Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of dibutyryl 3',5'-cyclic monophosphate (D-cAMP) on the neuromuscular transmission was studied in a patient with myasthenia gravis during anesthesia. D-cAMP caused a slight increase in single twitch tension, and an initial transient decrease in tension which resulted from the trains of 2 Hz stimuli disappeared after D-cAMP. The finding of the present study suggests that D-cAMP has an anti-fatigue effect in patients with myasthenia gravis.
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PMID:Effect of dibutyryl cyclic AMP on neuromuscular transmission in myasthenia gravis. 18 50

Fourteen patients with a variety of neoplasms not responsive to standard forms of therapy underwent whole body hyperthermia for a maximum 4 h at 41.8 degrees C. This was a phase-I cancer trial designed to develop whole body hyperthermia as an adjuvant to systemic chemotherapy. Intravenous analgesia was used to sedate patients, obviating the need for general endotracheal anesthesia. Hyperthermia was induced by means of a high-flow water perfusion suit. Cardiovascular performance was evaluated using a flow-directed pulmonary artery catheter. Patients developed a twofold mean increase in cardiac index without evidence of cardiac damage by ECG or creatine phosphokinase (CPK) isoenzymes. An acute fall in serum magnesium and phosphate and an acute rise in arterial pH, serum CPK values, and granulocyte count occurred in all patients. There were no clotting abnormalities. Toxicity included fatigue, diarrhea, nausea, and transient elevations in liver enzymes. Four patients were febrile for 36 h after initial defervescence. Peripheral neuropathy developed in four. These results show that with carefully monitored conditions whole body hyperthermia is feasible.
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PMID:Whole body hyperthermia: a phase-I trial of a potential adjuvant to chemotherapy. 42 99

Until recently use of adhesives was confined to cases in which glued areas could be pre-treated or at least cleaned. Thus, grease or oil contaminated surfaces could not be joined together by glueing. More recently, some adhesives have been developed which allow previous treatment of greasy surfaces to be avoided. Among these we find epoxy resins, acrylics and polyurethances. These adhesives have been used until now in various industries. We have begun a research program with these products and in aiming to design an adhesive which would enable immediate and strong bone bonding and avoid problems of metallic fixation, this study is a continuation of our previous research. Thus we tested - currently available surgical and dental adhesives - original mixtures developed in our laboratory. Mechanical assays were performed on bone samples from human femurs in different conditions : dried, cleaned, fresh, or after immersion in physiological solution. They consist essentially of tensile tests on Lhomargy and Zwick's machine wherein the stress is directed perpendicular to the interface. Variations of tensile strength (in h bar) are related to hardening time and to mixture composition. The specimens are joined together either in monolayers or in multilayers. The use of adequate catalysts ensures setting at room temperature. Torsion tests and fatigue tests are carried out concomitantly. Standardized bevel fermoral osteotomies were performed on mice with a dental saw after I.P. Nembutal anesthesia in order to test biological tolerance : - for the control group we study the evolution of bone repair after circumferential wiring - for the animals under test, bones are glued together with one of the proposed adhesives. Radiological and histological studies (using classical Azantrichrome staining after demineralization) are carried out at regular time intervals. In the control animals particular attention is paid to the time course of the formation, constitution and evolution of callus. In the test animals, we can observe callus formation, bone growth into the adhesive material and glue resorption, and look for specific antigenic phenomena. Despite expected improvements, bone glueing remains a challenge and only restricted clinical applications can be proposed.
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PMID:Bone bonding through bioadhesives: present status. 45 83

We have studied two cases of the syndrome of myokymia and impaired muscular relaxation with continuous motor unit activity. Both patients complained of muscle twitching, weakness, stiffness, and hyperhydrosis during their illness. Myokymia was present over the entire body in both. On repetitive testing of muscle strength each patient showed initial fatigue followed by increasing strength as he continued his efforts. Both patinets improved on phenytoin therapy at high blood levels. Nerve conduction velocities were decreased. Electromyograms showed continuous electrical activity at rest which persisted during sleep and spinal anaesthesia but was diminished by curare. Intravital staining with methylene blue in one case demonstrated sprouting and beading of motor nerve terminals with multiple innervation of muscle fibres. The neurophysiological and pathological findings in these two cases indicate an abnormality of peripheral nerve in this disorder.
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PMID:Myokymia and impaired muscular relaxation with continuous motor unit activity. 46 63

