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Evaluation of gastric emptying in Parkinson's disease
83 and skin is differentiated and, in terms of the reflex patterns, can be divided into different functional pathways. This study was designed to determine if such a differentiation is also present in the rat. Experiments were conducted on pentobarbitone anaesthetized Wistar rats either breathing spontaneously or being artificially ventilated. Postganglionic single and multi-unit activity was recorded from fine strands isolated from the saphenous (cutaneous vasoconstrictor neurones, CVC) and gastrocnemic (muscle vasoconstrictor neurones, MVC) nerves with conventional techniques. Phrenic nerve activity was recorded in order to monitor central respiration. Reflex responses to noxious stimulation of skin, stimulation of visceral receptors in the urinary bladder and phasic stimulation of the arterial baroreceptors were tested. Furthermore, respiratory modulation of sympathetic activity was analysed. The majority of MVC neurones was excited by noxious stimuli, whereas most CVC neurones were inhibited. Phasic baroreceptor inhibition was significantly stronger in MVC than in CVC neurones. Stimulation of afferents from the urinary bladder mostly excited MVC and CVC neurones. Respiratory modulation of ongoing activity mostly consisted of a depression during inspiration and a peak during expiration and did not differ between MVC and CVC neurones. In conclusion, the sympathetic outflows to skin and skeletal muscle of the rat show some differentiation, but to a lesser extent than in the cat.
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Treatment of Postprandial and Orthostatic Hypotension by Nasal Administration of Vasopressin S. Hakusui t, A. Takahashi 2, T. Mano 3, Y. Hasegawa 4, Y. Koike 2, Y. Sugiyama 3, S. Iwase 3, M. Hirayama 2, T. Ieda 2, T. Yasuda I and T. Yanagi l
1Department of Neurology, Nagoya Daini Red Cross Hospital Nagoya 466, Japan, 2Department of Neurology, Nagoya University School of Med., Nagoya 466, Japan, 3The Res. Inst. Environ. Med., Nagoya University, Nagoya 464, Japan, and 4Department of Neurology, Nagoya National Hospital, Nagoya 460, Japan We studied the therapeutic effects of nasal administration of vasopressin (lysine vasopressin (LVP) and arginine vasopressin (AVP)) in treating postprandial hypotension (PPH) in two subjects with multiple system atrophy (a 41-year-old man and a 71-year-old woman). PPH was induced by oral loading of 75 g glucose. About 30 minutes before the loading, LVP (5U, 10U, 15U or 20U) or AVP (1U or 2U) was transnasally administered on different days. In the 41-year-old male patient we also conducted standing position loading using a tilting bed (the angles
from 0 ° , 20 ° , 40 ° and 70 ° ) and measured blood pressure before and after the transnasal administration of either 10U LVP or 1U AVP. Our results show that both LVP and AVP well prevent PPH in their minimum dose (LVP 5U, AVP 1U) and have significant effects on orthostatic hypotension at the doses of 10U LVP and 1U AVP. 72
Evaluation of Gastric Emptying in Parkinson's Disease T. Harada l, S. Fujika l, R. Orita l, C. Hiwaki l, T. Joh 1, F. Ishizaki2 and S. Nakamura 2
~Department of Internal Medicine, Hiroshima Prefectural Hospital, 1-5-54 Ufina-Kanda, Minami-ku, Hiroshima 734, Japan and 2Third Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734, Japan Constipation is the most common symptom among digestive disturbances in Parkinson's disease (PD). However, the complaints in the upper digestive tract such as nausea, gastric fullness and heaviness are often overlooked. To evaluate the function of the upper digestive tract, we studied gastric emptying using an acetaminophen (AAP) method in 20 patients with PD. The AAP is not absorbed through the gastric mucosa at all, but is very soon absorbed through the intestine into the blood after oral administration. Therefore, the plasma AAP concentration is related to the gastric emptying time. The plasma AAP concentrations in patients with PD were significantly lower than those in controls, indicating that a delay of gastric emptying existed in PD. The plasma AAP concentrations were correlated with the coefficient of R-R interval of electrocardiogram in PD. The decreased plasma AAP concentrations were related to the severity of PD. The plasma AAP concentrations were significantly decreased by L-dopa treatment. Consequently, we considered that the abnormality of gastric emptying indicated the impairment of autonomic nervous system in PD. Also, it was showed that the gastric emptying function was reduced by the treatment of L-dopa in PD.
