Simple mechanical-chemical systemic pressure-control device

An implantable mechanical-chemical device was constructed to act as a feedback mechanism in controlling the blood pressure. It consisted of a balloon connected to a rubber catheter ending in a slit valve. Flow-pressure curves were derived fromin vitro testings for three valve thresholds (120, 140 and 170 mmHg). Five fast-acting hypotensive drugs subsequently filled the device during 40 noradrenaline infusions in 25 dogs, with the balloon in the abdominal aorta and the catheter in the inferior vena cava. The results were as follows: (i) Following a short initial increase in systolic aortic pressure, significantly lower (p<0·001) than in control experiments, the device prevented any pressure rise above its threshold. (ii) The time needed for pressure lowering at the device's threshold depended on the drug used being 3·34±0·84 (mean ± s.e. in minutes) for sodium nitroprusside, 5·99±0·96 for phentolamin, 11·63±2·97 for hydralazine, 14·54±2·43 for a-methyl-dopa and 23·32±2·07 for diazoxide.     

Ventilatory response to oscillating and non-oscillatingPa CO 2 in the anesthetized cat

Summary In 11 adult cats, lightly anesthetized with chloralose-urethane, blood from both common carotid arteries was led into a plastic chamber of 15–20 ml and returned to the carotids at a point 1.5 cm more cranial. By doing so arterial blood was assumed to pool within the chamber and lose itsP _{CO 2} oscillations which are normally known to exist as a result of the respiratory cycle. In control periods blood bypassed the chamber, thus maintaining respiratoryP _{CO 2} oscillations. Spontaneous ventilation was measured spirometrically. The animals were breathing pure O₂.Results. 1. When the sinus (carotid) nerves were intact or sectioned there was no significant difference in ventilation before or after switching from non-oscillating to oscillatingPa _{CO 2}. 2. When the vertebral arteries were ligated a drop in ventilation occurred after turning to oscillatingPa _{CO 2} which was followed by a slight rise above control values after 30–50 sec. This phenomenon was independent of sinus nerve integrity. Thus in hyperoxie condition the smallPa _{CO 2} oscillations known to occur in phase with respiration do not seem to provide a respiratory stimulus to resting ventilation above that generated by the mean level ofPa _{CO 2}. The ventilatory depression after vertebral artery ligation must at this time remain unexplained.     

Independent coactivation of shoulder and elbow muscles

 The aim of this study was to examine the possibility of independent muscle coactivation at the shoulder and elbow. Subjects performed rapid point-to-point movements in a horizontal plane from different initial limb configurations to a single target. EMG activity was measured from flexor and extensor muscles acting at the shoulder (pectoralis clavicular head and posterior deltoid) and elbow (biceps long head and triceps lateral head) and flexor and extensor muscles acting at both joints (biceps short head and triceps long head). Muscle coactivation was assessed by measuring tonic levels of electromyographic (EMG) activity after limb position stabilized following the end of the movements. It was observed that tonic EMG levels following movements to the same target varied as a function of the amplitude of shoulder and elbow motion. Moreover, for the movements tested here, the coactivation of shoulder and elbow muscles was found to be independent – tonic EMG activity of shoulder muscles increased in proportion to shoulder movement, but was unrelated to elbow motion, whereas elbow and double-joint muscle coactivation varied with the amplitude of elbow movement and were not correlated with shoulder motion. In addition, tonic EMG levels were higher for movements in which the shoulder and elbow rotated in the same direction than for those in which the joints rotated in opposite directions. In this respect, muscle coactivation may reflect a simple strategy to compensate for forces introduced by multijoint limb dynamics. Received: 7 July 1998 / Accepted: 28 July 1998     

