Regeneration of the x-ray irradiated gastrocnemius muscle in old rats after stimulation

In the present study the implantation of nonexposed muscle tissue to the site of injury in irradiated musculus gastrocnemius and following laser therapy were applied in order to stimulate this muscle's posttraumatic regeneration in old rats. It was shown that a far larger amount of functionally active muscle tissue was formed at the site of injury compared with rats received laser therapy alone or the ones which were only implanted nonexposed minced muscle tissue. The muscle tissue consisted of muscle fibers which originated from the grafted pieces of nonexposed skeletal muscle and the ones produced by myofibers of muscle stumps recovered after irradiation. The connective tissue developed more evenly. The formation of adipose tissue was not observed at the site of injury. Moreover, the skin wound healing and the hair growth were stimulated as well.     

Effects of intramuscular fat infiltration, scarring, and spasticity on the risk for sitting-acquired deep tissue injury in spinal cord injury patients

Sitting-acquired deep tissue injury (DTI) is a severe form of pressure ulcer (PU) often affecting patients with spinal cord injury (SCI) who also tend to suffer from intramuscular fat infiltration, soft tissue scarring (due to previous PU), and/or muscle spasticity in their buttocks. We previously used finite element (FE) modeling to evaluate whether abnormal bodyweight is a risk factor for sitting-acquired DTI. Here we hypothesize that fat infiltration, scarring, or spasms increase internal loads in the gluteus muscles in the vicinity of the ischial tuberosities during sitting, which consequently put SCI patients with these conditions at a higher risk for DTI. Our objective was to determine changes in gluteal strains and stresses and tissue volumes exposed to elevated strains/stresses associated with these factors. Thirty-five FE models of coronal slices through the seated buttocks, simulating these conditions at different severities, were developed. We calculated peak strains and stresses in glutei and percentage volumes of muscle tissue exposed to above-critical strains/stresses (compression strain≥50%, compression/von Mises stress≥2?kPa, and strain energy density≥0.5?kPa). Progressive intramuscular fat infiltration increased all the aforementioned outcome measures. Increase in size of scar patterns that were contained in both muscle and fat tissues similarly elevated the outcome measures. Spasms increased muscle stresses and volumetric exposures to stress, but tissue volumes at risk were ～1-2% and increases due to spasticity were slight. We conclude that the above potential risk factors can be listed according to the following order of importance: (i) fat infiltration, (ii) scars contained in both muscle and fat tissues, and (iii) spasms. This information should be considered when prioritizing prevention means and resources for patients with SCI.     

Biological approaches to improve skeletal muscle healing after injury and disease

Skeletal muscle injury and repair are complex processes, including well‐coordinated steps of degeneration, inflammation, regeneration, and fibrosis. We have reviewed the recent literature including studies by our group that describe how to modulate the processes of skeletal muscle repair and regeneration. Antiinflammatory drugs that target cyclooxygenase‐2 were found to hamper the skeletal muscle repair process. Muscle regeneration phase can be aided by growth factors, including insulin‐like growth factor‐1 and nerve growth factor, but these factors are typically short‐lived, and thus more effective methods of delivery are needed. Skeletal muscle damage caused by traumatic injury or genetic diseases can benefit from cell therapy; however, the majority of transplanted muscle cells (myoblasts) are unable to survive the immune response and hypoxic conditions. Our group has isolated neonatal skeletal muscle derived stem cells (MDSCs) that appear to repair muscle tissue in a more effective manner than myoblasts, most likely due to their better resistance to oxidative stress. Enhancing antioxidant levels of MDSCs led to improved regenerative potential. It is becoming increasingly clear that stem cells tissue repair by direct differentiation and paracrine effects leading to neovascularization of injured site and chemoattraction of host cells. The factors invoked in paracrine action are still under investigation. Our group has found that angiotensin II receptor blocker (losartan) significantly reduces fibrotic tissue formation and improves repair of murine injured muscle. Based on these data, we have conducted a case study on two hamstring injury patients and found that losartan treatment was well tolerated and possibly improved recovery time. We believe this medication holds great promise to optimize muscle repair in humans. (Part C) 96:82–94, 2012. © 2012 Wiley Periodicals, Inc.     

