Synthesis of proteins by automated flow chemistry

Ribosomes can produce proteins in minutes and are largely constrained to proteinogenic amino acids. Here, we report highly efficient chemistry matched with an automated fast-flow instrument for the direct manufacturing of peptide chains up to 164 amino acids long over 327 consecutive reactions. The machine is rapid: Peptide chain elongation is complete in hours. We demonstrate the utility of this approach by the chemical synthesis of nine different protein chains that represent enzymes, structural units, and regulatory factors. After purification and folding, the synthetic materials display biophysical and enzymatic properties comparable to the biologically expressed proteins. High-fidelity automated flow chemistry is an alternative for producing single-domain proteins without the ribosome.

Randomized multicentre feasibility trial of intermediate care versus standard ward care after emergency abdominal surgery (InCare trial)

Background

Emergency abdominal surgery carries a considerable risk of death and postoperative complications. Early detection and timely management of complications may reduce mortality. The aim was to evaluate the effect and feasibility of intermediate care compared with standard ward care in patients who had emergency abdominal surgery.

Methods

This was a randomized clinical trial carried out in seven Danish hospitals. Eligible for inclusion were patients with an Acute Physiology And Chronic Health Evaluation (APACHE) II score of at least 10 who were ready to be transferred to the surgical ward within 24 h of emergency abdominal surgery. Participants were randomized to either intermediate care or standard surgical ward care after surgery. The primary outcome was 30-day mortality.

Results

In total, 286 patients were included in the modified intention-to-treat analysis. The trial was terminated after the interim analysis owing to slow recruitment and a lower than expected mortality rate. Eleven (7·6 per cent) of 144 patients assigned to intermediate care and 12 (8·5 per cent) of 142 patients assigned to ward care died within 30 days of surgery (odds ratio 0·91, 95 per cent c.i. 0·38 to 2·16; P = 0·828). Thirty (20·8 per cent) of 144 patients assigned to intermediate care and 37 (26·1 per cent) of 142 assigned to ward care died within the total observation period (hazard ratio 0·78, 95 per cent c.i. 0·48 to 1·26; P = 0·310).

Conclusion

Postoperative intermediate care had no statistically significant effect on 30-day mortality after emergency abdominal surgery, nor any effect on secondary outcomes. The trial was stopped prematurely owing to slow recruitment and a much lower than expected mortality rate among the enrolled patients. Registration number: NCT01209663 (http://www.clinicaltrials.gov).

Outcome of 45 Dogs With Laryngeal Paralysis Treated by Unilateral Arytenoid Lateralization or Bilateral Ventriculocordectomy

The purpose of this retrospective study was to assess risk factors and complications affecting postoperative outcome of dogs with laryngeal paralysis treated by either unilateral arytenoid lateralization (UAL) or bilateral ventriculocordectomy (VCC). Medical records of all dogs having either UAL or VCC between 2000 and 2011 were analyzed. Twenty-five dogs had VCC and 20 dogs had UAL. The overall postoperative complications rates for VCC and UAL were similar (52% and 60%, respectively; P = .0887). Dogs that had UAL were more likely to have acute postoperative respiratory distress and aspiration pneumonia (P = .0526). Dogs with VCC were more likely to have chronic postoperative respiratory distress and aspiration pneumonia (P = .0079). Revision surgery was required in 6 dogs (24%) following VCC and 2 dogs (10%) following UAL. Sex, breed, presenting complaint, type of service provided, and concurrent diseases were not significantly associated with higher risk of either death or decreased survival time postoperatively with either procedure. Overall postoperative complication rates, required revision surgeries, and episodes of aspiration pneumonia were similar in dogs undergoing UAL and VCC surgeries. Dogs that had VCC appeared to have an increased risk of lifelong complications postoperatively compared with UAL; therefore, VCC may not be the optimal choice for treatment of laryngeal paralysis.

The effects of clomipramine hydrochloride in cats with psychogenic alopecia: a prospective study

A double-blind, placebo-controlled clinical trial was conducted to determine the efficacy of clomipramine hydrochloride in cats with psychogenic alopecia. Twenty-five cats were randomly assigned to receive clomipramine hydrochloride (0.5 mg/kg orally q 24 hours) or placebo for 56 days. Eleven cats in each group completed the trial. The results of this study showed that clomipramine hydrochloride failed to demonstrate significant changes in the number of grooming bouts, hair regrowth, and the area of alopecia in cats with psychogenic alopecia when compared to a placebo. It was uncertain whether these results reflected a lack of drug efficacy, insufficient treatment duration, or an insufficient number of cases enrolled.

