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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiovascular responses have been studied in baboons, after total exchange transfusion with hemoglobin solutions having various P50 values. At the end of the exchange transfusion, the hematocrit was 1.5%, the mean hemoglobin concentration was 4.4 g/dl, and the P50 varied between 12 and 26 mm Hg. Cardiac output did not change during the study, although heart rate increased, and stroke volume and MAP decreased. Hemoglobin concentration, per se, does not appear to be the critical stimulus for an increase in cardiac output with hemoglobin solution. In addition, the position of the hemoglobin-oxygen dissociation curve does not appear to influence these hemodynamic responses. The physiological response to anemia in the presence of hemoglobin solution appears different from that observed in the absence of plasma O2 carriers.
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PMID:Cardiac output response to extreme hemodilution with hemoglobin solutions of various P50 values. 11 94

Blood parameters concerning oxygen transport and relative organ weights of 11 Suncus etruscus and 13 Crocidura russula under light halothane anesthesia were investigated. Mean body weight of S. etruscus was 2.5 g and for C. russula was 9 g, hemoglobin concentration was 17.4 and 15.6 g/100 ml blood, hematocrit was 50 and 44%, red blood cells were 18 and 11 X 10(6)/microliter, respectively. Mean corpuscular volume was calculated to be 26 and 41 micron3, mean diameter 5.5 and 7 micron, and mean thickness 1.2 and 1.1 micron, respectively. Mean corpuscular hemoglobin concentration was in the normal range of mammalian red blood cells. A blood oxygen half-saturation pressure of 35 and 34 Torr at pH 7.4, 37 degrees C and a Bohr factor deltalog P50/deltapH of -0.61 and -0.66 was measured. Experiments with stripped hemoglobin showed that 2,3-diphosphoglycerate is the main oxygen affinity reducing allosteric factor. Relative weights of heart, kidney, and liver are remarkably high in S. etruscus. The maximal oxygen transport of 400 ml . kg-1 . min-1 of S. etruscus is feasible by an enormous heart rate, a large relative stroke volume, a high hemoglobin concentration combined with a low oxygen affinity, and a large Bohr effect.
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PMID:Blood oxygen transport and organ weights of two shrew species (S. etruscus and C. russula). 42 99

A severely anaemic, but asymptomatic patient, who is a heterozygous carrier of haemoglobin Hammersmith (beta42 (CD1) phenylalanine - Serine), has been studied to elucidate the mechanisms resulting in physiological compensation for the anaemia. Four factors have been investigated: the oxygen affinity of her blood, the cardiac output at rest and during exercise, the blood gas indices, and pulmonary function. It was found that due to the presence of Heinz bodies within the erythrocytes, the level of functional, haemoglobin was considerably less (50 g/l) than that measured by standard methods (87 g/l). In addition a moderate degree of arterial hypoxaemia (arterial oxygen tension = 10.7 kPa (80.4 mmHg) was present which could not be explained on the basis of abnormal pulmonary function. Both of these factors would result in tissue hypoxia, but the finding of consistently normal oxygen tensions ('mixed' venous oxygen tension = 5.4 kPa (40.3 mmHg) in blood obtained from the right atrium, suggested that hypoxia was not present. This was explained by a decreased whole blood oxygen affinity (P50 = 4.6 kPa (34.5 mmHg) at pH 7.4) and an increase in the cardiac index (5.3 L.min.-1m-2). The latter was the result of an increased stroke volume (125 - 135 ml), the heart rate being normal (63/min.). During moderate exercise, further increases at cardiac output were brought about by a change in heart rate alone. It has been calculated that the decrease in whole blood oxygen per se could not account for adequate tissue oxygenation. This is confirmed by the finding of an increased cardiac output in this patient. It is suggested that in any severe haemolytic anaemia, even if the whole blood oxygen affinity is low, cardiac output is probably increased to achieve complete physiological compensation.
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PMID:Compensatory mechanisms for the severe anaemia caused by haemoglobin Hammersmith. 93 44

Phosphate has been proposed as an ergogenic aid since it may enhance O2 delivery and cardiac work efficiency by increasing plasma phosphate (P Pi), red blood cell phosphate (RBC Pi), 2,3-diphosphoglycerate (DPG), RBC adenosine triphosphate (ATP), and P50. In 10 normal, fasting males we measured cardiac output (Q) by CO2 rebreathing, heart rate (HR), O2 deficit (O2DEF), and O2 consumption (VO2) during cycle ergometer exercise (60% of peak VO2). Stroke volume (SV) and arteriovenous O2 difference (A-VO2) were calculated. Following a baseline blood sample (BASE) for P Pi, RBC Pi, DPG, RBC ATP, and P50 (3 h before exercise), a single oral dose of dicalcium phosphate (129 mmol) and glucose (500 ml/10% sol, PHOS), or placebo (PLA), was administered in a random, crossover, double-blind fashion. Blood sampling was repeated immediately before and after exercise (PRE-EX and POST-EX). PHOS induced increases in P Pi (3.87 to 4.35 mg.dl-1, P less than 0.05), RBC Pi (3.86 to 4.63 mg.dl-1, P = 0.08), DPG (11.8 to 13.1 mumol.g-1 Hb, P less than 0.05), RBC ATP (4.2 to 4.4 mumol.g-1 Hb, P less than 0.05), and P50 (26.8 to 27.9 mm Hg, P less than 0.05) from BASE to PRE-EX. All variables remained elevated through the exercise period, as evidenced by higher levels than BASE at POST-EX (P less than 0.05). However, P50 was not different across conditions at PRE-EX (PHOS P50 = 27.9, PLA P50 = 28.3 mm Hg) or POST-EX (PHOS P50 = 28.0, PLA P50 = 28.1 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Oxygen delivery and cardiac output during exercise following oral phosphate-glucose. 238 2

