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Biomedical subjects

T S Hakim

Publications and source records attributed to T S Hakim.

15 recordsLinked to original sources

Opiate action in the pulmonary circulation.

To gain insight into the mechanisms underlying the association between acute pulmonary edema and narcotic abuse, the direct action of morphine was examined in isolated, perfused left lower lobe (LLL) preparations in dogs and cats. Morphine sulphate injected (0.6 mg/kg) into the pulmonary artery of the LLL increased the pulmonary vascular resistance (PVR) by about 100% in both species. The increase in PVR was primarily due to constriction of the veins, as determined with the arterial and venous occlusion technique. The increase in PVR with morphine injection was unaffected by alpha-adrenergic antagonists, but was reversed by chlorpheniramine, a histamine H1-receptor antagonist. Pretreatment, but not post-treatment with the opiate antagonist, naloxone, blocked the effect of morphine on PVR. Thus, the rapid administration of morphine produces pulmonary venoconstriction via histamine release from the lung, and the latter may account for the well-documented association between acute pulmonary edema and narcotic abuse.

Animals

Is flow in subpleural region typical of the rest of the lung? A study using laser-Doppler flowmetry.

The microcirculation in the subpleural region of the lung is thought to be physiologically typical of the entire vasculature. To investigate this issue, an in situ blood-perfused dog lung lobe (500 ml/min) was prepared and the blood flow in the subpleural region (Qs) was monitored with laser-Doppler flowmetry (LDF). The flow rates into and out of the lobe were monitored with in-line flow probes, and the arterial and venous pressures were recorded from side ports in the cannulas. The LDF signal measures flow in arbitrary units over a region less than 2 mm deep and 1 mm2. The LDF signal was independent of site of measurement and was linearly proportional to total flow rate (r2 greater than 0.9), suggesting that during baseline conditions Qs behaves similarly to, although not necessarily the same as, blood flow in the rest of the lung. However, if the vasculature is constricted by serotonin (arterial constriction) or by histamine (venous constriction), Qs decreases significantly relative to total flow. In fact, in some cases Qs approached zero during vasoconstriction, despite the fact that total flow was maintained constant and the pulmonary arterial pressure became elevated. Reduction in Qs most likely reflects a redistribution from the subpleural to the central regions of the lung. The results of this study suggest that LDF is a useful tool for monitoring flow in the subpleural region of the lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Instant of vascular occlusion defined with laser-Doppler flowmetry.

Derivation of capillary pressure from tracings postarterial (AO) or -venous (VO) occlusion requires back extrapolation to an instant near the time of occlusion. This instant is difficult to identify because of pressure artifacts created by the occlusion maneuver. Theoretically, when the flow in the main artery (or veins) is stopped instantaneously, the flow in the arterioles (or venule) will stop after a short time delay (perhaps less than 100 ms). When flow had stopped in the main artery and in the arteriole, the pressure in the main artery at that instant would equal the pressure in the arterioles. We sought to identify the instant when flow stops in the arterioles and venules after AO and VO, respectively. In an isolated perfused dog left lower lobe preparation flow in the main vessels were monitored with inline flow probes, whereas flow in the microcirculation was monitored with laser-Doppler flow (LDF) probe placed on the lung surface. A sudden decline in arterial flow was detected by the LDF probe after 54 ms, while a sudden decline in venous flow was detected in the venules after 35 ms. These time delays were used as wave transmission time across the arterial and venous trees. Consequently, it was concluded that after AO, flow in the arterioles would stop 54 ms after it had become zero in the main artery, while after VO flow in the venules would stop 35 ms after it had become zero in the main vein. The pressure post-AO and post-VO was read at these instants (54 and 35 ms after flow in the main vessel reached zero).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Relative contribution of bronchial flow to subpleural region in dog lung.

The bronchial flow is approximately 1% of the total pulmonary flow. Anastomosis between the bronchial and pulmonary vessels occurs primarily at the microcirculatory level. It is assumed that bronchopulmonary anastomoses are present in a homogeneous manner throughout lung parenchyma. To investigate this issue, an in situ blood-perfused left lower lung lobe (500 ml/min) was prepared in a live dog. The bronchial flow rate in the entire lobe was monitored using the rate of volume gain in the reservoir while the pulmonary and bronchial flow in the subpleural region was monitored using laser-Doppler flowmetry. The results were expressed as ratio of bronchial to pulmonary flow rate for the entire lobe and for the subpleural region. We found that, for the entire lobe, bronchial flow was 1.0% of pulmonary flow, while for the subpleural region this ratio was much higher, with an average of 12%. In two different experimental conditions that were imposed to affect the global bronchial flow, these ratios changed in the same direction as the global bronchial flow. After transfusion of blood into the animal, bronchial flow increased to 1.7%, while the subpleural bronchial flow increased to 18% of the subpleural pulmonary flow. During elevation of venous pressure, bronchial flow decreased to 0.6%, while the subpleural bronchial flow decreased to 10% of the subpleural pulmonary flow. The differences in the ratios between the global and subpleural region may be explained by having low pulmonary blood flow in the periphery compared with the interior regions of the lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Criteria for analysis of arterial and venous occlusion.

