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Biomedical subjects

J T Reeves

Publications and source records attributed to J T Reeves.

At least 73 records · Page 4Linked to original sources

Plasma changes in beta-endorphin to acute hypobaric hypoxia and high intensity exercise.

The purpose of this study was to examine the immediate post-exercise effects of acute exposure to a simulated altitude of 4,300 m on plasma concentrations of beta-endorphin (beta-EP) and associated changes of adrenocorticotropin (ACTH), and cortisol to high intensity cycle exercise (i.e., stages of 90 and 100% peak Vo2). Exercise intensities were assigned relative to peak O2 uptake both under sea level conditions and under acute hypobaric hypoxic conditions. Plasma beta-EP concentrations significantly increased from pre- to immediately post-exercise at both 90 and 100% peak Vo2 in both the sea level and acute hypobaric hypoxic trials. No associated exercise-induced changes were observed for ACTH or cortisol pre- to immediately post-exercise at either sea level or during hypoxic conditions. Exercise at acute hypobaric hypoxia elicited no significantly different responses in plasma beta-EP, ACTH, or cortisol than those elicited by the same relative exercise intensities under normobaric normoxic conditions. Additionally, no changes in the beta-EP/ACTH molar ratio for exercise or between conditions were observed. These data indicate that acute simulated high altitude exposure neither diminishes nor augments the physiological stimuli involved with high relative exercise intensity activation mechanisms of these hormones.

Adaptation, Physiological↗

Greater maximal O2 uptakes and vital capacities in Tibetan than Han residents of Lhasa.

Maximal O2 uptake provides an index of the integrated functioning of the O2 transport system. Whether lifelong high altitude residents have greater maximal exercise capacities than acclimatized newcomers is of interest for determining whether years to generations of high altitude exposure influence maximal O2 uptake and, if so, what components of O2 transport are involved. We studied 16 Tibetan lifelong residents of Lhasa, Tibet, China (3658 m) and 20 Han ("Chinese") 8 +/- 1 year residents of the same altitude who were matched for age, height, weight and lack of exercise training. At maximal effort, the Tibetans compared to the Hans had greater O2 uptakes (51 +/- 1 vs 46 +/- 1 ml STPD.min-1.(kg bw)-1, P less than 0.05), exercise workloads (177 +/- 5 vs 155 +/- 6 watts, P less than 0.05), minute ventilations (149 +/- 6 vs 126 +/- 4 IBTPS/min, P less than 0.01) and O2 pulse (15.2 +/- 0.4 vs 13.3 +/- 0.5 ml O2 consumption/heart beat, P less than 0.05). Equally high heart rates were present at maximal effort (191 +/- 3 vs 187 +/- 3 beats/min, P = NS), supporting the likelihood that true maxima were achieved in both groups. The greater minute ventilation in the Tibetans resulted from greater tidal volume and the greater maximal tidal volume correlated positively with the resting vital capacity. We concluded that the Tibetans achieved a higher maximal O2 uptake than the Hans, implying an increased capacity for O2 transport to the working muscle.

Acclimatization↗

Spontaneous hypoxaemia and right ventricular hypertrophy in fast growing broiler chickens reared at sea level.

1. At 6 weeks of age, the time of most rapid body growth, fast growing broiler chickens showed more right ventricular hypertrophy than slower growing chickens. 2. The degree of right ventricular hypertrophy was directly related to blood haematocrit and indirectly related to arterial oxygen saturation (estimated in the chickens using an ear oximeter designed for man). 3. When oxygen saturation was estimated sequentially from 6 to 17 weeks of age, mean oxygenation improved with age, partly due to the death of the chickens with the worst saturations, but also because of an improvement in oxygenation of the survivors.

Altitude↗

Decreased ventilation and hypoxic ventilatory responsiveness are not reversed by naloxone in Lhasa residents with chronic mountain sickness.

