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Results for “Recovery phases”

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PubMed1994

Surfactant protein A and saturated phosphatidylcholine in respiratory distress syndrome.

We measured surfactant protein A (SP-A) by ELISA using a rabbit antihuman SP-A polyclonal antibody and saturated phosphatidylcholine (SPC) by thin-layer chromatography in sequential tracheal fluid samples obtained from 16 preterm neonates without lung disease and 37 with respiratory distress syndrome (RDS). SP-A and SPC were lower in neonates with RDS than in control infants (1.0 +/- 0.1 versus 8.9 +/- 2.2 ng SP-A/microgram protein [p < 0.0001] and 0.20 +/- 0.05 versus 0.70 +/- 0.19 mumol SPC/mg protein [p < 0.01], respectively). Initial SP-A concentrations correlated inversely with severity of RDS (r = 0.45, p < 0.01) but did not correlate with initial SPC levels. Significant increases in SP-A were detectable within 12 to 24 h after birth in neonates with RDS. Further increases occurred subsequently and were similar for neonates treated with either a synthetic (Exosurf) or a modified natural (Survanta) surfactant. Using two-dimensional gel electrophoresis, SP-A in tracheal fluid obtained during the early and recovery phases of RDS exhibited lesser degrees of posttranslational modification than SP-A forms from control neonates. Administration of Exosurf or Survanta resulted in comparable increases in SPC in tracheal fluid. Preterm neonates with RDS seem to have an immature SP-A metabolism that persists for several days after birth. The type of surfactant used does not modify the recovery of SP-A or SPC in tracheal fluid from infants with RDS.

Analysis of Variance↗

PubMed1997

Learned changes in the complexity of movement organization during multijoint, standing pulls.

This paper tests the hypothesis that the central nervous system (CNS) learns to organize multijoint movements during a multijoint 'bouncing pull' task such that, after practice, motion of the anterior-posterior center of mass (CMAP) more closely resembles that of a conservative, one degree of freedom (DF), inverted pendulum model. The task requires standing human subjects to produce precise peak pulling forces on a handle while maintaining balance-goals that can be easily accomplished if movement is organized as in the model. Ten freely standing subjects practiced making brief, bouncing pulls in the horizontal direction to target forces (20-80% of maximum) for 5 days. Pulling force, body kinematic and force plate data were recorded. An eight-segment analysis determined sagittal-plane CM motion. We compared the effects of practice on the regression-based fit between actual and model-simulated CMAP trajectories, and on measures of CMAP phase plane symmetry and parameter constancy that the model predicts. If the CNS learns to organize movements like the inverted pendulum model, then model fit should improve and all other measures should approach zero after practice. The fit between modeled and actual CMAP motion did not improve significantly with practice, except for moderate force pulls. Nor did practice increase phase plane symmetry or parameter constancy. Specifically, practice did not decrease the differences between the pre-impact and rebound positions or speeds of the CMAP, although speed difference increased with pulling force. CMAP at the end of the movement was anterior to its initial position; the anterior shift increased after practice. Differences between the pre-pull and balance-recovery ankle torque (TA) impulses were greater on day 5 and correlated with the anterior shift in CMAP. These results suggest that practice separately influenced the force production and balance recovery phases. A modified model with damping could not explain the observed behaviors. A modified model using the actual time-varying TA profiles improved fit at lower force levels, but did not explain the increased postural shift after practice. We conclude that the CNS does not learn to organize movements like the conservative, inverted pendulum model, but rather learned a more complex form of organization that capitalized on more time-varying controls and more intersegmental dynamics. We hypothesize that at least one additional DF and at least one time-varying parameter will be needed to explain fully how the CNS learns to organize multijoint, bouncing pulls made while standing.

Adult↗

PubMed1998

Pregnancy-associated osteoporosis: preliminary densitometric evidence of extremely rapid recovery of bone mineral density.

Pregnancy-associated osteoporosis (PAO) is considered a rare complication of pregnancy and lactation, but the actual incidence is unknown. Pregnancy-associated osteoporosis is self-limited and usually does not recur during subsequent pregnancies, but little is known about its pathogenesis or the dynamics of bone density during the evolution and recovery phases of an acute episode. We report a case of idiopathic PAO. Follow-up included repeat measurements of bone density, which revealed a striking rate of improvement during the first 6 months after delivery (50% increase) and continuous improvement, at a diminished though still relatively high rate, during the successive year. This observation provides insight into the early stages of recovery from PAO.

