Glomerular hypertrophy after subtotal nephrectomy: relationship to early glomerular injury

Structural adaptations in response to approx. 70% nephrectomy were studied in male Sprague-Dawley rats. Rats developed systemic hypertension as well as progressive albuminuria after nephrectomy. At 18–26 weeks after nephrectomy (n=6) or sham treatment (n=6) kidneys were perfusion-fixed and examined by light and electron microscopy. Glomerular tuft volume (+140%), capillary volume (+151%) and length (+77%), mesangial volume (+115%), podocyte volume (+96%), glomerular basement membrane surface area (+107%) and filtration slit length (+85%) were all significantly greater in nephrectomized rats. The incidence of segmental glomerular sclerosis was low and variable among these rats, but was significantly higher than in controls (P=0.037). Urinary albumin excretion was elevated in the nephrectomized rats (89±72 SD mg/day vs 11±11 mg/day in control rats, P=0.01) and correlated significantly with the incidence of sclerosis (r=+0.8311, P<0.05). The relationships of the level of albuminuria and the sclerosis rate to various morphometric parameters were examined by regression analysis for the nephrectomy group. A significant negative correlation was found between albuminuria and average tuft volume (r=–0.8136) and glomerular basement membrane surface area (r=–0.8168). Both sclerosis rate and albuminuria showed negative correlations with filtration slit length (r=–0.8180 and r=–0.8598). These findings suggest that under some circumstances, glomerular hypertrophy may prevent or ameliorate the early stages of glomerular injury after subtotal nephrectomy.     

Muscle cross-sectional area,force production and relaxation characteristics in women at different ages

Summary Thirty women, divided among three different age groups, i.e. 30 years (range 26–35;n = 10), 50 years (range 46–55;n = 10) and 70 years (range 66–75;n = 10) volunteered as subjects for examination of the characteristics of the muscle cross-sectional area (CSA), maximal voluntary isometric force, isometric force-time and relaxation-time of their leg extensor muscles. The CSA of the quadriceps femoris muscle in the youngest age group was slightly larger (NS) than in the middle-aged group and much larger (P<0.41) than in the oldest age group whose CSA was markedly smaller (P<0.01) than the middle-aged group. Maximal force in the youngest group was slightly greater (NS) than in the middle-aged group and much greater (P<0.01) than in the oldest group whose values were markedly smaller (P<0.05) than the middle-aged group. The individual values in CSA correlated with maximal force both in the total subject sample (r=0.82;P<0.001) and in the three age groups separately (r=0.72;P<0.01;r=0.86;P<0.01 andr=0.67;P<0.05, respectively). When the force values were related to the CSA of the muscle, the mean values of 45.4N·cm^–2, SD 5.6, 47.6 N·cm^–2, SD 5.0 and 46.8 N· cm^–2, SD 7.0 for the three groups did not differ significantly from each other. The isometric force-time curves differed among the groups, so that the times to produce the same absolute as well as relative force levels were shorter in the 30-year age group (P<0.05) than in the 70-year age group. The times of relaxation did not differ significantly among the groups. The present results suggested that the decline in maximal force in females with age could well be related to the decline in the cross-sectional area of the muscle. However, the time taken in the production of explosive force may worsen even more than maximal strength especially at older ages. This indicated that atrophying effects of aging may be greater on fast than on slow twitch muscle fibres and/or that the rate of neural activation of the muscles could also be influenced by aging.     

Effects of different strength training regimes on moment and power generation during dynamic knee extensions

This study examined the effect of different training regimes on moment and power generation during maximal knee extensions at low to very high extension velocities (0–1000°·s^–1 individual range). A group of 24 soccer players performed 12 weeks of progressively adjusted strength training of the knee extensors at either high resistance (HR,n=7), low resistance (LR,n=6), loaded kicking movements (FU,n=6), while one group served as controls (n=5). Moment and power generation of the knee extensors were determined before and after the training period with a nonisokinetic measuring method recently described. Following HR training, knee extension moment increased 9%–10% at knee angular velocities 0 (isometric) and 30° · s^–1 (P<0.05), peak moment increased 20% at 240–300°·s^–1 (P<0.05), while power generation increased 5%–29% at 240–480° · s^–1 (P<0.01). In addition, in the HR group maximal recorded power increased 45% (P<0.01). After FU training a 7%–13% increase in moment and power was observed at 30–180° · s^–1 (P<0.05). Following LR training, peak moment increased 9% at 120° · s^–1 (P<0.05). Improvements in knee extension moment and power were generally related to the angular velocities employed during training. However, as evaluated using the present measuring method, moment and power increased not only at very low but also at high knee angular velocities following the high-resistance strength training.     

