Computerised transient hyperaemic response test--a method for the assessment of cerebral autoregulation

A simple bedside test has been developed to assess the state of autoregulation in subarachnoid haemorrhage patients. Transcranial Doppler was used to measure blood flow velocity in the middle cerebral artery after a brief common carotid compression. Acceleration of blood flow postcompression was interpreted as evidence of intact cerebral autoregulation. A program using the Windows environment was designed for signal analysis of the transient hyperaemic response test (THRT). The flow velocity signal from the TCD was recorded, carotid compression and release automatically detected and the test results immediately displayed and stored in a database. The program was verified in 614 tests; 552 of them were analysed off-line using previously recorded data and 62 on-line during the examination. A significant correlation was found between the results of computerised testing and the patient's neurological state.     

Cyclic hypoxic pulmonary vasoconstriction induced by concomitant carbon dioxide changes

We examined the stability of acute lobar hypoxic pulmonary vasoconstriction. In 12 mongrel dogs the left lower lobe (LLL) was selectively ventilated with a constant minute molume with nitrogen and the electromagnetically measured fraction of the cardiac output perfusing the LLL and the LLL end-tidal CO2 concentration were observed for 1 h. We found that both the fraction of the cardiac output perfusing the LLL and the LLL end-tidal CO2 concentration initially decreased during LLL hypoxia and then oxcillated in a progressively damped fashion. When LLL end-tidal CO2 was kept constant by CO2 infusion during LLL hypoxia or when LLL hypoxia was induced by LLL atelectasis, no oscillations were observed. We conclude that if minute ventilation of a hypoxic area of lung is kept constant, then decreased regional blood flow decreases regional alveolar PCO2. As a consequence of these two opposing influences, blood flow to an acutely hypoxic area will be oscillatory.     

Sepsis-induced vasoparalysis does not involve the cerebral vasculature: indirect evidence from autoregulation and carbon dioxide reactivity studies

We have studied cerebral autoregulation and vasoreactivity to carbon dioxide in 10 patients with the sepsis syndrome receiving intensive therapy. All patients were sedated with infusions of midazolam and fentanyl, and their lungs were ventilated mechanically with oxygen-air to maintain normoxia and normocapnia. Inotropic support and antibiotics were administered as necessary. During a period of constant level of sedation and stable haemodynamics, cerebral autoregulation was tested by increasing mean arterial pressure (MAP) by 23 (SD 2) mm Hg from baseline with an infusion of phenylephrine and simultaneously recording middle cerebral artery blood flow velocity (vmca) using transcranial Doppler ultrasonography. Carbon dioxide reactivity was tested by varying PaCO2 between 3.0 and 7.0 kPa and simultaneously recording vmca. There was no significant change in vmca (57 (22) and 59 (23) cm s-1) during the increase in MAP (75 (11) to 98 (10) mm Hg). The mean index of autoregulation (IOR) was 0.92 (SEM 0.03), which was not significantly different from 1, indicating near perfect autoregulation. Although absolute carbon dioxide reactivity was lower than reported previously in awake subjects, relative carbon dioxide reactivity was within normal limits for all patients (11.6 (SEM 0.8) cm s-1 and 20.3 (3) % kPa-1, respectively). We conclude that cerebral carbon dioxide reactivity and pressure autoregulation remained intact in patients with the sepsis syndrome, providing indirect evidence that at least in the early stages of the syndrome, the widespread sepsis-induced vasoparalysis does not involve the cerebral vasculature.     

Cholinergic modulation of cerebral cortical blood flow changes induced by trauma

These experiments tested the role of cholinergic mechanisms in the changes of cerebral cortical blood flow (CBF) induced by brain trauma. CBF was measured with Iodo-14C-antipyrine autoradiography, in 128 cerebral cortex regions of both hemispheres, distributed in eight coronal slices. The effects of a 6.3-mm diameter craniotomy over the left motor-sensory cortex with no weight drop, and of trauma (drop weight of 20 g from 30 cm height on left motor-sensory cortex through a 6.3 mm circular craniotomy) on CBF were studied at 2 and 24 h after the interventions. A group of control animals that received no intervention was also set up. Animals were treated with the cholinesterase inhibitor physostigmine salicylate (3.3 microg/kg/min i.v. infusion started 60 min before CBF measurements), the cholinergic blocker scopolamine hydrobromide (1 mg/kg i.v. pulse, 18 min before CBF measurements), or with the drugs vehicle (saline). A focus of decreased CBF at the site of impact was observed 2 h after trauma, extending caudally as far as the occipital cortex. CBF on the contralateral cerebral cortex was also decreased. Both phenomena reversed partially at 24 h. This spontaneous recovery of CBF was blocked by scopolamine. Physostigmine reversed the decrease in CBF of the traumatized cortex, partially around the contused area and completely in more distant regions. The cerebral cortex contralateral to the trauma showed significantly higher CBF 24 h after trauma when compared to intact controls or craniotomy that peaked at the area symmetrical to the center of trauma. This phenomenon was also enhanced by physostigmine and completely blocked by scopolamine. These results suggest a prominent role of cholinergic mechanisms in the vascular adjustments that accompany cerebral trauma.     