Skeletal muscle tissue engineering

The reconstruction of skeletal muscle tissue either lost by traumatic injury or tumor ablation or functional damage due to myopathies is hampered by the lack of availability of functional substitution of this native tissue. Until now, only few alternatives exist to provide functional restoration of damaged muscle tissues. Loss of muscle mass and their function can surgically managed in part using a variety of muscle transplantation or transposition techniques. These techniques represent a limited degree of success in attempts to restore the normal functioning, however they are not perfect solutions. A new alternative approach to addressing difficult tissue reconstruction is to engineer new tissues. Although those tissue engineering techniques attempting regeneration of human tissues and organs have recently entered into clinical practice, the engineering of skeletal muscle tissue ist still a scientific challenge. This article reviews some of the recent findings resulting from tissue engineering science related to the attempt of creation and regeneration of functional skeletal muscle tissue.     

Assessment of a Lower Extremity Training Program

The response to a lower extremity program has been studied in workmen undergoing progressive rehabilitation following injury to the lower leg or ankle region. When first seen, the isometric strength of the injured limb was substantially reduced relative to its counterpart, and aerobic power was also poor, relative to normal standards. Substantial gains of isometric strength occurred over a four- to six-week period of therapy. Measurements above the site of injury suggested a 13% gain of strength, and measurements below the injury indicated a gain of 34%. On the other hand, there were minimal changes of thigh circumference over this period. Soft tissue radiographs taken in the posteroanterior and lateral planes showed a small (1%) increase of muscle tissue and a somewhat larger (5%) loss of subcutaneous fat. Dynamic exercise at a fixed percentage of aerobic power was associated with similar subjective discomfort and a similar accumulation of lactate before and after rehabilitation.It is concluded that the apparent improvement in isometric strength over the period of rehabilitation is due to (1) initial voluntary limitation of effort and (2) increase in skill. The use of soft tissue radiographs may afford a more objective basis for the evaluation of future muscle training programs.     

Resveratrol improves muscle regeneration in obese mice through enhancing mitochondrial biogenesis

Obesity is increasing rapidly worldwide and is accompanied by many complications, including impaired muscle regeneration. Obesity is known to inhibit AMP-activated protein kinase (AMPK) activity, which impedes mitochondrial biogenesis, myogenic differentiation and muscle regeneration. Resveratrol has an effective anti-obesity effect, but its effect on regeneration of muscle in obese mice remains to be tested. We hypothesized that resveratrol activates AMPK and mitochondrial biogenesis to improve muscle regeneration. Male C57BL/6J mice were fed a control diet or a 60% high-fat diet with or without resveratrol supplementation for 8 weeks and, then, the tibialis anterior muscle was subjected to cardiotoxin-induced muscle injury. Muscle tissue was collected at 3 and 7 d after injury. We found that resveratrol enhanced both proliferation and differentiation of satellite cells following injury in obese mice. Markers of mitochondrial biogenesis were upregulated in resveratrol-treated mice. In C2C12 myogenic cells, resveratrol activated AMPK and stimulated the expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, which were associated with enhanced myogenic differentiation. Such effects of resveratrol were abolished by AMPKα1 ablation, showing the mediatory roles of AMPK. In summary, dietary resveratrol activates AMPK/ proliferator-activated receptor gamma coactivator 1-alpha axis to facilitate mitochondrial biogenesis and muscle regeneration impaired due to obesity.     

Effects of minced muscle tissue implantation and subsequent laser therapy on regeneration of skeletal muscles in guinea pigs]

It is known that regenerative capacity of skeletal muscles in guinea pigs is less than in rats. The guinea pig muscle regenerates are characterized by smaller muscle fibers and greater amounts of interstitial connective tissue. The present experiments were designed to stimulate the regenerative capacity of muscle tissue in adult guinea pigs, using tissue and laser therapy. It was shown that the minced muscle tissue implantation to the site of injury in m. gastrocnemius increased the quantity of regenerating muscle tissue. When the same operation was combined with following laser therapy the increase of muscle tissue was observed as well but not by far. At the same time laser therapy promoted noticeable acceleration of fibrin resorption, wound healing and regenerative modifications in implanted muscle fragments. Thus, the present methods stimulated relatively law regenerative capacity of guinea pig muscle tissue and promoted more qualitative recovery of injured area.     

