RESUMEN
The consumption of alcoholic beverages influences carbohydrate and lipid metabolism, although it is not yet clear whether metabolism during physical exercise at different intensities is also affected. This was the objective of the present study. Eight young and healthy volunteers performed a treadmill test to identify the running speed corresponding to a lactate concentration of 4 mM (S4mM). At least 48 h later, they were subjected to two experimental trials (non-alcohol or alcohol) in which they performed two 1-km running sessions at the following intensities: 1) S4mM; 2) 15% above S4mM. In both trials, blood lactate, triglycerides, and glucose concentrations were measured before and after exercise. The acute alcohol intake increased triglycerides, but not lactate concentration under resting conditions. Interestingly, alcohol intake enhanced the exercise-induced increase in lactate concentration at the two intensities: S4mM (non-alcohol: 4.2±0.3 mM vs alcohol: 4.8±0.9 mM; P=0.003) and 15% above S4mM trial (P=0.004). When volunteers ingested alcohol, triglycerides concentration remained increased after treadmill running (e.g., at S4mM - at rest; non-alcohol: 0.2±0.5 mM vs alcohol: 1.3±1.3 mM; P=0.048). In contrast, glucose concentration was not modified by either alcohol intake, exercise, or their combination. We concluded that an acute alcohol intake changed lactate and lipid metabolism without affecting blood glucose concentration. In addition, the increase in lactate concentration caused by alcohol was specifically observed when individuals exercised, whereas augmented triglycerides concentration was already observed before exercise and was sustained thereafter.
Asunto(s)
Consumo de Bebidas Alcohólicas/sangre , Bebidas Alcohólicas/análisis , Glucemia/metabolismo , Etanol/metabolismo , Ácido Láctico/sangre , Resistencia Física/efectos de los fármacos , Adulto , Rendimiento Atlético/fisiología , Glucemia/análisis , Prueba de Esfuerzo , Humanos , Masculino , Resistencia Física/fisiología , Triglicéridos/sangre , Adulto JovenRESUMEN
The consumption of alcoholic beverages influences carbohydrate and lipid metabolism, although it is not yet clear whether metabolism during physical exercise at different intensities is also affected. This was the objective of the present study. Eight young and healthy volunteers performed a treadmill test to identify the running speed corresponding to a lactate concentration of 4 mM (S4mM). At least 48 h later, they were subjected to two experimental trials (non-alcohol or alcohol) in which they performed two 1-km running sessions at the following intensities: 1) S4mM; 2) 15% above S4mM. In both trials, blood lactate, triglycerides, and glucose concentrations were measured before and after exercise. The acute alcohol intake increased triglycerides, but not lactate concentration under resting conditions. Interestingly, alcohol intake enhanced the exercise-induced increase in lactate concentration at the two intensities: S4mM (non-alcohol: 4.2±0.3 mM vs alcohol: 4.8±0.9 mM; P=0.003) and 15% above S4mM trial (P=0.004). When volunteers ingested alcohol, triglycerides concentration remained increased after treadmill running (e.g., at S4mM - at rest; non-alcohol: 0.2±0.5 mM vs alcohol: 1.3±1.3 mM; P=0.048). In contrast, glucose concentration was not modified by either alcohol intake, exercise, or their combination. We concluded that an acute alcohol intake changed lactate and lipid metabolism without affecting blood glucose concentration. In addition, the increase in lactate concentration caused by alcohol was specifically observed when individuals exercised, whereas augmented triglycerides concentration was already observed before exercise and was sustained thereafter.
Asunto(s)
Humanos , Masculino , Adulto , Adulto Joven , Resistencia Física/efectos de los fármacos , Glucemia/metabolismo , Consumo de Bebidas Alcohólicas/sangre , Ácido Láctico/sangre , Etanol/metabolismo , Bebidas Alcohólicas/análisis , Resistencia Física/fisiología , Triglicéridos/sangre , Glucemia/análisis , Prueba de Esfuerzo , Rendimiento Atlético/fisiologíaRESUMEN
Brain serotonin and dopamine are neurotransmitters related to fatigue, a feeling that leads to reduced intensity or interruption of physical exercises, thereby regulating performance. The present review aims to present advances on the understanding of fatigue, which has recently been proposed as a defense mechanism instead of a "physiological failure" in the context of prolonged (aerobic) exercises. We also present recent advances on the association between serotonin, dopamine and fatigue. Experiments with rodents, which allow direct manipulation of brain serotonin and dopamine during exercise, clearly indicate that increased serotoninergic activity reduces performance, while increased dopaminergic activity is associated with increased performance. Nevertheless, experiments with humans, particularly those involving nutritional supplementation or pharmacological manipulations, have yielded conflicting results on the relationship between serotonin, dopamine and fatigue. The only clear and reproducible effect observed in humans is increased performance in hot environments after treatment with inhibitors of dopamine reuptake. Because the serotonergic and dopaminergic systems interact with each other, the serotonin-to-dopamine ratio seems to be more relevant for determining fatigue than analyzing or manipulating only one of the two transmitters. Finally, physical training protocols induce neuroplasticity, thus modulating the action of these neurotransmitters in order to improve physical performance.