Absorptiometry, Photon↗

PubMed1989

Temperature influence on phases of the tension response to sudden reduction of muscle length.

Phasic tension transients following a quick release in muscle length were studied to obtain information about the mechanism of force generation at different temperatures. The isometric tetanic tension increased (Q10 = 1.5) in the temperature range of 1.4 degrees C to 11.4 degrees C. The instantaneous stiffness (tension drop during the applied quick release in relation to the percentage of change of length) is slightly reduced by increasing temperature (Q10 = 0.9). The rate constant of the early tension recovery (phase 2) increased with increasing temperature (Q10 = 1.8). The results indicate that the increase of tetanic tension with increasing temperature is due to an increasing amount of force, generated by each cross bridge and a higher speed of rotation of the myosin head. The number of force generating cross bridges defined by the instantaneous elasticity is nearly independent of temperature range studied.

Animals↗

PubMed1989

The cytological and histological effects of photoperiodism and X-irradiation on the testes of the Syrian hamster.

The radiosensitivity of meiotic stem cells from photoregressed testes of the Syrian hamster was studied after in vivo irradiation with 2.67 Gy (1.77 Gy/min). The testes of Expt I animals were irradiated at the time of transfer from short days (11 weeks at 6L:18D (6 hours light: 18 hours) darkness) to long days (14L:10D) and sampled at weekly intervals between 5 and 10 weeks and at 15 weeks postirradiation. The Ext II animals received the same X-ray dose, 2, 4, 6, 8 weeks after the transfer to long days and were sampled 10 weeks postirradiation. In Expt I X-irradiation delayed the recovery of testis structure and function by 4 weeks. Animals in Expt II were homogeneous with regard to testicular weight, sperm count, tubule diameter and the level of pachytene, MI and MII damage. The incidence of structural chromosomal changes in primary spermatocytes at pachytene (synaptonemal complexes) and MI and MII was determined. In Exp I and II and data from X-irradiated testes (2.6 Gy) not exposed to short days (Control B, see Cawood and Breckon 1983), these cell types show a difference in sensitivity to the induction of structural damage. The lowest level of pachytene damage was in Expt II, and the ratio of the number of pachytene to MI cells showing structural change was 1.23:1 (P = 0.41), not significantly different from 1:1. In Expt I the pachytene, MI structural change ratio was 1.60:1 (P = 0.010), significantly different from 1:1. The control B ratio was 1.85:1 (P = 0.0037) which was significantly different from 1:1. The preliminary results indicate that testes fully regressed to the 'stem' cell level by exposure to short day length have a similar radiosensitivity to normal (non-regressed) testes. However, testes irradiated during the recovery phase from photoperiod-induced regression have increased sensitivity to radiation damage. The relative testis weight was reduced to a mean of 1.25 g by the sequential X-ray treatment--this may indicate that the effects of the X-rays (3 Gy) on a recovering photoregressed testis are independent of the time of the X-ray treatment during the recovery period. Recovery of tubule diameter is not perturbed and may be slightly increased, with an associated elevation of MI-MII activity--but a low spermatogonia count.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed2006

Quantitative analysis of HBsAg, IgM anti-HBc and anti-HBc avidity in acute and chronic hepatitis B.

