1.  98-03-06

Monica Smith, D.C.

Palmer Chiropractic College

A Compilation of Chiropractic Data: Final Project Stages

$19,050

In her collaborations with Miron Stano, Monica Smith has established herself as one of top five authors in the world publishing critical cost-effective data for chiropractic. This supplement will extend her efforts to identify, retrieve, and index information regarding the practice, delivery, utilization, organization, and cost of chiropractic care as described in a previous award from NCMIC [#96-03-12], as described above. This new award will allow Dr. Smith to complete a manual which would permit rapid public access to the databases compiled.

2. 98-10-05

Veronica M. Sciotti, Ph.D.

New York Chiropractic College

The Biochemical Profile of Myofascial Trigger Points: A Clinical Microdialysis Study

$94,605

The purpose of the proposed studies is to describe, for the first time, the extracellular milieu of muscle and connective tissue cells using a novel microdialysis sampling technique from the trapezius muscle of human subjects. Clinically diagnosed myofascial trigger points [TrPs] are to be sampled, with unaffected muscle on the opposite side of the subject serving as a control. It is presumed that microdialysis provides an excellent model of microcirculation by means of its ability to selectively collect low-molecular weight metabolites after the insertion of the probe into the fiber of interest. Rationales for measuring the concentrations of the following metabolites are:

a. ATP and products of ATP metabolism [adenosine, inosine, hyopoxanthine, uric acid]: indices of availability of high energy phosphate molecules, the lack of which is proposed by some to a predisposing factor for TrP formation;

b. Glycerol and glucose as indicators of availability of metabolic fuels required for muscle metabolism;

c. Primary amino acids [serine, threonine, alanine, taurine, citrulline] as indices of availability of gluconeogenic substrates and nitric oxide production.

d. Pyruvate and lactate as indicators of increased anaerobic respiration, found in muscle fatigue.

Measurement of these metabolites is to be accomplished either by high performance liquid chromatography or a microdialysis analyzer. Alterations of their levels will signal either increased metabolic demand or decreased metabolic supply to the tissue in question. Total blood flow within the tissue surrounding the microdialysis probe will also be monitored. A total of 30 human subjects presenting with myofascial TrPs identified by algometry performed by a D.C. is to be used in this investigation.

The clinical understanding to be gleaned from this study is twofold. First, the biochemical data obtained will further describe potential perturbations in muscle metabolism which may contribute to the clinical presentation of myofascial TrPs. Secondly, any changes observed may serve as future baselines with which to evaluate the effectiveness, if any, of chiropractic treatment in treating myofascial syndrome.