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Biomedical subjects

M Tabatabai

Publications and source records attributed to M Tabatabai.

At least 19 recordsLinked to original sources
PubMed1994

Treatment of de Quervain's disease.

This study compared the use of a mixed steroid/lidocaine injection alone, an immobilization splint alone, and the simultaneous use of both in improving symptoms in de Quervain's disease. Ninety-three wrists were included in the study, with an average follow-up examination of 13 months. Complete relief of symptoms was noted in 28 of 42 wrists receiving an injection alone, 8 of 14 wrists receiving both an injection and splint, and 7 of 37 wrists receiving a splint alone. No significant difference was noted between the injection alone and injection plus splint groups. A significant difference was seen between the injection alone and splint alone groups and the injection/splint and splint alone groups. Twenty of 45 wrists that underwent operative release demonstrated a septum at the first dorsal compartment. When the need for operative release was used as an outcome result for treatment failure, the injection alone and splint alone groups demonstrated significance. We recommend the use of a mixed steroid/lidocaine injection alone as the initial treatment of choice in this condition. No additional benefit is appreciated by the addition of splint immobilization and, in fact, patients are less restricted with a lower financial burden without its use.

Adolescent↗
PubMed1990

Changes in serum CPK, LDH, and their isoenzymes in the perioperative period in patients undergoing craniotomy.

The perioperative changes in the serum concentration of creatine phosphokinase (CPK) and its isoenzymes MM, MB, and BB and of lactic dehydrogenase (LDH) and its isoenzymes LDH1 to LDH5 were determined during craniotomy in order to distinguish operation-induced changes in these enzymes from those due to acute myocardial infarction and malignant hyperthermia. Twenty-eight male patients, 29 to 76 years of age (mean +/- SD = 58 +/- 13.2 years), undergoing craniotomy for tumor reseaction (n = 26) or cerebral artery aneurysm clipping (n = 2) were included in this study. Ten serial blood samples were obtained from each patient: one sample before and another after induction of anesthesia, and eight samples after the incision, over a period of 70 h. The preinduction serum CPK level of 97 +/- 32 U/L (mean +/- SD) increased gradually and significantly and reached the peak level of 542 +/- 116 U/L 34 h after incision (p <0.05). Whereas all of the CPK isoenzymes increased in terms of U/L after incision, only the MM fraction (expressed as percent of total CPK) increased, and the MB and BB fractions (expressed as percent of total CPK) decreased. The preinduction serum LDH level of 150 +/- 42 U/L (mean +/- SD) increased gradually after incision and reached the peak level of 210 +/- 32 U/L 58 h after incision (p <0.05). LDH2 as a percent of total LDH decreased significantly, but the LDH1/LDH2 ratio did not change. LDH4 and LDH5, as percents of total LDH, increased significantly. The large increases in total serum CPK and the concomitant decrease in MB percent after craniotomy may minimize and/or mask the percentage increase in the MB level following acute myocardial infarction. The perioperative serum CPK level as a marker in the diagnosis of malignant hyperthermia should be interpreted in light of the present results and in conjunction with clinical symptomatology.

Journal Article↗
PubMed1990

Mechanism of action of local anesthetics on synaptic transmission in the rat.

The mechanism of action of local anesthetics on synaptic transmission and their effects on synaptic components and on electrophysiologic properties of the nerve cell body are not clear. Therefore, the effects of lidocaine and bupivacaine on pre- and postsynaptic mechanisms underlying synaptic transmission in sympathetic ganglia were studied utilizing the techniques of intracellular recording and stimulation on isolated superfused superior cervical ganglia of rats. Lidocaine and bupivacaine either depressed or completely blocked synaptic transmission in sympathetic ganglia in a dose-dependent manner. Blockade of axonal conduction in presynaptic fibers was preceded by increased latency (the latency increased from 11.2 +/- 0.9 to 16.5 +/- 1.4 ms, mean +/- SEM, P less than 0.01) when the drugs were applied to the presynaptic nerves. Application of the drugs directly to the ganglion produced alterations in postsynaptic membrane properties consisting of decreased membrane resistance (from 40 +/- 3 to 32 +/- 3 M omega, P less than 0.01), increased firing threshold (from 14 +/- 0.5 to 18 +/- 0.5 mV, P less than 0.01), and decreased action potential amplitude (P less than 0.01) and/or blockade of action potential generation. Resting postsynaptic membrane potential did not change significantly. These changes were reversible. However, even after the excitatory postsynaptic potential resulting from presynaptic nerve stimulation had fully recovered during washout of the local anesthetic, the threshold for evoking the spike potential (firing level) still remained elevated for both presynaptic and intracellular stimulation of the ganglion cell, suggesting prolonged cell depression.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1990

