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Biomedical subjects

J E Cottrell

Publications and source records attributed to J E Cottrell.

At least 37 records · Page 2Linked to original sources
PubMed1997

Intramedullary pressure in syringomyelia: clinical and pathophysiological correlates of syrinx distension.

OBJECTIVE: The pathophysiological effects of syrinx distension are incompletely understood. Although it is generally assumed that the accumulation of fluid within syrinx cavities can contribute to neurological dysfunction, there are no reports describing intramedullary pressure in syringomyelia. The purpose of the current study was to measure syrinx pressures in patients with progressive clinical deterioration and to correlate these data with neurological deficits and intraoperative physiological findings. METHODS: Intramedullary fluid pressure was measured manometrically in 32 patients undergoing syrinx shunting procedures. The data were correlated with syrinx morphology, intraoperative somatosensory evoked potentials, laser Doppler measurements of local spinal cord blood flow (six patients), and neurological findings before and after syrinx decompression. RESULTS: Syrinx pressures recorded under atmospheric conditions ranged from 0.5 to 22.0 cm H2O (mean = 7.7 cm). There was a significant elevation of the cardiac pulse (mean = 0.7 cm H2O) and the respiratory pulse (mean = 1.1 cm H2O) that was consistent with raised cerebrospinal fluid pressure. Syrinx pressures decreased to subatmospheric levels after surgical drainage. In 18 of 24 patients with predrainage somatosensory evoked potential abnormalities, syrinx decompression produced a consistent reduction of N20 latencies (mean change = 0.49 ms +/- 0.094 SE right, P = 0.002; 0.61 ms +/- 0.089 SE left, P = 0.001) and a similar but less consistent increase in N20 amplitudes (mean change = 0.17 mV +/- 0.103 SE right, P = 0.115; 0.31 mV +/- 0.097 SE left, P = 0.027). Measurements of local spinal cord blood flow revealed very low baseline values (mean = 12.2 arbitrary units +/- 13.9 standard deviation), which increased to intermediate levels (mean = 144.7 arbitrary units +/- 42.6 standard deviation) after syrinx decompression. Patients with syrinx pressures greater than 7.7 cm H2O tended to have more rapidly progressive symptoms, exhibited greater improvements after shunting, and had a higher incidence of postoperative dysesthetic pain. CONCLUSION: The current study is the first to measure intramedullary pressure in a human disease. Evidence is presented that distended syringes are associated with varying levels of raised intramedullary pressure that can accentuate or induce neurological dysfunction by the compression of long tracts, neurons, and the microcirculation. Symptoms referrable to raised intramedullary pressure are potentially reversible by syrinx decompression.

Adolescent↗
PubMed1997

The effect of isoflurane on biochemical changes during and electrophysiological recovery after anoxia in rat hippocampal slices.

It is unclear whether isoflurane protects against neuronal damage. This study examines the extent and mechanism by which isoflurane might affect anoxic neuronal damage. The size of the evoked postsynaptic population spike recorded from the CA 1 pyramidal cell layer of the rat hippocampal slice 60 min after anoxia was compared with its preanoxic, preisoflurane level. Intracellular adenosine triphosphate (ATP), sodium, and potassium levels were measured in the dentate and CA 1 regions at the end of the anoxic period in similarly treated slices. Isoflurane increased the latency and reduced the amplitude of the evoked response before anoxia. Isoflurane (2%) did not significantly improve recovery of the evoked response after 5 min of anoxia (untreated slices = 6 +/- 2% (mean +/- SEM), isoflurane = 17 +/- 7%); 1.5% isoflurane also did not significantly improve recovery after 4 min of anoxia (untreated = 30 +/- 8% vs. 1.5% isoflurane = 47 +/- 12%). Isoflurane did not significantly attenuate the decrease in ATP levels in either the dentate or CA 1 regions of the hippocampal slice during 4 or 7 min of anoxia; however, there was a significant improvement in ATP levels after 10 min of anoxia in both regions of isoflurane-treated preparations (1.0 +/- 0.1 vs. 1.4 +/- 0.1, CA 1; 1.3 +/- 0.1 vs. 2.0 +/- 0.2 nM/mg dry weight, dentate). Sodium concentrations increased and potassium concentrations decreased during anoxia. Isoflurane did not significantly attenuate the changes in these ions during anoxia. In conclusion, isoflurane does not significantly improve recovery of CA 1 pyramidal cells during anoxia nor does it attenuate the anoxic changes in ATP, sodium, and potassium after 4 or 7 min of anoxia. With a more prolonged period of anoxia (10 min) isoflurane reduces the decrease in ATP levels.

