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Biomedical subjects

G Coates

Publications and source records attributed to G Coates.

At least 37 records · Page 2Linked to original sources
PubMed1992

Physiological effects of tapering in highly trained athletes.

This study examined some of the physiological and performance effects of three different tapers in highly trained athletes. After 8 wk of training, nine male middle-distance runners were randomly assigned to one of three different 7-day tapers: a high-intensity low-volume taper (HIT), a low-intensity moderate-volume taper (LIT), or a rest-only taper (ROT). After the first taper, subjects resumed training for 4 wk and performed a second taper and then resumed training for 4 wk and completed the remaining taper, so that each subject underwent all three tapers. Performance was measured before and after each taper by a treadmill run to fatigue at a velocity equivalent each subject's best 1,500-m time. Voluntary isometric strength and evoked contractile properties of the quadriceps were measured before and after each taper, as were muscle glycogen concentration and citrate synthase activity (from needle biopsies) and total blood and red cell volume by 125I and 51Cr tagging. Maximal O2 consumption was unaffected by all three tapers, but running time to fatigue increased significantly after HIT (+22%). It was unaffected by LIT (+6%) and ROT (-3%) procedure. Citrate synthase activity increased significantly with HIT and decreased significantly with ROT. Muscle glycogen concentration increased significantly after ROT and HIT, and strength increased after all three tapers. Total blood volume increased significantly after HIT and decreased after ROT.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Isotope lung imaging.

The contribution of isotope imaging to the investigation of respiratory disease has been primarily limited to the detection of ventilation and perfusion abnormalities and the investigation of inflammation or cancer. In recent years, there has been a growing interest in the metabolic function of the lung and in measurements of alveolar capillary permeability in a variety of conditions. This review will deal with these newer applications of isotope techniques in the lung in addition to developments in ventilation-perfusion imaging.

Capillary Permeability↗
PubMed1991

Early adaptations in gas exchange, cardiac function and haematology to prolonged exercise training in man.

In order to determine the effect of short-term training on central adaptations, gas exchange and cardiac function were measured during a prolonged submaximal exercise challenge prior to and following 10-12 consecutive days of exercise. In addition, vascular volumes and selected haematological properties were also examined. The subjects, healthy males between the ages of 19 and 30 years of age, cycled for 2 h per day at approximately 59% of pre-training peak oxygen consumption (VO2) i.e., maximal oxygen consumption (VO2max). Following the training, VO2max (l.min-1) increased (P less than 0.05) by 4.3% (3.94, 0.11 vs 4.11, 0.11; mean, SE) whereas maximal exercise ventilation (VE,max) and maximal heart rate (fc,max) were unchanged. During submaximal exercise, VO2 was unaltered by the training whereas carbon dioxide production (VE) and respiratory exchange ratio were all reduced (P less than 0.05). The altered activity pattern failed to elicit adaptations in either submaximal exercise cardiac output or arteriovenous O2 difference. fc was reduced (P less than 0.05). Plasma volume (PV) as measured by 125I human serum albumin increased by 365 ml or 11.8%, while red cell volume (RCV) as measured by 51chromium-labelled red blood cells (RBC) was unaltered. The increase in PV was accompanied by reductions (P less than 0.05) in haematocrit, haemoglobin concentration (g.100 ml-1), and RBCs (10(6) mm-3). Collectively these changes suggest only minimal adaptations in maximal oxygen transport during the early period of prolonged exercise training. However, as evidenced by the changes during submaximal exercise, both the ventilatory and the cardiodynamic response were altered.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1991

Cardiopulmonary function during long-term central venous catheterization.

