[Local anesthetics, analgesics, antiphlogistics and antibiotics in practice].
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Biomedical subjects
Publications and source records attributed to E Singer.
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Reflex sympathetic dystrophy of the face is an infrequently reported cause of chronic facial pain. We report the cases of two patients who were diagnosed and treated by sympathetic blockade of the stellate ganglion. Pathophysiologic mechanisms and rationale for treatment are discussed.
The New York Blood Center is developing a health education and psychosocial support program for blood donors who are notified that they are HIV antibody positive. The goals of that program are: to provide accurate and intelligible information about the test results to notified donors; to encourage behavior that will reduce the likelihood of spreading the virus; to encourage notified donors to behave in ways that will reduce the probability that they will develop AIDS; and to provide support and facilitate functional coping responses. This article reviews the theoretical and empirical work which informs the intervention program, and it describes how the program is being implemented.
The effects of a continuous iv infusion (osmotic minipumps) of angiotensin II (80 ng . kg-1 . min-1) and isoprenaline (10 ng . kg-1 . min-1) lasting 28 days were studied in six normotensive, conscious dogs. The parameters measured were systolic and diastolic blood pressure, heart rate, levels of angiotensin II, renin activity, aldosterone and antidiuretic hormone in plasma, baroreceptor reflex sensitivity and body weight. The treatment resulted in an approximately sevenfold increase in plasma angiotensin II level from 62.9 +/- 24.5 pg . ml-1 to 455.3 +/- 95.6 pg . ml-1. Systolic and diastolic blood pressure, measured for the first time 2 days after implanting the minipumps, were markedly increased throughout the infusion period (pretreatment value: 123.8 +/- 5.3/68.3 +/- 3.8 mmHg; after 2 days: 159.8 +/- 12.0/100.5 +/- 9.8 mmHg; after 28 days: 159.8 +/- 7.1/98.3 +/- 6.4 mmHg, whereas the heart rate remained unchanged due to the combined effects of angiotensin II and the concomitantly given isoprenaline. A high correlation was found between angiotensin II level in plasma and mean arterial blood pressure (r = 0.846; p less than 0.001). Furthermore, plasma renin activity was markedly suppressed by the treatment, and aldosterone levels rose. Plasma antidiuretic hormone levels were found to be unchanged at the chosen sampling time. A decrease in baroreceptor reflex sensitivity accompanied the development of the hypertensive state. There was also a loss of body weight during the infusion of angiotensin II and isoprenaline. The data provide evidence for the usefulness of the presented experimental protocol as an alternative model of arterial hypertension in chronically instrumented, conscious dogs.
In the present paper, findings on two neuropeptides, substance P (SP) and neurotensin (NT), are presented and discussed with respect to a neuromodulatory role of these peptides on brain monoamine transmitter systems. Substance P: In view of the close morphological relationship of serotonin-(5-HT-) and SP-neurons in the brainstem of the rat the effect of SP was studied in vitro on the field stimulated release of 3H-5-HT from slices of medulla oblongata. Substance P enhanced the electrically induced release of 3H-5-HT without affecting the basal release. Furthermore, the immunohistochemical evidence for the coexistence of SP and 5-HT in neurons of this area was corroborated by employing neurochemical lesioning techniques. Neurotensin: Binding sites for NT in the substantia nigra and the ventral tegmentum of the rat were decreased after stereotaxic injection of the neurotoxin 6-hydroxydopamine, which specifically destroys catecholamine-containing neurons. The results indicate a localization of NT-receptors on dopaminergic neurons in these regions. In the striatum and the nucleus accumbens, the field stimulated release of 3H-dopamine in vitro was markedly and dose-dependently increased in the presence of NT, demonstrating a direct effect of the peptide on dopamine-containing nerve terminals. In the medial preoptic nucleus, a high density of NT-binding sites was measured and stereotaxically microinjected NT caused a rise in plasma levels of luteinizing hormone (LH). Concomitantly, noradrenaline levels in the injected region were significantly reduced. The results favour an interaction of NT and noradrenergic neurons in the hypothalamic control of LH secretion.