His-bundle electrocardiography was used to evaluate the effect of halothane on AV nodal and His-Purkinje system conduction times in the spontaneously beating dog heart. During artrial pacing at basic heart rates of 120 or 200 beats per minute (bpm), an extrastimulus (cycle length longer or shorter than that of the basic rate) was delivered to test the effect of halothane on several parameters of AV nodal conductivity. Included were the functional refractory period, basal conduction time, and fatigue effect (prolongation of basal conduction time as heart rate was increased from 120 to 200 bpm). Increasing MAC level of halothane (1.25 to 2.75 MAC) prolonged both AV node and His-Purkinje conduction times, yet had little effect on the parameters of nodal conductivity tested for. These effects of halothane could be potentially dangerous in the clinical setting for patients with defective AV conduction. In addition, changes in conduction may be in part responsible for arrhythmias seen during halothane anesthesia.
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PMID:Halothane effects on conductivity of the AV node and His-Purkinje system in the dog. 55 37

In the past 25 years, we have studied 73 cases of Myasthenia. 19 of these have had 24 pregnancies. We confirm the results that are given in the literature (15). Pregnancy does not trigger off Myasthenia. The action of pregnancy on Myasthenia is variable and there is an equal chance of worsening, improvement or a stationary state of the condition. All the same, patients who are well stabilised and have been for some time do not become worse. Worsening, when it does happen, happens especially in the first trimester of the pregnancy and calls for precise observation of the patient in order to regulate the treatment. Myasthenia has no direct or indirect action on the fetus and the pregnancy is not disturbed. Labour can be normal but the second stage often has to be aided because of the patient's muscle tiredness. In labour and particularly in the second stage an acute crisis can occur with difficulty in breathing. For this it is necessary to have an anaesthetist present who can resuscitate the patient and if necessary give respiratory aid by ventilation. Curare and like substances are absoultely contra-indicated if general anaesthesia is required. Transitory neonatal Myasthenia is rare, but the severity of the respiratory complications can be such that is should be sought for routinely and if there is the slightest doubt the newborn should be transferred to the special care neonatal unit.
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PMID:[Myasthenia and pregnancy (author's transl)]. 74 45

The effect of halothane on A-V conduction was evaluated in gods during atrial pacing using the technique of His-bundle electrocardiography. In addition, the effects of lidocaine and diphenylkydantoin (DPH) on A-V conuction were examined during halothane anesthesia. Effects of these drugs on three subintervals of A-V conduction were compared. These included the -H (stimulus atifact of His-bundle deflection-atrioventricular conduction), H-Q (His-budnle deflection onset of QRS complex-His-Purkinje conduction), and H-S intervals(His-bundle delfection to end of QRS COmplex-total intraventricular conduction). Linear regression best described the relationship between duration of interval (P-H, H-V,and H-S) and heart rate during incremental increases in the atrial paced rate. Data from these experiments were fitted to a multiple lenear regression model that predicted the effect of increasing concentrations of halothan, lidocaine, and DPH on slope and intercept coefficients. In creasing concentrations of halothan ( 30 and 45 mg/100 ml arterial). Both lidocaine and DPH further depressed conduction at all levels of halothan anesthesia. The P-H interval was particularly sensitive todrug effefts. This may represent potentiation of the normal slowing of conduction through the AVnode in response to incremental increases in heart rate (fatigue response.) We conclude thatboth lidocaine and DPH fail to reverse the depressant effect of halothane on A-V conduction. This may explain their ineffectiveness in treating certain types of arrhythmias during halothane anesthesia.
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PMID:Diphenylhydantoin and lidocaine modification of A-V conduction in halothane-anesthetized dogs. 114 8

