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Volume 97 / No. 5 / 1996
FUNCTIONAL AND MORPHOLOGICAL CHANGES OF THE RESPIRATORY ORGANS IN CATS AFTER LONG-TERM EXPOSURE TO PURE NORMOBARIC OXYGEN
HANACEK J., BROZMANOVA M., STRAPKOVA A., SZEPE P., NAGYOVA B.
Background: Pulmonary oxygen toxicity is very well known and
proved. The influence of hyperoxia on the respiratory reflexes is not known
till now.
Main purpose: To ascertain if long-lasting breathing of pure
normobaric oxygen (PNO) alter respiratory reflexes.
Methods: 34 adult cats of both sexes, weighing 2.5—4.0 kg, were
used in two experiments. In the first experiment 16 animals with inserted
chronic tracheal cannula (CTC) were used. In the second experiment 18 animals
without CTC were emploied. Part of animals in both experiments was exposed
to PNO (day by day for 2 weeks, 10 h daily), remaining animals were exposed
to room air under the same conditions. Side tracheal pressure was recorded
in unanesthetized animals of the first experiment. The second experiment
was performed in anaesthetised animals (Pentobarbital Spofa, 35 mg/kg,
i.p.). Oesophageal pressure and blood pressure in femoral artery were recorded.
Cough reflex, sneezing and aspiration reflexes were induced by mechanical
stimulation of airway mucosa. Pulmonary chemoreflex was elicited by i.v.
administration of 50 µg phenyl biguanid. Hering-Breuer inflation reflex
was induced by lung inflation with pressure of 1 kPa. Reactivity of tracheal
and pulmonary smooth muscle to histamine were maeasured in vitro.
Differences in recorded parameters between animals exposed to PNO,
and to room air, were tested by Mann-Whitney-Wilcoxon test and by Student’s
t-test. When p<0,05, the differences were recognized as significant.
Results: Significant decreasing of the expiratory parameters
of the cough induced from laryngopharyngeal mucosa, inhibition of sneezing,
and inhibition of aspiration reflex, were found in animals exposed to PNO.
Relaxing reaction of tracheal smooth muscle of control animals to histamine
was reversed to contrac tion in animals exposed to PNO. Morphological changes
of the respiratory tract induced by influence of oxygen were found.
Conclusion: Long-lasting breathing of PNO induced changes of
respiratory reactions elicited mainly from upper airway. (Fig. 6, Tab.
3, Ref. 22.)
Key words: hyperoxia, respiratory reflexes, reactivity of tracheal
and lung smooth muscle, cat.
Bratisl Lek Listy 97; 1996: 251–259
CARDIOVASCULAR AND HAEMODYNAMIC CHANGES DURING ARTIFICIAL VENTILATION OF THE LUNGS
GECELOVSKA V., JAVORKA K.
The cardio-respiratory interactions include mechanical, reflex and humoral
mechanisms. However, in the organism they mutually overlaping, thus mating
their separate investigationis problematic.
Mechanical effects of conventional artificial ventilation (AV) and
high frequency ventilation (HFV) are elicited by increased intrapulmonary
pressure during lung inflation, as well as during application of positive
end expiratory pressure (PEEP). The increase in intrapulmonary pressure
compresses the pulmonary vessels and increases the pulmonary vascular resistance.
These changes deteriorate the right ventricular function. Mechanical factors
are responsible for the fall of the left ventricular (LV) filling, stroke
volume and alteration of the LV preload and afterload. LV filling is decreased
during artificial ventilation (AV) owing to the shifting of blood from
the central to the periferal circulation, and to the rise in pulmonary
vascular resistance Application of positive intrathoracic pressure during
ventricular ejection phase can diminish LV afterload and increase the cardiac
output. This effect is striking in LV failure.
The reflex effects of artificial ventilation are due to the activation
of baroreflexes and pulmo-vagally cardiac and vasoactive reflexes. Activation
of these reflexes depends on the level and characteristic of the pressure
in the airways, lungs, heart and vessels.
