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Improvement in functional recovery of stunned canine myocardium by long-term pretreatment with oral propranolol.

We investigated the effect of long-term oral pretreatment with the beta-adrenergic antagonist, propranolol (Inderal LA, 160 mg daily for 8 days) on the functional recovery of myocardium after 15-minute coronary artery occlusion followed by 3 hours of reperfusion in barbital-anesthetized dogs. Propranolol-pretreated dogs (N = 9) displayed a significantly lower left ventricular peak-positive rise in ventricular pressure (dP/dt), heart rate, and rate-pressure product throughout the experiment compared with the control group (N = 15). Subendocardial percent segment shortening as measured by sonomicrometry recovered to 65.4 +/- 7.2% of the preocclusion level after pretreatment with propranolol, whereas the control group recovered to only 11.1% +/- 10.2% after 3 hours of reperfusion. To ascertain the beneficial role of a lower heart rate on the recovery of regional contractile function, a third group of dogs (N = 6) was pretreated with propranolol, but heart rate was maintained at control levels by atrial pacing. The beneficial effects of pretreatment with propranolol were abolished in this group. There were no differences between groups in myocardial perfusion in the normal region as measured by the radioactive microsphere technique. However, in postischemic, reperfused myocardium, there was a significantly higher blood flow to subepicardium, mid-myocardium, and subendocardium after reperfusion in the propranolol-pretreated, unpaced group. Thus long-term oral pretreatment with propranolol enhances the contractile recovery of postischemic, reperfused myocardium. This protective effect of beta-adrenergic blockade is primarily related to the reduction in heart rate and enhanced perfusion in the postischemic region.

Administration, Oral

Macular recovery function (nyctometry) in diabetics without and with early retinopathy.

Nyctometry was used to assess macular recovery function in 234 diabetic patients; their retinopathy ranged from no retinopathy (99) to early background retinopathy (135). None had visual symptoms or macular oedema. Abnormal (reduced) nyctometry findings were significantly and directly related to the deterioration of diabetic retinopathy. There was no significant association between reduced or normal nyctometry findings and glycaemia at the time of the examination. The value of nyctometry in screening and follow-up is discussed.

Adaptation, Ocular

Recovery function of short latency components of surface and depth recorded somatosensory evoked potentials in the cat.

Recovery functions of early components of surface and depth recorded somatosensory evoked potentials were studied in the cat. At interstimulus intervals of 50 msec or less differentiation of surface components was optimal. Component I showed less decrement at all ISI's than did component II and recovery curves of both were distinctly different from those of components III (anterior) and IV and the cortical SEP. The latter three potentials had similar recovery curves. Comparisons of latencies and recovery curves of surface recorded potentials with those of depth recorded potentials indicate that component I principally reflects activity in posterior column, that potentials in medial lemniscus, cuneate nucleus, and lateral cuneate nucleus contribute to component II, that the major generator for the contralateral component III is the ventral postero-lateral nucleus of the thalamus, and that component IV is largely due to activity in the sensory radiation. The results of this study support previous observations and conclusions about the origin of short latency, surface recorded somatosensory evoked potentials preceding the cortical SEP.

Animals

Functional recovery after fractures of the distal forearm. Analysis of radiographic and other factors affecting the outcome.

Functional recovery of the wrist and hand after a fracture of the distal forearm in 207 consecutive patients was analysed. A good or excellent result was achieved in 77 percent, fair in 22.5 percent and poor in 0.5 percent of cases. The result in 14 unstable fractures treated with external fixation was as good as that of the whole series. Good functional results were associated with extra-articular fractures, good anatomical results, male sex and low age. Comminuted intra-articular fractures of the radiocarpal joint, fracture line into the distal radio-ulnar joint, fracture of the ulnar styloid and a poor anatomical result in addition to high age contributed to a poor result.

Adolescent

Oral administration of nimodipine accelerates functional recovery following peripheral nerve damage in the rat.

Oral administration of the Ca2+-entry blocker nimodipine accelerates in a dose-dependent manner the recovery of sensorimotor function following a crush lesion of the rat sciatic nerve. The beneficial effect of nimodipine was apparent in both a foot shock withdrawal test and in a test analyzing the walking pattern of the rat. These data are the first demonstration of nimodipine-induced enhanced recovery following peripheral nerve damage.

