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Biomedical subjects

J LeBlanc

Publications and source records attributed to J LeBlanc.

At least 19 recordsLinked to original sources

Mechanisms of adaptation to cold.

The animal model used the most frequently for understanding the mechanisms of adaptation to cold in humans has been the rat. It has been established that rats kept in the cold for a few weeks stop shivering while preserving a normal internal temperature because of an enhanced thermogenic capacity of the brown adipose tissue (BAT) mediated by the sympathetic nervous system. Studies on groups of humans exposed to cold have shown that shivering is also attenuated but without compensatory increased in heat production possibly because of non-significant contribution of the BAT. However when humans and laboratory animals are exposed repeatedly to short severe cold evidence for adaptation has been described. This adaptation is not metabolic; instead it is related to the phenomenon of habituation. When exposed to a novel stress such as cold, the alarm reaction is initiated as evidenced by the activation of the sympathetic nervous system which opposes the stressing situation. However with time, when it is realized that the normal functioning of the body is not endangered the responses are attenuated and enhanced tolerance is observed. This type of adaptation was observed in Eskimos, fishermen, outdoor workers, etc.

Adaptation, Physiological

Cold wind stimulation reflex.

The bradycardia induced by cold wind blown on the face and the early cephalic release of insulin induced by feeding have been shown to be caused by a vagal reflex stimulation. An experiment was designed to determine whether cold wind blown on the face would induce both pancreatic and cardiac stimulation. A 4 degrees C wind blown on the face for 4 min produced a rapid and persistent bradycardia, which interestingly persisted for up to 35 min after the test. The effect on respiration rate is more gradual and vanishes immediately after cold wind stimulation. Cold wind produced a slight reduction of insulin secretion, as evidenced by the fall of both plasma insulin and C-peptide, and caused a significant increase in plasma norepinephrine. These results suggest that the cold wind action of the vagus nerve is exerted on the heart and that of the sympathetic on the pancreas, whereas during the cephalic phase of feeding a vagal influence is observed on the pancreas and a sympathetic action on the heart. The mechanisms of the quantitative and qualitative control of these autonomic responses are not known and deserve further investigation.

Adult

Thermogenic and hormonal responses to palatable protein and carbohydrate rich food.

Simultaneous variations of oxygen consumption, and plasma insulin and norepinephrine were measured during the postprandial cephalic and gastrointestinal phases of feeding in six human subjects following the ingestion of various nutrients. On alternative days the subjects were given foods (1280 kjoules) either rich in carbohydrates (sugar pie) or in proteins (fish). Both nutrients produced an initial (0-40 min) enhanced thermogenesis and an early (2 min) cephalic insulin release. During that period, elevations of plasma norepinephrine were also observed with pie feeding at 10 and 30 min and at 10 min with fish. Palatability ratings indicated that both food items were equally tasting. During the gastrointestinal phase (40 to 120 min) the variations of these same parameters including glucagon seem to be explained by the content in carbohydrates and proteins in the food rather than by its palatability. Indeed during that period the protein meal was more thermogenic and the carbohydrate meal induced the expected insulin secretion. These results suggest that the palatability of the food is responsible for the early cephalic increase in postprandial thermogenesis, and for the insulin and norepinephrine release. During the subsequent gastrointestinal phase the increased thermogenesis is related to the composition of the food which exerts its action by the biochemical processes involved in the disposal of the absorbed nutrients.

Adult

Effect of patient positioning after needle aspiration lung biopsy.

Fifty-five patients who underwent fluoroscopically guided needle aspiration lung biopsy were randomly assigned to one of two postbiopsy treatment groups: Patients were placed recumbent with puncture site either down (n = 36) or up (n = 19) for at least 1 hour. No significant difference in pneumothorax rate was seen between the two groups. Chest tube placement, however, was required in 21% (four of 19) of the puncture-site-up group versus 3% (one of 36) of the puncture-site-down group, which was a significant difference (P = .04). Puncture-site-down postbiopsy positioning reduces the proportion of patients requiring chest tube placement after lung biopsy.

Biopsy, Needle

Effects of physical training and adiposity on glucose metabolism and 125I-insulin binding.

Eighteen young male subjects, aged 18-30 yr, with maximal oxygen intake (VO2max) varying between 36 and 80 ml.kg-1.min-1, were studied. Between 20 and 120 min after injection, tolerance to iv glucose (20 g/m2) was not affected by VO2max but the insulin response was very significantly reduced in the better trained subjects. 125I-insulin binding to monocytes was found to be greater in the best trained subjects. Simple correlation analysis indicates that both VO2max and adiposity are related to plasma glucose and plasma insulin levels as well as to 125I-insulin binding. Because VO2max is negatively correlated to percent of body fat, a partial correlation analysis was made. Results indicate that the differences observed in athletes with regard to glucose and insulin levels and 125I-insulin binding are related to reduced adiposity rather than to enhanced VO2max.

