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Biomedical subjects

H G Schuler

Publications and source records attributed to H G Schuler.

At least 19 recordsLinked to original sources

Low-dose remifentanil infusion does not impair natural killer cell function in healthy volunteers.

BACKGROUND: Mu opioid agonists suppress natural killer (NK) cell activity in animal models. Studies in human volunteers, however, have yielded conflicting results, with morphine suppressing and fentanyl increasing NK cell activity. This study evaluated the effect of a constant 8-h infusion of remifentanil on NK cell number and function in human volunteers. METHODS: After IRB approval and informed consent was obtained, 10 healthy volunteers underwent an 11 pm to 7 am infusion of saline, and at least 1 week later an infusion of 0.02-0.04 microg x kg(-1) min(-1) remifentanil. Blood was collected at 7 am for measurement of NK cell cytotoxicity using a (51)Cr release assay and measurement of NK cell number using fluorescent flow cytometry. RESULTS: Median and range of the total NK cell cytotoxicity (KU ml(-1)) was 745.0 (498.3-1483.6) on the control morning and 818.6 (238.5-1454.5) on the morning following the remifentanil infusion. Neither the number of NK cells ml(-1) (2.5 x 10(5) (1.4 x 10(5)-4.2 x 10(5)) vs 2.7 x 10(5) (1.1 x 10(5)-4.4 x 10(5))) nor the cytotoxicity per 1000 NK cells (KU 1000 NK cells(-1)) (3.0 (1.8-5.2) vs 2.9 (0.9-6.7)) changed between the control and remifentanil conditions. CONCLUSIONS: An 8-h infusion of remifentanil did not affect NK cell activity in normal volunteers. This result differs from previous findings of morphine-induced NK cell activity suppression and fentanyl-induced NK cell activity enhancement in normal volunteers.

Adult↗

Halothane constricts bovine pulmonary arteries by release of intracellular calcium.

In the canine lung, when compared with the conscious state, halothane causes vasoconstriction that is independent of blood flow. However, traditionally inhalational anesthetics have been shown to attenuate hypoxic pulmonary vasoconstriction and have therefore been considered pulmonary vasodilators. We have shown, in isolated bovine pulmonary artery, that halothane produces a transient contractile response. A variety of smooth muscle cellular mechanisms could be responsible for the vasoconstriction produced by halothane. The purpose of this study was to test the hypothesis that the halothane-induced contraction was caused by the release of sarcoplasmic reticular Ca++. Isometric tension was measured in isolated rings of bovine pulmonary artery with intact endothelium. Three protocols were followed. Rings were exposed to cyclopiazonic acid or ryanodine (modulators of sarcoplasmic reticular Ca++) (protocol 1), caffeine (protocol 2) verapamil or nicardipine (protocol 3). Halothane-induced contraction was measured before, during and after exposure to drug. In nominally Ca(++)-free buffer cyclopiazonic acid and ryanodine attenuated the halothane-induced contraction. Similar responses were seen with cyclopiazonic acid and ryanodine treatment when caffeine was substituted for halothane. The calcium channel blockers nicardipine and verapamil did not significantly alter the halothane-induced contraction. Our data in bovine pulmonary artery segments are consistent with halothane effects seen in vascular smooth muscle from several other tissues and species. The results of our experiments support the conclusion that the release of intracellular Ca++ from sarcoplasmic reticular stores is responsible for the halothane-induced vasoconstriction that has been observed in this tissue.

Anesthetics, Inhalation↗

Comparison of the alteration of cardiac function by sevoflurane, isoflurane, and halothane in the isolated working rat heart.

