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Biomedical subjects

J Eriksen

Publications and source records attributed to J Eriksen.

At least 109 records · Page 6Linked to original sources
PubMed1984

Cardiac performance in patients with asymptomatic alcoholic cirrhosis of the liver.

Twenty patients with biopsy-proved alcoholic cirrhosis of the liver and no cardiac symptoms entered a noninvasive investigation program in which cardiac performance was evaluated. One patient was excluded from the study because of a significant ethanol content in the serum at the time of investigation and 4 patients were excluded because of significant electrocardiographic ST-segment changes during exercise testing. Fifteen patients (12 men, 3 women, median age 47 years) who had abstained from alcohol drinking for at least 2 months were studied by exercise testing, echocardiography, measurement of systolic time intervals and left ventricular (LV) radionuclide ejection fraction (EF) at rest and during submaximal exercise. Twelve healthy persons of the same age served as control subjects. Heart rate at rest was significantly elevated in the patient group, median 90 beats/min (range 62 to 128) vs 73 beats/min (range 61 to 89) (p less than 0.02). No significant differences were found in physical work capacity and systolic time intervals, and echocardiographic parameters did not differ with the exception of left atrial dimension (median 36 mm [range 22 to 47] in the patient group and 31 mm [range 17 to 38] in the control subjects, p less than 0.05). No significant difference was found in LVEF at rest. During exercise, however, the median LVEF increased only 6% in the patients versus 14% in the control subjects (p less than 0.05). The results of this study suggest that patients with alcoholic liver cirrhosis, although free of cardiac symptoms, may have a latent or preclinical cardiomyopathy that is manifest during physical stress.

Adult↗
PubMed1984

Right and left ventricular ejection fraction and left ventricular volume changes at rest and during exercise in normal subjects.

The effect of exercise upon right and left ventricular ejection fractions (RVEF and LVEF) as well as the changes upon left ventricular end-diastolic and end-systolic volume indices (LVEDVI and LVESVI) were investigated. Twenty-two normal subjects were studied at rest and during upright submaximal exercise. RVEF was determined using a first-pass method. LVEF was measured using multiple gated blood pool imaging. During the exercise test ECGs remained normal. HR and BP increased significantly (P less than 0.01). RVEF increased from 44% +/- 4 (mean +/- SD) to 60% +/- 6 (P less than 0.001). LVEF increased from 62% +/- 6 to 76 +/- 5 (P less than 0.001). A wider scatter was observed in delta RVEF than in delta LVEF. There was a 14% increase in LVEDV-index and a 14% decrease in LVESV-index (P less than 0.001). A multiple regression analysis with delta RVEF as the dependent variable and delta HR, delta systolic BP, delta LVEF, delta LVEDV-index and LVESV-index as independent variables showed a significant correlation between delta RVEF and delta LVEF and delta systolic BP (P less than 0.05). Our data provide insight into the mechanisms by which the pump performance is increased in normal subjects. The central mechanisms observed are the Starling effect and an increase in contractility of the myocardium. This is connected in the general circulation to an increase in afterload, indicating a redistribution of blood from the vascular beds to the muscles and to the heart.

Adult↗
PubMed1984

Alfentanil and skeletal muscle circulation, oxygen consumption and P50.

The preservation of blood flow to skeletal muscles has low priority in the intact organism. If cardiovascular function is disturbed, for example by anesthetic drugs, skeletal muscle circulation diminishes or stops. Skeletal muscle surface pH (m-pH) is a sensitive indicator of muscle cell oxygenation and a fall in m-pH therefore provides an early warning of deterioration in overall cardiovascular performance. In the present study we investigated the peripheral effects of a new short-acting fentanyl derivative, alfentanil. Twelve dogs were anesthetized with a bolus injection of alfentanil 0.16 mg . kg-1 i.v. M-pH was recorded continuously, while total body oxygen consumption, oxygen transport and P50 were calculated. No changes were found. In the second part of the study, we pretreated six of the dogs with the "calcium antagonist" verapamil 0.5 mg X kg-1, while the other six dogs served as controls. After a rechallenge dose of alfentanil, we again found the peripheral perfusion sufficient to meet the oxygen demand of the muscles. Side-effects to alfentanil were a decrease in Pao2, due to an increase in pulmonary shunting of venous blood, and an increase in PaCO2. The changes in pulmonary ventilation-perfusion relationships were, however, not of a magnitude that should cause concern when alfentanil is used in normal subjects.

