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Coomans de Brachène A, Scoubeau C, Musuaya AE, Costa-Junior JM, Castela A, Carpentier J, Faoro V, Klass M, Cnop M, Eizirik DL. Exercise as a non-pharmacological intervention to protect pancreatic beta cells in individuals with type 1 and type 2 diabetes. Diabetologia 2023; 66:450-460. [PMID: 36401627 PMCID: PMC9676790 DOI: 10.1007/s00125-022-05837-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022]
Abstract
AIMS/HYPOTHESIS Diabetes is characterised by progressive loss of functional pancreatic beta cells. None of the therapeutic agents used to treat diabetes arrest this process; preventing beta cell loss remains a major unmet need. We have previously shown that serum from eight young healthy male participants who exercised for 8 weeks protected human islets and insulin-producing EndoC-βH1 cells from apoptosis induced by proinflammatory cytokines or the endoplasmic reticulum (ER) stressor thapsigargin. Whether this protective effect is influenced by sex, age, training modality, ancestry or diabetes is unknown. METHODS We enrolled 82 individuals, male or female, non-diabetic or diabetic, from different origins, in different supervised training protocols for 8-12 weeks (including training at home during the COVID-19 pandemic). EndoC-βH1 cells were treated with 'exercised' serum or with the exerkine clusterin to ascertain cytoprotection from ER stress. RESULTS The exercise interventions were effective and improved [Formula: see text] values in both younger and older, non-obese and obese, non-diabetic and diabetic participants. Serum obtained after training conferred significant beta cell protection (28% to 35% protection after 4 and 8 weeks of training, respectively) from severe ER stress-induced apoptosis. Cytoprotection was not affected by the type of exercise training or participant age, sex, BMI or ancestry, and persisted for up to 2 months after the end of the training programme. Serum from exercised participants with type 1 or type 2 diabetes was similarly protective. Clusterin reproduced the beneficial effects of exercised sera. CONCLUSIONS/INTERPRETATION These data uncover the unexpected potential to preserve beta cell health by exercise training, opening a new avenue to prevent or slow diabetes progression through humoral muscle-beta cell crosstalk.
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Affiliation(s)
| | - Corentin Scoubeau
- Laboratory for Biometry and Exercise Nutrition, Université Libre de Bruxelles, Brussels, Belgium
| | - Anyïshai E Musuaya
- ULB Center for Diabetes Research, Medical Faculty, Université Libre de Bruxelles, Brussels, Belgium
| | - Jose Maria Costa-Junior
- ULB Center for Diabetes Research, Medical Faculty, Université Libre de Bruxelles, Brussels, Belgium
| | - Angela Castela
- ULB Center for Diabetes Research, Medical Faculty, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Carpentier
- Laboratory for Biometry and Exercise Nutrition, Université Libre de Bruxelles, Brussels, Belgium
| | - Vitalie Faoro
- Cardiopulmonary Exercise Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Malgorzata Klass
- Laboratory for Biometry and Exercise Nutrition, Université Libre de Bruxelles, Brussels, Belgium
- Laboratory of Applied Biology and Research Unit in Applied Neurophysiology, Université Libre de Bruxelles, Brussels, Belgium
| | - Miriam Cnop
- ULB Center for Diabetes Research, Medical Faculty, Université Libre de Bruxelles, Brussels, Belgium
- Division of Endocrinology, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Decio L Eizirik
- ULB Center for Diabetes Research, Medical Faculty, Université Libre de Bruxelles, Brussels, Belgium
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Scoubeau C, Carpentier J, Baudry S, Faoro V, Klass M. Body composition, cardiorespiratory fitness, and neuromuscular adaptations induced by a home-based whole-body high intensity interval training. J Exerc Sci Fit 2023; 21:226-236. [PMID: 36970125 PMCID: PMC10034507 DOI: 10.1016/j.jesf.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/12/2023] Open
Abstract
Background/objective Bodyweight exercises performed at home could be a complementary approach to improve health-related fitness in people having little spare time and during stay-at-home periods. This study then investigated body composition, cardiorespiratory fitness, and neuromuscular adaptations to a home-based, video-directed, whole-body high-intensity interval training (WB-HIIT). Methods Fourteen subjects participated to an 8-week WB-HIIT (6 females, 23 ± 1 years) and fourteen were included in a non-exercise control group (CTL; 6 females, 24 ± 4 years). All took part to pre- and post-intervention assessments of body composition, peak oxygen uptake (VO2peak) and first ventilatory threshold (VT1; index of aerobic capacity), dynamic (leg press 3-repetition maximum) and isometric strength (knee extensors maximal isometric contractions with assessment of voluntary activation), and muscle endurance during an isometric submaximal contraction maintained till exhaustion. WB-HIIT consisted in 30-s all-out whole-body exercises interspaced with 30 s of active recovery. Training sessions were performed at home by means of videos with demonstration of exercises. Heart rate was monitored during sessions. Results WB-HIIT increased VO2peak (5%), VT1 (20%), leg lean mass (3%), dynamic (13%) and isometric strength (6%), and muscle endurance (28%; p < 0.05), while they did not improve in CTL. VO2peak increase was correlated (r = 0.56; p < 0.05) with the time spent above 80% of maximal heart rate during training sessions. Isometric strength increase was correlated with change in voluntary activation (r = 0.74; p < 0.01). Conclusion The home-based WB-HIIT induced concomitant cardiorespiratory fitness and neuromuscular improvements. The predominant effect was observed for aerobic capacity and muscle endurance which could improve exercise tolerance and reduce fatigability.
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Affiliation(s)
- Corentin Scoubeau
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université libre de Bruxelles, Belgium
| | - Julie Carpentier
- Research Unit in Biometry and Exercise Nutrition, Faculty of Motor Sciences, Université libre de Bruxelles, Belgium
| | - Stéphane Baudry
- Laboratory of Applied Biology and Research Unit in Applied Neurophysiology, Faculty of Motor Sciences, ULB Neuroscience Institute, Université libre de Bruxelles, Belgium
| | - Vitalie Faoro
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université libre de Bruxelles, Belgium
| | - Malgorzata Klass
- Research Unit in Biometry and Exercise Nutrition, Faculty of Motor Sciences, Université libre de Bruxelles, Belgium
- Laboratory of Applied Biology and Research Unit in Applied Neurophysiology, Faculty of Motor Sciences, ULB Neuroscience Institute, Université libre de Bruxelles, Belgium
- Corresponding author. Research Unit in Biometry and Exercise Nutrition, Faculty of Motor Sciences, Université libre de Bruxelles, Belgium.
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Bonnechère B, Klass M. Cognitive Computerized Training for Older Adults and Patients with Neurological Disorders: Do the Amount and Training Modality Count? An Umbrella Meta-Regression Analysis. Games Health J 2023; 12:100-117. [PMID: 36920851 DOI: 10.1089/g4h.2022.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Numerous applications have been created to train cognition and challenge the brain, a process known as computerized cognitive training (CCT). Despite potential positive results, important questions remain unresolved: the appropriate training duration, the efficacy of CCT depending on its type (commercial or developed in-house for the rehabilitation of specific patients) and delivery mode (at-home or on-site), and the patients most likely to benefit such intervention. This study aims to perform an umbrella meta-analysis and meta-regression to determine if the type of CCT, the delivery mode, the amount of training, and participants' age at inclusion influence the improvement of the cognitive function. To do so, we performed a umbrella meta-analysis. One hundred studies were included in this analysis representing 6407 participants. Statistical improvements were found for the different conditions after the training. We do not find statistical difference between the type of intervention or the delivery mode. No dose-response relationship between the total amount of training and the improvement of cognitive functions was found. CCT is effective in improving cognitive function in patients suffering from neurological conditions and in healthy aging. There is therefore an urgent need for health care systems to recognize its therapeutic potential and to evaluate at a larger scale their integration into the clinical pipeline as preventive and rehabilitation tool.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.,Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Malgorzata Klass
- Laboratory of Applied Biology and Neurophysiology, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
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Zhou N, Forton K, Motoji Y, Scoubeau C, Klass M, Naeije R, Faoro V. Right ventricular-pulmonary arterial coupling impairment and exercise capacity in obese adults. Front Cardiovasc Med 2022; 9:946155. [PMID: 36061564 PMCID: PMC9437327 DOI: 10.3389/fcvm.2022.946155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundObesity-related exercise intolerance may be associated with pulmonary vascular and right ventricular dysfunction. This study tested the hypothesis that decreased pulmonary vascular reserve and right ventricular (RV)-pulmonary arterial (PA) uncoupling contributes to exercise limitation in subjects with obesity.MethodsSeventeen subjects with obesity were matched to normo-weighted healthy controls. All subjects underwent; exercise echocardiography, lung diffusing capacity (DL) for nitric oxide (NO) and carbon monoxide (CO) and an incremental cardiopulmonary exercise test. Cardiac output (Q), PA pressure (PAP) and tricuspid annular plane systolic excursion (TAPSE) were recorded at increasing exercise intensities. Pulmonary vascular reserve was assessed by multipoint mean PAP (mPAP)/Q relationships with more reserve defined by lesser increase in mPAP at increased Q, and RV-PA coupling was assessed by the TAPSE/systolic PAP (sPAP) ratio.ResultsAt rest, subjects with obesity displayed lower TAPSE/sPAP ratios (1.00 ± 0.26 vs. 1.19 ± 0.22 ml/mmHg, P < 0.05), DLCO and pulmonary capillary blood volume (52 ± 11 vs. 64 ± 13 ml, P < 0.01) compared to controls. Exercise was associated with steeper mPAP-Q slopes, decreased TAPSE/sPAP and lower peak O2 uptake (VO2peak). The changes in TAPSE/sPAP at exercise were correlated to the body fat mass (R = 0.39, P = 0.01) and VO2peak (R = 0.44, P < 0.01).ConclusionObesity is associated with a decreased pulmonary vascular and RV-PA coupling reserve which may impair exercise capacity.
