Comparison of continuous and intermittent vibration effects on rat-tail artery and nerve

Serum levels of biomarkers related to severity staging of Raynaud's phenomenon, neurosensory manifestations, and vibration exposure in patients with hand-arm vibration injury

Our aim was to explore possible relationships between serum levels of biomarkers in patients with hand-arm vibration injury in relation to the severity of the vascular, i.e., Raynaud's phenomenon (RP), and neurosensory manifestations, the current exposure level, and the duration of exposure. This study was of case series design and involved 92 patients diagnosed with hand-arm vibration injury. Jonckheere's trend test was used to assess any association between serum levels of biomarkers and RP as well as neurosensory manifestations, graded by the International Consensus Criteria. Generalized linear models with adjustment for possible confounders were also used for associations between serum levels of biomarkers and; (1) severity of RP recorded as the extent of finger blanching calculated with Griffin score, (2) vibration perception thresholds, (3) magnitude of current exposure as [A(8); (m/s2)] value, and (4) the duration of exposure in years. Serum levels of thrombomodulin, von Willebrand factor, calcitonin gene related peptide (CGRP), heat shock protein 27, and caspase-3 were positively associated with severity of RP. Serum levels of CGRP were positively associated with the neurosensory component. No associations with exposure were shown for these biomarkers. For Intercellular adhesion molecule 1 and monocyte chemoattractant protein 1, no associations were found with neither severity nor exposure. Levels of serum biomarkers associated with endothelial injury or dysfunction, inflammation, vasodilation, neuroprotection, and apoptosis were positively associated with the severity of hand-arm vibration injury.

Serum biomarkers in patients with hand-arm vibration injury and in controls

Hand-arm vibration injury is a well-known occupational disorder that affects many workers globally. The diagnosis is based mainly on quantitative psychophysical tests and medical history. Typical manifestations of hand-arm vibration injury entail episodes of finger blanching, Raynaud's phenomenon (RP) and sensorineural symptoms from affected nerve fibres and mechanoreceptors in the skin. Differences in serum levels of 17 different biomarkers between 92 patients with hand-arm vibration injury and 51 controls were analysed. Patients with hand-arm vibration injury entailing RP and sensorineural manifestations showed elevated levels of biomarkers associated with endothelial injury or dysfunction, inflammation, vaso- or neuroprotective compensatory, or apoptotic mechanisms: intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein-1 (MCP-1); thrombomodulin (TM), heat shock protein 27 (HSP27); von Willebrand factor, calcitonin gene-related peptide (CGRP) and caspase-3. This study adds important knowledge on pathophysiological mechanisms that can contribute to the implementation of a more objective method for diagnosis of hand-arm vibration injury.

Problems related to measuring the transmissibility of anti-vibration gloves. Possible efficacy for impact tools used in mining and quarrying activities

AbstractThis commentary takes into account some of the most relevant studies investigating the transmissibility of anti-vibration (AV) gloves. AV gloves are almost useless at the palm level in the low frequencies (less than 31.5 Hz), while they generally start to have an appreciable reduction of the vibration over 400 Hz. In their use with impact tools, having a low dominant vibration frequency usually between 25-60 Hz for chipping hammers and drills, and less than 30 Hz for pneumatic breakers, the average transmissibility reduction at the palm level is 13% (min 2% - max 26%) when used with hammers, and 1% (increment of 4% and reduction of 6%) when used with breakers. The transmissibility at the finger level, especially in the low frequencies, is almost nothing or produces an increase of the vibration. Other problems related to the increase of the applied force and the reduction of dexterity are reported.

Local vibration induced vascular pathological structural changes and abnormal levels of vascular damage indicators

BACKGROUND

The vascular component of the hand-arm-vibration syndrome (HAVS) is often characterized by vibration-induced white fingers (VWF). Active substances secreted by the vascular endothelial cells (VEC) maintain a dynamic balance but damage to the blood vessels may occur when the equilibrium is altered, thus forming an important pathological basis for VWF. This study was aimed at investigating vascular damage indicators as a basis for an early detection of disorders caused by vibration, using the rat tail model.