Effects of different speeds of induction with sevoflurane on the EEG in Man

The effects of two kinds of induction speed of sevoflurane anesthesia on the EEG pattern were compared in the same individual using medical student volunteers: a first exposure of 4% was given, followed after full recovery, by incremental doses of 1, 2 and 4% successively, each being administered for 10min. The arterial blood level of the anesthetic was measured using gaschromatograph. The changes of EEG pattern during fast induction with 4% were not represented by the abbreviation of those observed during the slow induction with the incremental doses. The administration of 4% induced a sudden appearance of high voltage, rhythmic slow waves of 2–3Hz at 1–3min when the arterial blood anesthetic level increased maximally, which was then followed by a pattern of faster activities of 10–14Hz mixed with 5–8Hz slow waves. In contrast, the administration of incremental doses induced an increase in frequency and amplitude of EEG activities in the light plane, followed by their decreases in deeper planes. The final EEG patterns were identical for both these methods of induction. These findings confirmed our previous hypothesis that not only the arterial blood level of anesthetics but the rate of its increase are important factors determining the EEG pattern of anesthesia.(Avramov MN et al.: Effects of different speeds of induction with sevoflurane on the EEG in man. J Anesth 1: 1–7, 1987)     

Cardiovascular effects in rats of alpha1 and alpha2 adrenergic agents injected into the nucleus tractus solitarii

Summary The cardiovascular effects of selective alpha₁ and alpha₂ agonists and antagonists injected into the nucleus tractus solitarii (NTS) were studied in urethane-anesthetized rats. Methoxamine (0.3–3 g) injected bilaterally into the NTS caused a dose-dependent increase in blood pressure and heart rate. Phenylephrine (6 g) and an imidazolidine derivative St 587 (3 g) similarly injected also produced an increase in blood pressure, whereas a-methylnoradrenaline and an azepine derivative B-HT 920 (1 and 3 g) caused a decrease in blood pressure and heart rate. The pressor response to methoxamine (1 g) was markedly inhibited by prazosin (0.3 pg) injected into the same sites or hexamethionum (25 mg/kg, i. v.). Prazosin (0.3 g) alone injected bilaterally into the NTS did not affect the blood pressure, while yohimbine (0.1 g) similarly injected increased the pressure. These results suggest that in the rat NTS there exist alpha₁ adrenoceptors responsible for an increase in arterial pressure. The NTS alpha2 adrenoceptors seem to be involved in the tonic regulation of arterial pressure. Send offprint requests to T. Kubo at the above address     

Application of the medical anti-shock trouser (MAST) increases cardiac output and tissue perfusion in simulated,mild hypovolaemia

We have studied the haemodynamic effects of the application of the medical anti-shock trouser (MAST) in 10 healthy subjects in the semi-upright position in order to simulate mild hypovolaemia. Left ventricular end diastolic dimension (EDD) was measured by M-mode echocardiography and cardiac output (CO) by the Doppler ultrasound technique. Forearm blood flow (FBF) was measured by plethysmography and blood pressure (BP) by the standard cuff technique. Systematic increases in MAST pressure of up to 80 mm Hg were applied. EDD increased to a maximum of 9.3% (p0.01) which was associated with a maximum increase in CO of 31.7% (p0.05). FBF increased by a maximum of 54.2% (p0.001) whilst BP increased by a maximum of 12% (p0.001). These results demonstrate that the application of the MAST is an effective means of transferring blood to the central circulation by compression of the capacitance vessels resulting in significant increases in cardiac output and tissue perfusion. At high pressures there was evidence of compression of resistance vessels, which may be useful in reducing blood loss. The ease and rapidity with which his suit can be applied suggests that it may be useful in the short term treatment of hypovolaemia.     

Scanning electron microscopy of microarterial anastomoses with the argon laser

A carotid end-to-end anastomosis was performed in 50 Wistar rats (mean weight 260 g) by means of a Coherent 900 argon laser. Laser pulses (average 19) of 300 mW power and 5 s exposure time were used, the beam being focused to form a spot of 150 m diameter. From day 0 to day 210, 13 specimens underwent scanning electron microscope examination. The results show that the laser impact produces a wall injury of 100 m in width with some coagulative necrosis of the media and adventitia. The line of anastomosis became re-endothelialized within four days, at which time collagen fusion was observed in the subendothelial layers. The longitudinal arrangement of the endothelial cells was restored by day 10. In the long term, a thick collagenous meshwork maintained the strength of the media, while normal endothelium covered the anastomosis. Complications such as disruption and aneurysm formation were attributed to technical problems.