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Scoubeau C, Bonnechère B, Cnop M, Faoro V, Klass M. Effectiveness of Whole-Body High-Intensity Interval Training on Health-Related Fitness: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19:ijerph19159559. [PMID: 35954911 PMCID: PMC9367756 DOI: 10.3390/ijerph19159559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
Due to its versatility, whole-body high-intensity interval training (WB-HIIT) can be proposed to the general population and patients to improve health-related fitness. However, its effectiveness compared to traditional aerobic continuous or interval trainings has yet to be determined. A search of four electronic databases was conducted. Studies reporting the effects of WB-HIIT on cardiorespiratory fitness (CRF), fat mass, fat-free mass, musculoskeletal fitness and metabolic risk factors were included. Standardized mean differences (SMD) between WB-HIIT and no exercise or traditional aerobic trainings were calculated. A meta-regression assessed the effect of total training time on the different outcomes. Twenty-two studies were included in the systematic review and nineteen in the meta-analysis. Compared to no exercise, WB-HIIT improves CRF (SMD: 0.75; 95%CI: 0.28, 1.23; p < 0.001), fat-free mass (SMD: 0.38; 95%CI: 0.11, 0.65; p < 0.001), fat mass (SMD: 0.40; 95%CI: 0.09, 0.72; p < 0.001) and musculoskeletal fitness (SMD: 0.84; 95%CI: 0.61, 1.08; p < 0.001). Compared to other aerobic trainings, WB-HIIT has a lower effect on CRF (SMD: −0.40; 95%CI: −0.70, −0.11; p = 0.007), a similar effect on fat-free mass (SMD: −0.04; 95%CI: −0.44, 0.35; p = 0.8) and fat mass (SMD: −0.07; 95%CI: −0.39, 0.25; p = 0.7), and a larger effect on musculoskeletal fitness (SMD: 0.42; 95%CI: 0.14, 0.71; p = 0.003). WB-HIIT overall effect and specific effect on CRF and fat mass were associated with total training time. The systematic review did not provide evidence of metabolic risk improvement. Despite a slightly lower effect on CRF, WB-HIIT is equally effective as traditional aerobic trainings to improve body composition and more effective to enhance musculoskeletal fitness, which is essential for execution of daily tasks.
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Affiliation(s)
- Corentin Scoubeau
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, 1070 Bruxelles, Belgium; (C.S.); (V.F.)
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium;
| | - Miriam Cnop
- ULB Center for Diabetes Research, Université Libre de Bruxelles, 1070 Bruxelles, Belgium;
- Division of Endocrinology, Erasmus Hospital, Université Libre de Bruxelles, 1070 Bruxelles, Belgium
| | - Vitalie Faoro
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, 1070 Bruxelles, Belgium; (C.S.); (V.F.)
| | - Malgorzata Klass
- Research Unit in Biometry and Exercise Nutrition, Faculty of Motor Sciences, Université Libre de Bruxelles, 1070 Bruxelles, Belgium
- Laboratory of Applied Biology, Research Unit in Applied Neurophysiology, Faculty of Motor Sciences, ULB Neuroscience Institute, Université Libre de Bruxelles, 1070 Bruxelles, Belgium
- Correspondence:
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Zhou N, Scoubeau C, Forton K, Loi P, Closset J, Deboeck G, Moraine JJ, Klass M, Faoro V. Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery. Obes Facts 2022; 15:248-256. [PMID: 35086094 PMCID: PMC9021623 DOI: 10.1159/000521242] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/25/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Patients undergoing weight loss surgery do not improve their aerobic capacity or peak oxygen uptake (VO2peak) after bariatric surgery and some still complain about asthenia and/or breathlessness. We investigated the hypothesis that a post-surgery muscular limitation could impact the ventilatory response to exercise by evaluating the post-surgery changes in muscle mass, strength, and muscular aerobic capacity, measured by the first ventilatory threshold (VT). METHODS Thirteen patients with obesity were referred to our university exercise laboratory before and 6 months after bariatric surgery and were matched by sex, age, and height to healthy subjects with normal weight. All subjects underwent a clinical examination, blood sampling, and body composition assessment by dual-energy X-ray absorptiometry, respiratory and limb muscle strength assessments, and cardiopulmonary exercise testing on a cyclo-ergometer. RESULTS Bariatric surgery resulted in a loss of 34% fat mass, 43% visceral adipose tissue, and 12% lean mass (LM) (p < 0.001). Absolute handgrip, quadriceps, or respiratory muscle strength remained unaffected, while quadriceps/handgrip strength relative to LM increased (p < 0.05). Absolute VO2peak or VO2peak/LM did not improve and the first VT was decreased after surgery (1.4 ± 0.3 vs. 1.1 ± 0.4 L min-1, p < 0.05) and correlated to the exercising LM (LM legs) (R = 0.84, p < 0.001). CONCLUSIONS Although bariatric surgery has numerous beneficial effects, absolute VO2peak does not improve and the weight loss-induced LM reduction is associated to an altered muscular aerobic capacity, as reflected by an early VT triggering early exercise hyperventilation.
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Affiliation(s)
- Na Zhou
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium,
| | - Corentin Scoubeau
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
- Laboratory for Biometry and Exercise Nutrition, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Kevin Forton
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
- Department of Cardiology, Erasmus Hospital, Brussels, Belgium
| | - Patricia Loi
- Department of Gastric Surgery, Erasmus Hospital, Brussels, Belgium
| | - Jean Closset
- Department of Gastric Surgery, Erasmus Hospital, Brussels, Belgium
| | - Gael Deboeck
- Laboratory of Rehabilitation, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Jacques Moraine
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Malgorzata Klass
- Laboratory for Biometry and Exercise Nutrition, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
- Laboratory of Applied Biology, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Vitalie Faoro
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium
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Bonnechère B, Klass M, Langley C, Sahakian BJ. Brain training using cognitive apps can improve cognitive performance and processing speed in older adults. Sci Rep 2021; 11:12313. [PMID: 34112925 PMCID: PMC8192763 DOI: 10.1038/s41598-021-91867-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
Managing age-related decrease of cognitive function is an important public health challenge, especially in the context of the global aging of the population. Over the last years several Cognitive Mobile Games (CMG) have been developed to train and challenge the brain. However, currently the level of evidence supporting the benefits of using CMG in real-life use is limited in older adults, especially at a late age. In this study we analyzed game scores and the processing speed obtained over the course of 100 sessions in 12,000 subjects aged 60 to over 80 years. Users who trained with the games improved regardless of age in terms of scores and processing speed throughout the 100 sessions, suggesting that old and very old adults can improve their cognitive performance using CMG in real-life use.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium. .,Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK.
| | - Malgorzata Klass
- Laboratory of Applied Biology and Neurophysiology, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christelle Langley
- Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Barbara Jacquelyn Sahakian
- Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK
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Lakomek HJ, Rudwaleit M, Hentschel A, Broge B, Abrolat J, Bessler F, Hellmich B, Klemann A, Krause A, Klass M, Strunk J, Fiori W, Roeder N, Braun J. [Quality in acute inpatient rheumatology 2021 : Current aspects of the KOBRA quality label of the Association of Rheumatological Acute Care Clinics]. Z Rheumatol 2021; 80:758-770. [PMID: 33999267 PMCID: PMC8127451 DOI: 10.1007/s00393-021-01015-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 12/02/2022]
Abstract
Mit einer umfassenden gesundheitspolitischen Qualitätsoffensive ab 2021 sollen die Qualität und Transparenz in der Versorgung von Menschen mit Krankheiten in Krankenhäusern in Deutschland verbessert werden. Gesetzliche Vorgaben zu Mindestmengen und die Ausweitung von Qualitätsverträgen zwischen Kostenträgern und Krankenhäusern sowie die Verwendung von planungsrelevanten Qualitätsindikatoren für eine bedarfs- und qualitätsorientierte Weiterentwicklung der stationären Versorgung werden den Wettbewerb in der Versorgungsqualität zwischen den Krankenhäusern verstärken. Dem Thema „Entwicklung und Definition von Qualität in der Medizin“ hat sich auch der Verband der Rheumatologischen Akutkliniken e. V. (VRA) schon früh nach der Gründung im Jahr 1998 umfassend angenommen. Im Zentrum der akutstationären Qualitätssicherung stehen verbindlich festgelegte Strukturkriterien in Verknüpfung mit dem 2003 in der Rheumatologie gestarteten und bis heute kontinuierlich durchgeführten KOBRA-Projekt (Kontinuierliches Outcome Benchmarking in der Rheumatologischen Akutversorgung) mit der Messung von Prozess- und Ergebnisqualität. Auf der Basis dieses Rahmenkonzeptes (Erfüllung der Strukturkriterien und Durchführung des KOBRA-Projektes) können erfolgreich teilnehmende rheumatologische Einrichtungen für jeweils 2 Jahre das KOBRA-Label erwerben, welches von der Projektleitung – dem aQua-Institut – vergeben wird. Die herausragende Stellung des KOBRA-Projektes wird beispielhaft anhand von Datenauswertungen des Projektzyklus 2018 gezeigt mit Auswertungen zum Therapiestrategiewechsel bei aktiver rheumatoider Arthritis, Diagnosesicherung von Kollagenosen und Vaskulitiden während des stationären Aufenthaltes sowie zur partizipativen Entscheidungsfindung bei rheumatoider Arthritis. Auf den gesundheitspolitisch geforderten „Paradigmenwechsel – weg vom Bett, hin zu einer leistungs-, bedarfs- und qualitätsorientierten Planung“ – ist die akutstationäre Rheumatologie mit der Verankerung von Projekten zur Struktur‑, Prozess- und Ergebnisqualität sehr gut vorbereitet. Für die in der vom Gemeinsamen Bundesausschuss (G-BA) erstellten Richtlinie zu „Rheumatologischen Zentren“ geforderten Qualitätssicherung ist das KOBRA-Projekt ebenfalls eine sehr gute Voraussetzung.
