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PubMed1990

Metabolic reduction in hypothermia: pathophysiological problems and natural examples--Part 1.

Following a description of the protective effects of hypothermia, the limitations resulting from "cold swelling" of the brain, caused by a progressive discrepancy between active and passive cellular transport processes, are discussed. The observation that the tolerable limits of metabolic reduction lie well below the normal turnover rates leads to a short survey of the evolution of energy metabolism. The gradual development of the latter from anaerobiosis to aerobiosis and from poikilothermy to homeothermy apparently provides the background for transient reductions to lower rates which spontaneously occur even in higher vertebrates. As an impressive example of such a natural strategy, the anaerobic survival of diving turtles is outlined which essentially depends on an efficient buffering. This dependence bears analogy to cardioplegia, where an increase in buffering capacity can greatly retard the fall of energy turnover, thus leading, as is shown by microcalorimetry, to an intermediate plateau of anaerobic metabolism.

Adaptation, Physiological↗
PubMed1986

Current clinical management of organoprotection in hepatic surgery.

Ischemia of the liver in hepatic resection under inflow occlusion is tolerable for at least up to 60 min. For protection of the liver from ischemic injury, steroids are frequently used. In liver transplantation, cold ischemia of 6-8 h for the graft is considered to be acceptable. Organ preservation is most frequently accomplished by in situ perfusion of the liver with Euro Collins solution in the donor and consecutive hypothermic storage after hepatectomy, resulting in 96% of all grafts in primary function.

Humans↗
PubMed1986

Clinical experience with timolol maleate monotherapy of hypertension.

Beta-adrenergic blocking drugs are gaining acceptance as initial therapy for patients with mild to moderate hypertension. In a postmarketing surveillance study, 5,190 hypertensive patients received timolol maleate monotherapy and were evaluated by 1,355 physicians. A total of 1,057 patients did not complete the study: 28% of these patients experienced an adverse event. Mean systolic and diastolic blood pressure readings were reduced 20 and 13 mm Hg, respectively. Mean diastolic blood pressure was reduced 11% for patients with mild hypertension; larger mean reductions were noted for patients with moderate (17%) and severe hypertension (22%). The effect in black and elderly patients was less than in other groups. Although 22% of all patients experienced an adverse event, less than 2.2% of all patients experienced events related to beta-adrenergic blockade, ie, respiratory difficulty, heart failure, bradycardia, and cold extremities. Fatigue, dizziness, and nausea were the most frequently reported adverse events requiring discontinuation of therapy. Timolol monotherapy is a well-tolerated and effective treatment for a broad range of hypertensive patients.

Adult↗
PubMed1981

Uniform myocardial protection by cold potassium-induced cardioplegia for coronary artery bypass.

Cold potassium solution (4 C) is used to induce cardioplegia during coronary artery bypass surgery. When 1,000 ml of the cold solution are introduced through the root of the aorta, the temperature of the myocardium drops to about 7 C within a few minutes. At this level of hypothermia, ischemia can be tolerated for at least 2 h, the surgical field is rendered quiet and dry, and the safety and precision of the procedure are increased. This method, however, does not provide uniform cooling of the myocardium and some areas remain less protected than others. The temperatures in the different areas of the myocardium are measured directly with needle thermistors and the "warm" areas are cooled in turn, in descending order of myocardial temperature. Saphenous vein grafts are anastomosed to the arteries in these warm areas and additional cold solution is instilled through the graft until the temperature drops to 7 C. The coronary artery bypass, and any other required surgical procedure, is then performed. To maintain hypothermia, small amounts of cold solution are infused at intervals through the root of the aorta and through the appropriate graft. With this method of cooling, the operative mortality rate in a series of 200 high-risk patients with coronary artery disease in whom there was at least one factor predisposing to perioperative mortality and/or infarction was only 3%.

Coronary Artery Bypass↗
PubMed1993

A leaf-specific gene stimulated by light during wheat acclimation to low temperature.

