Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.24.59 (MIP)
 4,906 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the study was to testify the effectiveness and acceptance of combination of the resistive inspiratory muscle training and the following walking training in 26 stable COPD pts with FEVI%VC about 50%. Measurements of inspiratory (MIP cm H20) and expiratory (MEP cm H20) muscle strength and also spirometric examinations two times before the training and one time after every month of observation were done. During first 3 months of the training inspiratory resistor (Pflex) was used. Everyday 20 s MVV with smaller orifice of Pflex (strength training) and 30 min quiet breathing by medium orifice of Pflex 3 times a week (endurance training) were performed. In first 3 months of experiment 13 patients resigned of it. Other 13 pts (age 64 +/- 11.9. F-4 with medium FEVI%VC = 47.3 +/- 14.5, MIP = -54.1 +/- 11.4, MEP = = 99.8 +/- 40.5) were trained during 3 months. In 11 of them (FEVI%VC = 50.0 +/- 17.3) MIP improved by 33%. Values of other indices did not change at all. After 3 month of resistive training 11 pts (3-F) were qualified to walking training but only 5 (1-F) of them had finished it. After 5 month of exercises their MIP improved by 74% (p < 0.5) and MEP by 50% (p < 0.05). We conclude that our method of resistive breathing with Pflex is effective and well tolerated by stable COPD pts but accepted only by 50% of them. It may be used as the first step before conditioning training. Inspiratory muscle training is not alternative to pharmacological treatment but is valuable supplementation of it.
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PMID:[Results of respiratory muscle training in patients with chronic obstructive lung diseases with a moderately severe course]. 941 Feb 85

It has been reported that malnutrition is common in stable chronic obstructive pulmonary disease (COPD) patients. In order to observe the effects of Megestrol Acetate (MA) on nutritional status, respiratory muscle strength and immunological parameters in stable COPD patients, 31 stable COPD patients were divided into two groups at random--a treatment group of 16 cases and a control group of 15 cases. Before and after treatment all parameters were recorded, including food and energy intake, body weight, triceps skinfolds (TSF), pre-albumin, transferrin, albumin. Lung function, respiratory muscle and handgrip strength were examined and immunological parameters also determined. After taking MA 160 mg/day orally for two weeks, the treatment group got benefits as follows: heat energy and protein intake increased fro 6977.9 +/- 1136 kJ/d and 44.65 +/- 13.75 g/d to 9854.0 +/- 2355.3 kJ/d and 84.80 +/- 20.23 g/d respectively. With the increase of daily energy and protein intake, body weight increased from 48.27 +/- 8.61kg to 50.34 +/- 8.76 kg, TSF from 11.75 +/- 4.50 mm to 15.06 +/- 4.73 mm, serum pre-albumin from 306.6 +/- 33.7 mg/L to 332.6 +/- 1 mg/L, transferrin from 3.09 +/- 0.21 g/L to 3.46 +/- 0.32 g/L, albumin from 38.00 +/- 1.73 g/L to 42.64 +/- 3.36 g/L, MIP from 4.77 +/- 2.14 kPa (1 kPa = 7.5 mmHg) to 6.31 +/- 2.87 kPa, MEP from 6.21 +/- 2.90 kPa to 7.20 +/- 3.67 kPa and 6 minutes walking distance from 280.2 +/- 76.4 m to 370.6 +/- 81.5 m. Handgrip strength also improved. Blood lymphocyte transformation rate elevated too. (The changes of all these parameters indicated above were statistically significant, P < 0.01). However, parameters of lung function, blood gas analysis, serum immunoglobulin and complement 3 did not change significantly. In 15 control patients all the parameters did not change significantly. There were few side effects; only one case complained of nausea and vomiting. It was shown that MA can stimulate appetite and increase dietintake, improve nutritional status, elevate respiratory muscle strength, and enhance immunity. MA is a safe and effective drug which exerts a beneficial influence on stable COPD.
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PMID:[Observation on therapeutic effect of megestrol acetate on patients with chronic obstructive pulmonary disease at remission stage]. 959 19