Administration, Oral

Clinical implications of the impact of autologous blood donation on functional recovery.

The practice of depositing units of autologous blood to prepare for elective surgery is steadily increasing. This article outlines the advantages and limitations of autologous blood donations. Secondary analysis from a study of functional recovery following total knee replacement compares functional outcomes of people who predeposited autologous units with those who did not. Clinical implications and suggestions are made for managing the patient's physiologic status during the donation process, as well as hemodynamic status during the postoperative transfusion period.

Activities of Daily Living

Improved functional recovery of the isolated rat heart after 24 hours of hypothermic arrest with a stable prostacyclin analogue (ZK 36 374).

Prostacyclin (PGI2) can protect the heart against ischemia, i.e. it can reduce myocardial damage [9, 10]. PGI2 protects the myocardium in vivo by preventing platelets from clumping and by dispersing preformed platelet aggregates [1,14]. However, also in the absence of platelets, PGI2 was shown to protect the myocardium against ischemia at concentrations that did not affect smooth muscle tone in the vessel wall [2]. This protective effect of PGI2 in vitro might be related to a stabilization of cell membranes in adrenergic nerve endings and hence to the prevention of ischemia-induced catecholamine release [13]. The instability of PGI2, both in vitro and in vivo, limits its application during long ischemic periods. Recently, a stable prostacyclin analogue, ZK 36 374, was demonstrated to have several prostacyclin-mimetic activities, both in vitro and in vivo [11,12]. In this communication we report upon the beneficial effect of this stable prostacyclin analogue at a low concentration (4 nM) on the extent of ischemic damage, on the recovery of myocardial function and on the occurrence of arrhythmias in the isolated rat heart after 24 h hypothermic cardiac arrest.

Animals

Functional recovery of the developing rat ovary after transplantation: contribution of the extrinsic innervation.

These experiments were undertaken to define the neuroendocrine mechanisms underlying the recovery of ovarian function after transplantation to an ectopic site. Both ovaries from 23-day-old rats were transplanted to the region of the neck, next to the jugular vein. Serum gonadotropin and plasma immunoreactive inhibin-alpha levels were determined at several intervals thereafter. Serum estradiol (E2) was measured during the first week posttransplantation. Reinnervation of the ovary by sympathetic and sensory nerves was monitored by immunohistochemistry. Sympathetic nerves were identified as adrenergic by the presence of tyrosine hydroxylase (TH), the rate-limiting enzyme in catecholamine biosynthesis, and as peptidergic, by their neuropeptide-Y (NPY) or vasoactive intestinal peptide (VIP) immunoreactivity. Sensory nerves were identified by the presence of substance P (SP) and calcitonin-gene related peptide (CGRP) immunoreactivity. Serum LH and FSH increased, and plasma inhibin levels decreased, within 48 h after transplantation. Serum LH reached maximum levels on day 4, decreasing rapidly thereafter to basal values by day 6. These changes were functionally correlated with the posttransplantation fluctuations in serum E2, which decreased at 48 h, rebounded by day 4, and returned to basal values on day 7. Removal of the transplanted ovaries on day 3 resulted in the disappearance of serum E2 levels on day 4, thus confirming the ovarian graft as the source of E2. In contrast to LH, serum FSH remained significantly elevated for at least 3 weeks after transplantation, then decreased to basal levels after day 21, coinciding with the rise in inhibin secretion. Although a substantial loss of follicles was noted 48 h after transplantation, quantitative examination of the changes on day 4 revealed that approximately 40% of antral follicles were not necrotic. Ovulation and formation of corpora lutea were noted 21 days after transplantation. Reinnervation of the transplanted ovary by TH-, VIP-, NPY-, SP-, and CGRP-containing fibers was first detected 7 days after transplantation. Although VIP reinnervation was sparse and only transiently detected (days 7-21), the density of sympathetic (TH, NPY) and sensory (SP, CGRP) fibers increased 2- to 3-fold between days 7-28, remaining unchanged thereafter. Since apparent completion of this reinnervation coincided with reestablishment of normal levels of both LH and FSH, an additional experiment was performed to determine if the two events were causally related.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

Neutrophils delay functional recovery of the post-hypoxic heart of the rabbit.