METHODS AND RESULTS

Experiments were conducted using a control group of rats not exposed to vibration while two exposed groups having different exposure durations of 7 and 14 days were randomly formed. Following exposure, the structural changes of tail tissue samples in anesthetized rats were observed. Enzyme-linked immunosorbent assay (ELISA) was used for analyzing four vascular damage indicators myosin regulatory light chain (MLC2), endothelin-1 (ET-1), vinculin (VCL) and 5-hydroxytryptamine (5-HT) in tail blood samples. We found that both vascular smooth muscle and endothelial cells displayed changes in morphology characterized by vacuolization and swelling in the vibration-exposed group. The levels of vascular damage indicators were altered under the vibration.

CONCLUSION

The degree of vascular pathology increased with the longer duration exposure. Furthermore, the levels of MLC2, ET-1 and 5-HT in rat plasma were associated with vascular injury caused by local vibration.

Vibration Exposure Safety Guidelines for Surgeons Using Power-Assisted Liposuction (PAL)

BACKGROUND

As power-assisted liposuction (PAL) gains in popularity, plastic surgeons operating these devices experience occupational exposure to hand-transmitted vibration, which can result in hand-arm vibration syndrome, a debilitating neurovasculopathy.

OBJECTIVES

The objective of the study was to determine vibration exposure from the utilization of a PAL device during surgery to generate recommendations for safe use.

METHODS

Vibration emission of a commonly utilized PAL system (MicroAire-650, Surgical Instruments, Charlottesville, VA) was examined employing a vibration data logger under both controlled laboratory conditions and during 13 typical liposuction cases. Data were analyzed and compared with established safety limits of vibration exposure.

RESULTS

The experiments demonstrated a mean vibration magnitude of typical liposuction surgeries to be 5.69 ± 0.77 m/s2 (range, 4.59-6.27 m/s2), which is significantly higher than the manufacturer declared value of 3.77 m/s2. Cannula size was shown to be the most significant contributor to vibration magnitude, with larger cannulas causing more vibration transmission.

CONCLUSIONS

These results indicate that recommendations must be made to prevent undue occupational exposure to vibration from PAL. The MicroAire-650 can generally be safely utilized for less than 1.5 h/d. At exposure levels >1.5 h/d, there is increased risk of developing vibration-related injuries, and vibration-reducing strategies should be implemented. At exposure levels >6 h/d, the safety limit is exceeded and there is significantly increased risk of developing hand-arm vibration syndrome and vibration exposure should be halted.

LEVEL OF EVIDENCE: 4

Can Blood Flow be Used to Monitor Changes in Peripheral Vascular Function That Occur in Response to Segmental Vibration Exposure?

OBJECTIVES

Laser Doppler blood flow measurements have been used for diagnosis or detection of peripheral vascular dysfunction. This study used a rat tail model of vibration-induced vascular injury to determine how laser Doppler measurements were affected by acute and repeated exposures to vibration, and to identify changes in the Doppler signal that were associated with the exposure.

METHODS

Blood flow was measured immediately after a single exposure to vibration, or before vibration exposure on days 1, 5, 10, 15, and 20 of a 20 days exposure.

RESULTS

After a single exposure to vibration, average tail blood flow was reduced. With 20 days of exposure, there was a reduction in the amplitude of the arterial pulse on days 10 to 20 in vibrated rats and days 15 to 20 in control rats.

CONCLUSIONS

More detailed statistical analyses of laser Doppler data may be needed to identify early changes in peripheral circulation after exposure to vibration.

Effects of Local Vibration With Different Intermittent Durations on Skin Blood Flow Responses in Diabetic People

Objective: Poor blood flow supply is an important pathological factor that leads to the development and deterioration of diabetic foot ulcers. This study aims to investigate the acute effects of local vibration with varying intermittent durations on the plantar skin blood flow (SBF) response in diabetic and healthy subjects.

Methods: Eleven diabetic patients (7 males, 4 females) and 15 healthy adults (6 males, 9 females) participated in this experiment and accepted three tests. Local continuous vibration (LCV) and two levels of local intermittent vibration (LIV1 and LIV2) were randomly applied to the middle metatarsal head of each subject's right foot in each test. The SBF was measured prior to intervention (Baseline), during Vibration and during the Recovery Stage for each test. The mean SBF in each stage, the change percentages and change rates of SBF in Vibration and Recovery stage among three tests were compared and analyzed for both diabetic and healthy subjects.