Efficacy of imiquimod 5% cream in the treatment of equine sarcoids: a pilot study

Imiquimod is an immune response modifier with potent antiviral and antitumour activity. The objective of this pilot study was to evaluate the efficacy of an imiquimod 5% cream (Aldaratrade mark: 3M, Saint Paul, MN, USA) as a topical treatment for equine sarcoids. Fifteen horses with a total of 19 tumours were enrolled, including mixed (7), fibroblastic (5), flat (3), verrucous (2), and nodular (2) types. Baseline data included history, physical examination, tumour location, measurement and digital photography. Imiquimod was applied by the owners three times a week until complete resolution of the tumour or 32 weeks, whichever occurred first. Tumours were measured and photographed every 4 weeks. Treatment efficacy was defined as 75% or greater reduction of tumour size by the end of the trial. Four sarcoids were withdrawn from the study. Twelve of the remaining 15 tumours (80%) showed more than 75% reduction in size and nine (60%) totally resolved between 8 and 32 weeks. The most common adverse effects of exudation, erythema, erosions, depigmentation and alopecia were limited to the tumour and adjacent areas. The results suggest that topical imiquimod is a therapeutic option for the treatment of equine sarcoids, although more detailed studies are required to corroborate these initial findings.

Evaluation of the abdomen using ultrasound following a ventral midline celiotomy

Over the last 20 years, ultrasound has become a useful diagnostic tool in veterinary medicine. The purpose of this study was to use ultrasonographic examinations to determine if intra-abdominal contents could be visualized. Nineteen dogs, ranging from 8 months to 18 years of age were included. Each animal was evaluated sonographically prior to surgery, 24 h after surgery, and then 2-6 weeks following the surgical procedure. The results of our study suggest that ultrasound is an effective means for evaluation of the abdomen and surgery site following surgery. Both the abdomen and surgery site were clearly visualized in all dogs. In addition, subjective evaluation of the intra-abdominal contents was performed. The limiting factor in this study was not the presence of air, as was expected. Rather the limiting factor for appropriate visualization was pain. The information obtained could prove to be useful to surgeons and radiologists in assessing a patient's status postoperatively.

Frequency of urinary tract infection among dogs with pruritic disorders receiving long-term glucocorticoid treatment

OBJECTIVE

To determine frequency of urinary tract infection (UTI) among dogs with pruritic disorders that were or were not receiving long-term glucocorticoid treatment.

DESIGN

Observational study.

ANIMALS

127 dogs receiving glucocorticoids for > 6 months and 94 dogs not receiving glucocorticoids.

PROCEDURE

Bacterial culture of urine samples was performed in dogs receiving long-term glucocorticoid treatment, and information was collected on drug administered, dosage, frequency of administration, duration of glucocorticoid treatment, and clinical signs of UTI. For dogs not receiving glucocorticoids, a single urine sample was submitted for bacterial culture.

RESULTS

Multiple (2 to 6) urine samples were submitted for 70 of the 127 (55%) dogs receiving glucocorticoids; thus, 240 urine samples were analyzed. For 23 of the 127 (18.1%) dogs, results of bacterial culture were positive at least once, but none of the dogs had clinical signs of UTI. Pyuria and bacteriuria (present vs absent) were found to correctly predict results of bacterial culture for 89.9% and 95.8% of the samples, respectively. Type of glycocorticoid, dosage, frequency of administration, and duration of treatment were not associated with frequency of UTI. None of the urine samples from dogs not receiving glucocorticoids yielded bacterial growth. The frequency of UTI was significantly higher for dogs treated with glucocorticoids than for dogs that had not received glucocorticoids.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that dogs receiving long-term glucocorticoid treatment have an increased risk of developing a UTI. On this basis, we recommend that urine samples be submitted for bacterial culture at least yearly for such dogs.

Selective brain cooling in mammals and birds

Artiodactyls and felids have a carotid rete that can cool the blood destined for the brain and consequently the brain itself if the cavernous sinus receives cool blood returning from the nose. This condition is usually fulfilled in resting and moderately hyperthermic animals. During severe exercise hyperthermia, however, the venous return from the nose bypasses the cavernous sinus so that brain cooling is suppressed. This is irreconcilable with the assumption that the purpose of selective brain cooling (SBC) is to protect the brain from thermal damage. Alternatively, SBC is seen as a mechanism engaging the thermoregulatory system in a water-saving economy mode in which evaporative heat loss is inhibited by the effects of SBC on brain temperature sensors. In nonhuman mammals that do not have a carotid rete, no evidence exists of whole-brain cooling. However, the surface of the cavernous sinus is in close contact with the base of the brain and is the likely source of unregulated regional cooling of the rostral brain stem in some species. In humans, the cortical regions next to the inner surface of the cranium are very likely to receive some regional cooling via the scalp-sinus pathway, and the rostral base of the brain can be cooled by conduction to the nearby respiratory tract; mechanisms capable of cooling the brain as a whole have not been found. Studies using conventional laboratory techniques suggest that SBC exists in birds and is determined by the physical conditions of heat transfer from the head to the environment instead of physiological control mechanisms. Thus except for species possessing a carotid rete, neither a coherent pattern of SBC nor a unifying concept of its biological significance in mammals and birds has evolved.

