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Biomedical subjects

L S James

Publications and source records attributed to L S James.

At least 37 records · Page 2Linked to original sources
PubMed1985

Cerebrospinal fluid and plasma vasopressin in the fetal lamb: basal concentration and the effect of hypoxia.

The concentrations of vasopressin in the plasma and cerebrospinal fluid (CSF) of the chronically catheterized fetal lamb were measured under basal and hypoxic conditions. Under basal conditions, samples were obtained from 13 fetal lambs of 117-146 days gestation. The mean +/- SEM vasopressin level in CSF was 19.5 +/- 1.5 pg/ml; the mean plasma vasopressin level of 1.9 +/- 0.2 pg/ml was significantly less (P less than 0.001). No consistent change in concentrations of vasopressin in CSF was observed with gestational maturation in 3 animals sampled sequentially or in individual samples obtained over the last 32 days of gestation. The mean vasopressin concentration in the CSF of the pregnant ewe was 5.1 +/- 0.4 pg/ml. The gradients for osmolality, sodium, and potassium between fetal plasma and CSF were: osmolality, 298.4 +/- 1.6 to 304.3 +/- 1.4 mosmol/kg; sodium, 140.9 +/- 0.5-142.5 +/- 0.5 meq/liter; and potassium, 4.3 +/- 0.1 to 3.3 +/- 0.1 meq/liter. Fetal hypoxia was induced by exposure of the ewe to 10% O2 in N2 for 30 min. The concentration of vasopressin increased from 1.7 +/- 0.3 to 277 +/- 144 pg/ml (P less than 0.001) in fetal plasma and from 21.4 +/- 3.8 to 47.1 +/- 9.9 pg/ml (P less than 0.04) in fetal CSF. When the ewe was exposed to room air under comparable experimental conditions, no similar changes in plasma or CSF vasopressin levels were observed in the fetus. Infusion of vasopressin into the fetal jugular vein at 1.0 mU/min for 30 min increased plasma concentrations from 2.3 +/- 0.5 to 83 +/- 17 pg/ml, while the CSF vasopressin values were 31.9 +/- 5.9 (basally) and 30.7 +/- 4.8 pg/ml (after infusion). Mean plasma and CSF osmolality, sodium, and potassium were not changed by any of these experimental interventions. We conclude that 1) under basal conditions, high concentrations of vasopressin are present in the CSF of the fetal lamb, the blood-CSF barrier appears to be impermeable to vasopressin, and concentrations of the hormone in fetal plasma are less than those in CSF; and 2) hypoxia is a potent stimulus of vasopressin release in both fetal plasma and CSF. The route of vasopressin released into the fetal CSF may be distinct from that released into plasma.

Animals↗
PubMed1985

Gentamicin kinetics in the neonate.

Gentamicin serum levels were measured and elimination half-life was calculated in a group of neonates with postconceptual ages ranging between 25-42 weeks. Infants were receiving intravenous gentamicin (2.5 mg/Kg/dose) at various dosage intervals and t 1/2e was calculated using a one-compartment open model. Evidence of gentamicin accumulation was present in 82% of infants 34 weeks. T 1/2e was 8.8 +/- .7 hours in infants 30 weeks, 7.8 +/- 1.1 hour in infants between 30-34 weeks and 6.2 +/- .5 in infants greater than 34 weeks. The results of the study suggest that gentamicin elimination is related to postconceptual age and that infants treated with recommended dosage regimens may have possible gentamicin tissue accumulation and nephrotoxicity. Therefore, the dosage interval may have to be lengthened to 18 hours in infants less than 34 weeks with close gentamicin plasma level monitoring.

Bacterial Infections↗
PubMed1985

Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation.

The successful management of 15 infants suffering from persistence of fetal pulmonary circulation and in severe respiratory failure is presented. The treatment regimen focused on minimizing barotrauma. Infants were intubated nasotracheally and ventilated with intermittent mandatory ventilation. Peak inspiratory pressures were determined by the clinical assessment of chest excursion. Ventilator settings and fractional inspiratory oxygen (FiO2) were selected to maintain a PaO2 between 50 and 70 mm Hg; PaCO2 was not a controlling parameter and was allowed to increase as high as 60 mm Hg. Hyperventilation and muscle relaxants were not used. High ventilator rate was used in ten infants who required high inspiratory pressure to maintain chest excursion, with a favorable response in five. Tolazoline was given to 14 infants of whom ten showed an improvement in oxygenation; dopamine was given to three infants who were oliguric. All infants survived, and only one infant developed chronic lung disease which was defined by the infant's need for supplemental oxygen beyond 30 days of life.