Persons with chronic mountain sickness (CMS) hypoventilate and are more hypoxemic than normal individuals, but the cause of the hypoventilation is unclear. Studies of 14 patients with CMS and 11 healthy age-matched control subjects residing in Lhasa, Tibet, China (3,658 m) were conducted to test the hypothesis that hypoventilation, blunted hypoxic ventilatory responsiveness (HVR), and hypoxic ventilatory depression of CMS were due to increased endogenous opioid production. Patients with CMS compared with control subjects exhibited hypoventilation (end-tidal carbon dioxide pressure [PETCO2] = 36.6 +/- 1.0 versus 31.5 +/- 0.5 mm Hg, p less than 0.05), lower tidal volume (VT = 0.54 +/- 0.02 versus 0.61 +/- 0.02 ml BTPS, p less than 0.05), blunted HVR (shape parameter A = 17 +/- 8 versus 114 +/- 22 mm Hg/L BTPS/min, p less than 0.05), and a depressant effect of ambient hypoxia on ventilation (delta PETCO2 with acute hyperoxia = -3.5 +/- 0.5 versus -1.0 +/- 0.6 mm Hg, p less than 0.05). Reduced forced expiratory volume in 1 s to vital capacity ratios (FEV1/VC) and a higher proportion of cigarette smokers in the group of patients with CMS compared with control subjects suggested that at least some patients with CMS had mild airway obstructive lung disease. Naloxone infusion (0.14 mg/kg) to six patients with CMS did not change resting VT, PETCO2, HVR, or SaO2.(ABSTRACT TRUNCATED AT 250 WORDS)

Altitude Sickness↗

Growth factors for human fibroblasts in the solute remaining after clot formation.

Fibroblasts adhere to, and readily grow into, fibrin clots that form as a result of the cleavage of fibrinogen by thrombin. Subsequent fibroblast replication is believed to be stimulated by mitogens released by entrapped platelets, such as platelet-derived growth factor. We suggest that the supernatant remaining after the fibrinogen-thrombin reaction could stimulate fibroblast replication, even in the absence of other blood components. To examine this hypothesis we expressed liquid from a fibrin clot and measured its mitogenic activity on human lung fibroblasts, in serum-free conditions, using a colorimetric assay based on uptake and subsequent release of Methylene Blue. The clot supernatant caused a mitogenic response of 51 +/- 6% above control and was equivalent to about half that elicited by medium containing 10% newborn calf serum. On their own, both thrombin and fibrinopeptides A and B (small molecular weight cleavage products released from fibrinogen) showed some mitogenic activity, but there was also activity in higher molecular weight cleavage products, suggesting the presence of uncharacterized mitogens. It is proposed that these agents may play important roles in wound healing and diseases associated with vascular leakage and fibrosis, by stimulating fibroblast replication.

Blood Coagulation↗

Insulin-like growth factor (IGF)-I and IGF-binding activity in normal and fast-growing chickens.

Insulin-like growth factor(IGF)-binding activity were characterized in sera normal, fast growing, and very fast growing chicken strains. In contrast to a previous report, specific IGF-binding activity was observed in this nonmammalian species. Age-related IGF-binding activity levels did not differ between strains. IGF-I levels were significantly higher for the normal as compared to the 2 fast growing strains. Chromatographic studies show that IGF-I is associated with acid-dissociable high MW complexes in chicken serum, and the MW patterns are similar to human serum. Circulating levels of IGF-I or IGF-binding activity do not account for accelerated somatic growth in inbred large-bodied chicken strains.

Aging↗

Venous occlusion plethysmography reduces arterial diameter and flow velocity.

The measurement of peripheral blood flow by plethysmography assumes that the cuff pressure required for venous occlusion does not decrease arterial inflow. However, studies in five normal subjects suggested that calf blood flow measured with a plethysmograph was less than arterial inflow calculated from Doppler velocity measurements. We hypothesized that the pressure required for venous occlusion may have decreased arterial velocity. Further studies revealed that systolic diameter of the superficial femoral artery under a thigh cuff decreased from 7.7 +/- 0.4 to 5.6 +/- 0.7 mm (P less than 0.05) when the inflation pressure was increased from 0 to 40 mmHg. Cuff inflation to 40 mmHg also reduced mean velocity 38% in the common femoral artery and 47% in the popliteal artery. Inflation of a cuff on the arm reduced mean velocity in the radial artery 22% at 20 mmHg, 26% at 40 mmHg, and 33% at 60 mmHg. We conclude that inflation of a cuff on an extremity to low pressures for venous occlusion also caused a reduction in arterial diameter and flow velocity.