Measurement of health status and quality of life in neonatal follow-up studies

Mortality and neuro-developmental outcome can be precisely measured but in order to interpret the significance of changes in them, further information is needed about health status, the effect of health status on lifestyle of survivors and their families, the quality of life experienced by survivors and the value placed by the public and survivors on different health states. The ability to measure such aspects of health now allows more relevant follow-up studies to be designed. This article discusses concepts of health status and quality of life and the problems in applying these to children. There follows a critique of modern instruments for measuring health status and quality of life and their application in neonatal follow-up studies. We recommend that only a small number of well-established instruments should be considered so that results are valid and can be compared with other studies.

Effects of dehydration and rehydration on body temperatures in the black bedouin goat

The temperatures of the arterial blood and the brain in black Bedouin goats were measured continuously by miniature data loggers. The animals were either euhydrated or dehydrated to 75-80% of the initial body mass by withholding water for 3-4 days during exposure to intense solar radiation. The daily blood temperature means and maxima of were significantly higher in dehydration than in euhydration, but 40 degreesC was rarely exceeded even during the hot hours of the day. Selective brain cooling occurred in euhydration, but its extent was small when blood temperature was below 39.5 degreesC. In dehydration, however, selective brain cooling was frequent and the standard response when blood temperature exceeded 39 degreesC. We believe that selective brain cooling contributes to the inhibition of evaporative heat loss, which is the primary cause of the higher blood temperature in dehydration. Rapid rehydration with cold water induced long-lasting depression of blood temperature. No evidence was found for mechanisms attenuating the subsequent decrease of brain temperature which occurred a few minutes after the uptake of cold water.

Activity, blood temperature and brain temperature of free-ranging springbok

We used miniature data loggers to record temperature and activity in free-ranging springbok (Antidorcas marsupialis) naturally exposed to severe nocturnal cold and moderate diurnal heat. The animals were active throughout the day and night, with short rests; the intensity of activity increased during daylight. Arterial blood temperature, averaged over many days, exhibited a circadian rhythm with amplitude < 1 degree C, but with a wide range which resulted from sporadic rapid deviations of body temperature. Peak blood temperature occurred after sunset. Environmental thermal loads had no detectable effect on blood temperature, even though globe temperature varied by > 10 degrees from day to day and > 20 degrees C within a day. Brain temperature increased approximately linearly with blood temperature but with a slope < 1, so that selective brain cooling tended to be activated at high body temperature, but without a precise threshold for the onset of brain cooling. Low activity attenuated selective brain cooling and high activity abolished it, even at high brain temperature. Our results support the concept that selective brain cooling serves to modulate thermoregulation rather than to protect the brain against heat injury.

Blood and brain temperatures of free-ranging black wildebeest in their natural environment

Using miniature data loggers, we measured the temperatures of carotid blood and brain in four wildebeest (Connochaetes gnou) every 2 min for 3 wk and every 5 min, in two of the animals, for a further 6 wk. The animals ranged freely in their natural habitat, in which there was no shelter. They were subject to intense radiant heat (maximum approximately 1,000 W/m2) during the day. Arterial blood temperature showed a circadian rhythm with low amplitude (< 1 degree C) and peaked in early evening. Brain temperature was usually within 0.2 degrees C of arterial blood temperature. Above a threshold between 38.8 and 39.2 degrees C, brain temperature tended to plateau so that the animals exhibited selective brain cooling. However, selective brain cooling sometimes was absent even when blood temperature was high and present when it was low. During helicopter chases, selective brain cooling was absent, even though brain temperature was near 42 degrees C. We believe that selective brain cooling is controlled by brain temperature but is modulated by sympathetic nervous system status. In particular, selective brain cooling may be abolished by high sympathetic activity even at high brain temperatures.