We studied the impact of a 6-wk supervised, multimodality endurance exercise training program (EXT) on strength and endurance of ventilatory and peripheral muscles in patients with chronic airflow limitation (CAL), and determined whether potential improvements contributed to relief of exertional breathlessness (B) and perceived leg effort/discomfort (LE), respectively. Twenty breathless patients with stable CAL (FEV1 = 41 +/- 3% predicted; mean +/- SEM) were tested at 6-wk intervals at baseline, after a nonintervention control period (pre-EXT), and post-EXT. Measurements included: pulmonary function tests (PFTs), maximal inspiratory/expiratory pressures (MIP, MEP), inspiratory muscle endurance (V(LIM)), quadriceps strength and endurance, exercise endurance, and submaximal cycle exercise with cardioventilatory and symptom responses. Measurements at baseline and pre-EXT were identical. Post-EXT, PFTs did not change; exercise endurance measured on the treadmill, cycle ergometer, arm ergometer, and by 6-min walk distance increased 40 +/- 8%, 43 +/- 10%, 12 +/- 5%, and 34 +/- 9%, respectively (p < 0.05); quadriceps strength increased 21 +/- 5% (p < 0.01); MIP and MEP increased 29 +/- 11% and 27 +/- 11%, respectively (p < 0.05); V(LIM) increased almost threefold (p < 0.05). At isotime near end-exercise, B, LE, carbon dioxide production (VCO2), oxygen consumption (VO2), ventilation, and breathing frequency (F) all fell after EXT (p < 0.05): deltaB correlated with deltaF (r = 0.58, p < 0.01). Increased MIP and V(LIM) did not correlate with improved breathlessness or exercise endurance. Similarly, changes in quadriceps strength and endurance did not correlate with changes in LE or exercise endurance. In conclusion, general nonspecific EXT improved ventilatory and peripheral muscle function in severe CAL, but such improvements did not appear to contribute significantly to reduced exertional symptoms and enhanced exercise performance.
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PMID:General exercise training improves ventilatory and peripheral muscle strength and endurance in chronic airflow limitation. 960 28

Respiratory muscle weakness may be the sole cause of dyspnea or may aggravate dyspnea due to another respiratory disease, and is often difficult to recognise clinically. The assessment of respiratory muscles should follow a graded approach using tests of increasing complexity. Clinical examination should look for dyspnea, orthopnea, morning headache, daytime somnolence, fatigability, tachypnea, abdominal, or rib cage paradox, and amyotrophy. Imaging is useful in diagnosing diaphragmatic paralysis using chest radiograph, fluoroscopy or ultrasound. In cases of moderate to severe respiratory muscle weakness, lung volumes show reduced vital capacity and total lung capacity. Measuring the change in vital capacity from sitting to supine position is useful since it shows a 25-50% fall in cases of diaphragmatic paralysis. The specific and classical tests of respiratory muscle strength are maximum inspiratory and expiratory pressures (MIP and MEP) sustained during one second against near complete occlusion. Sniff nasal inspiratory pressure (SNIP) is a new and easier test of inspiratory muscle strength. Normal values obtained with these simple tests rule out clinically significant respiratory muscle weakness. In case of doubt, more complex and invasive tests can be used such as transdiaphragmatic pressure and magnetic stimulation of the phrenic nerves.
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PMID:[Evaluation of respiratory muscles]. 975 85

All employees of a chemical plant division producing chlorfenvinphos were studied, i.e. 35 males aged 25-57 years (mean 42.1); their employment period ranged from 1-15 years (mean 9.0). Chronic bronchitis was diagnosed in 13 workers (37.1%). Mean air chlorfenvinphos concentrations in the work environment estimated with gas-liquid chromatography were from 0.0008-0.0018 mg/m3 (maximum allowable concentration according to Polish standards is 0. 01 mg/m3). The activity of erythrocyte acetylcholinesterase was similar to that observed in people who were not exposed to chemicals, however, a slightly lowered activity of plasma cholinesterase in the studied population was evidently the result of mild liver impairment. Spirometric investigations performed in the studied workers revealed slight alterations manifested by increased intrathoracic gas volume (ITGV) (the value of the index was 138.6% of the mean value, 24 workers with an abnormally high index), as well as by decreased specific airway conductance (sGaw); its mean value in the studied group was 58.5% of the mean standard (11 people showed an abnormal index). Substantial functional changes were found in the respiratory muscles. Maximal inspiratory pressures (MIP = 97. 2 +/- 28.3 cm H2O) as well as maximal expiratory pressures (MEP = 113.9 +/- 44.2 cm H2O) in the studied group were significantly lower (p < 0.01) as compared to those observed in the control group (MIP = 120.7 +/- 31.7; MEP = 154.4 +/- 40.2 cm H2O) of 22 males having similar cigarette smoking habit, without occupational exposure to chemicals. It was also found that the people who had worked for more than 10 years under conditions of exposure to chlorfenvinphos showed significantly lower (p < 0.05) values of maximal inspiratory pressure (87.2 +/- 28.06 cm H2O, n = 17) compared to the workers whose period of employment was shorter than 10 years (106.6 +/- 26.8 cm H2O, n = 18). The two groups were comparable with regard to age and smoking habits. The values of maximal expiratory pressures were similar in both groups. No essential disturbances in neuro-muscular transmission were observed; only in 3 workers (8.5%) the electrostimulating myasthenic test showed some disturbances in neuro-muscular transmission. It seems that respiratory muscles impairment in humans exposed to chlorfenvinphos results from changes in the metabolism and structure of muscles, and partly from lung hyperinflation.
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PMID:Impaired respiratory muscle function in chemical plant workers producing chlorfenvinphos. 1038 11