We report here the identification and characterization of a new leaf-specific light-stimulated gene induced during cold acclimation of wheat. Sequence analysis revealed that the gene encodes a protein of 19 kDa with a pI of 8.8. This is a novel protein with a particular charge distribution. The C-terminal half has a high propensity to form an alpha-helix and contains all the acidic amino acids with a net negative charge of -7. On the other hand, the N-terminal half is rich in proline, lysine and arginine with a net positive charge of +10. These properties are commonly found in several transcription factors. The protein is also rich in alanine (21%), is hydrophilic but not boiling soluble in contrast to other alanine-rich proteins. During low temperature exposure, the corresponding mRNA accumulates rapidly in the leaf and remains at a constant level in two tolerant cultivars used. However, in a less tolerant cultivar, the mRNA level declines despite maintaining the plants at 4 degrees C. Southern blot analysis indicates that the differential expression in the less tolerant genotype is not due to a different genomic organization or gene copy number. The mRNA was specifically localized in leaf tissues and increased several-fold during the greening at 4 degrees C. Furthermore, this gene is not induced in callus cultures acclimated in the absence or presence of light. This suggests that the full expression of this gene is dependent on organized leaf tissue. The expression of this gene was not affected by ABA, drought, heat shock, salinity, wounding or anaerobiosis, demonstrating that it is specifically induced by low temperature. The Wcs19 mRNA is preferentially expressed in tolerant Gramineae species.

Adaptation, Physiological↗
PubMed1975

Cardiovascular effects of prolonged delta-9-tetrahydrocannabinol ingestion.

In contrast to the tachycardia and unchanged or increased blood pressure seen after single doses, prolonged delta-9-tetrahydrocannabinol (THC) ingestion produced significant heart rate slowing and blood pressure lowering in hospitalized volunteers. Impaired circulatory responses to standing, exercise, Valsalva maneuver, and cold pressor testing suggest a state of sympathetic insufficiency. Marked weight gain was observed in all subjects, which has been shown to be related to fluid retention and plasma volume expansion. Tolerance developed to orthostatic hypotension, possibly related to plasma volume expansion, but did not develop to the supine hypotensive effects. Nearly complete tolerance developed to the tachycardia and psychological effects produced by smoked marijuana while ingesting THC. Electrocardiographic changes were minimal despite the large cumulative dose of THC. The hypothesis that THC has a biphasic effect on the sympathetic nervous system in man, producing excitation with single doses and inhibition with prolonged administration, is discussed.

Administration, Oral↗
PubMed2005

Paroxetine, a cytochrome P450 2D6 inhibitor, diminishes the stereoselective O-demethylation and reduces the hypoalgesic effect of tramadol.