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Affiliation(s)
- H-J Lakomek
- Universitätsklinik für Geriatrie, Johannes-Wesling-Klinikum Minden, Hans-Nolte-Str. 1, 32429, Minden, Deutschland.
| | - M Rudwaleit
- Universitätsklinik für Innere Medizin und Rheumatologie, Klinikum Bielefeld Rosenhöhe, Bielefeld, Deutschland
| | - A Hentschel
- aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Deutschland
| | - B Broge
- aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Deutschland
| | - J Abrolat
- Klinik an der Weißenburg, Uhlstädt-Kirchhasel, Deutschland
| | - F Bessler
- Geschäftsbereich Medizin, Ev. Stiftung Volmarstein, Wetter, Deutschland
| | - B Hellmich
- Innere Medizin, Rheumatologie und Immunologie, medius Klinik Kirchheim, Kirchheim unter Teck, Deutschland
| | - A Klemann
- St.-Josef-Stift Sendenhorst, Sendenhorst, Deutschland
| | - A Krause
- Rheumatologie und Klinische Immunologie, Immanuel Krankenhaus Berlin, Berlin-Wannsee, Deutschland
| | - M Klass
- Rheumatologie und Physikalische Therapie, Helios Klinikum Duisburg, Duisburg, Deutschland
| | - J Strunk
- Abteilung Rheumatologie, Krankenhaus Porz am Rhein, Köln, Deutschland
| | - W Fiori
- Roeder & Partner, Ärzte Partnerschaftsgesellschaft, Senden, Deutschland
| | - N Roeder
- Roeder & Partner, Ärzte Partnerschaftsgesellschaft, Senden, Deutschland
| | - J Braun
- Rheumazentrum Ruhrgebiet, Herne, Deutschland
- Ruhr-Universität Bochum, Herne, Deutschland
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Lakomek HJ, Krause A, Braun J, Hellmich B, Klass M, Lorenz H, Schneider M, Schulze-Koops H, Specker C. [Future of acute inpatient rheumatology in Germany : Statement of the Boards of the German Society for Rheumatology and the Association of Rheumatological Acute Clinics on hospital planning North-Rhine/Westphalia 2019 for the discipline rheumatology]. Z Rheumatol 2020; 80:103-106. [PMID: 33313964 PMCID: PMC7872996 DOI: 10.1007/s00393-020-00939-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/03/2022]
Abstract
Im September 2019 wurde vom Ministerium für Arbeit, Gesundheit und Soziales (MAGS) in NRW ein Gutachten zur Krankenhausplanung veröffentlicht. Hierin wurde eine grundlegende Reform der Krankenhausplanung empfohlen, indem zukünftig eine Bedarfsplanung auf der Grundlage einer detaillierten Ausweisung von Leistungsbereichen und Leistungsgruppen erfolgen soll. Nach Aufforderung durch das MAGS NRW hat auch die Deutsche Gesellschaft für Rheumatologie (DGRh) mit Unterstützung des Verbandes Rheumatologischer Akutkliniken (VRA) hierzu Stellung genommen.
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Affiliation(s)
- H-J Lakomek
- Universitätsklinik für Geriatrie, Mühlenkreiskliniken, Johannes Wesling Klinikum Minden, Hans-Nolte-Str. 1, 32429, Minden, Deutschland.
| | - A Krause
- Abteilung Rheumatologie, Klinische Immunologie und Osteologie, Immanuel Krankenhaus Berlin, Berlin, Deutschland
| | - J Braun
- Rheumazentrum Ruhrgebiet und Ruhr-Universität Bochum, Herne, Deutschland
| | - B Hellmich
- Vaskulitiszentrum Süd, Klinik für Innere Medizin, Rheumatologie und Immunologie, Medius Kliniken - Akademisches Lehrkrankenhaus der Universität Tübingen, Kirchheim u. Teck, Deutschland
| | - M Klass
- Klinik für Rheumatologie und Physikalische Therapie, Helios St. Johannes Klinik, Duisburg, Deutschland
| | - H Lorenz
- Sektion Rheumatologie, Med. Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.,ACURA-Rheumazentrum Baden-Baden, Baden-Baden, Deutschland
| | - M Schneider
- Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - H Schulze-Koops
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik IV, Ludwig-Maximilians-Universität München, München, Deutschland
| | - C Specker
- Klinik für Rheumatologie und Klinische Immunologie, Evang. Krankenhaus Essen-Werden, Kliniken Essen-Mitte, Essen, Deutschland
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Bonnechère B, Van Hove O, Samadoulougou S, Klass M, Kirakoya‐Samadoulougou F, Sahakian B. Combination of cognitive training and assessment using mobile games with elderly participants. Alzheimers Dement 2020. [DOI: 10.1002/alz.041917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Bruno Bonnechère
- Université Libre de Bruxelles Brussels Belgium
- University of Cambridge Cambridge United Kingdom
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Zhou N, Klass M, Corentin S, Kevin F, Motoji Y, Beatrice P, Loi P, Closset J, Naeije R, Faoro V. Pulmonary hemodaynamic in obesity. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Higher prevalence of pulmonary hypertension exist in obesity subjects. Little known about pulmonary hemodynamics during exercise in obesity population.
Purpose
To assess and compare the response of pulmonary vascular resistance during exercise in obese subjects vs healthy controls.
Methods
Seventeen obesity subjects (gender: 25%men, age: 44±11 years, height: 1.7±0.1 m, weight: 111±17 kilogram, BMI: 38±4 kg/m2) were compared to twenty gender-, age-, height- and race-matched healthy control subjects (age: 46±12 years, height: 1.7±0.1 m, weight: 64±11 kilogram, BMI: 22±2 kg/m2). All subjects underwent an incremental exercise stress echocardiography with measurements of pulmonary artery pressure (PAP), cardiac output (CO), cardiac index (CI) and tricuspid annular plane systolic excursion (TAPSE) at rest and at increasing exercise intensities. Total pulmonary vascular resistance index (PVRi) was calculated as mean PAP/CI and right ventricular-arterial coupling as TAPSE/systolic PAP.
Results
The results are described in the table 1. Pulmonary hemodynamic was not different at rest between two groups, but lower at maximal exercise in obesity subjects. In obesity subjects, identical exercise level was associated with a higher mean PAP and PVRi, and a lower TAPSE/systolic PAP ratio.
Conclusion
While pulmonary hemodynamic seems preserved at rest in obesity patients, pulmonary vascular resistance is increased and right ventricular coupling is decreased, particularly at exercise.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Zhou
- Université libre de Bruxelles (ULB), Faculty of Motorskills Science, Laboratory of Exercise Physiology, Brussels, Belgium
| | - M Klass
- Université libre de Bruxelles (ULB), Faculty of Motorskills Sciences, Laboratory of Biometry and exercise Nutrition, Brussels, Belgium
| | - S Corentin
- Université libre de Bruxelles (ULB), Faculty of Motorskills Sciences, Laboratory of Biometry and exercise Nutrition, Brussels, Belgium
| | - F Kevin
- Université libre de Bruxelles (ULB), Faculty of Motorskills Science, Laboratory of Exercise Physiology, Brussels, Belgium
| | - Y Motoji
- Université libre de Bruxelles (ULB), Faculty of Motorskills Science, Laboratory of Exercise Physiology, Brussels, Belgium
| | - P Beatrice
- Université libre de Bruxelles (ULB), Faculty of Motorskills Science, Laboratory of Exercise Physiology, Brussels, Belgium
| | - P Loi
- Erasme Hospital (ULB), Department of Gastrointestinal Surgery, Brussels, Belgium
| | - J Closset
- Erasme Hospital (ULB), Department of Gastrointestinal Surgery, Brussels, Belgium
| | - R Naeije
- Université libre de Bruxelles (ULB), Faculty of Motorskills Science, Laboratory of Exercise Physiology, Brussels, Belgium
| | - V Faoro
- Université libre de Bruxelles (ULB), Faculty of Motorskills Science, Laboratory of Exercise Physiology, Brussels, Belgium
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Bonnechère B, Bier JC, Van Hove O, Sheldon S, Samadoulougou S, Kirakoya-Samadoulougou F, Klass M. Age-Associated Capacity to Progress When Playing Cognitive Mobile Games: Ecological Retrospective Observational Study. JMIR Serious Games 2020; 8:e17121. [PMID: 32530432 PMCID: PMC7320308 DOI: 10.2196/17121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/26/2020] [Accepted: 04/15/2020] [Indexed: 12/26/2022] Open
Abstract
Background The decline of cognitive function is an important issue related to aging. Over the last few years, numerous mobile apps have been developed to challenge the brain with cognitive exercises; however, little is currently known about how age influences capacity for performance improvement when playing cognitive mobile games. Objective The objective of this study was to analyze the score data of cognitive mobile games over a period of 100 gaming sessions to determine age-related learning ability for new cognitive tasks by measuring the level of score improvement achieved by participants of different ages. Methods Scores from 9000 individuals of different ages for 7 cognitive mobile games over 100 gaming sessions were analyzed. Scores from the first session were compared between age groups using one-way analysis of variance. Mixed models were subsequently used to investigate the progression of scores over 100 sessions. Results Statistically significant differences were found between age groups for the initial scores of 6 of the 7 games (linear trend, P<.001). Cognitive mobile game scores increased for all participants (P<.001) suggesting that all participants were able to improve their performance. The rate of improvement was, however, strongly influenced by the age of the participant with slower progression for older participants (P<.001). Conclusions This study provides evidence to support two interesting insights—cognitive mobile game scores appear to be sensitive to the changes in cognitive ability that occur with advancing age; therefore, these games could be a convenient way to monitor cognitive function over long-term follow-up, and users who train with the cognitive mobile games improve regardless of age.
