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Biomedical subjects

C E Sullivan

Publications and source records attributed to C E Sullivan.

At least 145 records · Page 8Linked to original sources
PubMed1984

Upper airway closing pressures in obstructive sleep apnea.

We studied 18 patients with obstructive sleep apnea (OSA). Each subject slept while breathing through the nose with a specially designed valveless breathing circuit. Low levels of continuous positive airway pressure (CPAP) applied through the nose (2.5-15.0 cmH2O) prevented OSA and allowed long periods of stable stage III/IV sleep and rapid-eye-movement (REM) sleep. Externally applied complete nasal occlusion while the upper airway was patent resulted in upper airway closure during inspiration which was identified by a sudden deviation of nasal pressure from tracheal or esophageal pressure. The level of upper airway closing pressure (UACP) did not change throughout the occlusion test, suggesting that upper airway dilator muscles do not respond to asphyxia during sleep. The upper airway was more collapsible during stage I/II non-rapid-eye-movement (NREM) and REM sleep compared with stage III/IV NREM sleep. The pooled mean UACP was 3.1 +/- 0.4 cmH2O in stage I/II NREM, 4.2 +/- 0.2 cmH2O in stage III/IV NREM, and 2.4 +/- 0.2 cmH2O in REM sleep. Nasal occlusion at successively higher levels of CPAP did not alter the level of UACP in stage I/II NREM and REM sleep but resulted in the upper airway becoming more stable in stage III/IV NREM sleep, suggesting a reflex which augments the tone of upper airway dilator muscles.

Adult↗
PubMed1984

Upper airway closing pressures in snorers.

We studied 14 subjects who were selected to represent the broad range of severity of snoring: group A, four subjects who gave a history of snoring only when provoked by nasal obstruction or alcohol intake; group B, six subjects who typically snored for long periods each night; and group C, four subjects who snored heavily all night and who typically experienced a few episodes of obstructive apnea (mean apnea index 4 apneas/h). Low levels of nasal continuous positive airway pressure (CPAP) (range, 2.0-6.0 cmH2O; mean, 4.0 cmH2O) prevented snoring. Nasal occlusion caused upper airway closure during inspiratory efforts in all 14 subjects. There was a relationship between the clinical severity of snoring and the upper airway closing pressure (UACP). Upper airway closure occurred at greater suction pressures in group A than in group C but there was overlap between the three categories. The upper airway was consistently more collapsible in rapid-eye-movement sleep than in non-rapid-eye-movement sleep. There was little evidence of breath-by-breath improvement of upper airway stability during sustained asphyxia, the UACP remaining constant despite marked increases in drive to the diaphragm. In five subjects UACP was measured following alcohol intake. Alcohol reduced upper airway stability in all subjects in a dose-dependent manner.

Adult↗
PubMed1984

Studies of oxygenation during sleep in patients with interstitial lung disease.

The pattern of change in arterial oxyhemoglobin saturation (SaO2%) during sleep was characterized in 13 patients with interstitial lung disease (ILD), 12 of whom had restrictive ventilatory impairment. Four patients snored during sleep. During the studies, 9 patients had unequivocal rapid eye movement (REM) sleep episodes. The total duration of each patient's REM episodes averaged 49 min (range, 26 to 93 min), which was 22 +/- 7% (1SD) of the total sleep duration. Seven of these 9 patients were nonsnorers but had definite falls in SaO2% during REM sleep (mean fall in SaO2%, 8 +/- 3%), and in 6 of them the falls in SaO2% were transient, with a mean duration of 28 +/- 12 s and a total duration of 6.4 +/- 3.9 min or 16 +/- 12% of the total REM sleep duration. The other nonsnorer showed sustained desaturation (SaO2, 80 to 85%) for his entire REM sleep period of 26 min. In the nonsnoring patients, the falls in SaO2% during REM sleep (8 +/- 3%) were usually greater than those occurring during awake exercise (6 +/- 7%). Two snorers had unexpected sleep apnea syndrome (minimal SaO2% during NREM sleep, 83 and 77%, respectively; minimal SaO2% during REM sleep, 58 and 67%, respectively). The other snorers had greater than 10% falls in SaO2% during NREM sleep. The breathing frequency in NREM sleep in patients with ILD (mean, 23 +/- 5 breaths/min) was persistently above the normal range (mean, 15 +/- 0.4 breaths/min). The possibility of sleep hypoxemia should be considered in the management of patients with ILD.

