Effect of upper limb, lower limb and combined training on exercise performance, quality of life and survival in COPD

Because there are differences between the upper limb [UL] and lower limb [LL] muscles in terms of the morphological and functional adaptations in COPD patients, specific protocols for strength training and endurance should be developed and tested for the corresponding muscle groups. To elucidate the potential effects of unsupported UL and/or LL exercise training in patients with COPD. The 6-min walking distance [6-MWD], unsupported upper limb endurance [UULE] time, St. George's Respiratory questionnaire [SGRQ], BODE index and pulmonary function tests are used as outcome measures. A prospective, randomized controlled study of patients with COPD. Patients were randomly assigned to one of 4 groups, group A received UL training, group B received LL training, group C received both UL and LL training and group D received no training [controls]. Patients in group A, B, and C underwent exercise training 3 times weekly for 8 weeks. The outcome measures were carried out at study entry and after 8 weeks. 78 patients completed the study: 20 patients in group A, 21 in group B, 19 in group C and 18 in group D. Upper limb training significantly increased UULE time without affecting 6-MWD while LL training significantly increased 6-MWD without changing UULE time. Combined UL and LL training significantly increased both UULE time and 6-MWD. Significant reductions in the scores of SGRQ and BODE index were observed in groups A, B and C but not group D [control]. No changes were found in pulmonary function in all groups at the end of the study. In patients with COPD, combined UL and LL training significantly enhanced the exercise tolerance and quality of life and reduced the risk of death [BODE index] without any change in the pulmonary function

Histological and scanning electron microscopic study of the effect of cigarette smoke on the heart of male albino rats

Environmental tobacco smoke has been shown to cause heart diseases among non-smokers. Twenty one adult male albino rats were used to investigate the effect of cigarette smoke on the heart and to evaluate the possibility of recovery. Rats were divided into 3 equal groups. Rats of group I were considered as control Rats of group II were exposed to cigarette smoke for 4 weeks, while those of group III were exposed to cigarette smoke for 4 weeks then the exposure was stopped for another 4 weeks. Exposure to cigarette smoke resulted in affection of the coronaries. Some cardiac muscle fibers showed vacuolated cytoplasm, while other showed deeply stained acidophilic cytoplasm and psychotic nuclei. Scanning electron microscopic examination showed that some cardiac muscle fibers appeared necrotic with loss of their normal architecture. There was a decrease in succinic dehydrogenase enzyme activity and in the antiapoptotic Bcl-x [L]protein expression. Stopping the exposure for 4 weeks showed that few cardiac muscle fibers were still affected. Areas of fibrosis were seen between the cardiac muscle fibers in Mallroy stained sections and in the scanning electron microscopic study. There was an increase in scenic dehydrogenase enzyme activity and in the Bcl-x[L] protein expression in the cardiac muscle fibers in group III- that was left for 4 weeks for recovery after 4 weeks of exposure to cigarette smoke- in comparison to those of group II, but was still less than those of the control It is concluded that cigarette smoke affected the cardiac muscle and some of its effects could not be reversible

ultrastructural study of dermal capillaries in diabetes mellitus

Dermal micro vessels were examined by electron microscopy in eight diabetic patients and four age matched control subjects. Alteration in capillary pattern was characterized by being enlarged and often with constricted lumen. The endothelial cells showed plenty of pinocytotic vesicles, microfilaments and inclusion bodies. Pericytes were seen separated from endothelial cells by wider spaces. Thus functional alteration of dermal capillaries was suggested to occur with diabetes mellitus. The ultrastructure of the material comprising the capillary basement membrane was similar in both diabetic and control groups. Thus, no correlation could be made between the degree of thickening of capillary basement membrane [CBMT] and diabetes. However, the consistent thickening of the capillary wall was observed in the pattern and amount of collagen fibrils surrounding the capillary wall or intermingled between the basement membrane layers. The findings suggested that dermal capillary changes were indicative of development of early diabetic dermopathy although dermal [CBMT] was not a perfect diagnostic tool for diabetic micro angiopathy