Endurance exercise training increases peripheral vascular response in human fingers.

The purpose of this study was to clarify whether peripheral vascular response to alteration of transmural pressure is changed by endurance exercise training. The healthy male subjects (training group; n = 6) performed endurance exercise training that consisted of cycle ergometer exercise 5 d.week-1 and 30 min.d-1 for a period of 8 weeks. Changes in the peripheral vascular response to alteration of transmural pressure in the human finger were measured by a differential digital photoplethysmogram (DeltaDPG) and blood pressure during passive movement of the arm to different vertical hand positions relative to heart level. Following 8 weeks of endurance training, percent changes in DeltaDPG from heart level in the training group increased significantly (mean +/- SD, -48.1 +/- 7. 3 to -58.7 +/- 9.3% at the lowered position, 46.1 +/- 13.4 to 84.6 +/- 8.8% at the elevated position, p<0.05). Similarly, the arterial compliance index, which was calculated from DeltaDPG-P wave amplitude and arterial pulse pressure, also significantly changed in the training group over the 8 weeks (5.6 +/- 1.3 to 2.7 +/- 1.6 mV. V-1.s-1.mmHg-1 at the lowered position, 30.0 +/- 12.4 to 54.4 +/- 18. 9 mV.V-1.s-1.mmHg-1 at the elevated position ). Maximal oxygen uptake (V.O2 max) was significantly increased in the training group. On the other hand, the control group (n = 6) showed no significant changes in all parameters for 8 weeks. Therefore these results suggest that endurance exercise training induces an increase in peripheral vascular response to alteration of transmural pressure in the human finger.

[Studies of psychiatric symptoms and personality traits in the 90+ years population].

Depressive symptoms and personality traits 90+ years population were examined. Data were obtained from 33 aged people (mean 93 +/- 3.2 years old; range 90-105 years old) using the Hamilton Rating Scale for depression and a questionnaire for the evaluation of type A personality trait (devised by Dr. Maeda). Scores of > 11 in the Hamilton Rating Scale for depression were considered indicative of depression. This score was found in 39% of cases. There are four types of depressive symptoms among the 90+ years population: sleep disturbance and somatic complain type; depressive mood type; hypochodrical type; reference of ideas and obsessive-compulsive type. The usual distributions of symptoms is 43, 29, 21 and 7% respectively. According to the questionnaire for type A personality trait among the 33 cases, there were more people with type A personality (n = 18; 56%) than there were those with type B (n = 15; 44%). Of the total number of cases studied, there was a tendency high scores to be achieved items characteristic of type A personality, such as a thorough native, self-confidence and precision. On the other hand, there are also tendencies for flexibilities and "going-my-way" traints in the 90+ year population. There is a significant correlation between scores in Hamilton Rating Scale for depression and scores in the type A personality questionnaire.

Somatosensory evoked potentials following voluntary movement during upper arm compression.

We examined the modulation of somatosensory evoked potentials (SEPs) during upper arm compression and following voluntary movement during upper arm compression. Most SEPs were significantly decreased, although some SEPs showed a slight, non-significant diminution. SEPs are mediated not only by myelinated fibers but also by mixed nerves and afferents from cutaneous, joints, and deep tissues, these being dependent upon the dorsal column-medical lemniscal system. Therefore, most of the diminution in SEPs found here may have been due to afferent occlusion from muscle, cutaneous, joints, and deep tissues, since normal SEPs are selectively modulated, corresponding to motor or mental tasks, regardless of whether gating is centrifugal or centripetal. In addition, the present experiments showed that all the SEPs at FZ, C3' and CZ were significantly decreased following voluntary movement at a pressure 25%-30% higher than the subject's systolic blood pressure. Comparing SEPs during upper arm compression and those following voluntary movement during upper arm compression at these pressures, we found that the SEPs at C3' were significantly diminished following voluntary movement during upper arm compression, with other SEPs showing slight, non-significant attenuation. In conclusion, it is possible that the diminution in SEPs following voluntary movement could be responsible for sensory inputs, however, when sensory inputs are present, centrifugal modulation would also be responsible for this diminution.

Analysis of microvascular responses in the finger to changes in arm position during cold water stimulation.

