In an attempt to determine whether myocardial catecholamines vary from season to season, their concentration in rabbits was measured throughout the whole year by the spectrophotofluorometric method. The highest concentration of cardiac catecholamine was observed in summer. Measurement of the atrial response to norepinephrine revealed no significant alteration during the entire period of the experiment.
Animals ; Catecholamines/*analysis ; Heart/*drug effects ; Myocardium/*analysis ; Norepinephrine/*pharmacology ; Rabbits ; *Seasons

OBJECTIVETo study the role of catecholamine(CA) in the mechanism of bio-effect of electromagnetic irradiation.

METHODSThe contents of norepinephrine (NE), epinephrine (E) and dopamine (DA) in serum and hippocampus of rats at 0, 8, 24, 48 hours after electromagnetic irradiation were measured by using high performance liquid chromatography with electrochemical detector(HPLC-ECD), and the influence of two kinds of shelter on CA was studied.

RESULTSThe levels of CA in serum and hippocampus increased obviously in an instant, decreased at 8 h and increased significantly again at 24 h after irradiation without shielding irradiation. But at 48 h, the levels of NA, DA in hippocampus were still higher and the serum's NA, DA were not different from the control. After irradiation with whole body shielding, the levels of CA had no changes. The contents of CA increased significantly only at 24 h after irradiation by 65 W/cm2 electromagnetic wave with trunk shielding. After irradiation by 129 W/cm2 with trunk shielding, the change of CA were similar to that of no shielding.

CONCLUSIONCA may take part in the injury to central nervous system and cardiovascular system after electromagnetic irradiation. And the injury to central nervous system may sustain longer than that of cardiovascular system. The protective effect of whole body shielding is the best, while trunk shielding may have some protective effect following lower and middle power electromagnetic wave. The most important protective measure is to shield the head.

Animals ; Catecholamines ; analysis ; blood ; Chromatography, High Pressure Liquid ; Electrochemistry ; Electromagnetic Phenomena ; Hippocampus ; chemistry ; radiation effects ; Rats

BACKGROUND: Patients experience preoperative anxiety which stimulates the release of catecholamines. They have influences on serum K+ level by shifting them into the intracellular space. The purpose of this study is to determine whether there is a correlation between anxiety and the serum potassium level immediately before induction of anesthesia. METHODS: Thirty patients were asked about their anxiety levels at 7 : 00 pm of the day before surgery and immediately before induction of anesthesia : 0; nil, 1; slight, 2; moderate, 3; marked. At those times, arterial blood was taken for checking serum K+ level and blood gas analysis. RESULTS: There was no significant correlation between anxiety level and serum potassium level. At 7 : 00 pm of the day before surgery, the anxiety levels of patients had no significant correlation with the changes of serum potassium level ("K1-K2"; K1 = serum potassium level of patient at 7 : 00 pm of the day before surgery, K2 = serum potassium level of patient immediately before induction of anesthesia). Definite correlation between the anxiety level immediately before induction of anesthesia and the changes of serum potassium level has been documented. Immediately before induction of anesthesia, 43% of patients had hypokalemia (K+ < 3.5 mEq/L). CONCLUSIONS: Anxiety level has no correlation with serum potassium level, but the anxiety level immediately before induction of anesthesia has the changes of serum potassium level. If a patient has high anxiety level immediately before induction of anesthesia, the possibility of hypokalemia is increased.
Anesthesia* ; Anxiety* ; Blood Gas Analysis ; Catecholamines ; Humans ; Hypokalemia ; Intracellular Space ; Potassium*

OBJECTIVETo study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.

METHODSSix pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for 30 minutes, which maintained the blood gas value at the fetal physiological level. The fetal blood pressure, heart rate, pH value and blood lactate levels were monitored. The levels of catecholamine, cortisol and insulin were measured pre-bypass and then again 30 minutes later. The blood glucose and free fatty acid levels were monitored continuously during the bypass. Fetal hepatic PAS staining was also carried out.

RESULTSThere were no changes before and during the bypass in fetal blood pressure, heart rate and blood gas. However, pH values decreased and blood lactate levels increased (P < 0.05). The fetal catecholamine and cortisol levels increased significantly (P < 0.01), while the levels of insulin did not change. The blood glucose and free fatty acid levels increased at the beginning of the bypass (P < 0.01), and then gradually slowed down during the bypass. The fetal hepatic PAS staining showed that hepatic glycogen was consumed in large amounts. After 30 minutes of bypass, the fetal lamb would not survive more than 1 hour.