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Affiliation(s)
- Bruno Bonnechère
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium.,Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Jean-Christophe Bier
- Department of Neurology, Hôpital Érasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Van Hove
- Department of Chest and Thoracic Surgery, Hôpital Érasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Sékou Samadoulougou
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Centre, Quebec City, QC, Canada
| | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Malgorzata Klass
- Laboratory of Applied Biology and Neurophysiology, Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
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Lievens E, Klass M, Bex T, Derave W. Muscle fiber typology substantially influences time to recover from high-intensity exercise. J Appl Physiol (1985) 2020; 128:648-659. [DOI: 10.1152/japplphysiol.00636.2019] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Human fast-twitch muscle fibers generate high power in a short amount of time but are easily fatigued, whereas slow-twitch fibers are more fatigue resistant. The transfer of this knowledge to coaching is hampered by the invasive nature of the current evaluation of muscle typology by biopsies. Therefore, a noninvasive method was developed to estimate muscle typology through proton magnetic resonance spectroscopy in the gastrocnemius. The aim of this study was to investigate whether male subjects with an a priori-determined fast typology (FT) are characterized by a more pronounced Wingate exercise-induced fatigue and delayed recovery compared with subjects with a slow typology (ST). Ten subjects with an estimated higher percentage of fast-twitch fibers and 10 subjects with an estimated higher percentage of slow-twitch fibers underwent the test protocol, consisting of three 30-s all-out Wingate tests. Recovery of knee extension torque was evaluated by maximal voluntary contraction combined with electrical stimulation up to 5 h after the Wingate tests. Although both groups delivered the same mean power across all Wingates, the power drop was higher in the FT group (−61%) compared with the ST group (−41%). The torque at maximal voluntary contraction had fully recovered in the ST group after 20 min, whereas the FT group had not yet recovered 5 h into recovery. This noninvasive estimation of muscle typology can predict the extent of fatigue and time to recover following repeated all-out exercise and may have applications as a tool to individualize training and recovery cycles. NEW & NOTEWORTHY A one-fits-all training regime is present in most sports, though the same training implies different stimuli in athletes with a distinct muscle typology. Individualization of training based on this muscle typology might be important to optimize performance and to lower the risk for accumulated fatigue and potentially injury. When conducting research, one should keep in mind that the muscle typology of participants influences the severity of fatigue and might therefore impact the results.
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Affiliation(s)
- Eline Lievens
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Malgorzata Klass
- Laboratory of Applied Biology and Research Unit in Applied Neurophysiology, ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Tine Bex
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Wim Derave
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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Klass M, Faoro V, Carpentier A. Assessment of energy expenditure during high intensity cycling and running using a heart rate and activity monitor in young active adults. PLoS One 2019; 14:e0224948. [PMID: 31697742 PMCID: PMC6837421 DOI: 10.1371/journal.pone.0224948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/24/2019] [Indexed: 11/23/2022] Open
Abstract
Objective Although high intensity physical activities may represent a great proportion of the total energy expenditure in active people, only sparse studies have investigated the accuracy of wearable monitors to assess activity related energy expenditure (AEE) during high intensity exercises. Therefore, the purpose of the present study was to investigate the accuracy of the Actiheart, a light portable monitor estimating AEE based on heart rate (HR) and activity counts (ACT), during two popular activities (running and cycling) performed at high intensities. The benefit of an individual calibration of the HR-AEE relationship established during a preliminary maximal test was also evaluated. Methods AEE was estimated in eighteen active adults (4 women and 14 men; 25 ± 4 yr) with indirect calorimetry using a respiratory gas analysis system (reference method) and the Actiheart during 5-min running and cycling at 60, 75 and 85% of maximal oxygen uptake (VO2max) previously determined during a maximal test performed on a treadmill or cycle ergometer. For the Actiheart, AEE was estimated either using the group or individual calibrated equations available in the dedicated software, and their respective HR, ACT or combined HR/ACT algorithms. Results When the HR algorithm was used for cycling and the HR or HR/ACT algorithms for running, AEE measured by the Actiheart increased proportionally to exercise intensity from 60 to 85% VO2max (P<0.001). Compared to indirect calorimetry, the Actiheart group calibrated equations slightly to moderately underestimated (3 to 20%) AEE for the three exercise intensities (P<0.001). Accuracy of AEE estimation was greatly improved by individual calibration of the HR-AEE relationship (underestimation below 5% and intraclass correlation coefficient [ICC]: 0.79–0.93) compared to group calibration (ICC: 0.64–0.79). Conclusion The Actiheart enables to assess AEE during high intensity running and cycling when the appropriate algorithm is applied. Since an underestimation was present for group calibration, an individual and sport-specific calibration should be performed when a high accuracy is required.
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Affiliation(s)
- Malgorzata Klass
- Laboratory for Biometry and Exercise Nutrition, Université Libre de Bruxelles (ULB), Brussels, Belgium
- * E-mail:
| | - Vitalie Faoro
- Cardiopulmonary Exercise Laboratory, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Alain Carpentier
- Laboratory for Biometry and Exercise Nutrition, Université Libre de Bruxelles (ULB), Brussels, Belgium
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15
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Kadji C, Cannie MM, De Angelis R, Camus M, Klass M, Fellas S, Cecotti V, Dütemeyer V, Jani JC. Prenatal prediction of postnatal large-for-dates neonates using a simplified MRI method: comparison with conventional 2D ultrasound estimates. Ultrasound Obstet Gynecol 2018; 52:250-257. [PMID: 28508549 DOI: 10.1002/uog.17523] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/30/2017] [Accepted: 05/04/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the performance of a simple semi-automated method for estimation of fetal weight (EFW) using magnetic resonance imaging (MRI) as compared with two-dimensional (2D) ultrasound (US) for the prediction of large-for-dates neonates. METHODS Data of two groups of women with singleton pregnancy between March 2011 and May 2016 were retrieved from our database and evaluated retrospectively: the first group included women who underwent US-EFW and MRI-EFW within 48 h before delivery and the second group included women who had these evaluations between 35 + 0 weeks and 37 + 6 weeks of gestation, more than 48 h before delivery. US-EFW was based on Hadlock et al. and MRI-EFW on the formula described by Baker et al. For MRI-EFW, planimetric measurement of the fetal body volume (FBV) was performed using a semi-automated method and the time required for measurement was noted. Outcome measure was the performance of MRI-EFW vs US-EFW in the prediction of large-for-dates neonates, both ≤ 48 h and > 48 h before delivery. Receiver-operating characteristics (ROC) curves for each method were compared using the DeLong method. RESULTS Of the 270 women included in the first group, 48 (17.8%) newborns had birth weight ≥ 90th centile and 30 (11.1%) ≥ 95th centile. The second group included 83 women, and nine (10.8%) newborns had birth weight ≥ 95th centile. Median time needed for FBV planimetric measurements in all 353 fetuses was 3.5 (range, 1.5-5.5) min. The area under the ROC curve (AUC) for prediction of large-for-dates neonates by prenatal MRI performed within 48 h before delivery was significantly higher than that by US (for birth weight ≥ 90th centile, difference between AUCs = 0.085, standard error (SE) = 0.020, P < 0.001; for birth weight ≥ 95th centile, difference between AUCs = 0.036, SE = 0.014, P = 0.01). Similarly, MRI-EFW was better than US-EFW in predicting birth weight ≥ 95th centile when both examinations were performed > 48 h prior to delivery (difference between AUCs = 0.077, SE = 0.039, P = 0.045). CONCLUSION MRI planimetry using our purpose-designed semi-automated method is not time-consuming. The predictive performance of MRI-EFW performed immediately prior to or remote from delivery is significantly better than that of US-EFW for the prediction of large-for-dates neonates. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C Kadji
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - M M Cannie
- Department of Radiology, University Hospital Brugmann, Brussels, Belgium
- Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - R De Angelis
- Department of Radiology, University Hospital Brugmann, Brussels, Belgium
| | - M Camus
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - M Klass
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - S Fellas
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - V Cecotti
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - V Dütemeyer
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - J C Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
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Schramm W, Benning NH, Bogusch J, Czekalla A, de Mey V, Fahn M, Fröhlich S, Hannß S, Hentschel S, Kellermann P, Klass M, Lochner D, Lüönd M, Schubert V, Schwarz J, Stein T, Trefz T, Wein M, Wettstein R. Validierung des PROSIT Typ 2 Diabetes Retinopathiemodells. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- W Schramm
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - NH Benning
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - J Bogusch
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - A Czekalla
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - V de Mey
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Fahn
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - S Fröhlich
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - S Hannß
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - S Hentschel
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - P Kellermann
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Klass
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - D Lochner
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Lüönd
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - V Schubert
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - J Schwarz
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - T Stein
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - T Trefz
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - M Wein
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
| | - R Wettstein
- Hochschule Heilbronn, GECKO Institut für Medizin, Informatik und Ökonomie, Heilbronn, Germany
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Klass M, Duchateau J, Rabec S, Meeusen R, Roelands B. Noradrenaline Reuptake Inhibition Impairs Cortical Output and Limits Endurance Time. Med Sci Sports Exerc 2017; 48:1014-23. [PMID: 26784275 DOI: 10.1249/mss.0000000000000879] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess the neural mechanisms that limit endurance time, we compared a fatiguing task performed under the influence of reboxetine (REB), a noradrenaline reuptake inhibitor, and placebo (PLA). METHODS Nine male subjects (age = 24 ± 2 yr) participated in this study. The fatiguing task involved repeated 3-s submaximal isometric contractions of the knee extensors (∼33% maximal voluntary contraction) with a 2-s rest between each contraction and performed until task failure. Before, during, and after exercise, changes in voluntary activation, corticospinal (motor-evoked potential) and spinal excitability (Hoffman reflex), and muscle contractile properties were tested using electrical and transcranial magnetic stimulations. A psychomotor vigilance task assessed reaction time before and after exercise. RESULTS Compared with PLA, REB reduced the endurance time by 15.6% (P = 0.04). The maximal voluntary contraction torque decreased to a similar extent at task failure in both conditions (P < 0.01), whereas the rate of decline was greater in REB than that in PLA (P = 0.02). The level of voluntary activation tested by transcranial magnetic stimulation and electrical stimulation decreased (P < 0.01) by 10%-15% at the end of the task, but the mean rate of decline was greater in REB (P ≤ 0.03). Although motor-evoked potential did not change during fatigue, Hoffman reflex, and electrically evoked torque decreased similarly in the PLA and REB conditions (P ≤ 0.02). After exercise, reaction time increased by 3.5% (P = 0.02) in REB but did not change in the PLA condition. CONCLUSION These findings suggest that because of the noradrenaline reuptake inhibition, the output from the motor cortex is decreased at a greater rate than that in the PLA condition, contributing thereby to shorten endurance time.