OBJECTIVE: Tramadol hydrochloride (INN, tramadol) exerts its antinociceptive action through a monoaminergic effect mediated by the parent compound and an opioid effect mediated mainly by the O-demethylated metabolite (+)-M1. O-demethylation is catalyzed by cytochrome P450 (CYP) 2D6. Paroxetine is a very potent inhibitor of CYP2D6. The objective of this study was to investigate the influence of paroxetine pretreatment on the biotransformation and the hypoalgesic effect of tramadol. METHODS: With and without paroxetine pretreatment (20 mg daily for 3 consecutive days), the formation of M1 and the analgesic effect of 150 mg of tramadol were studied in 16 healthy extensive metabolizers of sparteine in a randomized, double-blind, placebo-controlled, 4-way crossover study by use of experimental pain models. RESULTS: With paroxetine pretreatment, the area under the plasma concentration-time curve (AUC) of (+)- and (-)-tramadol was increased (37% [P = .001] and 32% [P = .002], respectively), and the corresponding AUCs of(+)- and (-)-M1 were decreased (67% [P = .0004] and 40% [P = .0008], respectively). (+)-M1 and (-)-M1 could be determined in all subjects throughout the study period regardless of paroxetine pretreatment. The sums of differences between postmedication and premedication values of pain measures differed between the placebo/tramadol and the placebo/placebo combination, with median values as follows: pressure pain tolerance threshold, 390 kPa (95% confidence interval [CI], 211 to 637 kPa) versus -84 kPa (95% CI, - 492 to -32 kPa) (P = .001); single sural nerve stimulation pain tolerance threshold, 25.8 mA (95% CI, 15.3 to 29.8 mA) versus 9.0 mA (95% CI, 1.5 to 14.8 mA) (P = .005); pain summation threshold, 10.7 mA (95% CI, 5.2 to 17.6 mA) versus 5.0 mA (95% CI, 2.8 to 11.2 mA) (P = .066); cold pressor pain, -4.2 cm x s (95% CI, -6.8 to -1.9 cm x s) versus -0.4 cm x s (-1.4 to 1.4 cm x s) (P = .002); and discomfort, -4.7 cm (95% CI, -10.6 to -2.8 cm) versus 0.5 cm (-0.1 to 1.4 cm) (P = .002). The sums of differences of the paroxetine/tramadol combination also differed from placebo/tramadol for some of the measures, with median values as follows: cold pressor pain, -2.2 cm x s (95% CI, -3.7 to -0.4 cm x s) (P = .036, compared with placebo/tramadol); and discomfort, -2.0 cm (95% CI, -5.6 to -1.2 cm) (P = .056). For the other measures, the hypoalgesic effect was retained on the paroxetine/tramadol combination, with median values as follows: pressure pain tolerance threshold, 389 kPa (95% CI, 141 to 715 kPa) (P = .278, compared with placebo/tramadol); single sural nerve stimulation pain tolerance threshold, 12.5 mA (95% CI, 6.2 to 28.3 mA) (P = .278); and pain summation threshold, 8.2 mA (95% CI, 4.4 to 14.6 mA) (P = .179). Paroxetine in combination with placebo showed no analgesic effect. CONCLUSIONS: It is concluded that paroxetine at a dosage of 20 mg once daily for 3 consecutive days significantly inhibits the metabolism of tramadol to its active metabolite M1 and reduces but does not abolish the hypoalgesic effect of tramadol in human experimental pain models, particularly in opioid-sensitive tests.

Adult↗
PubMed1986

Interferon-beta ser as prophylaxis against experimental rhinovirus infection in volunteers.

The first test of intranasal recombinant human interferon-beta ser (IFN-beta ser) as prophylaxis against common colds is reported. IFN-beta ser was cleared from the nose like IFN-alpha. A total of 10 volunteers were each given a total of 2.6 X 10(7) units of IFN-beta ser as 13 doses administered three times daily over 4 days and there were negligible symptoms that were not significantly different from those in 10 given placebo. Twenty-seven volunteers were then given the same regime and challenged after the fourth dose with rhinovirus types 9 and 14. Compared with 27 volunteers given placebo and virus, there were significant reductions in the mean total clinical scores, the amount of nasal secretion, and the frequency of virus excretion. It is concluded that IFN-beta shows antiviral activity in the human respiratory tract and should be tested to determine whether it is tolerated on continued administration.

Adolescent↗
PubMed2003

Gender affects calf venous compliance at rest and during baroreceptor unloading in humans.

Leg venous compliance is a determinant of peripheral venous pooling during orthostatic stress such that high venous compliance could contribute to reduced orthostatic tolerance. We tested the hypotheses that 1) calf venous compliance is reduced during baroreceptor unloading, and 2) calf venous compliance is greater in women than men. Twelve men (27 +/- 2 yr) and 12 women (25 +/- 2 yr) were studied in the supine posture. Calf venous compliance was determined by inflating a thigh venous collecting cuff to 60 mmHg for 8 min and then decreasing cuff pressure at a rate of 1 mmHg/s to 0 mmHg. The slope of the pressure-compliance relation (compliance = beta(1) + 2.beta(2).cuff pressure), which is the first derivative of the quadratic pressure-volume relation [(Deltalimb volume) = beta(0) + beta(1).(cuff pressure) + beta(2).(cuff pressure)(2)] during the reduction in collecting cuff pressure, was used to assess venous compliance at baseline and during one-legged lower body negative pressure (LBNP; -50 mmHg). At baseline, calf venous compliance was 48% lower (P < 0.001) in women than men and decreased in men (Delta-25 +/- 8%; P < 0.05) but not women (Delta1 +/- 11%) during LBNP. Rhythmic ischemic handgrip (Delta6 +/- 9%) and cold pressor testing (Delta-9 +/- 7%) did not alter calf venous compliance in a subgroup of men (n = 6). These data indicate gender-dependent effects on calf venous compliance under conditions associated with low sympathetic outflow (i.e., rest) and high sympathetic outflow (i.e., LBNP). However, they cannot explain gender-associated differences in orthostatic tolerance.