Results: For diabetic subjects, the SBF was significantly increased in both Vibration and Recovery Stage with local intermittent vibrations (LIV1 and LIV2), but not with LCV. However, there was no significant difference in change percentage and change rate of SBF in diabetic subjects across the three tests. For healthy subjects, all vibration interventions significantly increased the SBF in the Vibration Stage and in the first 1.5 min of the Recovery Stage. Also, the change rate of SBF during the Vibration stage in LIV1 test was significantly greater than that in LIV2 test for healthy subjects. Moreover, change percentage of SBF in Vibration stage of LIV1 test and in some periods of Recovery stages of LIV1 and LIV2 tests for diabetic subjects were lower than for healthy subjects; the absolute change rate of SBF in LIV1 test for diabetic subjects was also lower than for healthy subjects.

Conclusion: These findings suggest that both LIV1 and LIV2 may effectively improve SBF in the feet of diabetic people, but LCV may not achieve the same level of vasodilatation. The diabetic subjects were also found to have a lower SBF response to applied vibration than the healthy subjects.

Acute Vibration Induces Peripheral Nerve Sensitization in a Rat Tail Model: Possible Role of Oxidative Stress and Inflammation

Prolonged occupational exposure to hand-held vibrating tools leads to pain and reductions in tactile sensitivity, grip strength and manual dexterity. The goal of the current study was to use a rat-tail vibration model to determine how vibration frequency influences factors related to nerve injury and dysfunction. Rats were exposed to restraint, or restraint plus tail vibration at 62.5 Hz or 250 Hz. Nerve function was assessed using the current perception threshold (CPT) test. Exposure to vibration at 62.5 and 250 Hz, resulted in a reduction in the CPT at 2000 and 250-Hz electrical stimulation (i.e. increased Aβ and Aδ, nerve fiber sensitivity). Vibration exposure at 250 Hz also resulted in an increased sensitivity of C-fibers to electrical stimulation and thermal nociception. These changes in nerve fiber sensitivity were associated with increased expression of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in ventral tail nerves, and increases in circulating concentrations of IL-1 β in rats exposed to 250-Hz vibration. There was an increase in glutathione, but no changes in other measures of oxidative activity in the peripheral nerve. However, measures of oxidative stress were increased in the dorsal root ganglia (DRG). These changes in pro-inflammatory factors and markers of oxidative stress in the peripheral nerve and DRG were associated with inflammation, and reductions in myelin basic protein and post-synaptic density protein (PSD)-95 gene expression, suggesting that vibration-induced changes in sensory function may be the result of changes at the exposed nerve, the DRG and/or the spinal cord.

Systemic Effects of Segmental Vibration in an Animal Model of Hand-Arm Vibration Syndrome

OBJECTIVE

Epidemiology suggests that occupational exposure to hand-transmitted (segmental) vibration has local and systemic effects. This study used an animal model of segmental vibration to characterize the systemic effects of vibration.

METHODS

Male Sprague Dawley rats were exposed to tail vibration for 10 days. Genes indicative of inflammation, oxidative stress, and cell cycle, along were measured in the heart, kidney, prostate, and liver.

RESULTS

Vibration increased oxidative stress and pro-inflammatory gene expression, and decreased anti-oxidant enzymes in heart tissue. In the prostate and liver, vibration resulted in changes in the expression of pro-inflammatory factors and genes involved in cell cycle regulation.

CONCLUSIONS

These changes are consistent with epidemiological studies suggesting that segmental vibration has systemic effects. These effects may be mediated by changes in autonomic nervous system function, and/or inflammation and oxidative stress.