Adult↗
PubMed1983

Solid state 13C NMR study of collagen molecular dynamics in hard and soft tissues.

The molecular dynamics of the collagen backbone in intact connective tissues has been elucidated using 13C line shape analysis. Since one-third of the amino acid residues in collagen are glycines, we have labeled: (a) reconstituted lathrytic (uncross-linked) chick calvaria collagen fibrils; (b) rat tail tendon (cross-linked); and (c) rat calvaria (cross-linked and mineralized) collagen with [1-13C]glycine. The proton-enhanced and normal 90 degrees - t proton-decoupled spectrum of each collagen sample shows an asymmetric chemical shift powder pattern for the glycine carbonyl carbon. The powder line width, delta, (delta = sigma zz - sigma xx) at 22 degrees C for the uncross-linked reconstituted collagen fibril is 108 ppm, whereas the maximum value of delta (140 ppm) is observed for the cross-linked and mineralized collagen fibrils in rat calvaria. The powder line widths for the cross-linked fibrils in tail tendons and demineralized calvaria are 124 and 120 ppm, respectively. However, since the same line shape and line width (145 ppm) are observed for all samples at -35 degrees C, the difference in delta values observed at room temperature is attributed to differences in molecular mobility of collagen in various samples. The line shapes are analyzed using a dynamic model in which azimuthal orientation of the collagen backbone is assumed to fluctuate as a consequence of reorientation about the helix axis. The observed line shapes are sensitive to motions having correlation times less than approximately 10(-4) s and the analysis provides the values of the root mean square fluctuation in azimuthal angle, gamma rms, due to such motions. It is found that gamma rms equals 41 degrees, 33 degrees, and 14 degrees for the uncross-linked, cross-linked, and mineralized collagens, respectively. These results provide the first information about the extent that cross-linking and mineralization restrict molecular motion in collagen.

Animals↗
PubMed1983

Mobility and function in elastin and collagen.

13C- and 2H-labelled amino acids have been incorporated into elastin and collagen and rotational correlation times of the labelled sites have been derived from an analysis of nuclear magnetic resonance relaxation parameters and line-shapes. The elastin experiments were designed to discriminate between the various models that have been proposed to account for the rubber-like elasticity of elastin. The correlation times of carbonyl carbons of the elastin backbone show that elastin chains are very flexible at the molecular level. In addition, the molecular dynamics and viscoelastic behaviour of elastin are well correlated over a wide range of temperatures and solvents. These results all support the rubber-like network model of elastin structure. The collagen experiments were designed to investigate the intermolecular interactions between molecules in collagen fibres. Correlation times of labelled sites in the collagen backbone and side-chains show that substantial flexibility, especially of the side-chains, takes place in reconstituted (non-cross-linked) collagen fibrils. Therefore, the interactions between side-chains that presumably direct and stabilize the fibrillar assembly take place in fluid domains. The molecular flexibility is not affected by the presence of cross-links but is absent when the collagen is mineralized.

Animals↗
PubMed1983

Arousal and breathing responses to airway occlusion in healthy sleeping adults.