Effects of increased cardiac mechanical performances on flow rates of cardiac lymph in dogs

Summary Relationship between flow rates of cardiac lymph (LF), and coronary blood flow (CF), coronary perfusion pressure (PP), left ventricular peak systolic pressure (LVSP) and heart rate (HR) was studied in open-chest dogs. Intra-coronary administration of catecholamines (CA) and electrical stimulation of the cardiac sympathetic nerve (ES) increased LF transiently with a concomitant rise in the cardiac mechanical performance, while dipyridamole induced no change in LF in spite of a marked increase in CF. Isoproterenol at doses of 0.3 and 3×10^–8 g/kg induced an increase in LF to 119±4 and 167±20% (mean ±SE); norepinephrine, 0.3 and 3×10^–7 g/kg, to 118±4 and 141±13%; ES at 5 and 20 Hz, to 135±11 and 167±10%, respectively. Peak responses of LF correlated with changes in LVSP (r=0.59,n=51,P<0.001), CF (r=0.53,n=51,P<0.001), PP(r=0.49,n=51,P<0.001) but not with changes in HR (r=0.27,n=51, 0.05<P<0.10). Cardiac pacing also showed a poor correlation between the changes in LF and HR under the same LVSP within the changes in HR up to 134% of control value (r=–0.12,n=17,P>0.50). It is concluded that LF is independent of changes in HR, and increased LF after CA or ES may be caused mainly by an augmented propulsive force.     

The use of ratings of perceived exertion for regulating exercise levels in rowing ergometry

The purpose of this study was to examine the validity of the use of ratings of perceived exertion (RPE) to estimate and regulate exercise intensity during rowing ergometry. Nine competitive male rowers [mean age 28.6 years, (SD 6.3)] completed two rowing trials on an ergometer. The first trial (estimation) consisted of an incremental protocol designed to elicit a range of work outputs (WO) and heart rates (HR). The subjects indicated their perception of effort using a 15-point scale at each intensity level. In the second trial (production), 7–14 days later, the subjects were asked to produce exercise intensities corresponding to five levels of RPE: 15,11,17,13, and 19. Data analysis revealed high Pearson correlation coefficients between HR and RPE (r = 0.95,P < 0.01) and WO and RPE (r = 0.96,P < 0.01) during the estimation trial. In addition, significant correlations (P < 0.01) were obtained between the estimation and production trials for HR (r = 0.82) and WO (r = 0.84). Posthoc analysis of variance revealed that the observed differences in mean HR were not significant (P > 0.05) at three of the five intensity levels (RPE 15,17 and 19), but were at the two lowest RPE levels (11 and 13). Significant mean differences in WO were seen at all but RPE 17. These data support the validity of the RPE scale as a measure of physiological strain among competitive male rowers, and offer support for its use as a method of regulating the intensity of rowing ergometry, especially at higher levels.     

Effects of inspiratory impedance on hemodynamic responses to a squat–stand test in human volunteers: implications for treatment of orthostatic hypotension