CONCLUSIONThe fetal lamb has a strong negative reaction to cardiopulmonary bypass.

Animals ; Blood Gas Analysis ; Blood Glucose ; analysis ; Cardiopulmonary Bypass ; adverse effects ; Catecholamines ; blood ; Fatty Acids, Nonesterified ; blood ; Fetus ; physiology ; Hemodynamics ; physiology ; Hydrocortisone ; blood ; Lactates ; blood ; Sheep

BACKGROUND: The apnea test is an essential component in the clinical determination of brain death, however it may incur a significant risk of complications such as hypotension, hypoxia and even cardiac arrest. We analyzed the risk factors associated with a failed apnea test during brain death assessment in order to predict and avoid these adverse events. METHODS: Medical records on apnea tests performed for brain-dead donors at our institution between January 2009 and January 2016 were retrospectively reviewed. Age, gender, etiology of brain death, use of catecholamines and results of arterial blood gas analysis (ABGA), systolic/diastolic blood pressure (SBP/DBP), mean arterial pressure and central venous pressure prior to apnea test initiation were collected as variables. A-a gradient and P(aO2)/F(iO2) were calculated for more precise assessment of the respiratory system. In total, 267 cases were divided into two groups based on those who completed the apnea test and those who failed the test. RESULTS: 13 cases failed the apnea test. Among them, seven cases failed due to severe hypotension (SBP < 60 mmHg) and the others failed due to refractory hypoxia. In terms of hemodynamic state, SBP was significantly higher in the completed test group than the failed group (126.5 ± 23.9 vs. 103 ± 15.2, respectively; p = 0.001). In ABGA, the completed test group showed significantly higher P(aO2)/F(iO2) (313.6 ± 229.8 vs. 141.5 ± 131.0, respectively; p = 0.008) and a lower A-a gradient (278.2 ± 209.5 vs. 506.2 ± 173.1, respectively; p = 0.000). In multivariable analysis, low SBP (p = 0.003) and high A-a gradient (p = 0.044) were independent risk factors associated with a failed apnea test. CONCLUSIONS: Although the unexpected adverse events during the apnea test for brain death determination do not occur frequently, they can be fatal. If a brain-dead patient has low SBP and a high A-a gradient, clinicians should pay more attention and prepare for potential complications prior to the apnea test.
Anoxia ; Apnea* ; Arterial Pressure ; Blood Gas Analysis ; Blood Pressure ; Brain Death* ; Brain* ; Catecholamines ; Causality ; Central Venous Pressure ; Heart Arrest ; Hemodynamics* ; Humans ; Hypotension ; Medical Records ; Respiratory System ; Retrospective Studies ; Risk Factors ; Tissue Donors

Percutaneous cardiopulmonary support (PCPS) is a widely accepted treatment for severe cardiopulmonary failure. This system, which uses a percutaneous approach and autopriming devices, can be rapidly applied in emergency situations. We sought to identify the risk factors that could help predict in-hospital mortality, and to assess its outcomes in survivors. During a 2-yr period, 50 patients underwent PCPS for the treatment of severe cardiopulmonary failure, and of those, 22 (44%) were classified as survivors and 28 (56%) as non-survivors. We compared the 2 groups for risk factors of in-hospital mortality and to establish proper PCPS timing. Twenty patients underwent PCPS for acute myocardial infarction, 20 for severe cardiopulmonary failure after cardiac surgery, 7 for acute respiratory distress syndrome, and 3 for acute myocarditis. Multivariate analysis showed that an acute physiology, age, and chronic health evaluation (APACHE) III score > or =50 prior to PCPS was the only significant predictor of in-hospital mortality (P=0.001). Overall 18-month survival was 42.2%. Cox analysis showed patients with APACHE III scores > or =50 had a poor prognosis (P=0.001). Earlier application of PCPS, and other preemptive strategies designed to optimize high-risk patients, may improve patient outcomes. Identifying patients with high APACHE scores at the beginning of PCPS may predict in-hospital mortality. Survivors, particularly those with higher APACHE scores, may require more frequent follow-up to improve overall survival.
*APACHE ; Adult ; Aged ; Aged, 80 and over ; *Cardiopulmonary Resuscitation/methods/utilization ; Catecholamines/therapeutic use ; Female ; Heart Failure/mortality/*therapy ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome

