Altitudinal field losses with congenital optic nerve head anomalies.
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Biomedical subjects
Publications and source records attributed to T D Williams.
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Goldmann perimetry was done on 11 pseudophakic subjects and results were compared to those of age-matched phakic subjects and a third group of aphakic individuals who were wearing rigid gas permeable contact lenses. Testing showed that the I-3 and I-4 fields of the subjects who had had cataract surgery were generally constricted when compared to the normal phakic population. Possible explanations for this include media clarity not being as important a factor in determining field size as was previously thought, peripheral retinal changes, and implant material affecting contrast sensitivity.
Pressor sensitivities to infusions of arginine vasopressin (AVP), noradrenaline (NA) and angiotensin II (AII), as well as cardiovascular responses to head-up tilt, were assessed in subjects with central diabetes insipidus (CDI) and compared with those in normal control subjects. During incremental i.v. infusions of AVP at 0.2-5.0 pmol min-1 kg-1, mean arterial blood pressure (MABP) rose progressively in CDI subjects only and the rise was significantly greater than that which occurred in control subjects during their final infusion. The pressor effects of incremental i.v. infusions of NA and AII were greater, and the bradycardia associated with NA was more pronounced, in CDI subjects than in controls. Whole body tilt from supine to 45 degrees head-up was associated with increased heart rate and an insignificant rise in MABP in both groups, although a rise in plasma AVP occurred in control subjects only. These results demonstrate that subjects with CDI are more sensitive than control subjects to the pressor effects of NA and AII, and also develop sensitivity to the pressor effects of AVP. Their cardiovascular responses to head-up tilt remain intact. Presumably the increased vascular sensitivity to NA and AII in subjects with CDI is sufficient to compensate for their lack of AVP response during head-up tilt.
We have compared the effects of a 48-h continuous infusion of arginine vasopressin (AVP) given to four subjects (one subject studied twice) with that given to four patients lacking adrenocortical function and maintained on fixed doses of mineralocorticoid and glucocorticoid replacement therapy. Both patients and normal subjects were subjected to dietary salt and water restriction during the period of the infusion, and all participants were in balance on a low sodium diet at the start of the infusion period. Infusion of vasopressin in normal subjects was associated with an increase in fractional excretion of sodium by the kidney, which continued during the day after the infusion was stopped. The infusion was also associated with a fall in plasma aldosterone as well as falls in whole blood packed cell volume, plasma renin activity and plasma noradrenaline. Infusion of vasopressin in patients lacking adrenocortical function was associated with a smaller increase in fractional excretion of sodium by the kidney in comparison with that seen in normal subjects, and the increase in sodium excretion was confined to the period of the infusion. Mineralocorticoid activity was maintained constant during the infusion, although a fall in whole blood packed cell volume, plasma renin activity and plasma noradrenaline were noted, in similarity to the study made in normal subjects. We conclude that changes in mineralocorticoid activity are the main factors contributing to the increase in renal sodium excretion seen during, and after, the continuous infusion of vasopressin in salt- and water-restricted man.
To investigate whether atrial natriuretic peptide (ANP) release during paroxysmal tachycardia is due to increased atrial rate or increased atrial pressure, plasma ANP concentrations were measured during atrial pacing at increasing rates in six alpha-chloralose-anesthetized dogs whose atrial pressures were maintained artificially low by balloon occlusion of the inferior vena cava (IVC). These ANP concentrations were compared with those seen during identical increasing atrial rates in the same dogs without IVC occlusion. During incremental pacing without IVC occlusion, pulmonary wedge pressure (PWP; mean +/- SE) rose progressively from 5.3 +/- 1.6 at 200 to 20.2 +/- 2.3 mmHg at 350 beats/min (P less than 0.01), and right atrial pressure (RAP) rose progressively from 2.5 +/- 0.9 at 200 to 6.7 +/- 2.1 mmHg at 350 beats/min (P less than 0.05). At the same time, arterial and coronary sinus ANP concentrations rose from 116 +/- 55 and 339 +/- 91 to 1,126 +/- 226 and 1,960 +/- 456 pmol/l, respectively (P less than 0.01). In contrast, incremental pacing with IVC occlusion produced no significant increase in PWP and RAP. Arterial and coronary sinus ANP concentrations during IVC occlusion were, respectively, 208 +/- 126 and 388 +/- 159 at 200 and 261 +/- 83 and 345 +/- 80 pmol/l at 350 beats/min (NS). This study demonstrates that the release of ANP during tachycardia is primarily dependent on increased atrial pressure and not atrial rate.