Asunto(s)
Dopamina/fisiología , Ejercicio Físico/fisiología , Fatiga/etiología , Fatiga/metabolismo , Serotonina/fisiología , Animales , Rendimiento Atlético/fisiología , Encéfalo/metabolismo , Humanos , Neurotransmisores/metabolismo , Factores de TiempoRESUMEN
HLA-B*49:39 allele is characterised by 1 amino acid substitution in the alpha 1 domain.
Asunto(s)
Alelos , Exones , Antígenos HLA-B/genética , Trasplante de Células Madre Hematopoyéticas , Leucemia/terapia , Polimorfismo de Nucleótido Simple , Sustitución de Aminoácidos , Secuencia de Bases , Codón/química , Femenino , Expresión Génica , Antígenos HLA-B/inmunología , Haplotipos , Prueba de Histocompatibilidad , Humanos , Leucemia/inmunología , Leucemia/patología , Masculino , Núcleo Familiar , Linaje , Reacción en Cadena de la Polimerasa , Alineación de Secuencia , Análisis de Secuencia de ADN , Donantes de TejidosRESUMEN
Physical exercise triggers coordinated physiological responses to meet the augmented metabolic demand of contracting muscles. To provide adequate responses, the brain must receive sensory information about the physiological status of peripheral tissues and organs, such as changes in osmolality, temperature and pH. Most of the receptors involved in these afferent pathways express ion channels, including transient receptor potential (TRP) channels, which are usually activated by more than one type of stimulus and are therefore considered polymodal receptors. Among these TRP channels, the TRPV1 channel (transient receptor potential vanilloid type 1 or capsaicin receptor) has well-documented functions in the modulation of pain sensation and thermoregulatory responses. However, the TRPV1 channel is also expressed in non-neural tissues, suggesting that this channel may perform a broad range of functions. In this review, we first present a brief overview of the available tools for studying the physiological roles of the TRPV1 channel. Then, we present the relationship between the TRPV1 channel and spontaneous locomotor activity, physical performance, and modulation of several physiological responses, including water and electrolyte balance, muscle hypertrophy, and metabolic, cardiovascular, gastrointestinal, and inflammatory responses. Altogether, the data presented herein indicate that the TPRV1 channel modulates many physiological functions other than nociception and thermoregulation. In addition, these data open new possibilities for investigating the role of this channel in the acute effects induced by a single bout of physical exercise and in the chronic effects induced by physical training.
Asunto(s)
Ejercicio Físico/fisiología , Locomoción/fisiología , Canales Catiónicos TRPV/metabolismo , Rendimiento Atlético/fisiología , Regulación de la Temperatura Corporal/fisiología , Capsaicina/metabolismo , Humanos , Factores de TiempoRESUMEN
Physical exercise triggers coordinated physiological responses to meet the augmented metabolic demand of contracting muscles. To provide adequate responses, the brain must receive sensory information about the physiological status of peripheral tissues and organs, such as changes in osmolality, temperature and pH. Most of the receptors involved in these afferent pathways express ion channels, including transient receptor potential (TRP) channels, which are usually activated by more than one type of stimulus and are therefore considered polymodal receptors. Among these TRP channels, the TRPV1 channel (transient receptor potential vanilloid type 1 or capsaicin receptor) has well-documented functions in the modulation of pain sensation and thermoregulatory responses. However, the TRPV1 channel is also expressed in non-neural tissues, suggesting that this channel may perform a broad range of functions. In this review, we first present a brief overview of the available tools for studying the physiological roles of the TRPV1 channel. Then, we present the relationship between the TRPV1 channel and spontaneous locomotor activity, physical performance, and modulation of several physiological responses, including water and electrolyte balance, muscle hypertrophy, and metabolic, cardiovascular, gastrointestinal, and inflammatory responses. Altogether, the data presented herein indicate that the TPRV1 channel modulates many physiological functions other than nociception and thermoregulation. In addition, these data open new possibilities for investigating the role of this channel in the acute effects induced by a single bout of physical exercise and in the chronic effects induced by physical training.