BACKGROUND AND OBJECTIVES: We evaluated hepatitis B virus (HBV) serological markers by novel, quantitative immunoassays in order to study their behaviours and possible role in the various phases of HBV infection. STUDY DESIGN: The quantitative determination of HBsAg and anti-HBc/IgM by chemiluminescent immunoassays (Abbott Architect) and the calculation of anti-HBc avidity index have been carried out on repository specimens from patients with acute or chronic hepatitis B. RESULTS: In acute hepatitis the levels of HBsAg were generally >10,000 UI/mL and decreased sharply in the recovery phase. In 35 anti-HBe-positive chronic hepatitis cases HBsAg levels were generally lower than 10,000 UI/mL (mean: 2655), whereas in five HBeAg-positive chronic hepatitis patients the mean value was 78,756 UI/mL and 90% of specimens exceeded 10,000 UI/mL. The lowest values (mean: 1029 IU/mL) were found in the seven patients with minimal hepatic damage. IgM anti-HBc antibodies were positive in all acute cases and in 68/207 samples (32.85%) from patients with chronic hepatitis, with significantly lower levels (average sample/cutoff (S/CO) ratio: 2.95 in chronic cases versus 25.96 in acute cases; p<0.005). A S/CO value of 10 for anti-HBc IgM had a 100% negative predictive value and a 99.13% positive predictive value for acute hepatitis B. The study of anti-HBc avidity by an experimental procedure showed that an avidity index (AI) threshold of 0.7 had a good efficacy to discriminate the cases of chronic hepatitis, among whom only 2 specimens out of 193 (1.04%) had an AI<0.7. CONCLUSION: The quantitative determination of HBsAg, anti-HBc/IgM and anti-HBc avidity provides additional information and may be useful in the differential diagnosis of acute and chronic HBV infections and in the follow-up of chronically infected patients.

Acute Disease↗

PubMed1986

Changes of plasma gastrointestinal glucagon concentrations following lethal infusions of E. coli.

We have determined the effect of lethal E. coli infusions in dogs on plasma concentrations of pancreatic and gastrointestinal-derived glucagon and have explored the contributions of each source of glucagon during the early and recovery phases of shock. We examined 18 adult dogs in three protocols: group I received LD100 E. coli alone, group II received LD100 E. coli + tobramycin (TOB), and group III received LD100 E. coli + TOB + methylprednisolone sodium succinate (MPSS). E. coli organisms were infused intravenously during a 1-hour period and each animal was monitored for 6 hours and observed for a 7-day recovery period. Plasma concentrations of pancreatic and gastrointestinal glucagon were determined by specific RIAs. The survival percentages (greater than 7 days) were 0% in group I, 17% in group II, and 83% in group III. Early progressive increases in plasma concentrations of pancreatic and gastrointestinal-derived glucagon, reaching statistical significance by 6 hours following the onset of E. coli administration, were seen in the three groups. The increase in gastrointestinal-derived glucagon was of a greater magnitude than that from the pancreas. Attenuation of the increase appeared to be achieved by corticosteroid infusion during its time of administration (6 hours). Recovery from shock was characterized by an exceptionally slow return (greater than or equal to 7 days) to control levels of glucagon in all recovering animals.

Animals↗

PubMed1994

Autografting in chronic myeloid leukaemia.

Autografting in chronic myeloid leukaemia (CML) has been performed at various stages in the disease using different regimens for the past 20 years. Early experience suggested that autografting in blastic transformation could prolong survival and, as with allogeneic transplantation, the use of autografting was then gradually extended to the chronic phase of the disease. Autografting techniques have been modified in recent years to exploit the presence of putative normal residual haemopoietic cells in the marrow of patients with CML. These include in vitro manipulations of marrow cells such as 10 day culture, purging with chemotherapeutic and other agents, and in vivo approaches such as collecting peripheral blood progenitor cells for autografting in the early recovery phase following high dose chemotherapy. Despite these advances, no large clinical trials have been carried out to address the question of whether autografting in CML extends the duration of chronic phase or prolongs survival. Therefore for the present autografting for CML must still be regarded as experimental, but interest in this approach continues since for the majority of patients allogeneic transplantation is not currently possible.

Bone Marrow Transplantation↗

PubMed1995

Interpretation of embolic phenomena during carotid endarterectomy.

BACKGROUND AND PURPOSE: Air and particulate emboli are a major source of morbidity during carotid endarterectomy (CEA); however, amplitude overload and poor time resolution have restricted the ability of transcranial Doppler ultrasound to differentiate between the two. METHODS: We have now overcome these two limitations by (1) rerouting embolic signals away from the audio frequency amplifier to avoid amplitude overload and (2) substituting the Wigner distribution function for the fast Fourier transform to improve time and frequency resolution. Thus, we can now accurately determine embolic duration and embolic velocity, the product of which is the sample volume length (SVL). This measurement represents the physical distance over which an embolic signal can be detected. The underlying hypothesis was that air reflected more ultrasound and would therefore be detected over a greater SVL. RESULTS: The median SVL (interquartile range) for 75 in vitro air emboli was 1.97 cm (range, 1.70 to 2.35) compared with 0.27 cm (range, 0.16 to 0.43) for 185 particulate emboli detected during the dissection phase of CEA. Off-line analysis on an additional 560 embolic signals detected during different phases of CEA suggested that 46 of 143 (32%) of emboli immediately after shunt insertion were particulate, as were 19 of 33 (58%) occurring during shunting, 28 of 78 (36%) after restoration of flow in the external carotid artery, 23 of 251 (9%) after restoration of flow in the internal carotid artery, and 55 of 55 (100%) of those emboli detected during the early recovery phase. CONCLUSIONS: This development provides objective physical criteria upon which embolus characterization (particulate/air) can be based. This could have major implications for future patient monitoring with respect to modification of surgical technique and pharmacological intervention.

