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Query: UMLS:C0038454 (
stroke
)
147,016
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
To compare the hemodynamic effect of vasodilator therapy on different regurgitant lesions, we infused
sodium
nitroprusside intraooperatively in 12 patients with mitral regurgitation and 15 with aortic regurgitation. During the critical period preceding establishment of cardiopulmonary bypass, both groups had developed intense vasoconstriction and cardiac decompensation. All demonstrated improved cardiac function with vasodilator therapy; however, the degree of improvement with nitroprusside differed in the two groups.
Stroke
volume increased 10 ml. per beat per meter squared in those patients with aortic regurgitation and only 6 ml. per beat per meter squared in those with mitral regurgitation (p less than 0.05). The percent increase in stoke volume induced by nitroprusside was inversely correlated to the preoperative left ventricular ejection fraction (r = 0.44, p less than 0.02). Patients with aortic regurgitation had lower preoperative left ventricular ejection fractions than those with mitral regurgitation (0.53 versus 0.63, p less than 0.02). Therefore, we conclude that patients with aortic regurgitation derived greater intraoperative hemodynamic benefit from unloading with nitroprusside, because they came to surgery with greater impairment of left ventricular contractility. Although nitroprusside improved cardiac function in both groups, only the patients with aortic regurgitation achieved normal pulmonary artery pressure (17 torr) and pulmonary vascular resistance (2.1 units) as a result of unloading. Those with mitral regurgitation continued to have pulmonary hypertension (28 torr) and increased pulmonary vascular resistance (3.9 units) despite vasodilator therapy. Thus the data suggest that patients with mitral regurgitation derived less hemodynamic benefit from intraoperative nitroprusside therapy because they were also limited by right ventricular dysfunction and a less responsive pulmonary vasculature.
...
PMID:Comparison of intraoperative nitroprusside unloading in mitral and aortic regurgitation. 44 73
f2 bacteriophage in the presence of fetal calf serum (at a final concentration of 10%) was exposed to six commonly used disinfectants for times of 10, 20 and 30 sec. At the end of exposure times skim milk neutralized the disinfectant activity and residual virus was assayed using the plaque technique. The 6 disinfectants considered were Javex,
sodium
hydroxide, ethanol, Wescodyne, One
Stroke
Ves-Phene and Sonacide. A 0.25% (w/v) solution of
sodium
hydroxide and 1/50 Javex (1200 parts/10(6) chlorine) were the most effective of the six disinfectants considered since 10(5) f2 bacteriophage were inactivated in 30 seconds in each instance. Since a 0.25% (w/v) solution of
sodium
hydroxide had a pH of 12.5 this made it too caustic to use as a disinfectant in many practical situations. It was concluded therefore that Javex at some dilution less than 1/50 (greater than 1200 parts/10(6) chlorine) was the most practical of the six disinfectants to use. Ethanol (95%, v/v) inactivated 10(3) f2 bacteriophage in 30 seconds while 1/20 Wescodyne and undiluted Sonacide inactivated 10(1)-virus particles. Ves-Phene at a dilution of 1/50 was a completely ineffective virucide during the 30 sec exposure. The resistance of f2 bacteriophage to inactivation by these six disinfectants was compared with that of echovirus 11 and coxsackievirus B5. In all instances except exposure to undiluted Sonacide, f2 was comparable in resistance to inactivation and in many cases had greater resistance.
...
PMID:The relative resistance of f2 bacteriophage to inactivation by disinfectants. 45 39
In a group of seven patients who had had cardiac operations, intravenous (IV) hydralazine was used to provide afterload reduction in situations of severe left ventricular dysfunction. Despite fluid loading, inotropic support with dopamine, and afterload reduction with
sodium
nitroprusside, the patients had persistent states of low cardiac output and high systemic vascular resistance. Administration of
sodium
nitroprusside was limited by its effect on preload and blood pressure, so that it necessitated frequent fluid challenges. The addition of IV hydralazine to this regimen caused a mean increase of 44.7% in the
stroke
index and a mean reduction of 28.6% in systemic vascular resistance without significant change in pulmonary artery wedge pressure, mean arterial pressure, or heart rate. Rapid weaning of
sodium
nitroprusside and, on occasion, dopamine was facilitated. Frequent fluid challenges to restore preload were unnecessary. Dose requirements of hydralazine were small: 2.5 to 5.0 mg IV initially, and then a maintenance dose of 2.5 to 7.5 mg IV every 4 to 6 hours. These preliminary clinical observations indicate that in patients with low cardiac output--high resistance states and normal or elevated preload, the important benefit of specific afterload reduction may be provided by parenteral hydrolazine in the early period following cardiac surgery. Prospective, controlled studies with this agent in this situation appear warranted.