Adenosine Triphosphate↗
PubMed1996

Conditions affecting beliefs about visual perception among children and adults.

Children and adults were tested on their beliefs about whether visual processes involved intromissions (visual input) or extramissions (visual output) across a variety of situations. The idea that extramissions are part of the process of vision was first expressed by ancient philosophers, including Plato, Euclid, and Ptolemy and has been shown to be evident in children and in some adults. The present research showed that when questions about vision referred to luminous as opposed to non-luminous objects, under certain conditions there was some increase in intromission beliefs, but almost no corresponding decline in extramission beliefs, and no evidence of transfer of intromission responses to questions referring to nonluminous objects. A separate study showed that college students, but not children, increased their extramission responses to questions providing a positive emotional context. The results are inconsistent with the idea that simple experiences increase or reinforce a coherent theory of vision. The results also have implications for understanding the nature of beliefs about scientific processes and for education.

Adolescent↗
PubMed1996

Images, words, and questions: variables that influence beliefs about vision in children and adults.

In three studies we used animated computer graphics to examine beliefs among children and adults that vision involved input to the eyes (the intromission theory) or emissions from the eye (the extramission theory). Results supported previous findings which showed a decrease in extramission and an increase in intromission responses across age. The findings also indicated that there were more extramission interpretations when subjects were tested with graphic images, and more intromission interpretations when the questioning was purely verbal. However, the magnitude of the effect was highly dependent upon question format. The differences between graphic and verbal question presentations (A) are consistent with our theory on the origins of extramission beliefs, (B) suggest that beliefs can vary as a function of form of symbolization, and (C) are contrary to long-standing beliefs of educators and psychologists that emphasize the importance of concrete, pictorial representation.

Adolescent↗
PubMed1996

Intraoperative improvement of somatosensory evoked potentials and local spinal cord blood flow in patients with syringomyelia.

This report is the first to correlate data concerning intraoperative somatosensory evoked potentials (SSEPs) and local spinal cord blood flow (ISCBF) in patients with syringomyelia. In a consecutive study, bilateral median nerve SSEPs were recorded intraoperatively in 13 patients undergoing a syrinx shunt to the posterior fossa cisterns (syringocisternostomy). ISCBF was measured in five of these patients using laser doppler flowmetry (LDF) calibrated in arbitrary units (AU). SSEP recordings obtained 30 min after syrinx decompression demonstrated a slight but consistent reduction of N20 latencies (mean change: 0.53 ms right, p < 0.003; 0.58 ms left, p < 0.001) concurrent with a similar but less consistent increase of N20 amplitudes (0.16 mV right, p = 0.256; 0.29 mV left, p = 0.03). Prior to shunting, LDF recordings from the spinal cord overlying syrinxes revealed very low ISCBF values in five of five patients (mean LDF, 13.2 AU +/- 15.3 SD). Immediately after shunting, there was a dramatic rise of ISCBF (mean LDF, 241.2 AU +/- 106.3 SD) associated with visualized hyperemia of the spinal cord and pial vessels. The ISCBF fell to intermediate levels after 2 min (157.2 AU +/- 33.0 SD) and remained at these levels during the interval of recording (5 min). Hyperventilation testing in two patients prior to shunting revealed no change in ISCBF consistent with a loss of CO2 vascular reactivity and a paradoxical increase of ISCBF in one patient 5 min after shunting. Each patient in this study experienced neurological improvement in the immediate postoperative period associated with collapse or disappearance of the syrinx on magnetic resonance imaging scans. Because syrinx shunting results in an acute decompression of the distended spinal cord, it is possible that the rapid improvement of SSEPs reflects a relief of mechanical factors such as stretching and compression of nervous tissue. However, the LDF findings in this study suggest that distended spinal cord cavities are also capable of producing regional ischemia. A significant reduction of ISCBF is a possible contributing cause of neurological injury and SSEP abnormalities. Intraoperative improvement of SSEPs and ISCBF were found to correlate well with neurological recovery following syringocisternostomy. Our results indicate that SSEP monitoring can provide useful information during surgical procedures for syringomyelia and that further experience with LDF monitoring may provide insights into the pathophysiology of this condition.

