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Density and morphologic features of primary epidermal laminae in the feet of three-year-old racing Quarter Horses.

OBJECTIVE: To quantify the density of primary epidermal laminae (PELs) around the solar circumference and evaluate the relationship between regional PEL density and hoof capsule morphology in horses. SAMPLE POPULATION: Forefeet from nine 3-year-old Quarter Horse cadavers. PROCEDURES: Data pertaining to gross features of hoof morphology and PEL variables, including number, density, and distribution patterns around the perimeter of the hoof wall and number of bar PELs, were collected. Tissues of the laminar junction were examined histologically. RESULTS: No significant differences were found between left and right forefeet with respect to gross hoof morphologic measurements. Mean +/- SD number of PELs, including those at the bars of the hoof, was 551 +/- 30. Primary epidermal laminar density in the toe was significantly higher, compared with that in the quarter and heel regions, and was higher on the lateral aspect of the foot, compared with the medial aspect. Feet were significantly wider on the lateral aspect of the foot, compared with the medial aspect, as measured across the widest point of the solar surface. Histologic examination revealed atypical laminar morphology at the toe. CONCLUSIONS AND CLINICAL RELEVANCE: Variations were detected in PEL density and morphology around the solar circumference of hooves from 3-year-old racing Quarter Horses. A better understanding of relationships between laminar density, laminar morphology, and gross morphology of the hoof capsule in different populations of horses may aid practitioners in diagnosis and treatment of disease involving the hoof wall in horses.

Animals↗

Automated determination of left ventricular volume curves from bi-plane digital angiography without explicit use of edge detection algorithms.

Automated computation of left ventricular (LV) global and regional function using contrast angiography has not yet become a routine procedure with the advent of digital cardiac imaging systems. We describe a new technique to compute LV volume curves which does not require the use of manual or semi-automated detection of endocardial borders and provides on-line implementation of volumetric curves and computation of pressure volume loops during catheterization. The approach uses the concepts of variable entropy (or information) of left ventricular images throughout the cardiac cycle. LV volume curves are computed with an interpolation scheme using those LV volume curves of a patient data base which are associated with the closest variation in entropy in the RAO projection to the analyzed patient data according to a simple metric. Computed LV volume curves were correlated with those obtained with manual tracing. Left ventricular ejection fraction (LVEF), time to end systole (TES) and angiographic cardiac output (CO) were compared to those obtained with the manual method. Results using a data base of 365 patients revealed excellent correlation (r = 0.97) between manually derived volume curves and volume curves computed with the automated technique within a large range of LVEFs. In 87% of all cases the computed LVEF values were found within +/- 10% of the value obtained with the gold standard method. The systolic phase of the volume curves showed that 81% of all cases had the same accuracy. The TES showed much more variation due to undersampling of the cardiac cycle in time (r = 0.71).

Algorithms↗

Geophysical variables and behavior: XCVII. Increased proportions of the left-sided sense of presence induced experimentally by right hemispheric application of specific (frequency-modulated) complex magnetic fields.

12 young men and women who were not aware of the stimulus order were exposed to 8 configurations of weak 1 microTesla) magnetic fields for 5 min. each, applied primarily over the right parietotemporal region. The numbers of sensed presences along the left side, right side, or front/back, as inferred by button presses at the time of the experience, were recorded. There were significantly (eta2= .37) more experiences along the left side than the right side during the presentations of a frequency-modulated (Thomas) pattern with 3-msec. point durations compared to the presentation of its temporally reversed structure or to patterns that were more or less complex. 40% of all left-sided presences occurred during the 5-min. presentation of this specific frequency-modulated pattern. These results suggest that the subjective lateralization of a sensed presence to the left during right hemispheric stimulation by weak magnetic fields is enhanced by the specific temporal structure of the applied field.

Brain↗

Quantitative analysis of regional variability in the distribution of transverse tubules in rabbit myocardium.

