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Evaluation of autonomic nervous function in essential hypertension by noninvasive hemodynamic studies
63 Effect of Neurotropin on Rat Hypothalamic Neuron Activity and A u ~ n o m i c Response During Operant Behavior Taketoshi O n o , Kiyomi N a k a m u r a , Masaji F u k u d a a n d Ryoi Tamura
Effect of Local Cutaneous Pressure on Cutaneous Blood Flow. A Device for Measurement and Changes in Amyotrophic Lateral Sclerosis Masaaki Tsuchiya, Koichi C h i d a a n d Toshiaki T a k a s u
Department of Physiology, Faculty of Medicine, Toyama Medical and Pharmaceutical Unit:ersity, Toyama 930-01, Japan
Department of Neurology, Nihon Unit,ersity School of Medicine, Tokyo 173, Japan
N e u r o t r o p i n , an extract from the inflamed skin of rabbits inoculated with vaccinia virus, p r o d u c e s t h e r a p e u t i c effects by normalizing the a u t o n o m i c nervous system a n d the i m m u n e system of an organism suffering from o n e of various diseases. In the present study, the action of n e u r o t r o p i n a n d n o r e p i n e p h r i n e on the paraventricular nucleus of the hypothalamus, a central a u t o n o m i c nucleus, was investigated by eleetrophoretic application of neurotropio, n o r e p i n e p h r i n e a n d n o r e p i n e p h r i n e antagonists (prazosin, yohimbine a n d propranolol), by direct microinjection of norep i n e p h r i n e antagonists into the p a r a v e n t r i c u l a r nucleus, a n d by intravenous administration of n e u r o t r o p i n . Rats were trained to discriminate cue tone stimuli that p r e c e d e d glucose or intracranial self-stimulation as r e w a r d i n g stimuli, or electric shock or tail pinch as aversive stimuli, u n d e r a n identical behavior, licking. P a r a v e n t r i c u l a r neurons, the activity of which correlated with blood pressure increase d u r i n g learning of cue tone stimuli, were excited by iontophoretic application of n o r e p i n e p h r i n e a n d inhibited by n e u r o t r o p i n . These increase in activity was blocked by iontophoretically applied prazosin, but not by yohimbine or propranolol. Both intravenous application a n d microinjection of prazosin in the p a r a v e n t r i c u l a r nucleus suppressed the increase in blood pressure during learning of cue tone stimuli. The results suggest that n e u r o t r o p i n suppresses excitatory afferent a l p h a Ia d r e n e r g i c input to the p a r a v e n t r i c u l a r nucleus which is i m p o r t a n t in the central control of blood pressure during cue tone stimulus learning in emotional behavior.
This investigation was carried out to establish w h e t h e r c u t a n e o u s blood flow is affected by local c u t a n e o u s pressure in neurological patients w h o are resistant to bedsores. Twenty-one healthy volunteers, 9 patients with a m y o t r o p h i c lateral sclerosis, 4 with Parkinson's disease, a n d 4 with alcoholic p o l y n e u r o p a t h y were investigated. C u t a n e o u s blood flow was m e a s u r e d by laser D o p p l e r flowmetry. Local c u t a n e o u s pressure was m e a s u r e d with a strain g a u g e a t t a c h e d vertically to a p r o b e disk. Resting c u t a n e o u s blood flow was greatest at the right t h e n a r eminence, intermediate at the right heel, a n d smallest in the sacral a r c a . The skin of each a r e a was then gradually c o m p r e s s e d with the p r o b e disk, while continuously recording the blood flow. T h e pressure required to decrease the blood flow by 50 a n d 75% was d e t e r m i n e d in e a c h location. In healthy controls, five r e p e a t e d m e a s u r e m e n t s were f o u n d to be a d e q u a t e for reliable results. The pressure required was least at the t h e n a r eminence, intermediate at the heel a n d greatest in the sacral area. Raising the room t e m p e r a t u r e to 30°C decreased the pressure required, w h e r e a s emotional stress caused by noise, which activates sympathetic functions, increased the pressure, so that a g r e a t e r c u t a n e o u s pressure was necessary to reduce the blood flow than in resting conditions. In patients with a m y o t r o p h i c lateral sclerosis the local c u t a n e o u s pressure n e e d e d to reduce c u t a n e o u s blood flow was higher than in healthy controls. We suggest that the vascular tone resultant from sympathetic hyperfunction may cause tolerance to local c u t a n e o u s pressure, preventing bedsores in patients with a m y o t r o p h i c lateral sclerosis. (The A u t o n o m i c Nervous System, 27: 528-533, 19911)
