[Coverage of post-traumatic brain exposure by a total temporal flap: a case report]. / Couverture d'une exposition cérébrale post-traumatique par un lambeau temporal total : à propos d'un cas.

Major defect of the scalp associated with penetrating brain injury is one of the most challenging issues in acute craniofacial trauma. Depressed skull fractures associated with injuries of the skin and periosteal tissue can be easily covered using various locoregional scalp flap techniques. However, if the skin is damaged around the wound, the surgical possibilities are reduced, allowing only local transposition flap or free flap coverage with many disadvantages for the latter such as vascular micro-anastomosis issues, unsuitable underlying vascular status, and a "patch" effect which is often unsightly. The authors describe, using a clinical case, the steps to provide a total temporal flap to cover a defect of both skin and bone. This can be performed in three separated stages: the first is the empowerment of both middle temporal pedicles; the second stage, 15 days later, is the section, transposition and coverage of the wound; the third stage, 30 days later, is the flap separation.

[Vascularized bone transfer of scapula apophysis]. / Transfert osseux vascularisé d'épiphyse scapulaire.

The vascularized bone transfer of the scapular apophysis was described for the first time by Gilbert and Téot (1982) [1]. The growing pattern of this specific apophysis has large capacity and the plasticity during remodeling is unique. Primarily used for mandibular reconstruction, the scapular crest is also suitable for humeral or femoral reconstruction as well as for carpal stabilization in radial hand malformation, which is considered to be the main clinical indication. The radial hand malformation is characterized by an insufficient ulnar carpal stabilization which leads to luxation and radial deviation of the carpus. Using the vascularized scapular transfer in volar apposition to the ulnar, it enables enlarging the contact surface area with the carpus, thus stabilizing the wrist. Due to the preserved epiphyseal vascularization, good remodeling and integration of the scapular crest is achieved until consolidation takes place.

Severe peritonitis due to Balantidium coli acquired in France.

The case reported here concerns an alcoholic pork-butcher who presented with severe colitis with peritonitis, caused by the only ciliate protozoan capable of infecting humans, Balantidium coli. This parasite is common in a variety of domestic and wild mammals, mainly pigs; however, its prevalence rate in humans is very low--particularly in industrialised, northern countries, including France. The infection is most frequently acquired by ingesting food or water contaminated by pig faeces, and it may be asymptomatic or may cause acute diarrhoea. Specific antibiotic treatment is efficacious, and it is important to consider the risk of this parasitic disease in susceptible patients presenting with bloody diarrhoea.

Effect of endurance training on oestrogen receptor alpha expression in different rat skeletal muscle type.