The goal of the present investigation was to compare quantitatively the distribution of T-tubules between regions of the myocardium. The volume fraction and surface density of T-tubules in rabbit right atrial free wall, left atrial free wall, right ventricular free wall, left ventricular free wall, right ventricular papillary muscle, and left ventricular papillary muscle were measured using established, electron-microscopic, morphometric techniques. T-tubules were delineated using wheat-germ agglutinin conjugated to horseradish peroxidase as a tracer. No significant differences were found in the morphometric parameters between any two ventricular samples or between atrial samples. Furthermore, little difference between T-tubule volume fraction or surface density was found between individual animals for any given site. Both volume fraction and surface density of ventricular T-tubules were more than ten-times their values in atrial tissue (volume fraction: 3.43% +/- 0.35 vs. 0.20 +/- 0.09; surface density: 2.46 microns 2/microns 3 +/- 0.11 vs 0.10 +/- 0.04). Measurements show that there is greater variation of T-tubule volume fraction and surface density within atrial samples than within ventricular samples. This suggests greater inhomogeneity in T-tubule distribution in atrial myocardium than in ventricular myocardium. Morphometric data also indicate that the mean diameter of atrial T-tubules is greater than that of ventricular T-tubules while qualitative observations show that atrial T-tubules are distributed less regularly and have a larger longitudinal component to their organization than those in the ventricular myocardium.

Animals↗

Urinary bladder distension: its effects on carotid baroreceptor reflex left ventricular inotropic response in the dog.

1. The effects of distension of the urinary bladder on heart rate, maximum rate of change of left ventricular pressure (dP/dt max) and hindlimb vascular resistance together with their modulation at different carotid sinus pressures were studied in dogs anaesthetized with a mixture of chloralose and urethane and artificially ventilated. 2. When the carotid sinus mean perfusion pressure was raised in randomly selected steps from 60 to 210 mmHg, it caused a progressive bradycardia, and a reduction in left ventricular dP/dt max and in arterial blood pressure, together with vasodilatation in the perfused hindlimb. Distension of the bladder at each level of carotid sinus pressure resulted in tachycardia, a small but significant increase in left ventricular dP/dt max (160 +/- 30 mmHg s-1) and hindlimb vasoconstriction. 3. When heart rate and arterial blood pressure were held constant to exclude these secondary effects on left ventricular dP/dt max, raising the carotid sinus pressure caused a progressive reduction in left ventricular dP/dt max and hindlimb vasodilatation. Superimposition of tests of bladder distension at each level of sinus pressure resulted in variable responses, but overall there was a significant increase in left ventricular dP/dt max of 190 +/- 54 mmHg s-1. Hindlimb vasocontriction, however, was a consistent finding. 4. The gain of the relationship between the carotid sinus perfusion pressure and left ventricular dP/dt max was unaffected by distension of the bladder. 5. It is concluded that, when changes secondary to increases in heart rate and blood pressure are prevented, distension of the bladder causes a small but significant reflex increase in left ventricular dP/dt max. The responses, however, are variable and the possible reasons for this are discussed.

Adrenergic beta-Antagonists↗

Assessment of hibernating myocardium by dobutamine stimulation in a canine model.

OBJECTIVES: The purpose of this study was to 1) develop an animal model of hibernating myocardium, and 2) evaluate the ability of dobutamine stimulation to detect hibernating myocardium using both qualitative and quantitative assessment of regional myocardial function. BACKGROUND: Left ventricular dysfunction may be due to chronic ischemia with or without myocardial infarction and may improve after coronary blood flow is enhanced by revascularization procedures. This condition has been coined "hibernating myocardium" and variably defined in recent years. The results of recent clinical studies suggest that dobutamine echocardiography may be useful for detecting viable myocardium in patients with left ventricular dysfunction. METHODS: Twenty-one dogs underwent initial operation. Sonomicrometer crystals were implanted, and baseline measurements of segment shortening and wall thickening (by echocardiography) were made. A coronary artery was ligated; the chest was closed; and measurements were repeated. Dobutamine was incrementally infused with determination of wall thickening and segment shortening at baseline and on days 3 and 7 and weeks 2 and 4 after coronary artery occlusion. Finally, the chest was reopened; the ligated vessel was bypassed; and measurements were repeated. RESULTS: Of the 10 dogs that completed the entire protocol, 7 had varying degrees of nontransmural myocardial infarction (group 1), and 3 had complete transmural myocardial infarction (group 2). In group 1, baseline function was significantly impaired compared with preligation function but increased during dobutamine infusion. When reperfused after 4 weeks, both wall thickening and segment shortening increased significantly. In group 2, significant changes were not seen during the dobutamine studies or after reperfusion. Myocardial perfusion during dobutamine infusion increased in group 1 but did not change in group 2. CONCLUSIONS: We demonstrated improvement in chronically dysfunctional myocardium after restoration of previously interrupted myocardial blood flow in dogs after nontransmural myocardial infarction, thus validating a canine model of hibernating myocardium. As assessed by two independent methods, dobutamine infusion identified hibernating myocardium in an animal model.