Enflurane depresses activity of the medullary inspiratory neurons in the cat.

The effect of enflurane on the firing activity (spikes/sec) of the inspiratory neurons of the dorsal respiratory group (DRG) of the medulla oblongata was studied in decerebrate, paralyzed, mechanically ventilated cats before and after bilateral cervical vagotomy. Inspiratory neuronal activity, phrenic neurogram, arterial blood pressure, tracheal pressure, and end tidal CO2 concentration were recorded. Cells whose firing activity was in phase with that of the phrenic nerve were considered inspiratory neurons. Administration of 1 and 2% enflurane in oxygen produced gradual, significant, and dose-dependent depression of the cell activity with cervical vagi either intact or severed. Recovery of the cell activity occurred after termination of enflurane administration. In cats with intact vagi, 10 min after introduction of 1 and 2% enflurane, the cell activity (mean +/- SE) expressed as percentage of the control was 70 +/- 6% (P less than 0.05) and 48 +/- 5% (P less than 0.01), respectively. Bilateral cervical vagotomy did not affect the degree of cell depression due to enflurane. Hypercarbia induced by inhalation of 5% CO2 increased cell activity, but it did not block enflurane-induced cell depression, although it reduced it. It may be concluded that enflurane depresses the activity of the inspiratory neurons of the DRG. The results also suggest that the respiratory depressant effect of enflurane has a central component and that the DRG region may serve as a site to mediate the enflurane-induced respiratory depression.

Animals↗
PubMed1990

Effects of lidocaine on the excitability and membrane properties of the nerve cell soma.

The effects of lidocaine, an amide local anesthetic, on the electrophysiologic properties of the nerve cell soma were studied on isolated superfused superior cervical ganglia of rats. Administration of 400 nmol of lidocaine to the preparation evoked significant reversible changes in the membrane properties of the nerve cell soma. The firing threshold, the action potential duration and the intracellular current threshold for firing the cells increased significantly (p less than 0.01), while the action potential amplitude decreased significantly (p less than 0.01). The resting membrane potential change was not significant. The membrane resistance decreased by 20% (p less than 0.01). The change in membrane resistance, and the spike potential evoked by excitatory postsynaptic potential or intracellular current injection were the last to recover after application of lidocaine. The results show that the postsynaptic cell body is a major site of action of the local anesthetic lidocaine, and that it is more sensitive to the action of lidocaine than the presynaptic nerve fibers. The implication of the results is that when local anesthetics are injected to areas where cell bodies and processes (axons and dendrites) are present together, such as during stellate ganglion block, lumbar sympathetic block, celiac plexus block and intrathecal administration for spinal anesthesia, the cell bodies and the processes are all affected, and their excitability and function suppressed. Further, the duration of the block will be determined by the duration of lidocaine-induced cell block rather than the duration of lidocaine-induced nerve fiber block.

Animals↗
PubMed1989

Serum creatine phosphokinase, lactic dehydrogenase, and their isoenzymes in the perioperative period.

