The role of the pituitary-adrenal system in the restoration of the vital functions after clinical death

Summary The course of resuscitation was compared after fatal blood loss in hypophysectomized and healthy cats. Experiments have demonstrated that removal of the anterior lobe of the hypophysis impedes the restorative process. Hypophyseal-adrenal insufficiency becomes manifest during functional normalization of the subcortical centers and metabolism. ACTH and cortisone therapy is recommended in terminal conditions.(Presented by Active Member, Academy of Medical Sciences, U.S.S.R., A. V. Lebedinskii) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 51, No. 4, pp. 32–39, April, 1961Report on the Annual Scientific Conference of the Stalinsk Postgraduate Medical School, March 29, 1960.     

Structure of the respiratory cycle during extinction and restoration of vital functions

Summary Acute experiments on dogs were made to study by means of electromyography the structure of the respiratory cycle of the main and accessory respiratory muscles at various stages of extinction of the vital functions during death from blood loss and in the first 1.5–3 h of resuscitation after a 3–5 min clinical death. Dying of the animals is accompanied by disturbances in the reciprocal relations between the inspiratory and expiratory centers, as a result of which in the agonal state the expiratory and accessory respiratory muscles contract during inspiration. The mechanisms ensuring an active expiration are more sensitive to hypoxemia; during dying the expiratory muscles are excluded from the respiratory activity earlier and are restored to function later than the inspiratory muscles. Normalization of the activity of the expiratory muscles depends on the restoration of the parts of the brain stem on the border between the medulla oblongata and the pons Varoli. As evidenced by EMG data, the degree of pulmonary ventilation corresponds to the structure of the respiratory cycle much more than to its pneumographic characteristics.(Presented by Academician V. V. Parin) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 59, No. 5, pp. 35–40, May, 1965.     

Disturbances in and restoration of function is of viscera after clinical death

Summary The author has studied the secretory and motor (hunger perlodical motions) stomach activity in the gastrooesophagotomized dog. Following the establishment of standards of the activity under investigation, the dog was twice bled to death in short experiments. The clinical death lasted 2 minutes in the first experiment and 7 minutes in the second. Then the changes of the stomach activity and the dynamics of the processes of recovery were studied. Exhaustion of the secretory function of the organism and chaotic motor function of the stomach were revealed. The process of recovery took from 2 to 4 months.Presented by V. N. Chernigovsky, Member AMS USSR     

On the restoration of the neuroreflex regulation of the cardiovascular system during resuscitation after clinical death

Summary Investigations carried out by the author have demonstrated that in reviving the organism after clinical death the activity of the vagus center is restored subsequent to the appearance of respiration. Up to that time the cardiovascular system was under a preponderant effect of the sympathetic nervous system. In the next few days following the revival, the heart reactions to external stimuli were inadequate. This may be due to an incomplete central nervous system restoration. Cardiac reaction to external stimuli normalized in 1–4 weeks.(Presented by Active Member, AMS USSR, V. V. Parin) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 52, No. 10, pp. 34–38, October, 1961     

Hemocoagulation while dying of blood loss and restoration to life after clinical death]

Hemostatic system function was studied in dogs dying of acute blood loss and restoring to life after 4-min clinical death. Phasic changes in hemostatic system of two and three types occurred in the blood loss and reanimation, respectively. Dogs with favorable postresuscitation period exhibited hypercoagulation when dying, hypocoagulation 1 hour after reanimation and normal coagulation 3-6 hours after clinical death.     