Adipose Tissue

Plasma catecholamines and cardiovascular responses to cold and mental activity.

Plasma epinephrine (E) and norepinephrine (NE) as well as blood pressure and heart rate variations were measured in 12 male subjects before, during, and after a cold hand test (5 degrees C for 2 min), a mental arithmetic test, and a combination of both these tests. Although the cold and mental tests had comparable effects on blood pressure, the heart rate response was greater than the mental test. The mental test produced a greater increase of E than the cold test, but the effect of the cold test was greater on NE than on E. Changes in heart rate were significantly correlated with E variations but not with NE, whereas changes in blood pressure were correlated with NE. Resting NE was correlated with resting blood pressure and resting E with resting heart rate. Finally the levels of basal E were positively correlated with the increase in E during the test. Cardiovascular changes were shown to be differently modified by a mental and a cold test. Evidence was given indicating that these changes are related to differences in E and NE responses in the presence of these tests.

Adrenal Medulla

An economic evaluation of present and proposed methods of compensating hearing loss.

The basis for compensation of industrial hearing loss in the Province of Ontario is described, and contrasted with schemes utilized in other parts of Canada, United Kingdom, Australia, and the United States. Changes are suggested for the method used to derive the percentage of permanent disability related to hearing loss. A randomly selected population of claimants for industrial hearing loss have been used to model the economic effect of such changes, which are discussed.

Audiometry

Effects of age, sex, and physical fitness on responses to local cooling.

The response to local cooling was estimated by the cold hand test (5 degrees C for 2 min) and the cold face test (0 degrees C with 66 km.h-1 wind for 2 min). Heart rate, blood pressure, and skin temperature were measured before, during, and after the tests. The increase in blood pressure (cold hand test) and the fall in Tsk (cold face test) were reduced in trained subjects. Similarly older subjects (53-60 yr of age) responded less to a cold hand test than younger subjects aged 20-40. However, the bradycardia caused by the cold face test was more pronounced in the older subjects. The responses to the cold hand and cold face tests were the same for male and female subjects. During the 2 min after the test, blood pressure and heart rate fell below initial values in the female group but not in the male. It is concluded that, besides adaptation to cold, individual factors such as age, sex, and physical fitness also have a relative importance in the responses to local cooling.

Adult

Metabolic and cardiovascular responses to norepinephrine in trained and nontrained human subjects.

Forty young male adults, aged 18-30 yr, with maximal oxygen intake (VO2 max) varying between 35 and 76 ml-kg-1-min-1 were studied. The fasting subjects were perfused for 15 min with saline and thereafter for 30 min with norepinephrine (0.1 mug/kg per min). Blood variables were determined at the end of slaine perfusion, at 15 and 30 min during norepinephrine perfusion and 15 min after the end of NE perfusion. Trained subjects are characterized by lower basal plasma glucose and insulin concentration. NE perfusion produced a larger increase in plasma glucose in the trained subjects. Levels of insulin in the postperfusion period were smaller in the trained group. Serum free fatty acids (FFA) and glycerol increased less in the trained subjects during NE perfusion and this difference persisted in the post-perfusion period. During NE perfusion, blood lactate increased only in the nontrained subjects. Initial heart rate and blood pressure were lower in trained subjects but, during NE perfusion, elevated levels of blood pressure and decreased levels of heart rate were comparable in both groups. Because of similarities in responses to exercise and to NE in trained subjects, the results of the present study suggest a possible role for NE in exercise training.

Adolescent

Effect of adrenaline on insulin secretion in rats treated chronically with adrenaline.

To determine whether rats could adapt to a chronic exogenous supply of adrenaline by a decrease in the well-known inhibitory effect of adrenaline on insulin secretion, plasma glucose and insulin levels were measured in unanesthetized control and adrenaline-treated rats (300 mug/kg twice a day for 28 days) during an adrenaline infusion (0.75 mug kg-1 min-1), after an acute glucose load (0.5 g/kg), and during the simultaneous administration of both agents. Chronic treatment with adrenaline did not modify the initial glucose levels but it greatly diminished the basal insulin values (21.57+/-2.48 vs. 44.69+/-3.3muU/ml, p less than 0.01). In the control rats, despite the elevated glucose concentrations, a significant drop in plasma insulin levels was observed within the first 15 min of adrenaline infusion, followed by a period of recovery. In the adrenaline-treated group, in which plasma glucose levels were lower than in control animals, plasma insulin levels did not drop as in control rats, but a significant increase was found after 30 min of infusion. During the intravenous glucose tolerance test, the plasma glucose and insulin responses showed similar patterns; however, during the concomitant adrenaline infusion, the treated rats showed a better glucose tolerance than their controls. These results indicate that rats chronically treated with adrenaline adapt to the diabetogenic effect of an infusion of adrenaline by have a lower inhibition of insulin release, although the lower basal insulin levels may indicate a greater sensitivity to endogenous insulin.