Animals↗

Value of transesophageal dobutamine stress echocardiography in assessing coronary artery disease.

The introduction of digital echocardiography has significantly enhanced our ability to select the best set of frames for analysis. However, despite the beneficial attributes of transthoracic dobutamine stress echocardiography, poor quality 2-dimensional images continue to be a significant limiting factor in patients with chest deformities, severe chronic obstructive lung disease, marked obesity, and previous chest surgery. Transesophageal echocardiography provides a new window to monitor left ventricular contractility without the interference of bone and air-filled structures of the thoracic cage. The transesophageal dobutamine stress test is a logical but poorly explored modality to image/stress the heart in certain patients with known or suspected myocardial ischemia. Overall sensitivity (< or = 85%) and specificity (< or = 95-100%) of transesophageal dobutamine stress echocardiography appear to be similar to that of previous transthoracic studies, although no direct comparison has been accomplished between transthoracic and transesophageal stress images. False negative transesophageal dobutamine stress echocardiography results have been described in patients with single-vessel disease in whom ischemic regions may not have been visualized throughout the entire study. False positive study results may be present in patients with hypertension and myocardial hypertrophy that may have signs and symptoms of myocardial ischemia in absence of obstructive disease of the epicardial coronary arteries, presumably related to either microvascular disease or impaired vasodilatory reserve. The proportion of patients with coronary artery disease who need a transesophageal examination for reliable assessment of echocardiographic response to stress varies depending on the operators' skills, the interpreters' experience, and the use of videotape or digitizing systems for image analysis. Although clinically useful in its present transthoracic and transesophageal form, a major limitation of dobutamine stress echocardiographic study is the subjective visual interpretation of endocardial motion and wall thickening, which is only semiquantitative. Color kinesis and tissue Doppler imaging (TDI) are 2 novel echocardiographic techniques that color code endocardial motion and myocardial velocity online and have the potential to objectively quantify regional left ventricular function. Quantitative standardization of transthoracic and transesophageal data interpretation, such as establishing endocardial motion by color kinesis or velocity thresholds by TDI for an abnormal segmental response to stress, has the potential to decrease interobserver variability and increase interinstitutional agreement.

Adrenergic beta-Agonists↗

Regulation of human B19 parvovirus promoter expression by hGABP (E4TF1) transcription factor.

The genetic expression of human B19 parvovirus is only dependent on one promoter in vivo and in vitro. This is the P6 promoter, which is located on the left side of the genome and is a single-stranded DNA molecule. This led us to investigate the regulation of the P6 promoter and the possible resulting variability of the nucleotide sequence. After analysis of the promoter region of 17 B19 strains, only 1.5% variability was found. More exciting was the finding of mutations that were clustered around the TATA box and defined a highly conserved region (nucleotides 113-210) in the proximal part of the P6 promoter. HeLa and UT7/Epo cell extracts were found to protect this region, which contained a core motif for Ets family proteins, with YY1 and Sp1 binding sites on either side. Gel mobility shift assays performed with nuclear proteins from HeLa and UT7/Epo cells identified DNA-binding proteins specific for these sites. By supershift analysis, we demonstrated the binding of the hGABP (also named E4TF1) protein to the Ets binding site and the fixation of Sp1 and YY1 proteins on their respective motifs. In Drosophila SL2 cells, hGABPalpha and -beta stimulated P6 promoter activity, and hGABPalpha/hGABPbeta and Sp1 exerted synergistic stimulation of this activity, an effect diminished by YY1.