Thermal signals in control of selective brain cooling

In species with a carotid rete, the arterial blood destined for the brain can be cooled on its passage through the rete. The temperature difference between the blood before the rete and the brain is termed selective brain cooling (SBC). The onset and degree of cooling depend on internal body temperature. The aim of this study was to determine the brain sites where the temperature signals driving SBC are generated. Thirty-six experiments were performed in three conscious goats, which were prepared with an arteriovenous shunt, carotid loops, and hypothalamic thermodes to manipulate the temperatures of the trunk (Ttr), the hypothalamus (Thyp), the extrahypothalamic brain (Texh), or the whole brain (Tbr). In all experiments, Ttr was clamped at 39.5 degrees C. The increase of SBC was 2.1 degrees C per 1 degree C increase of Tbr (gain = 2.1). The rise of Thyp at constant Texh yielded a gain of 1.6, whereas the gain of Texh at constant Thyp was 0.7. It is concluded that onset and degree of SBC are predominantly determined by temperature signals generated in the hypothalamus itself.

Evidence against brain stem cooling by face fanning in severely hyperthermic humans

To achieve a hyperthermic state 11 subjects exercised at 35 degrees C air temperature in a water-impermeable outfit, until their oesophageal temperature (Tes) exceeded 39 degrees C. Changes of brain stem temperature were assessed by the interspike intervals of auditory evoked potentials, which depend on brain stem temperature. These were recorded at rest before exercise (condition A), after exercise during a period when heat loss from the face was prevented by covering the head with a plastic hood (condition B), and again during face fanning (condition C). An increase in Tes from 37.14 +/- 0.25 degrees C to 39.05 +/- 0.15 degrees C (A to B) produced a significant reduction in interspike intervals, indicating an increase in brain stem temperature. Changing from conditions B to C, Tes and interspike intervals remained constant, indicating no change of brain stem temperature in spite of face fanning. Thus, even in severely heat stressed humans face fanning is not able to lower brain stem temperature significantly below that of the rest of the body core.

Effects of selective brain cooling on mechanisms of respiratory heat loss

Experiments (n = 36) in three conscious goats were performed at 35 degrees C air temperature and low (LH) or high (HH) humidity. Prior to the experiments the animals received carotid loops and an arteriovenous shunt, which made it possible to increase the temperature of the blood flowing to head and trunk (series A), or to increase the temperature of the trunk at constant carotid blood and hypothalamic temperature (Thyp), respectively (series B). Owing to the smaller cooling power of the inspired air in HH, the slope of respiratory evaporative heat loss versus aorta blood temperature (Taor) was reduced in series A and B. In series A the slopes of respiratory minute volume (VE) and respiratory frequency (RF) versus Taor were larger in HH than in LH. The effects were caused by a reduction of selective brain cooling in HH, which resulted in higher levels of Thyp. This is concluded from the results of series B, in which Thyp was equal in LH and HH, and the slopes of VE and RF over Taor showed no differences. Thus, selective brain cooling contributes to counteract the deterioration of the gain of the respiratory heat loss mechanism, which occurs during exposure to humid air.

No evidence for brain stem cooling during face fanning in humans

The interpeak latencies (IPLs) of the acoustically evoked brain stem potentials depend on brain stem temperature. This was used to see whether face fanning during hyperthermia lowers brain stem temperature. In 15 subjects, three thermally stable conditions were maintained by a water bath. In each condition the IPLs were determined in 10 separate trials. In condition A esophageal temperature (Tes) was 36.9 +/- 0.3 degrees C and increased to 38.6 +/- 0.2 degrees C in condition B. In conditions A and B the head was enclosed in a ventilated hood (air temperature 38 degrees C, relative humidity 100%) to suppress any direct heat loss from the head. From conditions A to B the IPL at peaks I-V decreased by 0.146 ms/degrees C change in Tes, reflecting a change in brain stem temperature. In condition C the hood was removed and the face was fanned by a cold air-stream (8-15 degrees C, 4-10 m/s) to maximize direct heat loss from the head. Skin temperature at the sweating forehead decreased from 38 to 23 degrees C, whereas Tes in condition C was maintained at the same level as in condition B (38.5 +/- 0.2 degrees C). The IPL at peaks I-V showed no difference between conditions B and C. It is concluded that face fanning in hyperthermic subjects does not dissociate brain stem temperature from Tes.