Adult↗

Operation Everest II: maximal oxygen uptake at extreme altitude.

Chronic exposure to high altitude reduces maximal O2 uptake (VO2max). At extreme altitudes approaching the summit of Mt. Everest [inspiratory PO2(PIO2) = 43 Torr], mean VO2max have been determined to be 15.3 ml.kg-1.min-1 in two subjects who breathed 14% O2 at 6,300 m on Mt. Everest (West et al., J. Appl. Physiol. 54: 1188-1194, 1983). To provide a more complete description of performance near the limits of human tolerance to chronic hypoxia, we measured VO2max in volunteers in an altitude chamber before, during, and after a 40-day decompression to a barometric pressure (PB) of 240 Torr (PIO2 = 43 Torr). In five of eight subjects studied at sea level and PB of 464, 347, 289, and 240 Torr, VO2max was reduced from 4.13 to 1.17 l/min (49.1-15.3 ml.kg-1.min-1) in agreement with the prior study. Although the range decreased, the rank order among the subjects was preserved. Arterial O2 saturation at maximum effort decreased (46% by ear oximetry), but minute ventilation, respiratory frequency, and tidal volume did not. The highest minute ventilation (201 l/min BTPS) was observed at PB of 464 Torr. Arterial PCO2 in three subjects at PB of 240 Torr, at rest, and with maximum effort, averaged 10.3 and 9.6 Torr, respectively. Sustained hyperventilation was crucial to exercise performance during chronic, severe hypoxemia. VO2max was lower after altitude exposure compared with initial sea level values, indicating that exposure had not improved sea level exercise capacity.

Adult↗

Increased exercise SaO2 independent of ventilatory acclimatization at 4,300 m.

Arterial O2 saturation (Sao2) decreases in hypoxia in the transition from rest to moderate exercise, but it is unknown whether other several weeks at high altitude SaO2 in submaximal exercise follows the same time course and pattern as that of ventilatory acclimatization in resting subjects. Ventilatory acclimatization is essentially complete after approximately 1 wk at 4,300 m, such that improvement in submaximal exercise SaO2 would then require other mechanisms. On days 2, 8, and 22 on Pikes Peak (4,300 m), 6 male subjects performed prolonged steady-state cycle exercise at 79% maximal O2 uptake (VO2 max). Resting SaO2 rose from day 1 (78.4 +/- 1.6%) to day 8 (87.5 +/- 1.4%) and then did not increase further by day 20 (86.4 +/- 0.6%). During exercise, SaO2 values (mean of 5-, 15-, and 30-min measurements) were 72.7% (day 2), 78.6% (day 8), and 82.3% (day 22), meaning that all of the increase in resting SaO2 occurred from day 1 to day 8, but exercise SaO2 increased from day 2 to day 8 (5.9%) and then increased further from day 8 to day 22 (3.7%). On day 22, the exercise SaO2 was higher than on day 8 despite an unchanged ventilation and O2 consumption. The increased exercise SaO2 was accompanied by decreased CO2 production. The mechanisms responsible for the increased exercise SaO2 require further investigation.

Acclimatization↗

Decreased exercise muscle lactate release after high altitude acclimatization.

Blood lactate concentration during exercise decreases after acclimatization to high altitude, but it is not clear whether there is decreased lactate release from the exercising muscle or if other mechanisms are involved. We measured iliac venous and femoral arterial lactate concentrations and iliac venous blood flow during cycle exercise before and after acclimatization to 4,300 m. During hypoxia, at a given O2 consumption the venous and arterial lactate concentrations, the venous and arterial concentration differences, and the net lactate release were lower after acclimatization than during acute altitude exposure. While breathing O2-enriched air after acclimatization at a given O2 consumption the venous and arterial lactate concentrations and the venous and arterial concentration differences were significantly lower, and the net lactate release tended to be lower than while breathing ambient air at sea level before acclimatization. We conclude that the lower lactate concentration in venous and arterial blood during exercise after altitude acclimatization reflected less net release of lactate by the exercising muscles, and that this likely resulted from the acclimatization process itself rather than the hypoxia per se.

Acclimatization↗

The relationship between rapid growth and pulmonary hemodynamics in the fast-growing broiler chicken.

