Search PubMed⌕ Search

Biomedical subjects

Y Jammes

Publications and source records attributed to Y Jammes.

At least 109 records · Page 6Linked to original sources

Laryngeal afferents activated by phenyldiguanide and their response to cold air or helium-oxygen.

In anesthetized cats, sensory neurons in the superior laryngeal nerves (SLN) were identified with respect to their response to (1) phenyldiguanide (PDG) i.v., (2) mechanical stimulation and (3) lowering temperature in an isolated tracheolaryngeal segment. The activity originating from 107 SLN afferent units activated by PDG was recorded using glass microelectrodes advanced in the nodose ganglion. All tested afferent units increased their discharge rate during direct touching of the airway mucosa. None showed flow or pressure related activity during abrupt changes in constant laryngeal flow or transmural pressure in the isolated segment. Fifteen units were inhibited by cold air. Sixty-two units significantly increased their firing rate when the temperature approached 18 degrees C, reached a peak discharge near 15 degrees C, then their activity decreased or stopped. The response to cold air was compared to cold heliox (79% He-21% O2), which enhanced the respiratory heat loss by conduction. The peak firing rate was significantly higher with heliox (+356% compared to +246% with air), the temperature threshold higher (25 degrees C +/- 1.0 degree C) and the temperature range broader (25-11.5 degrees C). Present results show that a large proportion (58%) of afferent SLN fibres activated by PDG are likely non-proprioceptive units, which are stimulated by cooling the inspired gas. Thermosensitive units in the upper airways may act as sensors of the thermal flux through the airway wall more than as detectors of the absolute value of temperature in the airway lumen.

Action Potentials↗

The effects of ischemia, lactic acid and hypertonic sodium chloride on phrenic afferent discharge during spontaneous diaphragmatic contraction.

In 9 sodium pentobarbital anaesthetized cats, 50 single-unit phrenic afferent recordings were determined during spontaneous ventilation, retrograde carotid arterial injection of lactic acid (LA, 0.1 N) and NaCl (5%), and a 2-min occlusion of the superior thoracic aorta. Fifty percent of the units had tonic low-frequency spontaneous discharge; 50% had phasic high-frequency discharge. Tonic fiber activity increased significantly with LA, NaCl and occlusion, while phasic fiber activity decreased in all 3 conditions. These results suggest that the diaphragm contains sensory endings sensitive to ischemia and extracellular metabolic changes.

Animals↗

[Trial of a new technic of transcutaneous diaphragmatic electrostimulation in man].

A new method of diaphragmatic pacing by transcutaneous electrical stimulation, using alternative currents with frequency and amplitude modulations, was tested in 12 subjects: 3 were normal and awake (group I); 4 were studied in acute respiratory failure while under mechanical ventilation and central apnea (group II) and 5 were studied while anaesthetized for peripheral venous surgery and breathing spontaneously (group III). Stimulation was performed either during spontaneous ventilation (groups I and II) or during short periods of respiratory depression (group III). Tidal volume was measured by pneumotachography. A positive correlation was found between stimulus intensity and inspired volume. This effect was not due to voluntary control alone, since diaphragmatic stimulation could support 24% of the theoretical minute ventilation in group II subjects and 64% in group III subjects. These preliminary results demonstrate the relative efficacy of this new method of diaphragmatic pacing using computerized alternative currents.

Adult↗

Cold-induced bronchospasm in normal and sensitized rabbits.

In anesthetized, paralyzed and artificially ventilated rabbits, changes in lung resistance induced by cooling the inspired air were studied under dry air conditions. Airway response to cold was measured in normal animals and in rabbits sensitized to bovine serum albumin. The magnitude of cold-induced bronchospasm was significantly greater in sensitized than in normal rabbits but the time course for recovery of control lung resistance during rewarming was the same in both groups and lasted longer than 4 min. Inhalation of a nebulized aerosol of sodium cromoglycate (SCG) markedly reduced cold-induced bronchospasm and shortened the recovery period, which then lasted only 20 to 30 sec. Vagotomy abolished the airway response to cold air in all cases and this was observed whether the vagus nerves were cut before or after SCG inhalation. SCG or vagotomy exerted the same effect on the response to cold air in normal or sensitized rabbits. Sensitized animals showed an hyperresponsiveness to histamine as well as to cold air. These results suggest that cold-induced bronchospasm results from a vagally mediated reflex whose effects are only enhanced and prolonged by a local release of humoral factors, linked to the reflex path. The increased response to cold air in the sensitized rabbits seems to correspond to non-specific hyperresponsiveness of bronchial smooth muscle rather than to an increased local release of inflammatory mediators.