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Affiliation(s)
- Malgorzata Klass
- 1Laboratory of Applied Biology, ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, BELGIUM; 2Department of Human Physiology, Vrije Universiteit Brussel, Brussels, BELGIUM; 3School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Queensland, AUSTRALIA; and 4Fund for Scientific Research Flanders (FWO), Brussels, BELGIUM
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Jesunathadas M, Klass M, Duchateau J, Enoka RM. Discharge properties of motor units during steady isometric contractions performed with the dorsiflexor muscles. J Appl Physiol (1985) 2012; 112:1897-905. [PMID: 22442023 DOI: 10.1152/japplphysiol.01372.2011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to record the discharge characteristics of tibialis anterior motor units over a range of target forces and to import these data, along with previously reported observations, into a computational model to compare experimental and simulated measures of torque variability during isometric contractions with the dorsiflexor muscles. The discharge characteristics of 44 motor units were quantified during brief isometric contractions at torques that ranged from recruitment threshold to an average of 22 ± 14.4% maximal voluntary contraction (MVC) torque above recruitment threshold. The minimal [range: 5.8-19.8 pulses per second (pps)] and peak (range: 8.6-37.5 pps) discharge rates of motor units were positively related to the recruitment threshold torque (R(2) ≥ 0.266; P < 0.001). The coefficient of variation for interspike interval at recruitment was positively associated with recruitment threshold torque (R(2) = 0.443; P < 0.001) and either decreased exponentially or remained constant as target torque increased above recruitment threshold torque. The variability in the simulated torque did not differ from the experimental values once the recruitment range was set to ∼85% MVC torque, and the association between motor twitch contraction times and peak twitch torque was defined as a weak linear association (R(2) = 0.096; P < 0.001). These results indicate that the steadiness of isometric contractions performed with the dorsiflexor muscle depended more on the distributions of mechanical properties than discharge properties across the population of motor units in the tibialis anterior.
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Affiliation(s)
- Mark Jesunathadas
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.
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Roelands B, Klass M, Levenez M, Fontenelle V, Duchateau J, Meeusen R. Neurotransmitter modulation and supraspinal fatigue. Br J Sports Med 2011. [DOI: 10.1136/bjsports-2011-090606.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Klass M, Baudry S, Duchateau J. Modulation of reflex responses in activated ankle dorsiflexors differs in healthy young and elderly subjects. Eur J Appl Physiol 2011; 111:1909-16. [DOI: 10.1007/s00421-010-1815-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Accepted: 12/24/2010] [Indexed: 11/30/2022]
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Enoka RM, Baudry S, Rudroff T, Farina D, Klass M, Duchateau J. Unraveling the neurophysiology of muscle fatigue. J Electromyogr Kinesiol 2010; 21:208-19. [PMID: 21071242 DOI: 10.1016/j.jelekin.2010.10.006] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 10/13/2010] [Indexed: 11/16/2022] Open
Abstract
Despite 100years of research since the seminal work of Angelo Mosso (1846-1910), our understanding of the interactions between the nervous system and muscle during the performance of fatiguing contractions remains rather rudimentary. Although the nervous system simply needs to provide an activation signal that will elicit the net muscle torque required for a prescribed action, changes in the number and diversity of synaptic inputs that must be integrated by the spinal motor neurons to accommodate the changes in the force-producing capabilities of the muscle fibers complicate the process of generating the requisite activation signal. This brief review examines two ways in which the activation signal can be compromised during sustained contractions and thereby contribute to the rate at which the muscles fatigue. These examples provide insight on the types of adjustments that occur in the nervous system during fatiguing contractions, but emphasize that much remains to be learned about the physiological processes that contribute to the phenomenon known as muscle fatigue.
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Affiliation(s)
- Roger M Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.
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22
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Baudry S, Klass M, Duchateau J. Postactivation potentiation of short tetanic contractions is differently influenced by stimulation frequency in young and elderly adults. Eur J Appl Physiol 2008; 103:449-59. [PMID: 18392844 DOI: 10.1007/s00421-008-0739-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2008] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to examine the effects of postactivation potentiation (PAP) on the torque and rate of torque development for contractions evoked by short trains of stimuli at different frequencies, in young and elderly adults. Individual mechanical contributions to each electrical stimulus within trains were also analysed. Single pulse, and two- (PT2) and three-pulse trains (PT3) delivered at 20, 50, 80 and 100 Hz were evoked before and during a 10 min period after a 6-s conditioning MVC. The results show that PAP of the torque for PT2 decreased with the increase of the stimulation frequency for young (from 184.5 to 140.4% of control values) and elderly (from 140.5 to 109.6%). Regardless of the stimulation frequency, the peak of PAP was greater in young than in elderly and occurred immediately after the conditioning MVC but was delayed for the 100 Hz condition in elderly adults. For PT3, the results were similar although the extent of PAP was less. The PAP of the mechanical contributions within the trains also decreased with the augmentation of the stimulation frequency. For most of the frequencies above 20 Hz, the peak of PAP for each mechanical contribution was delayed by 1 min after the conditioning MVC. These results indicate an age- and frequency-related PAP saturation of the successive mechanical contributions within a train of stimuli that decrease with time. The functional implication of the findings is that PAP effect is lower and delayed at high compared with low activation rate.
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Affiliation(s)
- Stéphane Baudry
- Laboratory of Applied Biology, Université Libre de Bruxelles, Route de Lennik, 808, CP 640, 1070 Brussels, Belgium.
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Klass M, Lévénez M, Enoka RM, Duchateau J. Spinal mechanisms contribute to differences in the time to failure of submaximal fatiguing contractions performed with different loads. J Neurophysiol 2008; 99:1096-104. [PMID: 18184884 DOI: 10.1152/jn.01252.2007] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study compared the mechanisms that limit the time to failure of a sustained submaximal contraction at 20% of maximum when the elbow flexors either supported an inertial load (position task) or exerted an equivalent constant torque against a rigid restraint (force task). The surface electromyogram (EMG), the motor-evoked potential (MEP) in response to transcranial magnetic stimulation (TMS) of the motor cortex, and the Hoffmann reflex (H-reflex) and maximal M-wave (Mmax) elicited by electrical stimulation of the brachial plexus were recorded in biceps brachii during the two tasks. Although the time to failure for the position task was only 44% of that for the force task, the rate of increase of the average EMG (aEMG; % initial MVC) and MEP area (% Mmax) did not differ significantly during the two tasks. At task failure, however, the increases in normalized aEMG and MEP area were significantly (P < 0.05) greater for the force task (36.4 and 219.9%) than for the position task (22.4 and 141.7%). Furthermore, the superimposed mechanical twitch (% initial MVC), evoked by TMS during a brief MVC of the elbow flexors immediately after task failure, was increased similarly in both tasks. Although the normalized H-reflex area (% Mmax) decreased during the two fatiguing contractions, the reduction was more rapid and greater during the position task (59.8%) compared with the force task (34.7%). Taken together, the results suggest that spinal mechanisms were a major determinant of the briefer time to failure for the position task.
