Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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

The haemodynamic and neurohormonal responses to the angiotensin converting enzyme (ACE) inhibitor captopril were studied in 12 patients with primary autonomic failure; seven had multiple system atrophy and five had pure autonomic failure. Basal supine mean arterial blood pressure was higher in the patients with multiple system atrophy than in those with pure autonomic failure and the normal subjects. Basal plasma noradrenaline levels were normal in the patients with multiple system atrophy, but lower in those with pure autonomic failure. Captopril lowered the mean arterial pressure in the patients with multiple system atrophy and pure autonomic failure but not in the normal subjects. In the patients with multiple system atrophy and pure autonomic failure, captopril lowered the cardiac output and the stroke volume. Forearm vascular resistance was unchanged. No significant changes occurred in the normal subjects. Plasma renin activity was unchanged after captopril in the patients with autonomic failure, but rose in the normal subjects. Plasma noradrenaline was unchanged in all groups after the administration of captopril. We conclude that captopril lowers the mean arterial pressure in patients with multiple system atrophy and pure autonomic failure. After the administration of captopril there is a reduction in cardiac output, secondary to a fall in stroke volume. The vasodepressor response to captopril in patients with autonomic failure is not related to the basal level of plasma renin activity or sympathetic nervous activity, indicating that the hypotensive effects of bradykinin or prostaglandins, or both, may contribute.
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PMID:Angiotensin converting enzyme inhibition lowers blood pressure in patients with primary autonomic failure independently of plasma renin levels and sympathetic nervous activity. 269 48

Autologous blood clot was injected into six dogs to produce a graduated decrease in cardiac output (CO). The effects of an infusion of norepinephrine, titrated to specific end points, were recorded before embolization and at two levels of pulmonary hypertension. Simultaneous measurements of systemic and renal hemodynamics were made. Sequential blood clot injection increased (p less than .01) pulmonary vascular resistance (PVR) from 1.3 to 13 to 33 mm Hg.L-1.min and reduced CO 45 percent and 75 percent (p less than .01). Norepinephrine increased both stroke volume and CO (p less than .01) in each condition and did not increase PVR. Since the biventricular filling pressures remained constant or fell slightly with norepinephrine, the increase in CO is best explained by an improvement in pump performance. There was no deterioration in renal blood flow or creatinine clearance with norepinephrine. The data suggested that in this model of right ventricular dysfunction, norepinephrine consistently improved myocardial performance without provoking further vasoconstriction in either the pulmonary or renal circulations.
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PMID:The cardiopulmonary and renal hemodynamic effects of norepinephrine in canine pulmonary embolism. 272 Dec 72

The hemodynamic changes on the course of septic multiorgan failure (s-MOF), and the effects of norepinephrine administrated at septic shock state were evaluated in thirteen patients who died of s-MOF in ICU. The course in ICU was divided into following three stages. Stage I was for a few days after admission in ICU. Stage II was severe infected state. Stage III was the terminal state, i.e., a few days before death. Norepinephrine was administrated when conventional catecholamines (dopamine and/or dobutamine) could not maintain the blood pressure level in the shift from stage II to III, and the hemodynamic changes were evaluated before and after the administration. The following results were obtained: 1) Hemodynamic changes: The stage I was characterized as a moderately hyperdynamic state. The stage II exhibited a typical hyperdynamic state distinguished by a decrease in systemic vascular resistance (SVR). The stage III was distinguished as a normodynamic shock state, because of fall of cardiac output within normal control level. 2) Norepinephrine increased cardiac index, heart rate, and right ventricular stroke work index, but mean arterial pressure, stroke index and SVR did not exhibit any change. However, norepinephrine was useful aid to maintain the circulation in hypotensive state, when conventional catecholamines could not maintain blood pressure any more.
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PMID:[Hemodynamic changes on the course of septic multiorgan failure patients]. 274 4

Tail arteries isolated from the stroke-prone substrain of the spontaneously hypertensive rat (SHR-SP) exhibit oscillatory contractile responses to norepinephrine. Simultaneous recording of force generation and membrane potential (Em) has previously demonstrated that the contractile phase of these oscillations is associated with bursts of calcium-dependent action potentials. The smooth muscle cells are electrically quiescent during the relaxation phase of the oscillations. The present studies were designed to test the hypothesis that this quiescent period results from the stimulation of a calcium-activated potassium conductance (gKCa) in the cells responsible for triggering the bursting activity. Isolated tail artery strips from SHR-SP and Wistar-Kyoto rats (WKY) were prepared for measurement of isometric force generation or for simultaneous recording of force and Em. The channel-specific toxins apamin (4 x 10(-7) mol/l) and charybdotoxin (4.7 x 10(-8) did not alter the oscillatory pattern of contraction in response to norepinephrine. Oscillations were converted to sustained contraction by barium (10(-4) mmol), quinidine (5.8 x 10(-5) mmol) and elevation of extracellular potassium (20 mmol/l). Em recordings show that both potassium and barium convert bursting activity into tonic firing. Only 20 mmol/k+ caused significant depolarization in addition to that produced by norepinephrine. In contrast, quinidine appears to alter oscillatory behavior by interfering with calcium-spike generation. Norepinephrine-induced electrical activity is diminished in the presence of quinidine. These results suggest that potassium conductance plays an important role in controlling Em, electrical spiking and therefore oscillatory contractile activity in response to norepinephrine in the tail arteries of SHR-SP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Potassium conductance and oscillatory contractions in tail arteries from genetically hypertensive rats. 277 13