OBJECTIVES: Despite its widespread use, little is known about sevoflurane's physiologic effects. The direct myocardial effects of sevoflurane were compared with both halothane and isoflurane. DESIGN: Administration of minimum alveolar concentration (MAC) fractions of anesthetic (0 to 3.0) was systematically varied to decrease the possibility of time-related effects on measured parameters. SETTING: Isolated rat hearts were perfused using a working heart model where the parameters affecting myocardial work were carefully controlled and monitored. PARTICIPANTS: To avoid confounding effects of prior anesthetic administration, hearts were removed from rats, after decapitation, in the absence of anesthetic. INTERVENTIONS: In the first series, isolated perfused rat hearts were exposed to one of the three anesthetics in doses of 0 to 1.5 times MAC. In the second series, hearts were exposed to either sevoflurane or isoflurane in doses of 0 to 3.0 times MAC. The following variables were measured: the rate of change of left ventricular pressure; aortic flow rate; cardiac output; left ventricular end-diastolic pressure; the time constant of isovolumetric relaxation; and coronary vascular resistance. Oxygen consumption was measured during the first series. MEASUREMENTS AND MAIN RESULTS: In the first series, all systolic variables were reduced in the presence of halothane when compared with either isoflurane or sevoflurane. Halothane affected diastolic function to a greater degree than either sevoflurane or isoflurane, as measured by the rate of relaxation and end-diastolic pressure. In the second series, at a dose of 3.0 times MAC, both sevoflurane and isoflurane decreased systolic and diastolic function, with a greater reduction in cardiac output, and peak aortic flow and higher left ventricular end-diastolic pressures observed with isoflurane. Coronary resistance and oxygen consumption were not affected by any of the anesthetics. CONCLUSIONS: These data suggest that sevoflurane depresses cardiac function less than either halothane in doses of 1.0 and 1.5 x MAC or isoflurane at doses of 3 x MAC.

Anesthetics, Inhalation↗

Potassium channel blockade and halothane vasodilation in conducting and resistance coronary arteries.

On the basis of reports that volatile anesthetics, such as halothane, open membrane potassium channels in several tissues, it was investigated whether coronary vasodilation by halothane is mediated by a similar mechanism. The ability of glyburide, a blocker of ATP-sensitive K+ (KATP) channels, and tetraethylammonium (TEA+), a blocker of Ca(2+)-activated K+ channels, to modify halothane-induced vasodilation was assessed in two vascular preparations. First, coronary resistance vessel tone was measured in isolated rat hearts arrested with tetrodotoxin and, second, conducting vessel responsiveness was evaluated in ring segments of the porcine epicardial coronary artery contracted with prostaglandin F2 alpha. Halothane alone markedly vasodilated the perfused hearts and attenuated the agonist contraction of the coronary rings. Blockade of KATP channels with glyburide alone did not affect the base-line vascular tone or responsiveness but it inhibited cromakalim vasodilation. TEA+ alone caused vasoconstriction. In hearts perfused at constant pressure, glyburide significantly attenuated the halothane-induced increase in coronary flow by 56% and perfusion with a high K+ buffer reduced the halothane-induced vasodilation response by 94%. In endothelium-denuded coronary rings, glyburide did not affect halothane-induced relaxation but KATP channel blockade potentiated halothane-caused relaxation in endothelium-intact rings. The attenuation of halothane-induced vasodilation by TEA+ seen in the perfused hearts did not achieve statistical significance and no halothane/TEA+ interaction was evident in the coronary rings. Thus, the data from the perfused heart experiments suggest that halothane relaxes rat coronary resistance vessels, in part, by opening K+ channels.

Animals↗

Transvalvular left ventricular pressure measurement in the isolated working rat heart.

A method of continuously measuring left ventricular (LV) pressure in an isolated buffer-perfused working rat heart is described. Transvalvular placement of a micromanometer through the aorta is the unique feature of this procedure. Advantages include catheter stability and lack of myocardial trauma. Changes in cardiac function were quantified by exposing hearts to either isoproterenol (10(-9) M) or halothane (1.5% vol/vol). To examine if any obstruction to LV outflow was caused by the micromanometer, cardiac performance was assessed during pullback from the ventricle to the aorta. Complications such as aortic insufficiency and ventricular arrhythmias were also studied. The results indicate that the transvalvular placement of a micromanometer can provide continuous, high-fidelity reproduction of LV pressure in this small-organ preparation. The presence of the micromanometer did not significantly alter cardiac performance, and proper catheter placement was achieved easily in a high percentage (> 90%) of cases.