BACKGROUND: The apnea test is an essential component in the clinical determination of brain death, however it may incur a significant risk of complications such as hypotension, hypoxia and even cardiac arrest. We analyzed the risk factors associated with a failed apnea test during brain death assessment in order to predict and avoid these adverse events. METHODS: Medical records on apnea tests performed for brain-dead donors at our institution between January 2009 and January 2016 were retrospectively reviewed. Age, gender, etiology of brain death, use of catecholamines and results of arterial blood gas analysis (ABGA), systolic/diastolic blood pressure (SBP/DBP), mean arterial pressure and central venous pressure prior to apnea test initiation were collected as variables. A-a gradient and P(aO2)/F(iO2) were calculated for more precise assessment of the respiratory system. In total, 267 cases were divided into two groups based on those who completed the apnea test and those who failed the test. RESULTS: 13 cases failed the apnea test. Among them, seven cases failed due to severe hypotension (SBP < 60 mmHg) and the others failed due to refractory hypoxia. In terms of hemodynamic state, SBP was significantly higher in the completed test group than the failed group (126.5 ± 23.9 vs. 103 ± 15.2, respectively; p = 0.001). In ABGA, the completed test group showed significantly higher P(aO2)/F(iO2) (313.6 ± 229.8 vs. 141.5 ± 131.0, respectively; p = 0.008) and a lower A-a gradient (278.2 ± 209.5 vs. 506.2 ± 173.1, respectively; p = 0.000). In multivariable analysis, low SBP (p = 0.003) and high A-a gradient (p = 0.044) were independent risk factors associated with a failed apnea test. CONCLUSIONS: Although the unexpected adverse events during the apnea test for brain death determination do not occur frequently, they can be fatal. If a brain-dead patient has low SBP and a high A-a gradient, clinicians should pay more attention and prepare for potential complications prior to the apnea test.
Anoxia ; Apnea ; Arterial Pressure ; Blood Gas Analysis ; Blood Pressure ; Brain Death ; Brain ; Catecholamines ; Causality ; Central Venous Pressure ; Heart Arrest ; Hemodynamics ; Humans ; Hypotension ; Medical Records ; Respiratory System ; Retrospective Studies ; Risk Factors ; Tissue Donors

OBJECTIVETo analyze the clinical characteristics of the patient with tyrosine hydroxylase deficiency, and investigate it's molecular mechanism.

METHODThe clinical characteristics of a patient with tyrosine hydroxylase deficiency were summarized and analyzed, his and his family's peripheral blood specimens were collected after informed consent was signed. All exons and the intron-exon boundaries of guanosine triphosphate hydroxylase I gene, tyrosine hydroxylase gene and sepiapterin reductase gene were examined by DNA-PCR, bi-directional sequencing.

RESULTThe patient was a 3-year-old boy, presented with unexplained dystonia for 3 years, without significant impairment of intelligence. Physical examination showed limb muscle strength grade V, rigidity of extremities, hypertonicity, brisk deep tendon reflexes in limbs, without obvious abnormalities in auxiliary examination, such as brain MRI, hepatic biochemical panel, creatine kinase, and ceruloplasmin. He dramatically responded to small doses of levodopa in the follow-up for half a year. A homozygous missense change in exon 5 of TH gene, c.605G > A (p.R202H), which was a known pathogenic mutation, was found in the patient. His parents were heterozygous for the R202H mutation.

CONCLUSIONThe age of onset in tyrosine hydroxylase deficiency patients is usually within the first year of life. Unexplained dystonia and hypokinesia were the main clinical features of tyrosine hydroxylase deficiency. The dopa-responsive effects for some patients are so obvious that we should strengthen awareness of the disease. TH gene c.605G > A (p.R202H) may be a common type of causative mutations for the mild form at home and abroad.

Brain ; metabolism ; pathology ; Catecholamines ; biosynthesis ; Child, Preschool ; DNA ; genetics ; DNA Mutational Analysis ; Dopamine Agents ; administration & dosage ; therapeutic use ; Dystonic Disorders ; drug therapy ; genetics ; metabolism ; Homozygote ; Humans ; Hypokinesia ; drug therapy ; genetics ; metabolism ; Levodopa ; administration & dosage ; therapeutic use ; Male ; Muscle Rigidity ; drug therapy ; genetics ; metabolism ; Mutation, Missense ; Polymerase Chain Reaction ; Tyrosine 3-Monooxygenase ; deficiency ; genetics ; metabolism