Aerosols↗

Role of vagal and spinal sensory pathways on eupneic diaphragmatic activity.

The interactions between vagal and spinal afferents in the control of eupneic diaphragmatic activity were studied in two groups of cats anesthetized either with pentobarbital sodium (SPB) or with ethyl carbamate-alpha-chloralose (ECC), which enhanced spinal reflexes. Under both conditions of anesthesia two experimental protocols were performed: 1) bilateral cervical vagotomy followed by spinal section at C8 level or 2) spinal section followed by vagotomy. Changes in integrated diaphragmatic activity (Edi) were studied during eupneic ventilation and tracheal occlusion at end expiration. Vagotomy always significantly increased the amplitude of Edi during eupnea (SPB + 30%; ECC + 15%) and prolonged its duration (Tdi) (SPB + 110%; ECC + 75%) but did not modify the overall shape of the Edi vs. time relationship. Spinal section induced reverse changes in the amplitude of Edi, whether vagal afferents were present or suppressed and modified the shape of the Edi wave, but did not significantly modify Tdi. These results indicate that both vagal and spinal afferents may participate in the control of eupneic inspiration but exert different and interdependent influences on the recruitment and firing time of phrenic motoneurons. In addition, Tdi measured during tracheal occlusion (Todi) was markedly prolonged under ECC anesthesia. In this situation spinal section reduced Todi, which became close to the values obtained in intact or spinal cats under SPB anesthesia. Thus the response to tracheal occlusion at end expiration cannot be interpreted as resulting from the sole suppression of volume related vagal information.

Afferent Pathways↗

Phrenic afferents and their role in inspiratory control.

In anesthetized cats, with vagi cut and the spinal cord severed at the C8 level, phrenic motor and/or sensory discharge was recorded. Small afferent phrenic fibers were identified through their activation by lactic acid, hyperosmotic NaCl solution, or phenyl diguanide. They exhibited a spontaneous but irregular low-frequency discharge. Block of their conduction by procaine had no effect on eupneic motor phrenic activity. Large afferent phrenic fibers showed a spontaneous rhythmic discharge, and cold block (6 degrees C) of these fibers significantly prolonged the phrenic discharge time (Tphr) and total breath duration (TT) during eupnea. The stimulation of all afferent phrenic fibers lowered the impulse frequency of phrenic motoneurons (f impulses) and shortened both Tphr and TT. When the stimulation was performed during cold block all of the effects on phrenic output persisted, but changes in timing were less pronounced. Under procaine block, only the effects of phrenic nerve stimulation on Tphr persisted. These results suggest that both large and small afferent phrenic fibers control the inspiratory activity with a prominent role of small fibers on phrenic motoneuron impulse frequency.

Afferent Pathways↗

Pulmonary function and electromyographic study of respiratory muscles in myotonic dystrophy.

Ten adult myotonic dystrophy patients underwent measurements of lung function, maximal dynamic and static ventilatory efforts, and respiratory muscle electromyography (EMG). EMG studies were performed during spontaneous breathing or when subjects breathed through high inspiratory or expiratory resistive loads. Present results show that (1) a moderate restriction of lung volumes with hypoxemia plus normocapnia is often observed; (2) patients sustain dynamic ventilatory efforts more easily than static work; and (3) abnormalities in respiratory muscle EMG exist with spontaneous expiratory and inspiratory intercostal activities during quiet breathing and changes in muscular response to resistive loads. Inspiratory loading evokes contraction of expiratory muscles, with a marked decrease in inspiratory activities. Expiratory resistive loads prolong the diaphragmatic contraction throughout the expiratory time, and in some patients, relaxation of the diaphragm does not occur during the loaded run. These EMG data suggest that the reciprocal inhibition among respiratory neurons is enhanced in myotonic dystrophy and that myotonia also occurs in the diaphragm when loads oppose its relaxation.

Adult↗

Effects of pleural pressure and abdominal pressure on diaphragmatic blood flow.

