Demand dynamic bio-girdling in heart failure: improved efficacy of dynamic cardiomyoplasty by LD contraction during aortic out-flow

PURPOSE: The value of dynamic cardiomyoplasty has been brought into question by the disappointing results produced by slow contraction-relaxation cycle and possibly degeneration of the latissimus dorsi muscle (LD) secondary to temporary tenotomy and chronic daily electrical stimulation. Objective of our study is to determine whether daily periods of rest introduced by demand stimulation in the continuous contraction protocol produce systolic assistance and improve clinical results. METHODS: Twelve dynamic cardiomyoplasty patients (mean age 58.2 +/- 5.8 years, M/F=11/1, sinus rhythm/atrial fibrillation=11/1) with dilated myocardiopathy were enrolled in an unrandomized trial of Demand Dynamic Heart Bio-Girdling in a public regional teaching hospital. Periods of LD inactivity, each lasting several hours, were introduced daily on a heart rate-based demand regime. To avoid full transformation of LD, fewer impulses per day were delivered, daily providing the LD with long periods of rest (Demand light stimulation). The contractile properties were measured by transcutaneous non-invasive LD tensiomyogram interrogation (LD tensiomyogram). Bio-Girdle activation was synchronized to heart beat by combining tensiomyogram and echocardiography. Clinical, echocardiographic and hemodynamic records, as well as aortic flow measurements by Doppler aortic flow wire were taken during the follow-up. MAIN FINDINGS: Mean duration of the demand stimulation follow-up was 40.2+13.8 months. At five years, "Demand stimulation" shows: 1) no operative death; 2) 83% actuarial survival; 3) highly significant 47.4% decrease of the NYHA class (from 3.17 +/- 0.38 to 1.67 +/- 0.77, p=0.0001); 4) 41.6% improvement of LVEF (from 22.6 +/- 4.38 to 32.0 +/- 7.0, p=0.001); 5) 7.5 +/- 3.0% increase in aortic flow velocity peak in assisted vs. unassisted beats, and 6) preservation of LD from slowness (TFF value 33 +/- 7.86 at follow-up versus 15.8 +/- 11.1 Hz just before switching from continuous to demand stimulation, p=0.0001) and muscle degenerative atrophy. CONCLUSIONS: In dynamic cardiomyoplasty the demand light stimulation maintains LD contraction properties over time, produces effective systolic assistance, and improves clinical results. Demand dynamic bio-girdling is a safe and effective treatment for end-stage heart failure in selected patients.     

New advances in dynamic cardiomyoplasty: Doppler flow wire shows improved cardiac assistance in demand protocol

No data have been published on real cardiac assistance with demand dynamic cardiomyoplasty. We tested the utility of a Doppler flow wire in measuring beat by beat aortic flow velocity and evaluating cardiac assistance in demand cardiomyoplasty patients. The technique was tested in seven patients (M/W = 6/1; age, 57.1+/-6.2 years; atrial fibrillation/ sinus rhythm = 1/6; New York Heart Association [NYHA] classification = 1.4+/-0.5). Measurements were done using a 0.018 inch peripheral Doppler flow wire advanced through a 5 French arterial femoral sheath. Three 1 minute periods with the stimulator off, and three 1 minute periods with clinical stimulation were recorded. We measured peak aortic flow velocity in all beats. Latissimus dorsi mechanogram was simultaneously recorded. Comparison between preoperative and follow-up data showed significantly higher values of tetanic fusion frequency and ejection fraction at follow-up, whereas mean NYHA class was significantly lower. Statistical analysis showed an increase in aortic flow velocity not only in the assisted versus rest period, but also in assisted versus unassisted beats (8.42+/-6.98% and 7.55+/-3.07%). A linear correlation was found between increase in flow velocity and latissimus dorsi wrap tetanic fusion frequency (r2 = 0.53). In demand dynamic cardiomyoplasty, systolic assistance is significant and correlated to the latissimus dorsi speed of contraction; a demand stimulation protocol maintains muscle properties and increases muscle performance.     