Base Sequence↗

Glyburide, a KATP channel antagonist, attenuates the cardioprotective effects of isoflurane in stunned myocardium.

This investigation examined the role of myocardial adenosine triphosphate-regulated potassium (KATP) channels in isoflurane-induced enhancement of myocardial function after reversible tissue injury produced by a 15-min left anterior descending coronary artery occlusion (LAD) and reperfusion. Dogs (n = 14) were chronically instrumented for measurement of left ventricular (LV) and aortic blood pressure, cardiac output, coronary blood flow velocity, and subendocardial segment length. Regional myocardial contractility was evaluated with preload recruitable work area (PRWA). Isovolumic relaxation was assessed with a time constant (tau). Hemodynamic variables and LV function were measured in the conscious state, during 2% isoflurane anesthesia for 45 min before and during a 15-min LAD occlusion, and at several intervals after reperfusion in dogs pretreated with glyburide (0.3 mg/kg, intravenously) or drug vehicle. LAD occlusion caused regional dyskinesia and increases in tau. Vehicle-pretreated dogs demonstrated full recovery of segment shortening by 5 h postreperfusion and recovery of PRWA and tau by 30 min postreperfusion. In contrast, dogs pretreated with glyburide demonstrated sustained systolic and diastolic dysfunction. Segment shortening recovered to only 70% +/- 5%, PRWA remained depressed at 48% +/- 10% and tau was prolonged to 116% +/- 5% of control values at 5 h postreperfusion. The results indicate that isoflurane enhances recovery of myocardial contractile function by 5 h postreperfusion, in comparison to previous findings in conscious dogs. These effects are partially blocked by glyburide pretreatment, indicating that KATP channel activation by isoflurance may mediate these cardioprotective effects.

Anesthetics, Inhalation↗

Localization of epileptogenic zones in F-18 FDG brain PET of patients with temporal lobe epilepsy using artificial neural network.

For an objective interpretation of cerebral metabolic pattern to find epileptogenic zones in patients with temporal lobe epilepsy (TLE), we developed a computer-aided classifier using an artificial neural network (ANN). We studied 261 epilepsy patients diagnosed as no abnormal findings (NA, n = 64), left TLE (n = 116), or right TLE (n = 81) on interictal brain F-18-fluorodeoxyglucose positron emission tomography (FDG PET) by the consensus of two expert physicians. Seventeen asymmetry indexes between the mean counts of the 34 mirrored regions were extracted from the spatially normalized images and used as input parameters. The three diagnoses of NA, left TLE, and right TLE were used as outputs of the ANN. The structure of the ANN was optimized with variable error goals and the number of hidden units. On the criteria of agreement of diagnoses with those of expert viewers, the best classifier was chosen, which yielded a maximum average agreement of 85% for the test set when we used an error goal of 20 (sum of squared error) and ten hidden units. We could devise an ANN that performed as well in diagnosing left or right TLE on FDG PET as human experts and could be used as a clinical decision support tool.

Adult↗

Effects of recombinant equine growth hormone on in vitro biomechanical properties of the superficial digital flexor tendon of Standardbred yearlings in training.