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Affiliation(s)
- Malgorzata Klass
- Laboratory of Applied Biology, Institute for Motor Sciences, Université Libre de Bruxelles, 808 route de Lennik, 1070 Brussels, Belgium
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Klass M, Baudry S, Duchateau J. Age-related decline in rate of torque development is accompanied by lower maximal motor unit discharge frequency during fast contractions. J Appl Physiol (1985) 2008; 104:739-46. [PMID: 18174392 DOI: 10.1152/japplphysiol.00550.2007] [Citation(s) in RCA: 216] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the association between the rate of torque development and maximal motor unit discharge frequency in young and elderly adults as they performed rapid submaximal contractions with the ankle dorsiflexors. Recordings were obtained of the torque exerted by the dorsiflexors during the isometric contractions and the surface and intramuscular electromyograms (EMGs) from the tibialis anterior. The maximal rate of torque development and integrated EMG (percentage of total EMG burst) at peak rate of torque development during fast contractions were lower in elderly than young adults by 48% (P < 0.05) and 16.5% (P < 0.05), respectively. The young adults, but not the elderly adults, exhibited a positive association (r2 = 0.33; P < 0.01) between the integrated EMG computed up to the peak rate of torque development and the maximal rate of torque development achieved during the fast contractions. These age-related changes during fast voluntary contractions were accompanied by a decline (P < 0.001) in motor unit discharge frequency (19, 28, and 34% for first 3 interspike intervals, respectively) and in the percentage of units (45%; P < 0.05) that exhibited double discharges (doublets) at brief intervals (<5 ms). Because aging decreased the maximal rate of torque development of fast voluntary contractions to a greater extent ( approximately 10%) than that of an electrically evoked twitch, collectively the results indicate that the age-related decline in maximal motor unit discharge frequency likely limit, in addition to the slowing of muscle contractile properties, the performance of fast voluntary contractions.
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Affiliation(s)
- Malgorzata Klass
- Laboratory of Applied Biology, ISM, Université Libre de Bruxelles, 808 route de Lennik, CP 640, 1070 Brussels, Belgium
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Klass M, Baudry S, Duchateau J. Age-related decline in rate of torque development during fast contractions is caused by lower neural activation and slower muscle contractile kinetics. Comput Methods Biomech Biomed Engin 2008. [DOI: 10.1080/10255840802296558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lévénez M, Garland SJ, Klass M, Duchateau J. Cortical and spinal modulation of antagonist coactivation during a submaximal fatiguing contraction in humans. J Neurophysiol 2007; 99:554-63. [PMID: 18046002 DOI: 10.1152/jn.00963.2007] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study investigates the control mechanisms at the cortical and spinal levels of antagonist coactivation during a submaximal fatiguing contraction of the elbow flexors at 50% of maximal voluntary contraction (MVC). We recorded motor-evoked potentials in the biceps brachii and triceps brachii muscles in response to magnetic stimulation of the motor cortex (MEP) and corticospinal tract (cervicomedullary motor-evoked potentials--CMEPs), as well as the Hoffmann reflex (H-reflex) and maximal M-wave (Mmax) elicited by electrical stimulation of the brachial plexus, before, during, and after the fatigue task. The results showed that although the coactivation ratio did not change at task failure, the MVC torque produced by the elbow flexors declined by 48% (P < 0.01) with no change in MVC torque for the elbow extensors. While the MEP and CMEP areas (normalized to Mmax) of the biceps brachii increased ( approximately 50%) over the first 40% of the time to task failure and then plateaued, both responses in the triceps brachii increased ( approximately 150-180%) gradually throughout the fatigue task. In contrast to the monotonic increase in the MEP and CMEP of the antagonist muscles, the H-reflex of the triceps brachii exhibited a biphasic modulation, increasing during the first part of the contraction before declining subsequently to 65% of its initial value. Collectively, these results suggest that the level of coactivation during a fatiguing contraction is mediated by supraspinal rather than spinal mechanisms and involves differential control of agonist and antagonist muscles.
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Affiliation(s)
- Morgan Lévénez
- Laboratory of Applied Biology, Université Libre de Bruxelles, Brussels, Belgium
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Klass M, Baudry S, Duchateau J. Voluntary activation during maximal contraction with advancing age: a brief review. Eur J Appl Physiol 2006; 100:543-51. [PMID: 16763836 DOI: 10.1007/s00421-006-0205-x] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Accepted: 04/20/2006] [Indexed: 10/24/2022]
Abstract
It is well established that the loss of muscle mass (i.e. sarcopenia) is the primary factor contributing to the reduction in muscle force with ageing. Based on the observation that force declines at a faster rate than muscle mass, neural alterations are also thought to contribute to muscle weakness by reducing central drive to the agonist muscles and by increasing coactivation of the antagonist muscles. Researchers have attempted to quantify the contribution of impaired voluntary drive to the decline in muscle force using superimposed electrical stimulation during maximal voluntary contractions (MVCs) and by recording surface electromyographic (EMG) activity. Although reduced voluntary activation of agonist muscles and increased coactivation of antagonist muscles during a MVC have been reported with advancing age, such changes are not supported by all studies. These discrepancies may be explained by differences in sensitivity between the methods used to assess voluntary activation, as well as differences between the characteristics of the study population, the muscle group that is tested, and the type of contraction that is performed. The objective of this review is to summarize current knowledge regarding the activation of agonist and antagonist muscles during MVC in elderly and to try to clarify the disparities in literature concerning the influence of a possible deficit in voluntary activation on the maximal force capacity of muscles in elderly adults.
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Affiliation(s)
- Malgorzata Klass
- Laboratory of Applied Biology, Université Libre de Bruxelles, 28 avenue P. Héger, CP 168, 1000 Brussels, Belgium
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Baudry S, Klass M, Pasquet B, Duchateau J. Age-related fatigability of the ankle dorsiflexor muscles during concentric and eccentric contractions. Eur J Appl Physiol 2006; 100:515-25. [PMID: 16718508 DOI: 10.1007/s00421-006-0206-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Accepted: 04/04/2006] [Indexed: 11/29/2022]
Abstract
This study compares the fatigability of the ankle dorsiflexors during five sets of 30 maximal concentric and eccentric contractions in young and elderly adults. The torque produced by the ankle dorsiflexors and the average surface electromyogram (aEMG) of the tibialis anterior were continuously recorded. The contribution of central and peripheral mechanisms to muscle fatigue was tested before, after each set of contractions, and during a 30 min recovery period by the superimposed electrical stimulation method. The compound muscle action potential (M-wave), the mechanical response to single (twitch) and paired (doublet) stimulation, and the postactivation potentiation were also recorded. Compared with young subjects, elderly adults exhibited a greater loss of torque for concentric (50.2 vs. 40.9%; P<0.05) and eccentric (42.1 vs. 27.1%; P < 0.01) contractions. Although young subjects showed a lesser decrease in torque during the eccentric compared with concentric contractions, elderly adults experienced similar fatigability for the two types of contractions despite a comparable depression in the EMG activity of both groups and contraction types (10-20%). As tested by the interpolated-twitch method and aEMG/M-wave ratio, voluntary activation was not altered during either type of contraction or for either age group. During the two fatigue tasks, only elderly adults experienced a decrease in M-wave area (26.4-35.4%; P < 0.05). All together, our results suggest that the fatigue exhibited by both young and elderly adults during maximal concentric and eccentric contractions mainly involved peripheral alterations and that elderly adults may also have experienced a decline in neuromuscular propagation.
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Affiliation(s)
- Stéphane Baudry
- Laboratory of Applied Biology, Université Libre de Bruxelles, 28 avenue P. Héger, CP 168, 1000 Brussels, Belgium
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Baudry S, Klass M, Duchateau J. Age-related changes in fatigability during concentric and eccentric contractions. Comput Methods Biomech Biomed Engin 2005. [DOI: 10.1080/10255840512331388065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Klass M, Baudry S, Duchateau J. Aging does not affect voluntary activation of the ankle dorsiflexors during isometric, concentric, and eccentric contractions. J Appl Physiol (1985) 2005; 99:31-8. [PMID: 15705734 DOI: 10.1152/japplphysiol.01426.2004] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study examines the age-related deficit in force of the ankle dorsiflexors during isometric (Iso), concentric (Con), and eccentric (Ecc) contractions. More specifically, the contribution of neural and muscular mechanisms to the loss of voluntary force was investigated in men and women. The torque produced by the dorsiflexors and the surface electromyogram (EMG) from the tibialis anterior and the soleus were recorded during maximal Iso contractions and during Con and Ecc contractions performed at constant angular velocities (5-100 degrees/s). Central activation was tested by the superimposed electrical stimulation method during maximal voluntary contraction and by computing the ratio between voluntary average EMG and compound muscle action potential (M wave) induced by electrical stimulation (average EMG/M wave). Contractile properties of the dorsiflexor muscles were investigated by recording the mechanical responses to single and paired maximal stimuli. The results showed that the age-related deficit in force (collapsed across genders and velocities) was greater for Iso (20.5%; P < 0.05) and Con (38.6%; P < 0.001) contractions compared with Ecc contractions (6.5%; P > 0.05). When the torque produced during Con and Ecc contractions was expressed relative to the maximal Iso torque, it was significantly reduced in Con contractions and increased in Ecc contractions with aging, with the latter effect being more pronounced for women. In both genders, voluntary activation was not significantly impaired in elderly adults and did not differ from young subjects. Similarly, coactivation was not changed with aging. In contrast, the mechanical responses to single and paired stimuli showed a general slowing of the muscle contractile kinetics with a slightly greater effect in women. It is concluded that the force deficit during Con and Iso contractions of the ankle dorsiflexors in advanced age cannot be explained by impaired voluntary activation or changes in coactivation. Instead, this age-related adaptation and the mechanisms that preserve force in Ecc contractions appeared to be located at the muscular level.
