Effects of KRN2391-induced hypotension on the endocrine system and carbohydrate metabolism in halothane-anesthetized dogs

Purpose. The hemodynamic profiles of KRN2391-induced hypotension have been reported to be a hyperdynamic state. However, the endocrine effects of KRN2391-induced hypotension remain to be elucidated. We investigated the endocrine and metabolic effects of KRN2391-induced hypotension on the plasma concentrations of catecholamines, aldosterone, cortisol, glucose, and lactic acid and on plasma renin activity. Methods. Eight dogs were anesthetized with 087% halothane in oxygen. After a baseline period, mean arterial pressure (MAP) was lowered to 60 mmHg for 60min by the infusion of KRN2391. Results. KRN2391-induced hypotension resulted in a 50% decrease (P<0.01) in MAP due to a 80% reduction (P<0.01) in systemic vascular resistance associated with a 224% increase (P<0.01) in cardiac index. Plasma norepinephrine concentrations increased (P<0.01) after 60 min of hypotension. Plasma epinephrine concentrations and plasma renin activity both increased (P<0.05) during the hypotensive period. Plasma aldosterone concentrations remained unchanged during the hypotensive period, but then increased (P<0.05) after termination of KRN2391. Plasma cortisol concentrations remained unchanged throughout the observation period. Plasma glucose concentrations increased (P<0.01) during the hypotensive period. Plasma lactic acid concentrations increased (P<0.01) throughout the observation period. Conclusion. KRN2391-induced hypotension activates the sympathetic nervous system and consequently may modulate the renin-angiotensin-aldosterone axis and carbohydrate metabolism.     

Halothane anesthesia suppresses reflex tachycardia caused by calcitonin gene-related peptide in dogs

Calcitonin gene-related peptide (CGRP) is known to produce vasodilation, hypotension, and tachycardia. To investigate the interaction between CGRP and anesthetics, the hemodynamic response to infusions of CGRP was studied in dogs anesthetized with halothane or pentobarbital. In halothane-anesthetized dogs given 0.4 μg·kg⁻¹ of CGRP, mean arterial pressure (MAP) did not change significantly. However, there was a significant reduction in systemic vascular resistance (SVR) associated with significant increases in cardiac index (CI) and stroke volume index (SVI). Higher doses (4 and 40 μg·kg⁻¹) of CGRP produced dose-dependent decreases in MAP accompanied by a reduction in SVR. Further, both CI and SVI significantly increased at 4 μg·kg⁻¹ CGRP but remained unchanged at the 40 μg·kg⁻¹ infusion rate. Heart rate (HR) was not increased at all doses but was decreased at 40 μg·kg⁻¹. In pentobarbital-anesthetized dogs, CGRP at doses of 4 μg·kg⁻¹ produced a qualitatively similar cardiovascular responses as that observed in halothane-anesthetized dogs, but with one exception: HR was significantly increased. The results show that the hemodynamic profiles induced by CGRP during halothane or pentobarbital anesthesia are a decrease in MAP accompanied by a reduction in SVR and no consistent alterations in CI. However, CGRP effects on HR showed in a different way. The results also show that HR response differs depending on the anesthetics used: HR increases during pentobarbital anesthesia, while it does not increase during halothane anesthesia. This study was presented in part at the 39th annual meeting of the Japan Society of Anesthesiology, Fukuoka, April 1992, and at the annual meeting of the American Society of Anesthesiologists, New Orleans, October 1992     

Gallbladder disease,primary cholelithiasis,or gallbladder hydrops: review of 32 children