Animals↗

Direct vasodilation by sevoflurane, isoflurane, and halothane alters coronary flow reserve in the isolated rat heart.

Direct vasodilation of coronary resistance vessels by anesthetics may reduce coronary flow reserve and interfere with myocardial flow-metabolism coupling. This study was performed to evaluate the potential for the halogenated anesthetic agents sevoflurane, isoflurane, and halothane to alter the regulation of coronary flow via a direct action on coronary resistance vessels. Coronary flow and flow reserve were measured in the quiescent isolated perfused rat heart at anesthetic concentrations between 0 and 3 x MAC. In order to minimize anesthetic-induced secondary changes in coronary resistance, constant coronary perfusion pressure was maintained; the left ventricular cavity was vented; and tetrodotoxin was used to achieve cardiac arrest. These conditions permitted the dissociation of direct anesthetic actions from indirect regulatory processes affecting coronary vascular resistance (CVR). Coronary flow reserve was defined as the difference between coronary flow prior to and during administration of a maximally vasodilating dose of adenosine. Each anesthetic significantly reduced the magnitude of both CVR and coronary flow reserve in a concentration-dependent manner. Sevoflurane reduced coronary flow reserve significantly less than did halothane and isoflurane. At high concentrations (3.0 x MAC), coronary flow reserve was abolished by halothane and was decreased to near zero by isoflurane; however, flow reserve was reduced only 48% from control by sevoflurane. This difference among anesthetics is explained primarily by variations in the magnitude of direct coronary vasodilation produced by each anesthetic, rather than by effects on maximal vasodilator capacity. These data show that sevoflurane's intrinsic vasodilator action on coronary resistance vessels differs substantially from that of halothane and isoflurane.

Adenosine↗

Vascular responses to dopamine and dobutamine in the awake calf during constant aortic flow or constant aortic pressure.

We investigated vascular effects of dopamine and dobutamine infusions in awake calves implanted with the Penn State total artificial heart (TAH). This preparation uniquely permits independent servo-control of cardiac output (CO) and arterial blood pressure (BP). Thirty-two studies (22 with dopamine and 10 with dobutamine) were performed in four juvenile calves from 1 to 4 months after TAH implantation. Studies were performed in one of two TAH operating conditions: (a) constant aortic flow, in which the CO is fixed and aortic BP varies with systemic vascular resistance (SVR), or (b) constant pressure, in which the CO varies to maintain a constant BP when SVR changes. During both constant flow and constant pressure studies, dopamine caused a dose-dependent increase and dobutamine caused a dose-dependent decrease in SVR. There was no difference in the SVR response between constant flow or constant pressure conditions at any dose of dopamine or dobutamine (p greater than 0.05). The infusion doses of dopamine required to raise the SVR 20 and 50% during constant flow studies were 7.2 and 12.4 micrograms.kg-1.min-1, respectively. In constant pressure studies, these doses were 7.7 and 13.5 micrograms.kg-1.min-1. The infusion dose of dobutamine resulting in a 20% reduction in SVR was 27.2 micrograms.kg-1.min-1 in constant flow studies 26.2 micrograms.kg-1.min-1 in constant pressure studies. These data suggest that baroreflex and other indirect mechanisms are less important than direct vascular drug effects in this system.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Direct effects of myocardial depressant drugs on coronary vascular tone: anesthetic vasodilation by halothane and isoflurane.