Birth Weight↗
PubMed1984

Effects of hypoxia on vasopressin concentrations in cerebrospinal fluid and plasma of sheep.

The relationship between concentrations of vasopressin in plasma and cerebrospinal fluid (CSF) was examined under basal and hypoxic conditions in unanesthetized and unrestrained adult female sheep. Under basal conditions mean (+/- SE) concentration of vasopressin (4.1 +/- 0.3 pg/ml) in CSF was significantly (p less than 0.001) higher than the concentration in arterial plasma (2.4 +/- 0.2 pg/ml). There was a significant positive correlation between CSF and plasma vasopressin concentrations (r = 0.66, p less than 0.01). The introduction of severe hypoxia by exposure of the sheep to an inspired gas mixture of 5% O2 in N2, a known stimulus to systemic release of vasopressin, was associated with an increase in the concentration of vasopressin in plasma to 339 +/- 65 pg/ml and CSF to 19 +/- 3.9 pg/ml. This increase of vasopressin in CSF was delayed in time with respect to the increases in the plasma and of a lesser magnitude. With moderate hypoxia (10% O2 in N2 exposure) no increase in CSF or plasma vasopressin concentration was observed, suggesting a threshold response. Intravenous infusion of vasopressin to achieve plasma values comparable to those seen with hypoxia was not accompanied by a significant increase in CSF vasopressin concentration. Thus, severe hypoxia is a potent stimulus for release of vasopressin into both CSF and plasma. Furthermore, data suggest that vasopressin may be released into CSF via a separate route from that released into plasma.

Animals↗
PubMed1984

Gentamicin absorption during prophylactic use for necrotizing enterocolitis.

Gentamicin absorption was measured after oral administration in 18 neonates treated prophylactically in an attempt to decrease the incidence of necrotizing enterocolitis. Patients were given 10 mg/kg/day in four divided doses via nasogastric tube for a total of 10 days. Levels were assayed using the Emit system. Serum levels ranged between 0 and 2.2 micrograms/ml. Mean levels over 10 days were 0.42 +/- (SD) 0.47 micrograms/ml and did not vary significantly from day to day. From these data we conclude that enterally administered gentamicin is not absorbed to a degree that would result in toxic or even therapeutic serum concentrations.

Birth Weight↗
PubMed1984

Fetal growth retardation due to maternal tobacco smoke exposure in the rat.

Smoking during pregnancy results in offspring with an average birth weight 200 g less than those of non-smoking mothers. The pathogenesis of this effect is still unknown and there is no general agreement about the causal relationship between maternal smoking and subsequent fetal growth retardation. In the present study, a model of maternal smoking during pregnancy in the rat was established using the P & I Walton Exposure Machine. The study consisted of three groups: control, pair-fed, and smoke-exposed. Smoke-exposed animals were exposed continuously to tobacco smoke for cycles of 7 min, 16 times a day from d 5 to d 20 of gestation. On d 21 of gestation, fetuses from all groups were removed by cesarean section, weighed, and dissected. The fetal brain, liver, and lungs as well as the placentas were weighed and analyzed for nucleic acid content. Fetal weight was found to be significantly reduced in both pair-fed and smoke-exposed groups compared with the control group. There was also a significant reduction in fetal body weight of the animals in the smoke-exposed group in comparison to those in the pair-fed group. Exposing the mother to smoke affected neither fetal brain weight nor nucleic acid content whereas fetal liver and lungs showed a significant decrease in both weight and nucleic acid content. These results indicate that the fetal growth retardation associated with maternal exposure to tobacco smoke in the rat corresponds to a disproportionate type.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Excretion of vasopressin in the hypoxic lamb: comparison between fetus and newborn.

The factors associated with increased renal excretion of vasopressin (VP) were examined in the hypoxic fetus and newborn. Studies were conducted on six chronically instrumented fetal (117-136 days gestation) and seven newborn lambs (2-6-day-old). Hypoxia was produced by administration of 10% oxygen to the ewe or neonate for 30 min. This procedure caused a 50% reduction in PaO2, no significant change in pHa in either fetus or neonate and a slight fall in PaCO2. Hypoxia caused an increase in VP concentrations in plasma from 1.3 +/- 0.53 to 46.4 +/- 4.71 pg/ml in the fetus and from 5.9 +/- 2.80 to 50.2 +/- 26.68 pg/ml in the neonate. After hypoxia there was a fall in urine output from 0.27 +/- 0.045 to 0.17 +/- 0.046 ml/(min X kg) in the fetus and from 0.15 +/- 0.033 to 0.09 +/- 0.022 ml/(min X kg) in the newborn. The corresponding values for urine osmolality were the following: 168 +/- 30.8 to 325 +/- 30.6 mOsm/kg in the fetus and 388 +/- 65.4 to 523 +/- 51.8 mOsm/kg in the newborn. VP concentration in urine increased from 13 +/- 9.4 to a maximum of 176 +/- 32.4 pg/ml after 30 min of recovery in the fetus and 39 +/- 4.6 to 278 +/- 132.5 pg/ml after 1 h of recovery in the newborn. These levels remained high for at least 1 h after the end of hypoxia. There was a good linear correlation between plasma VP levels and the corresponding urine levels and excretion rates in both the fetus and newborn.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Vasopressin concentration in amniotic fluid as an index of fetal hypoxia: mechanism of release in sheep.