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Affiliation(s)
- Malgorzata Klass
- Laboratory of Applied Biology, Université Libre de Bruxelles, 28 Ave. P. Héger, CP 168, 1000 Brussels, Belgium
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Baudry S, Klass M, Duchateau J. Postactivation potentiation influences differently the nonlinear summation of contractions in young and elderly adults. J Appl Physiol (1985) 2004; 98:1243-50. [PMID: 15557015 DOI: 10.1152/japplphysiol.00735.2004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The force enhancement of a twitch after a maximal conditioning muscle contraction [i.e., postactivation potentiation (PAP)] is reduced with aging, but its influence on the summation of force in response to repetitive stimulation at different frequencies is not known. The purpose of this work was to compare the electrically evoked mechanical responses of the tibialis anterior muscle between young and elderly adults after a 6-s maximal voluntary contraction (MVC). The results showed that, immediately after the conditioning MVC, twitch torque and its maximal rate of development and relaxation were significantly enhanced in both groups, but the magnitude of potentiation was greater in young (148.0 +/- 14.2, 123.7 +/- 16.5, and 185.4 +/- 36.5%, respectively) compared with elderly adults (87.4 +/- 15.2, 63.8 +/- 9.9, and 62.9 +/- 11.0%, respectively). This age-related difference in potentiation of the twitch disappeared completely 1 min after the conditioning MVC. The potentiation of torque and speed-related parameters in response to two- and three-pulse trains, delivered at a constant interval of 10 ms (100 Hz), was less than for a single pulse for both groups. In young adults, the magnitude of PAP on the successive individual mechanical contributions within a train of stimuli declined progressively such that the third contribution did not differ significantly from the same contribution before the conditioning MVC. In contrast, the second and third contributions did not potentiate (P > 0.05) in elderly adults. Although these contributions did potentiate significantly at a lower frequency of stimulation (20 Hz) in the two groups, the difference in PAP between young and elderly adults still persisted. This overall attenuation of potentiation with aging, however, appears to have a moderate influence on the decrement of the muscular performance.
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Affiliation(s)
- Stéphane Baudry
- Laboratory of Applied Biology, Université Libre de Bruxelles, 28 Ave. P. Héger, CP 168, 1000 Brussels, Belgium
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Klass M, Guissard N, Duchateau J. Limiting mechanisms of force production after repetitive dynamic contractions in human triceps surae. J Appl Physiol (1985) 2003; 96:1516-21; discussion. [PMID: 14607852 DOI: 10.1152/japplphysiol.01049.2003] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The influence of repetitive dynamic fatiguing contractions on the neuromuscular characteristics of the human triceps surae was investigated in 10 subjects. The load was 50% of the torque produced during a maximal voluntary contraction, and the exercise ended when the ankle range of motion declined to 50% of control. The maximal torque of the triceps surae and the electromyographic (EMG) activities of the soleus and medial gastrocnemius were studied in response to voluntary and electrically induced contractions before and after the fatiguing task and after 5 min of recovery. Reflex activities were also tested by recording the Hoffmann reflex (H reflex) and tendon reflex (T reflex) in the soleus muscle. The results indicated that whereas the maximal voluntary contraction torque, tested in isometric conditions, was reduced to a greater extent (P < 0.05) at 20 degrees of plantar flexion (-33%) compared with the neutral position (-23%) of the ankle joint, the EMG activity of both muscles was not significantly reduced after fatigue. Muscle activation, tested by the interpolated-twitch method or the ratio of the voluntary EMG to the amplitude of the muscle action potential (M-wave), as well as the neuromuscular transmission and sarcolemmal excitation, tested by the M-wave amplitude, did not change significantly after the fatiguing exercise. Although the H and T reflexes declined slightly (10-13%; P < 0.05) after fatigue, these adjustments did not appear to have a direct deleterious effect on muscle activation. In contrast, alterations in the mechanical twitch time course and postactivation potentiation indicated that intracellular Ca(2+)-controlled excitation-contraction coupling processes most likely played a major role in the force decrease after dynamic fatiguing contractions performed for short duration.
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Affiliation(s)
- M Klass
- Laboratory of Applied Biology, Université Libre de Bruxelles, 1000 Brussels, Belgium
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Hackett J, Hoff-Velk J, Golden A, Brashear J, Robinson J, Rapp M, Klass M, Ostrow DH, Mandecki W. Recombinant mouse-human chimeric antibodies as calibrators in immunoassays that measure antibodies to Toxoplasma gondii. J Clin Microbiol 1998; 36:1277-84. [PMID: 9574691 PMCID: PMC104814 DOI: 10.1128/jcm.36.5.1277-1284.1998] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In the present study, we examined the feasibility of using recombinant antibodies containing murine variable regions and human constant regions as calibrators or controls in immunoassays. As a model system, we chose the Abbott IMx Toxo immunoglobulin M (IgM) and Toxo IgG assays designed to detect antibodies to Toxoplasma gondii. Two mouse monoclonal antibodies were selected based on their reactivity to the T. gondii antigens P30 and P66. Heavy- and light-chain variable-region genes were cloned from both hybridomas and transferred into immunoglobulin expression vectors containing human kappa and IgG1 or IgM constant regions. The constructs were stably transfected into Sp2/0-Ag14 cells. In the IMx Toxo IgG assay, immunoreactivity of the anti-P30 chimeric IgG1 antibody paralleled that of the positive human plasma-derived assay calibrators. Signal generated with the anti-P66 chimeric IgG1 antibody was observed to plateau below the maximal reactivity observed for the assay calibrator. Examination of the IgM chimeric antibodies in the IMx Toxo IgM assay revealed that both the anti-P30 and anti-P66 antibodies matched the assay index calibrator manufactured with human Toxo IgM-positive plasma. When evaluated with patient samples, the correlation between results obtained with the chimeric antibody calibrators and the positive human plasma calibrators was > or =0.985. These data demonstrate that chimeric mouse-human antibodies are a viable alternative to high-titer positive human plasma for the manufacture of calibrators and controls for diagnostic assays.
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Affiliation(s)
- J Hackett
- Abbott Diagnostics Division, Abbott Laboratories, North Chicago, Illinois 60064, USA.
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Erley CM, Berger ED, Heyne N, Klass M, Krämer D, Braun N, Wolf S, Risler T. [Renal hemodynamics and proteinuria in chronic glomerulonephritis treated with beta-receptor blockers or ace inhibitors]. Dtsch Med Wochenschr 1997; 122:953-8. [PMID: 9280714 DOI: 10.1055/s-2008-1047714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE In patients with chronic glomerular nephropathy associated arterial hypertension and proteinuria are considered to be cardinal risk factors in the progressive deterioration of renal function. Treatment regimens which reduce proteinuria and hypertension improve prognosis. The effect of the new beta-receptor blockers compared to common ACE-Inhibitors is of special interest. PATIENTS AND METHODS The studied cohort consisted of 11 patients with CGN, hypertension and proteinuria > 400 mg/24 h. Four drugs were given for 4 weeks, doubly blinded and randomized according to a "Latin-square design": Celiprolol (beta-1-antagonist, beta-2-agonist, 200 mg/d), Atenolol (selective beta-1-antagonist, 50 mg/d), Ramipril (ACE-inhibitor, 2.5 mg/d) and placebo. There was a two-week wash-out phase between each of the four treatment phases. At the end of each treatment phase glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured by inulin and para-amino-hippuric acid (PAH) clearance. Proteinuria was determined in the course of a three-day collection period at the end of each treatment phase. During this period blood pressures were measured with a continuous 24-hour blood pressure monitor. RESULTS Mean arterial blood pressure (MAP) was significantly reduced, compared with placebo, by all three antihypertensives (108 +/- 9 mm Hg with placebo, 98 +/- 12 mg Hg with atenolol, 101 +/- 11 mm Hg with celiprolol and 98 +/- 8 mm Hg with ramipril; P < 0.01). Celiprolol produced a significant rise In ERPF (322 +/- 109 ml/min with placebo, 391 +/- 110 ml/min with celiprolol: P < 0.05). GFR was slightly, but not significantly, reduced by celiprolol and atenolol. Filtration fraction remained unchanged with atenolol and celiprolol, while it was slightly, but not significantly, reduced with ramipril. Compared with the placebo, all three drugs significantly reduced proteinuria (P < 0.05): 1.8 +/- 1.3 g/24 h with placebo, 1.2 +/- 1.2 g/24 h with atenolol, 1.2 +/- 1.1 g/24 h with celiprolol and 1.4 +/- 1.4 g/24 h with ramipril. CONCLUSION These data indicate that, in addition to ACE inhibitors, the new generation of beta-receptor blockers in particular, because of their vasodilator action, favourably influence proteinuria and renal blood flow in patients with CGN and arterial hypertension.
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Affiliation(s)
- C M Erley
- Abteilung Innere Medizin III, Medizinischen Universitätsklinik der Eberhard-Karls-Universität Tübingen.