Threshold and slope of selective brain cooling

Experiments (n = 50) in three conscious goats were performed in a thermoneutral environment to determine the threshold (i.e. the point at which the brain temperature is equal to the carotid blood temperature) and slope (i.e. the difference between brain and carotid blood temperatures as a function of carotid blood temperature) of selective brain cooling (SBC) and analyse the thermal inputs affecting them. Prior to the experiments the animals received carotid loops and an arteriovenous shunt to manipulate head and trunk temperatures independently of each other. The mean SBC threshold was 38.75 degrees C T(carotis) and independent of T(trunk). When body core temperature was increased from a hypo- to a moderately hyperthermic level, the SBC threshold was passed before metabolic rate had reached its minimum and before cutaneous vasodilation occurred. The mean SBC slope was 0.78 and rose with increasing Ttrunk. The degree of SBC was principally independent of respiratory heat loss: high levels of heat loss were found without SBC, and large degrees of SBC were observed at low levels of heat loss. The effect of SBC in and around normothermia is to smooth the onset of shivering or panting and to establish a range of internal temperature within which metabolic rate and respiratory heat loss are simultaneously at low levels.

Effects of spinal cord temperature on the generation and transmission of temperature signals in the goat

A series of 38 experiments were performed in five conscious goats at air temperatures of +20 degrees C or +30 degrees C to see whether a temperature dependence of spinal cord signal transmission affects the relationships between body temperature and metabolic rate (MR) or respiratory evaporative heat loss (REHL). Prior to the experiments the animals received peridural thermodes to clamp the spinal cord temperature by perfusion temperatures of 31 degrees C, 38 degrees C or 43 degrees C (45 degrees C), carotid loops to clamp the brain temperature at 39 degrees C or 39.5 degrees C, and arteriovenous shunts to alter the trunk temperature and to determine thresholds and slopes of MR and REHL over trunk temperature. The trunk temperature thresholds, at which MR and REHL increased, were inversely related to the spinal cord temperature, thereby confirming previous observations on the generation of specific spinal temperature signals. The slopes at which MR rose below the threshold, increased with decreasing spinal cord temperature. The slopes of REHL over trunk temperature were independent of spinal cord temperature. Both observations are at variance with previously observed temperature effects on hypothalamic signal transmission and imply that temperature-dependent signal transmission at the spinal level cannot account for nonlinear interaction of various body temperatures in the control of MR and REHL.

Non-cutaneous peripheral thermosensitivity in the goat (Capra hircus)

1. A 0.2 m2 area of the trunk skin was denervated and its center was externally cooled or warmed, when central body temperature was lowered. 2. When the denervated skin was cooled, the central body temperature, at which shivering occurred, was significantly higher than with warming of the denervated skin. 3. It is concluded that the difference was caused by temperature signals originating from thermoreceptors in tissue layers underneath the denervated skin.

The metabolic response to skin temperature

Experiments were done to assess that fraction of the metabolic response to external cold exposure, which is attributable to skin temperature. In 5 conscious and closely clipped goats the metabolic rate was determined at various stable levels of skin temperature in the range from 13 to 41 degrees C, while core temperature was kept constant at 38.8 degrees C. Skin temperature was manipulated by a rapidly circulating shower bath, while core temperature was controlled by means of heat exchangers acting on arterial blood temperature in a chronic arteriovenous shunt. The metabolic response to skin temperature fell into two clearly discernible sections: a first zone with skin temperatures above 25-30 degrees C, within which the metabolic rate rose at a rate of -0.34 +/- 0.07 W/kg.degrees C with decreasing skin temperature, and a second zone with skin temperatures below 25-30 degrees C, within which the metabolic rate either plateaued or even grew smaller with further decreasing skin temperature. It is concluded that the relationship between skin temperature and metabolic rate does not directly reproduce the temperature-response curve of cutaneous cold receptors but also reflects a complex interaction of several factors, including an unspecific temperature effect on muscle metabolism.

Thermosensitivity of the goat's brain

1. Experiments were done in conscious goats to estimate the gain of brain temperature sensors and to evaluate that fraction of the thermosensitivity of the entire brain which can be determined by a thermode located in the hypothalamus. 2. The animals were implanted with local thermodes, carotid loops and intravascular heat exchangers permitting independent control of hypothalamic temperature, extrahypothalamic brain temperature and trunk core temperature. 3. Small and slow ramp-like displacements of hypothalamic temperature generated continuously increasing thermoregulatory responses without any dead band, if a negative feed-back from extrahypothalamic sources was suppressed. 4. The hypothalamic sensitivity determined by the metabolic response to slow ramp-like cooling of the thermode amounted to -1.4 W/(kg degrees C) and equalled approximately 30% of what had been found for total body core sensitivity in another series of experiments. 5. Total brain thermosensitivity was -1.6 W/(kg degrees C), which implies that a large thermode centred in the hypothalamus can detect approximately 85% of the thermosensitivity of the entire brain.