GSK-3beta activity is increased in skeletal muscle after burn injury in rats

Previous reports suggest that burn-induced muscle proteolysis can be inhibited by treatment with GSK-3beta inhibitors, suggesting that burn injury may be associated with increased GSK-3beta activity. The influence of burn injury on muscle GSK-3beta activity, however, is not known. We determined the effect of a 30% total body surface full-thickness burn injury in rats on muscle GSK-3beta activity by measuring GSK-3beta activity and tissue levels of serine 9 phosphorylated GSK-3beta, p(Ser9)-GSK-3beta, by Western blot analysis and immunohistochemistry. Because burn-induced muscle wasting is, at least in part, mediated by glucocorticoids, we used dexamethasone-treated cultured muscle cells in which GSK-3beta expression was reduced with small interfering RNA (siRNA) to further assess the role of GSK-3beta in muscle atrophy. Burn injury resulted in a seven-fold increase in GSK-3beta activity in skeletal muscle. This effect of burn was accompanied by reduced tissue levels of p(Ser9)-GSK-3beta, suggesting that burn injury stimulates GSK-3beta in skeletal muscle secondary to inhibited phosphorylation of the enzyme. In addition, burn injury resulted in inhibited phosphorylation and activation of Akt, an upstream regulatory mechanism of GSK-3beta activity. Reducing the expression of GSK-3beta in cultured muscle cells with siRNA inhibited dexamethasone-induced protein degradation by approximately 50%. The results suggest that burn injury stimulates GSK-3beta activity in skeletal muscle and that GSK-3beta may, at least in part, regulate glucocorticoid-mediated muscle wasting.     

Reduction of skeletal muscle injury in composite tissue allotransplantation by heat stress preconditioning

Ischemia-reperfusion injury is a dominant factor limiting tissue survival in any microsurgical tissue transplantation, a fact that also applies to allogeneic hand transplantation. The clinical experience of the 12 human hand transplantations indicates that shorter ischemia times result in reduced tissue damage and, ultimately, in better hand function. Heat stress preconditioning and the accompanying up-regulation of the heat shock protein 72 have been shown to reduce the ischemia-reperfusion injury following ischemia of various organs, including organ transplantation. The aim of this study was to reduce the ischemia-reperfusion injury in a model of composite tissue allotransplantation. Allogeneic hind limb transplantations were performed from Lewis (donor) to Brown-Norway rats. Donor rats in group A (n = 10) received a prior heat shock whereas rats in group B (n = 10) did not receive any prior heat shock. Group C served as a control group without transplantation. The transplantations were performed 24 hours after the heat shock, at which time the heat shock protein 72 was shown to be up-regulated. The outcome was evaluated 24 hours after transplantation by nitroblue tetrazolium staining and wet-to-dry weight ratio of muscle slices (anterior tibial muscle). The nitroblue tetrazolium staining showed a significant reduction of necrotic muscle in group A (prior heat shock) (p = 0.005). The wet-to-dry ratio was significantly reduced in group A (prior heat shock), indicating less muscle edema and less tissue damage (p = 0.05). Heat shock preconditioning 24 hours before an ischemic event leads to an up-regulation of heat shock protein 72 in muscle and to a tissue protection reducing ischemia-reperfusion injury in composite tissue transplantation.     

Impaired Skeletal Muscle Regeneration in the Absence of Fibrosis during Hibernation in 13-Lined Ground Squirrels

Skeletal muscle atrophy can occur as a consequence of immobilization and/or starvation in the majority of vertebrates studied. In contrast, hibernating mammals are protected against the loss of muscle mass despite long periods of inactivity and lack of food intake. Resident muscle-specific stem cells (satellite cells) are known to be activated by muscle injury and their activation contributes to the regeneration of muscle, but whether satellite cells play a role in hibernation is unknown. In the hibernating 13-lined ground squirrel we show that muscles ablated of satellite cells were still protected against atrophy, demonstrating that satellite cells are not involved in the maintenance of skeletal muscle during hibernation. Additionally, hibernating skeletal muscle showed extremely slow regeneration in response to injury, due to repression of satellite cell activation and myoblast differentiation caused by a fine-tuned interplay of p21, myostatin, MAPK, and Wnt signaling pathways. Interestingly, despite long periods of inflammation and lack of efficient regeneration, injured skeletal muscle from hibernating animals did not develop fibrosis and was capable of complete recovery when animals emerged naturally from hibernation. We propose that hibernating squirrels represent a new model system that permits evaluation of impaired skeletal muscle remodeling in the absence of formation of tissue fibrosis.     