A postischemic contractile dysfunction termed myocardial stunning has been described in vivo and is attributed, in part, to the generation of oxygen-derived free radicals and the presence of neutrophils. An analogous contractile derangement occurs in the posthypoxic heart in vitro. This study determined the role of neutrophils in hypoxia/reoxygenation-induced cardiac dysfunction in the isolated buffer-perfused rabbit heart utilizing a recirculating system with or without neutrophils present. In control hearts perfused with a neutrophil-free buffer, reoxygenation after 20 min of hypoxia was associated with a slow recovery of contractility which returned to prehypoxic values by 30 to 45 min. Although perfusion with buffer-containing neutrophils did not affect the hypoxia-induced decrease in myocardial contractility, the recovery of contractile function during subsequent reoxygenation was significantly diminished (P less than .01 vs. control), remaining depressed by 30 to 35% at 45 min. The myocardial neutrophil content increased approximately 2-fold in response to hypoxia and reoxygenation, as assessed using 51Cr-labeled neutrophils. The deleterious effects of neutrophil perfusion on cardiac function could not be attributed to neutrophil-mediated plugging of coronary vessels or enhanced myocellular damage. These results support the concept that neutrophils contribute to the cardiac dysfunction described in this model.

Animals

Plasticity of catecholaminergic neurons in aged rat brain: reinnervation and functional recovery after axotomy.

Regenerative growth at the lesion site, reinnervation of a target nucleus and functional manifestations of recovery were studied in aged (20 and 30 months old) rats subjected to long-term transection of catecholaminergic (CA) fibers which contact and influence neurons of the supraoptic nucleus (SON). Small bilateral knife cuts were placed stereotaxically just caudal and medial to the SON. CA histofluorescence, induced by formaldehyde-glutaraldehyde (FAGLU) or aluminum-formaldehyde (ALFA) methods, was examined in hypothalamus at 2, 14, 21 and 60 days postsurgically. Water consumption, and urine volume and osmolality, were monitored presurgically, and through survival times. Subtotal CA denervation in the SON, and typical axonal transmitter "pile-up" at the lesion site, were evident two days after surgery. Among these degenerative profiles, which persisted for up to three weeks, fine-sized new fibers were apparent at the lesion, beginning between 2 and 14 days, and persisting throughout the period studied. At 21 days, and progressively thereafter, SON neurons were rimmed with fluorescent varicosites. Water consumption initially was depressed, but returned to presurgical mean levels by nine days. Urine volume returned to normal by 32 days. Urine osmolality showed a recovery by approximately three weeks. These functional parameters rebounded to levels higher than presurgical means among 20 month old, but not 30 month old, rats beyond 6 weeks survival, concurrent with a morphological hyperinnervation. The results reaffirm morphological regeneration, and support reinnervation and functional recovery, which extend considerably into the aging process.

Afferent Pathways

Effectiveness of passive vs. assistive robotic gait training on functional recovery and neuroplasticity post-stroke: A randomized controlled trial.

OBJECTIVE: This study seeks to compare the impacts of various robotic gait training (RAGT) modes on lower limb motor function recovery in stroke patients while exploring the corresponding neural mechanisms. DESIGN: A single-blind, randomized controlled trial. SETTING: Inpatient Rehabilitation Facility. PARTICIPANTS: Forty-eight patients aged 18-80 who had experienced their first unilateral subacute stroke accompanied by walking impairments were included. INTERVENTIONS: Participants were randomly assigned to: (1) assistive mode training, (2) passive mode training, or (3) control group receiving only traditional rehabilitation. Clinical and neurological outcomes were assessed at pre-intervention (T0), and post-2-week intervention (T1). MAIN OUTCOME MEASURES: Outcomes were evaluated using the Fugl-Meyer Assessment for Lower Extremity, Berg Balance Scale, Modified Barthel Index, the Functional Ambulatory Category, and functional near-infrared spectroscopy. RESULTS: Among the 48 patients recruited, significant time effects were observed across all groups in FMA-LE scores (p&#x202f;<&#x202f;0.001). Notable improvements were detected in the conventional group (MD = 2.69, p&#xff1c;0.01) and the passive group (MD = 3.67, p&#x202f;<&#x202f;0.001), with the assistive mode also demonstrating a significant effect (MD = 1.79, p&#x202f;<&#x202f;0.05). BBS scores improved across all groups; however, no significant differences were noted between the groups (p&#x202f;=&#x202f;0.11). Similarly, MBI scores showed a significant time effect (p&#x202f;<&#x202f;0.001), without notable group differences (p&#x202f;=&#x202f;0.29). CONCLUSION: All training modalities effectively enhanced motor function, balance, and daily living skills in stroke patients. Distinct cortical activation and connectivity patterns were observed between training modalities, which may reflect different neuroplastic mechanisms. These preliminary neural differences may help inform personalized rehabilitation strategies, although no clinical superiority of one mode over another can be concluded from the present data.