A prospective study was performed in an ambulatory group of infants, children, and young adults with neoplastic disorders to determine the prevalence of significant cardiopulmonary complications during long-term central venous catheterization. A cohort of 20 consecutive patients who had central venous catheters in situ for a mean of 13.5 months underwent pulmonary function testing, chest radiography, ventilation perfusion lung scintigraphy, electrocardiography, and echocardiography. No significant complications were seen. Specifically, there was no evidence of localized thrombus formation or pulmonary emboli, and no indirect evidence of pulmonary hypertension. In addition, we reviewed retrospectively the autopsy reports of 15 patients who died with central venous catheters in place. Three of these patients had superficial endocardial reactions. One patient had a right atrial mural thrombus related to the catheter, but two other patients were noted to have left atrial mural thrombi. This study demonstrates that central venous catheters can be used safely on a long-term basis in ambulatory patients requiring frequent venous access for treatment of their neoplastic disorders.

Adolescent↗
PubMed1991

Operation Everest II: structural adaptations in skeletal muscle in response to extreme simulated altitude.

Alterations in skeletal muscle structure were investigated in 6 male subjects who underwent 40 days of progressive decompression in a hypobaric chamber simulating an ascent to the summit of Mount Everest. Needle biopsies were obtained from vastus lateralis of 5 subjects before and immediately after confinement in the chamber, and were examined for various structural and ultrastructural parameters. In addition, total muscle area was calculated in 6 subjects from CT scans of the thighs and upper arms. Muscle area at these sites was found to decrease significantly (by 13 and 15%) as a result of the hypobaric confinement. This was substantiated by significant (25%) decreases in cross sectional fibre areas of the Type I fibres and 26% decreases (non significant) in Type II fibre area. Capillary to fibre ratios remained unchanged following hypoxia as did capillary density although there was a trend (non significant) towards an increase in capillary density. There were no significant increases in mitochondrial volume density or other morphometric parameters. These data indicate that chronic, severe hypoxia on its own does not result in an increase in absolute muscle capillary number or a de novo synthesis of mitochondria. The trends toward an increase in capillary density and mitochondrial volume density were interpreted as being secondary occurrences in response to the pronounced muscle atrophy which occurred.

Acclimatization↗
PubMed1991

Response of red cell and plasma volume to prolonged training in humans.

To clarify the role of progressive heavy training on vascular volumes and hematologic status, seven untrained males [maximal O2 uptake (VO2max) = 45.1 +/- 1.1 (SE) ml.kg-1.min-1] cycled 2 h/day at an estimated 62% of VO2max. Training was conducted five to six times per week for approximately 8 wk. During this time, VO2max increased (P less than 0.05) by 17.2%. Plasma volume (PV) measured by 125I increased (P less than 0.05) from 3,068 +/- 104 ml at 0 wk to 3,490 +/- 126 ml at 4 wk and then plateaued during the remaining four wk (3,362 +/- 113 ml). Red cell (RBC) mass (RCM) measured by 51Cr-labeled RBC did not change during the initial 4 wk of training (2,247 +/- 66 vs. 2,309 +/- 128 ml). As well, no apparent change occurred in RCM during the final 4 wk of training when RCM was estimated using PV and hematocrit (Hct). Collectively, PV plus RCM, expressed as total blood volume (TBV), increased (P less than 0.05) by 10% at 4 wk and then stabilized for the final 4 wk. During the initial phase of training, reductions (P less than 0.05) were also noted in Hct (4.6%), hemoglobin (Hb, 4.0%), and RBC count (6.3%). In contrast, an increase in mean cell volume (MCV, 1.7%) and mean cell Hb (2.3%) was observed (P less than 0.05). From 4 to 8 wk, no further changes (P greater than 0.05) in Hb, RBC, and MCV were found, whereas both mean cell Hb and Hct returned to pretraining levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1991

Noninvasive measurement of lung carbon-11-serotonin extraction in man.

The fraction of serotonin extracted on a single passage through the lungs is being used as an early indicator of lung endothelial damage but the existing techniques require multiple arterial blood samples. We have developed a noninvasive technique to measure lung serotonin uptake in man. We utilized the double indicator diffusion principle, a positron camera, 11C-serotonin as the substrate, and 11CO-erythrocytes as the vascular marker. From regions of interest around each lung, we recorded time-activity curves in 0.5-sec frames for 30 sec after a bolus injection of first the vascular marker 11CO-erythrocytes and 10 min later 11C-serotonin. A second uptake measurement was made after imipramine 25-35 mg was infused intravenously. In three normal volunteers, the single-pass uptake of 11C-serotonin was 63.9% +/- 3.6%. This decreased in all subjects to a mean of 53.6% +/- 1.4% after imipramine. The rate of lung washout of 11C was also significantly prolonged after imipramine. This noninvasive technique can be used to measure lung serotonin uptake to detect early changes in a variety of conditions that alter the integrity of the pulmonary endothelium.