The aim of this experiment was to determine if blood flow to the diaphragm is affected by generating the transdiaphragmatic pressure mainly with positive abdominal pressure or mainly with negative pleural pressure, during both sustained and intermittent diaphragmatic contractions. Diaphragmatic blood flow was measured in anesthetized mongrel dogs by the radionuclide-labeled microsphere method. Sustained and intermittent tetanic diaphragmatic contractions were produced with 1) free abdomen and closed chest (high negative pleural pressure) and 2) bound abdomen and open chest (high positive abdominal pressure). During sustained contractions, diaphragmatic blood flow at maximum levels of activation was significantly higher with negative pleural pressure (P less than 0.05). In contrast with this, intermittent diaphragmatic contractions did not yield a significant difference between diaphragmatic blood flow with negative pleural pressure and with positive abdominal pressure at maximal levels of transdiaphragmatic pressure. During both sustained and intermittent contractions, blood pressure, as measured from the carotid artery, did not vary significantly between negative pleural pressure and positive abdominal pressure. We conclude that during sustained tetanic diaphragmatic contractions, diaphragmatic blood flow is obstructed by high positive abdominal pressures, but during intermittent diaphragmatic contractions, high positive abdominal pressures do not affect total blood flow, since any inhibition of blood flow during the contractile period can be compensated for during the relaxation period between contractions.

Abdomen↗

Ventilatory effects of biceps vibration during leg exercise in healthy humans.

The ventilatory effects of biceps tendon vibration were studied in healthy human subjects at rest and at two levels of light leg exercise. This was performed with intent to add the ventilatory effects of selective stimulation of muscle spindles to nervous and humoral respiratory inputs from contracting muscles. Tendon vibration performed in individuals at rest elicited a marked increase in respiratory frequency and in the ratio between inspiratory time and total breath duration with variable changes in tidal volume; this was in agreement with previous results (Jammes et al., 1981). When stimulation of biceps proprioceptors was performed during steady state exercise, the changes in ventilatory timing were attenuated, but variations in tidal volume often occurred. These results suggest that, when respiratory centers are being entrained by performance of work, further activation of muscle receptors exerts complex effects on the breathing pattern with a lack of facilitatory influences in ventilation and gas exchange.

Adult↗

Respiratory effects of cold air breathing in anesthetized cats.

Respiratory effects of cold air breathing were studied in anesthetized cats. Two different protocols were used: the air temperature was either lowered in an isolated segment, constituted by the larynx and oropharynx or in lower airways, so that the cats inspired the cold air directly. Temperatures ranged between 37 and 8 degrees C (first protocol) or between 37 and 15 degrees C (second protocol). When the temperature fell below 15 degrees C in the upper segment, marked increase in lung resistance occurred, without any significant changes in ventilatory variables nor in diaphragmatic electrical activity. The section of superior laryngeal nerves abolished this bronchomotor effect. In present experimental circumstances, thermal changes measured in lower airways when cats breathed cold air were mainly located in the cervical trachea. An increase in lung resistance and weak but significant changes in the diaphragmatic electromyogram began when the inspired air temperature fell below 25 degrees C. A selective local block of conduction in small vagal fibres by procaine or section of vagus nerves suppressed all these effects. In all cases the cold-induced changes in lung mechanics began very early (less than 10 sec) but continued for few minutes after the physiological temperature range had been restored in airways. The present data strongly suggest that the bronchomotor response to cold air breathing is a reflex, mediated by afferent fibres in the superior laryngeal nerves and in the vagus nerves.

Anesthesia, General↗

Expiratory threshold load under extracorporeal circulation: effects of vagal afferents.

Nine anesthetized dogs breathed against an expiratory threshold load (ETL) applied by switching the expiratory circuit into a column of H2O to a depth of 20-30 cm. Arterial blood gas tensions were maintained in the normal range by placing the dogs under arteriovenous bypass to avoid any uncontrolled chemostimulation. There was an increase in integrated electromyogram activity of the diaphragm with the ETL. This was rarely observed after cold block of the vagus nerves which also reduced the evoked expiratory activity. The ventilatory response to hypercapnia was greatly depressed under loaded breathing whether vagal afferents were intact or blocked by cold. Both inspiratory drive and ventilatory timing were affected, suggesting that the central integration of chemosensitive afferents was altered. Proof of supraspinal projections of proprioceptive inputs from abdominal muscles was provided by the demonstration of changes in ventilatory timing during selective activation of muscle spindles in abdominal muscles by high-frequency mechanical vibration applied to the linea alba. Thus these observations suggest that during ETL breathing, a possible interaction exists between chemoreflex drive and proprioceptive afferents.