Because certain vasoactive drugs also possess negative myocardial inotropic properties, it is difficult to determine their direct pharmacological actions on coronary resistance vessels in situ. Thus, a drug's myocardial effects may induce indirect physiological changes in coronary vascular tone that confound measuring its direct action. To separate the direct from indirect drug actions on vascular tone, the authors describe an experimental system utilizing the isolated perfused rat heart arrested with tetrodotoxin. The direct effects of the volatile anesthetics halothane and isoflurane on coronary vascular tone were examined in this preparation, using the concept of minimum alveolar concentration as the measure of potency. Both anesthetics demonstrated a dose-dependent direct coronary vasodilation that was reversible, with the median effective dose being 1.31 +/- 0.08 (mean +/- S.E.) for halothane, and 1.53 +/- 0.12 for isoflurane (P = 0.06; units of measure are the fraction of minimum alveolar concentration for each anesthetic). Further studies indicated that maximal vasodilation by adenosine was diminished after 90 min of perfusion, independent of anesthetic administration. Myocardial oxygen consumption was decreased significantly from the beating state by arrest, but neither anesthetic nor adenosine affected myocardial oxygen consumption further. These data indicate that halothane and isoflurane are equipotent for inducing direct dilation of coronary resistance vessels in the isolated perfused arrested rat heart.

Adenosine↗

Halothane induces depressor responses to noxious stimuli in the rat.

The effect of halothane on hemodynamic responses to noxious stimuli was investigated in anesthetized male Sprague-Dawley rats. It was found that increasing the end-tidal halothane concentration from sub-MAC to supra-MAC levels was frequently associated with a reversal of the mean arterial pressure response to a noxious stimulus from a pressor response to depressor response. The depressor responses could be produced by noxious stimuli at several sites but were of greatest frequency (100%) and magnitude (up to -80 mmHg) after clamp application at the base of the tail. The depressor responses were often, but not always, accompanied by decreases in heart rate. The correlation coefficient between the changes in heart rate and the changes in mean arterial pressure caused by noxious stimuli was +0.61 (n = 9). The authors further characterized the depressor responses in an additional 18 rats. The depressor responses were not influenced by vagotomy or muscarinic cholinergic blockade and were associated with concurrent decreases in both cardiac output and systemic vascular resistance. The hemodynamic changes associated with the depressor responses were consistent with a centrally mediated withdrawal of sympathetic tone. Knowledge of this effect of halothane on the arterial blood pressure and heart rate responses to noxious stimuli may be important for correctly interpreting animal responses to noxious stimuli in the presence of general anesthetic agents, particularly because animals are frequently used to characterize both the potency and the hemodynamic effects of anesthetic agents. The presence of depressor responses also indicates that mean arterial pressure responses to noxious stimuli cannot be used as a linear index of anesthetic depth in rats anesthetized with halothane.

Anesthesia, General↗

The effect of neuromuscular blockade with vecuronium on hemodynamic responses to noxious stimuli in the rat.

The effect of neuromuscular blockade with vecuronium on the hemodynamic responses to a noxious stimulus was investigated in male Sprague-Dawley rats. The rats were anesthetized with either halothane (group 1, n = 10), or isoflurane (group 2, n = 10). The maximum values for heart rate and mean arterial pressure during the noxious stimulus (base-tail clamp) were measured, and the maximum changes in these values (maximum minus prestimulation) were calculated. The responses were measured at two different anesthetic concentrations (0.6 X MAC, 0.75 X MAC), before and after vecuronium 1.0 mg.kg-1 iv. It was found that neuromuscular blockade with vecuronium did not reduce any of the hemodynamic responses measured, at either anesthetic concentration, in either the halothane or the isoflurane group. However, increasing the anesthetic concentration from 0.6 X MAC to 0.75 X MAC produced statistically significant (P less than 0.01) reductions in several of the responses measured. The inability of vecuronium to reduce hemodynamic responses to noxious stimuli in this study suggests that neuromuscular blockade does not alter anesthetic depth in the rat. A knowledge of this "absence of effect" may be important for investigators who need to induce muscle relaxation in laboratory animals prior to examining the effect of anesthetic agents on hemodynamic responses to noxious stimuli. The results also question the ability of neuromuscular blockade to reduce anesthetic requirement, and support the view that neuromuscular blockade does not contribute to the anesthetic state.

Anesthesia, Inhalation↗

Palmitate oxidation by isolated working fetal and newborn pig hearts.