Asunto(s)
Humanos , Ejercicio Físico/fisiología , Locomoción/fisiología , Canales Catiónicos TRPV/metabolismo , Rendimiento Atlético/fisiología , Regulación de la Temperatura Corporal/fisiología , Capsaicina/metabolismo , Factores de TiempoRESUMEN
There is evidence that brain temperature (Tbrain) provides a more sensitive index than other core body temperatures in determining physical performance. However, no study has addressed whether the association between performance and increases in Tbrain in a temperate environment is dependent upon exercise intensity, and this was the primary aim of the present study. Adult male Wistar rats were subjected to constant exercise at three different speeds (18, 21, and 24 m/min) until the onset of volitional fatigue. Tbrain was continuously measured by a thermistor inserted through a brain guide cannula. Exercise induced a speed-dependent increase in Tbrain, with the fastest speed associated with a higher rate of Tbrain increase. Rats subjected to constant exercise had similar Tbrain values at the time of fatigue, although a pronounced individual variability was observed (38.7-41.7°C). There were negative correlations between the rate of Tbrain increase and performance for all speeds that were studied. These results indicate that performance during constant exercise is negatively associated with the increase in Tbrain, particularly with its rate of increase. We then investigated how an incremental-speed protocol affected the association between the increase in Tbrain and performance. At volitional fatigue, Tbrain was lower during incremental exercise compared with the Tbrain resulting from constant exercise (39.3±0.3 vs 40.3±0.1°C; P<0.05), and no association between the rate of Tbrain increase and performance was observed. These findings suggest that the influence of Tbrain on performance under temperate conditions is dependent on exercise protocol.
Asunto(s)
Animales , Masculino , Temperatura Corporal/fisiología , Encéfalo/fisiología , Ambiente Controlado , Fatiga/fisiopatología , Condicionamiento Físico Animal/fisiología , Esfuerzo Físico/fisiología , Regulación de la Temperatura Corporal/fisiología , Encéfalo/anatomía & histología , Prueba de Esfuerzo , Condicionamiento Físico Animal/métodos , Ratas Wistar , Estadística como Asunto , Volición/fisiologíaRESUMEN
There is evidence that brain temperature (T brain) provides a more sensitive index than other core body temperatures in determining physical performance. However, no study has addressed whether the association between performance and increases in T brain in a temperate environment is dependent upon exercise intensity, and this was the primary aim of the present study. Adult male Wistar rats were subjected to constant exercise at three different speeds (18, 21, and 24 m/min) until the onset of volitional fatigue. T brain was continuously measured by a thermistor inserted through a brain guide cannula. Exercise induced a speed-dependent increase in T brain, with the fastest speed associated with a higher rate of T brain increase. Rats subjected to constant exercise had similar T brain values at the time of fatigue, although a pronounced individual variability was observed (38.7-41.7°C). There were negative correlations between the rate of T brain increase and performance for all speeds that were studied. These results indicate that performance during constant exercise is negatively associated with the increase in T brain, particularly with its rate of increase. We then investigated how an incremental-speed protocol affected the association between the increase in T brain and performance. At volitional fatigue, T brain was lower during incremental exercise compared with the T brain resulting from constant exercise (39.3 ± 0.3 vs 40.3 ± 0.1°C; P<0.05), and no association between the rate of T brain increase and performance was observed. These findings suggest that the influence of T brain on performance under temperate conditions is dependent on exercise protocol.
Asunto(s)
Temperatura Corporal/fisiología , Encéfalo/fisiología , Ambiente Controlado , Fatiga/fisiopatología , Condicionamiento Físico Animal/fisiología , Esfuerzo Físico/fisiología , Animales , Regulación de la Temperatura Corporal/fisiología , Encéfalo/anatomía & histología , Prueba de Esfuerzo , Masculino , Condicionamiento Físico Animal/métodos , Ratas Wistar , Estadística como Asunto , Volición/fisiologíaRESUMEN
Fatigue during prolonged exercise is related to brain monoamines concentrations, but the mechanisms underlying this relationship have not been fully elucidated. We investigated the effects of increased central tryptophan (TRP) availability on physical performance and thermoregulation in running rats that were pretreated with parachlorophenylalanine (p-CPA), an inhibitor of the conversion of TRP to serotonin. On the 3 days before the experiment, adult male Wistar rats were treated with intraperitoneal (ip) injections of saline or p-CPA. On the day of the experiment, animals received intracerebroventricular (icv) injections of either saline or TRP (20.3 µM) and underwent a submaximal exercise test until fatigue. Icv TRP-treated rats that received ip saline presented higher heat storage rate and a 69% reduction in time to fatigue compared with the control animals. Pretreatment with ip p-CPA blocked the effects of TRP on thermoregulation and performance. Moreover, ip p-CPA administration accelerated cutaneous heat dissipation when compared with saline-pretreated rats. We conclude that an elevated availability of central TRP interferes with fatigue mechanisms of exercising rats. This response is modulated by serotonergic pathways, because TRP effects were blocked in the presence of p-CPA. Our data also support that a depletion of brain serotonin facilitates heat loss mechanisms during exercise.