Ischaemia and reperfusion effects on skeletal muscle tissue: morphological and histochemical studies

This was a study on the oxidative stress due to ischaemia (I) and reperfusion (R) in skeletal muscle tissue. Using a tourniquet, groups of rats were submitted to ischaemia for 4 h, followed by different reperfusion periods. The animals were divided in four groups: control; 4 h of ischaemia (IR); 4 h of ischaemia plus 1 h reperfusion (IR-1 h); 4 h of ischaemia plus 24 h reperfusion (IR-24 h); and 4 h of ischaemia plus 72 h reperfusion (IR-72 h). At the end of the procedures, samples of soleus muscle were collected and frozen in n-hexane at -70 degrees C. Cryostat sections were submitted to haematoxylin-eosin, succinate dehydrogenase (SDH) and nicotinamide adenine dinucleotide-tetrazolium reductase (NADH-TR) stains. An additional muscle sample was processed for electron microscopy. No alterations were found in control animals. IR group showed fibres had normal aspect besides some round, acidophilic and hypertrophic fibres. There were several fibres with angular outlines and smaller diameters in this group compared with control group. NADH-TR/SDH reaction was moderately intense in most fibres. In some fibres, cytoplasm showed areas without activity and other fibres had very intense reactivity. IR-1 h group showed oedema hypercontracted fibres with disorganized myofibrils, mitochondria with focal lesions and dilated sarcoplasmic reticulum. NADH-TR/SDH reaction was moderate to weak. IR-24 h showed intense inflammatory infiltrate in the endomysium and perimysium. NADH-TR/SDH reaction was similar to IR-1 h. IR-72 h showed necrotic fibres, areas with inflammatory infiltrate, reduced muscle fibres at different stages of necrosis and phagocytosis, and many small round and basophilic fibres characterizing a regeneration process. NADH-TR/SDH reaction was weak to negative. Our results suggest that ischaemia and the subsequent 1-, 24- and 72-h reperfusions induced progressive histological damage. Although progressive, it may be reversible because there were ultrastructural signs of recovery after 72-h reperfusion. This recovery could in part be due to the low oxidative stress identified by the morphological and histochemical analysis.     

Morphological changes in rat hindlimb muscle fibres during recovery from disuse atrophy

AIM: The present study attempted to use HE staining to clarify morphological changes in muscle fibres during recovery from disuse muscle atrophy. METHODS: Disuse muscle atrophy was induced by suspending 7-week-old male Wistar rats by their tails for 5 weeks (hindlimb unloading or HU group). Histological changes in the soleus muscle (SOL) during the recovery process were examined and compared with those in control rats who were raised freely without unloading (C group). RESULTS: Wet muscle mass and muscle cross-sectional area per fibre of SOL in the HU group were 52 +/- 5 and 22 +/- 5% of those in the C group, respectively. Muscle atrophy was largely attributable to decreases in the size of muscle fibres, rather than to muscle fibre damage or loss. Muscle mass in the HU group increased quickly after reloading, but recovery of cross-sectional area per fibre was slow, with mean area in the HU group measuring 69 +/- 10% of that in the C group even after 5 weeks of reloading. After 1, 2 and 5 weeks of reloading, incidences of muscle fibres displaying central nuclei (regenerated muscle fibres) were 7.4 +/- 2.4, 7.2 +/- 6.3 and 19.2 +/- 14.5%, respectively. CONCLUSION: These findings suggest that recovery of muscle fibres atrophied by disuse involves not only growth of atrophied muscle fibres, but also regeneration of muscle fibres. Cross-sectional areas recovery of atrophied muscle fibres thus continues after increases of muscle mass.     

Myosin heavy chain composition of single fibres from m. biceps brachii of male body builders

The myosin heavy chain (MHC) composition of single fibres from m. biceps brachii of young sedentary men (28 +/- 0.4 years, mean +/- SE, n = 4) and male body builders (25 +/- 2.0 years, n = 4) was analysed with a sensitive one-dimensional electrophoretic technique. Compared with sedentary men, the body builders had a higher proportion of fibres containing only MHC type IIa (36 +/- 4 vs 12 +/- 2%; P less than 0.05), but a lower proportion of fibres with a coexistence of MHC types IIa and IIb (16 +/- 3 vs 34 +/- 2%; P less than 0.05) and nearly no fibres containing only MHC type IIb (1 +/- 1 vs 12 +/- 1%; P less than 0.05). Myofibrillar ATPase histochemistry only demonstrated a trend towards a higher proportion of type IIa fibres (31 +/- 6 vs 25 +/- 6%) and a lower proportion of type IIb fibres (18 +/- 5 vs 26 +/- 6%) within the body builders. These results, therefore, suggest an altered expression of MHC isoforms within histochemical type II fibres of human skeletal muscle with body building. Furthermore, in human skeletal muscle differences in expression of MHC isoforms may not always be reflected in the traditional histochemical classification of types I, IIa, IIb and IIc fibres.     