A theoretical model to study the effects of cellular stiffening on the damage evolution in deep tissue injury

Pressure induced deep tissue injury (DTI) is a severe form of pressure ulcers that is hard to detect in early stages and difficult to prevent and treat. High prevalence figures are partly due to a lack of understanding of pathological pathways involved in DTI. The aim of this study was to investigate, whether changes in material properties of damaged tissue can play a role in DTI aetiology. A numerical model was developed based on muscle microstructure and tissue engineering experiments. A time dependent damage law was proposed and stiffening of dead cells incorporated. The results obtained in the microstructural investigations were used to include the stiffening information in a pre-existing macroscopic model based on animal experiments, which correlated strains to tissue damage measured in the tibialis anterior muscle in rat limbs. With the modelling approach employed in this paper, the damaged area in the rat limb models increased up to 1.65-fold and the rate of damage progression was up to 2.1 times higher in microstructural simulations when stiffening was included.     

Musculotendon variability influences tissue strains experienced by the biceps femoris long head muscle during high-speed running

The hamstring muscles frequently suffer injury during high-speed running, though the factors that make an individual more susceptible to injury remain poorly understood. The goals of this study were to measure the musculotendon dimensions of the biceps femoris long head (BFlh) muscle, the hamstring muscle injured most often, and to use computational models to assess the influence of variability in the BFlh’s dimensions on internal tissue strains during high-speed running. High-resolution magnetic resonance (MR) images were acquired over the thigh in 12 collegiate athletes, and musculotendon dimensions were measured in the proximal free tendon/aponeurosis, muscle and distal free tendon/aponeurosis. Finite element meshes were generated based on the average, standard deviation and range of BFlh dimensions. Simulation boundary conditions were defined to match muscle activation and musculotendon length change in the BFlh during high-speed running. Muscle and connective tissue dimensions were found to vary between subjects, with a coefficient of variation (CV) of 17±6% across all dimensions. For all simulations peak local strain was highest along the proximal myotendinous junction, which is where injury typically occurs. Model variations showed that peak local tissue strain increased as the proximal aponeurosis width narrowed and the muscle width widened. The aponeurosis width and muscle width variation models showed that the relative dimensions of these structures influence internal muscle tissue strains. The results of this study indicate that a musculotendon unit’s architecture influences its strain injury susceptibility during high-speed running.     

Effect of therapeutic pulsed ultrasound on parameters of oxidative stress in skeletal muscle after injury

Contusion injuries are a very common form of both athletic and non-athletic injury, that effect muscle function. Treatments to augment the normal repair and regeneration processes are important for a wide variety of patients. Therapeutic ultrasound has been claimed to promote tissue repair, especially by enhancing cell proliferation and protein synthesis. The present study aimed to investigate the effect of therapeutic pulsed ultrasound (TPU) on parameters of oxidative stress, namely thiobarbituric acid-reactive substances (TBARS), protein carbonyl content and the activities of antioxidant enzymes, catalase and superoxide dismutase (SOD), in skeletal muscle after injury. Wistar rats were submitted to an animal model of muscle (gastrocnemius) laceration. TPU was used once a day. One, three or five days after muscle laceration, the animals were killed by decapitation and oxidative stress parameters were evaluated. Serum CK levels were increased in muscle-injured animals, indicating that the laceration animal model was successful. TBARS were not altered after muscle injury, when compared to the sham group. Protein carbonyl content was increased after muscle laceration. Catalase and SOD activities were increased 1 day after muscle injury and not altered at days 3 and 5. TPU decreased TBARS levels after muscle laceration when compared to injured muscle animals without treatment. Protein carbonyl content evaluation presented similar results. It is tempting to speculate that TPU seems to protect the tissue from oxidative injury. TPU diminished catalase and SOD activities, especially on the first day following muscle laceration.     