OBJECTIVE: To determine whether recombinant equine growth hormone (rEGH) would alter the in vitro biomechanical properties of the forelimb superficial digital flexor tendon (SDFT) in exercising young Standardbred horses. STUDY DESIGN: Randomized complete block design. ANIMALS: Twelve Standardbred yearlings. METHODS: Horses were trained for 12 weeks on a high-speed treadmill (10% positive incline). rEGH was administered intramuscularly (IM) daily (10 microg/kg during week 4; 20 microg/kg for weeks 5-9) to 6 horses (treated group), whereas 6 horses (control group) were administered an equivalent daily volume of sterile water IM. At 12 weeks, horses were euthanatized and left forelimb SDFTs were collected and stored (-70 degrees C). A section from the mid-region of the SDFT was held in cryoclamps with a 4 cm interspace distance and distracted at 10 mm/s until failure. The variables evaluated were maximal load at yield and failure, ultimate and yield tensile stress and strain, tendon stiffness, and mode of failure. Data were analyzed using unpaired, two-tailed, Student's t-test. Statistical significance was set at P < or =.05. RESULTS: Yield and ultimate tensile stress were significantly lower in the rEGH-treated horses compared with controls. There was a trend toward increased maximal displacement, increased ultimate tensile strain, and decreased tendon stiffness in rEGH-treated horses compared with controls. Tensile stress and cross-sectional area, and tensile stress and stiffness were significantly correlated at yield and failure points. CONCLUSIONS: rEGH, administered at the manufacturer's recommended dose rates to maturing Standardbred horses in training, does not significantly augment the in vitro biomechanical properties of the forelimb SDFT. CLINICAL RELEVANCE: Administration of rEGH to young horses in training is unlikely to enhance the physiologic adaptation of the SDFT to exercise stress.

Animals↗

Identification of cerebral networks by classification of the shape of BOLD responses.

Changes in regional blood oxygen level dependent (BOLD) signals in response to brief visual stimuli can exhibit a variety of time-courses. To demonstrate the anatomical distribution of BOLD response shapes during a match to sample task, a formal analysis of their time-courses is presented. An event-related design was used to estimate regional BOLD responses evoked by a cue word, which instructed the subject to attend to the motion or color of an upcoming target, and those evoked by a briefly presented moving target consisting of colored dots. Regional BOLD time-courses were adequately represented by the linear combination of three orthogonal waveforms. BOLD response shapes were then classified using a fuzzy clustering scheme. Three classes (sustained, phasic, and negative) best characterized cue responses. Four classes (sustained, sustained-phasic, phasic, and bi-phasic) best characterized target responses. In certain regions, the shape of the BOLD responses was modulated by the instruction to attend to the target's motion or color. A left frontal and a posterior parietal region showed sustained activity when motion was cued and transient activity when color was cued. A right thalamic and a left lateral occipital region showed sustained activity when color was cued and transient activity when motion was cued. Following the target several regions showed more sustained activity during motion than color trials. In summary, the effect of the task variable was focal following the cue and widespread following the target. We conclude that the temporal patterns of neural activity affected the shape of the BOLD signal.

Brain↗

FMRI of past tense processing: the effects of phonological complexity and task difficulty.

The generation of regular and irregular past tense verbs has been an important issue in cognitive science and has been used to advance different models of the organization of language in the brain. The dual-system view holds that the regular past tense forms are generated by a rule while irregular forms are retrieved from memory. The single-system view, on the other hand, holds that both forms are generated by a single integrated system and differ only in their reliance on factors such as phonology and semantics. We conducted an event-related fMRI study to examine the activation patterns associated with the generation and reading of regular and irregular past tense forms, in addition to the reading of their stems. Regular and irregular past tense generation activated similar brain regions compared to the reading of their respective stems. The areas activated more for irregular generation compared to regular generation included inferior frontal, precentral, and parietal regions bilaterally. This activation can be interpreted as reflecting the greater attentional and response selection demands of irregular generation. Compared to irregular generation, regular generation activated a small region in the left superior temporal gyrus when the regular and irregular past tense forms were mismatched on phonological complexity. No areas were more activated for regulars than irregulars when the past tense forms were matched on this variable. This suggests that the activation specific to regulars was related to the higher phonological complexity of their past tense forms rather than to their generation. A contrast of the reading of regular and irregular past tense forms was consistent with this hypothesis. These results support a single-system account of past tense generation.

Adult↗

Use of chromametry and digital photography for objective measurement of skin color in clinically normal dogs.