Visceral fat and total body fat mass correlate differently with hormones in rat

Forty-eight 67-day-old male Wistar rats (330+/-5g) were fed ad libitum either with a lipid enriched diet or a standard laboratory chow. Half of each sub-group was submitted to training. Training and difference in diet composition induced nonsignificant changes in body adiposity. Visceral fat (perirenal adipose tissue mass) was correlated with leptin (r=0.35, p=0.02) and insulin (r=0.38, p=0.01). Total body fat mass (measured by DEXA) was correlated with leptin only (r=0.58, p=0.003). Other correlations between perirenal adipose tissue or fat mass and adiponectin or insulin like growth factor 1 were nonsignificant. These results suggest that, in rat like in human, visceral fat development is linked with insulin insensitivity.     

Glycogen depletion of human skeletal muscle fibers in response to high-frequency electrical stimulation.

The purpose of the present study was to evaluate the pattern of change in muscular glycogen content in response to high-frequency electrical stimulation (HFES). Muscle biopsies were taken from the vastus lateralis muscle of 7 healthy young men before, 15 min after, and 30 min after electrical stimulation delivered at a 50-Hz frequency (15 s on, 45 s off) at an intensity of 100 mA. The glycogen content of type I, IIA, and IIB muscle fibres was evaluated using microphotometry of periodic acid Schiff (PAS) stained fibres. After 15 min of electrical stimulation, the glycogen content in type I, IIA, and IIB muscle fibres significantly decreased from 113 +/- 10 (mean +/- SE) to 103 +/- 10 (p < or = 0.05), 129 +/- 9 to 102 +/- 12 (p < or = 0.01), and 118 +/- 8 to 90 +/- 13 (p < or = 0.01) arbitrary relative units, respectively. No further decrement in glycogen content was observed in all three fibre types following an additional 15 min of HFES. In addition, isometric force decreased by approximately 50%, from 125.9 +/- 20.0 N to 64.2 +/- 7.7 N (p < or = 0.01), during the first 15 contractions. No further decrease in isometric force was observed following an additional 15 contractions of HFES. These results reveal that significant reductions in isometric force of knee extensor muscles and glycogen content of all human skeletal muscle fibre types in vastus lateralis muscle are observable after 15 min of neuromuscular high-frequency transcutaneous electrical stimulation.     

Cardiomyoplasty: long-term results in ischemic cardiomyopathy

INTRODUCTION: Cardiomyoplasty was introduced into clinical practice in 1985 by Alain Carpentier. Since then, the procedure has been performed on more than 400 patients worldwide. The latissimus dorsi muscle is prepared maintaining the vascular supply, then the muscle flap is wrapped around the heart and connected to a cardiomyostimulator. The muscle is later stimulated synchronously with ventricular systole to augment the cardiac contractility. METHODS: To evaluate the long-term outcome of cardiomyoplasty, we investigated 3 patients electively undergoing this procedure in our hospital. All of these patients (2 male, 1 female) had severe chronic heart failure which did not respond to optimal medical treatment. The mean follow-up time was 42 months (range 24 - 60). All patients showed symptoms corresponding to NYHA class III, and one patient intermittently showed class IV despite conventional medical therapy. Patients were evaluated at 6-month intervals for 2 years with right heart catheterization, radionuclide scans, echocardiography, as well as questionnaires for assessing quality of life. RESULTS: There was no operative mortality. One patient experienced sudden death 2 years after operation. There were no significant changes in hemodynamic variables at 6, 12 or 24 months after surgery, respectively. Left ventricular ejection fraction increased from 20.0 ( 9.2 to 40.0 +/- 7.1 % (p = 0.05) 1 year after operation. Considerable improvement of symptoms was seen in all, and 1 patient returned to work. NYHA-class decreased from 3.1 to 2.0 (p = 0.02). CONCLUSIONS: Following cardiomyoplasty, patients may exhibit impressive clinical improvement with less striking changes of objective hemodynamic parameters. Thus, in our patients, dynamic cardiomyoplasty improves quality of life. We do not consider this treatment to be an alternative to heart transplantation. It does, however, provide a therapeutic option for patients for whom transplantation is contraindicated.     

