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Biomedical subjects

D R Bacon

Publications and source records attributed to D R Bacon.

At least 37 records · Page 2Linked to original sources

Optic nerve vasomotor effects of topical apraclonidine hydrochloride.

AIMS: To examine, in vivo, the anterior optic nerve vasomotor effects of chronic apraclonidine hydrochloride in rabbits. METHODS: After local treatment in one randomly chosen eye with apraclonidine hydrochloride 0.5% over 21 days, the microvasculature of the optic nerve was examined in five rabbits using an intraluminal microvascular corrosion casting technique. The investigators were masked as to which eye was treated. The vasoconstriction near the branching point of arterioles supplying the optic nerve was calculated as a percentage of the downstream vessel calibre. An average constriction was calculated and compared between the treated and the contralateral, untreated, eyes by means of a two tailed t test for paired variables. Constriction values of a total of 72 arterioles supplying the optic nerve were obtained for the five rabbits. RESULTS: The average constriction in the treated and the control eyes was comparable (p = 0.96). CONCLUSION: Chronic administration of apraclonidine hydrochloride 0.5% produces no observable optic nerve vasomotor effects in the rabbit eye.

Administration, Topical↗

An endothelin-1 induced model of optic nerve ischemia in the rabbit.

PURPOSE: To evaluate blood flow reduction and topographic optic nerve changes after the local administration of endothelin-1 in vivo, delivered to the perineural region of the anterior optic nerve in the rabbit. METHODS: Endothelin-1 (five rabbits) in a dosage of 0.1 microgram/day or balanced salt solution (two rabbits) was delivered to the perineural region of the anterior optic nerve with osmotically driven minipumps. Optic nerve blood flow was determined by the colored microspheres technique after 14 days of local endothelin-1 or balanced salt solution administration to the microvasculature of the optic nerve. In addition, optic nerve blood flow was determined in two rabbits that had no minipump implants. The morphologic changes induced by reduction of blood flow were assessed in five additional rabbits implanted with osmotically driven minipumps containing endothelin-1 (0.1 microgram/day). These rabbits were observed for 8 weeks, and the morphologic optic nerve changes were monitored with a confocal scanning laser ophthalmoscope. RESULTS: Independent of intraocular pressure, endothelin-1 induced a decrease in blood flow of approximately 38% in the experimental eye, compared to the decrease induced by balanced salt solution or to the decrease in rabbits without minipumps (analysis of covariance, P = 0.0092). Multivariate statistical analysis showed a significant change in topometric parameters (cup area, cup depth, rim volume) obtained with a confocal scanning laser ophthalmoscope, indicating an increase in optic nerve cupping and a decrease of the perineural rim volume in the experimental eyes (P = 0.017). CONCLUSIONS: The current results suggest that morphologic optic nerve alterations can be induced experimentally in the rabbit model after ischemia produced by the local administration of endothelin-1 to the perineural region of the anterior optic nerve.

Animals↗

An endothelin-1-induced model of chronic optic nerve ischemia in rhesus monkeys.

PURPOSE: The purpose of this study was to evaluate flow reduction to the optic nerve after chronic administration of endothelin-1 in primates. MATERIALS AND METHODS: Endothelin-1 (three rhesus monkeys), in a dosage of 0.1 microgram/day, or balanced salt solution (three rhesus monkeys) was delivered to the perineural region of the anterior optic nerve via osmotically driven minipumps. Optic nerve blood flow was determined by means of a colored microspheres technique after 7 days of local endothelin-1 or balanced salt solution administration. The effect of endothelin-1 on optic nerve blood flow was analyzed by analysis of convariance (ANCOVA) in a 2 (between groups: endothelin-1, balanced salt solution) x 2 (within subject: blood flow minipump optic nerve, blood flow controls) design, with intraocular pressure as a changing covariate. RESULTS: The decrease of optic nerve blood flow in the endothelin-1 eyes was significant compared to the balanced salt solution eyes (ANCOVA p = 0.015). Among the monkeys implanted with endothelin-1 minipumps, the decrease in optic nerve blood flow in the experimental eye compared to the contralateral eye (mean +/- SD 35.7 +/- 9.1%) was significant (p = 0.01), while that among the monkeys implanted with balanced salt solution minipumps (mean +/- SD 0.7 +/- 5.5%) was not (p = 0.73). CONCLUSIONS: This new primate model of chronic optic nerve ischemia may represent a method to evaluate experimentally the implication of a local hemodynamic perturbation in various optic neuropathies.

Animals↗

Ralph Waters and the beginnings of academic anesthesiology in the United States: the Wisconsin Template.