Asunto(s)
Regulación de la Temperatura Corporal/efectos de los fármacos , Temperatura Corporal/efectos de los fármacos , Fatiga , Fenclonina/farmacología , Condicionamiento Físico Animal/fisiología , Triptófano Hidroxilasa/antagonistas & inhibidores , Triptófano/farmacología , Animales , Cloro/farmacología , Prueba de Esfuerzo , Inyecciones Intraventriculares , Masculino , Fenilalanina/farmacología , Ratas , Ratas Wistar , Serotonina , Triptófano/metabolismo , Triptófano Hidroxilasa/fisiologíaRESUMEN
We investigated brain mechanisms modulating fatigue during prolonged physical exercise in cold environments. In a first set of studies, each rat was subjected to three running trials in different ambient temperatures (T(a)). At 8 °C and 15 °C, core body temperature (T(core)) decreased and increased, respectively, whereas at 12 °C, the T(core) did not change throughout the exercise. In another set of experiments, rats were randomly assigned to receive bilateral 0.2 µL injections of 2.5 × 10(-2) M methylatropine or 0.15 M NaCl solution into the ventromedial hypothalamic nuclei (VMH). Immediately after the injections, treadmill exercise was started. Each animal was subjected to two experimental trials at one of the following T(a) : 5 °C, 12 °C or 15 °C. Muscarinic blockade of the VMH reduced the time to fatigue (TF) in cold environments by 35-37%. In all T(a) studied, methylatropine-treated rats did not present alterations in T(core) and tail skin temperature compared with controls. These results indicate that, below the zone of thermoneutrality, muscarinic blockade of the VMH decreases the TF, independent of changes in T(core). In conclusion, our data suggest that VMH muscarinic transmission modulates physical performance, even when the effects of thermoregulatory adjustments on fatigue are minimal.
Asunto(s)
Regulación de la Temperatura Corporal/efectos de los fármacos , Frío , Hipotálamo Medio/efectos de los fármacos , Esfuerzo Físico/efectos de los fármacos , Receptores Muscarínicos/fisiología , Animales , Regulación de la Temperatura Corporal/fisiología , Hipotálamo Medio/fisiología , Masculino , Fatiga Muscular/efectos de los fármacos , Esfuerzo Físico/fisiología , Ratas , Ratas Wistar , Receptores Muscarínicos/administración & dosificación , Carrera/fisiologíaRESUMEN
Biofilm-associated infections in wounds or on implants are difficult to treat. Eradication of the bacteria is nearly always impossible, despite the use of specific antibiotics. The bactericidal effects of high-energy extracorporeal shock waves on Staphylococcus aureus have been reported, but the effect of low-energy shock waves on staphylococci and staphylococcal biofilms has not been investigated. In this study, biofilms grown on stainless steel washers were examined by electron microscopy. We tested ten experimental groups with Staph. aureus-coated washers and eight groups with Staph. epidermidis. The biofilm-cultured washers were exposed to low-energy shock waves at 0.16 mJ/mm(2) for 500 impulses. The washers were then treated with cefuroxime, rifampicin and fosfomycin, both alone and in combination. All tests were carried out in triplicate. Viable cells were counted to determine the bactericidal effect. The control groups of Staph. aureus and Staph. epidermidis revealed a cell count of 6 × 10(8) colony-forming units/ml. Complete eradication was achieved using the combination of antibiotic therapy (single antibiotic in Staph. aureus, a combination in Staph. epidermidis) and shock wave application (p < 0.01). We conclude that shock waves combined with antibiotics could be tested in an in vitro model of infection.