Blood Pressure↗
PubMed2001

Altered responsiveness to stress and NMDA following prenatal exposure to cocaine.

Pregnant Sprague--Dawley rats were treated once daily with 40-mg/kg cocaine or saline from gestation days (GD) 12 to 21. A third group of pregnant dams was used as a pairfed control. Male and female offspring were examined for stress endurance response as determined by the cold-water swim test on postnatal days (PND) 21, 30, 40, and 60. Male and female offspring exposed to cocaine in utero were found to have diminished tolerance and altered hormonal response to stress. Moreover, prenatal cocaine exposure has been associated with significant increases in severity of N-methyl-D-aspartate (NMDA; 35 mg/kg) behavioral responses (tail twitches, wetdog shaking, and convulsion) as compared to control. Examining the experimental groups for pain sensitivity using the tail-flick and the hot-plate methods indicated that prenatal cocaine exposure altered pain sensitivity. NMDA receptor binding studies showed an increase in receptor density in the hippocampus and hypothalamus of the cocaine-treated group. These results indicate that gestational cocaine exposure is associated with long-term alterations in response to stress, NMDA receptor, and pain sensitivity in the rat offspring.

Aging↗
PubMed2006

Freezing or supercooling: how does an aquatic subterranean crustacean survive exposures at subzero temperatures?

Crystallization temperature (T(c)), resistance to inoculative freezing (IF), ice contents, bound water, protein and glycogen body contents were measured in the aquatic subterranean crustacean Niphargus rhenorhodanensis and in the morphologically close surface-dwelling aquatic crustacean Gammarus fossarum, both acclimated at 12 degrees C, 3 degrees C and -2 degrees C. Cold acclimation induced an increase in the T(c) values in both species but no survival was observed after thawing. However, after inoculation at high sub-zero temperatures, cold-acclimated N. rhenorhodanensis survived whereas all others, including the 3 degrees C and -2 degrees C acclimated G. fossarum died. In its aquatic environment, N. rhenorhodanensis is likely to encounter inoculative freezing before reaching the T(c) and IF tolerance appears as a highly adaptive trait in this species. Bound water and glycogen were found to increase in the 3 degrees C and -2 degrees C acclimated N. rhenorhodanensis, whereas no variation was observed in G. fossarum. Considering the hydrophilic properties of glycogen, such a rise may be correlated with the increased bound water measured in cold-acclimated N. rhenorhodanensis, and may be linked to the survival of this species when it was inoculated. The ecological significance of the survival of the aquatic subterranean crustacean to inoculative freezing is paradoxical, as temperature is currently highly buffered in its habitat. However, we assume that past geographical distribution and resulting life history traits of N. rhenorhodanensis are key parameters in the current cold-hardiness of the species.

Acclimatization↗
PubMed1990

Is increased metabolism in rats in the cold mediated by the thyroid?