The use of oral phosphate (Pi) supplements to improve muscular work performance has long been proposed without substantiating data. In a double-blind, crossover experiment 11 male runners ingested calcium Pi (176 mmol/day) or placebo for 4 days. On the 3rd treatment day, subjects ran an incremental maximal aerobic capacity test (VO2 max) on a treadmill, and on the 4th day a treadmill run to exhaustion at approximately 70% VO2max. By the 4th day of Pi loading, plasma Pi was significantly higher than control (P less than 0.05); however, erythrocyte Pi, 2,3-diphosphoglycerate, and O2 half-saturation pressure of hemoglobin (P50) were not elevated. VO2 max was not changed by the treatments (mean 62.9, 64.2, 64.9 ml.kg-1.min-1 for control, Pi, and placebo bouts, respectively) nor was submaximal run time to exhaustion (61.6 min for Pi, 65.5 min for placebo). Stroke volume at steady-state VO2 was decreased with Pi (P less than 0.05), whereas cardiac output tended (P = 0.07) to be lower. Greater arteriovenous O2 difference (P less than 0.05) with Pi suggested a peripheral effect that increased O2 extraction. We concluded that in healthy individuals Pi loading produced no improvement in work tolerance or aerobic capacity but did alter some aspects of cardiovascular function.
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PMID:Phosphate supplementation, cardiovascular function, and exercise performance in humans. 318 42

The effects of glucose-insulin-potassium (GIK) on hemodynamics, oxygen transport, P50, 2,3-diphosphoglycerate (2.3-DPG), and adenosine triphosphate (ATP) were evaluated in canine endotoxin shock. Ten dogs were studied under general anesthesia and controlled ventilation. Shock was induced with Escherichia coli endotoxin (1.5 mg/kg body wt). Thereafter two groups of five dogs each were formed by randomization. The one group received GIK (glucose 50%, 2 g/kg, insulin 3 U/kg, and 10 mmole K) in the period between 90 and 120 min after endotoxin. The other group received an equal amount of NaCl infusion and served as a control group. Observations were completed at 180 min after endotoxin. GIK resulted in a significant increase of cardiac output, stroke volume, mean arterial pressure, and oxygen consumption. Serum phosphate levels decreased. No changes were observed of P50 in vitro (at 37 degrees C and pH 7.40) and of P50 in vivo, nor of 2.3-DPG and ATP in the red cells. The data suggest that the increased oxygen consumption after GIK in canine endotoxin shock is caused only by improvement of cardiac output and oxygen availability and not by an effect on oxygen unloading capacity of hemoglobin.
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PMID:Effects of glucose-insulin-potassium (GIK) on the position of the oxyhemoglobin dissociation curve, 2.3-diphosphoglycerate, and oxygen consumption in canine endotoxin shock. 633 16

We examined the acute effects of a change in hemoglobin oxygen affinity (P50) on systemic oxygen transport and oxygen consumption during hypoxia. Ten awake, intact, newborn lambs were studied during four consecutive conditions: normoxia (FIO2 = 0.21); hypoxia (FIO2 = 0.10); hypoxia after isovolemic exchange transfusion, raising P50 8 +/- 3 Torr without changing hematocrit; and normoxia after the exchange transfusion. With hypoxia, oxygen extraction rose, cardiac output increased minimally, and systemic oxygen transport and oxygen consumption fell. After exchange transfusion during hypoxia, oxygen consumption rose to resting levels due to a significant augmentation of systemic oxygen transport, which resulted from an increase in cardiac output. This change in cardiac output was due to an increased stroke volume, most likely due to an improved inotropic state. The above findings are consistent with observations in newborn infants with respiratory distress syndrome who underwent exchange transfusion.
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PMID:Oxygen transport in the intact hypoxic newborn lamb: acute effects of increasing P50. 670 Oct 46