Hypoxia is a potent stimulus to the release of vasopressin in fetal sheep and, in turn, plasma concentrations of the hormone correlate inversely with fetal oxygenation. Because the fetal kidney contributes to vasopressin clearance, we propose that measurement of increased amounts of vasopressin in amniotic fluid would be indicative of fetal hypoxia. We therefore measured concentrations of vasopressin in amniotic fluid under resting conditions, during and after fetal hypoxia, and with intravenous and intra-amniotic administration of vasopressin in 15 chronically instrumented fetal lambs 111-141 d gestation. In the resting state mean (+/- SE) vasopressin concentrations in amniotic fluid (1.6 +/- 0.3 pg . ml-1) did not differ from those in maternal (1.4 +/- 0.4 pg . ml-1) or fetal (1.8 +/- 0.2 pg . ml-1) plasma. After exposure of the ewe to 10% O2 or partial occlusion of the umbilical cord, vasopressin concentrations in fetal plasma increased significantly (P less than 0.001) to 200 +/- 59 pg . ml-1 with a delayed increase in amniotic fluid concentrations (P less than 0.03) to 15.8 +/- 4.5 pg . ml-1. This rise in concentration of vasopressin in amniotic fluid was sustained for at least 24 h and levels at that time were highly correlated with peak plasma concentrations (r = 0.83, P less than 0.001). Intravenous infusion of vasopressin into the fetus was accompanied by an equally significant (P less than 0.02) and sustained increase of vasopressin in amniotic fluid. After intraamniotic injection of vasopressin, levels remained increased for at least 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗
PubMed1984

Vasopressin concentration in amniotic fluid as an index of fetal hypoxia: mechanism of release in sheep.

Hypoxia is a potent stimulus to the release of vasopressin in fetal sheep, and plasma concentrations of the hormone correlate inversely with fetal oxygenation. Since the fetal kidney contributes to vasopressin clearance, we propose that measurement of increased amounts of vasopressin in amniotic fluid would be indicative of fetal hypoxia. Therefore, we measured concentrations of vasopressin in amniotic fluid under resting conditions, during and after fetal hypoxia, and with intravenous and intra-amniotic administration of vasopressin in 15 chronically instrumented fetal lambs between 111 and 141 days gestation. In the resting state, mean (+/- SE) vasopressin concentrations in amniotic fluid (1.6 +/- 0.3 pg ml-1) did not differ from those in maternal (1.4 +/- 0.4 pg ml-1) or fetal (1.8 +/- 0.2 pg ml-1) plasma. Following exposure of the ewe to 10% O2 or partial occlusion of the umbilical cord, vasopressin concentrations in fetal plasma increased significantly (P less than 0.001) to 200 +/- 59 pg ml-1 with a delayed increase in amniotic fluid concentrations (P less than 0.03) to 15.8 +/- 4.5 pg ml-1. This rise in concentration of vasopressin in amniotic fluid was sustained for at least 24 h and levels at that time were highly correlated with peak plasma concentrations (r = 0.83; P less than 0.001). Intravenous infusion of vasopressin into the fetus was accompanied by an equally significant (P less than 0.02) and sustained increase of vasopressin in amniotic fluid. Following intra-amniotic injection of vasopressin, levels remained increased for at least 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗
PubMed1984

A scoring system for states of sleep and wakefulness in term and preterm infants.

We designed and validated a system for determining the state of sleep or wakefulness in both term and preterm infants. The system is based on independent assessments of behavioral and electroencephalographic (EEG) patterns. Overall agreement between observers in coding individual behavioral patterns was 77.6%. Agreement between observers in coding EEG patterns was 87.4%. Designation of an infant's state is made by combining concurrent behavioral and EEG scores into a single two-number code. The distribution of sleep state for eight infants greater than 36 wk postconceptional age (PCA) was the following: quiet sleep (QS), 30.4%; active sleep (AS), 50.0%; indeterminate sleep (IS), 11.4%, and wakefulness (W), 7.5%. The distribution of sleep state for 15 infants less than 36 wk PCA was as follows: QS, 18.9%; AS, 52.9%; IS, 16.4%; and W, 10.5%. Our experience with the system suggests that it is useful for relating sleep state to physiologic variables during neonatal experimental studies.