Asunto(s)
Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Staphylococcus aureus/efectos de los fármacos , Staphylococcus epidermidis/efectos de los fármacos , Humanos , Pruebas de Sensibilidad Microbiana/métodos , Microscopía Electrónica de Rastreo , Radiación no Ionizante , Staphylococcus aureus/crecimiento & desarrollo , Staphylococcus aureus/efectos de la radiación , Staphylococcus epidermidis/crecimiento & desarrollo , Staphylococcus epidermidis/efectos de la radiación , Staphylococcus epidermidis/ultraestructuraRESUMEN
The effects of blocking ventromedial hypothalamic nucleus (VMH) muscarinic cholinoceptors on cardiovascular responses were investigated in running rats. Animals were anesthetized with pentobarbital sodium and fitted with bilateral cannulae into the VMH. After recovering from surgery, the rats were familiarized to running on a treadmill. The animals then had a polyethylene catheter implanted into the left carotid artery to measure blood pressure. Tail skin temperature (T(tail)), heart rate, and systolic, diastolic and mean arterial pressure were measured after bilateral injections of 0.2 microl of 5 x 10(-9) mol methylatropine or 0.15 M NaCl solution into the hypothalamus. Cholinergic blockade of the VMH reduced time to fatigue by 31 % and modified the temporal profile of cardiovascular and T(tail) adjustments without altering their maximal responses. Mean arterial pressure peak was achieved earlier in methylatropine-treated rats, which also showed a 2-min delay in induction of tail skin vasodilation, suggesting a higher sympathetic tonus to peripheral vessels. In conclusion, muscarinic cholinoceptors within the VMH are involved in a neuronal pathway that controls exercise-induced cardiovascular adjustments. Furthermore, blocking of cholinergic transmission increases sympathetic outflow during the initial minutes of exercise, and this higher sympathetic activity may be responsible for the decreased performance.
Asunto(s)
Presión Sanguínea/fisiología , Frecuencia Cardíaca/fisiología , Condicionamiento Físico Animal/fisiología , Receptores Muscarínicos/fisiología , Núcleo Hipotalámico Ventromedial/fisiología , Animales , Derivados de Atropina/farmacología , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Masculino , Parasimpatolíticos/farmacología , Ratas , Ratas Wistar , Temperatura Cutánea/efectos de los fármacos , Temperatura Cutánea/fisiología , Sistema Nervioso Simpático/fisiología , Cola (estructura animal) , Vasodilatación/efectos de los fármacos , Vasodilatación/fisiología , Núcleo Hipotalámico Ventromedial/efectos de los fármacosRESUMEN
The aim of this study was to evaluate the effects of the stimulation of central cholinergic synapses in the regulation of heat loss in untrained rats during exercise. The animals were separated into two groups (exercise or rest) and tail skin temperature (T(tail)), core temperature and blood pressure were measured after injection of 2 microL of 5x10(-3) M physostigmine (Phy; n = 8) or 0.15 M NaCl solution (Sal; n = 8) into the lateral cerebral ventricle. Blood pressure was recorded by a catheter implanted into the abdominal aorta, T(tail) was measured using a thermistor taped to the tail and intraperitoneal temperature (T(b)) was recorded by telemetry. During exercise, Phy-treated rats had a higher increase in mean blood pressure (147 +/- 4 mmHg Phy vs. 121 +/- 3 mmHg Sal; P < 0.001) and higher T(tail) (26.4 +/- 1.0 degrees C Phy vs. 23.8 +/- 0.5 degrees C Sal; P < 0.05) that was closely related to the increase in systolic arterial pressure (r = 0.83; P < 0.001). In addition, Phy injection attenuated the exercise-induced increase in T(b) compared with controls without affecting running time. We conclude that the activation of central cholinergic synapses during exercise increases heat dissipation due to the higher increase in blood pressure.