OBJECTIVE: To evaluate whether skin erythema in clinically normal dogs can be quantified by use of chromametry and image analysis of digital photographs. ANIMALS: 9 German Shepherd Dogs and 10 mixed-breed dogs. PROCEDURE: Hair was clipped at 7 sites on the body. Skin erythema was evaluated at the axillary region, right and left lateral aspect of thorax, right and left loin area (ie, part of the back between the thorax and pelvis), right and left groin area (ie, the junctional region between the abdomen and thigh), metatarsal digital pad, and on the nose. Replicate measurements were done by use of chromametry and image analysis of digital photographs, using erythema values in accordance with the Committee International d'Eclairage (CIE)-Lab color system. RESULTS: Repeatability was high for both techniques. Within-dog variation was lower than between-dog variation. Between-dog variation was high for both groups of dogs. Interregional variation was significant in German Shepherd Dogs and mixed-breed dogs. Erythema values revealed symmetry between the right and left lateral aspects of the thorax and loin and groin areas. CONCLUSIONS AND CLINICAL RELEVANCE: Precise objective methods are available for skin erythema quantification. Chromametric and photographic erythema values had a high within-dog reproducibility. Between-dog variability was high for German Shepherd Dogs and mixed-breed dogs as was regional variation, indicating differences in color among dogs.

Animals↗

Left ventricular remodeling after infarction: sequential MR imaging with oral nicorandil therapy in rat model.

PURPOSE: To use magnetic resonance (MR) imaging in quantification of the short- and long-term effects of therapy with orally administered nicorandil on left ventricular (LV) geometry and function independent of infarction size. MATERIALS AND METHODS: Forty-six rats were subjected to reperfused infarction and randomly divided into two groups. Group 1 rats (n = 21) were treated with nicorandil (3 mg/kg/day in drinking water) for 4 days before infarction and 8 weeks after infarction (hereafter, the nicorandil group). Group 2 rats (n = 25) received tap water for the same period and served as the control group. Mesoporphyrin- (as a necrosis-specific agent) enhanced MR imaging was used to define necrotic myocardium on day 2 after infarction in all 46 animals. Contrast material-enhanced MR images showed large but identical infarction size in 11 control and 11 nicorandil rats. Only these 22 rats underwent repeat MR imaging at 8 weeks after infarction. The following variables were measured: LV volumes, ejection fraction, mass, wall thickness, and infarction size. Student t test and analysis of variance for repeated measurements were used for statistical analysis. RESULTS: The size of the necrotic region on mesoporphyrin-enhanced MR images was 39% +/- 3 of the size of the left ventricle in the control group and 41% +/- 2 in the nicorandil group (difference not significant, unpaired Student t test). Pretreatment with nicorandil for 6 days before imaging did not reduce LV dilation or improve function compared with those in control animals with identical infarction size. Eight weeks after infarction, control animals showed deterioration in LV function, wall thinning, and gradient in regional dysfunction (analysis of variance test). Nicorandil produced significant salutary effects on LV ejection fraction (37% +/- 3 in the nicorandil group vs 24% +/- 3 in the control group), end-diastolic volume (0.53 mL +/- 0.03 vs 0.65 mL +/- 0.04), end-systolic volume (0.36 mL +/- 0.03 vs 0.49 mL +/- 0.05), LV wall thickening in remote noninfarcted myocardium (28% +/- 2 vs 19% +/- 1), and a rim of infarction (16% +/- 2 vs 8% +/- 1) (P <.05 for all parameters). The increase in LV mass was reduced in the nicorandil group (0.73 g +/- 0.03) compared with that in the control group (0.89 g +/- 0.04) (P <.05). CONCLUSION: In animals studied longitudinally, MR imaging demonstrated the deleterious changes in LV geometry and function in the period after infarction and the salutary effects of medical therapy.

Administration, Oral↗

Qualitative assessment of regional left ventricular function can predict MRI or radionuclide ejection fraction: an objective alternative to eyeball estimates.