The arousal and breathing responses to total airway occlusion during sleep were measured in 12 normal subjects (7 males and 5 females) aged 25-36 yr. Subjects slept while breathing through a specially designed nosemask, which was glued to the nose with medical-grade silicon rubber. The lips were sealed together with a thin layer of Silastic. The nosemask was attached to a wide-bore (20 mm ID) rigid tube to allow a constant-bias flow of room air from a blower. Total airway occlusion was achieved by simultaneously inflating two rubber balloons fixed in the inspiratory and expiratory pipes. A total of 39 tests were done in stage III/IV nonrapid-eye movement (NREM) sleep in 11 subjects and 10 tests in rapid-eye-movement (REM) sleep in 5 subjects. The duration of total occlusion tolerated before arousal from NREM sleep varied widely (range 0.9-67.0 s) with a mean duration of 20.4 +/- 2.3 (SE) s. The breathing response to occlusion in NREM sleep was characterised by a breath-by-breath progressive increase in suction pressure achieved by an increase in the rate of inspiratory pressure generation during inspiration. In contrast, during REM sleep, arousal invariably occurred after a short duration of airway occlusion (mean duration 6.2 +/- 1.2 s, maximum duration 11.8 s), and the occlusion induced a rapid shallow breathing pattern. Our results indicate that total nasal occlusion during sleep causes arousal with the response during REM sleep being more predictable and with a generally shorter latency than that in NREM sleep.

Adult↗
PubMed1983

Remission of severe obesity-hypoventilation syndrome after short-term treatment during sleep with nasal continuous positive airway pressure.

Two patients with the Pickwickian syndrome and with life-threatening sleep hypoxemia were treated with continuous positive airway pressure (CPAP) applied through the nares only during sleep periods. Each patient presented with severe daytime somnolence, disturbed sleep, nocturnal confusion, and daytime awake cardiorespiratory failure (PaCO2, 63 and 55 mmHg). Both patients demonstrated grossly abnormal breathing during sleep with severe sleep hypoxemia, the arterial oxyhemoglobin saturation (SaO2%) falling repetitively to levels below 50%. One patient had a hypoxemic convulsion during the initial sleep evaluation. Low levels (3.5 and 8.0 cm H2O) of continuous positive airway pressure, when applied via a comfortable nose mask, prevented occlusive apnea and obstructive hypopnea during sleep in both patients and maintained steady levels of arterial oxyhemoglobin saturation. There was rapid recovery of mental function and loss of cardiorespiratory failure within 3 days of treatment. After short-term treatment with nocturnal CPAP therapy (23 days and 35 days) both patients were able to sleep, unaided, without sleep-induced upper airway occlusion with arterial oxyhemoglobin levels sustained above 80%. We conclude that nasal CPAP therapy during sleep is an effective noninvasive therapy for patients with the Pickwickian syndrome, and may lead to a stable remission of the underlying severe disordered breathing in sleep.

Aged↗
PubMed1982

Characterization of leucine side-chain reorientation in collagen-fibrils by solid-state 2H NMR.

We have used 2H quadrupole-echo NMR spectroscopy to study the molecular dynamics of the leucine side chain in collagen fibrils labeled with [2H10]leucine. X-ray crystallographic studies of leucine and small leucyl-containing peptides and proteins [Benedetti, C. (1977) in Proceedings of the Fifth American Peptides Symposium, eds, Goodman, M. & Meienhofer, J. (Wiley, New York), pp. 257--274; Janin, J., Wodak, S., Levitt, M. & Maigret, B. (1978) J. Mol. Biol. 125, 357--386] show that the amino acid side chain exists predominantly in only two of the nine possible conformations. 2H NMR spectra of polycrystalline D,L [2H10]leucine obtained from -45 degrees C to +100 degrees C showed that interconversion of the two conformations did not take place on the 2H NMR timescale in this temperature range. In contrast, experimental lineshapes observed for [2H10]leucine-labeled collagen fibrils from -85 degrees C to +30 degrees C were simulated by using a model in which the side chain hops at various rates between the two predominant conformations found by the x-ray studies. A small difference between calculated and observed linewidths above the freezing point of water can be accounted for by backbone reorientation or by the presence of a small percentage of other side-chain conformations. Thus, these results provide strong evidence that the two predominant x-ray conformations not only exist in the fibrils as the preferred orientations but interconvert at rates that are proportional to temperature over the range - 85 degrees C to +30 degrees C. These observations concur with previous NNR studies of collagen fibrils that demonstrated a mobile contact region between collagen molecules.

