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1.
It is well established that painful distension of hollow viscera such as the oesophagus can evoke a reflex tachycardia and pressor response; however, the nature of the oesophageal afferent pathway(s) remains controversial. This study investigated the afferent arc which mediates these reflex cardiovascular changes in the decerebrate rat. In addition, the effect of oesophageal distension on the respiratory activity of the costal diaphragm was studied. Focal distension of the oesophagus (volume of 0.3 ml applied for 10 s) just above the diaphragmatic hiatus evoked a reproducible pressor response and tachycardia in the decerebrate rat. Respiration was transiently inhibited at the beginning of oesophageal distension and prior to the rise in blood pressure. Neuromuscular blockade with the nicotinic acetylcholine receptor blocker alpha-bungarotoxin (140 microg bolus) had no effect on the magnitude of the cardiovascular response. Therefore the efferent supply to the striated muscle of the rat oesophagus was not essential in mediating this reflex. Signal averaging of the mean blood pressure response showed that neither selective ablation of oesophageal spinal afferents nor bilateral vagotomy altered the early trajectory of the pressure response. Bilateral vagotomy reduced the peak magnitude of the response to sustained oesophageal distension. In contrast, selective removal of spinal afferents had no effect on the response. Ablation of both neural pathways was essential to abolish the reflex cardiovascular and respiratory responses. It can be concluded that both vagal and spinal afferent pathways are utilised in the reflex cardiorespiratory response to painful oesophageal distension. Although ablation of one neural pathway had no effect on the response it was still implicated in the reflex, since ablation of both pathways was necessary to prevent the cardiorespiratory changes. This study emphasises the need for caution when inferences are made concerning single selective ablations of multiply innervated organs. 相似文献
2.
Jean-Pierre Bassand René Faivre Pascal Berthout Jean-Claude Cardot Josette Verdenet Roland Bidet Jean-Pierre Maurat 《European journal of nuclear medicine and molecular imaging》1987,13(8):419-424
The influence of left ventricular volume variations and regurgitant fraction variations upon left ventricular ejection fraction, during exercise was examined using equilibrium radionuclide angiography in patients suffering from aortic regurgitation. Ejection fraction (EF), regurgitant fraction (RF), end diastolic volume (EDV) and end systolic volume (ESV) variations from rest to peak exercise were determined in 44 patients suffering from chronic aortic regurgitation (AR) and in 8 healthy volunteers (C). In C, EF increased (+0.10±0.03, P<0.01) and ESV decreased significantly (-23%±12%, P<0.01) RF and EDV did not vary significantly. In AR patients, EF, EDV and ESV did not vary significantly because of important scattering of individual values. Changes in EF and ESV were inversely correlated (r=-0.79, P<0.01) and RF decreased significantly (-0.12±0.10, P<0.01). Volumes and EF changes during exercise occurred in three different ways. In a 1st subgroup of 7 patients, EF increased (+0.09±0.03, P<0.05) in conjunction with a reduction of ESV (-24%±12%, P<0.05) without a significant change in EDV. In a 2nd group of 22 patients. EF decreased (-0.04±0.07, P<0.01) in association with an increase in ESV (+17%±16%, P<0.01) and no change in EDV. In a 3rd subgroup of 15 patients, EF decreased (-0.02±0.06, P<0.01) despite a reduction in ESV (-7%±6%, P<0.01) because of a dramatic EDV decrease (-10%±6%, P<0.05). In this subgroup, changes in EF were inversely correlated with changes in ESV (r=-0.55, P<0.01) and positively related to EDV variations (r=0.42, P=0.02). EDV related to EDV variations (r=0.42, P=0.02). EDV changes were weakly, but significantly, correlated to RF decrease (r=0.39, P<0.05). We conclude that changes in left ventricular ejection fraction during exercise in patients with chronic aortic regurgitation are significantly related in some patients to changes in ventricular loading conditions as well as contractile state. Therefore, a correct interpretation of EF changes during exercise requires the simultaneous determination of changes in LV volumes.Abbreviations EDV
end diastolic volume
- EF
ejection fraction
- ESV
end systolic volume
- LV
left ventricle
- RV
right ventricle 相似文献
3.
