[Priorities in psychiatric care--a process based on arbitrary decisions of professionals?].
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Ethics, Medical↗
Biomedical subjects
M Axelsson
Publications and source records attributed to M Axelsson.
[Medical ethics. Social medicine and moral philosophy--an analysis of mandatory psychiatric care].
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Commitment of Persons with Psychiatric Disorders↗
Influence of heating rate in thermal expansion of dental phosphate-bonded investment material.
The thermal expansion of a phosphate-bonded investment material was tested when three heating rates were used during the heating procedure. One of them was too low, one too high, and the third, in the middle. The examination was done through the fit of 12 MOD inlays and 12 full crowns in steel master dies. From the results it can be concluded that rates that are too fast must be avoided in the heating procedure, because they reduce the thermal expansion of the phosphate-bonded investment material and thus produce castings with limited fit.
Crowns↗
Flow dynamics of the crocodilian heart.
We report for the first time the flow events corresponding to the pressure patterns in the left and right aorta (LAo and RAo) during the cardiac cycle in the caiman (Caiman crocodylus ssp). These experiments show a complex LAo flow pattern; an initial small anterograde flow in the early systole is reversed to a backflow at midsystole. At the end of systole there is again a small anterograde flow. This second flow pulse corresponds to a pressure peak ("foramen spike") in the LAo pressure trace. The observed pattern is compatible with the view that the foramen Panizzae is obstructed by the medial cusp of the RAo valve during part of the systole. LAo pressure remains normally above right ventricular pressure throughout the cardiac cycle and there is thus no contribution to LAo flow from the right ventricle. The net flow in the LAo normally equals the flow through the foramen Panizzae and is very small compared with the systemic flow in the RAo.
Alligators and Crocodiles↗
Cardiovascular regulation in the mudpuppy Necturus maculosus at rest and during short term exercise.
Prebranchial blood pressure (Pva), heart rate (fH) and plasma catecholamine concentration were measured in the mudpuppy Necturus maculosus at rest and during exercise. During exercise, both fH and Pva increased, as did the plasma noradrenaline concentration. There was no significant effect on Pva after injection of the adrenergic neuron blocker, bretylium, in resting animals, neither did bretylium affect the exercise-induced increase in Pva. This suggests that there is no adrenergic nervous tone on the vasculature at rest or during exercise. The alpha-adrenoceptor antagonist yohimbine had no effect on the resting Pva in the bretylium-treated animals, but it abolished the increase in Pva during exercise. This is compatible with the view of no influence on Pva by the plasma catecholamines at rest, while during exercise the increase in plasma noradrenaline concentration is responsible for the increase in Pva. Injection of atropine elevated resting fH, and reduced or abolished cardiac arrythmia, indicating an inhibitory cholinergic tone on the heart at rest, and that variations in this tone are responsible for the intrinsic variation seen in untreated animals. After the atropine treatment, there was still an increase in fH during exercise. The beta-adrenoceptor antagonist sotalol decreased fH in resting atropinized animals, and inhibited the exercise-induced tachycardia, implying that there is an additional beta-adrenoceptor-mediated adrenergic tone, affecting the heart both at rest and during exercise. The cholinergic tone decreased during exercise with a concomitant increase in adrenergic tone. Falck-Hillarp fluorescent histochemistry was used to study the presence of adrenergic nerve fibres and other catecholamine-storing cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Bombesin-like immunoreactivity and the effect of bombesin in the gut, circulatory system and lung of the caiman, Caiman crocodylus crocodylus, and the crocodile, Crocodylus porosus.
The presence of bombesin-like material in nerves and endocrine cells of the gastrointestinal canal, the circulatory system and the lung of the caiman, Caiman crocodylus crocodylus, has been investigated with immunohistochemistry (IHC) and radioimmunoassay (RIA). The effect of bombesin has been studied on the vascularly perfused lung and on isolated strip preparations of the gut wall of the caiman, and on the circulatory system in vivo in both the caiman and the crocodile, Crocodylus porosus. Bombesin-like immunoreactivity is present in water and acid extracts of the muscle layer and the mucosal layer of the gut. IHC demonstrated a dense network of nerve fibres in the sub-mucosa, circular muscle layer and myenteric plexus of the whole gut. A more sparse innervation by single fibres often following septal edges or small vessels is found in the lung. Systemic vessels are innervated by a loose plexus of small fibre bundles. The levels of immunoreactive material in the lung and heart were low. Bombesin is excitatory on strip preparations of the smooth muscle layers of the intestinal wall, and causes an increase in inflow resistance in the perfused lung. In vivo, bombesin increases the blood flow in the left aorta and the coeliac artery.