Very fast-growing (VFG) broiler chickens tend to have marked right ventricular hypertrophy when compared with slower growing chickens. We hypothesized that, in the setting of rapid growth, a hypoxic stimulus would cause greater pulmonary hypertension and right ventricular hypertrophy (RVH). We have studied the relationship between artial oxygenation (SaO2), RVH, and pulmonary artery pressure (Ppa) in 28 awake VFG chickens. We found that the hypoxemic chickens had pulmonary hypertension and that the Ppa was linearly related to the SaO2. The relationship between Ppa and RVH, however, was best described by a broken line (p less than 0.05). Thus, at higher pressures, the RVH seemed excessive for a given Ppa. We have also studied the effects of reducing FIO2 on Ppa, systemic pressure, cardiac output, and calculated total pulmonary resistance (TPR) in lightly anesthetized fast-growing and normal chickens. We found that normal chickens and fast growers had similar TPR in room air, but that the fast growers had a greater increase in TPR than did the normal chickens in response to hypoxia (p less than 0.05). Finally, we placed 2-wk-old normal and VFG chicks in a hypobaric chamber set at "10,000 feet" for 2 wk and found that the VFG but not the normal chickens developed marked RVH in response to the hypoxia. However, the RVH in the fast-growing chickens could be prevented by restricting their diet, and hence their growth. We conclude that hypoxemia probably caused the pulmonary hypertension and RVH in the fast-growing chickens, but that the rapid growth appeared to act as an important amplifier of this response.

Air Pressure↗

Effects of propranolol on acute mountain sickness (AMS) and well-being at 4,300 meters of altitude.

A number of physiological responses and adjustments occur at high altitude to compensate for hypoxia. We hypothesized that interference with one component of the normal compensatory process, the sympathetic nervous system, would hinder altitude acclimatization and thereby exacerbate acute mountain sickness (AMS) and compromise well-being. Twelve young males (21.2 +/- 0.4 years) received either 80 mg propranolol (PRO; n = 6) or placebo (PLA; n = 6), t.i.d. at sea level (SL) and during the first 15 d of a 19-d residence at 4,300 m (HA). Individuals were randomly assigned to each group. The Environmental Symptoms Questionnaire (ESQ) was administered at SL and twice daily (AM and PM) during the entire altitude exposure in order to assess AMS symptoms and subjective feelings of well-being. Supine heart rate (HR) was determined at rest twice at SL and four times at HA. HR in the PLA group increased 40% over SL values (57 +/- 3 to 80 +/- 4 beats/min) by day 7 at HA (p less than 0.01). HR in the PRO group did not increase above SL values during medication at HA. By 4 d after the medication administration was terminated, HR in the PRO group had increased and did not differ from the PLA group. Throughout the entire altitude exposure, ESQ scores for the PRO group were lower than or similar to the PLA group. Furthermore, cessation of PRO treatment did not result in a change in well-being. These findings suggested that interference with the normal acclimatization process by beta-adrenergic blockade did not exacerbate AMS or reduce feelings of well-being.

Acute Disease↗

Propranolol and the compensatory circulatory responses to orthostasis at high altitude.

Tachycardia has been shown to be an important response involved in the maintenance of cardiac output during orthostasis at high altitude. This study was undertaken to determine if tachycardia, mediated by beta-adrenergic sympathetic stimulation, actually represents an essential response. Twelve young, healthy male subjects were administered either 80 mg propranolol (n = 6) or placebo (n = 6), t.i.d. at sea level and for 3 days (d) prior to and during the first 15 d of a 19-d altitude sojourn (On Treatment). Individuals were randomly assigned to each group. Upright tilt tests were performed at sea level and at high altitude during days 2, 7, and 15 On Treatment. Subjects were also tilt-tested at sea level and on day 19 of the altitude exposure without placebo or propranolol administration (Off Treatment). Heart rate, stroke volume, calf blood flow, and blood pressure were obtained during supine rest and after 12 min of 60 degrees tilt. We found no differences between groups in any of the circulatory measurements at sea level and altitude while Off Treatment. During the On Treatment phases at sea level and altitude, propranolol caused reductions in heart rate and blood pressure values in each position (p less than 0.05). Supine and upright cardiac output, however, were found not altered due to compensatory increases in stroke volume (p less than 0.05). We concluded that tachycardia, both at rest and during upright tilt at high altitude is important, but not essential to maintain cardiac output.