The effects of infusions of atrial natriuretic peptide (ANP) on the hormonal and hemodynamic responses to head-up tilt were investigated in six healthy adults. Head-up tilt at 45 degrees for 2 h during placebo saline infusion caused a 7% fall in blood volume accompanied by increases in plasma renin activity (PRA) and plasma arginine vasopressin (AVP) of 112 and 175%, respectively. Head-up tilt was repeated during an infusion of ANP producing a four- to sixfold increase in plasma ANP concentrations. This resulted in an 18% fall in plasma volume, yet despite this greater fall in plasma volume, PRA did not change. Two subjects experienced vasovagal symptoms toward the end of the ANP infusions accompanied by large increases in plasma AVP. In the other four subjects, plasma AVP remained unchanged during ANP infusions. Both procedures resulted in similar increases in plasma norepinephrine levels and in heart rate. Infusion of ANP prevents the posturally stimulated release of renin and AVP.
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A 24-year-old Caucasian woman spontaneously developed four hemorrhages, each with a "preretinal" or "subhyaloid" appearance. The largest was in the macular area: the others were more peripheral. The central hemorrhage followed a characteristic pattern of reabsorption, while the peripheral ones followed a different pattern, which seems consistent with the formation of a clot, removal of blood pigments, and ultimate removal of the fibrin. The photographs suggest that the hemorrhage in the macular area had both intra- and pre-retinal components. Aside from a history of lupus erythematosus (which was in remission when the hemorrhages occurred), there was no other apparent ocular or systemic cause for the hemorrhages.
A 60-year-old woman presented with deteriorating vision. A computed tomography (CT) scan showed pituitary enlargement with chiasmal compression. Serum prolactin levels were normal but assessment of thyroid function showed a serum thyroxine level of 25 nmol/l (normal range 76-160 nmol/l) and a thyroid-stimulating hormone (TSH) level of 60 mU/l (normal range 0.5-5.0 mU/l). After 8 weeks of thyroxine replacement therapy (0.05 mg daily increasing to 0.1 mg daily after 3 weeks) the visual defects had resolved, serum TSH had fallen to 0.7 mU/l, and the CT scan showed pronounced reduction in the size of the pituitary gland. Measurement of TSH as well as prolactin is essential in all patients with pituitary enlargement, to avoid unnecessary pituitary surgery.
The osmotic and cardiovascular control of arginine vasopressin (AVP) secretion, and the effect of this hormone on cardiovascular regulation were assessed both in normal controls and in subjects with tetraplegia. Infusion of hypertonic saline caused a marked rise in blood pressure in the tetraplegics but not in the normal controls. Head-up tilt resulted in a greater AVP response in the tetraplegics than in the controls because of the additional hypotensive response in the tetraplegics. Infusion of AVP itself at physiological concentrations had little effect on blood pressure in the normal subjects but resulted in a marked rise in blood pressure in the tetraplegics. Tetraplegics therefore show appropriate release of AVP to both osmotic and cardiovascular stimuli but increased sensitivity to the pressor effects of this hormone.
Ocular fundus photographs of the optic nerve head of 396 normal eyes were obtained. An ellipse was fitted to points digitized around the circumference of each nerve head. The length of the major and minor axes, and the orientation of the major axes were determined. This paper gives frequency distributions for the degree of ellipticalness of 396 nerve heads. The long axis is on average 11.5% longer than the short axis and the top of the long axis tends on average to be tilted toward the midline of the head by 10 degrees. In addition, it appears that the population of Elschnig type III nerve heads includes higher elliptical values than that for the Elschnig type II nerve heads.
The relationships between the hemodynamic, renal, and endocrine changes induced by rapid atrial pacing were studied in seven chloralose-anesthetized greyhounds paced from the right atrial appendage for 60 min at 250 beats/min. Pacing increased mean pulmonary wedge pressure, decreased cardiac output, and decreased mean arterial pressure. Systemic vascular resistance did not change significantly. Coronary sinus atrial natriuretic peptide (ANP) concentrations rose maximally within 5 min of commencing pacing. The corresponding increase in arterial ANP concentrations during this time was only 44% of its maximum value after 30 min of pacing. Plasma concentrations of arginine vasopressin were unchanged. Plasma renin activity decreased during pacing and showed a marked rebound increase at 60 min postpacing. Plasma norepinephrine levels did not change significantly during pacing. Urine flow increased during the latter 30 min of pacing. There was no significant change in sodium clearance despite high sustained concentrations of ANP. The lack of significant natriuretic and systemic vasodilator effects in association with high arterial plasma concentrations of endogenous ANP, in the absence of antagonistic mechanisms, suggests that the natriuretic and vascular effects of ANP may not be its major physiological actions.