Alligators and Crocodiles↗
[The LSPV project--a study of involuntary commitment and voluntary treatment in 2 counties. A wholly negative picture of psychiatric hospitalization. Reforms are necessary after criticism expressed by both patients and relatives].
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Commitment of Persons with Psychiatric Disorders↗
The importance of nervous and humoral mechanisms in the control of cardiac performance in the Atlantic cod Gadus morhua at rest and during non-exhaustive exercise.
The nervous regulation of heart rate and stroke volume in the Atlantic cod Gadus morhua was investigated both in vivo, during rest and exercise, and in vitro. The cholinergic and adrenergic influences on the heart were estimated in experiments with injections of atropine and sotalol. At rest the cholinergic and adrenergic tonus on the heart were 38% and 21%, respectively (ratio 1.81:1). At the end of an exercise period, the cholinergic tonus had decreased to 15% but the adrenergic tonus had increased to 28% (ratio 0.54:1). The results suggest that variation of the cholinergic tonus on the heart is a major factor in the regulation of the heart rate. In one group of fish, cardiac output was also measured, allowing calculation of stroke volume. Cardiac output increased significantly during exercise, and this effect persisted in the presence of both atropine and sotalol, although the increase in heart rate was reduced or abolished. The persisting increase in cardiac output during exercise is due to an increase in stroke volume, reflecting a Starling relationship. In the presence of the adrenergic neurone-blocking agent bretylium, a positive inotropic effect on isolated, paced atrial and ventricular strips was observed. In the atrial preparations the effect persisted after 24 h. The effect was prevented by pretreatment with sotalol or cocaine, but potentiated by phentolamine pretreatment. This shows that bretylium exerts its neurone-blocking action after being taken up into the adrenergic nerves, and suggests that the positive inotropic effect of bretylium observed in vivo is due to release of endogenous catecholamines. The concentration-response curves for adrenaline on isolated spontaneously beating atrial preparations showed that the concentrations of catecholamines necessary to produce appreciable effects on the heart are higher than the concentrations found in cod plasma during 'stress' situations (handling and exhaustive swimming).
Animals↗
Estrogen receptor levels and survival of breast cancer patients. A study on patients participating in randomized trials of adjuvant therapy.
A series of 1,022 patients taking part in clinical trials to compare postoperative radiation therapy with postoperative CMF chemotherapy, and postoperative tamoxifen with no adjuvant therapy, had their tumors analyzed for estrogen receptor content. Isoelectric focusing of the receptor in polyacrylamide gel was used for receptor assay and the results were related to tumor DNA content. The estrogen receptor content was significantly correlated to prolonged survival both for premenopausal and postmenopausal women. It was confirmed that postmenopausal women have increased median receptor values, and for this group values of more than approximately 0.3 fmol per microgram DNA were correlated to prolonged survival. For premenopausal women, a lower level of more than 0.1 fmol per microgram of DNA defined patients with prolonged survival. Lymph node involvement and receptor level were independent prognostic indicators. Patients randomized to tamoxifen or CMF tended to live longer as compared with control patients but this was not statistically significant. Moreover, there was no tendency for adjuvant tamoxifen to further increase the survival of patients with receptor-containing tumors as compared with control patients with similar receptor values.
Adult↗
Cholinergic and adrenergic influence on the teleost heart in vivo.
The tonical cholinergic and adrenergic influence on the heart rate was investigated in vivo in seven species of marine teleosts (pollack, Pollachius pollachius; cuckoo wrasse, Labrus mixtus; ballan wrasse, Labrus berggylta; five-bearded rockling, Ciliata mustela; tadpole fish, Raniceps raninus; eel-pout, Zoarces viviparus and short-spined sea scorpion, Myoxocephalus scor pius) during rest and, in two of the species (P. pollachius and L. mixtus), also during moderate swimming exercise in a Blazka-type swim tunnel. Ventral aortic blood pressure and heart rate were recorded via a catheter implanted in an afferent branchial artery, and the influence of the cholinergic and adrenergic tonus on the heart rate was assessed by injection of atropine and sotalol respectively. During rest the adrenergic tonus was higher than the cholinergic tonus in all species except L. berggylta, where the reverse was true. In P. pollachius and L. mixtus, exercise appeared to produce a lowering of the cholinergic tonus on the heart and, possibly, a slight increase of the adrenergic tonus. The nature of the adrenergic tonus (humoral or neural) is not clear, but the low plasma concentrations of catecholamines both during rest and exercise could be interpreted in favour of a mainly neural adrenergic tonus on the teleost heart. These experiments are compatible with the view that both a cholinergic inhibitory tonus and an adrenergic excitatory tonus are general features in the control of the teleost heart in vivo, both at rest and during moderate swimming exercise.