The strength of the respiratory muscles can be evaluated from static measurements (maximal inspiratory and expiratory pressures, MIP and MEP) or inferred from dynamic maneuvers (maximal voluntary ventilation, MVV). Although these data could be suitable for a number of clinical and research applications, no previous studies have provided reference values for such tests using a healthy, randomly selected sample of the adult Brazilian population. With this main purpose, we prospectively evaluated 100 non-smoking subjects (50 males and 50 females), 20 to 80 years old, selected from more than 8,000 individuals. Gender-specific linear prediction equations for MIP, MEP and MVV were developed by multiple regression analysis: age and, secondarily, anthropometric measurements explained up to 56% of the variability of the dependent variables. The most cited previous studies using either Caucasian or non-Caucasian samples systematically underestimated the observed values of MIP (P < 0.05). Interestingly, the self-reported level of regular physical activity and maximum aerobic power correlates strongly with both respiratory and peripheral muscular strength (knee extensor peak torque) (P < 0.01). Our results, therefore, provide a new frame of reference to evaluate the normalcy of some useful indexes of respiratory muscle strength in Brazilian males and females aged 20 to 80.
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PMID:Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. 1041 50

Reduced respiratory muscle strength has been reported in chronic heart failure (CHF) in several studies. The data supporting this conclusion come almost exclusively from static inspiratory and expiratory mouth pressure maneuvers (MIP, MEP), which many subjects find difficult to perform. We therefore performed a study using measurements that are less dependent on patient aptitude and also provide specific data on diaphragm strength. In 20 male patients and 15 control subjects we measured MIP and MEP as well as esophageal and transdiaphragmatic pressure during maximal sniffs (Sn Pes, Sn Pdi) and cervical magnetic phrenic nerve stimulation (Tw Pdi). In a subgroup the response to paired phrenic nerve stimulation (pTw Pdi) at interpulse intervals from 10 to 200 ms (5 to 100 Hz) was also determined. As expected, MIP was significantly reduced in the CHF group (CHF, 69.5 cm H(2)O; control, 96.7 cm H(2)O; p = 0.01), but differences were much less marked for Sn Pes (CHF, 95.2 cm H(2)O; control, 104.8 cm H(2)O; p = 0.20) and MEP (CHF, 109.1 cm H(2)O; control, 135.7 cm H(2)O; p = 0.09). Diaphragm strength was significantly reduced (Sn Pdi: CHF, 123.8 cm H(2)O; control 143.5 cm H(2)O; p = 0.04. Tw Pdi: CHF, 21.4 cm H(2)O; control, 28.5 cm H(2)O; p = 0.0005). Paired phrenic nerve stimulation suggested a trend to increased twitch summation at 5 to 20 Hz in CHF, although this did not reach significance. We conclude that mild reduction in diaphragm strength occurs in CHF, possibly because of an increased proportion of slow fibers, but overall strength of the respiratory muscles remains well preserved.
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PMID:Diaphragm strength in chronic heart failure. 1043 Jul 24