Recent studies in our laboratory demonstrated that spontaneous breathing through an inspiratory impedance threshold device (ITD) increased heart rate (HR), stroke volume (SV), cardiac output (Q), and mean arterial blood pressure (MAP) in supine human subjects. In this study, we tested the effectiveness of an ITD as a countermeasure against development of orthostatic hypotension, provoked using a squat-to-stand test (SST). Using a prospective, randomized blinded protocol, 18 healthy, normotensive volunteers (9 males, 9 females) completed two-counterbalanced 6-min SST protocols with and without (sham) an ITD set to open at 0.7 kPa (7-cm H₂O) pressure. HR, SV, Q, total peripheral resistance (TPR), and MAP were assessed noninvasively with infrared finger photoplethysmography. Symptoms were recorded on a 5-point scale (1=normal; 5=faint) of subject perceived rating (SPR). The reduction in TPR produced by SST (–35±5 %) was not affected by the ITD. Reduction in MAP with ITD during the transient phase of the SST (–3.6±0.5 kPa or –27±4 mmHg) was less (P=0.03) than that measured while breathing through a sham device (–4.8±0.4 kPa or –36±3 mmHg) despite similar (P<0.926) elevations in HR of 15±2 bpm. SV (+2±4 %) and Q (+22±5 %) with the ITD were higher (P<0.04) than SV (–8±4 %) and Q (+10±6 %) without the ITD. SPR was 1.4±0.1 with ITD compared to 2.0±0.2 with the sham device (P<0.04). This reduction in orthostatic symptoms with application of an ITD during the SST was associated with higher MAP, SV and Q. Our results demonstrate the potential application of an ITD as a countermeasure against orthostatic hypotension.     

Twenty‐four‐hour non‐invasive monitoring of systemic haemodynamics and cerebral blood flow velocity in healthy humans

Acute short‐term changes in blood pressure (BP) and cardiac output (CO) affect cerebral blood flow (CBF) in healthy subjects. As yet, however, we do not know how spontaneous fluctuations in BP and CO influence cerebral circulation throughout 24 h. We performed simultaneous monitoring of BP, systemic haemodynamic parameters and blood flow velocity in the middle cerebral artery (MCAV) in seven healthy subjects during a 24‐h period. Finger BP was recorded continuously during 24 h by Portapres and bilateral MCAV was measured by transcranial Doppler (TCD) during the first 15 min of every hour. The subjects remained supine during TCD recordings and during the night, otherwise they were seated upright in bed. Stroke volume (SV), CO and total peripheral resistance (TPR) were determined by Modelflow analysis. The 15 min mean value of each parameter was assumed to represent the mean of the corresponding hour. There were no significant differences between right vs. left, nor between mean daytime vs. night time MCAV. Intrasubject comparison of the twenty‐four 15‐min MCAV recordings showed marked variations (P < 0.001). Within each single 15‐min recording period, however, MCAV was stable whereas BP showed significant short‐term variations (P < 0.01). A day–night difference in BP was only observed when daytime BP was evaluated from recordings in the seated position (P < 0.02), not in supine recordings. Throughout 24 h, MCAV was associated with SV and CO (P < 0.001), to a lesser extent with mean arterial pressure (MAP; P < 0.005), not with heart rate (HR) or TPR. These results indicate that in healthy subjects MCAV remains stable when measured under constant supine conditions but shows significant variations throughout 24 h because of activity. Moreover, changes in SV and CO, and to a lesser extent BP variations, affect MCAV throughout 24 h.     

Elevated Allergen-Induced IL-13 Secretion Predicts IgE Elevation in Children Ages 2–5 Years

It is unclear if early immune responses to allergens, specifically Th1 and Th2 cytokine production, predict later immune responses, including increased IgE levels. In a group of children (n = 151) with a parental history of allergy or asthma followed from ages 2 through 5 years, we examined IL-13, IL-4, and IFN-γ secretion by peripheral blood mononuclear cells in response to phytohemagglutinin (PHA), and to dust mite (Der f 1), cockroach (Bla g 2), and cat (Fel d 1) allergens in relation to elevated IgE. Elevated IgE was defined either as a positive IgE-specific response to at least one allergen (dust mite, cockroach, cat, and ovalbumin) or as an elevated total IgE level above a specified cut-off value. In multivariate logistic regression models including 181 observations made between the age of 2 through 5 years and accounting for repeated measures, we found an association between increased IL-13 secretion in response to Der f 1 and elevated IgE (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.09–1.34). Age did not modify this relationship. No association was found between allergen-induced IFN-γ secretion and IgE production. Among the group of children with measurements made at age 4–5 (n = 70), IL-13 in response to Der f 1 (p = 0.046), and IL-4 in response to PHA (p = 0.04) were increased among children with elevated IgE. In a smaller subset of children with measurements made at both age 2–3 and age 4–5 (n = 36), IL-13 levels at age 2–3 were also significantly increased in response to Der f 1 (p = 0.01) and Fel d 1 (p = 0.002) among those with elevated IgE at age 4–5. In a group of children ages 2–5 years, there is an association between IL-13 and elevated IgE.     