The effect of clonidine on cerebral blood flow velocity, carbon dioxide cerebral vasoreactivity, and response to increased arterial pressure in human volunteers

BACKGROUND: Because patients may be taking clonidine chronically or may be receiving it as a premedication before surgery, the authors investigated its effect on cerebral hemodynamics. METHODS: In nine volunteers, middle cerebral artery mean blood flow velocity (Vm) was measured using transcranial Doppler ultrasonography (TCD). CO2 vasoreactivity was measured before clonidine administration (preclonidine), 90 min after clonidine, 5 microg/kg orally, then following restoration of mean arterial pressure (MAP) to the preclonidine level. In addition, Vm was measured after a phenylephrine-induced 30-mmHg increase in MAP. RESULTS: After clonidine administration, Vm decreased from 62 +/- 9 to 48 +/- 8 cm/s (P < 0.01), and MAP decreased from 86 +/- 10 to 63 +/- 5 mmHg (P < 0.01; mean +/- SD). Clonidine decreased the CO2 vasoreactivity slope from 2.2 +/- 0.4 to 1.2 +/- 0.5 cm x s(-1) x mmHg(-1) (P < 0.05); restoring MAP to the preclonidine level increased the slope to 1.60 +/- 0.5 cm x s(-1) x mmHg(-1), still less than the preclonidine slope (P < 0.05). CO2 vasoreactivity expressed as a percentage change in Vm, decreased after clonidine, 3.5 +/- 0.8 versus 2.4 +/- 0.8 %/mmHg (P < 0.05); this difference disappeared after restoration of MAP, 3.1 +/- 1.2 %/mmHg. With a 30-mmHg increase in MAP, Vm increased by 13% before and after clonidine (P < 0.05). CONCLUSIONS: Clonidine, 5 microg/kg orally, decreases Vm and slightly attenuates cerebral CO2 vasoreactivity, therefore decreased cerebral blood flow and mildly attenuated CO2 vasoreactivity should be anticipated.     

Fast and slow components of cerebral blood flow response to step decreases in end-tidal PCO2 in humans

This study examined the dynamics of the middle cerebral artery (MCA) blood flow response to hypocapnia in humans (n = 6) by using transcranial Doppler ultrasound. In a control protocol, end-tidal PCO2 (PETCO2) was held near eucapnia (1.5 Torr above resting) for 40 min. In a hypocapnic protocol, PETCO2 was held near eucapnia for 10 min, then at 15 Torr below eucapnia for 20 min, and then near eucapnia for 10 min. During both protocols, subjects hyperventilated throughout and PETCO2 and end-tidal PO2 were controlled by using the dynamic end-tidal forcing technique. Beat-by-beat values were calculated for the intensity-weighted mean velocity (VIWM), signal power (P), and their instantaneous product (P.VIWM). A simple model consisting of a delay, gain terms, time constants (tauf,on, tauf, off) and baseline levels of flow for the on- and off-transients, and a gain term (gs) and time constant (taus) for a second slower component was fitted to the hypocapnic protocol. The cerebral blood flow response to hypocapnia was characterized by a significant (P < 0.001) slow progressive adaptation in P.VIWM, with gs = 1.26 %/Torr and taus = 427 s, that persisted throughout the hypocapnic period. Finally, the responses at the onset and relief of hypocapnia were asymmetric (P < 0.001), with tauf,on (6.8 s) faster than tauf,off (14.3 s).     

Texture evolution induced by strain path changes in low carbon steel sheets

Two-stage sequences of simple shear performed on low carbon steel sheets were supplemented by texture measurements. A detailed analysis of the texture evolution during the simple shear sequences was realized by studying the orientation distribution functions. The calculation of the orientation stability map (using the classical viscoplastic Taylor model) allows explanation of the observed texture development: the initial texture is shown to be partly stable and hence the measured textures differ from the usually reported ones. The influence of the texture evolution on the shape of the stress-strain curves, as well as on the remaining symmetries of the material, is also discussed. In particular, it is demonstrated that both intragranular and geometrical contributions have to be considered to explain the shape of the stress-strain curves after a strain path change.     

