Factors influencing preoperative stress response in coronary artery bypass graft patients

BACKGROUND: In many studies investigating measures to attenuate the hemodynamic and humoral stress response during induction of anaesthesia, primary attention was paid to the period of endotracheal intubation since it has been shown that even short-lasting sympathetic cardiovascular stimulation may have detrimental effects on patients with coronary artery disease. The aim of this analysis was, however, to identify the influencing factors on high catecholamine levels before induction of anaesthesia. METHODS: Various potential risk factors that could impact the humoral stress response before induction of anaesthesia were recorded in 84 males undergoing coronary aortic bypass surgery, and were entered into a stepwise linear regression analysis. The plasma level of norepinephrine measured immediately after radial artery canulation was chosen as a surrogate marker for the humoral stress response, and it was used as the dependent variable in the regression model. Accordingly, the mean arterial blood pressure, heart rate and the calculated pressure-rate product were taken as parameters of the hemodynamic situation. RESULTS: Stepwise regression analysis revealed that the oral administration of low-dose clonidine (mean dose 1.75 μg.kg-1) on the morning of surgery was the only significant predictor (p = 0.004) of the high variation in preoperative norepinephrine plasma levels. This intervention decreased norepinephrine levels by more than 40% compared to no clonidine administration, from 1.26 to 0.75 nmol.l-1. There was no evidence for dose-responsiveness of clonidine. All other potential predictors were removed from the model as insignificant (p > 0.05). The use of beta-blocker, ace-inhibitors, ejection fraction, and body mass index were significant determinants for the hemodynamic situation (heart rate, mean arterial pressure, pressure rate product) of the patient during the pre-induction period. CONCLUSION: The oral administration of clonidine is the only significant predictor for the observed variation of norepinephrine levels during the preoperative period. Lack of significant dose responsiveness suggests that even a low dose of the drug can attenuate the preoperative stress response and thus is recommended in cardiovascular high risk patients.     

Coronary pressure and FFR predict long-term outcome after PTCA

Although coronary stents have been the most important improvement in percutaneous coronary interventions in the last 10 years, it is well known to interventionalists that many patients after percutaneous transluminal coronary angioplasty (PTCA) have a favourable outcome without stenting. Coronary angiography, however, is not sensitive enough to identify those particular patients and it has been suggested that a combination of angiographic and functional criteria would be more suitable to distinguish patients with a low restenosis chance after plain balloon angioplasty. In the present study, the authors investigated the value of coronary pressure measurement for conditional stenting in 85 patients. It was demonstrated that in patients in whom a high fractional flow reserve (FFR) was present (> 0.90), the incidence of coronary events at two-year follow-up was almost three times lower than in those patients with an FFR below 0.90. Such high FFRs could be obtained in approximately 45% of all patients. In an additional group of patients, it was demonstrated by intravascular ultrasound (IVUS) studies that the mechanism of a high FFR after plain balloon angioplasty is most likely the result of a larger lumen compared with patients with a suboptimal FFR. This means that, in patients in whom both the angiographic and the functional result after PTCA is optimal, a restenosis rate is achieved similar to that achieved by stenting. Obviously, in such patients, additional stenting and a number of problems in the long-term possibly related to stenting can be avoided. Therefore, coronary angiography and coronary pressure measurement have a complementary value in the evaluation of PTCA results and such information can be easily obtained by using a pressure wire instead of a regular guidewire.     

Leaf Anatomy, Emphasizing Unusual 'Concertina' Mesophyll Cells, of Two East African Legumes (Caesalpinieae, Caesalpinioideae, Leguminosae)

Cordeauxia edulis (Somalia and Ethiopia), andStuhlmannia moavii(Tanzania, Kenya and Madagascar) are evergreen shrubs or smalltrees of dry areas. They have similar leaf anatomy as revealedby resin sectioning and scanning electron microscopy. The cuticleis extremely thick and all vascular bundles lack bundle sheathextensions. The most unusual feature is the mesophyll, threeto seven layers consisting entirely of cylindrical palisadecells with lateral walls capable of changing vertical lengthby folding in a concertina-like manner. The matching outwardfolds of two adjacent cells always remain attached by meansof a row of wall thickenings (‘pegs’). The pegscan elongate, especially so between the widely separated mesophyllcells that occupy the substomatal chamber area. The unattachedflexible inward wall folds enable these ‘concertina’cells to shorten or lengthen vertically without disrupting cellinterconnections in the interior of each relatively long-livedleaf as it periodically loses and gains water. Concertina cellsmay be an anatomical adaptation allowing these leaves to remainevergreen and survive extended periods of drought and yet tostore water quickly when it becomes available. Leguminosae; Caesalpinioideae; Cordeauxia ; Stuhlmannia ; ‘concertina’ mesophyll cells; desert adaptation; hollow glandular trichomes; leaf anatomy; wall thickenings     

WATER EXCHANGE, TEMPERATURE TOLERANCE, OXYGEN CONSUMPTION AND ACTIVITY OF THE NAMIB DESERT SNAIL, TRIGONEPHRUS SP.