Effects of exercise training on plasma catecholamines and blood pressure in labile hypertensive subjects

Summary Plasma catecholamine concentrations (norepinephrine, NE; epinephrine, E) were measured along with heart rate (HR) and blood pressure (BP) at rest in supine (20 min) and standing (10 min) positions and in response to cycle ergometer exercise (5 min; 60% estimated maximal aerobic power) in 12 hypertensive patients before and after 20 weeks of aerobic training on cycle ergometer (six males, one female) or by jogging (five males). In a control group of labile hypertensive patients (five males, two females), estimated maximal aerobic power as well as HR and BP at rest in the supine and standing positions and in response to exercise were not modified from the first to the second evaluation (43±4 vs 43±5 ml·kg^–1·min^–1). In comparison estimated maximal aerobic power significantly increased in both training groups (cycle: 38±4 to 43±4; jogging: 38±3 to 46±4 ml·kg^–1·min^–1). However HR and BP were not modified following training, except for small reductions in systolic (18.9 to 18 kPa: 142 to 135 mmHg) and diastolic pressures (13.3 to 12 kPa: 100 to 90 mmHg) (p<0.05) at standing rest in the cycle group. Changes in plasma E and NE concentrations at rest and in response to exercise were small and not consistent: plasma NE was lower at standing rest following cycle training, (559±95 vs 462±108 pg·ml^–1) but a similar reduction was observed in the control group (428±45 vs 321±28 pg·ml^–1); plasma E was lower at rest following cycle training (29±7 vs 12±8 pg·ml^–1), but was higher in response to exercise (137±24 vs 419±113 pg·ml^–1). These results are in accordance with previous reports which do not clearly demonstrate that physical training in hypertensive patients lowers BP and the activity or reactivity of the sympathetic system.     

Diurnal variations of serum erythropoietin at sea level and altitude

This study tested the hypothesis that the diurnal variations of serum-erythropoietin concentration (serum-EPO) observed in normoxia also exist in hypoxia. The study also attempted to investigate the regulation of EPO production during sustained hypoxia. Nine subjects were investigated at sea level and during 4 days at an altitude of 4350 m. Median sea level serum-EPO concentration was 6 (range 6–13) U·l^–1. Serum-EPO concentration increased after 18 and 42 h at altitude, [58 (range 39–240) and 54 (range 36–340) U·l^–1, respectively], and then decreased after 64 and 88 h at altitude [34 (range 18–290) and 31 (range 17–104) U·l^–1, respectively]. These changes of serum-EPO concentration were correlated to the changes in arterial blood oxygen saturation (r = –0.60,P = 0.0009), pH (r = 0.67,P = 0.003), and in-vivo venous blood oxygen half saturation tension (r = –0.68,P = 0.004) but not to the changes in 2, 3 diphosphoglycerate. After 64 h at altitude, six of the nine subjects had down-regulated their serum-EPO concentrations so that median values were three times above those at sea level. These six subjects had significant diurnal variations of serum-EPO concentration at sea level; the nadir occurred between 0800–1600 hours [6 (range 4–13) U·l^–1], and peak concentrations occurred at 0400 hours [9 (range 8–14) U·l^–1,P = 0.02]. After 64 h at altitude, the subjects had significant diurnal variations of serum-EPO concentration; the nadir occurred at 1600 hours [20 (range 16–26) U·l^–1], and peak concentrations occurred at 0400 hours [31 (range 20–38) U·l^–1,P = 0.02]. This study demonstrated diurnal variations of serum-EPO concentration in normoxia and hypoxia, with comparable time courses of median values. The results also suggested that EPO production at altitude is influenced by changes in pH and haemoglobin oxygen affinity.     