Calpain inhibition and insulin action in cultured human muscle cells

Variation in the calpain 10 gene has been reported to increase susceptibility to type 2 diabetes. Part of this susceptibility appears to be mediated by a decrease in whole body insulin sensitivity. As skeletal muscle is the primary tissue site of the peripheral insulin resistance in type 2 diabetes, the aim of this study was to use a human skeletal muscle cell culture system to explore the effects of calpain inhibition on insulin action. Calpain 10 mRNA and protein expression was examined in cultured myoblasts, myotubes, and whole skeletal muscle from non-diabetic subjects using RT-PCR and Western blotting. Changes in insulin-stimulated glucose uptake and glycogen synthesis in response to the calpain inhibitors ALLN and ALLM were measured. Calpain 10 expression was confirmed in cultured human myoblasts, myotubes, and native skeletal muscle. Insulin-stimulated glucose uptake was significantly decreased following preincubation with ALLN [404+/-40 vs 505+/-55 (mean+/-SEM)pmol/mg/min; with vs without ALLN: p = 0.04] and ALLM [455+/-38 vs 550+/-50 pmol/mg/min; with vs without ALLM: p = 0.025] in day 7 fused myotubes, but not in myoblasts. Neither ALLN nor ALLM affected insulin-stimulated glycogen synthesis in myoblasts or myotubes. These studies confirm calpain 10 expression in cultured human muscle cells and support a role for calpains in insulin-stimulated glucose uptake in human skeletal muscle cells that may be relevant to the pathogenesis of the peripheral insulin resistance in type 2 diabetes.     

The effects of the inotropic agent EMD 57033 on activation and relaxation kinetics in frog skinned skeletal muscle

The effect of the cardiotonic sensitizing drug EMD 57033 was studied in frog skinned skeletal muscle fibres at 12 degrees C to provide a baseline for skeletal muscle studies and for comparison with cardiac fibres. The activation and relaxation of fibres were induced by laser flash photolysis of the caged calcium NP-EGTA, and caged calcium chelator diazo-2 respectively. EMD 57033 (10 microM) slightly increased the rate of relaxation (rate constant k1 changing from 24.0 +/- 2.9 s-1 in control to 28.1 +/- 3.2 s-1) but had no significant effect on the rate of activation (k1 = 9.6 +/- 0.9 s-1 in control conditions, 9.7 +/- 1.6 s-1 with EMD 57033). The effect of the optical isomer of EMD 57033, EMD 57439, was examined on steady-state force and relaxation rate. EMD57439 (10 microM) slowed the rate of relaxation (k1 = 20.5 +/- 2.4 s-1) but had no effect on the maximal calcium-activated force whereas EMD 57033 increased it by 16.5 +/- 5.7%. These results are compared to earlier results from this laboratory in guinea-pig skinned trabeculae, and a possible model for the action of EMD 57033 whereby the drug enhances force per cross-bridge is discussed.     

Effects of chronic caffeine intake and low-intensity exercise on skeletal muscle of Wistar rats