P Campion 《The Practitioner》1987,231(1433):1056, 1058, 1061-1056, 1058, 1062
4.
Christian Mazel Jean-Pierre Elsig Pierre Kehr Nathalie Richard 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2007,17(6):617-623
The eleventh Argos international symposium was held on 25 and 26 January 2007 at Maison des Arts et Métiers, Paris. Regular attendees were present as well as newcomers from around the world. 相似文献
5.
Mario Sénéchal Isabelle Lemieux Isabel Beucler Gerard Drobinski Sylvie Cormont Michelle Dubois Iradj Gandjbakhch Jean-Pierre Després Richard Dorent 《The Journal of heart and lung transplantation》2005,24(7):819-826
BACKGROUND: This study evaluated the prevalence of the atherogenic metabolic triad and the hypothesis that waist circumference and fasting triglyceride concentrations could be used as screening tools for identification of the atherogenic metabolic triad in a population of heart transplant men. It also evaluated the relationship between the atherogenic metabolic triad and coronary artery disease (CAD). METHODS: In the study group of 83 consecutive male heart transplant patients having their routine annual coronarography, 23 patients (28%) were characterized by the atherogenic metabolic triad defined by the presence of elevated fasting insulin and apolipoprotein B concentrations and by small low-density lipoprotein (LDL) particles. RESULTS: Seventy-seven per cent of patients with waist circumference values >/= 90 cm and with elevated triglyceride levels (>/=2.0 mmol/liter) were characterized by this atherogenic metabolic triad. Patients with the atherogenic metabolic triad were at markedly increased risk of CAD (odds ratio of 25.3, 95% CI: 1.11-577.3, p < 0.04) compared to heart transplant patients without the atherogenic metabolic triad. CONCLUSIONS: About 30% of heart transplant patients showed the features of the atherogenic metabolic triad. Measurement and interpretation of waist circumference and fasting triglycerides could be used among heart transplant patients to early identify men characterized by the presence of elevated fasting insulin and apolipoprotein B concentrations and small LDL particles. The presence of the atherogenic metabolic triad identified patients at high risk of CAD even in the heart transplant population. 相似文献
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Residual bone-mineral density and muscle strength after fractures of the tibia or femur in children.
R C Henderson G J Kemp E R Campion 《The Journal of bone and joint surgery. American volume》1992,74(2):211-218
This study compared the bone-mineral density in the proximal part of the femur and the flexion and extension strength of the knee in the fractured and the non-fractured limbs after an uncomplicated fracture of the tibia or femur in children. Thirty-eight children, whose ages ranged from two to fifteen years at the time of the injury, were evaluated at an average of 2.3 years after the injury. The mean difference in bone-mineral density between the fractured and non-fractured limbs was 3.3 per cent (p = 0.004). There was no significant difference between the bone-mineral density of the limbs that had been immobilized for less than four weeks and that of the contralateral, non-fractured limbs. However, the mean difference between the bone-mineral density of the limbs that had been immobilized for more than eight weeks and that of the contralateral limbs was 4.3 per cent (p = 0.006). There was little or no relationship between the time since the injury and the difference in bone-mineral density between the two limbs of the patient at the intervals of follow-up that were studied. No residual weakness in flexion and extension of the knee was detected, and no relationship was established between the limb-to-limb differences in strength and the limb-to-limb differences in bone-mineral density. The residual bone-mineral deficit was found to be minimum after an uncomplicated fracture. This difference, while statistically significant, is unlikely to be clinically important in the long term. However, the fact that there was a deficit raises a potential concern for children who have more severe or repeated injuries. 相似文献