Blood flow velocity changes in the middle cerebral artery induced by processing of hierarchical visual stimuli

Transcranial Doppler ultrasound was used to measure mean flow velocities in both middle cerebral arteries while 16 young subjects performed a visual task involving the processing of hierarchically structured stimuli. Specifically, large (global) letters composed of smaller (local) letters were presented, with the subjects' task being to attend either to the local or to the global level and press a button whenever a target on the designated level occurred. Each run was comprised of a 35-sec period of passive stimulation, followed by 65 sec of active task. A highly significant increase of blood flow was detected upon initiation of the active task, which was clearly present after ca. 4 sec. The flow velocity reached a maximum after 20 sec and remained stable for the remainder of the active condition. No hemispheric differences with respect to global or local conditions were observed.     

Heat and mass transfer limitations in gasification of carbon by carbon dioxide

Rates of gasification of carbon by carbon dioxide were measured in the laboratory using a thermogravimetry apparatus. The experiments were conducted at various temperatures and sample bed depths using powders of graphite and coconut char as sources of carbon, under flowing gas of CO₂. Various CO–CO₂ mixtures were also employed for the study of coconut char. The measured rate data were subjected to a heat and mass transfer analysis to find out the values of isothermal and non-isothermal effectiveness factors. These values were utilized to predict the intrinsic chemical reactivities of graphite and coconut char samples, free from heat and mass-transfer limitations. Extrapolation of experimental data to hypothetical zero bed depth showed good agreements with the above at various temperatures, thus providing valuable cross-checks. The activation energies were found to be 260 and 250 kJ/mol for graphite and coconut char, respectively, under CO₂. Carbon monoxide was found to decrease the rate of gasification but not as drastically as some literature reports predict.     

Kinetics of oxidation of carbon in liquid iron-carbon-silicon-manganese-sulfur alloys by carbon dioxide in nitrogen

The oxidation of carbon with the simultaneous oxidation of silicon, manganese, and iron of liquid alloys by carbon dioxide in nitrogen and the absorption of oxygen by the alloys from the gas were studied using 1-g liquid iron droplets levitated in a stream of the gas at 1575 °C to 1715 °C. Oxidation of carbon was favored over oxidation of silicon and manganese when cast iron (3.35 pct C, 2.0 pct Si, 0.36 pct Mn, and 0.05 pct S) reacted with CO₂/N₂ gas at 1635 °C. An increase in the flow rate of CO₂/N₂ gas increased the decarburization rate of cast iron. The rate of carbon oxidation by this gas mixture was found to be independent of temperature and alloying element concentrations (in the range of silicon = 0 to 2.0 pct manganese = 0 to 0.36 pct and sulfur = 0 to 0.5 pct) within the temperature range of the present study. Based on the results of a kinetic analysis, diffusion of CO₂ in the boundary layer of the gas phase was found to be the rate-limiting step for the reactions during the earlier period of the reaction when the contents of carbon, silicon, and manganese are higher. However, the limiting step changed to diffusion of the elements in the metal phase during the middle period of the reaction and then to the diffusion of CO in the gas phase during the later period of the reaction when the content of the elements in the metal were relatively low. For the simultaneous oxidation reactions of several elements in the metal, however, the diffusion of CO₂ in the gas phase is the primary limiting step of the reaction rate for the oxidation of carbon during the later period of reaction. Formerly Visiting Assistant Research Scientist, Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI 48109     

Chlorination of hafnium dioxide by gaseous chlorine in the presence of carbon

The thermodynamic simulation of chlorination of hafnium oxide by gaseous chlorine in the presence of carbon at T = 450–1000°C is performed. It is shown that the main reaction products are gaseous hafnium tetrachloride, carbon monoxide, and carbon dioxide; as the temperature increases, the partial pressure of CO increases, while that of CO₂ decreases. In the mentioned temperature range, the variations in the enthalpy, entropy, and the Gibbs energy of chlorination reactions are calculated and the composition of the gas phase under the conditions of thermodynamic equilibrium is determined. In the course of studying the kinetics of chlorination of HfO₂ in the presence of carbon in the range T = 600–950°C, it is established that its limiting stage depends on the process temperature. Below 700°C, its rate is limited by the chemical reaction on the surface of nonporous solid spherical particles of the body with the formation of the volatile product; above 700°C, it is limited by the mass transfer of gaseous substances.     