Asunto(s)
Presión Sanguínea/efectos de los fármacos , Regulación de la Temperatura Corporal/efectos de los fármacos , Inhibidores de la Colinesterasa/farmacología , Esfuerzo Físico/fisiología , Fisostigmina/farmacología , Carrera , Acetilcolina/metabolismo , Animales , Área Bajo la Curva , Encéfalo/citología , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Inhibidores de la Colinesterasa/administración & dosificación , Inyecciones Intraventriculares , Masculino , Neuronas/efectos de los fármacos , Neuronas/metabolismo , Condicionamiento Físico Animal , Fisostigmina/administración & dosificación , Ratas , Ratas Wistar , Temperatura Cutánea/efectos de los fármacos , Transmisión Sináptica/efectos de los fármacos , Telemetría , Factores de TiempoRESUMEN
The effect of gene therapy with adenovirus-mediated (Ad) vascular endothelial growth factor (VEGF) was compared to that of shock wave (SW) therapy on skin flap survival in a rat model, using the epigastric skin flap, based solely on the right inferior epigastric vessels. Thirty male Sprague-Dawley rats were randomly divided into three groups (SW-group, Ad-VEGF-group, and Control-group) of 10 rats each. Immediately after surgery, the SW-group was administered 2500 impulses at 0.15mJ/mm(2), in the Ad-VEGF-group injections were made to the subdermal space whereas the Control-group received no treatment. Flap viability was evaluated on day 7 after the operation. Standardised digital pictures of the flaps were taken and transferred to the computer, and necrotic zones relative to total flap surface area were measured and expressed as percentages. Overall, significantly smaller areas of necrotic zones were noted in the SW-group and the Ad-VEGF-group compared with the Control-group (SW-group: median 2.23% (range: 0-5.1) versus Control-group: median 17.4% (range: 11.8-22.8) (p<0.05); Ad-VEGF-group: median 9.25% (range: 7.6-11.9) versus Control-group: median 17.4% (range: 11.8-22.8) (p<0.05)). Furthermore, in the SW-group, areas of necrotic zones were significantly smaller than in Ad-VEGF-group (SW-group: median 2.23% (range: 0-5.1) versus Ad-VEGF-group: median 9.25% (range: 7.6-11.9) (p<0.05)). We conclude that treatment with SW enhances epigastric skin flap survival significantly more than Ad-VEGF treatment and also represents a feasible and cost effective technique to improve blood supply in ischaemic tissue.
Asunto(s)
Terapia Genética/métodos , Ondas de Choque de Alta Energía/uso terapéutico , Isquemia/prevención & control , Trasplante de Piel/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Factor A de Crecimiento Endotelial Vascular/genética , Adenoviridae/genética , Animales , Vectores Genéticos , Supervivencia de Injerto , Masculino , Necrosis/prevención & control , Ratas , Ratas Sprague-Dawley , Piel/patología , Colgajos Quirúrgicos/patología , Transfección , Factor A de Crecimiento Endotelial Vascular/metabolismoRESUMEN
Studies on the migration of an implant may be the only way of monitoring the early performance of metal-on-metal prostheses. The Ein Bild Roentgen Analyse--femoral component analysis (EBRA-FCA) method was adapted to measure migration of the femoral component in a metal-on-metal surface arthroplasty of the hip using standard antero-posterior radiographs. In order to determine the accuracy and precision of this method a prosthesis was implanted into cadaver bones. Eleven series of radiographs were used to perform a zero-migration study. After adjustment of the femoral component to simulate migration of 3 mm the radiographs were repeated. All were measured independently by three different observers. The accuracy of the method was found to be +/- 1.6 mm for the x-direction and +/- 2 mm for the y-direction (95% percentile). The method was validated using 28 hips with a minimum follow-up of 3.5 years after arthroplasty. Seventeen were sound, but 11 had failed because of loosening of the femoral component. The normal (control) group had a different pattern of migration compared with that of the loose group. At 29.2 months, the control group showed a mean migration of 1.62 mm and 1.05 mm compared with 4.39 mm and 4.05 mm in the failed group, for the centre of the head and the tip of the stem, respectively (p = 0.001). In the failed group, the mean time to migration greater than 2 mm was earlier than the onset of clinical symptoms or radiological evidence of failure, 19.1 versus 32.2 months (p = 0.001) and 24.8 months (p = 0.012), respectively. EBRA-FCA is a reliable and valid tool for measuring migration of the femoral component after surface arthroplasty and can be used to predict early failure of the implant. It may be of value in determining the long-term performance of surface arthroplasty.
Asunto(s)
Artroplastia de Reemplazo de Cadera/métodos , Prótesis de Cadera , Adulto , Anciano , Enfermedades Óseas/cirugía , Cadáver , Análisis de Falla de Equipo/métodos , Femenino , Fémur/cirugía , Articulación de la Cadera/cirugía , Humanos , Artropatías/cirugía , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Falla de Prótesis , Reproducibilidad de los Resultados , Programas InformáticosRESUMEN
Several methods have been used in an attempt to increase blood supply and tissue perfusion in ischemic tissues. The authors investigated the effect of extracorporal shock wave (ESW) treatment on compromised skin flaps. For this purpose, the epigastric skin flap model in rats, based solely on the right inferior epigastric vessels was used. Twenty male Sprague-Dawley rats were divided into two groups (ESW-group, Control group) of 10 rats each. The ESW-group was administered 2500 impulses at 0.15 mJ/mm(2) immediately after surgery, whereas, the control group received no treatment. Flap viability was evaluated on day 7 after the operation. Standardised digital pictures of the flaps were taken and transferred to the computer, and necrotic zones relative to total flap surface area were measured and expressed as percentages. Overall, there was a significant reduction in the surface area of the necrotic zones of the flaps in the ESW group compared to the control group (ESW group: 2.2+/-1.9% versus control: 17.4+/-4.4% (p < 0.01). In this study, the authors demonstrated that treatment with ESW enhanced epigastric skin flap survival, as confirmed by the significant reduction of necrotic flap zones. ESW treatment seems to represent a feasible and cost effective method to improve blood supply in ischemic tissue.