New families of adhesion molecules play a vital role in platelet functions

Adhesion molecules play a crucial part in cell-matrix and in cell-cell interactions. These interactions, which are essential to the body's defense processes, involve adhesion molecules belonging to different families: integrins, immunoglobulins and selectins. Integrins are expressed by a large number of tissues, whereas other adhesion molecule families are restricted to a small number of cell types. A recent symposium dealt with the recruitment of circulating platelets at specific sites, their adhesion to extracellular matrix components and their activation by agonists leading to aggregation or attachment to other cells. These events, supporting hemostasis and thrombosis, involve integrins, selectins and other adhesion molecules. This report focuses on newly reported integrins (GPIa, GPIc, GPIIa), selectins (GMP-140) and GPIIIb, previously known as 'minor' surface oriented platelet glycoproteins. Major membrane glycoproteins such as GPIIb-IIIa (an integrin) and GPIb, which also play a vital role in platelet functions, have been extensively reviewed elsewhere.     

Restoration of vital function in monkeys after bleeding to death during hypothermia

Summary Clinical death resulting from acute blood loss in monkeys was prolonged up to 20–30 minutes with the aid of hypothermia. Vital function was restored by means of centripetal arterial blood transfusion and artificial respiration; direct cardiac massage and elimination of defibrillation by electrical stimulation were used in a number of cases. Monkeys are, however, more sensitive to the hypoxia caused by bleeding to death than are dogs, even under hypothermic conditions. Thus, complete restoration of vital function was achieved only in 1 monkey out of the 4 which sustained a 30 minute period of clinical death. At the same time, when the monkeys recover, vital function is restored more rapidly than in dogs. The latter is evidently due to more perfect compensation.Presented by Active Member of the AMN SSSR V. N. Chernigovskii     

The vital role of the cottage community hospital

The history of general-practitioner hospitals is reviewed and a case made for their retention and extension. Among the advantages they provide are: a local service for patients, less expensive hospital care than is possible in a district general hospital, less travelling expenses for patients, valuable postgraduate education for doctors, and improvement of general-practitioner morale.     

Changes in the adrenals in the sudden death syndrome in infants

Adrenal glands of 52 children dying from a syndrome of sudden death (SSD) and 14 children of the same age dying from acute viral respiratory infections (AVRI) with a long terminal period were studied. The following adrenal changes typical for the SSD were observed: low weight, decrease of the size of the definitive cortex and its zones, the appearance of numerous adenomatous growths in the definitive cortex and so-called giant cells in the fetal cortex, low secretory activity. The appearance of adenomas and giant cells in the presence of organ hypoplasia is a compensatory-hyperplastic adrenal response which attests to a long glucocorticoid deficiency in the SSD. It is suggested that the deficiency of these hormones leads to the metabolic disturbances in various organs, including brain, resulting in the narrowing of the range of homeostatic host responses; this may become the cause of sudden death when the clinical and morphological manifestations of AVRI are insignificant.     

Disturbance and restoration of motor functions in ducks after hemisection of the spinal cord

Summary Experiments were staged in chronic conditions on 29 ducks. At first, hemisection of the spinal cord was done at the level of the sixth cervical vertebra, and then two-stage excision of the hemispheres of the forebrain was performed. Each of the subsequent operations was carried out after the highest possible restoration level of disturbed functions (caused by the previous operation) was reached. Urethane anesthesia (1.0 gm/kg of body weight) was used.Locomotor functional disturbances caused by the spinal cord hemisection in ducks are compensated, although only partially, in about 3 months. Excision of one of the hemispheres of the forebrain led to decompensation of the motor functions restored earlier. Removal of one of the forebrain hemispheres in ducks caused locomotor functional disturbances not only as a result of functional decompensation of one extremity (at the side of hemisection), but also due to disturbed function of the second extremity. The highest possible restoration level of the secondarily disturbed standing and walking functions occurred somewhat earlier and was somewhat more complete after the removal of the contralateral hemisphere of the forebrain (in 1–1.5 months) than following the excision of the homolateral hemisphere (in 1.5–2 months). Removal of the second forebrain hemisphere again provoked decompensation of the twice restored standing and walking functions; the latter were restored three weeks after the last operation.(Presented by Active Member AMN SSSR N. I. Grashchenkov) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 55, No. 5, pp. 29–33, May, 1963