The University of Wisconsin, Madison, was one of the few places offering postgraduate training in the science and art of anesthesia in the late 1920s and 1930s. Weaving together clinical and basic science research, and fully supported by his surgical colleagues, Ralph Waters was able to create the first collegiate-based academic anesthesiology department. While Waters' department was an important milestone establishing anesthesia within the university setting, it did not guarantee true academic standing nationwide. For that to occur, Waters realized that it was necessary to establish other academic departments across the country. Attempting to replicate the department at his university. Waters searched for institutions where surgeons desired an academic anesthesia department. Additionally, he sought basic scientists ready to collaborate in scientific research in anesthesiology and a brisk clinical service. Successful application of the Wisconsin model was best reflected in the work of Waters' academic descendants: "sons" Emery Rovenstine and Robert Dripps, and "grandsons" Stuart Cullen and Emanuel Papper.

Academic Medical Centers↗

Optic nerve vasomotor effects of topical beta-adrenergic antagonists in rabbits.

PURPOSE: To examine the anterior optic nerve vasomotor effects of nonselective and relatively beta-1-selective beta-adrenergic antagonists in rabbits, because different influences on optic nerve blood flow with these medications have been suggested. METHODS: After topical therapy for 30 days with either timolol maleate 0.5% (six rabbits), betaxolol hydrochloride 0.5% (six rabbits), or placebo (two rabbits), the microvasculature of the optic nerve was examined with an intraluminal microvascular corrosion casting technique. The investigators were masked to both the medication group and the treated eye. The constriction, in percent of the downstream vessel caliber, was measured at the vascular branching point of arterioles supplying the anterior optic nerve. An average constriction was calculated and compared between the medication groups and between the treated and the contralateral, untreated eyes. RESULTS: Constriction values from a total of 218 arterioles supplying the anterior optic nerve were obtained for the 14 rabbits. The means of the average constriction on the treated side were comparable between the groups treated with timolol maleate, betaxolol hydrochloride, and placebo (one-way analysis of variance, P = .64), as well as between the treated and untreated eyes (two-tailed t-test for paired variables, P = .68 for timolol maleate and P = .42 for betaxolol hydrochloride). The statistical power to find a difference of 5% or more average constriction was at least 90%. CONCLUSIONS: Both relatively selective and nonselective beta-adrenergic antagonists produce no observable optic nerve vasomotor effects in the rabbit eye.

Administration, Topical↗

Microvasculature of the human optic nerve.

PURPOSE: Methyl methacrylate vascular corrosion casting techniques were used to examine the normal anterior optic nerve microvasculature in 18 human eye bank eyes. METHODS: Selective cannulation of the central retinal artery, the short posterior ciliary arteries, or both, allowed the methyl methacrylate to be injected into the anterior optic nerve circulation. Preflushing with tissue plasminogen activator greatly enhanced the filling of the fine microvasculature by dissolving the intraluminal clots. RESULTS: The superficial nerve fiber layer of the optic nerve received its primary blood supply from the central retinal artery. In 11 of 13 eyes injected with methyl methacrylate through the short posterior ciliary arteries, there was a perineural, circular arterial anastomosis (circle of Zinn-Haller) at the scleral level. Branches from this circle penetrated the optic nerve to supply the prelaminar and laminar regions and the peripapillary choroid. In the two eyes without this arterial circle, direct branches from the short posterior ciliary arteries supplied the anterior optic nerve. The venous drainage of the anterior optic nerve was almost entirely through the central retinal vein and its tributaries. CONCLUSIONS: This study demonstrates that the main arterial vascular supply to the anterior optic nerve is from the short posterior ciliary arteries. The contribution of the peripapillary choroid to the anterior optic nerve is minimal in comparison to the direct contribution from the short posterior ciliary arteries.

Arteries↗

Perforation and partial obstruction of an armored endotracheal tube.

Armored endotracheal tubes are often used during cases in which there is a risk of compromise of a polyvinylchloride tube with positioning of a patient's head. The authors describe a case in which partial airway obstruction and perforation of such a tube occurred as a result of biting by a patient. Ways to avoid this complication are discussed.

Adult↗

An in vivo model of chronic optic nerve ischemia: the dose-dependent effects of endothelin-1 on the optic nerve microvasculature.