Lung transplantation recipients have reduced exercise capacity despite normal resting pulmonary and hemodynamic function. The limiting factor may be contractile dysfunction of skeletal muscle. To test this postulate, we measured limb and respiratory muscle function in nine clinically stable lung allograft recipients (six men and three women, aged 30 to 65 yr, at 5 to 102 mo after transplantation) with reduced exercise capacity. Respiratory muscle strength was tested by measuring maximal inspiratory and expiratory pressure (MIP and MEP, respectively). Ankle dorsiflexor muscle strength was measured during maximal voluntary contraction (MVC). In a subset of six recipients, we also measured contractile properties and fatigue characteristics of the tibialis anterior muscle, using electrical stimulation of the motor point. Data were compared with values from age- and sex-matched control subjects. MIP values of transplant recipients did not differ from control values; however, MEP was blunted by 30% relative to control (p < 0.05), and MVC was decreased by 39% (p < 0.05). The force-frequency relationships and fatigue characteristics of the tibialis anterior were not different between the patient and control groups. We conclude that stable lung allograft recipients experience expiratory and lower limb weakness that may contribute to exercise intolerance.
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PMID:Respiratory and limb muscle function in lung allograft recipients. 1050 8

The effect of Cushing's syndrome on respiratory muscle strength is unknown. Therefore, we studied 10 consecutive patients with severe Cushing's syndrome. The respiratory muscles were assessed using maximal inspiratory and expiratory mouth pressures (MIP, MEP), maximal sniff transdiaphragmatic pressures (max sniff Pdi), and maximal sniff esophageal pressures (max sniff Pes). Maximal quadricep strength was also assessed. The patients demonstrated an overall mean MIP 92 cm H(2)O, SD 19 (mean 105% of predicted; SD, 23%), mean MEP 134 cm H(2)O, SD 35 (mean 99% of predicted; SD, 25%), mean max sniff Pdi 107 cm H(2)O, SD 12 (mean 78% of predicted; SD, 10%) and mean max sniff Pes of 92 cm H(2)O, SD 11 (mean 92% of predicted; SD, 11%). Quadriceps muscle strength was reduced in all 10 patients: mean 26 kg, SD 9 (mean 49% of predicted strength, SD 21%). Respiratory muscle weakness was not found, despite the presence of severe quadriceps impairment. We conclude that major weakness of the respiratory muscles is not usual in Cushing's syndrome.
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PMID:Respiratory muscle strength in Cushing's syndrome. 1055 53

Ankylosing spondylitis (AS) has been shown to produce exercise limitation and breathlessness. The purpose of this study was to investigate factors which may be responsible for limiting aerobic capacity in patients with AS. Twenty patients with no other cardio-respiratory disease performed integrative cardiopulmonary exercise testing (CPET). The results were compared to 20 age and gender matched healthy controls. Variables that might influence exercise tolerance, including pulmonary function tests (body plethysmography), respiratory muscle strength (MIP, MEP) and endurance (Tlim), AS severity assessment including chest expansion (CE), thoracolumber movement (TL), wall tragus distance and peripheral muscle strength assessed by maximum voluntary contraction of the knee extensors (Qds), hand grip strength and lean body mass (LBM), were measured in the patients with AS and used as explanatory variables against the peak VO2 achieved during CPET. As subjects achieved a lower peak VO2 than controls (25.2 +/- 1.4 vs. 33.1 +/- 1.6 ml kg-1min-1, mean +/- SEM, P = 0.001). When compared with controls, ventilatory response (VE/VCO2) in AS was elevated (P = 0.01); however gas exchange indices, transcutaneous blood gases and breathing reserve were similar to controls. AS subjects developed a higher HR/VO2 response (P < 0.01) on exertion but without associated abnormalities in ECG, blood pressure response or anaerobic threshold. The AS group experienced a greater degree of leg fatigue (P < 0.01) than controls at peak exercise. Although the breathlessness scores (BS) were comparable to controls at peak exercise, the slopes of the relationship between BS and work rate (WR) [AS 0.054 (0.1), Controls 0.043 (0.06); P < 0.05] and BS and % predicted oxygen uptake [AS 0.084 (0.18), Controls 0.045 (0.06); P < 0.01] were steeper in the AS subjects. There was weak association between peak VO2 and vital capacity (r2% 12.0), MIP (11.8) but no association between Tlim, CE, Wall tragus distance or TL movement. The strongest association with aerobic capacity was between measurements of peripheral muscle strength (Qds; r = 0.75; hand grip; r = 0.47) accounting for 53% (P < 0.001) and 23.5% (P < 0.01) of the total variance in peak VO2, respectively. The addition of LBM to Qds in the regression model significantly improved the explained variance to 78.3% (P < 0.001). This study shows that peripheral muscle function is the most important determinant of exercise intolerance in AS patients suggesting that deconditioning is the main factor in the production of the reduced aerobic capacity.
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PMID:An investigation of factors limiting aerobic capacity in patients with ankylosing spondylitis. 1058 58


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