Afferent Pathways↗

Vagal feedback with expiratory threshold load under extracorporeal circulation.

In 11 anesthetized dogs placed under extracorporeal circulation, the vagal feedback was tested by electrical stimulation of the vagus nerves with cold block of their caudal part and by passive lung hyperinflation. The apneic response to such vagal stimulation progressively disappeared during expiratory threshold load breathing but then returned to control values some minutes after the load was removed. This suppression of the inhibitory response to stimulation of the vagus nerves was usually observed when vagal afferents were intact or blocked by cold. However, it was not observed whether no evoked activity continued in expiratory muscles after the cold block, or after suppression of all proprioceptive muscular afferents after transection of the spinal cord at C6 level. These results strongly suggest that enhancement of proprioceptive inputs to the respiratory centers counteracts the vagally mediated inspiratory "off-switch" mechanisms.

Abdominal Muscles↗

Afferent and efferent components of the bronchial vagal branches in cats.

The composition of the bronchial branches of the vagus nerves was studied in cats using light and electron microscopy. In order to determine the number and the diameter of fibers in the afferent and the efferent components, a unilateral efferent vagotomy was performed. The myelinated and the non-myelinated fibers were counted from the total nerve area and the endoneural area of each one was measured by means of a computer. Composition of "afferent" bronchial nerves (after degeneration following the efferent vagotomy) was compared to that of "entire" nerves. The main results are: (1) efferent fibers represent about 40% of the "entire" bronchial nerve; (2) non-myelinated fibers constitute more than 90% of the total population of the "entire" nerves as well as of the efferent component; (3) the density of myelinated and non-myelinated fibers (i.e. their number per surface unit) was similar in all nerves. However, there were discrepancies between diameter histograms established from different areas of a section. This feature seems to be due to preferential compartmentalization by Schwann cell envelopment of fibers having comparable diameter. This "packing effect" was observed in both efferent and afferent components.

Afferent Pathways↗

Changes in activity of vagal bronchopulmonary C fibres by chemical and physical stimuli in the cat.

1. In eighteen anaesthetized cats, action potentials in non-myelinated vagal afferent neurones were recorded in the nodose ganglion by means of extracellular micro-electrodes. 2. The pulmonary or bronchial origin of these C fibres was assessed in closed chest preparations by injecting phenyl diguanide into either the right atrium or the ascending aorta (bronchial circulation). This was confirmed in two animals by local mechanical stimulation. 3. Eighty per cent of bronchopulmonary C fibres increased their discharge frequency when the end-tidal CO2 concentration (FA,CO2) increased from 0.02 to 0.10. Most of these C endings showed a maximal response when FA,CO2 reached 0.04. For the others a further increase in discharge occurred when CO2 concentration reached 0.08-0.10. Continuous measurement of C fibre discharge frequency indicated that they detected preferentially changes in the inspired CO2 content, but adapted when a high CO2 level was maintained. Their activation by hypercapnia was followed by an increase in lung resistance. 4. Lowering the O2 content of the inspired gas had no effect on the spontaneous activity of bronchopulmonary C endings. 5. When the stroke volume of the pump was doubled, the spontaneous activity of bronchopulmonary C fibres decreased in intact chest preparations. Inflation of the lungs had the opposite effect after the chest was opened. In both cases hyperdeflation was a potent stimulus to these receptors. 6. In tracheotomized cats, the tracheal temperature was 28-29 degrees C. When normal thermal conditions were restored in the tracheal lumen (33-34 degrees C) the spontaneous discharge frequency of some bronchial C fibres was greatly increased. 7. It is concluded that the spontaneous activity of most of the bronchial or pulmonary C fibres was maximal when chemical and physical physiological conditions were restored in the lungs. It appears that changes in alveolar CO2 concentration constitute the usual stimulus for these fibres.

Action Potentials↗

Ventilatory responses to muscular vibrations in healthy humans.

