[Adrenergic hyperactivity in tetanus].
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Biomedical subjects
Publications and source records attributed to C Carlsson.
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The 119 patients who had undergone previous Caesarean section lumbar extradural block was administered to 77 (65%); the other 42 (35%) received analgesia with ketobemidone 0.8-1.0 ml i.m. or nitrous oxide in oxygen intermittently, or both. Controlled i.v. infusion of oxytocin for induction or acceleration of labour was given to 77% in the extradural group and to 40% in the other group. In both groups 88% were delivered per vaginam. In two patients the uterine scar ruptured; both had received oxytocin during extradural block.
Lumbar epidural block was performed during labour in 50 healthy women, with 2% chloroprocaine in an initial dose of about 6 ml. Pain relief was achieved within 5 min and the mean duration of action was 43 min. The frequency of instrumental deliveries was lower than earlier obtained with bupivacaine. No specific adverse reactions were found in the infants. In 20 cases, serum cholinesterase activity was analysed in mothers as well as infants and found to be normal.
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The influence of an anaesthetic dose of chlormethiazole (Hemineurin) on blood flow (CBF) and oxygen consumption (CMRO2) in the rat brain was investigated. In spontaneously breathing animals a dose of 160 mg . kg-1 of chlormethiazole, infused i.v., induced a state close to surgical anaesthesia. In paralyzed animals, the same dose decreased CBF and CMRO2 to about 60% of control, an effect similar to that observed after an anaesthetic dose of phenobarbitone. Neither a protective nor a detrimental effect of chlormethiazole could be demonstrated when the drug was given during reversible and pronounced, incomplete ischaemia, as evaluated from the postischaemic tissue concentrations of labile phosphates (PCr, ATP, ADP, AMP) and of lactate and pyruvate. It is concluded that protection in this situation (as earlier shown with phenobarbitone) must, at least partly, be related to other mechanisms than a depression of metabolism.
A total of 34 male inpatients with advanced chronic alcoholism and a clinical picture of impaired working capacity were examined by pneumoencephalography and 29 of them by psychometric tests. All or almost all (depending on the criteria chosen) showed degenerative changes in the cerebrum and about one-third showed degenerative changes in the cerebellum. All 29 patients who were psychometrically investigated showed signs of cerebral dysfunction. The correlation between the single pneumoencephalographic and psychometric variables was at most 0.46 and abnormalities of the third ventricle showed the highest correlation to the psychometric variables. An overall assessment of the degree of degenerative changes in the cerebrum (pneumoencephalographic findings) and the degree of cerebral dysfunction (psychometric findings) resulted in a correlation of r = 0.54 (P less than 0.001).
Retrospective and prospective investigations of children to alcoholic women gave an incidence of fetal alcohol lesion of one per 300 deliveries of whom half had the complete fetal alcohol syndrome. Perinatal and infant mortalities were increased seven to tenfold and low birth weight (less than or equal to 2 500 g), preterm deliveries (less than 37 weeks) and smallness for gestational age (less than -2 S.D.) were increased eightfold, threefold and twelvefold, respectively. Small size at birth correlated with reduced mental performance later in life, 58% had IQ below 85 and 19% below 70.8% had cerebral palsy. The incidence of cerebral palsy associated with maternal inebriety was 1/5 000 deliveries, i.e. every sixth case of cerebral palsy. Tracing of alcoholic women during pregnancy and treatment gave favourable effect on intrauterine growth when sobriety could be induced early in pregnancy but could not protect from functional brain disturbance measured by neurological performance and be evoked response electroencephalography. Damage to the fetus by alcohol is now the largest known health hazard by a noxious agent that is preventable.
Heart surgery with hypothermic cardioplegia during normothermic bypass is sometimes complicated by rewarming of the myocardium caused by collateral flow of arterial blood. This problem is particularly evident in surgery of congenital malformations. The present work is a comparative study in dogs on 3 methods of avoiding the rewarming problem. In the first group, the heart was kept cold and the warm blood was drained off from the left atrium. In the second group, total body hypothermia to the level desired was used and in the third group, normothermic cardioplegia was induced (Cardioplegin) in normothermic animals. In the two latter groups, the undesired temperature gradient between heart and body was eliminated. Evaluation of the differences was made by means of ventricular function determinations. Local, hypothermic cardioplegia showed the best postoperative function (69%) followed by the total body cooling which was fully acceptable (41%). Normothermic cardioplegia after the same duration of arrest showed a too low myocardial performance (20%).
In a double-blind study in chronic alcoholics melperone (Buronil) was shown to significantly improve muscular and nervous tension, emotional lability, somatization, ability to sleep, anxiety, depression, paranoid ideation and presumed ability to work, but had no effect on alcoholic craving. The results received from three rating scales, and the theoretical aspects of alcoholism are discussed.
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The influence of a sedative dose of "lytic cocktail" (chlorpromazine, promethazine and pethidine) on cerebral blood flow (CBF) and oxygen consumjtion (CMRO2) was tested in artificially ventilated rats, maintained on either 70% N2 or 70% N2O. When given alone, the lytic cocktail had no significant effect on CBF or CMRO2. However, in the presence of nitrous oxide there was a 25% reduction in blood flow and oxygen consumption.