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Compensatory regional contraction following coronary artery occlusion depends on subendocardial hyperaemia and hyperkinesis.

The effects of circumflex coronary artery occlusion on regional myocardial performance and blood flow in the left ventricular anterior wall was studied, using 16 thoracotomized pentobarbital-anaesthetized cats. Two pairs of ultrasonic crystals were placed in the midwall; one segment (longitudinal) parallel to the subendocardial fibres, the other (circumferential) being aligned to the fibres of the outer half-layer. A shunt line from the right subclavian artery to the main left coronary artery was unrestricted in eight cats (Group A) and clamped in another eight cats (Group B) until coronary perfusion pressure was clearly reduced with only a minor reduction in shunt flow, but without changes in global cardiac function. After circumflex coronary occlusion hyperkinesis was most pronounced in segments parallel to subendocardial fibres (longitudinal), also validated as a marked leftward shift in the end-systolic pressure-length relation of these segments. Such a shift may indicate decreased regional afterloading along the cardiac major axis. Hyperkinesis of longitudinal segments was attenuated in Group B where a fixed shunt stenosis hampered subendocardial and mid-myocardial hyperaemia. The lesser hyperkinesis of Group B was associated with decreased left ventricular systolic pressure and cardiac output. Thus, impaired compensatory contraction outside an acute ischaemic region was produced by a significant coronary stenosis which precluded the subendocardial hyperaemia and hyperkinesis of that region.

Animals

Compensatory subendocardial hyperkinesis in the cat is abolished during coronary insufficiency outside an acutely ischaemic region.

OBJECTIVE: The aims were to determine (1) whether acute coronary occlusion provoked uniform hyperkinesis in remote non-ischaemic myocardium, and (2) how subsequent coronary stenosis affected such hyperkinesis. METHODS: Two pairs of ultrasonic crystals were placed in the anterior left ventricular midwall of nine pentobarbitone anaesthetised open chest cats. One pair (longitudinal) ran parallel to subendocardial fibres; the other pair (circumferential) was aligned with subepicardial and mid-myocardial fibres. Following circumflex coronary occlusion, subsequent hypoperfusion of the anterior wall was established by controlled constriction of a shunt line from the right subclavian artery to the left main coronary artery in two discrete steps. RESULTS: Following circumflex occlusion maximum systolic shortening of segments aligned to subendocardial fibres increased from 6.7(SEM 0.9)% to 11.5(1.4)% (p less than 0.001), whereas circumferential segment shortening was unchanged, at 12.2(0.8)% v 14.1(1.1)%. During mild shunt stenosis [delta P = 42(2) mm Hg] subendocardial tissue blood flow in the anterior wall decreased by 42(10)% (p less than 0.001), and longitudinal segment shortening decreased from 11.5(1.4)% to 6.9(1.1)% (p less than 0.001). Corresponding shortening of circumferential segments did not change. During severe shunt stenosis [delta P = 52(3) mm Hg] subendocardial tissue blood flow decreased further, and shortening of longitudinal segments approached zero value (p less than 0.001). CONCLUSIONS: Compensatory hyperkinesis of remote non-ischaemic myocardium following an acute coronary occlusion may depend mostly on augmented subendocardial contraction.

Animals

Operant conditioning of EEG rhythms and ritalin in the treatment of hyperkinesis.

Enhanced voluntary motor inhibition regularly accompanies conditioned increases in the sensorimotor rhythm (SMR), a 12--14-Hz Rolandic EEG rhythm in cats.A similar rhythm, presumably SMR, has also been identified in the human EEG. The clinical effectiveness of SMR operant conditioning has been claimed for epilepsy, insomnia, and hyperkinesis concurrent with seizure disorders. The present report attempts to follow up and replicate preliminary findings that suggested the technique's successful application to hyperkinesis uncomplicated by a history of epilepsy. SMR was defined as 12--14-Hz EEG activity in the absence of high-voltage slow-wave activity between 4 and 7 Hz. Anticipated treatment effects were indexed by systematic behavioral assessments of undirected motor activity and short attention span in the classroom. EEG and behavioral indices were monitored in four hyperkinetic children under the following six conditions: (1) No Drug, (2) Drug Only, (3) Drug and SMR Training I, (4) Drug and SMR Reversal Training, (5) Drug and SMR Training II, (6) No Drug and SMR Training. All hyperkinetic subjects were maintained on a constant drug regimen throughout the phases employing chemotherapy. Contingent increases and decreases in SMR occurred in three of four training subjects and were associated with similar changes in classroom assessments of motor inactivity. Combining medication and SMR training resulted in substantial improvements that exceeded the effects of drugs alone and were sustained with SMR training after medication was withdrawn. In contrast, these physiological and behavioral changes were absent in one highly distractible subject who failed to acquire the SMR task. Finally, pretraining levels of SMR accurately reflected both the seve-ity of original motor deficits and the susceptibility of hyperkinetic subjects to both treatments. Although the procedure clearly reduced hyperkinetic behavior, a salient, specific therapeutic factor could not be identified due to the dual EEG contingency imposed combined with associated changes in EMG. Despite these and other qualifying factors, the findings suggested the prognostic and diagnostic value of the SMR in the disorder when overactivity rather than distractibility is the predominant behavioral deficit.