Palmitate oxidation and the effect of palmitate on glucose and lactate utilization were investigated in isolated, perfused, fetal (0.9 gestation), and neonatal (2 day old) pig hearts. Hearts were perfused under working conditions, developing a mean aortic pressure of 50-55 mmHg, paced at 180 beats/min for 30 min, with Krebs-Henseleit buffer containing 3% albumin, glucose (5 mM), and insulin (100 microU/ml). Palmitate (1 mM) and lactate (5 mM), either individually or in combination, were added to the perfusion buffer. Palmitate oxidation was assessed from 14CO2 production from [U-14C]-palmitate, glucose uptake as 3H2O production from D-[2-3H]-glucose, and lactate metabolism from changes in buffer lactate content. After perfusion, ATP, creatine phosphate, triglycerides, and glycogen were measured. Substantial palmitate oxidation was observed at both ages but was greater in neonatal hearts. Nevertheless, palmitate inhibited lactate utilization and glucose uptake similarly in fetal and neonatal hearts. Lactate also reduced palmitate uptake and oxidation by 40-60% in both fetal and neonatal hearts. During perfusions with palmitate, tissue concentrations of triglycerides increased approximately threefold in fetal hearts and were unaffected by lactate. Thus both palmitate and lactate can act as major energy substrates for the immature heart. Both substrates significantly (P less than 0.01) suppress glucose utilization, and each has suppressive effects on the other's metabolism.

Adenosine Triphosphate↗

Mechanisms of differential growth of heart ventricles in newborn pigs.

The left ventricular free wall (LVFW) grew approximately three times faster than the right ventricular free wall (RVFW) during the first 10 days of life in neonatal pigs. Faster growth was associated with proportional increases in total RNA and messenger RNA. These findings indicated that greater capacity for protein synthesis was a major factor in accelerated growth. Despite faster growth, heart content of ribosomal subunits was higher in piglets than in 60-day-old pigs or adult rats, suggesting a relatively slower rate of peptide chain initiation than elongation. When hearts from 5-day-old pigs were perfused in vitro, protein synthesis was more rapid in the LVFW than in the RVFW. In the absence of added insulin, the higher rate was due to both greater efficiency and greater capacity for protein synthesis. In the presence of the hormone, greater capacity was responsible for the increased rate of protein synthesis in the LVFW as compared with the RVFW.

Animals↗

Mass spectrometry for monitoring respiratory and anesthetic gas waveforms in rats.

A method is presented for real-time monitoring of airway gas concentration waveforms in rats and other small animals. Gas is drawn from the tracheal tube, analyzed by a mass spectrometer, and presented as concentration vs. time waveforms simultaneously for CO2, halothane, and other respiratory gases and anesthetics. By use of a respiratory simulation device, the accuracy of mass spectrometric end-tidal CO2 analysis was compared with both the actual gas composition and infrared spectrophotometry. The effects of various ventilator rates and inspiration-to-expiration ratios on sampling accuracy were also examined. The technique was validated in male Sprague-Dawley rats being ventilated mechanically. The difference between the arterial PCO2 (PaCO2) and the end-tidal PCO2 (PETCO2) was not significantly different from zero, and the correlation between PETCO2 and PaCO2 was strong (r = 0.97, P less than 0.0001). Continuous gas sampling for periods up to 5 min did not affect PaCO2, PETCO2, or airway pressures. By use of this new method for measuring end-tidal halothane concentrations in rats approximately 6.5 mo of age, the minimum alveolar concentration of halothane that prevented reflex movement in response to tail clamping was 0.97 +/- 0.04% atmospheric (n = 14). This mass spectrometric technique can be used in small laboratory animals, such as rats, weighing as little as 250 g. Gas monitoring did not distort either PETCO2 or PaCO2. Under the defined conditions of this study, accurate and simultaneous measurements of phasic respiratory concentrations of anesthetic and respiratory gases can be achieved.

Anesthetics↗

Halothane selectively attenuates alpha 2-adrenoceptor mediated vasoconstriction, in vivo and in vitro.