PURPOSE: Assessment of left ventricular function is important in patients with heart disease. We hypothesized that regional wall motion assessed qualitatively by cine magnetic resonance imaging (MRI) can predict the left ventricular ejection fraction (EF). METHODS: The correlations between MRI EF and the American Society of Echocardiography (ASE) score index and a modified ASE score index were established in 117 subjects. The model was tested in the next 86 patients. Interobserver variability was studied in 30 patients. Radionuclide EF was compared in 81 patients. Cine MRI studies were performed on a 1.5 T scanner. RESULTS: From the initial 117 patients, there was a linear correlation between the ASE score index and MRI (r = 0.85), but the relationship improved by including a category of hyperkinetic wall motion (r = 0.90). Using these correlations to predict MRI EF in the next 86 patients, there was a good agreement (r = 0.93 for the ASE score index and r = 0.97 for the modified ASE score index). Correlations between radionuclide EF and the EF predicted by the modified ASE score index or the MRI EF by planimetry were similar (r = 0.91 vs. r = 0.90, respectively). Four observers tested the model and achieved comparable results (r = 0.88 to 0.95). CONCLUSIONS: There is a close relationship between ejection fraction and the ASE score index or modified ASE score index. This correlation can provide an objective prediction of ejection fraction based solely on a qualitative reading of regional wall thickening.

Adolescent↗

Effects of isoflurane on regional pulmonary blood flow during one-lung ventilation.

Isoflurane has been reported to inhibit hypoxic pulmonary vasoconstriction. However, the effects of one-lung ventilation and isoflurane on regional pulmonary blood flow (Qr) have not been investigated in detail. Therefore, using radionuclide labelled microspheres we measured Qr in rabbits (n = 8) in the left lateral decubitus position during two- and one-lung ventilation under i.v. baseline anaesthesia and during additional administration of 1.5% isoflurane. Macrohaemodynamic variables were recorded continuously. Isoflurane increased non-dependent lung blood flow during two-lung ventilation. One-lung ventilation caused a homogeneous decrease in Qr throughout the hypoxic lung, irrespective of isoflurane administration (P < 0.001). However, isoflurane significantly augmented Qr of the hypoxic lung during one-lung ventilation (P < 0.05). During all phases, Qr of the upper lobe was higher compared with that in the lower lobe in isogravitational slices of both lungs; a ventrodorsal perfusion gradient was found in the left upper lobe. We conclude that 1.5% isoflurane increased perfusion of the non-dependent lung, inhibited hypoxic pulmonary vasoconstriction-induced redistribution of pulmonary blood flow and did not influence isogravitational perfusion gradients.

Anesthesia, Intravenous↗

Myocardial dysfunction in ankylosing spondylitis.

Echocardiographic evidence has suggested abnormalities of the myocardial function in patients with ankylosing spondylitis. In this work the cardiac function in patients with ankylosing spondylitis and in normal volunteers was evaluated. Twenty four normal volunteers and 21 patients with ankylosing spondylitis aged 18-45 were studied. None had overt cardiac disease. Cardiac function was assessed at rest with echocardiography, at rest and during supine bicycle exercise using radionuclide angiography in the left anterior oblique position following equilibration with 740 MBq of technetium-99. The subjects undertook supine bicycle exercise with 30 W increments every three minutes to the point of fatigue. Comparison of data from normal volunteers and patients with ankylosing spondylitis were made using Student's t test for independent samples or the Mann-Whitney non-parametric technique, as appropriate. Subjects were matched for age, sex, height, and weight. There were no echocardiographic differences; however, global nuclide left ventricular function showed several differences between normal volunteers and patients with ankylosing spondylitis. The peak filling rate during exercise was significantly lower in patients with ankylosing spondylitis: normal volunteers 6.5 (SD 1.2); patients with ankylosing spondylitis 5.7 (1.2). The time to reach peak filling during exercise was significantly lower in patients with ankylosing spondylitis: normal volunteers 102 (22); patients with ankylosing spondylitis 120 (23). Regional analysis also showed differences between patients with ankylosing spondylitis and normal volunteers both at rest and during exercise. In the anteroseptal region the filling fraction and peak filling rate were significantly lower in patients with ankylosing spondylitis. Most of the differences (although not all) were in the variables of diastolic function. This study shows that there are subtle abnormalities in cardiac function in patients with ankylosing spondylitis. The major abnormalities are in the diastolic function, suggesting a decrease in left ventricular compliance.

Adult↗