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Erley CM, Klass M, Krämer D, Berger E, Heyne N, Braun N, Wolf S, Risler T. Randomized controlled trial of ACE-inhibitors and beta-blockers with and without vasodilating activity in chronic glomerulonephritis. Int J Clin Pharmacol Ther 1996; 34:504-9. [PMID: 8937934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A prospective double-blind, randomized study was conducted to compare the effects of the beta 1 antagonist, beta 2 agonist celiprolol (200 mg daily) on renal hemodynamics and protein excretion with those of the beta 1 antagonist atenolol (50 mg daily), the ACE-inhibitor ramipril (2.5 mg daily), and placebo in 11 patients with proteinuria > 400 mg/24 h due to chronic glomerulonephritis. All 4 substances were given in a double-blind, randomized manner according to a latin-square design over a period of 4 weeks with a wash-out period of 2 weeks in between. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured by inulin and PAH clearance. Proteinuria was assessed by urine sampling at the end of each treatment period. Mean arterial pressure (MAP) was reduced significantly (p < 0.01) by all 3 drugs compared to placebo (108 +/- 9 mmHg placebo, 98 +/- 12 mmHg atenolol, 101 +/- 11 mmHg celiprolol, and 98 +/- 8 mmHg ramipril). Celiprolol induced a significant increase in ERPF compared to placebo (322 +/- 109 ml/min under placebo versus 391 +/- 110 ml/min under celiprolol, p < 0.05). GFR was slightly but insignificantly increased under atenolol and celiprolol. Filtration fraction (FF) remained unchanged in case of atenolol and celiprolol treatment and was slightly but not significantly reduced by ramipril. Proteinuria was significantly (p < 0.05) reduced compared to placebo by all 3 drugs (1.8 +/- 1.3 g/24 h under placebo, 1.2 +/- 1.2 g/24 h under atenolol, 1.2 +/- 1.1 g/24 h under celiprolol, and 1.4 +/- 1.4 g/24 h under ramipril). These data demonstrate that new beta-blocking agents show favorable effects on proteinuria and renal blood flow in patients with chronic glomerulonephritis and arterial hypertension. This may be attributed to their vasodilating properties.
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Affiliation(s)
- C M Erley
- Section of Nephrology and Hypertension, University of Tübingen, Germany
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Abstract
Abstract
Some of the greatest beneficiaries of the revolutionary advances in biotechnology over the past 15 years have been producers of diagnostic reagents, especially for the cloning and expression of antigens, primarily of viral origin. Recombinant DNA technology provides methods for producing antigens for diagnostic assays that are more highly purified, more specific, and safer to produce than viral culture and that are significantly less expensive to manufacture. Antigens so produced can be used for production of antibodies or antisera for competition assays, as reagents for mapping epitopes, as affinity-chromatography ligands for purification of antibodies or protein, and as research reagents. Their initial use in some hepatitis B assays may be primarily a cost-reduction application, but in other applications (e.g., HIV diagnostic tests) they present the first opportunity to commercially produce an otherwise very expensive antigen. Recombinant-DNA-produced antigens are also being used to develop safer vaccines, but not, however, without some consideration of the structural nature of immunodominant epitopes and the adequacy of the immune response.
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Affiliation(s)
- J L Fox
- Corporate Molecular Biology, Abbott Laboratories, Abbott Park, IL 60064
| | - M Klass
- Corporate Molecular Biology, Abbott Laboratories, Abbott Park, IL 60064
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Fox JL, Klass M. Antigens produced by recombinant DNA technology. Clin Chem 1989; 35:1838-42. [PMID: 2673579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Some of the greatest beneficiaries of the revolutionary advances in biotechnology over the past 15 years have been producers of diagnostic reagents, especially for the cloning and expression of antigens, primarily of viral origin. Recombinant DNA technology provides methods for producing antigens for diagnostic assays that are more highly purified, more specific, and safer to produce than viral culture and that are significantly less expensive to manufacture. Antigens so produced can be used for production of antibodies or antisera for competition assays, as reagents for mapping epitopes, as affinity-chromatography ligands for purification of antibodies or protein, and as research reagents. Their initial use in some hepatitis B assays may be primarily a cost-reduction application, but in other applications (e.g., HIV diagnostic tests) they present the first opportunity to commercially produce an otherwise very expensive antigen. Recombinant-DNA-produced antigens are also being used to develop safer vaccines, but not, however, without some consideration of the structural nature of immunodominant epitopes and the adequacy of the immune response.
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Affiliation(s)
- J L Fox
- Corporate Molecular Biology, Abbott Laboratories, Abbott Park, IL 60064
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Ward S, Burke DJ, Sulston JE, Coulson AR, Albertson DG, Ammons D, Klass M, Hogan E. Genomic organization of major sperm protein genes and pseudogenes in the nematode Caenorhabditis elegans. J Mol Biol 1988; 199:1-13. [PMID: 3351915 DOI: 10.1016/0022-2836(88)90374-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The major sperm proteins (MSPs) are a family of closely related, small, basic proteins comprising 15% of the protein in Caenorhabditis elegans sperm. They are encoded by a multigene family of more than 50 genes, including many pseudogenes. MSP gene transcription occurs only in late primary spermatocytes. In order to study the genomic organization of transcribed MSP genes, probes specific for the 3' untranslated regions of sequenced cDNA clones were used to isolate transcribed genes from genomic libraries. These and other clones of MSP genes were located in overlapping cosmid clones by DNA fingerprinting. These cosmids were aligned with the genetic map by overlap with known genes or in-situ hybridization to chromosomes. Of 40 MSP genes identified, 37, including all those known to be transcribed, are organized into six clusters composed of 3 to 13 genes each. Within each cluster, MSP genes are not in tandem but are separated by at least several thousand bases of DNA. Pseudogenes are interspersed among functional genes. Genes with similar 3' untranslated sequences are in the same cluster. The six MSP clusters are confined to only three chromosomal loci; one on the left arm of chromosome II and two near the middle of chromosome IV. Additional sperm-specific genes are located in one cluster of MSP genes on chromosome IV. The multiplicity of MSP genes appears to be a mechanism for enhancing MSP synthesis in spermatocytes, and the loose clustering of genes could be a result of the mechanism of gene duplication or could play a role in regulation.
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Affiliation(s)
- S Ward
- Department of Embryology, Carnegie Institution of Washington, Baltimore, MD 21210
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Abstract
The major sperm proteins (MSPs) are encoded in the Caenorhabditis genome by a multigene family with more than 50 genes dispersed in small clusters at three chromosomal loci. In spite of their dispersed locations, all of the MSP genes appear to be expressed at the same time exclusively in the testis, indicating co-ordinate temporal and spatial regulation of these dispersed genes. Many of the MSP genes must be transcribed, because RNA hybridization with gene-specific probes showed that individual genes each contribute less than 3% to the total poly(A)+ RNA, and 13 out of 14 sequenced cDNAs came from different genes. Primer extension assays from MSP mRNA showed that most of the MSP mRNAs must be initiated at position -35 from the translation start codon. Extensive similarity was found in the first 100 nucleotides of genomic sequence flanking the start codons of ten MSP genes from different chromosomal locations. All MSP genes contained a consensus ribosome binding site, a consensus TATA homology 27 nucleotides distal to the site of mRNA initiation, and ten highly conserved nucleotides adjacent to the site of initiation. All the MSP genes contained the sequence AGATCT located approximately 65 nucleotides upstream from the transcriptional start, but little or no similarity was found more distal to this. Some of these conserved sequences may be cis-acting control elements that ensure the cell and temporal specificity of transcription of these co-ordinately regulated genes.
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Affiliation(s)
- M Klass
- Biology Department, University of Houston/University Park, TX 77004
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Abstract
We have shown the expression of transformed genes in the nematode Caenorhabditis elegans using a new gene fusion system. Vectors consisting of the flanking regions of a collagen gene (col-1) or a major sperm protein gene of C. elegans fused to the Escherichia coli uidA gene, encoding beta-glucuronidase, were microinjected into worms and found to be propagated as high-copy extrachromosomal tandem arrays. We have detected beta-glucuronidase activity in transformed lines, and have shown that the activity is dependent upon the correct reading frame of the construction and on the presence of the worm sequences. The enzyme activity was shown to be encoded by the chimeric beta-glucuronidase gene by co-segregation analysis and by inactivation with specific antisera. Expression is at a very low level, and seems to be constitutive. We have used histochemical techniques to visualize the enzyme activity in embryos.
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Abstract
Analysis of DNA from the nematode Caenorhabditis elegans demonstrated a number of significant age-correlated changes. The number of single-strand breaks as assayed by an in vitro assay procedure using Escherichia coli DNA polymerase I increased significantly with age. There was also an exponential increase in the amount of 5-methylcytosine in C. elegans DNA as the worm matured and aged. Furthermore, DNA isolated from older worms exhibited reduced transcriptional capacity when assayed in a HeLa cell in vitro transcription system. Finally, a biological assay to determine age-correlated changes in the DNA of aging sperm demonstrated a significant reduction in the capacity of the sperm to support zygotic development as the age of the male increased. These findings demonstrated significant age-correlated alterations and modifications occurring in the DNA template of the nematode, and their implications to the aging process are discussed.
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Abstract
The clonal age in paramecia refers to the total number of vegetative divisions a clone has undergone since its origin at autogamy (self-fertilization). As clonal age increases, the interfission time usually increases. The DNA synthesis pattern of cells of different ages was compared by autoradiographic analysis of the DNA synthesis of synchronized cells at various time intervals during the cell cycle (from one division to the next). The study showed that the G(1) period (the lag in DNA synthesis post division) was constant, irrespective of interfission time or clonal age; but the duration of the DNA synthesis period increased with increased interfission time or clonal age. Therefore, we have shown for the first time that the G(1) period is fixed, and the S period is increased in a eukaryotic unicellular organism as a function of interfission time and clonal age.
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It has been possible to investigate for the first time at the cellular level, the influence of parental age on progeny life span, using Paramecium. As parental age increased, progeny life span decreased. The process of generating progeny clones from aging parents yielded paramecia with different life spans, allowing the study of the influence of parental life span on progeny life span. We found that parental life span was also a significant variable in the progeny life span. The theoretical basis for cellular aging and rejuvenation (the reinitiation of the life cycle) in paramecia is discussed in relation to the present data and previous studies.
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