Adjuvants, Anesthesia↗
PubMed1984

Gamma-glutamyltranspeptidase, aspartate aminotransferase, and erythrocyte mean corpuscular volume as indicators of alcohol consumption in liver disease.

Gamma-glutamyltransferase (GGT), aspartate aminotransferase (ASAT), and erythrocyte mean corpuscular volume (MCV) were used as indicators of continued alcohol abuse in 178 patients with known liver disease studied for 5-49 months after diagnosis. Abstension was checked by interviews and blood alcohol determinations. Persistent alcoholics had significantly higher values for all three tests than abstainers. At values above upper normal limits, GGT was the most sensitive test, but the least specific. A positive predictive value of 80% for continued alcohol consumption was chosen, and the corresponding discriminating levels of the tests were compared. With this specificity GGT was the least sensitive test, and it did not add to the efficiency of ASAT or MCV when the tests were combined. Abstinence could not be predicted by low levels of the tests. It is concluded that these biochemical tests are valuable as indicators of alcohol consumption in patients with liver disease and that ASAT and MCV are equally efficient, whereas GGT is inferior to these.

Adult↗
PubMed1981

Skeletal muscle circulation during sufentanyl and morphine anesthesia in propranolol treated dogs.

Sufentanyl is a new, potent, short-acting, fentanyl-like morphinomimetic. In the present study we compared the effects of high doses of sufentanyl and morphine on the peripheral circulation in beta-blocked dogs. Skeletal muscle surface pH (m-pH) was recorded continuously as an index of the microcirculation. Sufentanyl (0.01 mg/kg) had no adverse effects on the peripheral perfusion. Morphine (4 mg/kg) caused a severe and rapid fall in m-pH from 7.34 to 7.14 during the 30-min experimental period. At the same time calculated blood volume decreased by 20%. This hypovolemic deterioration of the circulation was probably caused by a histamine-mediated increase in capillary pressure and filtration of plasma from the intravascular space to the interstitial space. As sufentanyl could be safely administered to beta-blocked dogs, we recommend human studies. On the other hand, we discourage the use of high-dose morphine anesthesia until human studies have proved that the collapse of the peripheral perfusion seen in this study is species specific.

Adrenergic beta-Antagonists↗
PubMed1981

Early response in central hemodynamics to high doses of sufentanil or morphine in dogs.

The hemodynamic effects of high doses of sufentanil, a newly synthetized highly potent analgesic, were investigated in dogs. This study compared the early (30 min) cardiovascular effects of sufentanil 0.01 mg . kg-1 and morphine 4 mg . kg-1. Sufentanil caused a moderate and insignificant decrease in mean arterial pressure (MAP). A 30% decrease in cardiac index (CI) was almost outbalanced by an increased systemic vascular resistance (SVRI). The lowering of CI was due to a more than 50% decrease in heart rate (HR) which was partly compensated for by a greater stroke volume index (SVI). In the first 5 min after morphine injection, MAP fell significantly to about 50 mmHg (below 50% of the control value). CI was reduced to about 50% of the control value because of significant decreases in both SVI and HR. The calculated SVRI was unchanged after morphine. Within 30 min some of the initially changed parameters had returned to control levels. Central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) increased immediately after sufentanil, but decreased after morphine. With time, both parameters returned towards control values. Peak left ventricular dP/dt decreased by about 25-50% after both analgesics. The rate-pressure products (RPP) were significantly decreased to less than one half of the control values after both analgesics. Mixed venous oxygen tension (PVO2), oxygen transport and oxygen consumption were significantly lowered in the sufentanil group, whereas immediate decreases after morphine were followed by gradual increases towards control values. We conclude that the use of high doses of sufentanil in dogs is safe. Apart from initial, transient changes, a stable cardiovascular state characterizes the high-dose sufentanil anesthesia, while morphine causes fluctuations in several hemodynamic parameters. Compared to morphine anesthesia, sufentanil anesthesia appears to be an attractive alternative which deserves further evaluation in humans.

Analgesics, Opioid↗
PubMed1981

High-dose analgesic anesthesia with morphine or sufentanil in propranolol-treated dogs.