It is well known that oestrogens exert muscle anabolic and metabolic effects. Oestrogens act via specific oestrogen receptor (ER) proteins. The mainly represented oestrogen receptor alpha messenger ribonucleic acid subtype (ER(alpha) mRNA) was described in various tissues including the skeletal muscle. Moreover, it has been shown that endurance training significantly increases ER(alpha) mRNA levels in the female rat gastrocnemius muscle. The aim of this study was to determine if this training programme also modifies ER(alpha) mRNA levels in muscles with different typology, the soleus (slow twitch muscle), extensor digitorum longus (fast twitch muscle) and gastrocnemius (intermediate muscle). So far, two groups of Wistar female rats were set up: untrained (u) (n = 7), and trained (e) (n = 7). The endurance training programme was performed for 7 weeks, 5 days per week and consisted of 1 h of continuous running on an adapted motor-driven treadmill involving progressive intensity and gradient of the treadmill. Three different skeletal muscles, extensor digitorum longus (E), gastrocnemius (G) and soleus (S), were isolated and weighed in the untrained (Eu, Gu and Su) and trained group (Ee, Ge and Se). Semi-quantification of ER(alpha) mRNA levels was performed by the reverse transcriptase-polymerase chain reaction (RT-PCR) technique. In order to attest the efficiency of our endurance training programme, the citrate synthase activity (CS) of each muscle was measured by a fluorimetric method. The CS activity was significantly increased with training in the gastrocnemius [100.00 +/- 4.99% in Gu (n = 6) vs. 138.10 +/- 8.82% in Ge (n = 6), P < 0.01] and in the soleus [100.00 +/- 2.92% in Su (n = 7) vs. 115.90 +/- 3.71% in Se (n = 7), P < 0.01] but not in the extensor digitorum longus [100.00 +/- 1.87% in Eu (n = 7) vs. 96.90 +/- 1.55% in Ee (n = 7)]. Concerning the influence of muscle type on ER(alpha) mRNA level (1) in the untrained group, the ER(alpha) mRNA level was significantly higher in soleus muscle compared with gastrocnemius and extensor digitorum longus muscles [0.43 +/- 0.04 in Su (n = 7) compared with 0.31 +/- 0.03 in Gu (n = 6) and 0.21 +/- 0.03 in Eu (n = 7), P < 0.05; P < 0.05); 2] in the trained group, the ER(alpha) mRNA level was significantly higher insoleus and gastrocnemius muscles compared with extensor digitorum longus muscle [0.43 +/- 0.06 in Se (n = 7) and 0.49 +/- 0.05 in Ge (n = 6) vs. 0.12 +/- 0.01 in Ee (n = 7), P < 0.05; P < 0.05]. Indeed, after training, the ER(alpha) mRNA level significantly increased in gastrocnemius muscle [0.31 +/- 0.03 in Gu(n = 6) vs. 0.49 +/- 0.05 in Ge (n = 6), P < 0.01], significantly decreased in extensor digitorum longus [0.21 +/- 0.03 in Eu (n = 7) vs. 0.12 +/- 0.01 in Ee (n = 7), P < 0.01] and was not significantly modified in soleus [0.43 +/- 0.04 in Su (n = 7) vs. 0.43 +/- 0.06 in Se (n = 7)]. The differences in ER(alpha) mRNA level between trained and untrained animals indicate training-induced effects that are specific to the skeletal muscle type.

[Portable ultrasonographic device and bladder dysfunction management in stroke patients]. / Place d'un échographe vésical portable dans la prise en charge des troubles de la vidange vésicale après accident vasculaire cérébral.

OBJECTIVE: To determine the usefulness of a portable ultrasonographic device in the management and rehabilitation of stroke patients' bladder voiding impairment in the early stage and to propose a well-fitted screening protocol. MATERIAL AND METHOD: A prospective observational study of 33 inpatients admitted into our stroke rehabilitation program. A urinary elimination assessment protocol defines the criteria of intermittent catheterization. The determination of bladder volume was performed with a Bladderscan BVI 3000 portable ultrasonographic device. RESULTS: Urinary retention was present in ten of the 33 patients at admission, who were started on one or many intermittent catheterizations. Retention was resolved for seven of them at discharge. The portable ultrasonographic device allows a very accurate bladder volume assessment, especially useful in at-risk patients: those with cognitive impairments, diabetes mellitus, and prestroke urinary pathology. A new version of our first screening protocol increases the ability to detect patients with true urinary retention. Results are discussed according to the literature data. CONCLUSION: The portable ultrasonographic device is a simple and noninvasive tool, useful for diagnosis, follow-up and therapy guidance of urinary retention after stroke. An adapted protocol is proposed in order to assess and rehabilitate this trouble. The goal is to avoid long-term catheterization and its linked infectious risk.

Effect of endurance training on oestrogen receptor alpha transcripts in rat skeletal muscle.