1. In the rat variation of metabolic heat production is the principal effector of thermoregulation. There is a continuous relationship between ambient temperature and metabolic rat over the whole range of tolerable environmental temperature. The mechanism that controls metabolic rate is unknown; this paper reports an attempt to test whether thyroid hormones provide the controlling pathway. 2. First, the changes in metabolic rate and in the plasma concentrations of thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4) were measured in rats living in a controlled environment, first at 23 degrees C and then at 6 degrees C. Metabolic rate increased from approximately 290 to 470 kJ day-1 when the temperature was lowered, a factor of ca 1.6, and the diurnal rhythm disappeared. The concentration of TSH increased from approximately 320 to 450 ng ml-1 (with loss of diurnal rhythm) and of T3 from ca 0.7 to 1.0 nmol l-1, a factor of ca 1.4 in each case. T4 concentration did not change. 3. Next, a dose schedule of T3 was found that, when injected I.V. via indwelling jugular cannulae in the same rats in an environment at 23 degrees C, maintained an increase in T3 concentration rather greater than had been found at 6 degrees C. 4. This dose of T3, given to the same rats at 23 degrees C, did not affect metabolic rate (or its diurnal pattern). 5. It is therefore unlikely that the increase in T3 concentration evoked the increase in metabolic rate when ambient temperature was changed from 23 to 6 degrees C; and therefore that the thyroid controls variation of metabolic rate in 'everyday' thermoregulation in the rat.

Animals↗
PubMed1974

Absence of drug abuse in prisoners in a major correctional institution.

Laboratory evaluation of illicit drug abuse was conducted in a major correctional institution. Fifty-eight prison inmates were screened for common drugs of abuse in conjunction with a triazolo-benzodiazipine compound tolerance protocol. Urine specimens were collected on days -1, 1, 15, 29, and 49 and assayed for amphetamines, opiates, barbiturates, and alcohol. Quinine was detected in two individuals and was probably derived from cold remedy preparations rather than the illegal use of heroin. While occasional illicit drugs may find their way into a prison population, this study showed no evidences of drug abuse in one correctional institution whose prisoners participated in Phase I drug evaluations.

Adult↗
PubMed2004

Identification of cold-inducible downstream genes of the Arabidopsis DREB1A/CBF3 transcriptional factor using two microarray systems.

The transcriptional factor DREB/CBF (dehydration-responsive element/C-repeat-binding) specifically interacts with the dehydration-responsive element (DRE)/C-repeat (CRT) cis-acting element (A/GCCGAC) and controls the expression of many stress-inducible genes in Arabidopsis. Transgenic plants overexpressing DREB1A showed activated expression of many stress-inducible genes and improved tolerance to not only drought, salinity, and freezing but also growth retardation. We searched for downstream genes in transgenic plants overexpressing DREB1A using the full-length cDNA microarray and Affymetrix GeneChip array. We confirmed candidate genes selected by array analyses using RNA gel blot and identified 38 genes as the DREB1A downstream genes, including 20 unreported new downstream genes. Many of the products of these genes were proteins known to function against stress and were probably responsible for the stress tolerance of the transgenic plants. The downstream genes also included genes for protein factors involved in further regulation of signal transduction and gene expression in response to stress. The identified genes were classified into direct downstream genes of DREB1A and the others based on their expression patterns in response to cold stress. We also searched for conserved sequences in the promoter regions of the direct downstream genes and found A/GCCGACNT in their promoter regions from -51 to -450 as a consensus DRE. The recombinant DREB1A protein bound to A/GCCGACNT more efficiently than to A/GCCGACNA/G/C.

Arabidopsis↗
PubMed1986

Comparative tolerability of labetalol versus propranolol, atenolol, pindolol, metoprolol, and nadolol.

The side-effect profile of labetalol was assessed in 34 patients with mild to moderate essential hypertension who had previously experienced side effects during beta-blocker therapy. The most frequently reported beta-blocker side effects were fatigue, impotence, cold extremities, and depression. After discontinuing their previous beta-blocker for 4 weeks, labetalol was titrated (100-400 mg b.i.d.) to achieve blood pressure control. Twenty-seven of 34 patients did not have a recurrence of a beta-blocker related side effect while receiving labetalol. The most common new side effect with labetalol was dizziness (3 patients). As judged by the attending physician and the patient, labetalol was better tolerated than conventional beta-blocker therapy in 30 of 34 patients (88%). Twenty-four of 34 patients (71%) preferred labetalol over previous therapy. Labetalol controlled blood pressure in 30 of 34 patients (88%). At equal antihypertensive doses, some side effects common to beta-blockers are seen less frequently with labetalol.

Adrenergic beta-Antagonists↗
PubMed2001

Hypoalgesic effect of caffeine in normotensive men and women.