The purpose of the present investigation was to determine the normal perioperative variations in the serum concentration of creatine phosphokinase (CPK) and its isoenzymes MM, MB, and BB, and of lactic dehydrogenase (LDH) and its isoenzymes LDH1 to LDH5 to distinguish operation-induced changes in these enzymes from those due to acute myocardial infarction or malignant hyperthermia. In 30 patients, 52 to 75 years of age undergoing elective orthopedic operations, 10 serial blood samples were obtained in the perioperative period: two samples before skin incision and eight samples after the incision over a time span of 70 hours. The preinduction mean serum CPK level of 141 U/L increased gradually and significantly and reached a maximum mean concentration of 809 U/L 34 hours after incision (p less than 0.01). The CPK-MM percent increased after incision, whereas that of CPK-MB and CPK-BB decreased, although their absolute values in terms of U/L rose. The preinduction mean serum LDH value of 173 U/L increased gradually after incision and achieved peak levels at 34 hours (203 U/L) and 58 hours (210 U/L) after incision (p less than 0.05). The LDH1:LDH2 ratio did not change. The LDH5 percent increased and peaked 10 hours after incision (p less than 0.05). There was a significant correlation between severity of operation-induced tissue damage and the serum CPK concentration (p less than 0.001). The large increase in total CPK (primarily MM fraction) occurring after surgery may minimize the percentile effects caused by an increase in MB level due to myocardial infarction.

Aged↗
PubMed1989

Disruption of the rhythmic activity of the medullary inspiratory neurons and phrenic nerve by fentanyl and reversal with nalbuphine.

The effects of intravenous administration of fentanyl (50 and 100 micrograms/kg) on the discharge activity of the medullary inspiratory neurons and of the phrenic nerve were studied following vagotomy in nine decerebrate, paralyzed mechanically ventilated cats. In six cats, the inspiratory neurons explored were in the dorsal respiratory group (DRG) associated with the nucleus of the tractus solitarius (NTS), while in the remaining three, they were in the ventral respiratory group (VRG). In the former group, the rhythmic discharge of the inspiratory neurons was disrupted by fentanyl and replaced by a continuous discharge superimposed with irregularly occurring bursts. These changes were also reflected by the phrenic nerve discharge. Inspiratory neuronal activity increased significantly (P less than 0.05) at 1 and 5 min after completion of fentanyl injection. Disruption of the rhythmic activity of the inspiratory neurons and its replacement by a continuous and irregular discharge may lead to sustained contraction of inspiratory muscles and cessation of respiration. In the VRG, the activity of the inspiratory neurons was totally abolished by fentanyl. Thus, it appears that different groups of medullary inspiratory neurons have differential sensitivity to fentanyl. Nalbuphine, an opiate agonist-antagonist, restored the normal pattern and magnitude of the activity of the inspiratory neurons.

Animals↗
PubMed1989

Comparison of cardiopulmonary variables with intermittent positive pressure ventilation and high-frequency jet ventilation during abdominal aortic operations.

Cardiopulmonary variables with intermittent positive pressure ventilation (IPPV) and high-frequency jet ventilation (HFJV) were compared in 8 patients undergoing elective abdominal aortic operations under fentanyl-nitrous oxide anesthesia. Hemodynamics were stable under the two methods of ventilation, and most of the corresponding hemodynamic variables were statistically indifferent from each other. Alveolar gas exchange was also adequate with either method and most of the corresponding respiratory variables were not statistically different. The peak airway pressure was significantly less during HFJV than during IPPV (p less than 0.01). Diaphragmatic excursions are less during HFJV than during IPPV, resulting in a quieter surgical field. Therefore, hemodynamic stability and gas exchange adequacy coupled with less diaphragmatic excursions and lower peak airway pressure make HFJV an acceptable alternative to IPPV during abdominal aortic operations.

Aged↗
PubMed1989

Effects of bupivacaine on the membrane properties of nerve cell soma.

While the effects of local anaesthetics on axonal conduction and axonal membrane have been extensively studied, there is little information about the actions of these agents on nerve cell soma. Therefore, the effects of the amide local anaesthetic bupivacaine on the electrophysiologic properties of the nerve cell soma were studied on isolated superfused superior cervical ganglia of rats. Administration of 100-200 nM of bupivacaine to the preparation produced marked changes in membrane properties of the cell soma. The resting membrane potential did not change, but the membrane resistance decreased 20% (P less than 0.01). The firing threshold, the action potential duration at 50% of maximal amplitude, and the intracellular current threshold for firing the cells increased significantly (P less than 0.01), while the action potential amplitude decreased significantly (P less than 0.01), before its complete blockade. The results show that the cell soma is a major site of action of local anaesthetics. The implication of the results is that when local anaesthetics are applied to areas where cell bodies and processes (axons and dendrites) are present together, such as during celiac plexus block, lumbar sympathetic block, stellate ganglion block, etc., they will all be effectively depressed and/or blocked.