Endurance training induces, in female rats, alterations of oestrous cycle with decrease in plasma oestradiol levels. Moreover, it is well known that oestradiol concentrations modify oestrogen receptor levels. In order to further explain the effects of oestrogens on skeletal muscles, we hypothesized that endurance training modifies the levels of oestrogen receptor alpha messenger ribonucleic acid (ER alpha mRNA) in rat gastrocnemius muscle. Wistar rats were separated into four groups: male controls (C(m)) (n=7), female controls (C(f)) (n=6), male trained (E(m)) (n=7) and female trained (E(f)) (n=6). The endurance training programme was performed for 7 weeks, 5 days week-1 and consisted of 1 h of continuous running on an adapted motor-driven treadmill. At the end of the training session, the gastrocnemius muscle was isolated, weighed and semiquantification of ER alpha mRNA was performed using the reverse transcriptase-polymerase chain reaction (RT-PCR) technique. The citrate synthase (CS) activity of the gastrocnemius muscle was measured by a fluorimetric method. The CS activity of the male and female gastrocnemius muscle, respectively, 100 +/- 7% in C(m) (n=7) vs. 120 +/- 14% in E(m) (n=6, P < 0.01) and 100 +/- 13% in C(f) (n=6) vs. 138 +/- 23% in E(f) (n=6, P < 0.01) was significantly increased after 7 weeks of training. The ER alpha mRNA levels were significantly increased in E(f) compared with C(f) (0.49 +/- 0.15 vs. 0.31 +/- 0.11, P < 0.01) but not in E(m) compared with C(m) (0.37 +/- 0.15 vs. 0.37 +/- 0.13). In conclusion, these results demonstrate that 7 weeks of endurance training increased the level of transcripts encoding ER alpha in rats with the increase restricted to the females.

Lactate transport in rat sarcolemmal vesicles after a single bout of submaximal exercise.

We investigated the effects of a single bout of non-exhaustive exercise (25 m x min(-1), 10% grade, for 30 min) on the initial rates of lactate uptake in rat skeletal muscle sarcolemmal vesicles and the monocarboxylate transporter 1 (MCT1) content in isolated hindlimb muscles in relation to the exercise-induced oxidative stress. The exercise led to a decrease in red gastrocnemius and red vastus lateralis muscle glycogen content by 74% and 83%, respectively, and an increase in blood lactate concentration from 1.67 +/- 0.15 to 3.44 +/- 0.47 mM (p < 0.05). Initial rates of lactate uptake were measured in zero-trans conditions, at pH 7.4, for 1, 10, 30 and 100 mM external lactate concentrations. Lactate transport capacity was significantly decreased at 1 mM in the exercised group (p < 0.05), while a non-significant trend towards an increase was observed at 10, 30 and 100 mM. We failed to obtain any change in soleus, red tibialis anterior and white gastrocnemius muscle MCT1 content (p>0.05), and no evidence of exercise-induced oxidative stress in terms of muscle malondialdehyde content and glutathione peroxidase and superoxide dismutase activities was observed after the 30 min exercise bout. These results indicate that a single bout of submaximal exercise, which did not induce an increase in muscle MCT1 content and apparent oxidative stress, decreased lactate transport capacity at low physiological concentration. Although the changes are small and independent of a MCT1-facilitated lactate transport regulation, we suggest that another MCT isoform with different kinetic properties from MCT1 could be present in the sarcolemma and responsible for lactate exchange alterations.

Between 21 and 34 years of age, aging alters the catecholamine responses to supramaximal exercise in endurance trained athletes.

The purpose of this study was to determine the effect of aging and training on the adrenaline (A) and noradrenaline (NA) responses during the Wingate-test in three age groups of subjects: 21 year old untrained subjects (21U), 21 year old endurance trained (21T) (national elite runners), 34 year old endurance trained (34T) (national elite runners). Performances during the test were judged using the usual parameters of peak power (Wmax) and mean power (W) expressed in absolute or relative values. A and NA responses were measured at rest (A0 and NA0) immediately at the end of the exercise (Amax and NAmax) and after 5 minutes recovery (A5 and NA5). Plasma maximal lactate (La(max)) was determined 3 minutes after the end of the exercise. Wmax, W and La(max) were always significantly lower in 34T compared to 21T and 21U. The catecholamine responses were similar in 21T and 21U. Inversely, a significantly lower value of Amax was observed in 34T (2.01 +/- 0.5 nmol x l(-1)) compared to 21U (3.62 +/- 0.3 nmol x l(-1)) associated with a significantly higher value of NA(max) in 34T versus 21T and 21U. Thus, the Amax/NA(max) ratio was found to be significantly lower in the older subjects versus both 21T and 21U. All these findings indicated that endurance training did not affect the sympathoadrenergic responses to a supramaximal exercise and suggested that only one decade may reduce the capacity of the medulla to secrete adrenaline and therefore the adrenal medulla responsiveness to the sympathetic nervous activity.