Risk Factors for the Development of Extended-Spectrum Beta-Lactamase-Producing Bacteria in Nonhospitalized Patients

Although the risk factors for acquiring infection by extended-spectrum beta-lactamase (ESBL)-producing bacteria have been investigated in hospitalized patients, such risk factors have not been defined in the community setting. In this study, clinical data from a total of 311 nonhospitalized patients with community-acquired urinary tract infection (128 with ESBL-positive strains and 183 with ESBL-negative strains) were obtained. According to a multivariate analysis, the following were identified as independent risk factors: previous hospitalization in the past 3 months (OR=8.95, 95%CI, 3.77–21.25), antibiotic treatment in the past 3 months (OR=3.23, 95%CI, 1.76–5.91), age over 60 years (OR=2.65, 95%CI, 1.45–4.83), diabetes (OR=2.57, 95%CI, 1.20–5.51), male gender (OR=2.47, 95%CI, 1.22–5.01), Klebsiella pneumoniae infection (OR=2.31, 95%CI, 1.17–4.54), previous use of third-generation cephalosporins (P=0.014, OR=15.8, 95%CI, 1.7–143), previous use of second-generation cephalosporins (P<0.0001, OR=10.1, 95%CI, 4.2–24), previous use of quinolones (P=0.001, OR=4.1, 95%CI, 1.8–9.0), and previous use of penicillin (P=0.003, OR=4.0, 95%CI, 1.6–9.0).     

Effect of moderate exercise on rat T-cells

Summary The aim of this study was a detailed examination of the effects of moderate exercise on T-cells in adult male Wistar rats. The T-cell populations were compared in sedentary rats (C, n = 5) and in rats trained for 4 weeks on a treadmill (30–60 min·day^–1, 6 days·week^–1, 20–30 m·min^–1) and sacrificed at rest (Trest, n=5). In the T-rest rats, there were higher percentages of CD4+CD8–, CD4– CD8 + and CD4 – CD8 –thymocytes (P<0.05, P<0.05 and P<0.01 respectively) and of CD4–CD8 + splenocytes (P< 0.01), and a lower percentage of CD4–CD8+ cells in the lymph nodes (P<0.01). Compared with T-rest or C rats, trained rats (n = 5) or untrained rats (n = 5) sacrificed immediately after a running session (60 min, 30 m·min^–1) had a higher percentage of mononucleated cells CD4 + CD8 -in the blood (P<0.05 and P<0.01). Lastly, compared with C rats, rats (n=5) sacrificed immediately after their 5th day of training (30–60 min·day^–1) presented a higher total splenocyte population (P<0.05) and greater in vitro production of T-cell growth factor (interleukin 2 + interleucin 4) by splenocytes in response to a mitogen (P<0.01). These results would indicate that moderate endurance training modifies the cellular composition of lymphoid organs, without impairing the in vitro functions of T-cells.     

A new instrument for the measurement of rib cage and abdomen circumference variation in respiration at rest and during exercise

A simple and inexpensive new extensometer for measuring changes in chest wall circumference during human respiratory movements is presented. The instrument detects the delay between ultrasound emission and reception at opposite ends of two rubber tubes encircling the rib cage and abdomen. Assuming a two degree of freedom model of the chest wall and employing an isovolume procedure for determination of volume-motion coefficients, extensometer estimation of tidal volume (V _T) from changes of rib cage and abdomen circumference was compared with spirometer measurements at rest and during exercise on a cycle ergometer (55–155 W) in six subjects and, in four of them, on a treadmill (4–12 km·h^–1). In three subjects hypercapnic hyperpnoea at rest was also studied. The slopes of the linear relationship between extensometer and spirometerV _T (litres) averaged 0.9967 (SD 0.0117) (r ² = 0.995–0.998;n = 90–143) for cycle ergometer exercise, 1.0072 (SD 0.0078) (r ² = 0.991–0.998;n = 75–93) for treadmill exercise and 0.9942 (SD 0.0188) (r ² = 0.997–0.998;n = 18–25) for hypercapnic hyperpnoea. In all instances the slope of the regression line was consistent with the model of the identity line (slope = 1). The changes in end-expiratory lung volume between respiration at rest and during exercise were determined by the extensometers, and were nearly identical (98.4% on average) to those measured with the spirometer (r ² = 0.945;n = 24). It is concluded that determination of chest wall circumference with this new instrument is suitable for quantitative measurement of ventilation and lung volume variations in humans under most physiological conditions.     