Asunto(s)
Supervivencia de Injerto , Ondas de Choque de Alta Energía , Colgajos Quirúrgicos/fisiología , Animales , Masculino , Modelos Animales , Necrosis , Ratas , Ratas Sprague-Dawley , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/patologíaRESUMEN
We implanted 71 metal-backed, porous-coated, hemispheric, press-fit Duraloc-100 cups in 68 consecutive patients. In 61 patients, the femoral stem was a cementless Spotorno and in ten a cemented Lubinus SP II. A 28-mm Biolox ceramic head was used with both stems. After an average follow-up of 4 (3.7-5.9) years, we examined 67 hips. Radiolucencies were described in three zones according to DeLee and Charnley, and migration was measured on serial radiographs using the computer-assisted EBRA method. Total migration of more than 1 mm within the first 2 years occurred in 22/62 cups. Nine cups showed more than 1.5 mm total migration within the first 2 years and more than 2 mm within the whole period. The presence of post-operative radiolucencies correlated significantly with a total migration value of more than 2 mm within the first 2 years (p=0.02). Post-operative radiolucencies in zone 1 correlated with a total migration value of more than 2 mm within the first 2 years (p=0.027) and more than 2.5 mm within the whole period (p=0.051). These correlation values might reflect the quality of operative technique, particularly reaming, and implant selection.
Asunto(s)
Prótesis de Cadera , Osteoartritis de la Cadera/diagnóstico por imagen , Osteoartritis de la Cadera/cirugía , Adulto , Anciano , Artroplastia de Reemplazo de Cadera , Distribución de Chi-Cuadrado , Femenino , Estudios de Seguimiento , Migración de Cuerpo Extraño/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Falla de Prótesis , Radiografía , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Involvement of the metacarpophalangeal (MP) joints is one of the major problems in patients with rheumatoid arthritis (RA). Although several data about the cumulative influence of steroid intake on bone are available, the course of demineralisation in RA has not been described by quantitative methods until now. PATIENTS AND METHODS: Computed tomography (CT) sections of 96 MP joints in 12 RA patients and of 32 MP joints in four age-matched healthy controls were investigated. Patients were classified according to Steinbrocker. Densitometric evaluation of subchondral bone density was performed by CT osteoabsorptiometry (CT-OAM). Quantitative CT-OAM was used to evaluate mineralisation of the articular surfaces in MP joints. RESULTS: In the distal articular surface of MP joints, the number of density maxima was reduced from 3 to 2.1+/-0.3, 1.9+/-0.5 and 1.3+/-0.3 in RA patients with early, mild to moderate, and severe disease, respectively. Means of calcium concentrations were 633.4+/-35. 3 mg Ca2+/mL, 518.9+/-56.2 mg Ca2+/mL, 497.7+/-23.8 mg Ca2+/mL and 455.1+/-28.6 mg Ca2+/mL for controls and RA patients with early, mild to moderate, and severe RA, respectively. Mineralisation of the distal articular surface was significantly reduced in all groups of RA patients [probability (p) = 0.005]. Regarding the number of density maxima, no differences were detected in the proximal articular surface of normal and RA fingers. However, mineralisation of the proximal articular surface was significantly reduced in all groups of RA patients (p = 0.004). Means of calcium concentrations of the proximal articular surface were 494.1+/-48.5 mg Ca2+/mL, 413.0+/-16.2 mg Ca2+/mL, 406.0+/-51.4 mg Ca2+/mL, 390,4+/-41.1 mg Ca2+/mL for controls and RA patients with early, mild to moderate, and severe RA, respectively. CONCLUSION: Patients with early and untreated RA show loss of mineralisation and altered morphology of the MP joints of the hand, even before corticosteroid therapy. CT-OAM provides evidence for an early alteration of functional anatomy in MP joints.