Lactate transport activity in rat skeletal muscle sarcolemmal vesicles after acute exhaustive exercise.

The effect of a single bout of exhaustive exercise on muscle lactate transport capacity was studied in rat skeletal muscle sarcolemmal (SL) vesicles. Rats were assigned to a control (C) group (n = 14) or an acutely exercised (E) group (n = 20). Exercise consisted of treadmill running (25 m/min, 10% grade) to exhaustion. SL vesicles purified from C and E rats were sealed because of sensitivity to osmotic forces. The time course of 1 mM lactate uptake in zero-trans conditions showed that the equilibrium level in the E group was significantly lower than in the C group (P < 0.05). The initial rate of 1 mM lactate uptake decreased significantly from 2.44 +/- 0.22 to 1.03 +/- 0.08 nmol. min(-1). mg protein(-1) (P < 0.05) after exercise, whereas that of 50 mM lactate uptake did not differ significantly between the two groups. For 100 mM external lactate concentration ([lactate]), exhaustive exercise increased initial rates of lactate uptake (219.6 +/- 36.3 to 465.4 +/- 80.2 nmol. min(-1). mg protein(-1), P < 0.05). Although saturation kinetics were observed in the C group with a maximal transport velocity of 233 nmol. min(-1). mg protein(-1) and a Michealis-Menten constant of 24.5 mM, saturation properties were not seen after exhaustive exercise in the E group, because initial rates of lactate uptake increased linearly with external [lactate]. We conclude that a single bout of exhaustive exercise significantly modified SL lactate transport activity, resulting in a decrease in 1 mM lactate uptake and was associated with alterations in the saturable properties at [lactate] above 50 mM. These results suggest that changes in sarcolemmal lactate transport activity may alter lactate and proton exchanges after exhaustive exercise.

Noninvasive skeletal muscle lactate detection between periods of intense exercise in humans.

We investigated whether localized 1H nuclear magnetic resonance spectroscopy (NMRS) using stimulated echoes (STEAM) with a long mixing time (t(m)) allowed the suppression of the fat signal and detection of lactate in skeletal muscle. The 1H NMRS sequence was first validated in three isolated and perfused rabbit biceps brachii muscles. Spectra were obtained on a wide-bore spectrometer using a dual-tuned probe (1H and 31P). Death was simulated by ceasing the muscle perfusion, which allowed post-mortem changes to be followed. During and after the simulated death, changes in levels of pH and in content of energy-rich compounds were observed with 31P NMRS. Our results showed an inverse linear relationship between pH and lactate in each of the three rabbits (r = 0.93, P < 0.001; r = 0.92, P < 0.01; r = 0.89, P < 0.01) and a decrease in phosphocreatine and concomitant increase in lactate. We then investigated whether this sequence allowed repeated detection of lactate in human soleus muscle during the recovery between periods of intense exercise (force-velocity test, F-v test). Seven subjects mean age 25.1 (SEM 0.8) years participated in this study. Soleus muscle lactate was detected at rest and for 3 min 30 s of the 5-min recovery between periods using a 2.35-T 40-cm bore magnet spectrometer. Arm venous plasma lactate concentration was measured at rest, during the F-v test when the subject stopped pedalling (S1), and at the end of each 5-min recovery between periods (S2). Results showed that the venous plasma lactate concentration at S1 and S2 increased significantly from the beginning of the F-v test to peak anaerobic power (W(an,peak)) (P < 0.001). The spectra showed that muscle lactate resonance intensity rose markedly when W(an,peak) was achieved. The muscle lactate resonance intensity plotted as a percentage of the resting value increased significantly at W(an,peak) compared with submaximal braking forces (P < 0.05). We concluded from these results that localized 1H NMRS using STEAM with a long t(m) allows suppression of the fat signal and repeated detection of lactate on isolated perfused skeletal muscle in animals and between periods of intense exercise in humans.