(The A u t o n o m i c Nervous System, 27: 512-520, 1991))
Evaluation of Autonomic Nervous Function in Essential Hypertension by Noninvasive Hemodynamic Studies Kazutoshi Komatsu, Hiroshi K a w a m u r a , Kenkin Suzuki, Michinobu H a t a n o a n d Koichi C h i d a "
Second Department of Internal Medicine, Nihon Unit~ersity School of Medicine, ~ Department of Neurology, Nihon University School of Medicine, Tokyo 173, Japan We investigated the a u t o n o m i c nervous functions in patients with essential hypertension by m e a n s of a noninvasive h e m o d y n a m i c m e t h o d , in o r d e r to overcome the ethical problems of the conventional invasive studies. Ten patients with essential hypertension a n d 11 a g e - m a t c h e d normotensive volunteers were studied. Pulsatile blood pressure was m e a s u r e d by the Penaz servopletbysmom a n o m e t e r (Finapres), a n d skin blood flow was m e a s u r e d by laser D o p p l e r flowmetry. In the cold pressor test, the pressor response of hypertensive patients was significantly g r e a t e r than that of normotensive subjects. Similarly, in p h a s e IV of the Valsalva m a n e u v e r , during a mental arithmetic test, a n d during isometric muscle contraction, the pressor responses of hypertensive patients t e n d e d to be g r e a t e r t h a n those of normotensive controls. In isometric muscle contraction, the skin blood flow d e c r e a s e d in hypertensive patients, w h e r e a s it did not c h a n g e in the controls. The blood pressure responses to these tests, as m e a s u r e d by the noninvasive m e t h o d , were similar to those o b t a i n e d by invasive m e t h o d s r e p o r t e d previously. T h e s e d a t a suggest that in patients with essential hypertension there may be a sympathetic hyperfunction a n d an alteration of c u t a n e o u s microcirculation. We conclude that noninvasive h e m o d y n a m i c m e t h o d s are very useful to evaluate a u t o n o m i c nervous functions in essential hypertension. (The A u t o n o m i c Nervous System, 27: 521-527, 1990)
Electrogastrography in Patients with Diabetic Autonomic Neuropathy with Reference to Gastric Emptying Yo O k u n o , Michio Hongo, Masahiko Y a m a d a , N a r u o Nishimura, Masamichi U e n o and Takayoshi Toyota
Third Department of Internal Medicine, Tohoku Unit~'ersity School of Medicine, Sendal 980, Japan E l e c t r o g a s t r o g r a p h y ( E G G ) is used to record cutaneously the electrical activity of the stomach; in normal subjects it shows a regular cyclic activity at 3 cycles per minute. Diabetic gastroparesis is thought to result from an a u t o n o m i c n e u r o p a t h y . To clarify the effect of a u t o n o m i c n e u r o p a t h y on the electrical activity of the stomach, we recorded the E G G from patients with (n = 10) and patients without (n = 10) a u t o n o m i c n e u r o p a t h y . T h e E G G was r e c o r d e d before a n d after a meal, for 30 minutes in each case. The p o s t p r a n d i a l E G G d a t a were c o m p a r e d with those on gastric emptying after a solid meal in diabetic patients. The a m p l i t u d e of the E G G waves increased after a meal, w h e r e a s their frequency did not change. Healthy subjects a n d patients without a u t o n o m i c n e u r o p a t h y h a d normal E G G waves p r e d o m i n a n t l y at 3 cycles per minute, both before and after a meal. Patients with a u t o n o m i c n e u r o p a t h y had irregular E G G t h r o u g h o u t the recording period. Most of their a b n o r m a l E G G waves were comprised of tachygastria with a rate of 3.5 to 3.7 cycles per minute, both before a n d after a meal, while there was a lower incidence of the waves at 3 cycles per minute in patients without a u t o n o m i c neuropathy. Gastric emptying of a solid meal was markedly delayed in patients with a u t o n o m i c n e u r o p a t h y , but not in those without a u t o n o m i c n e u r o p a t h y . A highly significant correlation was f o u n d between the frequency of o c c u r r e n c e of the 3.0 cycles p e r minute waves in the p o s t p r a n d i a l period a n d gastric emptying. F r o m these d a t a we conclude that patients with diabetic a u t o n o m i c n e u r o p a t h y have a b n o r m a l E G G waves, which may be responsible for diabetic gastroparesis. (The A u t o n o m i c Nervous System, 27: 534-540, 1990)