...
PMID:Specific afterload reduction with parenteral hydralazine following cardiac surgery. 45 26
Arterial compliance and indexes of ventricular ejection were measured in 27 men with systolic hypertension. The patients were separated into two age groups, younger or older than age 35 years, and matched with normotensive control subjects. Arterial compliance was estimated from analysis of the monoexponential blood pressure-time curve during diastole, according to a simple viscoelastic model. In the younger patients, arterial compliance and
stroke
volume were within normal ranges. Rapid ejection time was significantly reduced (P less than 0.001), indicating an increased venlocity in the first part of ventricular ejection. Systolic pressure decreased significantly after administration of propranolol, which also caused prolongation of rapid ejection time. In the older patients, indexes of ventricular ejection were within normal limits. arterial compliance was significantly reduced (P less than 0.01) and was negatively correlated with the level of systolic pressure (P less than 0.001). Systolic pressure decreased significantly after administration of
sodium
nitroprusside, which caused an increase in arterial compliance. These findings provide evidence that: (1) the hemodynamic mechanisms of systolic hypertension differ in younger and older patients, and (2) these hemodynamic differences should be taken into account when choosing drugs to decrease systolic pressure.
...
PMID:Systolic hypertension: hemodynamic mechanism and choice of antihypertensive treatment. 47 31
The systemic hemodynamic effects of deep hypotension (MAP: 38 +/- 6 mm Hg) induced by
sodium
nitroprusside (S.N.) were studied in 20 patients who underwent surgery for cerebral aneurysm. The hemodynamic measurements were performed four times.: (1) during the preoperative period, (2) during stable anesthesia just before hypotension, (3) during stable hypotension, (4) 20 minutes after stopping nitroprusside. All patients were mechanically ventilated with a constant tidal volume and rate. Parameters for acid-base balance and Pa O2 were also recorded. Nitroprusside produces arterial and venous dilatation which results in a decrease of afterload and preload. The mean dosage of S. N. was 18 mcg/kg/mn. Systemic vascular resistances decreased by 62 p. cent. Mean arterial pressure decreased by 53 p. cent; it reached 40 mm Hg. Fall in preload resulted in a decrease in pulmonary wedge pressure by 28 p. cent. This fall in preload produced a decrease in
stroke
index according to Frank-Starling's mechanisms. However tachycardia allowed a rise in cardiac index by 20 p. cent. Increase of pulmonary wedge pressure at 8-10 mm Hg by blood volume expansion maintains
stroke
index at control level. Under these conditions the elevation of cardiac index is due to tachycardia. Cardiac rhythm disorders (wandering pace-maker, nodal rhythm) are observed in 5 patients after having stopped nitroprusside.
...
PMID:[Deep hypotension induced by sodium nitroprusside in neurosurgery. I.--Systemic hemodynamic effects (author's transl)]. 48 87
The left cerebral hemisphere of Mongolian gerbils was used to elucidate the mechanisms of brain edema which develop during cerebral ischemia and after restoration of cerebral blood flow following temporary ischemia. Water content was measured by the tissue-drying method.
Sodium
and potssium ion concentration was measured by flame photometry. Passage of 131I-albumin (RISA) from blood to the cerebral parenchyma was measured on a gamma scintillation counter. Our findings indicate that pure cytotoxic edema develops during ischemia and during a short period after restoration of cerebral blood flow. Vasogenic edema, which is accelerated by the leakage of plasma constitutents from blood due to blood-brain barrier damage, developed after restoration of the cerebral blood flow. After less than 1 hr of ischemia, restoration of the cerebral blood flow drastically reduced the degree of brain edema. However, restoration of the cerebral blood flow greatly worsened the brain edema following more than 3 hr of ischemia.
