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R L Webb

Publications and source records attributed to R L Webb.

72 records · Page 4Linked to original sources

Synthesis, resolution, absolute stereochemistry, and enantioselectivity of 3',4'-dihydroxynomifensine.

3',4'-Dihydroxynomifensine, 8-amino-1,2,3,4-tetrahydro-4-(3,4-dihydroxyphenyl)-2-methylisoquinoli ne (1a), is an agonist of dopamine receptors in central and peripheral systems. Since this dopamine receptor agonist bears an asymmetric center at position 4, its synthesis and resolution were undertaken as part of a study directed toward determining the mode of interaction of these agents with the receptor(s). The enantiomers of 3',4'-dihydroxynomifensine are of particular interest, as they provide additional probes of present conceptual models of the dopamine receptor(s). Initial attempts to prepare 1a were inefficient or unsuccessful; instead, an isomeric compound, 1,2,4,5-tetra-hydro-2-(3,4-dihydroxyphenyl)-4- methyl-3H-1,4-benzodiazepine (9), was obtained. For this reason, a new route to 3',4'-dihydroxynomifensine was employed. The racemic dimethoxy intermediate 1d, thus obtained, was resolved. Methoxyl cleavage of the isomers of 1d afforded the enantiomers of 1a. Enantiomeric excess of these antipodes or appropriate derivatives was examined by NMR, CD, and HPLC methods. CD analysis suggests an enantiomeric excess greater than 99%. Determination of the absolute configuration of the enantiomers of 1a was determined by single-crystal X-ray diffractometric analysis. Examination of the isomers in several pharmacological test systems revealed a high degree of enantioselectivity. D-1 dopaminergic activity resides almost exclusively in the S enantiomer. The findings of the study have been employed to suggest an accessory binding site on the dopamine receptor(s) that differs from that advanced earlier. This accessory binding site may be specific for the D-1 subpopulation of dopamine receptors.

Adenylyl Cyclases↗

Clinical trial of a multi-channel cochlear prosthesis: results on 10 postlingually deaf patients.

The clinical trial of a multi-channel cochlear prosthesis has been carried out on 10 profoundly-totally deaf adult patients. Speech perception tests have shown that all the patients received significant benefit from the device. They obtained improvements in understanding running speech from 47% to 550% when using the device in conjunction with lipreading compared to lipreading alone. With an open-set CID sentence test, three patients obtained scores showing an ability to understand speech without the need to lipread, and a further three patients had scores indicating they could also receive useful information without lipreading. In two patients, very limited open-set scores for electrical stimulation alone were obtained. This was most probably due to the fact that only a few channels of stimulation were possible due to cochlear disease, and they were therefore receiving information more like a single-channel device. The prosthesis has also been found to provide considerable help in hearing and recognizing everyday sounds.

Adult↗

Evidence that central dopamine receptors modulate sympathetic neuronal activity to the adrenal medulla to alter glucoregulatory mechanisms.

Previous reports suggest that analogs of dopamine (DA) can produce hyperglycemia in rats by interacting with DA receptors. Experiments reported here indicate the site of action and describe the metabolic sequalae associated with the hyperglycemic effect of apomorphine (APO), produced in conscious unrestrained rats. Apomorphine was more potent when administered by intracerebroventricular (i.c.v.) injection than when given subcutaneously (s.c.). Very small doses of the DA receptor antagonist pimozide, given intraventricularly, blocked the hyperglycemic effect of apomorphine administered subcutaneously. Sectioning of the spinal cord at thoracic vertebra T1-2 or sectioning the greater splanchnic nerve blocked apomorphine-induced hyperglycemia; whereas section of the superior colliculus or section at T5-6 had no effect. A dose of apomorphine or epinephrine (EPI) producing a similar degree of hyperglycemia elevated the concentration of EPI in serum to a similar degree, and the increase in EPI in serum preceded the increase in glucose in serum. Fasting animals for 2 or 18 hr had no significant effect on EPI- or apomorphine-induced hyperglycemia despite a reduction (91-93%) of the glycogen content of liver and skeletal muscle during the 18 hr fast. 5-Methoxyindole-2-carboxylic acid (MICA), an inhibitor of gluconeogenesis, blocked EPI- and apomorphine-induced hyperglycemia in rats fasted for 18 hr. However, 5-methoxyindole-2-carboxylic acid was ineffective in blocking hyperglycemia in animals fasted for 2 hr. Changes in insulin or glucagon in serum alone cannot account for the hyperglycemic action of apomorphine. These data demonstrate that apomorphine interacts with central DA receptors located in the hindbrain to activate sympathetic neuronal activity to the adrenal gland which subsequently releases epinephrine to alter homeostasis of glucose. Epinephrine may then, depending on the nutritional status, facilitate glycogenolytic or gluconeogenic processes to produce hyperglycemia.