73
Posturai Responses of Plasma Vasopressin and Norepinephrine in Progressive Autonomic Failure Y. Hasegawal, 2, S. HakusuiL3, M. Hirayama l, Y. Koike 1, Y. Matsuoka I and A. Takahashi~
Departments of Neurology, 1Nagoya University, 2Nagoya National Hospital and 3Nagoya Daini Red Cross Hospital, Nagoya, Japan To evaluate a functional state of baroreflex in progressive
71
Treatment of Postprandial and Orthostatic Hypotension by Nasal Administration of Vasopressin S. Hakusui t, A. Takahashi 2, T. Mano 3, Y. Hasegawa 4, Y. Koike 2, Y. Sugiyama 3, S. Iwase 3, M. Hirayama 2, T. Ieda 2, T. Yasuda I and T. Yanagi l
1Department of Neurology, Nagoya Daini Red Cross Hospital Nagoya 466, Japan, 2Department of Neurology, Nagoya University School of Med., Nagoya 466, Japan, 3The Res. Inst. Environ. Med., Nagoya University, Nagoya 464, Japan, and 4Department of Neurology, Nagoya National Hospital, Nagoya 460, Japan We studied the therapeutic effects of nasal administration of vasopressin (lysine vasopressin (LVP) and arginine vasopressin (AVP)) in treating postprandial hypotension (PPH) in two subjects with multiple system atrophy (a 41-year-old man and a 71-year-old woman). PPH was induced by oral loading of 75 g glucose. About 30 minutes before the loading, LVP (5U, 10U, 15U or 20U) or AVP (1U or 2U) was transnasally administered on different days. In the 41-year-old male patient we also conducted standing position loading using a tilting bed (the angles
from 0 ° , 20 ° , 40 ° and 70 ° ) and measured blood pressure before and after the transnasal administration of either 10U LVP or 1U AVP. Our results show that both LVP and AVP well prevent PPH in their minimum dose (LVP 5U, AVP 1U) and have significant effects on orthostatic hypotension at the doses of 10U LVP and 1U AVP. 72
Evaluation of Gastric Emptying in Parkinson's Disease T. Harada l, S. Fujika l, R. Orita l, C. Hiwaki l, T. Joh 1, F. Ishizaki2 and S. Nakamura 2
~Department of Internal Medicine, Hiroshima Prefectural Hospital, 1-5-54 Ufina-Kanda, Minami-ku, Hiroshima 734, Japan and 2Third Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734, Japan Constipation is the most common symptom among digestive disturbances in Parkinson's disease (PD). However, the complaints in the upper digestive tract such as nausea, gastric fullness and heaviness are often overlooked. To evaluate the function of the upper digestive tract, we studied gastric emptying using an acetaminophen (AAP) method in 20 patients with PD. The AAP is not absorbed through the gastric mucosa at all, but is very soon absorbed through the intestine into the blood after oral administration. Therefore, the plasma AAP concentration is related to the gastric emptying time. The plasma AAP concentrations in patients with PD were significantly lower than those in controls, indicating that a delay of gastric emptying existed in PD. The plasma AAP concentrations were correlated with the coefficient of R-R interval of electrocardiogram in PD. The decreased plasma AAP concentrations were related to the severity of PD. The plasma AAP concentrations were significantly decreased by L-dopa treatment. Consequently, we considered that the abnormality of gastric emptying indicated the impairment of autonomic nervous system in PD. Also, it was showed that the gastric emptying function was reduced by the treatment of L-dopa in PD.
73
Posturai Responses of Plasma Vasopressin and Norepinephrine in Progressive Autonomic Failure Y. Hasegawal, 2, S. HakusuiL3, M. Hirayama l, Y. Koike 1, Y. Matsuoka I and A. Takahashi~
Departments of Neurology, 1Nagoya University, 2Nagoya National Hospital and 3Nagoya Daini Red Cross Hospital, Nagoya, Japan To evaluate a functional state of baroreflex in progressive