Effect of Local Cutaneous Pressure on Cutaneous Blood Flow. A Device for Measurement and Changes in Amyotrophic Lateral Sclerosis Masaaki Tsuchiya, Koichi C h i d a a n d Toshiaki T a k a s u
Department of Physiology, Faculty of Medicine, Toyama Medical and Pharmaceutical Unit:ersity, Toyama 930-01, Japan
Department of Neurology, Nihon Unit,ersity School of Medicine, Tokyo 173, Japan
N e u r o t r o p i n , an extract from the inflamed skin of rabbits inoculated with vaccinia virus, p r o d u c e s t h e r a p e u t i c effects by normalizing the a u t o n o m i c nervous system a n d the i m m u n e system of an organism suffering from o n e of various diseases. In the present study, the action of n e u r o t r o p i n a n d n o r e p i n e p h r i n e on the paraventricular nucleus of the hypothalamus, a central a u t o n o m i c nucleus, was investigated by eleetrophoretic application of neurotropio, n o r e p i n e p h r i n e a n d n o r e p i n e p h r i n e antagonists (prazosin, yohimbine a n d propranolol), by direct microinjection of norep i n e p h r i n e antagonists into the p a r a v e n t r i c u l a r nucleus, a n d by intravenous administration of n e u r o t r o p i n . Rats were trained to discriminate cue tone stimuli that p r e c e d e d glucose or intracranial self-stimulation as r e w a r d i n g stimuli, or electric shock or tail pinch as aversive stimuli, u n d e r a n identical behavior, licking. P a r a v e n t r i c u l a r neurons, the activity of which correlated with blood pressure increase d u r i n g learning of cue tone stimuli, were excited by iontophoretic application of n o r e p i n e p h r i n e a n d inhibited by n e u r o t r o p i n . These increase in activity was blocked by iontophoretically applied prazosin, but not by yohimbine or propranolol. Both intravenous application a n d microinjection of prazosin in the p a r a v e n t r i c u l a r nucleus suppressed the increase in blood pressure during learning of cue tone stimuli. The results suggest that n e u r o t r o p i n suppresses excitatory afferent a l p h a Ia d r e n e r g i c input to the p a r a v e n t r i c u l a r nucleus which is i m p o r t a n t in the central control of blood pressure during cue tone stimulus learning in emotional behavior.
This investigation was carried out to establish w h e t h e r c u t a n e o u s blood flow is affected by local c u t a n e o u s pressure in neurological patients w h o are resistant to bedsores. Twenty-one healthy volunteers, 9 patients with a m y o t r o p h i c lateral sclerosis, 4 with Parkinson's disease, a n d 4 with alcoholic p o l y n e u r o p a t h y were investigated. C u t a n e o u s blood flow was m e a s u r e d by laser D o p p l e r flowmetry. Local c u t a n e o u s pressure was m e a s u r e d with a strain g a u g e a t t a c h e d vertically to a p r o b e disk. Resting c u t a n e o u s blood flow was greatest at the right t h e n a r eminence, intermediate at the right heel, a n d smallest in the sacral a r c a . The skin of each a r e a was then gradually c o m p r e s s e d with the p r o b e disk, while continuously recording the blood flow. T h e pressure required to decrease the blood flow by 50 a n d 75% was d e t e r m i n e d in e a c h location. In healthy controls, five r e p e a t e d m e a s u r e m e n t s were f o u n d to be a d e q u a t e for reliable results. The pressure required was least at the t h e n a r eminence, intermediate at the heel a n d greatest in the sacral area. Raising the room t e m p e r a t u r e to 30°C decreased the pressure required, w h e r e a s emotional stress caused by noise, which activates sympathetic functions, increased the pressure, so that a g r e a t e r c u t a n e o u s pressure was necessary to reduce the blood flow than in resting conditions. In patients with a m y o t r o p h i c lateral sclerosis the local c u t a n e o u s pressure n e e d e d to reduce c u t a n e o u s blood flow was higher than in healthy controls. We suggest that the vascular tone resultant from sympathetic hyperfunction may cause tolerance to local c u t a n e o u s pressure, preventing bedsores in patients with a m y o t r o p h i c lateral sclerosis. (The A u t o n o m i c Nervous System, 27: 528-533, 19911)