Biofeedback, Psychology

Nutrient intakes of children on the hyperkinesis diet.

The nutrient intakes of fifty-four hyperactive children during a baseline period and while following the hyperkinesis diet were calculated. During both periods, mean dietary intakes compared favorably with the Recommended Dietary Allowances. A comparison of three-day food records showed that, relative to baseline values, nutrient intakes did not change significantly while the children followed the hyperkinesis diet. The majority of the children reported intakes sufficient to meet the recommended allowances during both the baseline and diet periods.

Child

Organic factors in hyperkinesis: a critical evaluation.

The role of organic factors in childhood hyperkinesis is evaluated, with a focus on electroencephalographic, neurological, biochemical, pregnancy and birth, and genetic research. Evidence that the majority of hyperkinetic children suffer from organic dysfunction is found to be minimal. This conclusion is discussed, and guidelines for future research are offered.

Attention Deficit Disorder with Hyperactivity

[Analysis of results with Depamide in children with psychomotor instability (hyperkinesis (author's transl)].

This study results from observations, for 10 years, of children with psychomotor instability, also called hyperkinesis, generally due to "minimal brain dysfunction". A clinical summary emphasizes instability and difficult coordination of all aspects of personality. A pathogenic hypothesis concerns one of the stimulation function which may be abnormal, as the control and regulation of personality, partly located, at the subcortical level, and creating secondary symptoms and reactional ones. The results of therapy are interpreted according to a clinical research protocol. It proposes a global appreciation, an appreciation of the duration of therapeutic effect through the study of variation of specific criteria, and a general appreciation correlating both aspects. Through this stern methodology and the mean duration of treatment of 2 years, the results are significant in 55% of the cases. Compared to other drugs, Depamide seems more valid. Furthermore, this drug is without secondary clinical and psychological effects.

Child

[Experimental hyperkinesis upon systemic activation of the limbic structures of the brain].

Proceeding from the standpoint of a systemic organization of nervous processes which determine the central mechanism of hyperkinesis, the authors modeled hyperkineses by a simultaneous or successional electric stimulation of the brain limbic system in dogs. It was established that there was a correlation between the external expression of hyperkineses, their stability and reproduction and the ordinal succession in which the structures are irritated. In such conditions it is possible to create a functional system where the activation of separate structures appears to be a link in the system while the separate links are inter-related on the basis of inborn and developed mechanisms.

Amygdala

Glomerular/tubular mixed-type proteinuria in a 3-year-old boy with mental retardation and hyperkinesis.

A 3-year-old boy with mixed glomerular/tubular proteinuria, mental retardation, and hyperkinesis is described. The proteinuria was discovered at the age of 3 years on urinary mass screening. Most of the urinary protein consisted of albumin, accompanied by increases in low molecular weight proteins, including beta 2-microglobulin and alpha 1-microglobulin. Mixed glomerular/tubular proteinuria is known to be caused by the following conditions: chronic renal failure, chronic pyelonephritis, cadmium poisoning, tubulointerstitial nephritis of various etiologies, and after strenuous, short-term, exhaustive exercise. The present patient did not display any of these disorders or conditions.

Child, Preschool

[Clinical picture and characteristics of the course of tic hyperkinesis in children].

The author examined 90 children with ticose hyperkinesis. On the basis of a thorough study of the clinical picture, course of the disease and the use of laboratory methods all the patients were divided into 3 groups: with regressive, remittent and progradient development and characteristic clinical signs. For each group a corresponding treatment with a good effect was selected.

Adolescent

[Bucco-linquo-facial and choriform hyperkinesies (author's transl)].

These bucco-linguo-facial and choriform hyperkinesies still remain all too frequent in many neurological diseases. The authors study exclusively the dyskinesies of essential origin or iatrogenous including the post neuroleptic and post dopatherapy dyskinesies. All the neuroleptics can be involved at different stages of the treatment, giving rise to difficulties in the diagnosis. Dopatherapy in the Parkinson disease is also responsable of many dyskinesias. Time of appearance after the drug's taking, significance and treatment are discussed. The idiopathic dyskinesis are more unusual either with the some only facial involvement, or in association with another abnormal movements. The physiopathology is doubtful, so the treatment is often very difficult.

Antipsychotic Agents

Caffeine potentiation of amphetamine: implications for hyperkinesis therapy.

Neither 0.05 mg/kg d-amphetamine nor 15 mg/kg caffeine alone produce amphetamine-like responding in rats trained in two-lever operant chambers to discriminate 0.8 mg/kg d-amphetamine from saline. The co-administration of the two drug doses produced responding similar to the 0.8 mg/kg d-amphetamine dose. A suggestion for the mechanism of action and a regimen of administration for caffeine in hyperkinetic children are discussed.

Animals