Embolism, Air↗

PubMed2006

Risk factors for psychological distress following injury.

OBJECTIVES: To identify predictors of psychological morbidity among injured patients admitted to an Emergency Department (ED). DESIGN: A prospective cohort study. PARTICIPANTS: Participants were consecutive male ED attenders. 210 (97.7%) patients consented to participate. At one month, 128 (61.0%) responded, at six months, 114 (54.3%), at eighteen months 96 (45.7%). MAIN OUTCOME MEASURES: Measures immediately following injury were the Hospital Anxiety and Depression Scale, the Eysenck Personality Questionnaire and the McGill pain questionnaire. Recovery at one month was recorded using the SF-36 Health Survey, COPE scale, Perceived Stress Scale and Revised Impact of Events Scale. At six and eighteen months outcome was measured using the General Health Questionnaire (28 items) and Revised Impact of Events Scale. Multivariate analysis identified pre-morbid, accident-related and recovery factors influencing outcome at six and eighteen months. RESULTS: The strongest predictors of outcome were initial levels of anxiety and depression, prior history of mental health problems, early PTSD symptoms and involvement in litigation. These factors predicted between 40-60% of the variance at six months (p<0.001), and 50-60% of the variance in psychological distress at eighteen months (p<0.001). CONCLUSION: Factors identifying individuals at-risk from psychological distress following injury include those related to the immediate response and the recovery phases of injury. Further development is needed to convert identified predictors into a comprehensive screening tool for clinical use.

Adolescent↗

PubMed2004

Recovery of Finnish short-stay surgery patients.

In order to counsel the surgical patient, the nurse needs to have a clear picture of home recovery based on the patient's biophysiologic health problems. The purpose of this study was to examine short-stay surgery patients' experiences of pain, nausea, vomiting, fatigue, and problems with elimination and wound healing during a 1-week recovery phase at home.

Ambulatory Surgical Procedures↗

PubMed1993

Ischemia on effort is not a determinant of stunned myocardium in man: a radioisotopic study based on quantitative evaluation of ventricular dynamics.

To assess whether myocardial stunning occurs following brief episodes of effort ischemia, ventricular function was assessed by radionuclide angiography in 29 patients with coronary artery disease. No patient had evidence of previous myocardial infarction. Patients were divided into two groups according to presence of single (14 patients, Group 1) or multi-vessel (15 patients, Group 2) coronary artery disease. Equilibrium radionuclide angiocardiography was performed in the left anterior oblique projection by a small field-of-view gamma-camera. Acquisition were performed at baseline, at peak exercise, then again at 1 and 5 minutes of the recovery phase. For each acquisition, ejection fraction, peak filling rate and wall motion index were measured and compared. No difference in baseline and stress measurements was found between Group 1 and Group 2, except for the wall motion index that was more impaired during ischemia in patients of Group 2. Global and regional indexes of ventricular function did not show significant differences also in the two recovery periods when compared to the relative baseline values. Transient ischemia caused by an increase of oxygen demand did not reproduce the phenomenon of systolic and diastolic stunning observed in animal experiments, although in all patients the ischemia was of sufficient duration and severity to induce transient ventricular dysfunction.

Adult↗

PubMed1988

Neovasculature and blood-brain barrier in ischemic brain infarct.