Humoral effects of AV on the cardiovascular system and hemodynamics
are triggered by lung expansion, circulatory changes, and they result in
a release of vasoactive substances from lung parenchyma. (Fig. 5, Ref.
45.)
Key words: artificial ventilation, cardio-respiratory relationships,
high frequency ventilation.
Bratisl Lek Listy 1996; 97: 260-266
SELECTED PARAMETERS OF THE LIPOPROTEIN METABOLISM IN CEREBROVASCULAR DISEASES
DROBNY M., SVALEKOVA A., KOSKOVA E., HAZLINGEROVA M., CELEC S.
In series of patients with stroke, selected by random (n=68), mean age
62.44±9.12 years (range 39—82 yrs), there were 23 females (33.8 %), mean
age 65.43±10.11 yrs and 45 males (66.2 %) mean age 60.8±8.3 yrs.
Lp(a) reference values have been obtained from a group of 283 healthy
individuals (age ranging from 15 to 65 years). The cholesterol, triacyglycerol,
Apo B reference values come from the database of the Department of Clinical
Biochemistry.
There were 52 hypoxemic stroke patients in the whole observed group.
Triacylglycerol serum level TAG<=2.89 mmol/l was observed in 47 cases
(90.3 %), the serum level TAG>2.89 mmol/l was present in 5 cases (9.7
%). The occurrence of TAG normal serum level was significantly more frequent
than its pathologic increase (p<0.001). Apolipoprotein Apo B<=1.67
g/l serum level was present in 4l (78.8 %) and Apo B>1.67 g/l in 11
(21.2 %) cases (p<0.001).
Apo B<=1.67 g/l serum levels in 23 cases (82,1 %) and Apo B>1.67
g/l in 5 cases (18 %) were observed among the stroke diabetes mellitus
patients (n=28) — statistic difference in 1/1000 level.
In the total hypoxemic stroke group (n=52), Lp(a)<=0.278 g/l was
observed in 44 cases (84.6 %), Lp(a) > 0.278 g/l serum level was present
in 8 cases (15.4 %)/ - p<0.001. According to EASD consensus the serum
level of Lp(a)=0.278 g/l has been considered as „cut-off limit". Similar
distribution of Lp(a) serum levels was observed in the diabetes mellitus
stroke group (n=28), the ischemic heart group (n=54), the group with aortosclerosis
(n=16) and in the group with arterial hypertension (n=50).
Elevated TAG serum levels were not in correlation with the number of
sites where atherosclerotic changes were proved by arteriography, ultrasound
investigation e.g. in the extracranial brain supplying arteries. Elevated
Lp(a) serum levels did not correlate with the stage of ischemic heart disease
and they correlated with the stage of functional CNS defect in arterial
hypertension and atherosclerosis.
Metabolic disorders of lipoprotein and apolipoprotein, namely genomic
transcription of lipoprotein seem to be more significant risk stroke factors,
but, if they are present, they contribute to the occurrence of arteriosclerosis
of some larger arteries. Elevated Lp(a) serum levels did not correlate
with the stage of the heart ischemic disease and aortosclerosis, but they
correlate with the stage of functional CNS defect due to arteriosclerosis
and arterial hypertension, hence the increase in Lp(a) serum level as an
indicator of arteriosclerotic evolution of cerebral arteries is significant.
Our results , hence, do confirm a common supposition for Lp(a) serum level
as an independent arteriosclerotic risk factor of the brain arteries. (Fig.
7, Tab. 1, Ref. 22.)
Key words: dyslipoproteinemia (DLP), triacylglycerol (TAG), apolipoprotein
B (Apo B), apolipoprotein A (Apo A), hypoxic stroke (HS), ultrasonography
(USG), ischemic heart disease (IHD).
Bratisl Lek Listy 1996; 97: 267–272
MAY PERMANENT SINUS ARRHYTHMIA IN CONSCIOUS DOGS BE SUPRESSED BY ANAESTHESIA?