No dynamic effector responses to fast changes of core temperature at constant skin temperature

Experiments in conscious goats were done to see whether heat production and respiratory evaporative heat loss show dynamic responses to changing core temperature at constant skin temperature. Core temperature was altered by external heat exchangers acting on blood temperature, while skin temperature was maintained constant by immersing the animals up to the neck in a rapidly circulating water bath. Core temperature was altered at various rates up to 0.9 degrees C/min. Step deviations of core temperature from control values were always followed by a positive time derivative of effector response, but never by a negative time derivative during sustained displacement of core temperature. Ramp experiments showed that the slopes at which heat production or heat loss rose with core temperature deviating from its control level grew smaller at higher rates of change of core temperature. It is concluded that neither heat production nor respiratory evaporative heat loss respond to the rate of change of core temperature. At constant skin temperature, thermoregulatory effector responses appear to be proportional to the degree to which core temperature deviates from its set level.

Work performance, thermoregulation and muscle metabolism in thyroidectomized goats (Capra hircus)

1. Thyroid hormone deficiency resulted in a markedly diminished work efficiency of goats exercising on a treadmill at an ambient temperature of 30 degrees C. 2. The close relationship between the exercise-induced increase in core temperature and the magnitude of evaporative heat loss, characteristic for intact animals, was nearly completely abolished after thyroidectomy. 3. Muscle glycogen utilization and lactic acid accumulation during exercise were enhanced in thyroidectomized animals in spite of the lower work rate and shorter duration of exercise in comparison with euthyroid goats.

Effects of skin temperature on cold defense after cutaneous denervation of the trunk

In intact goats the core temperature threshold below which heat production increases with falling core temperature, is inversely related to the temperature of the water bath in which they stand and is therefore assumed to be indicative of the central integration of signals from skin and core temperature receptors. The present study shows that a difference in core temperature thresholds for bath temperatures of 35 degrees C and 40 degrees C persisted after denervation of about two-thirds of the skin of the trunk and limbs. Also, for a given combination of skin and core temperatures, heat production was as great or greater after cutaneous denervation as before. It is concluded that, following denervation of the trunk and upper limbs, intact temperature receptors in the non-denervated skin of the legs and tail, and/or also in tissues between the skin and core, provide important and significant inputs to the temperature regulating system. But these inputs cannot explain fully the thermoregulatory responses observed unless it is assumed that the thermosensitivity of these tissues increased.

Skin and core temperatures as determinants of heat production and heat loss in the goat

In 82 experiments on 10 goats body core temperature (Tcore) was altered between 35 degrees and 42 degrees C by external heat exchangers acting on blood temperature while skin temperature (Tskin) was maintained constant, by a circulating shower bath, at different levels between 32 degrees and 44 degrees C. At all skin temperatures at least fourfold increases of heat production (M) and respiratory evaporative heat loss (REHL) occurred when Tcore was lowered or raised, respectively. The lower Tskin was, the higher were the thresholds of Tcore, at which M or REHL exceeded resting levels. The lower Tskin was, the higher were the slopes, at which M or REHL changed per unit of Tcore. At a given Tskin, the slopes decreased with increasing M or REHL, and were dependent on the range of Tcore. The higher the range of Tcore, the steeper changed M and REHL with changing Tcore, if all other variables were held constant. The results support the concept that an exponential relationship between Tcore and the rate of core temperature signals is the primary cause of the effects exerted by Tskin on the slopes, at which M or REHL change per unit of Tcore.

Effects of brain and trunk temperatures on exercise performance in goats

In 40 experiments on seven goats head and trunk temperatures were altered independently of each other and the effects on exercise performance on a treadmill (speed: 3 km/h, slope: 16%-20%) were observed. Brain temperature between 38.5 degrees C and 42.0 degrees C and trunk temperature between 39 degrees C and 43.5 degrees C did not reduce exercise performance or running time. Blood lactate concentration increased with rising brain and trunk temperatures, but did not exceed 13.1 mmol/l-1. Blood pressure and heart rate did not show any dependence on brain or trunk temperatures. Brain temperature between 42.0 degrees C and 42.9 degrees C shortened running time in 3 out of 12 experiments and reduced performance during shortlasting upward deviations of temperature. This suggests that in this species, the thermal safety limit to exercise is very close to that range of temperature which is likely to induce heat stroke.

Competition for cool nasal blood between trunk and brain in hyperthermic goats

An influence of brain and trunk temperatures controlled independently of each other by means of artificial heat exchangers, on the intensity of natural selective brain cooling (SBC) was studied in 6 conscious goats. Intensity of SBC was markedly enhanced by increasing brain temperature. On the other hand, a rise of trunk temperature with the cerebral temperature clamped at 39 degrees C or 40 degrees C, reduced SBC intensity in spite of a simultaneous increase in the respiratory evaporative heat loss. When brain temperature was clamped at 41 degrees C, the magnitude of SBC was essentially independent of trunk temperature. These results suggest that during hyperthermia a competition exists between trunk and brain for cool nasal blood.

