Ergotamine tartrate overdosage.
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Biomedical subjects
Publications and source records attributed to J Marshall.
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An intravenous 133Xe clearance technique for measuring cerebral blood flow (CBF) is described. Results obtained compared well with those using the intracarotid 133Xe technique. The reproducibility of the method was checked by repeating measurements within a few hours in 14 patients, when no significant overall change occurred, and after some days in 23 patients when a mean fall in flow of 8% was observed. CBF was measured in 52 control subjects. The mean fast component flow (Ff) was 68.6 ml/100 g/min (SD 11.3). No difference between the two hemispheres was found. Flow was confirmed to be higher anteriorly in the cerebral hemispheres. A significant inverse correlation was found between CBF and age.
Fifty-two patients presenting with dementia were divided into a group in whom clinical features suggested an ischaemic basis (multi-infarct dementia) and a group in whom a primary degenerative process seemed more likely. Focal EEG changes and angiographic evidence of ischeamic areas and atheromatous disease of intracranial vessels were more common in the "ischaemic" than in the primary degenerative group. CBF was significantly reduced in the former but the regional pattern was equally distorted in the two groups. These findings strengthen the belief that the ischaemic score can identify those patients whose dementia is associated with vascular disease.
A series of comparative exposures to both argon and krypton lasers have been made at 3 locations in a human retina--the fovea, the macula, and intraretinal vessels. In the fovea argon irradiations resulted in damage to both the inner and outer retinal layers as a result of absorption within the pigment epithelium and the macular pigment, while krypton exposures damaged the outer retina and the choroid. In the macula both systems resulted in damage to the outer retina, and again sufficient krypton radiation passed into the choroid to induce blood vessel occlusion, haemorrhage, and oedema. When intraretinal vessels were irradiated, only with argon was sufficient energy absorbed within the vessels to damage them or their surroundings in the inner retina. The implications of these findings are discussed in relation to the therapeutic uses of lasers.
In a morphological survey of 73 human retinae spanning 9 decades, and including 20 retinae which were obtained from eyes enucleated for malignant melanomas, nodular excrescences were noted in the outer segments of rods with an incidence which increased with age. These structures were sectioned in both their vertical and horizontal axes and on electron microscopical examination were seen to result from the localised convolution of affected outer segments. The topographic morphology of such convolutions is described and their modes of formation are discussed.
Experimental branch vein occlusion by laser photocoagulation in the rhesus monkey leads to early, marked, and lasting reduction of blood flow to the affected retinal region. The radioactive microsphere method demonstrates this reduction of blood flow in both gamma counting and autoradiography. The reduction of flow becomes evident as early as 2 hours after occlusion and persists up to 1 week. The mechanism of the altered flow is discussed.
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Cerebral blood flow (CBF) was measured before and after i.v. injection of the cerebral vasodilator 10-methoxy-1,6-dimethyl-ergoline-8 beta-methanol-(5-bromonicotinate) (nicergoline, Sermion) in 13 patients with cerebrovascular disease. CBF increased in seven. The possibility is discussed that the effect of the drug in the other patients may have been masked by a fall of CBF which occurs during sequential measurement of patients at rest. Nicergoline is an alpha-adrenergic receptor blocking agent which affects cerebral blood flow by reducing cerebrovascular resistance. The present study was undertaken to assess the acute effect of the drug on cerebral blood flow and blood pressure in patients with cerebrovascular diseases.
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A retrospective review of the clinical and angiographic features of 116 patients who had had one or more transient ischaemic attacks in the carotid territory showed that stenosis of ther cervical portion of the internal carotid artery was significantly more prevalent among patients whose attacks had been brief, with full recovery in under one hour. This information may be helpful in selecting patients for angiography.
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Thyroidal secretion of 3,3',5'-triiodothyronine (reverse T3, rT3) and its control by TSH was assessed by measuring (1) arterio-venous hormone gradients in patients undergoing surgery, (2) changes of hormone concentrations after induction of anaesthesia, and (3) changes induced by TRH administration. In ten patients in whom thyroid activity was under TSH control (parathyroidectomy and non-toxic goitre) increased thyroid vein/carotid artery ratios (TV/CA) for rT3 (mean TV/CA ratio 2.53) were found when compared to six patients with non-toxic goitre on suppressive doses of T4 (mean TV/CA ratio, 1.27) (P less than 0.05). The mean calculated operative secretion rate of rT3 was 12.5 microgram/day but only 2.4 microgram/day in patients receiving T4. In thirteen patients undergoing elective surgery induction of anaesthesia significantly increased rT3 levels. In nine euthyroid adults intravenous TRH (200 microgram) increased peripheral venous rT3 levels between 3 h (P less than 0.005) and 8 h (P less than 0.05) after the injection. It is concluded that significant amounts of rT3 are secreted by the thyroid gland at operation and this is, in part, under TSH control.