Carbon Radioisotopes↗
PubMed1990

Heparin effect on bone density.

In order to provide estimates of the risks of symptomatic osteoporosis and reduced bone density in premenopausal women treated with long-term (greater than 1 month) heparin therapy, we evaluated a cohort of 61 consecutive premenopausal women previously treated with long-term heparin (cases) and a group of controls matched for age, parity and duration between the last pregnancy and evaluation. All patients underwent dual photon absorptiometry of the lumbar spine and single photon absorptiometry of the wrist and most cases underwent plain lateral radiography of the thoracolumbar spine in order to exclude silent fractures. Although none of the cases suffered symptomatic fractures (0 of 61, 95% confidence intervals 0.0 to 5.9%), there was a significantly greater proportion of cases than controls with bone density below our pre-defined levels. The long-term implications of our findings are uncertain but because it is possible that the reduction in bone density predisposes women to fractures, this potential risk should be considered when treating women with long-term heparin.

Adult↗
PubMed1990

Clinical validity of a normal perfusion lung scan in patients with suspected pulmonary embolism.

The objective of this study was to test the safety of withholding anticoagulant therapy in patients with clinically suspected pulmonary embolism who have normal perfusion lung scans, regardless of the clinical manifestations. Anticoagulant therapy was withheld or withdrawn in 515 consecutive patients except in patients in whom deep-vein thrombosis was detected. Only three of the 515 patients had symptomatic venous thromboembolism on follow-up. The frequency of symptomatic pulmonary embolism on follow-up was one of 515 patients. With knowledge of the normal findings by perfusion scanning, an alternative diagnosis was established in 367 of the 515 patients. Cause of symptoms remained uncertain in 148 patients. It is safe to withhold anticoagulant therapy in patients with suspected pulmonary embolism and normal perfusion scans, regardless of the clinical manifestations. The finding of a normal perfusion scan excludes the presence of clinically important pulmonary embolism and makes pulmonary angiography unnecessary.

Adolescent↗
PubMed1989

Risks to the fetus of radiologic procedures used in the diagnosis of maternal venous thromboembolic disease.

The diagnosis of suspected venous thromboembolic disease during pregnancy is problematic because of the fear of fetal irradiation with routine diagnostic procedures. In order to develop rational guidelines, we have calculated levels of radiation exposure to the fetus for the common diagnostic procedures and conducted a literature review to examine the fetal risks associated with these levels of radiation. A small increase in the relative risk of childhood cancer is suggested by a literature review of outcomes following low dose (less than 5 rads), in utero radiation exposure. With careful use of the available procedures, a diagnosis of venous thrombosis is possible with fetal radiation exposure of less than 0.50 rads and a diagnosis of pulmonary embolism is possible with fetal radiation exposure of less than 0.05 rads. The risk of such exposure is small, both in relative and absolute terms.

Female↗
PubMed1989

The response of the pulmonary circulation to exercise during normoxia and hypoxia following pneumonectomy in the adult sheep.