Problems with neuronal models in temperature regulation

Neuronal models in temperature regulation are primarily considered explicit statements of assumptions and premises used in design of experiments and development of descriptive equations concerning the relationships between thermal inputs and control actions. Some of the premises of current multiplicative models are discussed in relation to presently available experimental evidence. The results of these experiments suggest that there is no skin temperature compatible with life which completely suppresses a rise of heat production in response to low internal temperature. The slope of heat production versus internal temperature at a given skin temperature is not constant but depends on internal temperature and the level of heat production. Therefore, a concept involving additive interaction of central and peripheral temperature signals appears more flexible in accepting data obtained even under extreme conditions.

Skin AVA and capillary dilatation and constriction induced by local skin heating

In conscious sheep, total femoral blood flow and flow through arteriovenous anastomoses (AVAs) and capillaries (CAP) in skin of the hindleg were measured employing electromagnetic and radioactive microsphere techniques. Core temperature (Tc) was manipulated using intravascular heat exchangers and hindleg skin temperature (Tsk) was manipulated by immersion in temperature controlled water. With Tc set 1 degree C above normal, AVA flow was highest at the lowest Tsk tested (34 degrees C); AVAs progressively constricted as Tsk was increased from 34 to 40-41 degrees C, then dilated again as Tsk reached the highest levels tested (42-44 degrees C). Skin CAP flow was not altered by Tsk of 34 to 42 degrees C but was increased at a Tsk of 44 degrees C. Therefore total skin blood flow followed essentially the same pattern as AVA flow; total femoral flow also followed this pattern. When Tc was set 0.5 degrees C below normal, AVA flow was low at all levels of Tsk. It is concluded that Tc plays a dominant role in control of skin blood flow, however, once Tc is at a level requiring increased heat loss, Tsk exerts an extremely potent influence on the nature and magnitude of changes in skin blood flow. The pattern of flow changes appears to reflect principally a negative feedback mechanism aimed at maintaining Tsk at approximately 40 degrees C; this may contrast with mechanisms associated with sweating and/or active vasodilatation in other species.

Use of fibrin glue in thoracic surgery

The results of closure of various types of postoperative thoracic fistulas with two-component fibrin sealant in 5 patients are presented. The use of a new technique for the noninvasive closure of bronchial fistulas with fibrin sealant is also described. Implications of the management of thoracic fistulas with fibrin sealant are discussed.

Circulation and acid-base balance in exercising goats at different body temperatures

Thirty experiments were performed in two goats at an air temperature of +35 degrees C and a relative humidity of 33%. By means of heat exchangers, body core temperature (Tpaor) was adjusted to 39, 40.5, or 42 degrees C and maintained at these levels for 120 min. During the last 60 min the animals worked at a rate of 1.2 W/kg (treadmill, 3 km/h, 15%). Blood gases (arteriovenous O2 difference, Po2, Pco2), hemoglobin (Hb), blood lactate (LA), cardiac output (CO), blood pressure (MAP), heart rate (HR), metabolic rate (M), and respiratory evaporative heat loss (REHL) were determined. M, CO, HR, and Hb increased with exercise and were independent of Tpaor. At rest and exercise, REHL increased and Pco2 decreased at higher levels of Tpaor resulting in a respiratory alkalosis. During exercise this was accompanied by an increase in LA. At all instants, the concentrations of LA were higher at higher Tpaor. It is concluded that in a virtually nonsweating species like the goat the overall stress on the circulatory system caused by hyperthermia during exercise is relatively small while the behavior of blood LA is indicative of a temperature-dependent accumulation of LA also in the exercising muscle.

Some characteristics of core temperature signals in the conscious goat

In three conscious goats, head and trunk temperatures were altered independently of each other by means of extracorporeal carotid heat exchangers and intravascular heat exchangers in the trunk veins. In 35 experiments heat production and heat loss were measured while head temperature was varied between 35.4 and 42.2 degrees C and trunk temperature between 34.5 and 42.4 degrees C. The largest temperature difference between head and trunk amounted to 6.6 degrees C. Head and trunk generated approximately equal fractions of the total core temperature input to the controller. The distribution of combinations of head and trunk temperatures resulting in constant levels of heat production and heat loss was consistent with the hypothesis that the total core temperature input to the controller equaled the sum of two identical inputs, both rising exponentially with temperature. The hypothesis implies that the input generated by core sensors of temperature in head and trunk is a continuum and conforms with the temperature-response curve of warm receptors.