Caffeine can affect muscle cell physiology and the inflammatory response during exercise. The purpose of this study was to analyse muscle damage markers and inflammatory cell infiltration into the soleus muscle of sedentary and exercised animals submitted to chronic caffeine intake. Thirty-two male Wistar rats were divided into the following four groups (n = 8 per group): sedentary control (SCO); sedentary + caffeine (SCAF); trained control (TCO); and trained + caffeine (TCAF). The animals were housed in individual cages and received tap water or caffeine (1 mg ml(-1)); they were maintained at rest or submitted to swimming for up to 40 min day(-1) with a 4% load, five times per week for 30 days. Blood samples were collected for analysis of serum lactate, creatine kinase and calcium. The right soleus muscle and the epididymal fat depot were weighed, and the muscle was submitted to histological analysis. Training and caffeine did not change body or muscle weight, food and liquid intake or serum calcium levels among groups. Decreased fat tissue (P < 0.05) was observed in the SCAF (4.05 ± 1.03 g), TCO (4.14 ± 0.78 g) and TCAF groups (4.02 ± 1.02 g) compared with the SCO group (5.31 ± 1.06 g). Serum creatine kinase activity was significantly reduced in the SCAF (787.3 ± 230.3 U l(-1)), TCO (775.3 ± 232.3 U l(-1)) and TCAF groups (379.5 ± 110.5 U l(-1)) compared with the SCO group (1610.2 ± 276.5 U l(-1)). Few damaged muscle fibres (P < 0.05) were found in SCAF (16.7 ± 12.8%) and TCAF groups (17.3 ± 11.7%) compared with the SCO group (53.6 ± 13.9%). The SCAF group presented fewer fields with inflammatory cells (7.6 ± 8.7 fields) compared with the SCO group (123 ± 146 fields). The results suggest that the chronic intake of caffeine, as well as chronic low-intensity exercise, decreased muscle damage and inflammatory infiltration into skeletal muscle.     

Cortisone-induced changes in myosin heavy chain distribution in respiratory and hindlimb muscles

In this study the effects of administration of cortisone acetate (100 mg kg^-1 body weight subcutaneously for 11 days) on distribution and cross-sectional area of different fibre types of rat skeletal muscles were investigated. Diaphragm, parasternal intercostal (PI), extensor digitorum longus (EDL) and soleus muscles were examined in cortisone treated animals (CA) in comparison with ad libitum controls (CTRL) and pair-fed (PF) controls. Four fibre types (I or slow and IIA, IIX, IIB or fast) were identified on the basis of their myosin heavy chain composition using a set of monoclonal antibodies. In CA rats the reduction of cross-sectional area was above 30% in IIX fibres of diaphragm, IIB fibres of PI and in all fast fibres of EDL. In all muscles slow fibres were spared from atrophy. Significant variations in fibre type distribution were found in the muscles of CA rats when compared to CTRL. The percentage of IIB fibres decreased in EDL, PI and diaphragm. This decrease was accompanied by an increase in the percentage of IIA fibres in the same muscles. No changes in the percentage of slow fibres and of fast IIX fibres were observed in EDL, PI and diaphragm of CA rats in comparison with CTRL. In soleus of CA rats the proportion of IIA fibres was lower than in CTRL. In EDL of PF rats atrophy of IIA fibres and changes in fibre type distribution were similar to those observed in CA rats. In diaphragm, PI and soleus of PF rats no significant decrease in fibre cross-sectional area nor significant changes in fibre distribution were found in comparison with CTRL rats.     

Comparison of energy balance in two inbred strains of rats: Fischer F344 prone to obesity and Lou rats resistant to obesity

This study aimed to compare energy balance, metabolic profiles and body composition between two inbred strains of rats (F344 and Lou) submitted to a self-selecting macronutrient. During the 3 weeks of experiment, the two strains did not differ significantly for their total energy intake; males: F344 = 5875.4 +/- 171.4 kJ, Lou = 5619.2 +/- 349.4 kJ; and females: F344 = 4058.8 +/- 118.7 kJ, Lou = 3864.4+/-166.4 kJ. However, F344 rats showed a higher weight gain, and percentage of total fat tissue, together with a lower percentage of carcass weight than Lou rats regardless of sex. The percentages of each macronutrient revealed a lower preference of protein for F344 males and the opposite in females for CHO. The thermogenic activity measured in interscapular brown adipose tissue was lower in Fischer than in Lou while the reverse was observed for leptinemia and insulinemia. These results indicate that the mechanism responsible for the regulation of body composition observed in Lou rats takes place very early in life and attest the interest in this strain for studying the features of resistance to obesity.     