The effects of combined alpha/beta-adrenoceptor blockade and of beta-receptor/slow channel calcium blockade on systemic and pulmonary hemodynamics and on adrenergic activity were compared in 2 matched groups of men suffering from ischemic heart disease. They were studied at rest supine and during ischemia-inducing exercise in the seated posture using invasive percutaneous techniques. Fourteen patients received 200 mg labetalol as a single oral dosis, 15 metoprolol (100 mg) plus nifedipine (10 mg). Both regimens reduced pressures in the systemic and pulmonary circulation under all conditions. At rest, stroke volume and cardiac output slightly decreased after labetalol and increased after metoprolol/nifedipine. During exercise the changes induced by the two regimens were virtually identical: heart rates and vascular resistances were reduced, stroke volume increased, cardiac output was not significantly changed. Plasma renin activity was lowered by labetalol, unchanged by metoprolol/nifedipine. Plasma adrenaline increased after metoprolol/nifedipine only, noradrenaline with both regimens. Both combinations significantly lowered stroke work and the rate pressure product and had similar beneficial effects on the onset and the duration of angina. It is concluded that both combinations attenuate or offset the potential adverse hemodynamic effects of beta-receptor blockade alone without loss but rather enhancement of symptomatic efficacy.
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PMID:Hemodynamic and adrenergic effects of combined alpha/beta-receptor blockade versus combined beta-receptor and slow channel calcium blockade in patients with ischemic heart disease. 279 65

The nature of alpha-adrenergic receptors in human cerebral arteries was characterized, and alteration of these receptors after subarachnoid hemorrhage was examined using a radioligand binding assay. Norepinephrine content of control arteries was also analyzed and compared with that of arteries after subarachnoid hemorrhage. Norepinephrine content in human cerebral arteries in cases of subarachnoid hemorrhage was about 5% of the control group. Specific binding of [3H]yohimbine, a selective alpha 2-antagonist, to cerebral arteries of the control group indicated two classes of binding sites: high-affinity sites with KD of 0.5 nM and Bmax of 18 fmol/mg protein and low-affinity sites with KD of 29 nM and Bmax of 248 fmol/mg protein. In cerebral arteries obtained from the subarachnoid hemorrhage group, [3H]yohimbine binding sites were of a single class with KD of 53 nM and Bmax of 456 fmol/mg protein. These results suggest that sympathetic denervation and subsequent alterations in alpha 2-adrenergic receptors occurred after subarachnoid hemorrhage in human cerebral arteries. These changes in sympathetic innervation to cerebral arteries were considered to be one of the antecedents of delayed vasospasm after subarachnoid hemorrhage.
Stroke 1988 Jan
PMID:Presynaptic and postsynaptic alpha 2-adrenergic receptors in human cerebral arteries and their alteration after subarachnoid hemorrhage. 282 50

Hemodynamic responses to the selective stimulation of alpha-1 and alpha-2 adrenoceptors were examined in chronically instrumented, conscious dogs. Norepinephrine (0.02-0.1 micrograms/kg/min), a mixed alpha-1/alpha-2 adrenoceptor agonist, phenylephrine (0.2-1.0 micrograms/kg/min), a selective alpha-adrenoceptor agonist and B-HT 920 (0.5-2.0 micrograms/kg/min), a selective alpha-2 adrenoceptor agonist, were infused i.v. after ganglionic (hexamethonium, 30 mg/kg i.v.), beta adrenoceptor (propranolol, 1, mg/kg i.v.) and muscarinic receptor (atropine methylbromide, 0.1 mg/kg i.v.) antagonism. Each of the alpha adrenoceptor agonists increased mean arterial pressure and total peripheral resistance but had no significant effect on cardiac output, stroke volume or heart rate. Equipressor doses of the alpha adrenoceptor agonists caused similar increases in left ventricular systolic and end-diastolic pressure, but there were no significant changes in left ventricular dP/dt or heart rate with any of the alpha adrenoceptor agonists. Selective antagonism of alpha-1 adrenoceptors with prazosin (1 mg/kg i.v.) abolished the pressor and vasoconstrictor responses to phenylephrine but had a lesser effect on the response to B-HT 920. Antagonism of alpha-2 adrenoceptors with rauwolscine (0.1 mg/kg i.v.) caused a significantly greater attenuation of the pressor and vasoconstrictor responses to B-HT 920 than to phenylephrine. The responses to norepinephrine were significantly attenuated by antagonism of either alpha-1 or alpha-2 adrenoceptors. Thus, in the conscious dog with reflex pathways blocked, selective stimulation of either postsynaptic alpha-1 or alpha-2 adrenoceptors increases arterial pressure and total peripheral resistance but does not significantly change heart rate, left ventricular dP/dt, stroke volume or cardiac output.
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PMID:Cardiovascular responses to the stimulation of alpha-1 and alpha-2 adrenoceptors in the conscious dog. 287 Jan 77