Compression-induced damage and internal tissue strains are related

Prolonged mechanical loading of soft tissues adjacent to bony prominences can lead to degeneration of muscle tissue, resulting in a condition termed pressure-related deep tissue injury. This type of deep pressure ulcers can develop into a severe wound, associated with problematic healing and a variable prognosis. Limited knowledge of the underlying damage pathways impedes effective preventive strategies and early detection. Traditionally, pressure-induced ischaemia has been thought to be the main aetiological factor for initiating damage. Recent research, however, proposes tissue deformation per se as another candidate for initiating pressure-induced deep tissue injury. In this study, different strain parameters were evaluated on their suitability as a generic predictive indicator for deep tissue injury. With a combined animal-experimental numerical approach, we show that there is a reproducible monotonic increase in damage with increasing maximum shear strain once a strain threshold has been exceeded. This relationship between maximum shear strain and damage seems to reflect an intrinsic muscle property, as it applied across a considerable number of the experiments. This finding confirms that tissue deformation per se is important in the aetiology of deep tissue injury. Using dedicated finite element modeling, a considerable reduction in the inherent biological variation was obtained, leading to the proposal that muscle deformation can prove a generic predictive indicator of damage.     

A substituted dextran enhances muscle fiber survival and regeneration in ischemic and denervated rat EDL muscle.

Ischemia and denervation of EDL muscle of adult rat induce a large central zone of degeneration surrounded by a thin zone of peripheral surviving muscle fibers. Muscle regeneration is a complex phenomenon in which many agents interact, such as growth factors and heparan sulfate components of the extracellular matrix. We have shown that synthetic polymers, called RGTA (as regenerating agents), which imitate the heparan sulfates, are able to stimulate tissue repair when applied at the site of injury. In crushed muscles, RGTA were found to accelerate both regeneration and reinnervation. In vitro, RGTA act as protectors and potentiators of various heparin binding growth factors (HBGF). It was postulated that in vivo their tissue repair properties were due in part to an increase of bioavailability of endogenously released HBGF. In the present work, we show that ischemic and denervated EDL muscle treated by a unique injection of RGTA differs from the control after 1 wk in several aspects: 1) the epimysial postinflammatory reaction is inhibited and the area of fibrotic tissue among fibers is reduced; 2) the peripheral zone, as measured by the number of intact muscle fibers, was increased by more than twofold; and 3) In the central zone, RGTA enhances the regeneration of the muscle fibers as well as muscle revascularization. These results suggest that RGTA both protects muscle fibers from degeneration and preserves the differentiated state of the surviving fibers. For the first time it is demonstrated that a functionalized polymeric compound can prevent some of the damage resulting from muscle ischemia. RGTA may therefore open a new therapeutic approach for muscle fibrosis and other postischemic muscle pathologies.     

Agent-based model provides insight into the mechanisms behind failed regeneration following volumetric muscle loss injury

Skeletal muscle possesses a remarkable capacity for repair and regeneration following a variety of injuries. When successful, this highly orchestrated regenerative process requires the contribution of several muscle resident cell populations including satellite stem cells (SSCs), fibroblasts, macrophages and vascular cells. However, volumetric muscle loss injuries (VML) involve simultaneous destruction of multiple tissue components (e.g., as a result of battlefield injuries or vehicular accidents) and are so extensive that they exceed the intrinsic capability for scarless wound healing and result in permanent cosmetic and functional deficits. In this scenario, the regenerative process fails and is dominated by an unproductive inflammatory response and accompanying fibrosis. The failure of current regenerative therapeutics to completely restore functional muscle tissue is not surprising considering the incomplete understanding of the cellular mechanisms that drive the regeneration response in the setting of VML injury. To begin to address this profound knowledge gap, we developed an agent-based model to predict the tissue remodeling response following surgical creation of a VML injury. Once the model was able to recapitulate key aspects of the tissue remodeling response in the absence of repair, we validated the model by simulating the tissue remodeling response to VML injury following implantation of either a decellularized extracellular matrix scaffold or a minced muscle graft. The model suggested that the SSC microenvironment and absence of pro-differentiation SSC signals were the most important aspects of failed muscle regeneration in VML injuries. The major implication of this work is that agent-based models may provide a much-needed predictive tool to optimize the design of new therapies, and thereby, accelerate the clinical translation of regenerative therapeutics for VML injuries.     