Transient electric changes immediately after surgical trauma

CONTEXT: Electric stimulation is frequently used to promote soft tissue healing, although we do not have a complete understanding of the tissue's electromagnetic properties. OBJECTIVE: To measure the transient electric changes in skin and muscle tissue immediately after trauma. DESIGN: 1-group time series. SETTING: Climate-controlled operating room in a public urban hospital. PATIENTS OR OTHER PARTICIPANTS: Eleven participants (8 females, 3 males) with a mean age of 65.18 +/- 11.36 years undergoing total hip arthroplasty. INTERVENTION(S): An incision approximately 10 cm distal to the posterior superior iliac spine extended distally over the greater trochanter and along the lateral limb. The incision was completed in 2 cuts: (1) skin and subcutaneous fat and (2) muscle tissue. MAIN OUTCOME MEASURE(S): Three measurement sessions were performed with an electrometer before and after a skin incision and after a muscle incision. Potential differences and current intensity were measured immediately after acute trauma to determine the transient electric changes associated with soft tissue injury. RESULTS: The electric potentials were significantly more negative after the skin incision (P = .036) and skin plus muscle incision (P = .008; preincision = 0.001 +/- 0.015 V, skin incision = -0.127 +/- 0.134 V, skin plus muscle incision = -0.192 +/- 0.153 V). Current intensity changed significantly after the skin plus muscle incision (P = .008; preincision = 0.046 +/- 0.112 pA, skin incision = -0.803 +/- 0.904 pA, skin plus muscle incision = -1.708 +/- 1.302 pA). CONCLUSIONS: Soft tissue trauma generated negative transient electric changes.     

Physical training in obese women

Summary Peripheral adaptations to 3 months of physical endurance training without food restrictions were studied in skeletal muscles of 14, middle-aged, physically untrained, obese women.In comparison to aged-matched controls of normal weight, the obese group showed significantly lower isometric endurance. In the obese group, physical training resulted in a significant increase of maximal isometric and isokinetic strength. Isokinetic but not isometric endurance also increased after training. The isometric strength of obese women showed a positive correlation with the percentage of FTb fibres.The training (50 min/day, 3 days/w) did not result in any change in body weight, body fat, and the number and weight of fat cells. The 20% increase of after training was found to be significantly correlated with the increase in the number of capillaries around muscle fibres. The relative percentage of FTa fibres, the number of capillaries per fibre as well as the activities of citrate synthase, 3-hydroxy-acyl-CoA-dehydrogenase, and hexokinase showed a significant increase after training.The concentrations of glucose during OGTT showed a trend to decrease with a significant decrease at the end glucose curve (120-min value). The concentration of insulin and C peptide and the insulin removal did not change after training. The changes in the concentration of glucose during OGTT was significantly correlated with the increase in muscle capillarization and of dynamic endurance.     

Effects of resistance training on cardiovascular responses to lower body negative pressure in the elderly.

The purpose of the present study was to determine whether resistance training alters the cardiovascular responses to submaximal lower body negative pressure (LBNP) in the elderly. Twenty-one subjects were randomized into a control (C: n=10; 70 +/- 3 years, mean +/- SD) or a resistance training (TR: n=11; 67 +/- 7 years) group. Subjects in the TR underwent 12 weeks of training consisting of three sets of 8-12 contractions at approximately 60-80% of their initial maximal one repetition, three times per week, on 10 different machines. Before (Pre) and after (Post) training, all subjects underwent exposures of LBNP of -10, -20 and -40 Torr and muscle biopsy sampling at the vastus lateralis. TR increased (P< or =0.05) knee extension (Pre=379 +/- 140 N, Post=534 +/- 182 N) and chest press (Pre=349 +/- 137 N, Post=480 +/- 192 N) strength. Neither body weight nor percentage body fat were altered (P >0.05) by training. Resistance training increased (P< or =0.05) cross-sectional area in both Type I (4203 +/- 1196 to 5248 +/- 1728 microm2) and Type II (3375 +/- 1027 to 4286 +/- 1892 microm2) muscle fibres. Forearm blood flow, forearm vascular conductance, mean arterial pressure, and heart-rate responses to LBNP were not altered by the training. These data suggest that the cardiovascular responses of elderly to LBNP are unaffected by 12 weeks of whole-body resistance training despite increases in muscle strength and size.     