Adolescent↗
PubMed1995

The importance of sodium for anoxic transmission damage in rat hippocampal slices: mechanisms of protection by lidocaine.

1. The effect of sodium influx on anoxic damage was investigated in rat hippocampal slices. Previous experiments demonstrated that a concentration of tetrodotoxin which blocks neuronal transmission protects against anoxic damage. In this study we examined low concentrations of lidocaine (lignocaine; which do not block neuronal transmission), for their effect on recovery of the evoked population spike recorded from the CA1 pyramidal cell layer. 2. Recovery of the population spike, measured 60 min after a 5 min anoxic period, was 4 +/- 2% of its preanoxic, predrug level. Lidocaine concentrations of 10, 50, and 100 microM significantly improved recovery to 56 +/- 12, 80 +/- 7 and 70 +/- 14%, respectively. 3. Lidocaine (10 microM) did not alter the size of the evoked response before anoxia and had no significant effect on potassium levels or calcium influx during anoxia. It did, however, reduce cellular sodium levels (146 +/- 7 vs. 202 +/- 12 nmol mg-1) and preserve ATP levels (2.17 +/- 0.07 vs. 1.78 +/- 0.07 nmol mg-1) during anoxia. All values were measured at the end of 5 min of anoxia except those for Ca2+ influx which were measured during 10 min of anoxia. 4. High concentrations of lidocaine (100 microM) did not improve recovery significantly over that observed with 10 microM. They also had no significantly greater effects on sodium levels than 10 microM lidocaine (137 +/- 12 vs. 146 +/- 7 nmol mg-1); however, 100 microM lidocaine significantly improved potassium (202 +/- 18 vs. 145 +/- 6 nmol mg-1) and ATP (2.57 +/- 0.06 vs. 2.17 +/- 0.07 nmol mg-1) levels, while reducing calcium influx (7.76 +/- 0.12 vs. 9.24 +/- 0.39 nmol mg-1 (10 min)-1) when compared with 10 microM lidocaine. 5. We conclude that sodium influx and ATP depletion are of major importance in anoxic damage since 10 microM lidocaine reduced these changes during anoxia and improved recovery of the population spike. In addition, our results indicate that the properties of the sodium channel are altered during anoxia, since sodium influx is blocked by a concentration of lidocaine that does not affect the population spike in the preanoxic period.

Adenosine Triphosphate↗
PubMed1995

[Pharmacologic brain protection: specific agents].

Dysfunctional sodium influx is the first step in the ischaemic cascade. It has been recently demonstrated that reducing ionic flux through voltagegated Na channels shortens the NMDA receptor activity of cultured hippocampal slices in which oxidative phosphorylation and glycolysis have been blocked. The implication of this finding is that blocking initial events in the ischaemic cascade, events which do not directly cause neuronal damage, will reduce the damage done by downstream events. It also seems intuitively reasonable to suppose that truncating initial steps of the ischaemic cascade, as distinct from blocking glutamate receptors and scavening free radicals, will reduce the probability of interfering with endogenous mechanisms of repair. Clinically useful, substantive, prophylactic, pharmacological cerebral protection will come from drugs that work upstream. And for pharmacological protection that can only be initiated subsequent to an ischaemic event, the more we learn about endogenous repair, or genetic pharmacology, the closer we will come to maximizing the benefits and minimizing the costs of downstream intervention.