Health effects associated with occupational exposure to hand-arm or whole body vibration

Workers in a number of different occupational sectors are exposed to workplace vibration on a daily basis. This exposure may arise through the use of powered-hand tools or hand-transmitted vibration (HTV). Workers might also be exposed to whole body vibration (WBV) by driving delivery vehicles, earth moving equipment, or through use of tools that generate vibration at low dominant frequencies and high amplitudes, such as jackhammers. Occupational exposure to vibration has been associated with an increased risk of musculoskeletal pain in the back, neck, hands, shoulders, and hips. Occupational exposure may also contribute to the development of peripheral and cardiovascular disorders and gastrointestinal problems. In addition, there are more recent data suggesting that occupational exposure to vibration may enhance the risk of developing certain cancers. The aim of this review is to provide an assessment of the occupations where exposure to vibration is most prevalent, and a description of the adverse health effects associated with occupational exposure to vibration. This review will examine (1) various experimental methods used to measure and describe the characteristics of vibration generated by various tools and vehicles, (2) the etiology of vibration-induced disorders, and (3) how these data were employed to assess and improve intervention strategies and equipment that reduces the transmission of vibration to the body. Finally, there is a discussion of the research gaps that need to be investigated to further reduction in the incidence of vibration-induced illnesses and injuries.

Contact area affects frequency-dependent responses to vibration in the peripheral vascular and sensorineural systems

Repetitive exposure to hand-transmitted vibration is associated with development of peripheral vascular and sensorineural dysfunctions. These disorders and symptoms associated with it are referred to as hand-arm vibration syndrome (HAVS). Although the symptoms of the disorder have been well characterized, the etiology and contribution of various exposure factors to development of the dysfunctions are not well understood. Previous studies performed using a rat-tail model of vibration demonstrated that vascular and peripheral nervous system adverse effects of vibration are frequency-dependent, with vibration frequencies at or near the resonant frequency producing the most severe injury. However, in these investigations, the amplitude of the exposed tissue was greater than amplitude typically noted in human fingers. To determine how contact with vibrating source and amplitude of the biodynamic response of the tissue affects the risk of injury occurring, this study compared the influence of frequency using different levels of restraint to assess how maintaining contact of the tail with vibrating source affects the transmission of vibration. Data demonstrated that for the most part, increasing the contact of the tail with the platform by restraining it with additional straps resulted in an enhancement in transmission of vibration signal and elevation in factors associated with vascular and peripheral nerve injury. In addition, there were also frequency-dependent effects, with exposure at 250 Hz generating greater effects than vibration at 62.5 Hz. These observations are consistent with studies in humans demonstrating that greater contact and exposure to frequencies near the resonant frequency pose the highest risk for generating peripheral vascular and sensorineural dysfunction.

A two scale modeling and computational framework for vibration-induced Raynaud syndrome

Hand-Arm Vibration syndrome (HAVS), usually caused by long-term use of hand-held power tools, can in certain manifestations alter the peripheral blood circulation in the hand-arm region. HAVS typically occurs after exposure to cold, causing an abnormally strong vasoconstriction of blood vessels. A pathoanatomical mechanism suggests that a reduction of the lumen of the blood vessels in VWF (Vibration White Finger) subjects, due to either hypertrophy or thickening of the vessel wall, may be at the origin of the disease. However, the direct and indirect effects of the load of the hand-held tools on the structure of blood vessels remain controversial:.one hypothesis is the mechanical action of vibration on the local acral dysregulation and/or on the vessel histomorphological modifications. Another hypothesis is the participation of the sympathetic nervous system to this dysregulation. In this paper, we assume the modifications as mechanobiological growth and the load-effect relationship may be interpreted as directly or indirectly induced. This work is the first attempt to model the effect of vibration through soft tissues onto the distal capillaries, addressing the double paradigm of multi space-time scales, i.e. low period vibration versus high time constant of the growth phenomenon as well as vibrations propagating in the macroscopic tissue including the microscopic capillary structures subjected to a pathological microstructural evolution. The objective is to lay down the theoretical basis of growth modeling for the small distal artery, with the ability to predict the geometrical and structural changes of the arterial walls caused by vibration exposure. We adopt the key idea of splitting the problem into one global vibration problem at the macroscopic scale and one local growth problem at the micro level. The macroscopic hyperelastic viscous dynamic model of the fingertip cross-section is validated by fitting experimental data. It is then used in steady-state vibration conditions to predict the mechanical fields in the close vicinity of capillaries. The space scale transfer from macroscopic to microscopic levels is ensured by considering a representative volume element (RVE) embedding a single capillary in its center. The vibrations emitted by the hand held power tool are next linked to the capillary growth through the adopted biomechanical growth model at the capillary level. The obtained results show that vibrations induce an increase of the thickness of the capillary's wall, thereby confirming the scenario of vibrations induced reduction of the lumen of blood vessels.