The effects of fatigue on the electromyographic (EMG) reflex activities were compared during sustained voluntary contractions and contractions evoked by electrical stimulation (30 Hz) in the human first dorsal interosseus (FDI). Short latency (SL), medium latency (ML) and long latency (LL) reflex responses to a ramp-and-hold stretch of the muscle were recorded and analysed in 27 healthy subjects of both sexes. The amplitude of the reflex components was normalized as function of the amplitude of the surface action potential (SAP) recorded in response to the supramaximal stimulation of the motor nerve. The results indicate that for a similar reduction of force, SL and ML are significantly reduced after fatigue induced by voluntary contractions but they are not when the fatigue test is performed by electrical stimulation at the motor point. In voluntary fatigue experiments, the LL component showed no significant decrease below control values, but an enhancement was observed during electrically evoked contraction. This enhancement remained above control values for at least 15 min during the recovery period, whereas SL and ML decreases returned to control within 5 min after the fatigue tests. The electrical stimulation applied to the skin overlying the FDI at an intensity lower than the motor threshold did not affect SL and ML, but enhanced LL for about 15 min. On the contrary, the anaesthesia of the skin overlying the FDI induced a decrease in LL without significant change of SL and ML. It is concluded that muscle reflex fatigue is present during sustained voluntary contractions and decreases SL and ML responses to quick stretches.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of fatigue on the stretch reflex in a human muscle. 137 44

The development of fatigue was investigated by electrical stimulation in 15 domestic pigs (1 yr old, 70-90 kg body weight) and seven adult dogs (3 yr old, 45 kg body weight). After anaesthesia, silver electrodes were implanted in the anterior and posterior parts of the right masseter muscles. The contralateral muscle was used as control. The bite force was measured. Muscle biopsies were obtained from the anterior, central and posterior parts, and were immediately frozen in liquid nitrogen. A fluorometrical analysis by enzymatic methods for glycogen, glucose, creatine phosphate, NAD, NADH, lactate and pyruvate was made. Blood flow was measured by 133Xe wash-out; oxygen consumption was monitored with an oxygen electrode. The porcine masseter was continuously stimulated for 60 min (100 V, 4 Hz and 2 ms). The canine masseter was intermittently stimulated (100 V, 20 Hz and 2 ms). The contraction was repeated four times, with a 10-min rest between. The porcine masseter could sustain longer endurance times than the canine masseter, which was easily fatigued. A marked substrate depletion was evident. The precontractional contents of glycogen, glucose and creatine phosphate were reduced. Lactate accumulation was evident (2-4 times more in the porcine and 4-8 times more in the canine masseter). The NADH concentration increased and the NAD content decreased. Blood-flow impairment (80% reduction in the dog, 60% in the pig) was observed. After the contraction phase, there was a hyperaemia (58% elevation of blood flow in the pig masseter, 45% in the canine). The oxygen tension followed in magnitude and time the blood-flow changes. These circulatory variables returned to normal after recovery. The high degree of substrate depletion, blood-flow impairment and a simultaneous decrease in oxygen transport to the contracted muscle, in combination with a prominent lactate accumulation, may induce a decrease in bite-force production.
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PMID:Bite-force development, metabolic and circulatory response to electrical stimulation in the canine and porcine masseter muscles. 147 60

This report describes a case of epinephrine predominant pheochromocytoma successfully managed intraoperatively with an infusion of diltiazem. A 50-yr-old woman with a 10-yr history of diabetes mellitus was admitted to the hospital because of thirst and general fatigue. A cystic left adrenal tumor was found on computed tomographic scan. Although resting plasma catecholamine levels were normal, plasma norepinephrine and epinephrine levels obtained from the left adrenal vein were 1.6 ng.ml-1 (normal, 0.04-0.35) and 6.2 ng.ml-1 (normal, less than 0.12), respectively. Diltiazem was administered i. v. at a rate of 3 micrograms.kg-1.min-1 before induction of anesthesia. Anesthesia was induced with enflurane 2-3% and nitrous oxide in oxygen, followed by tracheal intubation facilitated with vecuronium. Anesthesia was maintained with enflurane 1-3% and nitrous oxide in oxygen. Paralysis was maintained with vecuronium. Hypertension during the manipulation of the tumor was controlled by increasing the inspired concentration of enflurane or by increasing the infusion rate of diltiazem to 5 micrograms.kg-1.min-1. There was no tachyarrhythmia. The infusion of diltiazem was continued until the draining vein from the tumor had been ligated. Hypotension, after removal of the tumor, was treated by the rapid infusion of fluid. Plasma norepinephrine and epinephrine levels during tumor manipulation were 1.18 ng.ml-1 and 6.57 ng.ml-1, respectively.
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PMID:[Use of diltiazem in the anesthetic management of epinephrine predominant pheochromocytoma]. 149 89


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