Adrenal Medulla↗

Implanted material tolerance studies for a multiple-channel cochlear prosthesis.

We have performed a number of temporal bone and animal studies in order to evaluate the histopathological effects of intracochlear electrode implantation and chronic electrical stimulation. Our results indicate that (a) the insertion of a free-fit scala tympani array results in minimal damage to the membranous labyrinth; (b) the materials used in the electrode array evoke mild tissue reactions when implanted subcutaneously, in muscle, or within the scala tympani; (c) intracochlear electrical stimulation for periods of 500 to 2000 hours, using carefully controlled biphasic pulses, does not adversely affect the population or neural activity of the primary auditory neurones; (d) labyrinthine infection severely reduces the number of viable spiral ganglion cells; (e) an adequate fibrous tissue seal of the round window can prevent the spread of infection from the bulla to the implanted cochlea in cats, following inoculation of the bulla cavity with bacteria; (f) bone growth is not associated with electrical stimulation per se; (g) the electrode arrays show minimal platinum dissolution and no apparent degradation of the Silastic carrier following periods of long-term intracochlear electrical stimulation.

Animals↗

Clinical results using a multiple-channel cochlear prosthesis.

A total of eight profoundly deaf patients have been implanted with the Nucleus Limited multiple-channel cochlear prosthesis at the University of Melbourne since it became available in late 1982. All patients are everyday users of the device. Speech testing using the device alone has shown consistently high scores for a variety of closed set tests and significant levels of open set speech understanding in most of the patients. Lipreading assessment with phoneme, word, sentence and speech tracking material shows significant improvement when using the prosthesis for all patients tested. Other benefits reported are recognition of environmental sounds, decrease in tinnitus, increased confidence in social and vocational situations and improved voice control. One patient is able to cope with interactive conversations over the telephone and three others are able to use the telephone in a limited way without special codes.

Adult↗

Clinical trial of a multiple-channel cochlear prosthesis. An initial study in four patients with profound total hearing loss.

The clinical trial of a multiple-channel cochlear prosthesis was undertaken in four patients with postlingual deafness and profound total hearing loss. The results of open-set speech tests confirmed that, using electrical stimulation alone, one patient could have a meaningful conversation without resorting to lipreading (for example, this patient uses the prosthesis to converse with her husband on the telephone). The results of closed-set speech tests also suggested that a multiple-channel stimulator is more effective than a single-channel one in conveying speech information. The cochlear prosthesis was especially effective in all four patients when it was used in conjunction with lipreading, and speech-tracking tests showed that the patients could combine the information obtained from both electrical stimulation and lipreading.

Adult↗

Evidence for a central role for vasopressin in cardiovascular regulation.

Central vasopressin (VP) may modulate the functional activity of specific neuronal systems involved in cardiovascular regulation. To test this hypothesis we compared cardiovascular (CV) responses to electrical stimulation of the anteroventral region of the third ventricle (AV3V) in Brattleboro rats homozygous for diabetes insipidus (DI), in heterozygous DI rats (DI-HZ) and in normal Long-Evans rats (LE). We also studied the effects of peripheral and intracerebroventricular (ivt) treatment of DI rats with VP and treatment of LE rats with an antipressor blocker of VP on cardiovascular responses to AV3V stimulation. Stimulation of the AV3V region in anesthetized LE rats produced a frequency-dependent increase in renal (RVR) and mesenteric vascular resistance (MVR), a decrease in hindquarter vascular resistance (HQVR), and a decrease in arterial pressure (AP) and heart rate (HR). DI and DI-HZ rats showed significantly greater decreases in AP and HR and lesser changes in RVR, MVR, and HQVR. The deficiency in vasoconstriction in DI rats appeared to be centrally mediated inasmuch as vascular responses to peripherally administered phenylephrine and nerve stimulation were comparable in LE and DI rats. Treatment of DI rats with VP peripherally improved CV responses to AV3V stimulation. An even greater improvement in CV responses to AV3V stimulation was obtained when DI were given ivt infusion of VP. Finally, following intravenous administration of an antipressor VP blocker LE rats showed a greater decrease in AP and HR and lesser resistance changes in response to AV3V stimulation. Our data suggest that cardiovascular responses elicited from stimulation of the AV3V region may depend, in part, on a central vasopressin mechanism.