Long-term daily vibration exposure alters current perception threshold (CPT) sensitivity and myelinated axons in a rat-tail model of vibration-induced injury

Repeated exposure to hand-transmitted vibration through the use of powered hand tools may result in pain and progressive reductions in tactile sensitivity. The goal of the present study was to use an established animal model of vibration-induced injury to characterize changes in sensory nerve function and cellular mechanisms associated with these alterations. Sensory nerve function was assessed weekly using the current perception threshold test and tail-flick analgesia test in male Sprague-Dawley rats exposed to 28 d of tail vibration. After 28 d of exposure, Aβ fiber sensitivity was reduced. This reduction in sensitivity was partly attributed to structural disruption of myelin. In addition, the decrease in sensitivity was also associated with a reduction in myelin basic protein and 2',3'- cyclic nucleotide phosphodiasterase (CNPase) staining in tail nerves, and an increase in circulating calcitonin gene-related peptide (CGRP) concentrations. Changes in Aβ fiber sensitivity and CGRP concentrations may serve as early markers of vibration-induced injury in peripheral nerves. It is conceivable that these markers may be utilized to monitor sensorineural alterations in workers exposed to vibration to potentially prevent additional injury.

Regulation of mechanosensation in C. elegans through ubiquitination of the MEC-4 mechanotransduction channel

In Caenorhabditis elegans, gentle touch is sensed by the anterior (ALM and AVM) and posterior (PLM) touch receptor neurons. Anterior, but not posterior, touch is affected by several stress conditions via the action of AKT kinases and the DAF-16/FOXO transcription factor. Here we show that a ubiquitination-dependent mechanism mediates such effects. AKT-1/AKT kinase and DAF-16 alter the transcription of mfb-1, which encodes an E3 ubiquitin ligase needed for the ubiquitination of the mechanosensory channel subunit MEC-4. Ubiquitination of MEC-4 reduces the amount of MEC-4 protein in the processes of ALM neurons and, consequently, the mechanoreceptor current. Even under nonstress conditions, differences in the amount of MFB-1 appear to cause the PLM neurons to be less sensitive to touch than the ALM neurons. These studies demonstrate that modulation of surface mechanoreceptors can regulate the sensitivity to mechanical signals.

Modulation of C. elegans touch sensitivity is integrated at multiple levels

Sensory systems can adapt to different environmental signals. Here we identify four conditions that modulate anterior touch sensitivity in Caenorhabditis elegans after several hours and demonstrate that such sensory modulation is integrated at multiple levels to produce a single output. Prolonged vibration involving integrin signaling directly sensitizes the touch receptor neurons (TRNs). In contrast, hypoxia, the dauer state, and high salt reduce touch sensitivity by preventing the release of long-range neuroregulators, including two insulin-like proteins. Integration of these latter inputs occurs at upstream neurohormonal cells and at the insulin signaling cascade within the TRNs. These signals and those from integrin signaling converge to modulate touch sensitivity by regulating AKT kinases and DAF-16/FOXO. Thus, activation of either the integrin or insulin pathways can compensate for defects in the other pathway. This modulatory system integrates conflicting signals from different modalities, and adapts touch sensitivity to both mechanical and non-mechanical conditions.

Recovery of vascular function after exposure to a single bout of segmental vibration

Work rotation schedules may be used to reduce the negative effects of vibration on vascular function. This study determined how long it takes vascular function to recover after a single exposure to vibration in rats (125 Hz, acceleration 5 g). The responsiveness of rat-tail arteries to the vasoconstricting factor UK14304, an α2C-adrenoreceptor agonist, and the vasodilating factor acetylcholine (ACh) were measured ex vivo 1, 2, 7, or 9 d after exposure to a single bout of vibration. Vasoconstriction induced by UK14304 returned to control levels after 1 d of recovery. However, re-dilation induced by ACh did not return to baseline until after 9 d of recovery. Exposure to vibration exerted prolonged effects on peripheral vascular function, and altered vascular responses to a subsequent exposure. To optimize the positive results of work rotation schedules, it is suggested that studies assessing recovery of vascular function after exposure to a single bout of vibration be performed in humans.