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Résumé Anastomoses micro-artérielles au laser argon: étude en microscopie électronique à balayage. Les auteurs réalisent au laser Argon (Coherent 900) une anastomose carotidienne terminoterminale sur une série de 50 rats Wistar de poids moyen de 260 g. Les impacts laser (en moyenne 19) sont de 300 mW de puissance et d'une durée de 5 s chacun, avec un point de focalisation de 150 m de diamètre. On réalise sur 13 spécimens un examen en microscopie électronique à balayage. L'impact laser induit sur la paroi artérielle une lésion de 100 m de large avec une légère nécrose de coagulation de la media et de l'adventice. La ligne de suture est re-endothélialisée dès le quatrième jour, alors qu'une fusion du collagène est observée dans les couches sousendothéliales. L'arrangement longitudinal des cellules endothéliales est retrouvé dés le dixième jour. A long terme, un réseau collagénique serré assure la résistance de la media et un endothélium normal recouvre la ligne de soudure. Les complications tel que lâchage ou anéurysmes doivent être attribuées aux inconvénients techniques du début de l'expérimentation.

     

Short-termin vivo stability of endothelial-lined polyester elastomer and polytetrafluoroethylene grafts

A fibronectin substrate will significantly enhance the strength of endothelial cell attachment on grafts constructed of polyester elastomer (PE) and polytetrafluoroethylene (e-PTFE). This experiment was undertaken to determine the short-termin vivo stability of endothellum on these fibronectin coated surfaces. Eight mongrel dogs underwent bilateral carotid artery replacement with both graft materlals. All grafts were inoculated with 2,000 cells/mm² using cultured autogenous venous endothelium labelled with Indium-111-oxine. The Indium-111 label in the grafts was measured immediately prior to implantation, after 1 hour ofin vivo perfusion, and at explantation after 24 hours. The percentage of inoculated cells attached to the grafts before perfusion was simillar for both materials, 93.3±3.0% versus 92.2±7.2%, for PE and e-PTFE respectively. All grafts were patent at one hour after implantation. PE grafts were found to have 93.8±3.9 % of the attached cells present at one hour while e-PTFE grafts had only 54.5 ± 10.8 % remaining, p<.001. After 24 hours, 5/8 (62.5%) e-PTFE grafts and 2/8 (25.0 %) PE grafts remained patent, p=.13. Of the patent grafts however, endothelial cell retention was still superior on the PE grafts with 78.0±0.6% of the attached cells remaining compared to only 24.5±6.1% on e-PTFE, p<.001. Occluded PE grafts had fewer cells remaining at 24 hours than patent ones, 78.0±0.6% versus 31.1±32.8%, respectively, p=.13. Histologically, patent PE grafts demonstrated nearly confluent endothelial monolayers while e-PTFE had patches of endothelial cells surrounded by, a platelet-fibrin carpet. We conclude that short-term patency appears to be determined by the extent of endothelial retention on PE but not e-PTFE.     

冠心病患者甘油三酯水平对动脉僵硬度的影响

目的探讨冠心病患者甘油三酯水平对动脉僵硬度的影响。方法 539例冠心病患者根据cf-PWV值分为cf-PWV<12 m/s组(n=307)和cf-PWV≥12 m/s组(n=232),利用单变量分析及多元线性回归分析,探讨甘油三酯与动脉僵硬度的相关性。结果 cf-PWV≥12 m/s组的甘油三酯水平较高。单变量分析表明,甘油三酯与cf-PWV水平呈正相关(r=0.110, P=0.001)。多元线性回归分析显示甘油三酯与cf-PWV呈显著正相关(β=0.578, P <0.001)。结论甘油三酯是冠心病患者动脉僵硬度的独立预测因素。     

西洛他唑治疗糖尿病合并下肢动脉闭塞症的功效及安全性观察

目的：观察西洛他唑治疗糖尿病合并下肢动脉闭塞症的效果及安全性。方法：选择糖尿病合并下肢动脉闭塞症患者33例,给予西洛他唑第一周50mg,2次／日。第二周始改为100mg,2次／日,观察并检测治疗前后症状体征,双下肢血管直径及峰值血流速度,肝肾功能,血尿常规,血脂及血液流变学等指标。结果：患者主观症状改善率在80％以上,双下肢血流峰值速度治疗后有显著性增加（P＜0．01）,血尿常规,肝肾功能等各项指标治疗前后无明显差异。结论：西洛他唑对糖尿病合并下肢动脉闭塞症是一种安全有效的药物。