BERNADIC M., MAASOVA D., SASVARY F., HOLZEROVA J., HULIN I.
Objective: Large prospective studies in dogs with healed myocardial
infarction (MI) recently show a positive relation between heart rate variability
(HRV) and sudden cardiac death.
Methods: We have done similar experiments in dogs and we studied
HRV, ECG and body surface potential maps (BSPM) in 26 normal mongrel dogs
(10—15 kg) and 12 dogs with an experimental MI (ligation of LAD). A two-channel
8 hours lasting ECG recording was performed in all conscious dogs. The
2nd recording was done in Penthobarbital anaesthesia (30 mg/kg).
Results: We have found sinus arrhythmia (SA) in all 26 conscious
dogs. The anaesthesia supressed the sinus arrhythmia and HRV via compensatory
tachycardia and alterations in baroreflexes. The supression of arrhythmia
was also present in dogs with myocardial infarction.
Conclusions: It is suggested, that HRV and SA in dogs depend
on conscious state and anaesthesia. On the basis of our results we can
anticipate that the most important for HRV is the present status of the
sympathetic nerve. We suggest, that our results are an important finding
for experimental arrhythmology. (Fig. 4, Ref. 22.)
Key words: sinus arrhythmia, anaesthesia, conscious, heart rate
variability, dog.
Bratisl Lek Listy 1996; 97: 273-278
EXTRAUTERINE CHORIOCARCINOMA — RARE FORM OF TROPHOBLAST GESTATION DISEASE
DANIHEL L., SOKOL L., BREITENECKER G., KORBEL M., PORUBSKY J., LISKA J., ZAVIACIC T.
Choriocarcinoma represents the most serious form of tropho-blast gestation
disease. In the majority of cases the carcinomatous tissues fill out the
uterine cavity, or they grow in a form of nodes deep in the uterine wall.
The primary extrauterine localization of this tumour is very rare. The
authors describe two cases of choriocarcinomas with tubal or ovarian localization.
(Fig. 4, Ref. 19.)
Key words: choriocarcinoma, trophoblast disease, uterus, pathology.
Bratisl Lek Listy 1996; 97: 279–283
THE EFFECT OF EXPERIMENTAL GASTROESOPHAGEAL REFLUX ON THE COUGH IN ANAESTHETIZED CATS
TATAR M., PECOVA R.
Background: Gastroesophageal reflux (GER) is a common cause of
chronic cough. It has been suggested that GER most often causes chronic
cough by stimulating the distal oesophagus. Possible mechanisms of this
interactive process are: a) an oesophageal-tracheobronchial reflex, b)
acid reflux seems to be only a cofactor of cough; it decreases cough threshold.
Aim: To evaluate the effects of experimental GER on the cardiorespiratory
parameters and on the cough induced by mechanical stimulation of airways
mucosa in anaestetised cats.
Methods: In 10 adult cats of either sex, mean body weight 2.4±0.2
kg, anaesthetised with pentobarbitone sodium (30 mg/kg b.w., i.p.), oesophageal
pressure, blood pressure, and volume tidal were recorded. 2 ml 0.1 N HCl
was instilled into the isolated thoracic oesophagus with preserved innervation
over a period of 5 minutes. The cough was induced by the insertion of nylon
fibre into the airways and its intensity was evaluated from the changes
in oesophageal pressure. Cough challenge was also repeated during intraesophageal
instillation of 2 ml capsaicin (350 µmol/l). The parameters of cough intensity
elicited during experimental GER were compared with the control cough parameters
obtained during intraesophageal instillation of 2 ml physiological saline.
Results: Intraesophageal instillation of either HCl or capsaicin
was accompanied by the contractions of oesophageal wall and by the fluctuations
in volume tidal. These changes were more pronounced after capsaicin challenge.