The mechanism by which halothane interferes with catecholamine-induced vasoconstriction was examined, utilizing specific agonists at postjunctional alpha 1- and alpha 2-adrenoceptors on vascular smooth muscle. Stimulation of either adrenoceptor subtype normally produces vasoconstriction. Two experimental models of drug-induced vasoconstriction were used: in vivo blood pressure response in pithed rats, and in vitro isometric tension development in canine saphenous vein rings. These models were then utilized to examine the anti-vasoconstriction properties of halothane. In vivo, halothane (1 MAC) produced a significant depression in the vascular response to azepexole (an alpha 2-adrenoceptor agonist), but halothane did not alter vasoconstriction by phenylephrine (an alpha 1-adrenoceptor agonist). Halothane caused a 24% reduction of maximal response (P less than 0.0001) to azepexole in pithed rats, and a 3.2-fold rightward shift of the log dose-response curve (P less than 0.0001). Similarly, in vitro, halothane significantly attenuated alpha 2- but not alpha 1-adrenoceptor responsiveness. Halothane (4%) depressed maximal vein contraction to azepexole by 26% (P less than 0.0001), and shifted the log concentration-response curve 2.4-fold to the right (P less than 0.0001). The observed selective interference with alpha 2-mediated vasoconstriction by halothane is unlikely to represent drug antagonism at the receptor level. Our observations may suggest, indirectly, that halothane interferes with Ca+2 entry into vascular smooth muscle. The phenomenon of selective anti-vasoconstriction at alpha 2-adrenoceptors by halothane may explain why alpha 1-adrenergic agonists often appear to retain their vasopressor activity during halothane anesthesia. The mechanism of halothane-induced vasodilation thus includes attenuation of alpha 2- but not alpha 1-adrenergic vasoconstriction; this further demonstrates the multifactorial nature of halothane-induced vasodilation.

Adrenergic alpha-Agonists↗

Cardiac dysfunction during status epilepticus in the neonatal pig.

Cardiovascular complications frequently occur during status epilepticus. To determine the changes in systemic and pulmonary arterial pressure, cardi output, and left ventricular contractility during seizures, 1-week-old pigs were intubated, paralyzed, mechanicall entilated, and catheterized with a Swan-Ganz catheter. Seizures were induced with intravenous bicuculline. Early changes consisted of significant systemic and pulmonary arterial hypertension. After 2 hours of seizures, the animals developed progressive systemic hypotension and decreased cardiac output. M-mode echocardiography disclosed a decrease in left ventricular contractility. Cardiac tissue frozen in situ showed a significant increase in lactate and reductions in glucose, triglyceride, and adenosine triphosphate levels. Prolonged seizures in the neonatal pig result in cardiac dysfunction, which may play a role in the development of epileptic brain damage.

Acid-Base Equilibrium↗

Acute myocardial effects of chloramphenicol in newborn pigs: a possible insight into the gray baby syndrome.

Mechanical function and mitochondrial respiration were observed in newborn pig hearts in the presence of chloramphenicol. Isolated perfused hearts exposed to chloramphenicol (25, 50, or 100 micrograms/ml) demonstrated acute reductions in pressure development and cardiac output accompanied by elevated left atrial filling pressure. The effects of chloramphenicol and chloramphenicol succinate (25, 50, 100, or 200 micrograms/ml) on oxidative activity of isolated mitochondria were also investigated. With unesterified chloramphenicol, inhibition of state 3 respiration was most apparent when glutamate and palmitylcarnitine were supplied as substrates. Inhibition of mitochondrial oxidation of succinate or glutamate was only detectable at 200 micrograms/ml. Inhibition of alpha-ketoglutarate oxidation was not seen at any concentration of antibiotic studied. Chloramphenicol succinate most strongly inhibited state 3 oxidation of succinate and alpha-ketoglutarate and had relatively mild effects on oxidation of glutamate and palmitylcarnitine. Succinate oxidation by submitochondrial particles was unaffected by chloramphenicol succinate, a result suggesting interference with succinate transport.

Animals↗