Changes in maximal exercise ventilation and breathing pattern in boys during growth: a mixed cross-sectional longitudinal study.

The aim of this mixed cross-sectional longitudinal study covering a total age range of 11-17 years, i.e. the entire pubertal growth period, was (1) to specify the changes in maximal breathing pattern during incremental exercise; (2) to determine what parts of the changes are due to anthropometric characteristics, physical fitness and inspiratory or expiratory muscle strength; and (3) to determine if the role of these variables is identical before, during and after pubertal growth spurt. This study was conducted in 44 untrained schoolboys separated into three groups, with an initial age of 11.2 +/- 0.2 years for group A, 12.9 +/- 0.25 years for group B, and 14.9 +/- 0.26 years for group C. These children were subsequently followed for 3 years, during the same time period each year. The maximal inspiratory and expiratory pressures (PI max and PE max) were used as an index of the respiratory muscle strength. During an incremental exercise test, maximal ventilation (VE max), tidal volume (VT max), breathing frequency (fmax), inspiratory and expiratory times (tI max and tE max) and mean inspiratory flow (VT/tI max) were measured at maximal oxygen uptake (VO2max). Our study showed that there was a marked increase with age in VE max, VT max, and VT/tI max, and no significant changes in fmax, tI max and tE max. PI max and PE max showed a general trend towards an increase between 11 and 17 years. The study of the linear correlations between maximal breathing pattern and the anthropometric characteristics, physical fitness and inspiratory or expiratory muscle strength showed that, in the three groups of children, (1) lean body mass was the major determinant of VE max, VT max and VT/tI max and the relationships were significantly different before, during and after the pubertal growth spurt; (2) physical fitness was the main determinant of tI max, tE max and fmax before and after the pubertal growth spurt; and (3) maximal respiratory strength did not play a significant role. In conclusion, this mixed cross-sectional longitudinal study showed, at maximal exercise, a significant increase in VE max during growth due only to a significant increase in VT max and VT/tI max, and that the relationships of anthropometric characteristics and physical fitness with maximal breathing pattern change during growth.

Effect of 2-chloropropionate on initial lactate uptake by rat skeletal muscle sarcolemmal vesicles.

2-Chloropropionate (2-CP) is a halogenated monocarboxylic acid generally used to decrease blood lactate concentration in various metabolic states. To investigate whether it has an inhibitory effect on sarcolemmal lactate transport, we compared the initial rate of lactate transport in sarcolemmal membrane vesicles purified from 20 male Wistar rats with and without 2-CP. Transport by these vesicles was measured as uptake of L-(+)-[U-14C]lactate under pH gradient-stimulated cis inhibition. The time courses of 1 mM L-(+)-lactate uptake into vesicles both with and without 10 mM 2-CP (L- or D-) displayed saturation kinetics. Lactate uptake values were lower with 10 mM L-2-CP and 10 mM D-2-CP in comparison to the control values. Both 10 mM L-2-CP and 10 mM D-2-CP significantly inhibited 1 mM L-(+)-lactate uptake (55.8 +/- 9.1 and 53.5 +/- 12.1%, respectively; P < 0.001), whereas a smaller inhibition was observed with a higher lactate concentration of 50 mM (40.2 +/- 11.2 and 38.7 +/- 12.4%; P < 0.001 and P < 0.05, respectively). However, a higher D-2-CP concentration (50 mM) increased the inhibition of pH-stimulated 1 mM L-(+)-lactate uptake (77.0 +/- 9.4%; P < 0.001). D-2-CP had a trans-stimulation effect on the initial rate of lactate efflux of 1 mM L-(+)-lactate compared with baseline efflux (9.5 +/- 0.8 vs. 5.1 +/- 0.4 nmol.min-1.mg protein-1; P < 0.05). 2-CP significantly inhibited the initial rate of lactate uptake in skeletal muscle sarcolemmal membrane vesicles. This result suggests that 2-CP is a nonstereoselective substrate of the lactate muscle carrier that impairs lactate transport.