(The A u t o n o m i c Nervous System, 27: 512-520, 1991))
Evaluation of Autonomic Nervous Function in Essential Hypertension by Noninvasive Hemodynamic Studies Kazutoshi Komatsu, Hiroshi K a w a m u r a , Kenkin Suzuki, Michinobu H a t a n o a n d Koichi C h i d a "
Second Department of Internal Medicine, Nihon Unit~ersity School of Medicine, ~ Department of Neurology, Nihon University School of Medicine, Tokyo 173, Japan We investigated the a u t o n o m i c nervous functions in patients with essential hypertension by m e a n s of a noninvasive h e m o d y n a m i c m e t h o d , in o r d e r to overcome the ethical problems of the conventional invasive studies. Ten patients with essential hypertension a n d 11 a g e - m a t c h e d normotensive volunteers were studied. Pulsatile blood pressure was m e a s u r e d by the Penaz servopletbysmom a n o m e t e r (Finapres), a n d skin blood flow was m e a s u r e d by laser D o p p l e r flowmetry. In the cold pressor test, the pressor response of hypertensive patients was significantly g r e a t e r than that of normotensive subjects. Similarly, in p h a s e IV of the Valsalva m a n e u v e r , during a mental arithmetic test, a n d during isometric muscle contraction, the pressor responses of hypertensive patients t e n d e d to be g r e a t e r t h a n those of normotensive controls. In isometric muscle contraction, the skin blood flow d e c r e a s e d in hypertensive patients, w h e r e a s it did not c h a n g e in the controls. The blood pressure responses to these tests, as m e a s u r e d by the noninvasive m e t h o d , were similar to those o b t a i n e d by invasive m e t h o d s r e p o r t e d previously. T h e s e d a t a suggest that in patients with essential hypertension there may be a sympathetic hyperfunction a n d an alteration of c u t a n e o u s microcirculation. We conclude that noninvasive h e m o d y n a m i c m e t h o d s are very useful to evaluate a u t o n o m i c nervous functions in essential hypertension. (The A u t o n o m i c Nervous System, 27: 521-527, 1990)
Electrogastrography in Patients with Diabetic Autonomic Neuropathy with Reference to Gastric Emptying Yo O k u n o , Michio Hongo, Masahiko Y a m a d a , N a r u o Nishimura, Masamichi U e n o and Takayoshi Toyota
Third Department of Internal Medicine, Tohoku Unit~'ersity School of Medicine, Sendal 980, Japan E l e c t r o g a s t r o g r a p h y ( E G G ) is used to record cutaneously the electrical activity of the stomach; in normal subjects it shows a regular cyclic activity at 3 cycles per minute. Diabetic gastroparesis is thought to result from an a u t o n o m i c n e u r o p a t h y . To clarify the effect of a u t o n o m i c n e u r o p a t h y on the electrical activity of the stomach, we recorded the E G G from patients with (n = 10) and patients without (n = 10) a u t o n o m i c n e u r o p a t h y . T h e E G G was r e c o r d e d before a n d after a meal, for 30 minutes in each case. The p o s t p r a n d i a l E G G d a t a were c o m p a r e d with those on gastric emptying after a solid meal in diabetic patients. The a m p l i t u d e of the E G G waves increased after a meal, w h e r e a s their frequency did not change. Healthy subjects a n d patients without a u t o n o m i c n e u r o p a t h y h a d normal E G G waves p r e d o m i n a n t l y at 3 cycles per minute, both before and after a meal. Patients with a u t o n o m i c n e u r o p a t h y had irregular E G G t h r o u g h o u t the recording period. Most of their a b n o r m a l E G G waves were comprised of tachygastria with a rate of 3.5 to 3.7 cycles per minute, both before a n d after a meal, while there was a lower incidence of the waves at 3 cycles per minute in patients without a u t o n o m i c neuropathy. Gastric emptying of a solid meal was markedly delayed in patients with a u t o n o m i c n e u r o p a t h y , but not in those without a u t o n o m i c n e u r o p a t h y . A highly significant correlation was f o u n d between the frequency of o c c u r r e n c e of the 3.0 cycles p e r minute waves in the p o s t p r a n d i a l period a n d gastric emptying. F r o m these d a t a we conclude that patients with diabetic a u t o n o m i c n e u r o p a t h y have a b n o r m a l E G G waves, which may be responsible for diabetic gastroparesis. (The A u t o n o m i c Nervous System, 27: 534-540, 1990)