In propranolol-pretreated dogs (2 mg . kg -1) the immediate cardiovascular effects of sufentanil (0.01 mg . kg -1) or morphine (4 mg . kg -1) were compared. Besides a 40% decrease in cardiac index (CI), sufentanil and morphine initiated quite different hemodynamic changes. Sufentanil did not significantly change mean arterial pressure (MAP), central venous pressure (CVP) and mean pulmonary artery pressure (MPAP), while the pulmonary capillary wedge pressure (PCWP) increased by 50%. After morphine, MAP declined significantly by about 65%, and significant decreases in MPAP (14%) and PCWP (33%) were also observed. Propranolol reduced heart rate by 16%, and morphine caused no further reduction in HR. A significant decrease of about 30% was seen in HR after sufentanil. Sufentanil significantly raised systemic vascular resistance index (SVRI) by 15%, whereas morphine decreased it by 32%. Pulmonary vascular resistance index (PVRI) was unchanged after sufentanil, but significantly increased after morphine. Right ventricular stroke work index (RVSWI) was unaffected by both analgesics, and morphine decreased left ventricular work index (LVSWI) significantly by 80%. Oxygen transport index declined significantly after both analgesics. Sufentanil reduced oxygen consumption by 20%, while morphine left this parameter unaffected. We conclude that the administration of high-dose sufentanil leads to a stable circulation, even when a total beta-blockade exists.

Analgesics, Opioid↗
PubMed1981

Genetic transformation of Streptococcus sanguis. Further studies on the production and isolation of the competence factor.

Two new media were developed, containing only the dialyzable components of Todd Hewitt broth (TH) with (medium II) or without (medium IV) inactivated horse serum. The two media were used to detect activity of the competence factor (CF) and the competence factor inactivator (CGI) of Streptococcus sanguis, and in preliminary experiments of CF isolation. Because all the dissolved substances with molecular weight (mol. wt.) less than 12,000 can be removed from these media by dialysis, leaving the CF and possible other high mol. wt. substances formed by growth in the dialysis tube, the use of these media should facilitate the isolation of CF and other high mol. wt. substances involved in genetic transformation of S. sanguis. Dialysis experiments suggest a mol. wt. greater than 12,000 of the CFs of the strains Challis and 13b. The CF of strain 13b was further isolated by Sephadex gel filtration and was eluted in the fractions of low mol. wt. compounds.

Bacterial Proteins↗
PubMed1980

Immunochemical determination of the configuration of a haptenic substituent.

Quantitative inhibition of specific immune precipitation, a rapid microanalytical technique requiring no expensive equipment, was used to determine the stereoconfiguration of pyruvyl groups attached as acetals to two hydroxyls of nonreducing lateral end groups of the capsular polysaccharides of Klebsiella serotypes K11 and K21. The R and S isomers of 4,6-O-pyruvyl-D-alpha-methylgalactoside were used as inhibitors with appropriate polysaccharide antigens and antisera to the two serotypes. The R isomer was a potent inhibitor of precipitation in both antisera, showing that the pyruvylgalactosyl residues in the polysaccharides of both K11 and K21 are in the R form, in which the methyl group of pyruvyl is equatorial to the plane of the acetal ring.

Antigens, Bacterial↗
PubMed1980

Peripheral circulation during sufentanyl and morphine anesthesia.

Sufentanyl is a newly developed potent, short-acting fentanyl-like morphinomimetic. No independent studies of the peripheral circulation during sufentanyl anesthesia are available. In the present study we compared the effects of sufentanyl and morphine on the peripheral perfusion in dogs. The effects of total beta-blockade during sufentanyl and morphine anesthesia were also evaluated. We elected to record skeletal muscle surface pH (m-pH) continuously as an index of the microcirculation and cellular fractions. Arterial and mixed venous blood gases and acid-base status were measured to determine the respiratory component of changes in m-pH. Hematocrits, plasma electrolytes and plasma proteins were analyzed in order to permit calculations of fluid-shifts between the blood and the interstitial fluid. Sufentanyl (0.01 mg/kg) had no adverse effects on the peripheral perfusion. Morphine (4 mg/kg) caused a severe and rapid fall in m-pH from 7.29 to 7.11 during the 30-min experimental period. At the same time, calculated blood volume decreased by 20%. This hypovolemic deterioration of the circulation was probably caused by a histamine-mediated increase in capillary pressure with filtration of plasma from the circulation to the interstitial fluid. Calculated systemic vascular resistance was not correlated to the quality of the peripheral perfusion. Propranolol administered during sufentanyl and morphine anesthesia did not influence the peripheral perfusion. On the basis of the present study we recommend human studies on sufentanyl, and discourage the use of high-dose morphine anesthesia.

Anesthesia, Intravenous↗