To provide a better understanding of analysis of arterial (AO) and venous occlusion (VO) tracings, using a constant and nonpulsatile perfusion pressure system, we set up an isolated in situ dog lobe preparation perfused with autologous blood. Four signals were recorded: arterial pressure, arterial inflow rate, venous pressure, and venous outflow rate. The four signals were recorded into the memory of a computer. When flow into the lobe was abruptly stopped (AO), flow out of the lung continued unchanged for approximately 150 ms and then decreased slowly to zero. Likewise, when flow out of the lung was abruptly stopped (VO), the flow into the lung continued unchanged for approximately 130 ms and then decreased slowly to zero. A monoexponential curve was fitted to different stretches of data between 0.1 and 5 s postocclusion and extrapolated to the instant of occlusion (defined here as the instant when flow at the site of occlusion becomes zero). The results indicate that 1) the first 150 ms postocclusion should be avoided because of the oscillatory artifacts generated by the occlusion maneuver, 2) use of a long segment of postocclusion data (5 s) tends to underestimate the middle pressure gradient and overestimate the arterial and venous pressure gradients, and 3) the changes in segmental vascular resistance under different experimental conditions were found to be unaffected by the criteria of analysis. Analysis of the postocclusion (AO and VO) tracings was found to be most compatible with the double-occlusion capillary pressure by fitting a stretch of data between 0.2 and 2.5 s postocclusion and extrapolating back to the instant when flow becomes zero at the site of occlusion but no earlier.

Animals

Increased resistance in postobstructive pulmonary vasculopathy: structure-function relationships.

Postobstructive pulmonary vasculopathy (POPV) was produced by chronic ligation (120 days) of the left main pulmonary artery of seven dogs. To explain the abnormal physiological changes found using arterial and venous occlusion (AVO) in POPV (J. Appl. Physiol. 69: 1022-1032, 1990), the light-microscopic morphology, morphometry (n = 5), and ultrastructure (n = 6) of ligated left lower lobes were compared with contralateral control right lower lobes. First, there was a proliferation of bronchial vessels around pulmonary vessels and airways to explain bronchial blood flow rates of 330 ml/min in left lower lobes. The walls of the bronchial vessels contained smooth muscle with minimal elastic tissue and prominent myoendothelial junctions. Second, focal bronchopulmonary anastomoses were seen in pulmonary arteries approximately equal to 100 microns diam, which is consistent with our conclusion that the major site of communication is at the precapillary level and suggests that the limit between arterial and middle segments defined by AVO may lie in arteries of approximately equal to 100 microns. Third, to explain the increased arterial resistance in POPV, the pulmonary arteries had an increased percent medial muscle thickness, peripheral muscularization, and focal intimal thickening but had no plexiform lesions. The ultrastructure of the arteries revealed new intimal cells and numerous myoendothelial junctions rarely found in controls. Capillaries and veins were only subtly altered. Fourth, the hyperreactivity of arteries to serotonin and of veins to histamine found using AVO was partially explained by the increased medial thickness and decreased diameter but may also be due to increased receptor concentration or related to the myoendothelial junctions. We conclude that most of the hemodynamic alterations in POPV are related to morphological abnormalities and that this model has clinical and experimental relevance in the study of bronchopulmonary vascular interactions.

Airway Obstruction

Segmental vascular resistance in postobstructive pulmonary vasculopathy.

Chronic unilateral pulmonary arterial ligation has been touted as a model of arteriopathy resulting in a tremendous increase in anastomotic bronchial flow (Qbr) via collaterals. To investigate its effects on the pulmonary vasculature, we ligated the left main pulmonary artery of seven dogs and 120 days later pump perfused their left lower lobes (LLL) via a cannula in the pulmonary artery at pulmonary arterial flow (Qpa) of 250 ml/min. We measured Qbr (330 ml/min) and compared LLL with control contralateral right lower lobes (RLL) and three LLL from normal dogs. Pressure-flow (P-Q) curves were obtained by varying Qpa. With arterial and venous occlusion we measured total, arterial, venous, and middle segment resistances under baseline conditions, after serotonin and histamine, either with or without Qpa and with antegrade and retrograde Qbr. Light microscopy was done postmortem. The slope of the P-Q curve was 33.4 mmHg.l-1.min in the ligated lobes compared with 15.9 in the controls, attributable by the occlusion technique mainly to a rise in arterial resistance (22.4 mmHg.l-1.min compared with 7.4 in the controls) with a small rise in venous resistance. This was explained by significant arterial medial muscle thickening and some loss of LLL volume. The arterial segment was markedly hypersensitive to serotonin, and the venous segment was mildly hypersensitive to histamine compared with controls. The occlusion data also enabled us to model the point of entry of the bronchial circulation into the pulmonary circuit at the precapillary level and to calculate bronchial vascular resistance. We conclude that postobstructive vasculopathy substantially raises pulmonary vascular resistance, mainly upstream from the site of entry of the bronchial circulation. The role of the latter may be to keep it from rising excessively in the segments it perfuses, i.e., the middle and venous ones.