Hypohydration effects on thermoregulation during moderate exercise in the cold

Hyperosmotic hypovolemia impairs vasoconstriction during sedentary cold exposure. The purpose of this study was to determine whether hypohydration alters thermoregulation and cardiovascular responses to exercise in cold air. On four occasions, eight males [35.1 (2.7) years, 175.5 (3.1) cm, 73.3 (2.6) kg, 57.2 (2.6) ml kg^–1 min^–1 maximal oxygen uptake (O_2max), 19.6 (2.4)% fat] walked, in t-shirt, shorts, and shoes, at 50% O_2max, for 60 min in either a 4°C (Cold) or a 25°C (Temperate) environment in both hypohydrated state (HYPO, –4% body mass) and euhydrated state (EU). During exercise–cold stress, rectal temperature (T_re), mean weighted skin temperature, heart rate (HR), cardiac output (CO), and stroke volume (SV) were measured every 20 min. Mean weighted skin temperature values were not different between HYPO and EU but were lower (P<0.05) in Cold versus Temperate trials. T_re was not different (P>0.05) between HYPO–Cold and EU–Cold. CO and SV were not different within hydration states and were not different between Cold and Temperate trials (P<0.05). HR was not different between HYPO–Cold and EU–Cold. These data demonstrate that moderate intensity exercise in the cold while hypohydrated does not alter metabolic heat production, skin temperatures and heat loss, nor does it increase thermoregulatory and cardiovascular strain.     

Parathyroid hormone, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentration in elderly patients

Summary In 50 patients of a geriatric hospital (33 women, aged 65–96 years, mean age 80 years, and 17 men, aged 68–91, mean age 78.3 years) calcium, albumin, phosphate, urea, creatinine, parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were determined. Forty patients with serum creatinine levels up to 1.4 mg/dl (124 mol/l) and 10 patients with creatinine concentrations 1.5 mg/dl (132mol/l) were evaluated. In patients with normal creatinine, a positive correlation was found between parathyroid hormone and age (r=0.41;P<0.01). In patients with elevated creatinine, negative correlations were found in 1,25-dihydroxyvitamin D and calcium (r=–0.724;P<0.05), 1,25dihydroxyvitamin D and creatinine (r=–0.79;P<0.01) and 1,25-dihydroxyvitamin D and phosphate (r=–0.87;P< 0.002). The best correlation was observed in patients with elevated serum creatinine for 1,25-dihydroxyvitamin D and phosphate (r=–0.91;P< 0.001). The results suggest that low levels of calcium and phosphate stimulate the 1-hydroxylation of 25-hydroxyvitamin D even in advanced age and that the calcium metabolism of these patients is frequently disturbed. Nineteen patients had low levels of 25-hydroxyvitamin D, indicating an insufficient supply of vitamin D or rare exposure to sunlight. In 49 of 50 patients, one ore more of the parameters of calcium metabolism were outside the normal range.Abbreviations 25-OH-D 25-hydroxyvitamin D - 1,25(OH)₂D 1,25-dihydroxyvitamin D - PTH parathyroid hormone Supported by the Deutsche Forschungsgemeinschaft (Schm 405–407)     

Perceived exertion and blood lactate concentration during graded treadmill running

