Postural changes in plasma renin activity and responses to vasoactive drugs in a case of Shy-Drager syndrome

A male aged 47 years with gross autonomic insufficiency as part of the Shy-Drager syndrome is described. He did not sweat normally when warmed, and his circulatory responses to mental arithmetic, the Valsalva manoeuvre, and head-up tilt were abnormal indicating severe sympathetic failure. During head-up tilt there was a rise in plasma renin activity and plasma aldosterone. It is argued that plasma renin activity is not dependent on sympathetic nervous activity and may be mediated by renal baroreceptors. These rises may help sustain the blood pressure in such patients during repeated head-up tilts. Infusions of L-noradrenaline and angiotension produced greater hypertension, and injections of isoprenaline greater hypotension than in controls. Although it is difficult to exclude the possibility that one factor in this may be hypersensitivity of receptors in blood vessel walls, the principal factor is likely to be the absence of those baroreflexes of which the efferent pathways are in the sympathetic nervous system.     

Influence of water temperature on thermal, circulatory and respiratory responses to muscular work

Different muscular exercises have been executed on a bicycle ergometer during immersion in water, the temperature of which varied between 20 and 40 degrees C. During submaximal works, O2 consumption was not modified by the temperature of the water. On the other hand, body temperature (rectal and muscular) are clearly influenced by environment. The temperature of the quadriceps varies from 37.7-38.5 degrees C when the bath temperature rises from 20-40 degrees C during the same work intensity corresponding to 1/3 of the individual maximal work capacity. The rectal temperature was always lower about 0.5 degrees C. Ventilation and heart rate underwent modifications which were significantly accentuated in hot water. Maximal O2 consumption does not reach its highest level in cold water. The low muscular temperature observed in these conditions seems to limit the aerobic metabolism and the working of the muscles. Maximal O2 consumption then rises in parallel with the increase in bath temperature and in body temperatures. In very hot water however (40 degrees C), when rectal temperature rises unduly, the circulatory demand linked to thermolysis becomes excessive, and maximal O2 consumption decreases.     

Rhinomanometry in myocardial infarction

Describing two new cases of so-called Central Core Disease, the authors revealed certain atypical features: The cores were formed in central as well as in peripheral position; they were observed in some apparently type II fibers; typical "structured" and "unstructured" cores coexisted with "reversed" core. Starting from this pictures a cycle of core formation was imaginated supposing to be initiated as the consequence of abnormal functional interrelationship between muscular and neural components in early myogenesis.     

Present prognosis in neonatal meningitis

A retrospective study of neonatal meningitis for a period of 6 years (1970 to 1975) is described. It was found that though the survival rate had increased since the introduction of the aminoglycosides, it was at the expense of major neurological sequelae in the survivors. It is suggested that breast feeding of all infants in the first few days of life will reduce the incidence of neonatatl meningitis. It is recommended that pooled human breast milk should not be heat-sterilized as this destroys anti-Escherichia coli immunoglobulin A.     

The purine nucleotide cycle. Studies of ammonia production by skeletal muscle in situ and in perfused preparations

Ammonia production by hind limbs of rat was studied in perfused preparations during rest, exercise, and hypoxia, and while the perfusate contained epinephrine or cyanide. Ammonia production by hind limbs was also studied in situ during rest and exercise. Strong correlations were observed between ammonia, IMP, and lactate formation. Adenylosuccinate was not present in detectable amounts in resting muscle (less than 1 nmol/g dry weight) but it appeared and rose sharply in exercising muscle, and then declined during recovery. The maximum found was about 18 nmol/g dry weight. When IMP accumulation exceeded 2.8 mumol/g dry weight, the formation of adenylosuccinate diminished, presumably because of an inhibition of adenylosuccinate synthetase by excess substrate. Exercise resulted in a greatly increased output of ammonia and a decreased output of alanine and glutamine. The tissue contents of aspartate and glutamate were decreased, while that of alanine was increased. The content of malate increased 3-fold during exercise. Epinephrine, hypoxia, and cyanide each caused an increased output of ammonia at the expense of the amino acid content of the tissue. These results provide evidence for the operation of the purine nucleotide cycle in skeletal muscle under various conditions that are associated with an increased rate of glycolysis.     

Transtympanic facial nerve paralysis

In order to ascertain the immediate histopathological changes of rat brain following experimental surgical injury, fragments of left parietal cortex were obtained through craniotomy and fixed by immersion. Next, the animals were killed by perfusion with the same fixative used for the respective biopsy. Five groups of rats were tested, each for one different fixative. Dark neurons were by far the most prominent feature in surgically traumatized tissue, following both immersion and perfusion with all five fluids. They were morphologically identical at both sites, and fixatives with widely different chemical composition, e.g. Bouin's fluid and buffered glutaraldehyde, had no influence on their aspect. It is suggested that shrunken neurons are not to be interpreted systematically as artefacts, but also represent a form of short-latency cellular reaction to injury.     

Placental diffusing capacities at varied carbon monoxide tensions

To test the hypothesis that carbon monoxide transfer across the placenta is, in part, a facilitated process, we have looked for evidence of saturation kinetics for carbon monoxide. In eight pregnant ewes, fetal to maternal carbon monoxide transfer was examined in a preparation in which the fetal side of the placenta was perfused with blood. The carboxyhemoglobin concentrations on the fetal side of the placenta were varied from 4.8 to 70% in 23 measurements. At increased carbon monoxide tensions, the transfer from fetus to mother always decreased. The slope of log rate of carbon monoxide transfer vs. log partial pressure gradient across the placenta was significantly different from 1. Placental membrane diffusing capacity was calculated separately from total placental diffusing capacity which includes hemoglobin reaction rates and erythrocyte membrane diffusion. Placental membrane diffusing capacity decreased at increased carbon monoxide tensions. Placental permeability for urea did not change with increasing carbon monoxide tensions. These results are consistent with the hypothesis that carbon monoxide diffusion in the placenta is, in part, carrier mediated.