There was no induction of either cough or other respiratory reflexes with
forced expiration during the experimental GER. In other part of this study
there were not obtained any significant differences of the intensity of
mechanically—induced cough during intraesophageal instillation of physiological
saline, HCl, and capsaicin.
Conclusion: The oesophageal-tracheobronchial reflex mechanism
for either induction or modulation of cough is not present in healthy anaesthetised
cats. We agree with previous data that GER alone is not trigger agent of
cough. (Fig. 5, Ref. 17.)
Key words: gastroesophageal reflux, cough, anaesthetised cats.
Bratisl Lek Listy 1996; 97: 284–288
HIGH-RESOLUTION ELECTROCARDIOGRAPHY IN THE PROGRAMME OF ANTRACYCLINE – INDUCED MYOCARDIAL DAMAGE MONITORING AT CHILDREN
MLADOSIEVICOVA B., FOLTINOVA A., BERNADIC M., PETRASOVA H., HULIN I.
Background: Anthracycline cytostatics, widely used in oncologic
practice, may induce discrete myocardial damage occasionally culminating
in life-threatening cardiologic complications. The most serious clinical
manifestations of anthracycline cardiotoxicity are dilated cardiomyopathy,
heart failure and fatal arrhythmias.
Objectives, starting point and main purpose: High-resolution
electrocardiography (HRECG) is one of the latest cardiologic methods, which
can be promising for early identification of patients at risk of anthracycline
cardiotoxicity. The aim of this study is the evaluation of the incidence
of HRECG abnormalities in a group of paediatric patients treated with anthracyclines
and the usefulness of HRECG for stratification of patients at risk of the
clinical cardiotoxicity.
Patients and methods: A set of 60 oncologic paediatric patients
treated with anthracyclines was divided into two groups. The first group
was formed by 15 patients undergoing evaluation during their anthracycline
therapy (median after the last administration of antracyclines was 3.2
days). Their average age at the time of examination was 14.7±4.1 years.
The total cumulative dose of antracyclines was 40—300 mg/m˛ (median 150
mg/m˛). The second group was formed by 45 patients who were evaluated after
completing anthracycline therapy. The interval of time from the last administration
of antracycline in this subgroup of patients was 3 months—12 years (median
5.5 years). Their average age at the time of HRECG examination was 14±4.1
years. The total cumulative dose of anthracyclines was 90—440 mg/m˛ (median
230 mg/m˛). Six patients of this group (13.3 %) were treated also with
mediastinal radiotherapy (18—40 Gy). 43 patients (95.5 %) of second group
were in complete remission, two other patients yielded a progression of
their malignancy. 10 patients (22 %) were examined by HRECG 2—5 times in
app. two-month intervals. The control group was formed by 30 randomly selected
healthy children and adolescents with normal ECG. Average age was 15.1±5.8
years.
Using HRECG the time- and frequency-domain characteristics of the ECG
signal were analyzed. The time-domain analysis was performed at 40—250
Hz filter. The frequency-domain analysis was performed by fast Fourier
transformation (FFT), a 120 ms segment starting 20 ms before the end of
the QRS complex was analyzed. The altered frequency content was expressed
as the ratio of frequency areas (area ratio, AR) 20—50 Hz/0—20 Hz. The
average level of noise was 0.56 uV in the first group, 0.62 µV in the second
group of patients and 0.68 µV in the control group.
Results: Abnormalities in the time-domain analysis (ventricular
late potentials, VLP) were present in 2 (13.3 %) of 15 patients during
the anthracycline therapy in the first group and in 4 (8.8 %) of 45 patients
after completing therapy in the second group. No abnormalities in the time-domain
analysis were detected in the control group. Using frequency-domain analysis,
abnormalities in AR 20—50 Hz/0—20 Hz were found in 8 (53.3 %) of 15 patients
of the first group, and in 11 (24.4 %) of 45 patients of the second group.
Significant differences were observed in the frequency parameters of the
ECG signal in patients of the first group in comparison to the control
group (p=0.0018) and also when comparing the patients of the second group
and the control group (p=0.045).