Animals↗
PubMed1982

Alcohol, snoring and sleep apnea.

We studied the effect of alcohol ingestion on sleep-induced breathing abnormalities and arterial oxyhaemoglobin saturation in seven patients with a range of sleep-induced upper airway occlusion. The characteristics of each patient's sleep-induced breathing abnormality was established on one or more control all-night studies, and then a further all-night study was done immediately following alcohol ingestion. Alcohol increased the duration and frequency of the occlusive episodes in five patients with obstructive sleep apnoea, and resulted in a marked increase in the degree of hypoxaemia in the first hour of sleep. In two patients with benign chronic snoring, alcohol induced frank obstructive sleep apnoea during the first hour of sleep. We suggest that the increased tendency to develop obstructive apnoea after alcohol is the result of alcohol-induced oropharyngeal muscle hypotonia, while the increased duration of obstructive apnea is the result of alcohol-induced depression of arousal mechanisms.

Adult↗
PubMed1982

Ventilatory and arousal responses to hypoxia in sleeping humans.

We measured ventilatory and arousal responses to progressive eucapnic hypoxia during wakefulness, nonrapid-eye-movement (NREM) sleep, and rapid-eye-movement (REM) sleep using a progressive isocapnic rebreathing method. Nine healthy adults (4 female, 5 male) slept with a mask glued to the face with medical silicone rubber and breathed from a closed valveless biased flow circuit, including an in-line bag-in-box and a variable soda-lime absorber. Progressive hypoxia was induced by consumption of oxygen and by gradual replacement of circuit volume with nitrogen. Tidal volume was measured by electrical integration of the flow signal from a pneumotach on the box. Arterial hemoglobin oxygen saturation (SaO2) was measured with an ear oximeter and end-tidal CO2 tension (PetCO2) was measured continuously and kept constant by variable absorption. Sleep state was identified using standard criteria with 2 channels each of EEG, submental EMG, and EOG. There was marked variability in arousal level both in NREM and REM sleep, with subjects failing to awaken by 70% SaO2, our previously agreed safety limit, on 12 of 26 NREM tests, and 7 of 15 REM tests. During wakefulness, the mean slope +/- SEM of the ventilatory response to hypoxia was 0.68 +/- 0.07 L/min% SaO2 (n = 36, mean PetCO2 = 37.0 mmHg). In NREM sleep, this response decreased to a mean of 0.42 +/- 0.06 L/min/% SaO2 (n = 26, mean PetCO2 = 37.2 mmHg). In REM sleep, the average ventilatory response was further decreased to 0.33 +/- 0.06 L/min/% SaO2 (n = 15, mean PetCO2 = 37.8 mmHg). Analysis of variance showed a significant state-dependent effect on ventilatory response (p less than 0.01). The wake-NREM and wake-REM differences were significantly different (p less than 0.05), but the NREM-REM difference was not (p greater than 0.2). In REM sleep, breath-to-breath variability was marked, and in 2 cases, the response was not significantly different from zero. In all 3 states, the entire ventilatory response was due to increments in tidal volume. We conclude that (1) at normal alveolar CO2 tension, hypoxia is a poor arousal stimulus in humans, both in NREM and REM sleep, and (2) the eucapnic hypoxic response is reduced but present in NREM sleep and similarly reduced but not always present in REM sleep.

Adult↗
PubMed1981

Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares.

Five patients with severe obstructive sleep apnoea were treated with continuous positive airway pressure (CPAP) applied via a comfortable nose mask through the nares. Low levels of pressure (range 4.5-10 cm H2O) completely prevented upper airway occlusion during sleep in each patient and allowed an entire night of uninterrupted sleep. Continuous positive airway pressure applied in this manner provides a pneumatic splint for the nasopharyngeal airway and is a safe, simple treatment for the obstructive sleep apnoea syndrome.