The purpose of this study was to investigate the influences of treadmill gradients on the rating of perceived exertion (RPE) at two fixed blood lactate concentrations ( [La^–]_b). Ten subjects performed three different incremental treadmill protocols by running either uphill (concentrically-biased), downhill (eccentrically-biased), or on the flat (non-biased). Individual data of each protocol were interpolated to reflect [La^–]_b corresponding to 2.0 and 4.0 mmol·l^–1. At 2.0 mmol·l^–1 [La^– _b, RPE and treadmill speed during downhill running were greater than during level running which was greater than during uphill running (p < 0.05) . Also, the downhill heart rate (HR) was greater than the uphill HR, and downhill minute ventilation ( ) was greater than the level . Treadmill speed was the only measure at 4.0 mmol·l^–1 [La^–]_b to differ between gradients. There was a moderate correlation of RPE with HR at both [La^–]_b (r = 0.73 at 2.0 mmol·l^–1;r = 0.48 at 4.0 mmol·l^–1) while treadmill speed was moderately correlated with RPE only at 2.0 mmol·l^–1 [La^–]_b (r = 0.70). The results of this study demonstrated that the degree of eccentric-bias during running exercise is an influence of perceived exertion at a moderate but not at a high exercise intensity.     

Naloxone-provoked vaso-vagal response to head-up tilt in men

A double-blind paired protocol was used to evaluate, in eight male volunteers, the effects of the endogenous opiate antagonist naloxone (NAL; 0.05 mg· kg^–1) on cardiovascular responses to 50° head-up tilt-induced central hypovolaemia. Progressive central hypovolaemia was characterized by a phase of normotensive-tachycardia followed by an episode of hypotensive-bradycardia. The NAL shortened the former from 20 (8–40) to 5 (3–10) min (median and range; (P < 0.02). Control head-up tilt increased the means of thoracic electrical impedance [from 35.8 (SEM 2.1) to 40.0 (SEM 1.8) ; P < 0.01 of heart rate [HR; from 67 (SEM 5) to 96 (SEM 8) beats · min^–1, P < 0.02], of total peripheral resistance [TPR; from 25.5 (SEM 3.2) to 50.4 (SEM 10.5)mmHg min 1^–1,P < 0.05] and of mean arterial pressure [MAP; from 96 (SEM 2) to 101 (SEM 2)mmHg, P < 0.02]. Decreases were observed in stroke volume [from 65 (SEM 12) to 38 (SEM 9) ml, P < 0.01], in cardiac output [from 3.7 (SEM 0.7) to 2.5 (SEM 0.5) 1 · mint, P < 0.01], in pulse pressure [from 55 (SEM 4) to 37 (SEM 3)mmHg, P < 0.01] and in central venous oxygen saturation [from 73 (SEM 2) to 59 (SEM 4)%, P < 0.01]. During NAL, mean HR increased from 70 (SEM 3); n.s. compared to control) to only 86 (SEM 9) beats · min^–1 (P < 0.02 compared to control) and MAP remained stable. The episode of hypotensive-bradycardia appeared as mean control HR decreased to 77 (SEM 7)beats · min^–1, TPR to 31.4(SEM 7.7)mmHg · min · 1^–1 and MAP to 60 (SEM 5)mmHg (P < 0.01), and the volunteers were tilted supine. Cardiovascular effects of naloxone on central hypovolaemia included a reduced elevation of HR and blood pressures and provocation of the episode of hypotensive-bradycardia.     

Cardiac drift during prolonged exercise with echocardiographic evidence of reduced diastolic function of the heart

This study examined whether, in 16 male subjects, a continuous increase in heart rate (HR) during 4 h of ergometry cycling relates to cardiac fatigue or cardiomyocyte damage. Serum cardiac troponin T (cTnT) was determined and echocardiographic assessment was carried out prior to and after 2 h of exercise, within 15 min of completing exercise and after 24 h. Left ventricular contractile function (end-systolic blood pressure–volume relationship [SBP/ESV]) and diastolic filling (ratio of early to late peak left ventricular filling velocities [E:A]) were calculated. During exercise HR was 132±5 beats min^–1 after 2 h and increased to 141±5 beats min^–1 (mean ± SD; P<0.05), but there was no evidence of altered LV contractile function (SBP/ESV 39.0±5.1 mmHg cm^–1 to 36.5±5.2 mmHg cm^–1 and SBP/ESV was not correlated to maximal oxygen uptake (r²=0.363). In contrast, E:A decreased (1.82±0.32 to 1.48±0.30; P<0.05) and returned towards baseline after 24 h (1.78±0.28), and individual changes were correlated to maximal oxygen uptake (r²=0.61; P<0.05). Low levels of cTnT were detected in two subjects after 4 h of exercise that had normalised by 24 h of recovery. During prolonged exercise cardiovascular drift occurred with echocardiographic signs of a reduced diastolic function of the heart, especially in those subjects with a high maximal oxygen uptake.     

