been developed for the detection of the anti-PreS1(21-47aa) antibody in sera of hepatitis B virus (HBV)-infected patients. Anti-PreS1(21-47aa) antibody involves virus neutralization and is a new marker for diagnosing acute and chronic B hepatitis. METHODS: The expression plasmids pGEXS I and pGEXS II, which expressed glutathione S-transferase (GST) fusion proteins containing a copy of PreS1(21-47aa) peptide and two orderly joined copies of PreS1(21-47aa) peptide, were constructed. The soluble expression products were purified by affinity chromatography. RESULTS: The two PreS1(21-47aa) fusion proteins were both successfully applied in the immunoassay based on biotin-protein A and streptavidin-HRP, and could detect the anti-PreS1(21-47aa) antibody with high sensitivity in sera from hepatitis B patients. The anti-PreS1(21-27aa) antibody was detected during the recovery phase of acute hepatitis B patients, but it was found only in few of the chronic carriers by the established conventional system. CONCLUSIONS: The follow-up study suggested that the presence of the anti-PreS1(21-27aa) antibody correlated well with the recovery of patients from hepatitis and the improvement in health.

Amino Acid Sequence↗

Recovery and pharmacokinetic parameters of desflurane, sevoflurane, and isoflurane in patients undergoing urologic procedures.

STUDY OBJECTIVE: To compare the pharmacokinetics and the speed of recovery after inhalation anesthesia with desflurane, sevoflurane, and isoflurane in elective surgery. DESIGN: Prospective, randomized study. SETTING: University medical center. PATIENTS: 30 ASA physical status I and II adults presenting for elective surgery. INTERVENTIONS: Anesthesia was induced with etomidate and maintained with desflurane (n = 10), sevoflurane (n = 10), or isoflurane (n = 10) and nitrous oxide. The inhalation drugs were titrated until an adequate clinical depth of anesthesia was reached. At the end of anesthesia, the patients breathed oxygen via the endotracheal tube and after extubation via a face mask. MEASUREMENTS AND MAIN RESULTS: The groups were similar with respect to age, weight, duration of anesthesia, and mean arterial pressure. Mean end-tidal concentration (FA = FA0) at the end of anesthesia was 6.34 +/- 1.15% after desflurane, 1.85 +/- 0.42% after sevoflurane, and 1.10 +/- 0.24% after isoflurane. FA/FA0 decreased significantly faster with desflurane than with isoflurane, while there was little difference between desflurane and sevoflurane. As for the terminal half-life (t1/2), there were no differences among the groups (8.16 +/- 3.15 min after desflurane, 9.47 +/- 4.46 min after sevoflurane, and 10.0 +/- 5.57 min after isoflurane). The time until a command was followed for the first time was the same in all three groups (13.0 +/- 4.7 min after desflurane, 13.4 +/- 4.4 min after sevoflurane, and 13.6 +/- 3.4 min after isoflurane). There was no significant correlation between duration of anesthesia and the time until recovery. CONCLUSIONS: There are only minor differences with regard to the recovery phase in premedicated patients who receive clinically titrated inhalation anesthesia with desflurane, sevoflurane, or isoflurane.

Adolescent↗

Ion transport and energy metabolism in brain.

The kinetics of extracellular K+ activity was compared to the availability of energy in the cortex of rats and gerbils exposed to anoxia, hypoxia, spreading depression, and ischemia. A combined K+/DC surface electrode was used alone or together with a fiber optic light guide in various experiments. All experiments were done on slightly anesthetized animals that were practically awake. The results can be summarized in the following conclusions: (1) Under conditions such as hypoxia or ischemia, K+0 showed a two-phase efflux kinetics, and a transition or critical point was reached where the response proceeds at a higher rate. This critical point was in the range of 10-16 mEq/1 potassium. (2) Availability of oxygen is necessary but not sufficient for a full rate of recovery from a long-term oxygen-deprivation insult. (3) There is an energy debt or energy-transduction bottleneck formed during a prolonged O2 insufficiency. This debt is reversed slowly during the recovery phase even when full restitution of O2 supply and blood flow has occurred.

Animals↗

Regulated workplace ketones and their interference in the PFBHA method for aldehydes.