Humans

Effect of naloxone on functional recovery after experimental spinal cord injury in the rat.

The effect of the opiate antagonist naloxone on the functional recovery of rats injured with a 10 g-cm impact to the spinal cord at the T-3 level is studied. Sixteen rats were treated with 0.8 mg of naloxone in an intraperitoneal bolus 45 and 120 minutes after injury, 16 rats were given 4 mL of saline instead of naloxone, and 16 rats were neither injured nor treated. To asses weekly the motor recovery of the injured animals, the inclined plane method was employed. After the 10-week assessment period, naloxone-treated animals showed a significantly better performance on the inclined plane than saline-treated animals. Naloxone may be useful for the treatment of spinal cord injury although its mechanism of action remains unknown.

Animals

Mechanism of global functional recovery despite sustained postischemic regional stunning.

BACKGROUND: The mechanisms whereby reperfusion of a 20-minute coronary occlusion result in global functional recovery despite persistent regional dysfunction were studied in 11 open-chest reflex-blocked dogs. METHODS AND RESULTS: Pressure-volume and pressure-thickness relations were simultaneously determined before, during, and after reperfusion of left anterior descending artery (LAD) occlusion. Wall thickness was determined by sonomicrometry in both ischemic and remote regions. Chamber systolic function was assessed by end-systolic pressure-volume relations (ESPVR) obtained by conductance catheter and defined by a slope (Ees) and volume shift at a common end-systolic pressure (delta Ves). LAD occlusion produced regional systolic thinning (-7 +/- 6%) and global left ventricular dysfunction (ESPVR shifted rightward (delta Ves = +8.6 +/- 5.1 ml, p less than 0.001) with no Ees change). After nearly 1 hour of reperfusion, LAD region thickening remained markedly reduced at 4 +/- 7% (versus 23 +/- 8%, control), yet chamber systolic function fully recovered (ESPVR shifted back leftward delta Ves = -8.9 +/- 6.5 ml). Ischemia induced a leftward shift and systolic thinning of LAD region pressure-thickness relations. Reperfusion returned end-systolic pressure-thickness relations halfway to their control position and diastolic relations fully to control position. This was primarily due to increased passive stiffening in about half the hearts and a partial return of active function in the remaining ones. The net effect was to eliminate systolic thinning over a physiological loading range, thus normalizing chamber systolic performance. Reflex activation, remote hyperfunction, or altered chamber loading did not account for the postreperfusion disparity between global and regional function. CONCLUSIONS: These data suggest a mechanism to account for greater functional benefits of reperfusion beyond that anticipated from regional wall motion analysis.

Animals

Blocking weight-induced spinal cord injury in rats: effects of TRH or naloxone on motor function recovery and spinal cord blood flow.

The ability of thyrotropin releasing hormone (TRH) or naloxone to reduce the motor function deficit and to improve the spinal cord blood flow (SCBF) was investigated in a rat spinal cord compression injury model. Spinal cord injury was induced by compression for 5 min with a load of 35 g on a 2.2 x 5.0 mm sized compression plate causing a transient paraparesis. One group of animals was given TRH, one group naloxone and one group saline alone. Each drug was administered intravenously as a bolus dose of 2 mg/kg 60 min after injury followed by a continuous infusion of 2 mg/kg/h for 4 h. The motor performance was assessed daily on the inclined plane until Day 4, when SCBF was measured with the 14C-iodoantipyrine autoradiographic method. It was found that neither TRH nor naloxone had promoted motor function recovery or affected SCBF 4 days after spinal cord injury.

Animals

Association of myocardial glutamate and aspartate pool and functional recovery of postischemic heart.