Air Pressure

Pulmonary hemodynamic responses to elevated cerebral spinal fluid pressure in the dog.

To investigate the possibility that a pulmonary vasomotor reflex contributes to the pulmonary hemodynamic response to elevated cerebral spinal fluid pressure (PCSF), we studied 10 chloralose-anesthetized dogs in which the left lower lobe (LLL) perfusion was isolated to eliminate the influence of passive factors and of circulating vasoactive agents. Left lower lobe neural integrity was tested by electrically stimulating the stellate ganglion. This resulted in a 35.5% increase in lobar vascular resistance and a 29.1% increase in systemic vascular resistance. Elevating the PCSF to 137 Torr caused the systemic vascular resistance to increase 33.0%, but resulted in no change in LLL vascular resistance. In the intact right lung, this PCSF elevation resulted in increases in pulmonary artery and left atrial pressures, but no change in right lung vascular resistance. Because the neurally intact LLL did not respond to PCSF elevation and the responses of the right lung could be accounted for by passive mechanisms, we conclude that no pulmonary vascular reflex was elicited by PCSF elevation in this preparation.

Animals

Hemodynamic responses of dog lung lobe to lobar venous occlusion.

We perfused the left lower lobe of the dog lung with constant flow. When the lobar venous outflow was occluded, the lobar venous pressure rose suddenly to a level somewhere below the arterial pressure, and then the arterial and venous pressures began to rise more slowly. A possible explanation for this response is that, when the outflow was occluded, flow through some downstream segment of the bed ceased. Because flow into the lung continued, the arteriovenous pressure difference after occlusion represents the pressure drop across some upstream segment through which the flow continued. We designated the arteriovenous pressure difference just after outflow occlusion as the upstream pressure drop. The arteriovenous pressure difference before occlusion minus the upstream pressure drop was designated the downstream pressure drop. In an attempt to better understand the meaning of the upstream and downstream pressure drops, we examined the influence of pulmonary vasoconstriction and flow direction on the size of the upstream and downstream pressure drops. We also compared these pressure drops with the pressure drops occurring upstream and downstream from the midpoint of the lobar vascular volume, using the low-viscosity bolus technique. The results indicate that changes in the upstream and downstream pressure drops, as evaluated by outflow occlusion, reflect changes in the lobar arterial and venous resistances.

Animals

Pulmonary vasomotion and the distribution of vascular resistance in a dog lung lobe.

We examined the influence of stellate ganglion stimulation, hypoxia, and the infusion of norepinephrine, PGF2alpha, serotonin, and histamine on the longitudinal distribution of vascular resistance and intravascular pressures in an isolated left lower lobe of the dog lung using the low-viscosity bolus technique. Sympathetic stimulation, norepinephrine, serotonin, PGF2alpha, and hypoxia increased total pulmonary vascular resistance by increasing the resistance, primarily on the arterial or upstream side of the volume midpoint, whereas histamine increased the resistance near the venous end of the lobar vascular bed. Hypoxia increased the volume upstream from the site of maximum resistance, suggesting that the larger lobar arteries were distended by the elevated lobar artery pressure. Sympathetic stimulation, norepinephrine, PGF2alpha, and serotonin, on the other hand, had little effect on the volume upstream from the maximum resistance, suggesting that these vasomotor stimuli prevented distension of the larger arteries.

Animals

Anaphylaxis in isolated rabbit lungs.

Lungs from rabbits sensitized to ovalbumin or bovine gamma-globulin were isolated and perfused with autologous blood. The response to antigen challenge via the perfusate was immunologically specific and characterized by a marked increase in perfusion resistance, a moderate increase in airway resistance and a small decrease in lung compliance. The response could also be elicited by specific antigen challenge in lungs from sensitized rabbits perfused with blood from normal rabbits and in lungs from normal rabbits perfused with blood or plasma from sensitized rabbits. The magnitude of the response was greater when blood or plasma from sensitized animals was used as the perfusate. Therefore, blood and/or plasma factors appear to be the major contributors to the response.

Airway Resistance