The cellular events occurring in ischemic brain infarcts of 1 day to 8 weeks duration were investigated. The material consisted of 17 human postmortem brains with anemic infarcts caused by occlusive vascular diseases. Using antiserum against human plasma albumin as a marker for the breakdown of blood-brain barrier and ammoniacal silver nitrate stain to demonstrate the vasculature, the onset and distribution of the extravasated plasma protein was compared with histological changes in the blood vessels. It was observed that extravasation occurred in several separate regions of the infarct during different time periods. During the first few days, plasma proteins exudated from the vessels located at the marginal zone surrounding the infarct. This was followed by a prolonged phase of intense extravasation that coincided with the production of new capillaries originating from the blood vessels at the margin of the infarct and from pial vessels. It is postulated that the actively proliferative and migratory activities of the endothelial cells and pericytes in the neovasculature may be responsible for the extravasation which is reflected in the contrast enhancement of the infarct observed clinically during the recovery phase.

Blood-Brain Barrier↗

PubMed2005

Calcium-binding proteins annexin A2 and S100A6 are sensors of tubular injury and recovery in acute renal failure.

BACKGROUND: Rise in cellular calcium is associated with acute tubular necrosis, the most common cause of acute renal failure (ARF). The mechanisms that calcium signaling induce in the quiescent tubular cells to proliferate and differentiate during acute tubular necrosis have not been elucidated. METHODS: Acute tubular necrosis induced in mice by single intravenous injection of uranyl nitrate and examined after 1, 3, 7, and 14 days. Renal function was monitored and kidneys were evaluated by histology, immunohistochemistry, Western blotting, in situ hybridization, and real-time reverse transcription-polymerase chain reaction (RT-PCR). Models of folic acid induced-ARF and ischemic/reperfusion (I/R) injury were similarly investigated. RESULTS: Analysis of mRNA expression of intracellular calcium and phospholipid-binding proteins demonstrated selective expression of S100A6 and Annexin A2 (Anxa2) in the renal cortex with marked elevation on day 3, and gradually decline on day 7 and further attenuation on day 14. Similarly, the expression of both proteins, as demonstrated by immunohistochemistry and Western blot analysis, was increased and reached the peak level on day 7 and then gradually declined by day 14. Vimentin, a marker of dedifferentiated cells, was highly expressed during the recovery phase. Combined in situ hybridization immunohistochemistry revealed colocalization of both S100A6 and Anxa2 with proliferating cell nuclear antigen (PCNA). The universality of this phenomenon was confirmed in two other mouse acute tubular necrosis models, the ischemic-reperfusion injury and folic acid-induced ARF. CONCLUSION: Collectively, these findings demonstrate that S100A6 and Anxa2 expression, initiated in response to tubular injury, persist in parallel throughout the recovery process of tubular cells in acute renal failure.

Acute Kidney Injury↗

PubMed1999

Phase-related changes in right ventricular cardiac output under volume-controlled mechanical ventilation with positive end-expiratory pressure.

OBJECTIVE: To examine determinants of right ventricular function throughout the ventilatory cycle under volume-controlled mechanical ventilation with various positive end-expiratory pressure (PEEP) stages. DESIGN: Prospective observational animal pilot study. SETTING: Animal research laboratory at a university hospital. SUBJECTS: Eight healthy swine under volume- controlled mechanical ventilation. INTERVENTIONS: Flow probes were implanted in eight swine in order to continuously measure blood flow in the pulmonary artery and inferior vena cava. After a recovery phase of 14 days, the swine were subjected to various PEEP stages (0, 5, 10 cm H2O) during volume-controlled positive pressure ventilation. MEASUREMENTS AND MAIN RESULTS: Continuous flow measurement took place in the pulmonary artery and inferior vena cava. Data on standard hemodynamic parameters were additionally acquired. Respiration-phase-specific analysis of right ventricular cardiac output and of additional hemodynamic function parameters followed, after calculation of mean values throughout five respiration cycles. PEEP at 5 cm H2O led to significant decreases in inferior vena cava flow (4.1%), and in right ventricular cardiac output (5.2%); the respective decreases at PEEP 10 cm H2O were 13.9% and 18.3%. In the inspiration phase at PEEP 10 cm H2O, results revealed an overproportionally pronounced decrease in comparison with the expiration phase in inferior vena cava flow (-24.6% vs. -10%) and right ventricular cardiac output (-35% vs. -13.5%). This phenomenon is presumably caused by a PEEP-related increase in mean airway pressure by the amount of 10.7 cm H2O in inspiration. CONCLUSIONS: Increases in PEEP during volume-controlled mechanical ventilation leads to respiration-phase-specific reduction of right ventricular cardiac output, with a significantly pronounced decrease during the inspiration phase. This decrease in cardiac output should be taken into particular consideration for patients with already critically reduced cardiac output.