Adult↗

Early partial systolic closure of the pulmonic valve relates to severity of pulmonary hypertension.

Ultrasound studies in pulmonary hypertension often show systolic partial closure of the pulmonic valve and early peaking of Doppler pulmonary flow velocity, but these findings are poorly understood. Our initial observations of earlier systolic partial closure with higher pulmonary pressures suggested that this phenomenon might relate to pressure. In 30 patients with documented pulmonary hypertension, the timing of systolic partial closure and the corresponding decrease in Doppler flow velocity related inversely to pulmonary artery pressure at catheterization. Peak flow preceded the systolic velocity decrease and also related inversely to pressure. Since changing flow velocity might reflect a changing driving force across the valve, we examined simultaneous high-fidelity catheter pressure tracings from the right ventricle and pulmonary artery from 24 patients with and without pulmonary hypertension. In 30 studies, a positive right ventricular to pulmonary artery pressure gradient was present early in systole, but the gradient decreased to a minimum value in mid-to-late systole. The timing of this minimum also related inversely to pressure. We conjectured that forces opposing ejection occur earlier in pulmonary hypertension, thereby decreasing the forward driving force and allowing earlier partial systolic closure.

Adult↗

Usual clinical dose of acetazolamide does not alter cerebral blood flow velocity.

Prior reports indicate that acetazolamide, an inhibitor of carbonic anhydrase, in moderate doses reduces symptoms of acute mountain sickness, and in large doses increases cerebral blood flow. The effect on flow is not known for a moderate dose, but were flow to increase, then increased cerebral oxygen delivery would be one mechanism of benefit from acetazolamide at high altitude. We utilized Doppler ultrasound in 8 volunteers to determine whether a usual acetazolamide dose (250 mg three times daily) would increase flow velocities in internal carotid and vertebral arteries. Acetazolamide during normoxia decreased pHa, PaCO2, and PETCO2, but baseline flow velocity remained unchanged. In 2 subjects without acetazolamide, voluntary hyperventilation decreased both PETCO2 and flow velocity. Both hypoxia and hypercapnia caused increases in arterial velocities. The increases were not altered by acetazolamide administration. In one subject, 1 g acetazolamide by acute i.v. injection induced an increase in flow velocity (40%) concomitant with a 5 mm Hg decrease in PETCO2, confirming prior reports using similar intravenous dose. In doses employed for prevention of acute mountain sickness, acetazolamide induced metabolic acidosis and may have prevented the fall in velocity usually associated with hypocapnia, but it neither increased baseline cerebral blood flow velocity nor velocity responses to hypoxia and hypercapnia. Benefit of acetazolamide at high altitude may relate to mechanisms other than increased cerebral blood flow.

Acetazolamide↗

Determinants of the relation between systolic pressure and duration of isovolumic relaxation in the right ventricle.

Previous studies have suggested that right ventricular systolic pressure can be predicted from noninvasive estimates of the interval between pulmonary valve closure and tricuspid valve opening. To determine the basis for this relation, phonocardiograms and high fidelity right atrial and ventricular pressures were recorded in 29 patients with a right ventricular systolic pressure ranging from 20 to 149 mm Hg. In 22 patients with normal right atrial pressure (less than or equal to 8 mm Hg), both the time interval and the magnitude of pressure decrease from pulmonary valve closure to tricuspid valve opening were linearly related to systolic pressure (r = 0.89 and 0.96, respectively). Early pulmonary valve closure (decreased "hang-out" time) contributed to the greater magnitude of isovolumic pressure decrease at high systolic pressures, but correction for hang-out time did not eliminate the relation between systolic pressure and the pulmonary valve closure-tricuspid valve opening interval (n = 10). When patients with documented right coronary artery disease were excluded, the time constant for isovolumic pressure decrease also increased as a function of systolic pressure (r = 0.67, p less than 0.01, n = 24), suggesting impaired relaxation at high systolic pressures. However, the mean rate of pressure decrease (mean negative dP/dt) still was greater in patients with a high pressure because of the exponential nature of the isovolumic pressure-time relation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