Ketones are the major positive interferences for an aldehyde dynamic air sampler that consists of 200-mg 20 percent (w/w) O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine hydrochloride (PFBHA) on Tenax TA contained in a Pyrex tube 7-mm OD, 5-mm ID, and 70-mm in length, that utilizes a personal battery-powered pump at 10-50 mL/min. The ketone O-oxime derivatives were synthesized to allow absolute quantitation of O-oximes formed during sampling. Wet spiking allowed ketone recoveries to be found. Ketone vapors of known concentrations were generated statically in Tedlar gas bags. The O-oximes were desorbed with hexane, and an aliquot injected for gas chromatographic analysis on a nonpolar capillary column with mass spectrometric or electron capture detection. Gas phase recoveries up to 200 ppm-hour loadings exceeded 75 percent at 25 degrees C for chloroacetone, cyclohexanone, diacetone alcohol, diethyl ketone, dipropyl ketone, ethyl butyl ketone, methyl amyl ketone, methyl butyl ketone, 2-methylcyclohexanone, methyl ethyl ketone, methyl isobutyl ketone, methyl isopropyl ketone, and methyl propyl ketone. The recoveries for acetophenone, 2-chloroacetophenone, and ethyl amyl ketone were lower than 75 percent, and were caused by steric hindrance. Sampling for both aldehydes and ketones is recommended at 10 mL/min for TLV concentrations.

Air Pollution, Indoor↗

Effect of Eimeria species on the appearance of radioactivity in the blood of chicks fed radio-labeled glucose or 3-0-methyl-D-glucose.

Results of five trials with four species of coccidia (Eimeria acervulina, E. necatrix, E. tenella, and E. brunetti) failed to demonstrate any interference with glucose absorption in the parasitized intestines of intact chick hosts. In addition, circulating blood radioactivity in severely parasitized chicks, as evidenced by weight gain data and intestinal lesion scores, was significantly higher than that in control chicks following oral administration of 14C-glucose or 3-0-methyl-D-14C-glucose at 6 days postinfection. During the recovery phase of the infection (14 to 21 days postinfection), severely infected chicks rapidly gained weight and the blood radioactivity of parasitized chicks was consistently higher than that of uninfected control chicks. No significant differences in weight or blood radioactivity were observed during the post-recovery period (28 to 35 days postinfection).

Animals↗

High-dose ifosfamide, carboplatin and etoposide with autologous peripheral blood progenitor cell transplantation for small-cell lung cancer.

BACKGROUND: We investigated the feasibility and efficacy of high-dose chemotherapy consisting of ifosfamide, carboplatin and etoposide (HD-ICE) facilitated by autologous peripheral blood progenitor cell transplantation (ABPCT) for the treatment of small-cell lung cancer (SCLC). PATIENTS AND METHODS: Eleven patients aged 44 to 63 years old (5 with extensive disease [ED] and 6 with limited disease [LD]) were entered into this study. Induction chemotherapy consisted of 3 to 4 cycles of cisplatin and irinotecan for ED-SCLC, and cisplatin and etoposide for LD-SCLC. Patients with LD-SCLC received concurrent chest radiotherapy along with the first cycle of induction chemotherapy. After induction therapy, peripheral blood progenitor cells (PBPC) were collected following G-CSF administration during a recovery phase from high-dose etoposide (1,500 mg/m2). Eight patients (4 with ED and 4 with LD) with adequate organ function were treated with HD-ICE (15 g/m2 ifosfamide, 1,200 mg/m2 carboplatin and 1,500 mg/m2 etoposide) followed by ABPCT. RESULTS: Hematologic recovery was rapid and non-hematological toxicities were acceptable without treatment-related mortality. In ED-SCLC, all of the 4 patients achieved complete response (CR) or near CR but developed a relapse of the disease. In LD-SCLC, 2 of 4 patients with LD-SCLC are alive in continuous CR for 18 and 21 months after the beginning of induction therapy. CONCLUSIONS: Despite a limited number of patients and short follow-up time, these preliminary results indicate that marrow-ablative therapy (HD-ICE) supported by ABPCT is feasible in the treatment of elderly patients with LD- and ED-SCLC.

Adult↗