In healthy humans, we studied the effect of high-frequency mechanical vibrations applied unilaterally to the tendon of the biceps or triceps brachialis on ventilation and the breathing pattern. This stimulus preferentially activates the muscle spindle afferents. Increase of respiratory frequency and changes in the ventilatory timing started at the first or second inspiration during tendon stimulation, and no adaptation occurred as long as the vibrations continued. The tidal volume and mean inspiratory flow rate were only enhanced in individuals having high-frequency breathing during eupnea. The changes in ventilatory variables were observed when the motor response to vibrations was tested under isometric or isotonic conditions. Various experimental procedures enabled us to induce a tonic reflex contraction in either the vibrated muscle or the antagonist of no reflex contraction in either group of muscles. In all cases the increase in minute ventilation was identical. These changes in breathing pattern was not associated with a significant decrease in alveolar CO2 pressure and did not seem to be responsible for important variations in respiratory gas exchanges. The response to high-frequency vibrations was also studied after ventilation was increased with added dead space. The magnitude of hyperventilation an the pattern of ventilatory response produced by tendon stimulation did not change with increased ventilation. In conclusion, the stimulation of muscle spindles in human induces changes in ventilation and pattern of breathing , and the occurrence of a reflex muscular contraction does not seem necessary in order to obtain such effects.

Adult↗

Influence of anxiolytic drugs (Prazepam and Diazepam) on respiratory center output and CO2 chemosensitivity in patients with lung diseases.

Occlusion pressure at 0.1 s (P0.1) and its evolution during progressive hyperoxic hypercapnia (CO2 chemosensitivity) were measured in 40 patients. Most of them (26) were affected by asthma and /or chronic bronchitis and had mild obstruction and hypoxemia. Measurements were made after 2 days of oral prazepam, diazepam or a placebo (single-blind study). Diazepam induced a significant decrease in P0.1 without affecting CO2 chemosensitivity. In contrast, prazepam did not significantly modify P0.1 or CO2 chemosensitivity. However, P0.1 decreased in 5/18 individual cases. 1 week of treatment by prazepam has advantages over diazepam by not depressing respiratory center output.

Asthma↗

Assessment of the central chemosensitivity in man under transient or progressive hypercapnia.

In healthy man, the central chemosensitivity to CO2 was studied after depression of the arterial chemoreflex drive by inhalation of pure oxygen. The effectiveness of the functional decrease of arterial chemoreceptor function was assessed by the delayed hyperventilation which followed transient inhalation of hypercapnic gas mixtures for 3 or 5 breaths in hyperoxic conditions. In such a case the first significant increase in tidal volume (VT) occurred 13.9 +/- 3.2 (SE) sec later than the early change in this variable measured in normoxic conditions. The stimulus strength was estimated by the change in CO2 partial pressure in end-tidal alveolar gas (delta PETCO2). The central chemosensitivity (SCO2), defined as the ratio between change in ventilation (delta V) and delta PETCO2, was assessed either by transient inhalation of gas mixtures containing 5 to 8% CO2 in pure O2 ("varying transients") or by progressive hypercapnia (rebreathing in pure O2). In both cases, the first significant change in ventilation was due to an increase in VT, but, for a given delta PETCO2, VT changes were higher during rebreathing than after transient hypercapnia; (2) The respiratory frequency (fR) was progressively enhanced during rebreathing (shortening of expiratory duration in all cases and of inspiratory time in some subjects) but the ventilatory rhythm diminished after transient stimulation as soon as delta PETCO2 reached one kPa, and this was due to an increase in inspiratory duration; (3) The associated changes in VT and fR during rebreathing could explain that SCO2 values given by this method were 5.2 times greater than after transient hypercapnia ("varying tests"). The differences are discussed in terms of, (1) isolated changes in arterial PCO2 or associated decrease in pH of the cerebrospinal fluid; (2) changes in brain blood flow, and (3) stimulation of lung stretch receptors by the important increase in VT during rebreathing.

Adolescent↗

[Assessment of cardiac output by a non-invasive method. Estimation of partial pressure of CO2 by rebreathing of expired gas. Comparison with thermodilution].

The cardiac output was measured in 65 patients by the FICK principle after estimation of the pp CO2 in mixed venous blood by rebreathing. This technique has been used mainly during exercise, and recently in intensive care units. We used it in resting patients hospitalised for diagnosis and treatment of a range of cardiac diseases, and in patients referred to our Physiological Laboratory. The reproductibility of our results using the rebreathing method was good: the variation of the individual results averaged 8.9%. The values of the cardiac output by rebreathing were compared to those obtained by thermodilution in 30 patients. A high coefficient of correlation was found: r = 0,897 (2p less than 0,001). This non-invasive technique is simple, rapid, and easily repeatible. Its use for serial estimations of the cardiac output should be retained.

Carbon Dioxide↗