Pneumonectomy approximately halves the available pulmonary vascular bed. It is unknown whether the remaining lung has sufficient vascular reserve to cope with increased blood flow under stressful conditions without demonstrating abnormal pulmonary hemodynamics. To investigate this question, unanesthetized ewes with vascular catheters had hemodynamics assessed before and after a left pneumonectomy. Subsequently, on different days, the sheep were exercised on a treadmill under normoxic and hypobaric hypoxic (430 mmHg) (1 mmHg = 133.3 Pa) conditions. Pneumonectomy itself increased mean pulmonary arterial pressure by 4 mmHg. During normoxic or hypoxic exercise, the pneumonectomized sheep demonstrated a pulmonary hemodynamic response similar to normal sheep with two lungs. The pressure-flow relation for the right lung suggested the vascular reserve of the lung was not exceeded during exercise in the pneumonectomized sheep. Eighteen to 70 days after pneumonectomy there was no evidence of right ventricular hypertrophy, but there were small increases in the number of muscularized vessels less than 50 microns diameter and in the amount of muscle in normally muscularized pulmonary arteries. This study demonstrates that pneumonectomy slightly increases mean pulmonary arterial pressure. However, there is sufficient vascular reserve in the remaining lung to permit a normal hemodynamic response to exercise-induced increased blood flow even under hypoxic conditions.

Animals↗
PubMed1989

Simultaneous measurement of lung clearance rates for Tc- and In-DTPA in normal and damaged lungs.

We investigated the relative clearance rates for 99mTc-labeled diethylenetriamine-pentaacetate (Tc-DTPA) and 113mIn-labeled DTPA (In-DTPA) when they were inhaled and deposited together within the lungs of same animal. Submicronic aerosols containing Tc-DTPA and In-DTPA were simultaneously generated by different nebulizers and collected within the same anesthetic bag. The combined aerosols were insufflated into piglets. Clearances for both compounds were measured simultaneously in normal lungs and when the lungs were damaged by intravenous oleic acid or by a presumed oxidant agent, intravenous or intratracheal phorbol myristate acetate (PMA). A medium-energy collimator and a computer-assisted gamma camera were used to calculate clearances. Correction was made for downscatter from the In photopeak into the Tc window. Marked lung injury occurred as evidenced by increases in lung water content and decreases in arterial PO2. The clearance of In-DTPA was slightly but significantly slower than for Tc-DTPA in each group of animals. The correlation (r = 0.93) between clearances for Tc-DTPA and In-DTPA was good, even though in vitro studies demonstrated that Tc-DTPA, but not In-DTPA, slowly dissociated at room and body temperatures. Oleic acid increased, but surprisingly, PMA had no effect on clearance rates for both In-DTPA and Tc-DTPA. We recommend continued use of Tc-DTPA for these measurements in view of its lower cost, requirement for only low-energy collimation, better imaging characteristics, and widespread availability. The overlap between control and injured lungs and the lack of increased clearance rates after PMA suggest this technique does not always detect acute lung injury.

Aerosols↗
PubMed1989

The use of indium-111 oxine platelet scintigraphy and survival studies in pediatric patients with thrombocytopenia.

We have utilized 111In-labeled heterologous platelets to investigate the mechanism of thrombocytopenia in ten children. From the scintigraphic findings, platelet survival times, and clinical information, thrombocytopenia was ascribed to decreased production or to increased destruction. Two patients were found to have bone marrow production defects. Two patients with hemangiomas were studied. In one, the hemangioma was shown not to be the cause of thrombocytopenia. In the second, the hemangioma was proven the source of platelet destruction, but was much more extensive than clinically evident. In both, surgical manipulation of the hemangioma was avoided. Six additional patients had thrombocytopenia due to accelerated destruction. In four, the spleen was shown responsible. In two, however, the spleen was shown not to be responsible for the low platelet counts, and splenectomy was avoided. Thus, 111In-platelet scintigraphy and survival studies are valuable in the classification and management of childhood thrombocytopenia. We believe that this study should be performed, when possible, in any child with thrombocytopenia where the mechanism is unclear or the therapeutic intervention involves splenectomy or resection of a hemangioma.

Adolescent↗
PubMed1989

A new noninvasive management strategy for patients with suspected pulmonary embolism.