The purpose of this study was to evaluate the effects induced by chronic microapplication of endothelin-1 on the anterior optic nerve microvasculature and to determine the dose-response characteristics of endothelin-1 on this vascular bed. Daily dosages between 4.69 x 10(-4) and 9.0 x 10(-1) micrograms/day of endothelin-1 were delivered continually over 3 days, and at a constant flow rate, to the perineural region of the anterior optic nerve of 15 albino rabbits via osmotically-driven minipumps. The vasomotor effect of local endothelin-1 on the microvasculature of the optic nerve was examined using intraluminal microvascular corrosion casting technique. The vasomotor effects were quantified by measuring the relative amount of vasoconstriction of the arterioles supplying the anterior optic nerve (primary and secondary branches of the short posterior ciliary arteries). The average constriction was calculated for the endothelin-treated eyes and the untreated, contralateral eyes. The mean vasoconstriction in the endothelin treated eyes ranged from 14.7% to 30.0% and was highly correlated with the logarithmic value of the daily dose of endothelin-1 (R2 = 0.59, p = 0.00083). The interocular difference (between treated and untreated eyes) of the optic nerve vasoconstriction ranged from 0-19% (mean +/- SD: 7.23 +/- 5.7%). This interocular difference also correlated highly with the log of the daily endothelin-1 dosage (R2 = 0.80; p < 0.0001). By additionally accounting for the weight and sex in a multiple linear regression function, the correlation was markedly improved (R2 = 0.92; p < 0.0001). In conclusion, the microvasculature supplying the anterior optic nerve of the rabbit demonstrates a dose-dependent vasoconstriction with chronic local application of endothelin-1. This in vivo, experimental model offers a titratable method with which the effects of chronic vasoconstriction and vascular insufficiency on the optic nerve can be examined.

Animals↗

Reproducibility of topometric data with a scanning laser ophthalmoscope in rabbits.

The Heidelberg Retina Tomograph is a confocal scanning laser ophthalmoscope which obtains three-dimensional images of the optic nerve head and the retina in the human eye. Because of its potential investigative uses in experimental animal models of glaucoma, we examined its variability with optic nerve head measurements in the rabbit eye. Three topographic images, recorded on different days, were acquired from the right eye of 5 New Zealand white rabbits over 3 weeks. To estimate the lowest possible variability, a second series of three images was recorded in a single setting without displacement of the rabbits. The average coefficient of variability (standard deviation/mean) for the estimate of the optic nerve head cup volume (volume below surface) was 11.1% in the independent series and was decreased to 3.0% in the sequentially recorded series without displacement of the rabbits (P < 0.001). These values indicate a comparable variability for the estimate of the optic nerve head cup volume in the rabbit compared with those reported for the human eye. This variability is considerably decreased by maximally standardizing the image acquisition position, suggesting that variability largely depends on the alignment between the subject and the laser-scanner.

Animals↗

Interpleural analgesia for the treatment of severe cancer pain in terminally ill patients.

Interpleural analgesia was used to alleviate acute, severe exacerbations of chronic pain unrelieved by pharmacologic therapy in ten terminally ill cancer patients. Pain from metastatic disease to the neck, arms, chest, brachial plexus, thorax, or abdomen was effectively eliminated between 7 hr and 40 days in nine patients, who died with minimal or no pain. The technique was performed primarily using bupivacaine. No side effects were detected. Interpleural analgesia appears to be effective in rapidly controlling acute exacerbations of cancer pain in terminally ill patients. Moreover, it may also be a suitable therapy for moribund patients when used as a continuous-infusion technique.

Adult↗

Experimental validation of predicted temperature rises in tissue-mimicking materials.

Increasingly, it is recognised that diagnostic ultrasound is capable of causing temperature rises sufficient to damage tissue. Predictions of this heating are often based on simplified models of both the in vivo conditions and the relevant physical effects. Few measurements have been made to verify these predictions, however, particularly for the tightly focused beams often employed in diagnosis. Furthermore, non-linear effects in both the acoustic field and the surrounding medium have largely been ignored in calculations. To provide an alternative way to estimate the heating, NPL has developed a measurement system to determine directly the temperature rise in tissue-mimicking materials. If necessary, the measurement results can be processed to model the effects of blood perfusion. The temperature is measured using thin-film thermocouples, which have essentially no interaction with the ultrasound or thermal fields. Measurements were made on transducers operating in the frequency range 2-10 MHz and with focal beam-widths from 1 to 3 mm. The measurements agree with theoretical predictions that use either the measured beam-profile or a simplified (Gaussian) model. The results are also compared with the standard soft-tissue models developed by the National Council on Radiation Protection and Measurements (NCRP) and jointly between the American Institute of Ultrasound in Medicine and the National Electrical Manufacturers Association (AIUM/NEMA). On average, the predictions of the NCRP formula are 15% higher than the measurements, confirming its validity as a worst-case model. The predictions based on the AIUM/NEMA formula, however, are typically 30% lower than the measured values.

Body Temperature↗