Child Behavior↗
PubMed1983

Experimental production of pulmonary hypoplasia following amniocentesis and oligohydramnios.

We have analyzed the impact of a single needle puncture of the fetal rat membranes on day 15 of gestation on growth and development at term (day 21). Untouched littermate fetuses served as controls. The procedure led to persistent oligohydramnios. The experimental fetuses weighed less, 94% of the weight of controls, P less than 0.01. Both lungs and liver weighed significantly less, 72% (P less than 0.01) and 89% (P less than 0.03) of controls respectively and there was no effect on brain weight. When the values were expressed as organ/body weight ratio only the lung/body weight ratio was significantly lower, 77% of controls, P less than 0.01. DNA per lung was less, 83%, as was lung DNA per gram of fetal weight, 89%, and the lung protein/DNA ratio was lower, 79%, indicating lung hypoplasia and hypotrophy (all three P values less than 0.01). There were no significant differences in either liver or brain biochemical analysis. We conclude that pulmonary hypoplasia associated with oligohydroamnios in the rat is a suitable animal model of the human condition.

Amniocentesis↗
PubMed1983

Plasma renin, catecholamine, and vasopressin during nitroprusside-induced hypotension in ewes.

The effect of acute nitroprusside-induced hypotension on plasma renin activity, catecholamine, and vasopressin concentrations was examined in eight chronically catheterized, conscious ewes. Nitroprusside was infused intravenously for one hour at rates adjusted to achieve a 20% decrease in mean blood pressure (dose range: 14-50 mg, or about 5.8-18.5 micrograms X kg-1 X min-1). During hypotension, renin activity increased from 1.39 +/- 0.49 to 3.92 +/- 1.38 ng X ml-1. h-1, catecholamine concentrations remained unchanged, and vasopressin increased from 1.7 +/- 0.4 to 110 +/- 52.7 pg/ml. A significant positive correlation was obtained between total nitroprusside dose and peak vasopressin level (r = 0.749, P = 0.015). No significant change in arterial-blood pH, PO2, PCO2, plasma osmolality, or sodium concentration were observed throughout the experiment, thus eliminating the possibility of osmolar or hypoxic stimuli for the increased renin activity and vasopressin release. The magnitude of vasopressin release found in our studies implies that it plays a more important role than renin in defense against acute hypotension. In addition, the authors experiments suggest that variation in vasopressin release may be responsible for the variation of the dose of nitroprusside required to maintain hypotension.

Animals↗
PubMed1983

Instrumentation for the continuous measurement of gas exchange and ventilation of infants during assisted ventilation.

A system of instrumentation for continuous measurement of oxygen consumption (VO2), carbon dioxide production (VCO2) and minute ventilation (V1) in human newborns on assisted ventilation is described. VO2 and VCO2 are measured by open-circuit indirect calorimetry utilizing a Servomex OA 184 differential paramagnetic oxygen analyzer and a Beckman LB 2 infrared CO2 analyzer. Minute volume is measured with a body plethysmograph. Bench performance is described, limitations of the system are defined, and sample clinical data are presented. The instrumentation can measure safely, accurately, and continuously physiologic variables in sick infants on assisted ventilation.

Humans↗
PubMed1983

Factors in the release of vasopressin by the hypoxic fetus.

The relative effects of 3 stimuli in the release of vasopressin (VP) by the fetus were examined in 19 chronically instrumented fetal lambs, 118-135 days gestational age. The fetus was exposed to: 1) 30-min administration of 10% O2 to the pregnant ewe, 2) 20 min of partial occlusion of the umbilical cord, or 3) 2 min of complete occlusion of the umbilical cord. Twelve studies were conducted for each of these experimental protocols. The rises (mean +/- SE) in plasma VP in the 3 groups were 29.9 +/- 8.9, 48.9 +/- 11.5, and 157.8 +/- 12.5 pg/ml, respectively; the corresponding falls in PaO2 were 9.2 +/- 0.7, 7.7 +/- 0.9, and 12.7 +/- 1.2 mm Hg. pHa did not change in the group receiving 10% O2, fell by 0.11 +/- 0.02 and 0.14 +/- 0.01 after partial and complete occlusion of the umbilical cord. The rises in mean arterial pressure were 6 +/- 2.2, 10 +/- 1.9, and 23 +/- 3.1 mm Hg, respectively, at the end of the 3 procedures. The rise in plasma osmolality ranged from 2-8 mosmol/kg in all 3 groups. Linear regression analyses showed that log VP was negatively correlated with PaO2 (r = -0.827; P less than 0.01) and pHa (r = -0.706; P less than 0.01) and positively correlated to mean arterial pressure (r = 0.607; P = 0.01), but was not significantly correlated to plasma osmolality. Our present findings suggest that hypoxemia and acidemia are associated with and may both be potent stimuli for VP release in the hypoxic fetus. Increased release together with decreased rate of metabolism by the placenta offer an explanation for the very high VP levels found in the neonate after labor and delivery.