Apoptosis↗
PubMed1994

Anoxia reduces depolarization induced calcium uptake in the rat hippocampal slice.

Veratridine-induced depolarization caused a large increase in Ca uptake in the rat hippocampal slice (30.2 vs. 9.0 nM/mg dry weight). This uptake was reduced to 18.4 nM/mg when veratridine was combined with anoxia. When compared with veratridine exposure alone, the combination of anoxia and veratridine increased intracellular Na (460 vs. 380 microM/g), decreased intracellular K (30 vs. 40 microM/g) and decreased ATP levels (0.1 vs. 0.8 nM/mg). The changes in Na, K, and ATP should enhance net Ca uptake, yet Ca uptake was reduced. This suggests an effect of anoxia to block Ca channels. In summary anoxia attenuates depolarization-induced Ca uptake. This may represent a mechanism by which neurons are partially protected against anoxic damage which could be more severe if depolarization-induced Ca uptake was not limited.

Adenosine Triphosphate↗
PubMed1994

Propofol prevents or elevates the threshold for lidocaine-induced seizures in rats.

Hypothesizing that propofol's pro and anticonvulsant effects might be dose dependent, we determined the effect of 25, 50, and 100% of a previously determined anesthetic dose of propofol for rats on the amount of lidocaine required to induce seizures. Lidocaine was infused at 2.5 mg kg-1 min-1 into animals that were receiving either (a) 70% N2O balance O2 (n = 10), control group, (b) 2 mg kg-1 bolus followed by 12 mg kg-1 h-1 propofol infusion with 70% N2O (n = 10), group 2, (c) 4 mg kg-1 followed by 24 mg kg-1 h-1 propofol with 70% N2O (n = 20), group 3, (d) 8 mg kg-1 followed by 48 mg kg-1 h-1 propofol with 70% N2O (n = 10), group 4, or (e) 8 mg kg-1 followed by 48 mg kg-1 h-1 propofol without N2O (n = 10), group 5. Temperature PaCO2, and pH were maintained within normal limits until disturbed by seizure activity or lidocaine toxicity. The plasma concentration of lidocaine required to induce electroencephalographically (EEG) detected seizures was 8.7 +/- 0.7 micrograms ml-1 in control animals, 16 +/- 1.7 micrograms ml-1 in group 2, and 32 +/- 4 micrograms ml-1 in 13 animals from group 3 that experienced a seizure (p < 0.01). Seizures did not occur in seven of 20 group 3 rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Developmental changes in understanding an illusion based on perceptual adaptation: effects of feedback.

Children and adults were exposed to an illusion created by perceptual adaptation, in which they perceived two identical bottles, held simultaneously in a different hand, as being different in weight. Prior research has shown that young children treat the perceived difference as real rather than illusory. In an initial study, feedback designed to signal the illusory nature of the weight difference led many third graders to acquire an erroneous rule. Older children and adults more often gave a correct response, although there was no clear evidence that they understood the illusion. In Study 2, confronting children with the discrepancy between the preillusion phase of the testing and the subsequent experience of an illusion helped them to infer an understanding of the illusion when the discrepancy was large. The results have implications for the development of the understanding of perceptual processes, the appearance-reality distinction, and the child's theory of mind.

Adolescent↗
PubMed1993

The selection of a residency program: prospective anesthesiologists compared to others.