Airway Resistance↗

PubMed1982

Decompression of the left ventricle in the recovery period during myocardial revascularization.

Effective left heart decompression is essential for the reduction of myocardial oxygen consumption during recovery from an induced ischemic insult. During the early postischemic recovery phase of patients undergoing aorto-coronary bypass surgery, left ventricular, left atrial and aortic pressures were measured in non-vented hearts and in 2 types of left ventricular decompression. The following findings were made: Total cardiopulmonary bypass with effective decompression of the left ventricle decreases peak systolic left ventricular pressure, thereby reducing oxygen consumption of the myocardium. In this way adequate conditions are provided for recovery of the myocardium after unclamping of the aorta. The best method for decompression appears to be the placing of a large-lumen cannula in the left ventricle and allowing the blood to pour freely from the vent. The zero or near zero left ventricular filling pressure achieved with total cardiopulmonary bypass but without ventricular decompression does not prevent the chamber from producing isometric pressure work with peak systolic pressure reaching 80 to 90 torr. The hazard of air embolism may be reduced by precautionary measures. Left atrial monitoring permits recognition of pressure decreases to negative values. Active suction of the blood from the left ventricle is dangerous and should be avoided.

Blood Pressure↗

PubMed2006

BOLD signal and vessel dynamics: a hierarchical cluster analysis.

The aim of the present study was to analyze blood oxygenation level-dependent (BOLD) signal variation during an apnea-based task in order to assess the capability of a functional magnetic resonance imaging (fMRI) procedure to estimate cerebral vascular dynamic effects. We measured BOLD contrast by hierarchical cluster analysis in healthy subjects undergoing an fMRI experiment, in which the task paradigm was one phase of inspirational apnea (IA). By processing the time courses of the fMRI experiment, analysis was performed only on a subclass of all the possible signal patterns; basically, root mean square and absolute variation differences have been calculated. Considering the baseline value obtained by computing the mean value of the initial rest period as reference, particular voxels showed relative important variations during the IA task and during the recovery phase following the IA. We focused our interest on the signal response of voxels that would correspond mainly to white and gray matter regions and that also may be affected by the proximity of large venous vessels. The results are presented as maps of space-temporal distribution of time series variations with two levels of hierarchical clustering among voxels with low to high initial response. Furthermore, we have presented a clustering of the signal response delay, conducting to a partition and identification of specified brain sites.

Blood Vessels↗

PubMed1998

Impaired aerobic glycolysis in muscle phosphofructokinase deficiency results in biphasic post-exercise phosphocreatine recovery in 31P magnetic resonance spectroscopy.

Using 31P magnetic resonance spectroscopy, energy metabolism in calf muscles of two patients with biochemically and genetically proven muscular phosphofructokinase deficiency, and an asymptomatic heterozygote was monitored during isometric foot plantarflexion performed under aerobic and anaerobic conditions and in the aerobic recovery phases. In the heterozygote only a moderate alteration from normal was found in terms of an elevated ATP demand during exercise. In the homozygote, hexose phosphates, indicated as phosphomonoesters, increased dramatically during contraction. Phosphomonoester accumulation resulted in consumption of free inorganic phosphate (P(i)). During ischemic exercise the absence of glycolytic ATP formation resulted in a linear time course of phosphocreatine breakdown and a moderate alkalinization. During the recovery, phosphocreatine resynthesis showed a biphasic time course, indicating that mitochondrial function itself was not directly affected. At first glance, the early depletion of P(i) below initial resting levels and the rate of phosphate splitting from sugar phosphates seemed to become the limiting factor for the rate of the oxidative phosphorylation and creatine kinase reaction. However, the actual concentrations of P(i) and ADP estimated at the onset of delay were too high to exclusively explain the dramatic delay in PCr resynthesis. For this reason, a reduced turnover of the citric acid cycle was assumed, which was caused by the complete absence of glycolysis in PFK deficiency patients. Furthermore, results from PFK deficiency patients were compared with previous findings from myophosphorylase deficiency patients in the literature.

Adenosine Triphosphate↗