Magnetoencephalography (MEG) measures the extracranial magnetic fields produced by intraneuronal ionic current flow within appropriately oriented cortical pyramidal cells. Based upon superconducting quantum interference device technology operating at liquid helium temperatures (4 K), MEG offers excellent temporal and spatial resolution for selected sources, and complements information obtained from electroencephalograms and other functional imaging strategies. Current instrumentation permits recording up to several hundred channels simultaneously with head-shaped dewars, although the cost of such systems is high. The fact that magnetic fields fall off with the square of the distance from the source is both a benefit (when separating activity in the two hemispheres) and a limitation (when attempting to record deep sources). The lack of skin contact facilitates using MEG to record direct current and very high frequency (> 600 Hz) brain activity. The clinical utility of MEG includes presurgical mapping of sensory cortical areas and localization of epileptiform abnormalities, and localization of areas of brain hypoperfusion in stroke patients. MEG studies in psychiatric disorders have contributed materially to improved understanding of anomalous brain lateralization in the psychoses, have suggested that P50 abnormalities may reflect altered gamma band activity, and have provided evidence of hemisphere-specific abnormalities of short-term auditory memory function.
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PMID:Magnetoencephalography: applications in psychiatry. 1037 15

In order to compare the sensitivity of multichannel derived median nerve SEP with EEG in vascular cerebral lesions we examined 22 normals and 23 patients. SEP components within the first 50 ms could be divided into main waveform patterns: (1) a W-shaped parietal pattern consisting of N20, P25, N35 and P45 in most cases. (2) a frontal pattern with P20 and N30 as well as possibly detectible N24, P28, P33, N40 and P50. (3) a central P22. Two younger normals showed a V-shaped parietal pattern with N20 and P35, a frontal pattern with P20 and N36, and central P22 with a remarkably long latency. All components could be analysed sufficiently by means of three representative electrode positions (stimulation right/left): P3/P4, C3/C4, and F3/F4, which reduces the expense of recording and analysing considerably. 21 patients (91.3%) showed abnormal results in SEP, whereas 14 patients (60.9%) in EEG. A three channel electrode array can increase the usefulness of SEP and detect cerebral dysfunctions in cerebral lesions in spite of normal EEG under routine examination conditions. Analysis of multichannel derived SEPs during treatment and recovery after stroke and search for the prognostic value in the acute stage of the disease should be done in future.
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PMID:Multichannel derived median nerve SEP compared to EEG in patients with vascular cerebral lesions. 1144 39

Tenecteplase (TNK) was engineered to have increased fibrin specificity and an increased half-life compared to Alteplase. Although Tenecteplase is currently being tested in a Phase II clinical trial in acute ischemic stroke patients, little is known about the pharmacology and dose-response or therapeutic window for Tenecteplase in embolic stroke models. In the present study, we compared Tenecteplase with Alteplase on behavioral outcome in rabbits with embolic strokes. Male New Zealand white rabbits were embolized by injecting a suspension of small blood clots into the middle cerebral artery (MCA) via a catheter. The rabbit small clot embolic stroke model (RSCEM) was used for a dose-response profile analysis of Tenecteplase (0.1 mg/kg-3.3 mg/kg) and Alteplase (0.9 mg/kg-3.3 mg/kg) given intravenously 1 h following embolization. In additional studies, Tenecteplase (0.9 mg/kg) or Alteplase (3.3 mg/kg) was administered 3 (or 6) h following embolization to determine the therapeutic window for the thrombolytics. For both studies, behavioral analysis was conducted 24 h following embolization, allowing for the determination of the effective stroke dose (P50) or clot amount (mg) that produces neurological deficits in 50% of the rabbits. Using the RSCEM, a drug is considered beneficial if it significantly increases the P50 compared with the control group. The P50 of controls 24 h after embolization was 1.13 +/- 0.15 mg. Rabbits treated 1 h post-embolization with Tenecteplase (0.1, 0.25, 0.9, 1.5 or 3.3 mg/kg) had P50 values of 1.48 +/- 0.33, 2.20 +/- 0.44, 2.76 +/- 0.37, 2.15 +/- 0.29 and 2.78 +/- 0.31 mg, respectively. In Alteplase-treated rabbits, only the 3.3 mg/kg dose significantly increased the group P50 by 189% compared to control. Tenecteplase was also effective at increasing the P50 value to 2.21 +/- 0.43 mg if there was a 3-h delay following embolization, but not if there was a 6-h delay before administration. Alteplase was only effective if administered 1 h following embolization where it significantly increased the P50 value to 3.27 +/- 0.40 mg. This study indicates that Tenecteplase has a wide therapeutic range, a therapeutic window of at least 3 h and a durable effect. Moreover, the safety profile for Tenecteplase is similar to that of Alteplase. Tenecteplase does not increase the rate of intracerebral hemorrhage (ICH) above that produced by Alteplase. However, the therapeutic range and window for Alteplase is more limited than that for Tenecteplase. Our preclinical studies suggest that Tenecteplase has a better pharmacological profile than Alteplase and supports further investigation of Tenecteplase in randomized double-blinded clinical trials in stroke patients.
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PMID:Comparison of Tenecteplase with Alteplase on clinical rating scores following small clot embolic strokes in rabbits. 1469 26


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