Animals↗

Autologous blood retrieval in thoracic, cardiovascular, and orthopedic surgery.

A significant amount of red blood cells were conserved with use of the Cell Saver in cardiac surgery patients and in some orthopedic and vascular surgery patients. No major complications have been associated with its use in our cases. Our results are similar to those of others who have reported on the use of this device. In the cardiac surgery patients we observed significant serum protein losses which had to be replaced. We recommend the use of intraoperative albumin to help maintain adequate urinary output and hemodynamic stability.

Blood Proteins↗

Surgery for an improved multiple-channel cochlear implant.

An improved multiple-channel cochlear implant has been developed. The titanium container with enclosed electronics, the receiver coil, and the connector are embedded in medical-grade Silastic. The upper half of the implant has a diameter of 35 mm and a height of 4.5 mm, and the lower half a diameter of 23 mm and a height of 5 mm. The electrode array has also been designed to reduce the possibility of breakage due to repeated movements over many years. The surgery involves drilling a bed in the mastoid bone for the receiver-stimulator, and fixing the proximal electrode under the mastoid cortex. Gentle insertion of the electrode array through the round window and along the scala tympani is achieved with a specially designed microclaw .

Cochlear Implants↗

Banded intracochlear electrode array: evaluation of insertion trauma in human temporal bones.

A banded free-fit scala tympani array was inserted into the basal turn of nine human cochleas to evaluate the trauma produced by the procedure. These nine cochleas, together with five nonimplanted controls, were serially sectioned and examined microscopically for damage to the membranous labyrinth, in particular the spiral ligament, the basilar and Reissner's membranes, the stria vascularis, and the osseous spiral lamina. The severity and location of any trauma along the cochlear spiral were recorded. The results indicate that the insertion of the banded scala tympani array resulted in minimal mechanical damage, occurring primarily to a localized region of the spiral ligament. This would not result in significant neural degeneration, and therefore would not compromise the efficacy of the multichannel cochlear prosthesis.

Aged↗

Vasopressin-central nervous system interactions in the development of DOCA hypertension.

DOCA-salt hypertension does not develop in rats with hereditary lack of vasopressin (DI rats) nor in rats with lesion of the anteroventral region of the third ventricle (AV3V), an area controlling vasopressin (VP) release. We examined, therefore, the effect of VP treatment on the development of DOCA salt hypertension in AV3V-lesioned (AV3V-L) normal Sprague-Dawley rats and in Brattleboro rats homozygous for diabetes insipidus (DI rats). We also examined changes in vascular reactivity in isolated, perfused kidneys in the experimental groups. Whereas sham-lesioned (SL) rats showed hypertension at 5 weeks, AV3V-L rats showed no change in arterial pressure (AP) after DOCA. AV3V-L rats given VP exhibited only an intermediate rise in AP in spite of the fact that plasma VP levels were comparable in DOCA-treated SL rats and AV3V-L rats. SL and AV3V-L rats given VP showed enhanced renal vascular activity whereas no vascular changes occurred in AV3V-L rats. At 5 weeks post DOCA, intact DI rats given VP were hypertensive and exhibited enhanced renal vascular reactivity. AV3V lesion in DI rats completely prevented VP-induced DOCA/salt hypertension and enhanced vascular responsiveness. These data suggest that VP plays a primary role in DOCA-salt hypertension through an induction of enhanced vascular reactivity and through central mechanisms requiring the integrity of the AV3V region.

Animals↗