Lisuride prevents learning and memory impairment and attenuates the increase in extracellular dopamine induced by transient global cerebral ischemia in rats

In this experiment, we tested the efficacy of neuroprotection with lisuride, a dopamine agonist, using the 4-vessel occlusion rat model. Functional improvement was evaluated with two behavior tests exploring learning and memorization capacity in the rat, the Morris water maze and the 14-unit T-maze, 18 days after ischemia. Extracellular dopamine levels during ischemia were determined in search of a possible neuroprotection mechanism. Dopamine and its metabolites, DOPAC and HVA, as well as the serotonin metabolite, 5-HIAA, were assayed with HPLC-EC, in striatal extracellular fluid obtained by in vivo microdialysis in the awake rat. Lisuride was administered at a total dose of 10 ng by continuous intrastriatal infusion or at the dose of 0.5 mg/kg by i.p. infusion, 160 minutes before onset of ischemia for the neurochemical study and at the dose of 0.5 mg/kg via i.p. infusion, 1 hour before occlusion of the carotid arteries, for the behavior tests. Behavioral testing showed significantly better recovery in both sets of behavioral tests, with more pronounced positive results with the 14-unit T-maze, in comparison with the saline-treated animals. Microdialysis confirmed a significant attenuation of the ischemia-induced dopamine surge, whatever the mode of administration, compared with saline-treated animals. These results show that lisuride offers significant neuroprotection from the effect of experimental transient global forebrain cerebral ischemia in the rat; the mechanism would imply, at least in part, reduced levels of extracellular dopamine.     

Regional cerebral blood flow changes in chronic alcoholic patients induced by naltrexone challenge during detoxification

A follow-up study was performed with the aim to evaluate all individuals surgically treated by the uvulopalatopharyngoplasty (UPPP) or laser uvulopalatoplasty (LUPP) method from a whole county in Sweden, 1-8 years after surgery, by assessing snoring occurrence and daytime sleepiness, as experienced by the patients and their cohabitants. Questionnaires were mailed to all operated people (n = 457) and were returned by 91% (346 men, 69 women) preoperatively diagnosed as habitual snorers (n = 255), cases of obstructive sleep apnea syndrome (n = 110) and unspecified snorers (n = 48). In addition 345 bedpartners participated. For outcome of surgery, no significant differences in diagnoses or sex were found. Improvement in snoring occurrence was reported by 89.6% of the patients, confirmed by 92% of the cohabitants (r = 0.84, p < 0.01). The remaining snoring occurrence was significantly dependent on the surgical method and the time after operation. Excessive daytime sleepiness (EDS) was experienced by 73.3% of the patients compared to 67% reported by the cohabitants. Of 415 patients operated on, 18% were free from snoring and 25% were free from EDS. Individuals with a shorter time since surgery reported less snoring. The UPPP method gave a significantly better result than LUPP for the symptom 'snoring'.     

Interfacial reaction kinetics in the decarburization of liquid iron by carbon dioxide

The kinetics of decarburization of liquid iron have been studied between 1160 and 1600°C under conditions where mass transport of reactants is not rate determining. Studies with continuously carbon-saturated iron and of iron with varying carbon concentration have been used to show that the slow step at high concentrations of carbon is independent of carbon concentration and is first order with respect to the pressure of CO₂. For high purity iron, the forward rate constant, in mole cm² s^-1 atm^-1, is given by the equation ln k_f = -11,700/T-0.48. It is concluded that the data are consistent with the chemisorption process as the rate limiting step. A marked sensitivity of the rate to trace amounts of sulfur has been found and it is shown that this is consistent with ideal adsorption of sulfur and is in fair accord with the existing measurements of the depression of the surface tension of iron-carbon alloys by sulfur. D. R. Sain was formerly a Graduate Student.     

Ultrastructural changes in liver damage induced by carbon tetrachloride in spontaneously hypertensive rats and Wistar-Kyoto rats

The establishment of a better local area medical centre containing hospitals and clinics is thought to be a very important issue. The medical information system, which should be accepted by both hospitals and clinics, has been studied using graphic user interface (GUI) and a three dimensional structure. Our system files medical records and blood examination data as well as diagnostic images, which may be the first attempt in the world. It has been favourably evaluated by physicians through clinical evaluation.     

An experimental investigation of the gasification of graphite by carbon dioxide

The gasification of graphite by carbon dioxide was studied under atmospheric pressure in a fixed bed reactor in the temperature range of 1173–1773?K, CO₂ partial pressures 2–10?kPa and gas flow rate 0·5–2·0?L?min^?1. Iron presented in a small amount in graphite ash had a catalytic effect on the gasification reaction at 1373?K; this effect was weaker at 1473?K due to the melting of iron saturated with carbon. The gasification rate increased with increasing CO₂ partial pressure and total gas flow rate.