Long-term treatment with cinacalcet and conventional therapy reduces parathyroid hyperplasia in severe secondary hyperparathyroidism

Background. The effect of cinacalcet on the structural pattern of hyperplastic parathyroid glands was evaluated, using high-resolution colour Doppler (CD) sonography, in haemodialysis patients with severe, inadequately controlled, secondary hyperparathyroidism (sHPT)

Effect of a topical beta‐adrenergic receptor antagonist on the dynamics of steady‐state accommodation

The ocular accommodation response to a stationary near target exhibits microfluctuations which arc characterized by two dominant components of activity: a low‐frequency component (LFC: < 0.5 Hz) and a high‐frequency component (HFC: 1.0–2.2 Hz). We have shown recently that there is a significant correlation between the frequency of arterial pulse (AP) and the peak frequency of the HFC. If the mechanisms by which AP induces the HFC are intraocular they are likely to involve both rhythmic variations in choroidal blood flow and intraocular pressure (IOP) pulse: the former inducing changes in ciliary ring diameter from pulsatile blood volume changes in the ciliary body, the latter producing changes in effective lens power following small shifts in lens position or, with each drop in IOP. reduced resistance to inherenl lens substance and capsule elasticity. In addition to its well‐known ocular hypotensive effect, topical instillation of the beta‐ad renergic receptor antagonist timntol maleate has been shown to reduce significantly the magnitude of the IOP pulse, an effect that has been attributed to the vasoconstrictive action of the drug on the choroidal vasculature. Using li modified Canon IR optometcr we report on the effect of 0.5% timolol maleate on the accommodative microfluctuations for a group of 10 emmetropic subjects viewing a target monocularly at a distance of 25 cm. Following a double‐blind protocol against a saline control, timoloi was shown to reduce the rms for both LFCs and HFCs. An experiment to separate local from systemic effects involved four subjects whose treated and untreated eyes were examined to determine the effects of the consensual reduction in IOP: the results on microfluctuations in the untreated eyes were equivocal but the correlation between arterial pulse frequency and location of the peak frequency of HFC was maintained. The results show that factors relating to IOP and vasculature will affect the magnitude of accommodative microfluctuations. Copyright © 1991, Wiley Blackwell. All rights reserve

Prolonged space flight-induced alterations in the structure and function of human skeletal muscle fibres

The primary goal of this study was to determine the effects of prolonged space flight (∼180 days) on the structure and function of slow and fast fibres in human skeletal muscle. Biopsies were obtained from the gastrocnemius and soleus muscles of nine International Space Station crew members ∼45 days pre- and on landing day (R+0) post-flight. The main findings were that prolonged weightlessness produced substantial loss of fibre mass, force and power with the hierarchy of the effects being soleus type I > soleus type II > gastrocnemius type I > gastrocnemius type II. Structurally, the quantitatively most important adaptation was fibre atrophy, which averaged 20% in the soleus type I fibres (98 to 79 μm diameter). Atrophy was the main contributor to the loss of peak force (P0), which for the soleus type I fibre declined 35% from 0.86 to 0.56 mN. The percentage decrease in fibre diameter was correlated with the initial pre-flight fibre size (r = 0.87), inversely with the amount of treadmill running (r = 0.68), and was associated with an increase in thin filament density (r = 0.92). The latter correlated with reduced maximal velocity (V0) (r = −0.51), and is likely to have contributed to the 21 and 18% decline in V0 in the soleus and gastrocnemius type I fibres. Peak power was depressed in all fibre types with the greatest loss (∼55%) in the soleus. An obvious conclusion is that the exercise countermeasures employed were incapable of providing the high intensity needed to adequately protect fibre and muscle mass, and that the crew's ability to perform strenuous exercise might be seriously compromised. Our results highlight the need to study new exercise programmes on the ISS that employ high resistance and contractions over a wide range of motion to mimic the range occurring in Earth's 1 g environment