Dependence of vascular damage on higher frequency components in the rat-tail model

Hand-Arm Vibration Syndrome (HAVS) is caused by hand-transmitted vibration in industrial workers. Current ISO guidelines (ISO 5349) might underestimate vascular injury associated with range of vibration frequencies near resonance. A rat-tail model was used to investigate the effects of higher frequencies >100 Hz on early vascular damage. 13 Male Sprague-Dawley rats (250 ± 15 gm) were used. Rat-tails were vibrated at 125 Hz and 250 Hz (49 m/s(2)) for 1D, 5D and 10D; D=days (4 h/day). Structural damage of the ventral artery was quantified by vacuole count using Toluidine blue staining whereas biochemical changes were assessed by nitrotyrosine (NT) staining. The results were analyzed using one-way repeated measures mixed-model ANOVA at p<0.05 level of significance. The structural damage increased at 125 Hz causing significant number of vacuoles (40.62 ± 9.8) compared to control group (8.36 ± 2.49) and reduced at 250 Hz (12.33 ± 2.98) compared to control group (8.36 ± 2.49). However, the biochemical alterations (NT-signal) increased significantly for 125 Hz (143.35 ± 5.8 gray scale value, GSV) and for 250 Hz (155.8 ± 7.35 GSV) compared to the control group (101.7 ± 4.18 GSV). Our results demonstrate that vascular damage in the form of structural and bio chemical disruption is significant at 125 Hz and 250 Hz. Hence the current ISO guidelines might underestimate vascular damage at frequencies>100 Hz.

Frequency-dependent effects of vibration on physiological systems: experiments with animals and other human surrogates

Occupational exposure to vibration through the use of power- and pneumatic hand-tools results in cold-induced vasospasms, finger blanching, and alterations in sensorineural function. Collectively, these symptoms are referred to as hand-arm vibration syndrome (HAVS). Currently the International Standards Organization (ISO) standard ISO 5349-1 contains a frequency-weighting curve to help workers and employers predict the risk of developing HAVS with exposure to vibration of different frequencies. However, recent epidemiological and experimental evidence suggests that this curve under-represents the risk of injuries to the hands and fingers induced by exposure to vibration at higher frequencies (>100 Hz). To improve the curve, better exposure-response data need to be collected. The goal of this review is to summarize the results of animal and computational modeling studies that have examined the frequency-dependent effects of vibration, and discuss where additional research would be beneficial to fill these research gaps.

Vibration from a riveting hammer causes severe nerve damage in the rat tail model

INTRODUCTION

Hand-arm vibration syndrome (HAVS) is an occupational neurodegenerative and vasospastic disorder in workers who use powered hand tools. Frequency weighting (ISO 5349) predicts little risk of injury for frequencies >500 HZ. Potentially damaging high frequencies abound in impact tool-generated shock waves.

METHODS

A rat tail impact vibration model was developed to deliver shock-wave vibration from a riveting hammer to simulate bucking bar exposure. Rat tails were vibrated continuously for 12 min. Tail flick withdrawal times were determined for noxious heat. Nerve trunks and skin were processed for light and electron microscopy.

RESULTS

Immediately after vibration, the tails were hyperalgesic and had disrupted myelinated axons, fragmented nerve endings, and mast-cell degranulation. By 4 days, the tails were hypoalgesic; nerve endings were lost in the skin.

CONCLUSIONS

Shock-wave vibration causes severe nerve damage. Frequency weighting seriously underestimates the risk of nerve injury with impact tools.

Patterns in pharyngeal airflow associated with sleep-disordered breathing

OBJECTIVE

To establish the feasibility of a noninvasive method to identify pharyngeal airflow characteristics in sleep-disordered breathing.

METHODS

Four patients with sleep-disordered breathing who underwent surgery or used positive airway pressure devices and four normal healthy controls were studied. Three-dimensional CT imaging and computational fluid dynamics modeling with standard steady-state numerical formulation were used to characterize pharyngeal airflow behavior in normals and pre-and post-treatment in patients. Dynamic flow simulations using an unsteady approach were performed in one patient.