Animals↗
Blood pressure control during exercise in the Atlantic cod, Gadus morhua.
Atlantic cod were subjected to 12-15 min swimming exercise at 2/3 body lengths s-1 in a Blazka-type swim tunnel. Pre- and postbranchial blood pressures, cardiac output (ventral aortic blood flow) and heart rate were continuously recorded, and blood samples for measurement of arterial and mixed venous oxygen tension were taken before and at the end of the exercise period. In a second group of fish, subjected to similar exercise regimes, blood samples were taken for analysis of the plasma concentrations of catecholamines. Pre- and postbranchial blood pressures and cardiac output increase during exercise, while the mixed venous oxygen tension decreases. The effect on cardiac output is due to an increase of both heart rate and stroke volume. There are no significant changes in either systemic or branchial vascular resistances, or in the plasma concentrations of catecholamines. Injection of the adrenergic neurone-blocking drug bretylium produces a decrease in postbranchial blood pressure in resting cod, due to a decrease in the systemic vascular resistance. Exercising cod treated with bretylium have a significantly lower pre- and postbranchial blood pressure than exercising control cod. This is due mainly to a dramatic reduction in the systemic vascular resistance. The alpha-adrenoceptor antagonist phentolamine does not further affect the blood pressure in cod treated with bretylium. It is concluded that the exercise hypertension observed in cod depends on the effect of adrenergic vasomotor fibres maintaining the systemic vascular resistance, and also on the increase in cardiac output. An adrenergic innervation of the heart may play some role in the control of cardiac performance both at rest and during exercise, but the main cardioregulatory mechanism is likely to be non-adrenergic, most probably including cardiac control via variation of the cholinergic vagal cardioinhibitory tonus.
Animals↗
Control of the heart in the mudpuppy, Necturus maculosus.
The cardiac innervation of the mudpuppy, Necturus maculosus, was investigated using in vivo recording of blood pressure and heart rate, a perfused heart preparation, isolated paced ventricular and atrial strip preparations, Falck-Hillarp fluorescence histochemistry and measurements of plasma concentrations of catecholamines. The heart of Necturus receives a 'classical' vagal inhibitory innervation by cholinergic fibres which act via muscarinic cholinoceptors. In addition, there appears to be an atropine-resistant inhibitory component in the vagal innervation of the heart. This component is best seen at higher frequencies of vagal stimulation (10-20 Hz), but the mechanism behind this response is not known. There is no direct adrenergic innervation of the ventricle or atria, but by use of Falck-Hillarp fluorescence histochemistry, adrenergic fibres have been demonstrated at the atrio-ventricular border, particularly within the intracardiac ganglion. The histochemical evidence is consistent with a modulation of the ganglionic transmission in the vagal pathways by adrenergic neurons and small intensely fluorescent (SIF) cells, but physiological evidence is wanting. An adrenergic control of the heart via circulating adrenaline may occur during 'stress', when the plasma level of adrenaline is high enough to affect cardiac performance.
Acetylcholine↗
The coronary circulation: a fish perspective.
All elasmobranchs and about one-third of the teleosts studied have a well-developed coronary system. In species with a coronary system, there is a large inter-species variation in the proportion of the myocardium that is supplied, with a correlation between activity level and dependence on a coronary system. In fish, most of the knowledge about the control of the coronary circulation stems from in situ or in vitro work with only a few recent in vivo studies. In salmonids, about one percent of cardiac output is returned to compact myocardium through the coronary circulation. It has been shown that, as in mammals, the coronary circulation is compromised by the mechanical work of the heart and peak coronary flow occurs during diastole. The control systems involved in the regulation of the coronary vascular resistance changes include both neuronal and humoral components. As in mammals, there are alpha- and beta-adrenoceptors located in the coronary circulation and a cholinergically mediated vasodilatation has been described. ATP, ADP and prostaglandins are probably also involved in the control of the vascular resistance, and there is evidence that local metabolites also have a strong influence on the blood flow through the coronary system.
Animals↗