Histochemical and ultrastructural characteristics of leg muscle fibres in patients with repairative abdominal aortic aneurysm (AAA)

Tibialis anterior (ta) muscle biopsies before and after elective abdominal aortic aneurysm (AAA) repair operation were obtained, in order to observe possible changes after the aortic declamping reperfusion. Open muscle biopsies were taken from each of eight patients (60-75 years old) which were processed for enzyme histochemistry, and for transmission electron microscopy (EM). Morphometric analysis was applied to estimate the number and the area of muscle fibres of each fibre type. Rectus abdominis muscle biopsies were served as controls. Before the operation the predominant elements found were the presence of atrophic muscle fibres, fibre size diversity, localised cellular reactions, increased extent of connective tissue, disappearance, in many cases, of the mosaic pattern, predominance of type I and oxidative fibres, and existence of fibres with core-like structures in the sarcoplasm. Type I fibres consisted of 66.95 +/- 9% of all muscle fibres, the mean cross sectional area of which was 3,372.8 +/- 1,016 microm(2) and of type II fibres was 3,786.5 +/- 6,046 microm(2). After the aortic clamping was performed mitochondrial swelling was found, as well as disorganisation of sarcomeres. After declamping of the aorta, there were also severe edema, local fibre necrosis, and adhesion of leucocytes, whereas muscle fibre areas became 3,935.18 micro 531 microm(2) for type I and 5,804 +/- 1,075 microm(2) for type II. The short ischemic period during aortic clamping and the subsequent reperfusion resulted mainly in ultrastructural changes.     

Decreased skeletal muscle potassium in obesity

The effect of body weight on total body potassium, skeletal muscle electrolytes and fat content was studied in seven lean and seven obese middle-aged men and seven lean and eight obese middle-aged women. Total body potassium and total body fat increased with body weight (p less than 0.01 and less than 0.05 for men, and p less than 0.05 and p less than 0.001 for women, respectively). So did muscle fat in men (p less than 0.01), while muscle tissue potassium was decreased in both obese men (p less than 0.001) and obese women (p less than 0.05). The skeletal muscle Na/K-ratio tended to be higher in obese men (p less than 0.1) but was not related to body weight in women. Skeletal muscle magnesium was higher (p less than 0.01) in obese men than in lean men. No differences between lean and obese women were found. Obese men had higher diastolic blood pressure (p less than 0.05) than lean men, while there was no difference between obese and lean women. Compared with lean subjects, obese subjects thus had lower relative skeletal muscle mass and men, especially, had more fat and less potassium in the skeletal muscle.     

Three-dimensional hyaluronic acid grafts promote healing and reduce scar formation in skin incision wounds

Hyaluronic acid (HA) has been found to play important roles in tissue regeneration and wound-healing processes. Fetal tissue with a high concentration of HA heals rapidly without scarring. The present study employed HA formed into three-dimensional strands with or without keratinocytes to treat full-thickness skin incision wounds in rats. Wound closure rates of HA strand grafts both with and without keratinocytes were substantially enhanced. The closure times of both HA grafts were less than 1 day (average 16 h), about 1/7 that of the contralateral control incisions (114 h, p <.01). Average wound areas after 10 days were HA-only graft: 0.151 mm2 +/- 0.035; HA + cell grafts: 0.143 mm2 +/- 0.036 and controls: 14.434 mm2 +/- 1.175, experimental areas were 1% of the controls (p < 0.01). Transforming growth factor (TGF) beta1 measured by immunostaining was remarkably reduced in HA-treated wounds compared to the controls. In conclusion, HA grafts appeared to produce a fetal-like environment with reduced TGF-beta1, which is known to be elevated in incipient scars. The HA strands with or without cultured cells may potentially improve clinical wound healing as well as reduce scar formation.     

Investigation of the organelle pathology of skeletal muscle in chronic alcoholism.

The muscle abnormalities associated with chronic alcohol consumption were studied by applying histological and biochemical techniques to tissue obtained by percutaneous needle biopsy from the quadriceps muscles of 41 patients. Measurement of the fibre size showed atrophy of both type I (p less than 0.05) and type II (p less than 0.001) fibres. The degree of atrophy was more severe for type II fibres (33% reduction in median diameter) than type I (17%). Marker enzyme activities for the principal organelles were assayed. Compared with biopsy specimens from non-alcoholic controls, no differences were found in the activities of lysosomal, mitochondrial, peroxisomal, cytosolic, sarcolemmal, or sarcoplasmic reticulum enzymes, expressed per microgram DNA. A reduction in the protein to DNA ratio was evident in severely atrophic biopsies, and this was associated with a significant reduction of myofibrillary Ca2+-ATPase activity. These results suggest a selective loss of type II fibre myofibrillary protein and do not confirm earlier suggestions of specific mitochondrial damage.