Action Potentials↗
PubMed1987

Effects of halothane on medullary inspiratory neurons of the cat.

The effect of halothane on the electrical activity of inspiratory neurons of the nucleus tractus solitarius (NTS) was studied in decerebrate, paralyzed, mechanically ventilated cats. Simultaneous recording of the activity of the neurons of the NTS and the phrenic nerve was done to identify the inspiratory neurons. Cells whose firing activity was synchronous with that of the phrenic nerve were considered inspiratory neurons. Administration of 1% and 1.5% halothane in oxygen induced a dose-dependent depression of the cell activity (spikes/s) with the cervical vagi intact or severed. Five and ten minutes after inhalation of 1% halothane, the cell activity (mean +/- SE) expressed as per cent of the control was 55.3 +/- 9 and 27 +/- 7, respectively (P less than 0.001), before bilateral cervical vagotomy. The corresponding values for 1.5% halothane were 25 +/- 10.1 and 5.6 +/- 3, respectively. Upon termination of halothane administration, the cell activity gradually returned toward the control level. The cell response to halothane was not affected by bilateral cervical vagotomy. Hypercapnia produced by inhalation of 5% CO2 increased the cell activity, but halothane caused profound depression of the cells even in the presence of hypercapnia. Based on these results, it may be concluded that: halothane has inhibitory effects on the activity of the inspiratory neurons of the NTS; and halothane-induced respiratory depression has a central component and that the NTS may serve as a site of action of halothane for its respiratory depressant effect.

Animals↗
PubMed1986

Persistence of polymicrobial abscesses in the poorly controlled diabetic host.

Polymicrobial infections are frequently found in soft tissue infections of the lower extremities in diabetic patients. The relative susceptibility to and persistence of soft tissue polymicrobial infections of diabetic and nondiabetic mice using bacteria commonly found in clinical foot infections were studied. Subcutaneous abscesses were induced in three groups of diabetic and nondiabetic mice using: (1) E. coli and enterococcus, (2) enterococcus and Bacteroides fragilis (B. fragilis), and (3) E. coli and B. fragilis. Abscesses were removed at 1 and 2 wk for total colony counts. At 1 wk, there was a significantly greater bacterial growth in the abscesses of the diabetic mice compared with the nondiabetic mice only in the group injected with enterococcus and B. fragilis. There were significantly higher colony counts in the diabetic compared with the nondiabetic mice in all three groups at 2 wk after injection of the bacteria. Two weeks after injection of inocula containing B. fragilis, both in combination with E. coli or enterococcus, all nondiabetic mice had eradicated B. fragilis from the abscesses, but significant numbers of B. fragilis persisted in the abscesses of the diabetic mice. In the diabetic mice, the presence of enterococci was more synergistic for growth of B. fragilis than was the presence of E. coli. These studies demonstrate that the bacteria of polymicrobial soft tissue infections persist for a longer period of time in the diabetic compared with the nondiabetic host. In addition, B. fragilis has increased pathogenicity in the diabetic compared with the nondiabetic host, particularly in the presence of enterococci.

Abscess↗
PubMed1985

Fentanyl and alfentanil suppress brainstem pain transmission.

The effects of intravenously administered fentanyl (25 micrograms/kg, n = 9; 50 micrograms/kg, n = 5) and alfentanil (12.5 micrograms/kg, n = 5; 25 micrograms/kg, n = 7) on the noxiously evoked, single-unit activity of cells in the nucleus reticularis gigantocellularis (NRGC) were studied in decerebrate cats. Only cells of the NRGC excited exclusively by supramaximal electrical stimulation of A delta fibers (noxious stimulation) of the superficial radial nerve were studied. The noxiously evoked activity of all cells in the NRGC was suppressed by the administration of opioids (by 58 and 88% for fentanyl, 25 micrograms/kg and 50 micrograms/kg, respectively; by 35 and 78% for alfentanil 12.5 micrograms/kg and 25 micrograms/kg, respectively). Fentanyl and alfentanil effects were antagonized by the intravenous administration of naloxone. These results indicate that opioid suppression of noxiously evoked activity is seen in neurons located in the brainstem, and thus suppression of brainstem neurons may be important in the production of fentanyl and alfentanil analgesia.