RESULTS

The pre-treatment pharyngeal airway below the minimum cross-sectional area obstruction site showed airflow separation. This generated recirculation airflow regions and enhanced turbulence zones where vortices developed. This interaction induced large fluctuations in airflow variables and increased aerodynamic forces acting on the pharyngeal wall. At post-treatment, for the same volumetric flow rate, airflow field instabilities vanished and airflow characteristics improved. Mean maximum airflow velocity during inspiration reduced from 18.3±5.7 m/s pre-treatment to 6.3±4.5 m/s post-treatment (P=0.002), leading to a reduction in maximum wall shear stress from 4.8±1.7 Pa pre-treatment to 0.9±1.0 Pa post-treatment (P=0.01). The airway resistance improved from 4.3±1.4 Pa/L/min at pre-treatment to 0.7±0.7 Pa/L/min at post-treatment (P=0.004). Post-treatment airflow characteristics were not different from normal controls (all P ≥ 0.39).

CONCLUSION

This study demonstrates that pharyngeal airflow variables may be derived from CT imaging and computational fluid dynamics modeling, resulting in high quality visualizations of airflow characteristics of axial velocity, static pressure, and wall shear stress in sleep-disordered breathing.

The preventive effects of apolipoprotein mimetic D-4F from vibration injury-experiment in rats

Hand-arm vibration syndrome (HAVS) is a debilitating sequela of neurological and vascular injuries caused by prolonged occupational exposure to hand-transmitted vibration. Our previous study demonstrated that short-term exposure to vibration can induce vasoconstriction and endothelial cell damage in the ventral artery of the rat's tail. The present study investigated whether pretreatment with D-4F, an apolipoprotein A-1 mimetic with known anti-oxidant and vasodilatory properties, prevents vibration-induced vasoconstriction, endothelial cell injury, and protein nitration. Rats were injected intraperitoneally with 3 mg/kg D-4F at 1 h before vibration of the tails for 4 h/day at 60 Hz, 49 m/s(2) r.m.s. acceleration for either 1 or 3 days. Vibration-induced endothelial cell damage was examined by light microscopy and nitrotyrosine immunoreactivity (a marker for free radical production). One and 3-day vibration produced vasoconstriction and increased nitrotyrosine. Preemptive treatment with D-4F prevented these negative changes. These findings suggest that D-4F may be useful in the prevention of HAVS.

Neuropathic pain-like alterations in muscle nociceptor function associated with vibration-induced muscle pain

We recently developed a rodent model of the painful muscle disorders induced by occupational exposure to vibration. In the present study we used this model to evaluate the function of sensory neurons innervating the vibration-exposed gastrocnemius muscle. Activity of 74 vibration-exposed and 40 control nociceptors, with mechanical receptive fields in the gastrocnemius muscle, were recorded. In vibration-exposed rats ∼15% of nociceptors demonstrated an intense and long-lasting barrage of action potentials in response to sustained suprathreshold mechanical stimulation (average of 2635 action potentials with frequency of ∼44Hz during a 1min suprathreshold stimulus) much greater than that has been reported to be produced even by potent inflammatory mediators. While these high-firing nociceptors had lower mechanical thresholds than the remaining nociceptors, exposure to vibration had no effect on conduction velocity and did not induce spontaneous activity. Hyperactivity was not observed in any of 19 neurons from vibration-exposed rats pretreated with intrathecal antisense for the IL-6 receptor subunit gp130. Since vibration can injure peripheral nerves and IL-6 has been implicated in painful peripheral neuropathies, we suggest that the dramatic change in sensory neuron function and development of muscles pain, induced by exposure to vibration, reflects a neuropathic muscle pain syndrome.

Vibration disrupts vascular function in a model of metabolic syndrome

Vibration-induced white finger (VWF) is a disorder seen in workers exposed to hand-transmitted vibration, and is characterized by cold-induced vasospasms and finger blanching. Because overweight people with metabolic syndrome are pre-disposed to developing peripheral vascular disorders, it has been suggested that they also may be at greater risk of developing VWF if exposed to occupational vibration. We used an animal model of metabolic syndrome, the obese Zucker rat, to determine if metabolic syndrome alters vascular responses to vibration. Tails of lean and obese Zucker rats were exposed to vibration (125 Hz, 49 m/s(2) r.m.s.) or control conditions for 4 h/d for 10 d. Ventral tail arteries were collected and assessed for changes in gene expression, levels of reactive oxygen species (ROS) and for responsiveness to vasomodulating factors. Vibration exposure generally reduced the sensitivity of arteries to acetylcholine (ACh)-induced vasodilation. This decrease in sensitivity was most apparent in obese rats. Vibration also induced reductions in vascular nitric oxide concentrations and increases in vascular concentrations of ROS in obese rats. These results indicate that vibration interferes with endothelial-mediated vasodilation, and that metabolic syndrome exacerbates these effects. These findings are consistent with idea that workers with metabolic syndrome have an increased risk of developing VWF.