Pulmonary embolism is associated strongly with proximal-vein thrombosis. We tested the hypothesis that recurrent venous thromboembolism is unlikely in the absence of proximal-vein thrombosis. We performed a prospective cohort study in 874 patients with suspected pulmonary embolism. On long-term follow-up of 371 patients with the following characteristics: (1) abnormal, non-high-probability lung scans, (2) off anticoagulant therapy, and (3) serial noninvasive test results negative for proximal-vein thrombosis, only 10 (2.7%; 95% confidence limits, 1.3% to 4.9%) had venous thromboembolism. By comparison, venous thromboembolism on follow-up occurred in 3 (1%) of 315 patients (95% confidence limits, 0.2% to 2.8%) with normal lung scans, and in 5 (7%) of 66 patients (95% confidence limits, 2.5% to 16.8%) with high-probability lung scans. Patients whose serial noninvasive test results were negative for proximal-vein thrombosis have a good prognosis without anticoagulant therapy.

Adult↗
PubMed1988

The effect of hypoxia on platelet survival and site of sequestration in the newborn rabbit.

Thrombocytopenia occurs frequently in sick neonates that have experienced perinatal asphyxia. This study investigated the effect of one component of asphyxia, hypoxia, on platelet lifespan and site of sequestration. 111Indium oxine platelet survivals with scintigraphic imaging were performed in newborn and adult rabbits exposed to room air (normoxia) or following exposure to a 15 minute, severe hypoxic insult (FIO2 = 0.05). Platelet survivals in normoxic adults (n = 27) and newborn rabbits (n = 11) were similar (60 +/- 3.9 hr vs 64 +/- 8.0 hr, m +/- SEM). Inhalation of 5% oxygen for 15 minutes was not associated with an acidemia and did not produce thrombocytopenia but significantly shortened the platelet survival to 34 +/- 3 hr in the adult (n = 18) and 38 +/- 3 hr in the newborn rabbit (n = 7). Postmortem measurement of the sites of 111In-platelet accumulation showed that under normoxic conditions the platelets accumulated in the liver and spleen (23 +/- 4.3% and 8 +/- 1.0% of the total body counts) in the adult with even greater accumulation in the liver (58 +/- 6.8%) and spleen (19 +/- 4.9%) of the newborn (p less than 0.001). The latter observation was likely due to the relatively increased size of the liver and spleen in the newborn compared to the adult. Hypoxia did not alter the site of platelet sequestration in adults or newborns. Our results suggest that the newborn has the same platelet survival as the adult and that acute, severe hypoxia significantly shortens the survival of platelets in both groups. Although the sites of sequestration are qualitatively the same in the newborn, there is greater sequestration in the liver and spleen when compared to the adult.

Animals↗
PubMed1988

Nigrostriatal dopaminergic activity is increased during exhaustive exercise stress in rats.

Exercise capacity is influenced by both increases and decreases in central dopaminergic activity. To investigate the effects of exercise stress on intracerebral dopamine metabolism, rats were run on a motor driven treadmill at 37 m/min for varying times up to exhaustion at 19.6 +/- 0.6 min. Dopamine, DOPAC, and HVA concentrations in striatum, brain stem, and hypothalamus increased towards exhaustion. 5-HIAA concentrations increased in striatum whereas norepinephrine concentrations decreased in hypothalamus. The results indicate that delayed increases in dopaminergic activity occurs during exercise. These, and other observations indicate that central dopaminergic activity modulates exercise performance.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1988

Lung clearance of 99mTc-DTPA in patients with acute lung injury and pulmonary edema.

Several acute and chronic conditions that alter the integrity of the pulmonary epithelium increased the rate of absorption or clearance into the circulation of small solutes deposited in the alveoli. Technetium 99m diethylenetriamine pentaacetic acid can be deposited in the lungs as a submicronic aerosol and its rate of clearance measured with a gamma camera or simple probe. This clearance technique is currently being used to evaluate patients who have developed pulmonary edema and also to detect those patients from a high risk group who are likely to develop adult respiratory distress syndrome (ARDS). Its role in the evaluation of patients with pulmonary edema is still under active investigation. It is clear that a single measurement in patients who smoke is not useful, but repeated measurements may provide important information. The lung clearance measurement is very sensitive to changes in epithelial integrity but is not specific for ARDS. It may be most useful in combination with other predictive tests or when the clearance rate is normal.

Capillary Permeability↗