Conclusion: The HRECG results in time- and frequency-domain
analyses indicate to higher incidence of HRECG abnormalities in patiens
examined both during and after the antracycline therapy in comparison to
the control group. The prognostic use of the HRECG abnormalities must be
established in a larger and longer study. (Fig. 4, Tab. 2, Ref. 43.)
Key words: high resolution electrocardiography, ventricular late
potentials, frequency-domain analysis, anthracycline cardiotoxicity.
Bratisl Lek Listy 1996; 96: 289—297
ACETYLCHOLINESTERASE-POSITIVE INNERVATION OF THE OLD RATS THYMUS AFTER OVARIECTOMY
DORKO F., KOCISOVA M., GREGOR A., SCHMIDTOVA K., BANOVSKA E.
Surgical ovariectomy in aged rats entails regeneration of the involuted
thymus. These results correlate with our study of acetylcholinesterase
positive innervation of regenerated thymuses. We found out a marked autonomous
innervation of the perivascular tissues, as well as that of the functional
parenchyma of the thymus. We proved a significant increase in the density
of ACHE-positive nerves in the thymus of aged rats after surgical ovariectomy.
These results are considered to represent and indirect evidence of the
fact that cholinergic nerves stimulate lymphopoiesis in the thymus. (Fig.
5, Ref. 9.)
Key words: thymus, rat, ovariectomy, acetylcholinesterase (ACHE),
innervation.
Bratisl Lek Listy 1996; 97: 298–300
CIRCADIAN RHYTMICITY OF ENDOTHELIN-1 IN HEALTHY SUBJECTS
SOCHOROVA R., PAYER JR. J., HUORKA M., ONDREJKA P., HULIN I.
The possible circadian rhythmicity of endothelin-1 was investigated.
Radioimmunoassay method was used in 5 clinically healthy male subjects
aged 24—32 years. Blood samples were collected at 4-hour intervals over
a period of 24 hours. Data for ET-1 were fitted to a 24-hour cosine curve.
Statistically significant curves were found in two subjects (maximum at
4 p.m. and minimum at 10 p.m.), one did not yield a statistically significant
curve and in two subjects despite the fact that the curves were not presented.
Nevertheless, the circadian rhythmicity in our study was not confirmed
according to our results it could not be exluded. (Fig. 2, Tab. 2, Ref.
22.)
Key words: endothelin-1, circadian rhythm.
Bratisl Lek Listy 1996; 97: 301–303
PROBLEMS AND PROSPECTIVES OF MORE EXTENSIVE APPLICATION OF SALIVA FOR DIAGNOSTIC PURPOSES
DUBAYOVA K., KUSNIR J.
Saliva of individual salivary glands differs in appearance, density
and particularly in the chemical composition. Generally, the composition
of saliva is affected by the composition of blood plasma, salivary flow
rate, hormonal activity, drug administration, smoking and other physiological
and pathophysiological states of the organism.
In spite of these facts, many of the components are permanently present
in saliva (e.g. peptides, enzymes, hormones ...) only their concentrations
vary. In some special cases unusual constituents can be detected in the
saliva as legal and illegal drugs, antibodies (HIV), and abnormal bacteria
or viruses. When there is good correlation between the levels of constituents
in saliva and blood plasma then the determination of the constituent level
in saliva can be used for diagnostic and/or monitoring purposes. But the
main advantage of saliva analysis resides in stress-free and harmless collection
of saliva in comparison with blood withdrawing.
However, the use of saliva for diagnostic purposes is still at its
beginning. So far, only few such applications are known, but optimists
believe that the saliva analysis has a very prospective chance to substitute
or alternate the biochemical analysis of blood plasma due to the mentioned
advantage and to attribute more information on the processes in the human
body. (Fig. 1, Ref. 16.)
Key words: saliva, chemical composition, diagnostic tests.
Bratisl Lek Listy 1996; 97: 304–307