Evidence from both hypertensive and normotensive individuals indicate that elevated blood pressure is associated with decreased pain sensitivity. The current study sought to experimentally raise blood pressure using 250 mg caffeine, and investigate its effects on the cold pressor pain experiences of 25 men and 25 women. In a placebo-controlled repeated-measures experiment, caffeine increased systolic and diastolic blood pressure, as well as producing more clearheaded and energetic feelings. Caffeine produced higher pain threshold and pain tolerance levels compared to placebo, and women had a lower tolerance to pain than men. Finally, a significant association was found between caffeine-related increase in systolic blood pressure and caffeine-related increase in pain tolerance. Furthermore, this association was the strongest in women. These results are discussed in light of future directions for pain and hypertension research.

Adult↗
PubMed1992

The importance of a colloid in canine pancreas preservation.

The role of hydroxyethyl starch (HES), the colloid component of the UW solution, was tested in canine pancreas preservation. Segmental pancreatic autografts were preserved for 48 hr cold storage with UW solution with HES (group 1) or UW solution without HES (group 2). After preservation, the pancreas was transplanted, and survival, serum glucose, serum amylase, intravenous glucose tolerance tests, tissue water content, and histology were compared between groups. In group 1 (with HES), 9/10 dogs were long-term survivors with one dog dying due to causes unrelated to preservation failure. In group 2 (without HES), 3/6 dogs died due to graft loss within one week posttransplant (P = 0.01). No graft failure occurred in group 1 (0/9) versus graft loss in 4/6 dogs in group 2 (P = 0.04). All animals in group 1 (with HES) showed normal serum glucose and amylase concentrations postoperatively, normal tissue water values after preservation, k values comparable to those observed after segmental autotransplantation without preservation, and relatively good histology. In group 2 (without HES), in 4/6 dogs graft failure occurred that led to the death (3 dogs) of the animals or to a diabetic state (1 dog). After 48-hr cold storage without HES, a significant increase in tissue water content, glucose and amylase levels was seen. After transplantation, hyperglycemia, hyperamylasemia, and clinical diabetes were observed in 4/6 dogs. Autopsy and histological evaluation showed evidence of thrombosis and ischemic insult. Two of 6 dogs in group 2 remained normoglycemic during follow-up with borderline k values. The results suggested that for consistently successful 48-hr preservation of the pancreas, HES is an important component of the UW solution. Although a colloid may not be essential for short-term preservation of kidney and liver, it appears to be an important factor in successful pancreas preservation.

Adenosine↗
PubMed1996

Plaque-forming cell responses and antibody titers following injection of sheep red blood cells in nonstressed, acute, and/or chronically stressed handled and nonhandled animals.

Given the bidirectional nature of the communication between the immune and hypothalamic-pituitary-adrenal (HPA) systems, we examined whether animals that exhibit differences in HPA responses to stress would also exhibit differences in their plaque-forming cell (PFC) responses to sheep red blood cells (SRBC). Neonatally handled (H) animals exhibit lower HPA responses to a number of acute stressors in adulthood compared to nonhandled (NH) animals. Furthermore, these differences also emerge as a function of chronic, intermittent cold stress. We hypothesized that H and NH animals may exhibit differences in the PFC response to SRBC under conditions of acute and/or chronic stress (H CHR and NH CHR). Exposure to acute (4 hr) cold decreased PFC responses in both H and NH animals compared to nonstressed H and NH animals. The decrease in PFC response produced by chronic, intermittent cold stress was similar in H and NH animals and was not different from that found in acutely stressed animals. In H CHR animals reexposed to cold stress, the PFC response was not different from acutely stressed or chronically stressed H and NH animals. In contrast, the PFC response in NH CHR animals reexposed to cold stress was lower than all other groups studied. Thus, neonatal handling prevented prior chronic stress-induced suppression of the PFC response to a subsequent stress. These data suggest that there may be subpopulations of individuals in whom prior chronic stress does not exacerbate the immune suppression produced by acute stress. However, those chronically stressed individuals in whom immune suppression does occur may be more vulnerable to infection and disease.

Aging↗