Exhalation time effects on arterial and venous blood oxygen content and arterial PCO2 during high frequency jet ventilation of surfactant-depleted cats

Since high frequency jet ventilation (HFJV) relies on lung mechanics for the passive removal of expiratory gas, one would predict that the time allowed for exhalation would have serious effects on cardiopulmonary function. To document these effects we lavaged the lungs of ten cats with 30 ml/kg of saline six times, then sampled arterial and venous blood while the animals were ventilated conventionally at 30 BPM and then with HFJV at 600 BPM, varying inspiratory/expiratory ratios (I/E) from 1:1 to 1:5. The animals breathed 100% O2 throughout the study, and the mean airway pressure was held constant for each animal when the I/E was varied during HFJV. Decreasing the I/E from 1:1 to 1:5 during HFJV resulted in an increase of arterial oxygen content (Cao2) from 11.3 +/- 1.2S E to 13.6 +/- 1.2 ml O2/100 ml blood (P less than 0.01), a decrease of PaCO2 from 43 +/- 6 to 27 +/- 4 mm Hg, and an increase of alveolar to arterial oxygen gradient from 351 +/- 49 to 377 +/- 49 mm Hg. The ratio of systemic blood flow to oxygen consumption (Q/VO2) was similar during conventional ventilation and with HFJV at I/E of 1:1 (18.9 +/- 3.7 vs 18.0 +/- 2.9) but decreased when I/E was reduced to 1:5 during HFJV (13.9 +/- 2.1). The ratio of the product of CaO2 and Q (systemic oxygen availability) to VO2 (SO2 T/VO2) remained unchanged during all modes of ventilation (1.75 +/- 0.15). The increase in CaO2 observed when I/E was reduced from 1:1 to 1:5 during HFJV was counterbalanced by a decrease in Q/VO2 such that SO2 T/VO2 remained relatively constant.

Rapid mechanical ventilation effects on tracheal airway pressure, lung volume, and blood gases of rabbits

The purpose of this study was to demonstrate that ventilation of rabbit lungs (whose mechanics are similar to those of human infants) at rapid rates will lead to large alterations in tracheal airway pressures, tidal volume, and functional residual capacity (FRC) with only minor changes in arterial blood gases. Thirteen rabbits were ventilated at rates of 30, 60, 90, and 120 breaths per minutes (BPM) with pressures of 17/2 cm H2O. Tracheal peak inspiratory pressure (PIP) was always lower than ventilator PIP and decreased to 11 +/- 1 cm H2O at 120 BPM. Positive end-expiratory pressure (PEEP) in the trachea was always greater than 2 cm H2O and increased with rate (3.5 cm H2O at 120 BPM). Tidal volume decreased as rates were increased such that rates above 60 BPM resulted in insignificant changes in minute ventilation and arterial blood gases. However, the FRC increased from 16 (30 BPM) to 25 ml/kg (120 BPM), a 56% increase, suggesting large increases in end-expiratory alveolar pressure. We conclude that rapid-rate ventilation (greater than 60 BPM) of healthy rabbits results in significant increases in both tracheal PEEP and FRC without significantly affecting arterial blood gases. The increased tracheal PEEP and FRC are manifestations of inadvertent PEEP. The increased FRC without concomitant increase in PaO2 implicates alveolar overdistention. We speculate that rapid-rate ventilation of human infants having lung mechanics similar to rabbits, will also result in inadvertent PEEP and alveolar overdistention.

Borna disease virus. A possible etiologic factor in human affective disorders?

Borna disease virus is a unique neurotropic agent that appears to have a predilection for the limbic area of the brain. In some animal species, it can produce a behavioral syndrome characterized by aggressive and passive phases. This syndrome has suggested an analogy to certain human affective disorders. In this preliminary study, we examined the possible involvement of Borna disease virus in the etiology of human mood disorders by assaying for virus-specific antibodies in 265 patients with unipolar or bipolar depression and 105 normal, healthy volunteers. Twelve patients (4.5%) and none of the healthy controls demonstrated this antibody in their serum samples. It will be necessary to replicate and extend these intriguing preliminary results to determine if Borna disease virus is possibly involved in the pathogenesis of affective disorders in humans.

Ventilatory control and carbon dioxide response in preterm infants with idiopathic apnea

Idiopathic apnea in preterm infants, more than 30 weeks of gestation, after the first week of life is uncommon and poorly understood. To study ventilatory control in these infants we measured minute ventilation, respiratory frequency, tidal volume, end-tidal oxygen pressure and carbon dioxide pressure, and transcutaneous oxygen pressure before and during the fifth minute of breathing 4% carbon dioxide in air. Nine healthy preterm infants and eight infants with three or more episodes of apnea (greater than or equal to 20 s) in 24 hours were studied during active sleep. We found that infants with apnea had a significantly increased alveolar carbon dioxide pressure while respiratory frequency, minute ventilation, and slope were significantly decreased. Alveolar-transcutaneous oxygen gradients were essentially unchanged. These preterm infants with apnea have a decreased carbon dioxide sensitivity. They have a decreased minute ventilation primarily as a result of decreased respiratory frequency and their alveolar-transcutaneous oxygen gradient is normal. Our findings suggest that the major deficit in these infants is a central disturbance in the regulation of breathing.