Muscle tissue regeneration of the lymph hearts in adult Rana temporaria frogs. A study by light and electron microscopy autoradiography methods

The regeneration response of adult frog lymph heart muscle tissue was studied from 2 to 3 weeks after mechanical injury. High resolution autoradiographic studies showed that regenerative necrotic zones have many actively proliferating mononuclear cells deprived of cytoplasmic myofilaments. Some of them have numerous free ribosomes, so they might be identified as myoblasts. On the 13th day after injury newly-formed myotubes with chains of myonuclei and pictures of active sarcomerogenesis were observed. On the other hand, the surviving muscle fibers of the perinecrotic zone were rich in myonuclei at their growing ends. In the vicinity of nuclei, accumulation of a mass of non-differentiated cytoplasm rich in free ribosomes and polysomes, rough endoplasmic reticulum, Golgi apparatus, and centrioles are seen. Tritiated thymidine pulse-labeling showed that only rare myonuclei of the perinecrotic zone muscle fibers were labeled, whereas numerous non-differentiated cells of granulation tissue and myosatellites incorporated thymidine. The number of labeled myonuclei markedly increased 96 hours after 3HTdr administration. These data evidence that the myoblastic mechanism is predominant in the regeneration of adult frog lymph heart muscle tissue. It is necessary to emphasize that during the lymph heart muscle tissue reparative myogenesis some of the perinecrotic myonuclei are able to synthesize DNA and to divide mitotically, which distinguishes this type of muscle from skeletal muscle tissue of vertebrates.     

In vivo electrical impedance spectroscopic monitoring of the progression of radiation-induced tissue injury.

This study evaluates the potential of electrical impedance spectroscopy (EIS) as a noninvasive technique for tracking the progression of radiation-induced damage in normal muscle tissue. Male Sprague-Dawley rats were irradiated locally to the gastrocnemius and biceps femoris muscle. Single doses were administered using a procedure that spares skin and bone. Complex impedance spectral measurements (taken at 50 frequency points between 1 kHz and 1 MHz) were made at monthly intervals using recessed disk electrodes applied to the skin. A histological scoring scheme was developed for evaluation of injury. A strong dose-dependent progression of injury evident in both spectral measurements and histological scoring has been observed. Latent time also appears to be dependent on dose with changes induced by 70 Gy evident by 2 months, changes induced by 90 Gy observed by 1 month, and dramatic changes found within 3 weeks at 150 Gy. Injury was morphologically comparable to the type of damage that occurs in response to small, fractionated doses, but on a much shorter time scale. Increased spectral shift was a consistent indicator of the extent of tissue injury at the time of measurement. The use of a large single dose resulted in an excellent model in terms of inducing a significant progression in tissue injury over a short post-treatment follow-up period in the muscle mass while also providing a consistent location for in vivo electrical impedance measurements. The results show that EIS can follow radiation-induced tissue change, suggesting that EIS has the potential to monitor the types of injury observed in late radiation damage of muscle tissue noninvasively.     

Activation of serpins and their cognate proteases in muscle after crush injury

Direct muscle injury was induced in rats in order to evaluate alterations in the balance of serine proteases and inhibitors (serpins) as a response to tissue damage. It was previously found that certain proteases, specifically urokinase-like plasminogen activator (uPA) and others, required activation in order to effect regeneration. We hypothesized that the magnitude and temporal sequence of serpin activation would follow, pari passu, activation of their cognate proteases. In addition to uPA, tissue PA (tPA) and tissue kallikrein were the proteases studied. The serpins we analyzed were protease nexin I (PNI), PA inhibitor 1 (PAI-1), and the kallikrein-binding protein (KBP). uPA nearly doubled 48 h after injury, while there was no change in amidolytic activity after addition of fibrin monomer as an estimation of tPA activity. Tissue kallikrein activity, barely detectable in normal muscle, slowly increased, nearly tripling at 7 days after injury. Greater magnitude and more rapid changes in muscle serpins occurred over the same post-injury time course. By 24 h PNI increased threefold, while PAI-1 increased more slowly, reaching double the control values by 5 days after injury. Surprisingly, KBP, the serpin-class inhibitor of tissue kallikrein, had the most robust response, increasing tenfold over control 48 h after crush injury of muscle. These results further implicate the serpin:protease balance in tissue injury. Participation of complex receptors, such as the α₂-macroglobulin receptor/low density lipoprotein receptor-related protein (LRP), various growth factors, cytokines, and other molecules, in regulating this balance is implicated by these data. © 1994 wiley-Liss, Inc.