Effect of NaHCO3 on lactate kinetics in forearm muscles during leg exercise in man.

We investigated NaHCO3 infusion effects on plasma lactate removal by forearm muscles and performance during intensive leg exercise. Seven subjects performed the force-velocity (FV) test with placebo and NaHCO3 (2 mEq.min-1) with a double-blind crossover protocol. Blood samples for arterial ([LA]A) and venous ([LA]V) lactate determinations were taken 1) at rest before infusion, and 2, 6, 10, 14, 18, and 22 min following its start; and 2) at the end of each exercise bout. The arteriovenous difference ([LA]A-V) was determined for each sampling. NaHCO3 significantly increased arterial bicarbonate concentration and pH during rest (P < 0.001; P < 0.001) and the FV test (P < 0.001; P < 0.05). During the test, [LA]A and [LA]V were significantly higher with NaHCO3 (P < 0.05, P < 0.001). At test onset, [LA]A-V became positive and increased until the braking force of 6 kg, with NaHCO3 and placebo, with values significantly lower for NaHCO3 (P < 0.001). Peak anaerobic power (Wanae, peak) and the corresponding braking force (Fmax) were also determined. Fmax was significantly increased with NaHCO3 (P < 0.001). In conclusion, the increasing rise in [LA]A and [LA]V induced by NaHCO3 may be partly explained by a decreased rate of lactate uptake by forearm skeletal muscles. NaHCO3 did not improve Wanae, peak, but improved Fmax, thus increasing FV duration.

Effects of active recovery on plasma lactate and anaerobic power following repeated intensive exercise.

The purpose of this study was to investigate the effects of active recovery (AR) on plasma lactate concentration [La] and anaerobic power output as measured during repeated bouts of intense exercise (6 s) against increasing braking forces. Ten male subjects performed two randomly assigned exercise trials: one with a 5-min passive recovery (PR) after each exercise bout and one with a 5-min active recovery (AR) at a workload corresponding to 32% of maximal aerobic power. Blood samples were taken at rest, at the end of each exercise bout (S1) and at the 5th minute between bout-recovery (S2) for plasma lactate assay. During the tests, [La]S1 was not significantly different after AR and PR, but [La]S2 was significantly lower after AR for power outputs obtained at braking forces 6 kg (5.66 +/- 0.38 vs 7.56 +/- 0.51 mmol.l-1) and peak anaerobic power (PAnP) (6.73 +/- 0.61 vs 8.54 +/- 0.89 mmol.l-1). Power outputs obtained at 2 and 4 kg did not differ after AR and PR. However, when compared with PR, AR induced a significant increase in both power outputs at 6 kg (842 +/- 35 vs 798 +/- 33 W) and PAnP (945 +/- 56 vs 883 +/- 58 W). These results showed that AR between bouts of intensive exercise decreased blood lactate concentration at high braking forces. This decrease was accompanied by higher anaerobic power outputs at these forces.

Lactate uptake by skeletal muscle sarcolemmal vesicles decreases after 4 wk of hindlimb unweighting in rats.