Asunto(s)
Artritis Reumatoide/fisiopatología , Enfermedades Óseas Metabólicas/fisiopatología , Cartílago Articular/patología , Adulto , Anciano , Artritis Reumatoide/patología , Densidad Ósea , Enfermedades Óseas Metabólicas/diagnóstico por imagen , Enfermedades Óseas Metabólicas/patología , Calcio/sangre , Cartílago Articular/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Valores de Referencia , Tomografía Computarizada por Rayos XRESUMEN
Mibefradil is a novel Ca(2+) antagonist which blocks both high-voltage activated and low voltage-activated Ca(2+) channels. Although L-type Ca(2+) channel block was demonstrated in functional experiments its molecular interaction with the channel has not yet been studied. We therefore investigated the binding of [(3)H]-mibefradil and a series of mibefradil analogues to L-type Ca(2+) channels in different tissues. [(3)H]-Mibefradil labelled a single class of high affinity sites on skeletal muscle L-type Ca(2+) channels (K(D) of 2.5+/-0.4 nM, B(max)=56.4+/-2.3 pmol mg(-1) of protein). Mibefradil (and a series of analogues) partially inhibited (+)-[(3)H]-isradipine binding to skeletal muscle membranes but stimulated binding to brain L-type Ca(2+) channels and alpha1C-subunits expressed in tsA201 cells indicating a tissue-specific, non-competitive interaction between the dihydropyridine and mibefradil binding domain. [(3)H]-Mibefradil also labelled a heterogenous population of high affinity sites in rabbit brain which was inhibited by a series of nonspecific Ca(2+) and Na(+)-channel blockers. Mibefradil and its analogue RO40-6040 had high affinity for neuronal voltage-gated Na(+)-channels as confirmed in binding (apparent K(i) values of 17 and 1.0 nM, respectively) and functional experiments (40% use-dependent inhibition of Na(+)-channel current by 1 microM mibefradil in GH3 cells). Our data demonstrate that mibefradil binds to voltage-gated L-type Ca(2+) channels with very high affinity and is also a potent blocker of voltage-gated neuronal Na(+)-channels. More lipophilic mibefradil analogues may possess neuroprotective properties like other nonselective Ca(2+)-/Na(+)-channel blockers.
Asunto(s)
Canales de Calcio Tipo L/efectos de los fármacos , Activación del Canal Iónico/efectos de los fármacos , Mibefradil/farmacología , Bloqueadores de los Canales de Sodio , Animales , Bloqueadores de los Canales de Calcio/farmacología , Estimulación Eléctrica , Electrofisiología , Cobayas , Técnicas In Vitro , Músculo Esquelético/efectos de los fármacos , Músculo Esquelético/metabolismo , Técnicas de Placa-Clamp , Conejos , Ensayo de Unión RadioliganteRESUMEN
The iminodihydroquinoline WIN 17317-3 was previously shown to inhibit selectively the voltage-gated potassium channels, K(v)1.3 and K(v)1.4 [Hill, R. J., et al. (1995) Mol. Pharmacol. 48, 98-104; Nguyen, A., et al. (1996) Mol. Pharmacol. 50, 1672-1679]. Since these channels are found in brain, radiolabeled WIN 17317-3 was synthesized to probe neuronal K(v)1 channels. In rat brain synaptic membranes, [(3)H]WIN 17317-3 binds reversibly and saturably to a single class of high-affinity sites (K(d) 2.2 +/- 0.3 nM; B(max) 5.4 +/- 0.2 pmol/mg of protein). However, the interaction of [(3)H]WIN 17317-3 with brain membranes is not sensitive to any of several well-characterized potassium channel ligands. Rather, binding is modulated by numerous structurally unrelated sodium channel effectors (e.g., channel toxins, local anesthetics, antiarrhythmics, and cardiotonics). The potency and rank order of effectiveness of these agents in affecting [(3)H]WIN 17317-3 binding is consistent with their known abilities to modify sodium channel activity. Autoradiograms of rat brain sections indicate that the distribution of [(3)H]WIN 17317-3 binding sites is in excellent agreement with that of sodium channels. Furthermore, WIN 17317-3 inhibits sodium currents in CHO cells stably transfected with the rat brain IIA sodium channel with high affinity (K(i) 9 nM), as well as agonist-stimulated (22)Na uptake in this cell line. WIN 17317-3 interacts similarly with skeletal muscle sodium channels but is a weaker inhibitor of the cardiac sodium channel. Together, these results demonstrate that WIN 17317-3 is a new, high-affinity, subtype-selective ligand for sodium channels and is a potent blocker of brain IIA sodium channels.