Animals

Effects of temperature and wind on facial temperature, heart rate, and sensation.

Skin temperature measurements of the face have shown that the cheek cools faster than the nose and the nose faster than the forehead. The cooling effect of wind is maximum at wind speeds between 4.5 and 6.7 m/s. Cold winds produce significant bradycardia, which is, however, much more pronounced during the expiratory phase of respiration. A significant correlation was noted between cooling of face and the reflex bradycardia observed. Similarly, a very significant correlation was noted between drop in skin temperature and subjective evaluation of cold discomfort. Consequently, the drop in skin temperature, reflex bradycardia, and subjective evaluation are parameters which are directly affected by cold wind and can be used as adequate indicators of the degree of discomfort. When comparing the present results with the windchill index, it was found that in the zone described as "dangerously cold" the index fits well with the physiological measurements. In the zone described as "bitterly cold," the index by comparison with actual skin temperature measurements and subjective evaluation underestimates the cooling effects of combined temperature and wind by approximately 10 degrees C.

Adult

Effects of adrenaline on the dynamics of carbohydrate metabolism in rats treated chronically with adrenaline.

Following a subcutaneous injection of adrenaline (300 mug/kg), blood-glucose levels were lower in rats treated chronically with adrenaline (300 mug/kg twice a day for 28 days) than in control rats during at least 2.5 h after the injection. To explain this difference of response, the turnover rate of glucose was measured in control and adrenaline-treated rats during adrenaline infusion (0.75 mug/kg- minus 1 min- minus 1), with [U- minus 14C]glucose as tracer. It was found that the rate of appearance of glucose was greater in the control than in the adrenaline-treated group after a 120-min infusion of adrenaline. The rate of disappearance of glucose in the treated rats increased during the first 60 min of infusion and stayed at this elevated level for a subsequent 2 h, whereas in the control rats, it remained unchanged at the beginning of adrenaline infusion and significantly increased only during the second and third hours of infusion. In addition, the metabolic- clearance rate of glucose was not modified by adrenaline in the treated group, but in the control group, the initial clearance rate was significantly less than in the treated group, and decreased during the first hour of adrenaline infusion even though blood glucose reached values of 244 mg/100 ml. ,rom these data, it is suggested that rats adapt to a chronic exogenous supply of adrenaline by a reduced increase in glucose production in response to adrenaline infusion and a better glucose utilization, which possibly indicates a decrease in the inhibitory effect of adrenaline on insulin secretion.

Animals

Autonomic nervous system and adaptation to cold in man.

The responses to cold hand test (blood pressure increase and tachycardia) and to a cold face test (blood pressure increase and bradycardia) were used to study the role of the autonomic nevrous system in cold adaptation in humans. The Eskimos (men, women, children) were shown to have a very weak sympathetic response to cold but the vagal response (bradycardia) was identical to that of white people. A group of mailmen from Quebec city living outdoors approximately 30 h/wk throughout the year was also studied. A significant decline in the cold pressor response and an enhanced bradycardia (cold face test) were observed at the end of the winter. Similarly the fall in skin temperature of the cheek was not as pronounced when the measurements were made in May compared to those made in October. A group of soldiers was also studied before and after an Arctic expedition. It was found that the bradycardia of the cold face test was also more pronounced after sojourning in the cold. These results indicate that repeated exposures to severe cold in men activate some adaptive mechanisms characterized by a diminution of the sympathetic response and a concomitant enhancement of the vagal activation normally observed when the extremities and the face are exposed to cold.

Adaptation, Physiological

Ipsilateral acoustic reflex stimulation in normal and sensorineural impaired ears: a preliminary report.

Ipsilateral acoustic reflex thresholds were measured at 1,000 Hz and 2,000 Hz in 38 subjects with normal hearing and in 107 subjects with a symmetrical sensorineural hearing loss. Acoustic reflex thresholds were approximately six dB better for ipsilateral vs. contralateral stimuli for both subject groups. High ipsilateral reflex thresholds were associated with larger static compliance values in the sensorineural hearing impaired subjects. Reversed reflexes (increasing compliance with muscle contraction) were observed for ipsilateral stimulation in five per cent (two) of the normal hearing subjects, and 23 percent (25) of the sensorineural hearing impaired subjects. The number of reversed reflexes was greater for subjects with higher hearing thresholds and higher ipsilateral acoustic reflex thresholds. The results suggest that quantitative use of the ipsilateral acoustic reflex requires additional research. At present it seems prudent to use ipsilateral acoustic reflex measurements as a qualitative rather than a quantitative tool, e.g. in confirming the status of one middle ear when the other has a conductive hearing loss. However, even this limited role has a considerable clinical potential.

Acoustic Stimulation