We investigated the effects of 4 wk of hypodynamia on the rate of lactate transport in skeletal muscle sarcolemmal vesicles from control and hindlimb-suspended rats. Characterization of the sarcolemmal preparations was achieved with a marker enzyme (K+-p-nitrophenylphosphatase) and measurement of 1 mM [U-14C]lactate transport activity under zero-trans conditions with or without a pH gradient or the transport inhibitor alpha-hydroxycinnamate. Preparations from the two groups were not significantly different concerning yield and purification. Based on these results, we used this model to analyze the lactate transport activity after hypodynamia by tail suspension. Hindlimb suspension caused a shift from slow to fast myosin heavy chain isoforms in soleus muscles with a 40% decrease in the citrate synthase activity (from 35.3 +/- 3.7 to 21.4 +/- 2.1 mu mol x g-1 x min-1; P < 0.05). Lactate (1 mM) uptake in vesicles from the two groups was a function of time, and the rate after hindlimb suspension was significantly decreased in the suspended compared with the control group (2.25 +/- 0.44 and 3.50 +/- 0.26 nmol x min-1 x mg protein-1, respectively; P < 0.05). These differences were not observed for a higher lactate concentration (50 mM). These results suggest that the level of physical activity plays a role in the regulation of sarcolemmal lactate transport activity implicated in the exchanges of lactate between producing and utilizing cells, organs, and tissues, which are major ways of carbohydrate energy distribution in humans and others species.

Lactate uptake by forearm skeletal muscles during repeated periods of short-term intense leg exercise in humans.

We investigated the role of the forearm skeletal muscles in the removal of lactate during repeated periods of short-term intensive leg exercise, i.e. a force-velocity (FV) test known to induce a marked accumulation of lactate in the blood. The leg FV test was performed by seven untrained male subjects. Arterial and venous blood samples for determination of arterial ([la-]a) and venous ([la-]v) plasma lactate concentrations were concomitantly taken at rest before the test, during the FV test at the end of each period of intensive exercise just before the 5-min between-sprint recovery period, and after the completion of the test at 2, 4, 6, 8, 10, 15, and 20 min of the final recovery. The arteriovenous difference in concentration for plasma lactate ([la-]a-v) was determined for each blood sample. During the test, [la-]a and [la-]v increased significantly (P < 0.001; P < 0.001) with significantly higher values for [la-]a (P < 0.001). At the onset of the test, [la-]a-v became positive and increased up to a braking force of 6 kg, correlating significantly with [la-]a (r = 0.61, P < 0.001) with power (r = 0.58, P < 0.001) during the test. At the end of the test, [la-]a, [la-]v and [la-]a-v decreased (P < 0.001; P < 0.001; P < 0.001 respectively) but were still higher than the basal values after 20-min of passive recovery. In conclusion, forearm skeletal muscles would seem to have been involved in the removal of lactate from the blood during the leg FV test, with an increase in lactate uptake proportional to the increase in plasma lactate concentration and power.

[Toxocariasis and functional intestinal disorders. Presentation of 4 cases]. / Toxocarose et troubles fonctionnels intestinaux. Présentation de 4 cas.

We report 4 cases of adults patients, suffering from irritable bowel syndrome, which had been attributed late to toxocariasis and for whom the treatment led to recovery. Hypereosinophilia was present only in 3 cases. These cases show that toxocariasis is not limited anymore to its two classical expressions: visceral larva migrans and ocular toxocariasis. So it is useful to think of it to confirm and treat it in the case of patients suffering from irritable bowel syndrome. This enables shorter diagnosis delay (14 months in average for our patients) and this is essential for therapeutic efficiency.

Lactate kinetics during passive and partially active recovery in endurance and sprint athletes.