We evaluated the extent to which the myogenic autoregulatory response was affected by sympathetic vasoconstriction in humans. The stimulus used to produce sympathetic vasoconstriction was the cold water immersion of a contralateral finger. The stimulus used to elicit myogenic response was gravitational potential energy change (GPEC), that is, arm position change, i.e., the raising and lowering of the upper extremity 40 cm above and below the heart level. The response was observed in terms of the changes in amplitude on a differential digital photoplethysmogram (delta DPG) during this maneuver with and without cold stimulation. The subjects were seven healthy males. During non-immersion, the delta DPG amplitude increased to 55.7 +/- 7.6% (SE) at the elevated position and decreased to -56.3 +/- 4.0% at the lowered position. Mean finger arterial blood pressure (MBP) decreased by 34.0 +/- 1.8% at the elevated position and increased by 39.9 +/- 3.3% at the lowered position. During immersion, the delta DPG amplitude was significantly (p < 0.05) decreased by 25-40, 33-57, and 33-38% at the heart, elevated, and lowered position, respectively. MBP increased by 5-9%, but heart rate was unchanged throughout immersion. These results indicate that the myogenic response of arterioles is not entirely abolished by the present sympathetic vasoconstrictor effect. Thus interactions between these two effects may maintain both systemic and local circulatory homeostasis.

Effects of dilevalol in hypertension assessed by digital pulse plethysmography.

For two weeks, with the exception of one case involving long-term therapy, 15 hypertensive patients received 100 mg of dilevalol once daily and seven patients received 50 mg. Blood pressure and heart rate were measured and digital pulse plethysmography (DPG) was performed before and after the two-week trial. Systolic and diastolic blood pressure decreased significantly during treatment; heart rate did not change. There were also significant changes on the three DPG measures of vasodilatation: peak amplitude increased, the dicrotic index decreased, and peak amplitude on the differentiated DPG increased. A weak correlation was found between the changes in systolic blood pressure and changes in the two measures of DPG peak amplitude. It is concluded that dilevalol is effective in the treatment of hypertension and that DPG is a sensitive noninvasive method to measure vasodilatation.

[A case of delayed radiation lumbo-sacral plexopathy].

We report a 47-year-old woman who developed a slowly progressive lumbosacral plexopathy with mixed sensorimotor losses in the lower extremities. The symptoms were apparent 8 years after x-ray irradiation for an ovarian carcinoma. Neurological examination showed mild weakness and absent deep tendon reflexes of bilateral lower extremities, and hypesthesia to all modalities in anterior aspects of bilateral lower thighs, in dorsum pedis and soles. Extensive investigations regarding the possibility of tumor recurrence were negative. Computed tomography of pelvis showed abnormal soft tissue densities around the lumbosacral plexus. Intravenous pyelography showed bilateral hydronephrosis and narrowed ureters at the first sacral vertebra level. These findings are consistent with radiation-induced fibrosis rather than tumor infiltration. The results suggest the entrapment lumbosacral plexopathy due to surrounding fibrosis after irradiation. We speculated the sensorimotor losses caused by entrapment of the lumbosacral plexus.

The functional characteristics of tendon blood circulation in the rabbit hindlimbs.

Neurohormonal, mechanical, and muscle exercise effects on tendon blood flow were studied in thirty-five rabbits. After anesthesia by urethane, experiments were performed on in situ preparation of the hindlimb under stable state in systemic blood pressure. Tendon and muscle blood flow were measured simultaneously by the hydrogen gas clearance method, and their temperature and PO2 were continuously observed by thermocouple and oxygen sensor, respectively. The resting blood flow in the denervated tendon tibialis anterior, gastrocnemius, and soleus (ml/(100 g.min] was 39.0 +/- 4.0, 34.5 +/- 8.2, and 30.2 +/- 4.3, respectively, whereas in their muscles it was 17.8 +/- 1.5, 17.1 +/- 2.1, and 12.6 +/- 1.1, respectively. The tendon tissue temperature and PO2 increased gradually until 15-20 min after cutting the sciatic nerve, and the increasing rate depended upon the initial control level before denervation. Intravenous injection of noradrenaline in the dose of 1-9.9 micrograms/kg produced a marked decrease in the tendon tissue temperature of the tibialis anterior, but a mild one in the muscle. The longitudinal tension force produced a decrease in the tendon tissue temperature of the tibialis anterior, but no change in the muscle. During muscle exercise, tendon blood flow and temperature tended to decrease, whereas the muscle blood flow and temperature increased markedly from the beginning of muscle exercise. There was no evidence to demonstrate the existence of exercise hyperemia in the tendon tissue. These data suggest that tendon blood circulation can be modified by many factors, and that mechanical and exercise effects may play a role in regulation of tendon blood flow channels and fluid transfer for the lubrication of tendon fiber movements.

Noonan's syndrome with syringomyelia.

A case of Noonan's syndrome with cervical syringomyelia is presented here representing the second reported instance of such association. A CT of metrizamide myelography revealed a high density in the middle subintradural space in the cervical region below C2. Sensory dissociation was minimal and localized in the left C4. It could not be determined whether this association between syringomyelia and Noonan's syndrome is related or represents a chance.