Acid-Base Imbalance↗
PubMed1982

Vasopressin secretion induced by hypoxia in sheep: developmental changes and relationship to beta-endorphin release.

To investigate the developmental changes in the secretion of vasopressin and the potential role of beta-endorphin as a stimulus to the release of vasopressin, the concentrations of these peptides were measured in fetal, newborn, and adult sheep after episodes of induced hypoxia. The studies confirm that hypoxia is a potent stimulus to the release of both vasopressin and beta-endorphin in the fetal animal. In both the newborn lamb and the ewe, more profound hypoxia is necessary for a similar release. In the fetus, the release of both vasopressin and beta-endorphin after hypoxia increased with gestational maturation. A comparison of control concentrations of both peptides, the discordance of release in the newborn lamb, and the absence of a change in concentrations of vasopressin with infusion of beta-endorphin implies that these hormones are released in parallel but independently during hypoxic stress.

Aging↗
PubMed1982

Role of vasopressin in fetal homeostasis.

The role of vasopressin (VP) and the kidney in the maintenance of solute and volume homeostasis was studied in chronically instrumented fetal lambs during the third trimester. Plasma VP, urine and plasma osmolality, and urine output were measured in 74 simultaneous samples. The results show a strong positive nonlinear correlation between plasma VP and osmolality when a latter is higher than 290 mosmol/kg (r = 0.803, P = 0.03) and between plasma VP and urine osmolality (r = 0.806, P = 0.05). No correlation was found between fetal and maternal plasma VP. However, linear correlations were found in plasma osmolality and sodium concentrations between mother and fetus; mean maternal-fetal gradients were 4 mosmol/kg and 3.1 meq/liter, respectively. The highest values for plasma VP and osmolality found in our study were 7.0 pg/ml and 317 mosmol/kg, respectively. There values corresponded to urine output of 0.02 ml.kg-1.min-1 and osmolality of 517 mosmol/kg. In conclusion, there studies demonstrate that the relationship among plasma osmolality, plasma vasopressin concentration, and urine osmolality in the lamb fetus are qualitatively similar to those of the adult. The results suggest that the fetal neurohypophysis and kidney may participate in the maintenance of fetal osmolar and volume homeostasis.

Animals↗
PubMed1981

Effect of hypoxemia and acidemia on the fetal cardiac response to acetylcholine: experimental observations in fetal baboons.

The effect of hypoxemia and acidemia on the fetal cardiac response to acetylcholine (ACh) was studied in 24 baboon fetuses in utero. A bolus injection of ACh was given intravenously to the fetus at a dose that ranged from 5 to 160 micrograms/kg of estimated fetal weight. The responses were divided into two groups according to fetal oxygenation and acid-base state. Fetuses in group I were well oxygenated (PaO2, 31 +/- 1.4 mm Hg; pHa, 7.32 +/- 0.154; only five atrioventricular (A-V) heart blocks were induced with 50 +/- 3.3 micrograms/kg of ACh. Fetuses in Group II were hypoxemic (PaO2, 18 +/- 1.2 mm Hg) and acidemic (pHa, 7.05 +/- 0.048); ten A-V heart blocks were induced with a comparable dose of ACH (45 +/- 6.8 micrograms/kg). Dose response relationship is noted in individual fetuses with multiple dosage injections. These findings suggest that the fetal cardiac response to ACh is both dose related and more profound when the fetus is hypoxemic and acidemic, and indicate that the hypoxic and acidotic fetus is at a greater risk from strong stimulation of the parasympathetic nervous system. Atropine prevented myocardial conduction defect induced by intravenous injection of ACh even in the severely hypoxemic baboon fetus. This observation suggests that judicious use of atropine could be a life-saving measure when a prolonged severe degree of cord occlusion is suspected.

Acetylcholine↗