We investigated the effects of passive and partially active recovery on lactate removal after exhausting cycle ergometer exercise in endurance and sprint athletes. A group of 14 men, 7 endurance-trained (ET) and 7 sprint-trained (ST), performed two maximal incremental exercise tests followed by either passive recovery (20 min seated on cycle ergometer followed by 40 min more of seated rest) or partially active recovery [20 min of pedalling at 40% maximal oxygen uptake (VO2max) followed by 40 min of seated rest]. Venous blood samples were drawn at 5 min and 1 min prior to exercise, at the end of exercise, and during recovery at 1, 2, 3, 4, 5, 6, 8, 10, 15, 20, 30, 40, 50, 60 min post-exercise. The time course of changes in lactate concentration during the recovery phases were fitted by a bi-exponential time function to assess the velocity constant of the slowly decreasing component (tau 2) expressing the rate of blood lactate removal. The results showed that at the end of maximal exercise and during the 1st min of recovery, ET showed higher blood lactate concentrations than ST. Furthermore, ET reached significantly higher maximal exercise intensities [5.1 (SEM 0.5) W.kg-1 vs 4.0 (SEM 0.3) W.kg-1, P < 0.05] and VO2max [68.4 (SEM 1.1) ml.kg-1.min-1 vs 55.5 (SEM 5.1) ml.kg-1.min-1, P < 0.01]. There was no significant difference between the two groups during passive recovery for tau 2. During partially active recovery, tau 2 was higher than during passive recovery for both groups (P < 0.001), but ET recovered faster and sooner than ST (P < 0.05). Compared to passive recovery, the tau 2 measured during partially active recovery was increased threefold in ET and only 1.5-fold in ST. We concluded that partially active recovery potentiates the enhanced ability to remove blood lactate induced by endurance training.

Aerobic and anaerobic contribution to Wingate test performance in sprint and middle-distance runners.

We investigated the aerobic and anaerobic contributions to performance during the Wingate test in sprint and middle-distance runners and whether they were related to the peak aerobic and anaerobic performances determined by two commonly used tests: the force-velocity test and an incremental aerobic exercise test. A group of 14 male competitive runners participated: 7 sprinters, aged 20.7 (SEM 1.3) years, competing in 50, 100 and 200-m events and 7 middle-distance runners, aged 20.0 (SEM 1.0) years, competing in 800, 1,000 and 1,500 m-events. The oxygen uptake (VO2) was recorded breath-by-breath during the test (30 s) and during the first 20 s of recovery. Blood samples for venous plasma lactate concentrations were drawn at rest before the start of the test and during the 20-min recovery period. During the Wingate test mean power (W) was determined and three values of mechanical efficiency, one individual and two arbitrary, 16% and 25%, were used to calculate the contributions of work by aerobic (Waer,ind,16%,25%) and anaerobic (Wan,ind,16%,25%) processes. Peak anaerobic power (Wan,peak) was estimated by the force-velocity test and maximal aerobic energy expenditure (Waer,peak) was determined during an incremental aerobic exercise test. During the Wingate test, the middle-distance runners had a significantly greater VO2 than the sprinters (P < 0.001), who had significantly greater venous plasma lactate concentrations (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

[Evolution of breathing pattern and ventilation at maximal exercise during growth. Definition of reference values]. / Evolution du régime ventilatoire et de la ventilation à l'exercice maximal en période de croissance. Définition de valeurs de références.

The aim of the study was to define the changes of parameters of breathing pattern and ventilation (VE) as a function of age during maximal exercise in children. A multi-longitudinal survey was conducted in forty four untrained schoolboys, divided in three groups with initial age of 11.2 years for group I, 12.9 years for group II, and 14.9 for group III. These children were subsequently followed three years ago at the same period. The range age was thus 11.2 to 16.9 years. This study showed that, during growth, ventilation (VE max), tidal volume (VT max) and mean inspiratory flow (VT/TI max) increased significantly with age, that inspiratory frequency (f max) decreased, that inspiratory, expiratory and total time of the respiratory cycle (TI max, TE max, TTOT max) increased slightly and that the inspiration fraction (TI/TTOT max) was identical at 11 and 17 years. Furthermore we observed that the peak height velocity and peak tidal volume velocity took place at the same age, i.e., 14 years and that those of weight and VT/TI at the same age of 15 years. In conclusion, this study allowed us to define reference values for breathing pattern at maximal exercise in sedentary boys and to specify the relation between growth and parameters of breathing pattern in these children.