This article surveys the conventional neurotransmitters and modulatory neuropeptides that are found in the cerebral cortex and attempts to place them into the perspective of both intracortical circuitry and cortical disease. The distribution of these substances is related, where possible, to particular types of cortical neuron or to afferent or efferent fibers. Their physiological actions, where known, on cortical neurons are surveyed, and their potential roles in disease states such as the dementias, epilepsy, and stroke are assessed. Conventional transmitters that occur in afferent fibers to the cortex from brain-stem and basal forebrain sites are: serotonin, noradrenaline, dopamine, and acetylcholine. All of these except dopamine are distributed to all cortical areas: dopamine is distributed to frontal and cingulate areas only. The transmitter in thalamic afferent systems is unknown. Gamma aminobutyric acid (GABA) is the transmitter used by the majority of cortical interneurons and has a profound effect upon the shaping of receptive field properties. The vast majority of the known cortical peptides are found in GABAergic neurons, and the possibility exists that they may act as trophic substances for other neurons. Levels of certain neuropeptides decline in cases of dementia of cortical origin. Acetylcholine is the only other known transmitter of cortical neurons. It, too, is contained in neurons that also contain a neuropeptide. The transmitter(s) used by excitatory cortical interneurons and by the efferent pyramidal cells is unknown, but it may be glutamate or aspartate. It is possible that excitotoxins released in anoxic disease of the cortex may produce damage by acting on receptors for these or related transmitter agents.
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PMID:Neurotransmitters in the cerebral cortex. 287 11

Isolate tail arteries from spontaneously hypertensive rats-stroke prone strain (SHRSP) display oscillatory contractile responses to norepinephrine. These oscillations are not observed in tail arteries from normotensive Wistar-Kyoto rats (WKY). The mechanism underlying these oscillatory contractions was investigated by simultaneous measurement of isometric force development and membrane potential (Em) from tail artery strips in vitro. After equilibration in physiological salt solution containing 1.6 mM calcium (37 degrees C), resting Em was not different between WKY (-52 +/- 1.1 mV) and SHRSP (-52 +/- 0.4 mV). Norepinephrine (3 x 10(-7) M) produced a similar degree of depolarization in tissues from the two strains (WKY = (-42.5 +/- 0.9, SHRSP = -41 +/- 0.8). However, while Em recordings from WKY arteries were quiescent, those from SHRSP displayed bursts of electrical spiking activity that were temporally associated with the rising phase of oscillations in contractile force. The frequency and duration of these bursts of action potentials increased with the concentration of norepinephrine. Action potentials were not observed in calcium-free solution or in presence of nifedipine (3 x 10(-7) M). Releasing the passive stretch on the tissues caused a decrease in the rate of spiking. These studies demonstrate catecholamine-induced regenerative electrical activity in tail arteries from SHRSP that is dependent on extracellular calcium. This activity is unique to tail arteries from this strain.
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PMID:Regenerative electrical activity and arterial contraction in hypertensive rats. 291 Aug 15

We examined the effects of 20 minutes' cerebral ischemia on cerebral microcirculatory responses to topical norepinephrine and systemic hypotension in three groups (sham-operated control, 2-3 hours postischemia, and 24 hours postischemia) of anesthetized newborn pigs equipped with closed cranial windows. Cerebral ischemia may eliminate the prostanoid vasodilator system from the cerebral circulation. Norepinephrine (10(-4) M) decreased pial arteriolar diameters similarly in all three groups (27%, 28%, and 21%, respectively), but only the sham-operated group exhibited pial arteriolar dilation in response to hypotension (28% at 33 mm Hg). Two-three and 24 hours after cerebral ischemia, hypotension decreased pial arteriolar diameters (21% and 17%, respectively). In sham-operated piglets, norepinephrine and hypotension increased cortical periarachnoid cerebrospinal fluid prostanoid concentrations. However, neither norepinephrine nor hypotension altered cerebral prostanoid production 2-3 or 24 hours after cerebral ischemia. Therefore, we conclude that after cerebral ischemia, autoregulatory pial arteriolar dilation in response to hypotension is absent, while vasoconstriction in response to norepinephrine is intact.
Stroke 1989 Apr
PMID:Postischemic cerebral microvascular responses to norepinephrine and hypotension in newborn pigs. 292 31


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