Adolescent↗
PubMed1981

Enzymatic methylation of microsomal metabolites of benzo(a)pyrene.

These studies suggest that the microsomal metabolism of benzo(a)pyrene (BP) produces metabolites which can be methylated by the catechol-o-methyltransferase (COMT)/S-adenosylmethionine (SAM) enzyme/donor combination. Induced microsomes converted 12 to 15% of substrate BP to polar products. Approximately 0.06% of substrate BP was recovered as COMT/SAM-reactive substances. In tests for specificity, COMT/SAM was found to react with catechols, but not with dihydrodiols, quinones, a phenol, an epoxide, or 1,4-hydroquinone. Organic extracts of COMT/[14C]SAM incubations with BP were fractionated by high-performance liquid chromatography. The appearance of radiolabeled chromatographic bands required the presence of substrate BP, microsomes, and COMT/[14C]SAM. When the Ames mutagenesis assay was supplemented with COMT/SAM, a 36% reduction was observed in the number of revertant colonies induced by the microsomal oxidation of BP. In contrast, the mutagenic properties of 2-aminofluorene were not affected by COMT/SAM. These observations indicate that COMT/SAM does not generally inhibit mixed-function oxidase activity but rather reacts with substances which are activated by ring oxygenations.

Animals↗
PubMed1981

Early beikost.

Explore the source record for details and available documents.

Humans↗
PubMed1980

2H NMR study of molecular motion in collagen fibrils.

Collagen was labelled through tissue culture with [3,3,3-d3]alanine. 2HNMR spectra were obtained of the labelled collagen as fibrils and in solution using the quadrupolar echo technique for solids. The 2H NMR data were analysed in terms of a model for reorientation in which the molecule is considered to jump between two orientations in a time which is short compared to the residence time in each site, and short compared to (delta vq)-1. The best fit of the data indicates that the collagen molecule in the fibrils experiences reorientation about its long axis over an angular range of approximately 30--40 degrees. The T2 for [3,3,3-d3]alanine-labelled collagen fibrils is estimated to be approximately 110 mus.

Alanine↗
PubMed1980

Deuterium nuclear magnetic resonance of specifically labeled native collagen. Investigation of protein molecular dynamics using the quadrupolar echo technique.

Collagen was labeled with [3,3,3-d3]alanine and with [d10]leucine via tissue culture. 2H nuclear magnetic resonance (NMR) spectra were obtained of collagen in solution and as fibrils using the quadrupolar echo technique. The 2H NMR data for [3,3,3-d3]alanine-labeled collagen fibrils were analyzed in terms of a model for motion in which the molecule is considered to jump between two sites, separated azimuthally by an angle 2 delta, in a time which is rapid compared with the residence time in both sites. The data suggest that the molecule undergoes reorientation over an angle, 2 delta, of approximately 30 degrees in the fibrils, and that the average angle between the alanine C alpha--C beta bond axis and the long axis of the helix is approximately 75 degrees. Reorientation is possibly segmental. The T2 for [3,3,3-d3]alanine-labeled collagen fibrils was estimated to be 105 mus. The 2H NMR data for the methyl groups of [d10]leucine-labeled collagen were analyzed qualitatively. These data established that for collagen in solution and as fibrils, rotation occurs about the leucine side-chain bonds, in addition to threefold methyl rotation and reorientation of the peptide backbone. The T2 for the methyl groups of leucine-labeled collagen is estimated to be approximately 130 mus. Taken together, these data provide strong evidence that both polypeptide backbone reorientation and amino acid side-chain motion occur in collagen molecules in the fibrils. Stabilizing interactions that determine fibril structure must therefore depend upon at least two sets of contacts in any given local region.

Alanine↗