Effects of whole body vibration on the skeleton and other organ systems in man and animal models: what we know and what we need to know

Previous investigations reported enhanced osseous parameters subsequent to administration of whole body vibration (WBV). While the efficacy of WBV continues to be explored, scientific inquiries should consider several key factors. Bone remodeling patterns differ according to age and hormonal status. Therefore, WBV protocols should be designed specifically for the subject population investigated. Further, administration of WBV to individuals at greatest risk for osteoporosis may elicit secondary physiological benefits (e.g., improved balance and mobility). Secondly, there is a paucity of data in the literature regarding the physiological modulation of WBV on other organ systems and tissues. Vibration-induced modulation of systemic hormones may provide a mechanism by which skeletal tissue is enhanced. Lastly, the most appropriate frequencies, durations, and amplitudes of vibration necessary for a beneficial response are unknown, and the type of vibratory signal (e.g., sinusoidal) is often not reported. This review summarizes the physiological responses of several organ systems in an attempt to link the global influence of WBV. Further, we report findings focused on subject populations that may benefit most from such a therapy (i.e., the elderly, postmenopausal women, etc.) in hopes of eliciting multidisciplinary scientific inquiries into this potentially therapeutic aid which presumably has global ramifications.

Vibration causes acute vascular injury in a two-step process: vasoconstriction and vacuole disruption

Hand-arm vibration syndrome is a vasospastic and neurodegenerative occupational disease. In the current study, the mechanism of vibration-induced vascular smooth muscle cell (SMC) injury was examined in a rat-tail vibration model. Tails of male Sprague Dawley rats were vibrated continuously for 4 hr at 60 Hz, 49 m/s(2) with or without general anesthesia. Ventral tail arteries were aldehyde fixed and embedded in epoxy resin to enable morphological analysis. Vibration without anesthesia caused vasoconstriction and vacuoles in the SMC. Anesthetizing rats during vibration prevented vasoconstriction and vacuole formation. Exposing tail arteries in situ to 1 mM norepinephrine (NE) for 15 min induced the greatest vasoconstriction and vacuolation. NE induced vacuoles were twice as large as those formed during vibration. When vibrated 4 hr under anesthesia after pretreatment with NE for 15 min, the SMC lacked vacuoles and exhibited a longitudinal banding pattern of dark and light staining. The extracellular matrix was filled with particulates, which were confirmed by electron microscopy to be cellular debris. The present findings demonstrate that vibration-induced vasoconstriction (SMC contraction) requires functioning central nervous system reflexes, and the physical stress of vibration damages the contracted SMC by dislodging and fragmenting SMC vacuoles.

Acute vibration reduces Aβ nerve fiber sensitivity and alters gene expression in the ventral tail nerves of rats

Long-term occupational exposure to hand-arm vibration can result in a permanent reduction in tactile sensitivity in exposed fingers and hands. Little is known about how vibration causes this reduction in sensitivity, and currently no testing procedures have been developed to monitor changes in sensory perception during ongoing exposures. We used a rat-tail model of hand-arm vibration syndrome (HAVS) to determine whether changes in sensory nerve function could be detected after acute exposure to vibration. Nerve function was assessed using the current perception threshold (CPT) method. We also determined whether changes in nerve function were associated with changes in gene transcription. Our results demonstrate that the CPT method can be used to assess sensory nerve function repeatedly in rats and can detect transient decreases in the sensitivity of Abeta nerve fibers caused by acute exposure to vibration. This decrease in Abeta fiber sensitivity was associated with a reduction in expression of nitric oxide synthase-1, and a modest increase in calcitonin gene-related peptide transcript levels in tail nerves 24 h after vibration exposure. These transient changes in sensory perception and transcript levels induced by acute vibration exposure may be indicators of more prolonged changes in peripheral nerve physiology.