A study was undertaken to investigate factors important to senior medical students, particularly prospective anesthesiology residents, in selecting a residency program. A previously published questionnaire was used to determine whether previous findings could be replicated. One hundred ninety-seven senior medical students rated the importance of 22 items in their selection of a residency program. Factors were ranked nearly identically as in the previous study. Factors rated as most important were "diversity of training experience" as well as "house officer satisfaction," whereas items about treating patients with the acquired immunodeficiency syndrome were rated as least important. There were gender differences that showed women assigned more importance to having a manageable case load, call schedules, and geographic location. Prospective anesthesiology residents perceived "prestige" of the program, and the department as significantly more important than did prospective nonanesthesiology residents. The replication of results with regard to the overall ranking of factors demonstrates the reliability of the results. Resident selection committees need to focus on the issue of quality of training, the impression made by the interviewers, and include satisfied residents as part of the interview process.

Adult↗
PubMed1993

Cerebral edema formation in dogs following hypotension induced with isoflurane and labetalol.

The effects of induced hypotension with isoflurane and labetalol on cerebral edema formation were compared following a cryogenic brain injury in dogs. Thirteen dogs received a maintenance anesthetic of 70% N2O, 0.5% isoflurane in O2 and a fentanyl infusion (3 micrograms.kg-1 x hr-1). All dogs were normoventilated (PaCO2 of 35-40 mmHg) and monitored for temperature, arterial blood pressure, central venous pressure (maintained between 7-10 mmHg), end-tidal CO2, end-tidal anesthetic level, and urine output. Following a right parietal craniectomy, a standard sized cryogenic brain lesion was made. The animals were randomly allocated in two groups. Group I (n = 6) received maintenance anesthesia, but within a 30 minute period, mean arterial pressure (MAP) was reduced to 60 mmHg with isoflurane varying in inspired concentration from 2 to 4%. Thereafter, the MAP was maintained at this level for 60 minutes. The inspired concentration of isoflurane was decreased, then discontinued to allow the MAP to return to baseline during the next 30 minutes. Group II (n = 7) received maintenance anesthesia, and MAP was reduced to 60 mmHg during a 30 minute period with intravenous labetalol (20 mg.kg-1). This MAP was maintained for one hour with a continuous labetalol infusion. The infusion was discontinued and the MAP returned to baseline during the next 30 minutes. The wounds were surgically closed. Anesthesia was discontinued, paralysis was reversed, and the animals were extubated and transported to a recovery room. Forty-eight hours postoperatively, all animals were reanesthetized, injected with Evans' blue dye and sacrificed. The brain was removed, fixed in formalin, and sent "blindly" coded for neuropathologic evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

The barbiturate thiopental reduces ATP levels during anoxia but improves electrophysiological recovery and ionic homeostasis in the rat hippocampal slice.

The barbiturate anesthetic thiopental enhances recovery of the evoked population spike recorded from rat hippocampal slices after short periods of anoxia. Thiopental reduces changes in sodium, potassium and calcium but enhances the fall in ATP levels during anoxia. The postsynaptic population spike recorded from the CA1 pyramidal cell region of the slices treated with thiopental (600 microM) recovered to 67% of the preanoxic amplitude after 3.5 min of anoxia. There was less recovery (24%) when a lower concentration of thiopental (250 microM) was used. Untreated slices recovered to only 10% of their preanoxic amplitude after 3.5 min of anoxia. Other studies have demonstrated that maintaining ATP levels during anoxia may be an important mechanism of protection. In contrast to those studies, thiopental was protective although it enhanced the fall of ATP levels after 3.5 min of anoxia in the CA1 region and after 3.5 and 5 min in the dentate region. Thus enhanced recovery of the population spike with thiopental is not due to its preservation of ATP levels. This result allows a clear separation of improved ATP levels during anoxia from other mechanisms of protection. We therefore looked for other mechanisms of protection. Sodium and potassium levels were measured after 10 min of anoxia. In untreated tissue, sodium levels in the slice rose and potassium levels fell significantly. In thiopental-treated tissue, changes in sodium and potassium caused by anoxia and by veratridine under normoxic conditions were significantly reduced. During anoxia calcium-45 uptake increases; thiopental significantly reduces this uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