Stroke
PMID:Brain edema during ischemia and after restoration of blood flow. Measurement of water, sodium, potassium content and plasma protein permeability. 50 96
Brain edema was induced in rats by injecting 50 mu microspheres, labelled with 85Sr, into the internal carotid artery. The use of radioactive microspheres as embolic agents enabled the number of microspheres to be determined in each cerebral hemisphere. Edema was assessed 12 or 24 h after embolization by measuring brain water content and, in some experiments,
sodium
and potassium. Pretreatments with dexamethasone, parachlorophenylalanine (an inhibitor of 5-hydroxytryptamine synthesis), mepyramine and metiamide (H1 and H2 histamine receptor antagonists) or aminophylline did not influence significantly the development of brain edema evaluated 24 h after embolization. Aminophylline treatment (100 mg/kg) markedly increased mortality following embolization. Gamma-butyrolactone (300 mg/kg, every 2 h) inhibited significantly the development of brain edema evaluated 12 hours after embolization. Increases in water and
sodium
in the embolized cerebral hemisphere were reduced by about 50%. This protective effect may be related to the known depressant action on brain metabolism.
Stroke
PMID:Influence of various agents on the development of brain edema in the rat following microembolism. Protective effect of gamma-butyrolactone. 52 4
A new technique is described for the autoradiographic determination of regional brain glucose metabolism employing 14C labeled glucose as substrate and measurement principles previously described for whole brain. Regional glucose values correlate closely with those reported for the 14C-deoxyglucose technique. The method has the advantages of 1) a much shorter experimental period, 2) a relatively simple mathematical treatment, and 3) the utilization of the actual, fully metabolizable substance itself, glucose, as the label. In addition to normal rats, regional values are reported for 20 individual brain areas of rats in bicuculline induced status epilepticus, rats intoxicated with ammonium and rats anesthetized with pentobarbital
sodium
or ketamine.
Stroke
PMID:Measurement of regional brain glucose utilization in vivo using [2(-14)C] glucose. 52 10
1. Neonatal sympathectomy with 6 hydroxy-dopamine (6-OHDA) was used as a tool to assess the significance of an increased sympathetic vascular tone for the development of high blood pressure in
stroke
-prone spontaneously hypertensive rats. After administration of 6-OHDA the rise in blood pressure was blunted for the following 9 weeks until innervation was re-established. 6-OHDA-treated rats retained more
sodium
and had larger plasma and blood volumes than sham-treated rats. 2. Catecholamines in plasma were increased 2-10-fold immediately after sympathectomy, but their concentrations were subnormal on day 7. Eight weeks after sympathectomy plasma noradrenaline and dopamine were not elevated, but plasma adrenaline has increased twofold. 3. The reactivity of resistance vessels to noradrenaline was markedly enhanced and the neuronal uptake and metabolism of noradrenaline were still reduced 8 weeks after neonatal sympathectomy. 4. These results confirm the significance of an intact sympathetic nervous system for the development in these rats. Sodium retention and increased plasma and blood volume may be considered as a compensatory mechanism for the vasodilatation resulting from decreased vasomotor tone.
...
PMID:Effect of neonatal sympathectomy by 6-hydroxydopamine on volume and resistance regulation in stroke-prone spontaneously hypertensive rats. 54 Apr 31
Two aspects of the recovery period after endurance exercise were investigated: a) the fluid distribution between the intra- and extravascular parts of the extracellular fluid volume (ECFV) induced by exercise dehydration, b) the cardiovascular response pattern [blood pressure (BP), heart rate (HR), cardiac output (CO), total peripheral resistance (TPR), and central venous pressure (CVP)] to the heat load which results from the preceding exercise. Seven conscious dogs performed endurance exercise in a cool environment (16 degrees C) on a horizontal treadmill till 4% of the body weight was lost. It was found that about 70% of the total fluid loss of the body came from intracellular water. During exercise
sodium
and chloride concentrations rose by 6 mMol and 7 mMol respectively (P less than 0.005) and remained elevated throughout the early recovery period indicating a fluid loss of about 100-200 ml out of the ECFV. Direct measurements of the ECFV as sulfate space confirmed these values. Since the plasma volume remained unchanged, this fluid loss was carried totally by the interstitial fluid volume. Immediately after exercise body temperature was elevated by 1.5 degrees C and returned towards control within 90 min. Cardiac output was above control level for 2 h after the end of exercise, at first due to an increased HR and thereafter to an elevated
stroke
volume (SV) (P less than 0.02). CVP and TPR were below control levels for at least 2 h (P less than 0.01). A linear correlation was found between CVP and TPR. A close correlation existed between the body temperature and the cardiovascular parameters. It can be concluded that even long after exercise the cardiovascular system has to serve thermoregulatory needs.
...
PMID:Extracellular fluid volume and central circulation after long lasting exercise and dehydration in conscious dogs. 55 92
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