Chromosomal and behavioral studies of Mexican Drosophila. III. Inversion polymorphism of D. pseudoobscura

Four new gene arrangements of chromosome 3 of Drosophila pseudoobscura are reported, as well as an updated phylogenetic sequence of the inversion polymorphism in this species. Evidence that the Tree Line gene arrangement of chromosome 3 was the original form in D. pseudoobscura, and that Central Mexico is the center of distribution of this species is discussed.

Hepatic tumors and oral contraceptives: surgical management

The clinical and pathological features of 14 patients with benign liver tumors are reviewed. There were two males and 12 females in this series of cases. All but one of the females had been on contraceptive steroid therapy for an average of 7.8 years. Abdominal pain was the presenting complaint in 75% of cases, a palpable abdominal mass was present in 22%, while 12.5% of the patients presented with acute hemorrhagic shock due to rupture of a liver cell adenoma. Liver cell adenomas (LCA) were found in 87.5% of the cases and a diagnosis of focal nodular hyperplasia (FNA) was made at histologic examination of the resected tumors in 12.5% of cases. Surgical resection of the liver tumors was performed successfully in 89% of the cases. Hepatic lobectomy was accomplished in four patients, hepatic segmentectomy was possible in three cases, while local wedge resection or focal excision were indicated on seven occasions. There was no operative mortality in this series, but one patient required reoperation for drainage of a complicating subphrenic abscess.

Cardiovascular and catecholamine changes after administration of pancuronium in distressed neonates

Heart rate, blood pressure, transcutaneous gases, and catecholamine changes following intravenous injection of pancuronium were evaluated in seven ill newborn infants (birth weight: 1,280 to 4,500 g; gestational age, 29 to 42 weeks). Each infant was monitored continuously for 30 minutes before and 50 minutes after infusion of the paralyzing agent. There were no significant changes in transcutaneous gases, whereas significant increases in heart rate; systolic, diastolic, and mean blood pressures; and blood norepinephrine and epinephrine levels were found. The increase in heart rate lasted for 30 minutes, and the increase in blood pressure persisted for 50 minutes after administration of the drug. Because of the potential relationship between increased blood pressure and intraventricular hemorrhage and myocardial dysfunction, heart rate and blood pressure must be monitored during infusion of pancuronium in distressed newborns. These data suggest that pancuronium stimulates sympathetic activity in distressed newborns.

Septate uterus: sonographic diagnosis and obstetric complications

The present study is a report of the authors' sonographic and obstetric experience in seven cases with anatomically confirmed partial uterine septa. Emphasis is placed on the sonographic appearance and the differential diagnosis of a uterine septum. New sonographic findings are described that can resemble the appearance of a uterine septum during pregnancy, including uterine contractions, cystic masses adjacent to the uterine fundus, and a full urinary bladder. Obstetric complications are compared with previous studies. The authors observed one major obstetric complication of fetal malpresentation.

Phospholipids in tracheal effluent from infants with severe respiratory distress syndrome

The physiologic aberration that causes abnormal alveolar surface tension in the lungs of infants with RDS was investigated by measuring relative quantities of surfactant-related phospholipids in tracheal effluent from infants with RDS. A preliminary study in premature lambs demonstrated that the percent DSPC (molar ratio of DSPC to total phospholipid) is similar in tracheal effluent and lung lavagate. The percent DSPC in tracheal effluent from human infants with RDS was similar to the percent DSPC in effluent from non-RDS infants on the first day of life (47.4% +/- 2.9 vs 46.7% +/- 1.2), and remained constant during the first 8 days of life. Phosphatidylglycerol (PG) was universally absent in effluent from RDS infants on the first and second day of life but appeared by the eighth day of life in all infants who remained intubated. PG was present in tracheal effluent from only 10 of 16 non-RDS infants on the first day of life. These findings suggest that, in regard to the surface-active lecithin content, surfactant from RDS infants is qualitatively normal and that the absence of RDS is not dependent on the presence of PG.

Effect of oestradiol-17 beta on uterine epidermal growth factor concentration in immature mice

Using a specific and sensitive epidermal growth factor radioimmunoassay (EGF-RIA) we have identified EGF in immature mouse uterine tissue. In 16 day old mice a single injection of oestradiol-17 beta (E2) elicited an increase in uterine wet weight in 24 h but did not affect uterine EGF concentration. Sequential injection of E2 for a 7 day period increased both uterine wet weight and EGF concentration suggesting that change in EGF concentration is a delayed E2 response. The continuous treatment did not alter liver or submandibular gland tissue EGF concentrations, but significantly increased kidney EGF content. These data reveal that both uterine and renal tissue EGF concentrations are subject to modulation by E2 in developing mice.