Gallbladder disease is generally considered uncommon in childhood, but in recent years the frequency seems to be increasing. Therefore, a review was made of children appearing with gallbladder disease during the past 10 years at the Department of Pediatric Surgery, St. Göran's Hospital, Stockholm. There were 32 patients, 15 boys and 17 girls. Two-thirds of the cases were diagnosed in 1988 or later. One-half were younger than 8 years; 7 were 2 years old or younger. Hemolytic disease was found in 2/32 patients. One patient had received total parenteral nutrition, but only for a period of 10 days. In 6/32 children the symptoms were interpreted to be caused by gallbladder dysfunction, either as intermittent hydrops or a defect of emptying after a fatty meal. One of these 6 also had a stone. Surgery was performed in 22 children: cholecystectomy in 15 and cholecystotomy with stone extraction in 7. Analysis of 14 stones showed that pigmentary stones were most common. We conclude that gallbladder disease in children seems to be increasing. The preoperative examination should include both ultrasound and cholecystography. We also find that stone extraction is an adequate procedure if there is good gallbladder function and no sign of cholecystitis. Correpondence: M.-L. Molander     

Completely or nearly identical hepatitis B virus strains replicate between patients with acute or fulminant hepatitis B and their respective infectious sources

Five patients with acute hepatitis B and four with fulminant hepatitis B were selected for sequencing of the precore/core gene of the virus strains. Furthermore, identical sequencing was done with the HBV of the infectious sources, i.e., the sexual partner in eight cases and a natural child (chronic carrier) infecting the mother in one case. Of the subjects responsible for the infection, four were healthy HBV carriers, three suffered from chronic hepatitis B, and one from acute and one from fulminant hepatitis B. The nucleotide sequences of HBV from both the patients and the implicated sources of infection exhibited perfect identity of the precore region and perfect or high identity of the core region. The completely or nearly identical strain of virus seemed to proliferate successively in the patients following the transmission from the infecting individuals regardless of sequence variations and infectious status. In two cases a peculiar pattern of infection and disease was found: In one married couple the husband, during the incubation period of acute hepatitis B, infected his wife, who developed fulminant hepatitis. In another married couple, both partners ultimately developed fulminant hepatitis (the wife being the source of the infection). © 1994 Wiiey-Liss, Inc.     

Pericentric inversion of chromosome 9 in infertile men

Reproductive condition was studied in 6 infertile men with pericentric inversion of chromosome 9. Semen analyses revealed one azoospermia, one oligozoospermia, three asthenozoospermias and one normozoospermia. Four cases showed normal levels of plasma gonadotropins and testosterone. The response of plasma testosterone to human chorionic gonadotropin was within the normal range in all cases. However, the administration of LH-RH resulted in abnormal response of plasma gonadotropin in all patients. These results indicate that infertile males with pericentric inversion of chromosome 9 have an abnormality in the hypothalamic-pituitary-testicular axis.     

Do organic solvents induce changes in the dopaminergic system? Positron emission tomography studies of occupationally exposed subjects

Objectives: The objective of this study was to test the hypothesis that long-term occupational exposure to organic solvents may effect the levels and turnover of dopamine in man. Methods: A study was performed on 17 patients with neuropsychiatric symptoms due to occupational solvent exposure, and 11 healthy non-exposed male volunteers (controls). Positron emission tomography (PET) was used to assess striatal dopaminergic function, using l-[¹¹C]DOPA, [¹¹C]nomifensine and [¹¹C]raclopride as tracers. Results: The rate of dopamine synthesis was significantly increased among subjects with occupational exposure to organic solvents compared with non-exposed controls. After controlling for the difference in age between exposed and controls, the effect of solvent exposure became less apparent and was reduced from +32% (P = 0.009) to +25% (P = 0.07). There were no differences with regard to the binding of [¹¹C]nomifensine. Patients with and without the diagnosis of toxic encephalopathy did not differ with regard to their putaminal uptake of l-[¹¹C]DOPA, [¹¹C]nomifensine and [¹¹C]raclopride. Conclusion: The data support the hypothesis that long-term exposure to organic solvents may increase the rate of dopamine synthesis in the brain without affecting the number of presynaptic terminals or postsynaptic dopamine receptors. Received: 8 October 1996 / Accepted: 7 February 1997