The effect of low flow ischemia and subsequent reperfusion with 5.5 mM glucose or 5 mM acetate on energy metabolism and catabolism of myocardial glutamate and aspartate was studied in isolated perfused guinea pig hearts. Reperfusion with acetate was followed by low recovery of the cardiac contractile function associated with a great rise in isovolumic end-diastolic pressure. It was combined with more profound losses of tissue adenine nucleotides and the total Cr compared to reperfusion with glucose. The total glutamate and aspartate pool decreased more than two-fold compared to the initial one regardless of substrate. However, glutamate content was reduced by 58 and 38% with acetate and glucose, respectively. The expenditure of both amino acids was caused by alanine formation stimulated by glycolysis/glycogenolysis. The remaining glutamate and aspartate pool in the reperfused hearts positively correlated with adenine nucleotides (r = 0.62), the total creatine (r = 0.65), and the recovery of contractile function (r = 0.64). The results suggest that the glutamate and aspartate pool may be of critical importance for postischemic functional and metabolic recovery of the heart.

Adenosine Triphosphate

Effects of diltiazem on the functional recovery of the myocardium at organ and cellular level during prolonged hypothermic ischemic cardiac arrest.

The effectiveness of diltiazem on the functional recovery of the heart, calcium (Ca++) uptake and binding, Ca++ ATPase of cardiac sarcoplasmic reticulum (SR), and MB fraction of creatine kinase (MBCK) of coronary sinus blood was investigated after one and a half hours of reperfusion following three hours of ischemic cardiac arrest. The dogs were divided into three groups: group I, sham bypass; group II, cold crystalloid cardioplegia; and group III, cold crystalloid cardioplegia with diltiazem. There was a decrease in aortic pressures left ventricular pressure development (dp/dt), left ventricular work index (LVWI), total systemic vascular resistance (TSVR), and left ventricular systolic pressure (LVSP) in the sham bypass group. There was a decrease in cardiac index (CI), LVWI, and mean right atrial pressure (mRAP) and an increase in TSVR and pulmonary vascular resistance (PVR) in group II as compared with group I. Although there was a tendency for a decrease in the indices of myocardial contractility in group II, they were not significantly different from those in group I. The indices of myocardial contractility, CI, and LVWI in group III were slightly higher than in group II, but they were not significantly different from each other. The values for calcium uptake by SR in groups II and III were similar but significantly lower than those in group I. Calcium binding in group III was significantly lower than that in group I. Calcium ATPase of SR in the three groups were similar. Although MBCK increased in all the groups, the increases were not significantly different among the three groups. The results of this study indicate that cold crystalloid cardioplegia with diltiazem was not better than cold crystalloid alone in preserving the cardiac contractility and cellular function during prolonged ischemic cardiac arrest. However, the cardiac function in terms of cardiac index was better preserved with diltiazem.

Adenosine Triphosphatases

[The action of an impulse magnetic field on the motor function recovery of the peripheral nerve trunks].

The cut sciatic nerve trunk was sutured perineurally to study in chronic rabbit experiments of the neuromuscular functional recovery upon the exposure to impulse magnetic field with the intensity 1.2 T. Nonexposed animals served control. Myographic activity of reinnervated crural muscles in the irradiated animals recovered two times more rapidly compared to the controls, so did motor function of the limb operated on. It is inferred that impulse magnetic field produces therapeutic and preventive effect on neurodystrophy resultant from the nerve dissection.

Animals

The functional recovery of damaged brain: the effect of GM1 monosialoganglioside.

In the present study the topology and the biochemical mechanisms underlying the functional recovery of the dopaminergic nigrostriatal system is further analyzed. Rats with unilateral hemitransection were treated with 30 mg/kg GM1 monosialoganglioside or with its internal ester derivative for different periods of time. GM1 enhances 3H-dopamine uptake in striatal synaptosomes of the lesioned side, and the enhancement of dopamine uptake precedes that of striatal tyrosine hydroxylase activity. The above biochemical effects are accompanied by changes in behavioral- and electrophysiological-related parameters. The effect of GM1 on striatal tyrosine hydroxylase of the lesioned side disappears when the ascending dopaminergic fibers are extensively lesioned. This suggests that the source of regrowing dopaminergic nerve terminals in the striatum of partially lesioned rats resides mainly in the intact axons remaining in the ipsilateral side. When GM1 is injected into partially lesioned rats kept in darkness, no effect on tyrosine hydroxylase activity is observed. This indicates that the mechanism through which GM1 acts involves a normal light-dark cycle.

Animals