Sensorimotor unit activity related to intention in the pulvinar of behaving Cebus Apella monkeys

Previous observations made in our laboratory in a waking behaving Cebus Apella monkey revealed that neurons of the Pulvinar nucleus of the thalamus discharged preferentially in relation to intentional movements of the limbs and eyes. We give here a description of further observations made in two waking, behaving Cebus Apella monkeys trained to perform two tasks: in the first to make saccadic eye movements to eccentrically placed visual targets; in the second, to make projection movements of the arm and hand to touch targets within arm's reach. The electrical activity of thalamic neurons was recorded extracellularly and records were made simultaneously of the horizontal eye movements and of tasks events. Four-hundred-sixty-five neurons were studied: of these, the activity of 272 could be correlated with behavioral events, while the remaining 193 could not be correlated or classified in this manner. The cells identified were classed in five groups, as follows: (1) neurons active during attentive fixation of a target, but which did not respond to our ordinary visual test stimuli; (2) neurons active during projection movements of the arm or manipulation with the hand, but which were not active during casual movements of the hand or arm, and which were not activated by passive somatic sensory stimuli; (3) those active before, during or after evoked saccadic movements of the eyes, but which were not activated by our testing visual stimuli; (4) neurons active during tracking movements of the eyes, or during projection movements of the arm, alone, but which discharged maximally when these two events occurred simultaneously; and, (5) neurons active during both saccadic movements of the eyes and during projection movements of the arm. We regularly observed, for each of these classes of neurons of the Pulvinar, that optimal correlated activity depended upon the intentional nature of the associated behavioral events, and the animal's attention to them. We conclude that there exists at the level of the Pulvinar a neural correlate of certain evolving behavioral events, and particularly of intentional activity such as the projection of the arm or the direction of gaze towards targets of interest in the immediately surrounding visual environment. The regions of the Pulvinar containing neurons with these properties are reciprocally related to association areas of the Neocortex known to contain neurons with similar properties. It can then be concluded from both anatomical and electrophysiological observations that the Pulvinar is an essential part of the system controlling these complex behavioral events.

Synthesis and use of radio cobaltic EDTA as an extracellular marker in rabbit heart

A new gamma-labeled marker for extracellular space is the cobaltic form of 58Co-ethylenediaminetetraacetic acid (58Co-EDTA). The cobaltic ion has a much higher affinity for EDTA than the cobaltous ion; it is prepared as a potassium salt, K+(58Co3+-EDTA4-), and is apparently biologically inert. Testing by equilibration in intact rabbits and comparing the myocardial content with that of [14C]sucrose give values of the volume of distribution in the myocardium of 0.294 +/- 0.052 ml/g for 58Co-EDTA and 0.303 +/- 0.051 ml/g for [14C]sucrose (SD, n = 130, for two hearts), with the ratios of 58Co-EDTA/sucrose averaging 0.973 +/- 0.043 (n = 130). The average value of the extracellular fluid measured in isolated rabbit interventricular septum using Co-EDTA was 0.51 +/- 0.05 ml/g (SD, n = 16) and 0.46 +/- 0.04 ml/g using [14C]sucrose as an extracellular fluid space (ECF) marker. Flushing with a high concentration of nontracer Co-EDTA does not reveal any release from binding sites. The gamma-energy (811 KeV), long half-life (71.4 days), stability, and lack of binding to tissue components make 58Co-EDTA a useful marker for ECF.

Arterial PCO2 response to intravenous CO2 in awake dogs unencumbered by external breathing apparatus

The steady-state arterial CO2 tension (PaCO2) was examined during control and intravenous CO2 loading in awake dogs unencumbered by any breathing apparatus. The dogs inhaled air while undergoing intravenous CO2 loading, and we estimated the gain, delta VA/delta PACO2. CO2 was introduced into the systemic venous blood via a membrane gas exchanger in a femoral arteriovenous shunt circuit, and the extracorporeal blood flow was maintained constant at 0.5 l/min. A total of 11 experiments were performed in 3 dogs comprising 93 control observations and 83 CO2 loading observations. Intravenous CO2 produced a significant increase in the steady state PaCO2, a finding consistent with our previous study in tracheostomized awake dogs. We conclude that intravenous CO2 produces hypercapnia in the awake dog with an intact airway unencumbered by external respiratory apparatus.

Respiratory responses to intravenous and intrapulmonary CO2 in awake dogs

Ventilatory responses to CO2 inhalation and CO2 infusion were compared in the awake dog. The CO2 was introduced directly into the systemic venous blood via a membrane gas exchanger in a femoral arteriovenous shunt circuit, and the extracorporeal blood flow, QX, was maintained constant at one of two rates: low, 0.5 l/min; or high, 2.0 l/min. A total of 13 experiments was performed in four dogs comprising 50 control and 25 inhalation and infusion observations at each of the two flow rates. Comparison of CO2-response curve slopes, S = delta V E/delta PaCO2, between CO2 inhalation and infusion showed no significant difference either within or between flow rates. The mean value of S for all conditions was 1.88 l/min per Torr with a 95% confidence interval of 1.66 -2.14. An independent additive ventilatory drive amounting to 28% of low-flow control VE was found at the highflow rate. We conclude that at constant blood flow the responses to both CO2 inhalation and infusion are hypercapnic and not significantly different.