Two-day-old rats were pretreated with 50 mg/kg of capsaicin. After 3--4 months, specific binding of [3H]muscimol and [3H]strychnine was measured in membrane preparations from dorsal spinal cord. A 20-30% decrease of the number of [3H]muscimol binding sites was observed after capsaicin treatment. In contrast, [3H]strychnine binding was unchanged. The results provide indirect evidence for a presynaptic location of GABA receptors on capsaicin-sensitive primary afferent neurons.
The effects of etazolate and cartazolate, two pyrazolopyridine derivatives with anxiolytic actions, on the receptor binding of gamma-aminobutyric acid (GABA) was studied in vitro using membrane fractions prepared from rat brain. Both compounds increased the specific GABA receptor binding. This effect was markedly enhanced in the presence of several anions, predominantly halide ions. Pyrazolopyridines appear to modulate the binding properties of GABA receptors by acting on a site closely related to the chloride ion channel of the membrane. These results indicate that activation of the GABA system is a possible mechanism of action of pyrazolopyridines. In the second part of the study binding experiments were used to provide evidence for the presynaptic localisation of GABA receptors on primary afferent terminals in the dorsal horn of the rat spinal cord. Capsaicin-induced degeneration of primary afferent fibres significantly reduced the number of GABA receptors in the dorsal spinal cord, whereas the number of benzodiazepine and glycine receptors remained unchanged. The results support the role of GABA as transmitter involved in presynaptic inhibition in the spinal cord.
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The release of previously accumulated [3H]taurine and [14C]GABA from crude synaptosomal (P2) fractions isolated from rat cerebral cortex was studied using a superfusion system. The spontaneous efflux of [3H]taurine and [14C]GABA was stimulated by elevated concentrations of K+ (15--133 mM) in a concentration-dependent manner. This K+-stimulated relase of [14C]Gaba but not of [3H]taurine was enhanced in the presence of Ca2+. However, addition of 3 mM Ca2+ to the superfusion medium in the presence of the ionophore A 23187 resulted in a stimulation of the release of both [3H]taurine and [14C]GABA. These results are discussed in connection with the cellular localization of taurine in the central nervous system.
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Two cases with abnormal electrocardiogram were found to have the unusual direct communication between the coronary artery and left ventricular chamber without any manifestations of the other reported coronary arterial fistula.
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The effects of the beta-adrenergic blocking agent 3-tert.-butyl-amino-1-(6'-chloro-3'-methylphenoxy)-propan-2-ol hydrochloride (bupranolol; KL 255; Betadrenol) on the plasma renin activity (PRA) of normotensive rats were studied in comparison to propranolol. Bupranolol (10--100 microgram/kg) reduced basal PRA and inhibited the isoproterenol as well as dihydralazine induced increase of PRA in a dose dependent fashion. Bupranolol exhibited an effect 2--4 times stronger than that of propranolol. The PRA inhibiting effects of bupranolol seem to be linked to its beta-receptor blocking properties.
The influence of mepiprazole (EMD 16,923), a new pyrazol-ylalkyl-piperazine derivative, on the uptake of 3H-norepinephrine (NE), 3H-dopamine (DA), and 3H-serotonin (5-HT) into rat brain synaptosomes from cerebral cortex, corpus striatum, and hypothalamus was investigated in comparison with several psychotropic drugs, including oxypertine, d-amphetamine, imipramine, desipramine, chlorimipramine, amitriptyline, and chlorpromazine in vitro. Mepiprazole was a relatively weak inhibitor of monoamine uptake and exhibited its strongest action on the hypothalamic 5-HT uptake, being almost equipotent with desipramine (IC50 = 0.9 MUM). Furthermore, the influence of the drugs on the retention of 3H-amines previously taken up by whole rat brain synaptosomes was studied. Unlike the tricyclic antidepressants, mepiprazole as well as oxypertine and d-amphetamine markedly increased the efflux of radioactivity during a 20-min incubation at 37 degrees C at low concentrations (10(-6) to 10(-5) M), whereas at 10(-4) M all drugs greatly enhanced the efflux. The ability of mepiprazole to increase 5-HT concentration at the receptor level by a combination of neuronal uptake inhibition and release is discussed in relationship to the central actions of the drug.