Knee extensor and plantar flexor muscle size and function following 90 days of bed rest with or without resistance exercise

Skeletal muscle atrophy and strength loss induced by short-term simulated spaceflight are offset or attenuated by resistance exercise (RE). This study compared the effects of plantar flexor and knee extensor RE on muscle size and function in 17 healthy men (aged 26–41years) subjected to 90 days 6° head-down-tilt bed rest with (BRE; n=8) or without (BR; n=9) RE. The RE program consisted of coupled maximal concentric and eccentric actions in the supine squat (4 sets of 7 repetitions) and calf press (4×14) every third day employing a gravity-independent flywheel ergometer (FW). Prior to, and following bed rest, muscle volume was assessed using magnetic resonance imaging. Similarly, muscle strength and power and surface electromyographic (EMG) activity were determined during maximal actions using FW or isokinetic dynamometry. In BR, knee extensor and plantar flexor muscle volume decreased (P<0.05) 18% and 29%, respectively. Torque or force and power decreased (P<0.05) 31–60% (knee extension) and 37–56% (plantar flexion) while knee extensor and plantar flexor EMG activity decreased 31–38% and 28–35%, respectively following BR. Muscle atrophy in BRE was prevented (P>0.05; knee extensors) or attenuated (–15%; plantar flexors). BRE maintained task-specific force, power and EMG activity. The decrease in non-task-specific torque was less (P<0.05) than in BR. The present data imply that the triceps surae and quadriceps muscles show different responsiveness to long-term bed rest with or without resistance exercise. The results also suggest that designing in-flight resistance exercise protocols for space travellers is complex and must extend beyond preserving muscle only.     

Treadmill validation of an over-ground walking test to predict peak oxygen consumption

Summary The purpose of this study was to determine whether a test developed to predict maximal oxygen consumption (VO_2max) during over-ground walking, was similarly valid as a predictor of peak oxygen consumption (VO₂) when administered during a 1-mile (1.61 km) treadmill walk. Treadmill walk time, mean heart rate over the last 2 full min of the walk test, age, and body mass were entered into both generalized (GEN Eq.) and gender-specific (GSP Eq.) prediction equations. Overall results indicated a highly significant linear relationship between observed peakVO₂ and GEN Eq. predicted values (r=0.91), a total error (TE) of 5.26 ml · kg^–1 · min^–1 and no significant difference between observed and predicted peakVO₂ mean values. The peakVO₂ for women (n = 75) was predicted accurately by GSP Eq. (r = 0.85; TE = 4.5 ml · kg^–1 · min^–1), but was slightly overpredicted by GEN Eq. (overall mean difference = 1.4 ml · kg^–1 · min^–1;r=0.86; TE = 4.56 ml · kg^–1 · min^–1). No significant differences between observed peakVO₂ and either GEN Eq. (r=0.85; TE=4.3 ml · kg^–1 · min^–1) or GSP Eq. (r=0.85; TE = 4.8 ml · kg^–1 · min^–1)predicted values were noted for men (n=48) with peakVO₂ values less than or equal to 55 ml · kg^–1 · min^–1. However, both equations significantly underpredicted peakVO₂ for the remaining high peakVO₂ men (n = 22). In conclusion, the over-ground walking test, when administered on a treadmill, is a valid method of predicting peakVO₂ but underpredicts peakVO₂ of subjects with observed high peakVO₂ values. Present address: Human Performance Laboratory State University, Muncie, IN 47306, USA