Castration of juvenile and photorefractory adult starlings caused no immediate increase in circulating concentrations of LH. In castrated juveniles and adults exposed to natural changes in daylength, plasma LH increased between mid-October and mid-November, although the increase was more rapid in adults. In castrated photorefractory adults, plasma LH increased 3-5 weeks after transfer to artificial short days (8L:16D). In castrated juvenile starlings plasma LH increased 4-6 weeks after transfer to 8L:16D, irrespective of the age of the birds. Birds as young as 17 weeks had high LH concentrations. These results suggest that the reproductive system of juvenile starlings is in the same state as that of photorefractory adults, and therefore the activation of the hypothalamo-pituitary axis for the first time in juveniles is analagous to the termination of photorefractoriness in adults.
Nestling starlings (Sturnus vulgaris) were thyroidectomized, in the wild, when 8 days old. They were later brought into captivity and hand reared on a daylength of 16h light: 8h darkness per day. Thyroidectomy dramatically affected somatic development so that even at 23 weeks of age these birds retained the physical characteristics of approximately 3-week-old euthyroid birds. Nevertheless, they appeared to be healthy and were active. Despite retaining juvenile features, these thyroidectomized birds became sexually mature. In males, testicular growth began at 8 weeks of age and by 23 weeks both males and females had well developed gonads.
We report the negative ion chemical ionization mass spectra of 2,4-dinitrophenyl (DNP) amino acid methyl esters. For the common amino acids, these derivatives exhibit very simple mass spectra; the molecular anion is the base peak in all cases. The electrophilicity of the DNP group allows selective and sensitive ionization. Amino acids can be identified singly or in mixtures by their molecular weights, and picomole detection is possible. Chromatography is only needed for Leu/Ile differentiation. Amino-terminal analysis of proteins is demonstrated.
The role of endogenous opiates in the control of the secretion of oxytocin in the basal state in healthy male volunteers was investigated with the opiate antagonist naloxone. There was no change in plasma oxytocin levels, assessed for a 120 min period following the intravenous administration of naloxone (10 mg). Although there was no effect of opiate receptor blockade with naloxone in this basal situation, further studies are needed to evaluate the possible role of opioid regulation of oxytocin during lactation and parturition.
The renal response to graded intravenous infusions of arginine vasopressin (AVP) was investigated in a two part study in six volunteers. First, under maximal water diuresis, seven control incremental infusions of AVP were given from zero to 12 fmol min-1 kg-1. Second, the AVP infusions were repeated after pretreatment with indomethacin, 150 mg daily for 36 h. After the AVP infusions, plasma AVP concentrations did not change significantly and remained within the physiological range; in contrast, urinary AVP excretion rate increased steadily. Indomethacin did not alter the plasma or urinary concentrations of AVP. AVP caused a fall in urine flow rate from a state of maximal diuresis to one of maximal antidiuresis. After indomethacin, fractional free water clearance was reduced by an average of 26% at the zero, 2 and 4 fmol min-1 kg-1 infusion rates of AVP. A significant increase in fractional sodium clearance of approximately 50% occurred during the AVP infusions, which was abolished after pretreatment with indomethacin. After indomethacin, urinary prostaglandin E2 (PGE2) excretion rate was reduced by an average of 40% at the zero and 2 fmol min-1 kg-1 infusion rates of AVP. At higher AVP infusion rates, no significant inhibition of PGE2 was observed. Urinary kallikrein excretion rate decreased steadily to one-third of its original value after AVP and this change remained unaltered by indomethacin. The findings show that infusions of AVP, resulting in plasma concentrations in the physiological range, evoke a maximal antidiuretic response, which is accompanied by natriuresis.(ABSTRACT TRUNCATED AT 250 WORDS)
The blood pressure (BP) and heart rate (HR) responses to 5 min incremental intravenous infusions of noradrenaline (NA) and arginine vasopressin (AVP) were investigated both in patients with progressive autonomic failure (PAF) and in normal volunteers. Stepwise infusion of NA at rates of 300-3000 pmol min-1 kg-1 produced a bradycardia and a dose related increase in BP in normal subjects. In subjects with PAF there was no significant HR response but the dose-BP response was shifted to the left with significant pressor responses at infusion rates of 60-300 pmol min-1 kg-1. Stepwise infusion of AVP at 0.2-5.0 pmol min-1 kg-1 caused transient bradycardia but no pressor response in seven normal volunteers. Further increases in AVP infusion in three other subjects achieved plasma AVP levels as high as 3000-4000 pmol/l, and still no significant pressor response was observed. Stepwise infusion of AVP at 0.05-2.0 pmol min-1 kg-1 in the eight subjects with PAF resulted in a pressor response without any change in HR. During this infusion plasma AVP increased from 0.8 +/- 0.2 (mean +/- SEM) to 30 +/- 2 pmol/l. A significant pressor response was already apparent at a plasma AVP level of 5.5 +/- 1.8 pmol/l.