Temperature sensitivity of skeletal muscle in the conscious goat

A method has been developed to test the hypothesis that the deep tissues of the legs, e.g., skeletal muscle and/or periosteum, contain thermosensitive elements feeding signals into the temperature-regulating system. Stainless steel thermodes of 10 to 12-mm diameter and 100 to 150-mm length were chronically implanted into the marrow spaces of both humeri and femora, all of which have wide cavities and thin walls. Perfusing the thermodes with water of 0 degree C altered the temperature of the deep muscle layers by several degrees. The animals were further equipped with intravascular heat exchangers, which served to keep general body temperature constant during periods of leg cooling. Eighty experiments were performed in a hot and dry environment. During the middle period of each experiment the legs were cooled by perfusing the thermodes with water of 0 degree C. This caused respiratory evaporative heat loss to decrease by 0.15-0.20 W/kg. The small but significant response occurred at constant general body temperature and is therefore indicative of a local effect of the cooling on deep thermosensitive elements in the legs themselves and a neural afferent transmission of temperature signals into the temperature-regulating system.

Total body thermosensitivity and its spinal and supraspinal fractions in the conscious goose

1. Effects of general body cooling on heat production: an intravascular heat exchanger was used to alter total body temperature. Heat production increased with decreasing body temperature at an average rate of -12W/kg x degree C. The rate of rise was independent of air temperature. The threshold body temperature below which heat production rose was lower at higher air temperature. 2. Effects of spinal cord cooling: heat production increased with decreasing spinal temperature at an average rate of -0.3 W/kg x degree C. The rate of rise was not clearly affected by air temperature. The spinal threshold temperature was lower at warm ambient conditions. The results suggest that spinal thermosensitivity in the goose represents only a minor fraction of total body thermosensitivity. 3. Effects of head cooling: heat exchangers closing the carotid arteries were used to alter the temperature of the blood supplied to the head. Cooling increased heat production. When the thermosensitivity of the area, which was affected by heat exchanger, was calculated from the relationship between changes of heat production and brain temperature, values between -0.74 and -1.65 W/kg x degree C were obtained. Measurements of brain, spinal cord and head skin temperatures suggest that the thermosensitive structures which mediated the responses, were predominantly situated in the brain.

Independent clamps of peripheral and central temperatures and their effects on heat production in the goat

1. Experiments were performed to study the interaction of skin and core temperatures in the control of heat production. Shorn goats with intravascular heat exchangers to control core temperature were immersed to the neck in a circulating water bath to clamp skin temperature. With bath temperature kept constant at levels between 32 and 42 degrees C, core temperature was varied between 40 and 36 degrees C, and the changes in heat production were measured. 2. With falling core temperature shivering occurred at all bath temperatures, and heat production rose. The threshold of core temperature below which heat production increased varied inversely to the level of skin temperature. Even at a bath temperature of 42 degrees C the slope at which heat production rose exceeded -5 W. kg-1 . C-1. The results show that in the goat even very high skin temperatures do not abolish the central impulse to shiver which is caused by low core temperature. 3. It is concluded that in the control of heat production, skin temperature and core temperature provide linear and independent inputs which do not replicate any known relationship between temperature and discharge frequency of thermoreceptors.

Thermal control of respiratory evaporative heat loss in exercising dogs

Experiments were carried out to determine whether respiratory evaporative heat loss (REHL) in exercising dogs is entirely under thermal control or whether a nonthermal input is additionally involved. To determine body core thermosensitivity, hypothalamic perfusion thermodes and intravascular heat exchanges were chronically implanted in the animals. This allowed the temperature of these two areas to be independently manipulated. At 30 degrees C air temperature, REHL was measured in three dogs during rest or while running on a treadmill (6 km . h-1, 0 degree gradient). During exercise, the threshold temperature was lowered by 9 degrees C, and the slope of the heat-loss response was reduced to one-third as compared with rest when hypothalamic temperature alone was clamped at various levels between 30 degrees and 42 degrees C. However, when extrahypothalamic body core temperature was additionally clamped, the decrease in threshold during exercise was reduced to 0.43 degrees C, while the slope of the response was identical to that during rest. The results suggest that by taking account of total body core thermosensitivity, instead of hypothalamic thermosensitivity, the alleged role of a nonthermal input is greatly reduced. In addition, the results showed that the major pat of central thermosensitivity must be attributed to the extrahypothalamic body core.