Alfentanil↗
PubMed1982

Effect of administration of estrogen to pregnant rabbits on the lipid content and composition of the fetal brain.

Intramuscular injection of 17 beta-estradiol to pregnant rabbits did not produce any significant change in the phospholipid, neutral lipid and cholesterol content of the fetal brains, nor did it cause any significant difference in their wet and dry weights. It may be inferred that use of estrogen in the gestational period to enhance surfactant production and lung maturation in the fetus would not produce adverse effects on the fetal brain lipids.

Animals↗
PubMed1980

Ureteral motility in sheep.

Ureteral motility was studied in twenty-five sodium pentobarbital-anaesthetized sheep. Mean frequency of the peristaltic waves was 15 per min and the range was 11-19. Frequency was the same throughout the length of the ureter. Mean contraction pressure (cm H2O) was 40 in the upper ureter, 35 in the middle ureter and 31 in the lower ureter. Mean concentration time was 1 sec and range was 0.6-1.5. Mean relaxation time was 1.1 sec and range was 0.7-1.5. Diuresis induced by rapid intravenous administration of physiologic sodium chloride solution abolished the peristaltic activity.

Animals↗
PubMed1978

Effects of ovine hydatid cyst fluid in sheep before and after treatment with hydrocortisone, antihistamines and atropine.

The cardiovascular and respiratory responses to scolex-free ovine hydatid cyst fluid were studied in 65 sodium pentobarbital-anesthetized sheep. The arterial blood pressure (ABP), central venous pressure (CVP), stethogram and electrocardiogram were recorded. Intra-venous administration of 10 ml or less hydatid fluid brought about moderate to severe fall in ABP and rapid respiration or permanent respiratory cessation in majority of the animals. Forty six percent of the sheep died of circulatory and respiratory failure after the first injection or the hydatid fluid. Boiled hydatid fluid did not lose its potency to evoke the above responses. Hydrocortisone, given 200 mg daily for seven days, failed to prevent the reactions to hydatid fluid. Intravenous administration of the antihistamines chlorpheniramine, 4 mg/kg, and antazoline, 5 mg/kg, caused only partial prevention of the responses in 8 out of 15 responsive sheep. Pretreatment of the animals with atropine, 0.5--1 mg/kg subcutaneously, did not block the reactions. The cardiovascular and respiratory responses to ovine hydatid fluid may be due to antigen-antibody reactions or some toxic component of the fluid.

Animals↗
PubMed1976

Effect of electrolytic lesions of the medullary inspiratory region in rats.

The medulla oblongatas of 48 anesthetized rats were explored by electrical stimulation. The pneumotachogram and in some, the arterial blood pressure as well, were recorded. The inspiratory area was located in the ventral reticular formation from the obex to 1.8 mm rostral to the obex. It occupied about 2.2 mm3 on each side of the midline. The expiratory reactive points were scattered in a region which was dorsal and caudal to the inspiratory area. Unilateral and midline lesions produced by 3, 5 and 8 ma direct current did not stop rhythmic respiration. There was an initial increase in the respiratory rate followed by diminution to below that of the prelesion time. The respiratory air flow was decreased. The changes in respiratory rate and air flow were not statistically significant in majority of the above groups. Bilateral lesions produced by 3 or 5 ma stopped breathing. Continuation of thythmic respiration after destruction of a number of inspiratory neurons and/or fibers in the midline or one side of the medulla indicates that all the inspiratory neurons and fibers are not essential for the maintenance of respiration. Cessation of thythmic respiration after destruction of all or most of inspiratory neurons on both sides of the midline indicates the essential role of the medulla-oblongata for genesis or maintenance of rhythmic respiration.

Animals↗