Water exchange, temperature tolerance and oxygen consumptionof the snail, Trigonephrus sp., from the southern Namib desertof Namibia were examined and related to activity. At 25°Cand 15% R.H. mean water loss and food and water uptake were5.95 mg. day^–1 and 630 mg.day^–1, respectively. Bodytemperature tracked sand temperature. Snails tolerated sandtemperatures as high as 45°C. Mean ± S.D. oxygenconsumption rates were 32.0 ± 2.94 µlO₂.g totalbody mass^–1.h^–1 at 15°C, when the snails wereactive, and 11.27 µlO₂.g total body mass^–1.h^–1at 25°C, when the snails were inactive. These values are2-6 times lower than those recorded for the similarly sizedmesic snail, Helix aspersa. Activity experiments indicated thatlow ambient temperatures and high humidities were favoured bythe snails. This, together with the burying behaviour of thesesnails during high temperatures, suggests that they limit stressby restricting activity to physiologically-favourable periods,even though more-extreme conditions may be tolerated. (Received 7 June 1990; accepted 20 November 1990)     

A Method for Analysing Plant Architecture as it Relates to Fruit Quality Using Three-dimensional Computer Graphics

A method was developed for the spatial analysis of plant architectureas it relates to the within-plant variation in the physical,chemical, and postharvest characteristics of the fruit Computergraphics were used to reconstruct the architectural frameworkand spatial arrangement of the fruit in the canopy of kiwifruitvines (Actinidia deliciosa) trained on two different supportstructures An infra-red beam theodolite was used to obtain thespatial coordinates of the vines components The data files generatedby the theodolite were in turn used with software specificallywritten for the project (MAPIT—Microcomputer Aided PlantImaging Technology) to provide a 3-dimensional reconstructionof the original vines Each fruit was colour coded so that extremesin their attributes could be easily identified and accuratelylocated in the canopy of the vine Patterns were clearly discerniblefor both the pergola and T-bar trained vines The heavier fruitwere located at the apical ends of the canes, while greatersoluble solids concentrations were associated with the smallerfruit located closer to the cordon These patterns were consistentfor all of the vines examined The use of the theodolite coupledwith the computer graphics described in this paper providesa rapid and objective means of accurately describing plant architecture Computer graphics, plant architecture, spatial analysis, theodolite, three-dimensional analysis, fruit quality, Actinidia deliciosa, kiwifruit     

A note on the use of dextran in blood cultures monitored by conductance methods

The incorporation of dextran into broth for the detection of bacteraemia by conductance monitoring is recommended to eliminate the effect of sedimenting blood cells which may mask early signals from bacteria. Broth containing ten times the recommended concentration of dextran was tested with a wide range of bacteria without demonstrating any reduction in growth or rate of change of conductance.     

Design of reference populations for genomic selection in crossbreeding programs

Background

In crossbreeding programs, genomic selection offers the opportunity to make efficient use of information on crossbred (CB) individuals in the selection of purebred (PB) candidates. In such programs, reference populations often contain genotyped PB animals, although the breeding objective is usually more focused on CB performance. The question is what would be the benefit of including a larger proportion of CB individuals in the reference population.

Methods

In a deterministic simulation study, we evaluated the benefit of including various proportions of CB animals in a reference population for genomic selection of PB animals in a crossbreeding program. We used a pig breeding scheme with selection for a moderately heritable trait and a size of 6000 for the reference population.

Results

Applying genomic selection to improve the performance of CB individuals, with a genetic correlation between PB and CB performance (r_PC) of 0.7, selection accuracy of PB candidates increased from 0.49 to 0.52 if the reference population consisted of PB individuals, it increased to 0.55 if the reference population consisted of the same number of CB individuals, and to 0.60 if the size of the CB reference population was twice that of the reference population for each PB line. The advantage of using CB rather than PB individuals increased linearly with the proportion of CB individuals in the reference population. This advantage disappeared quickly if r_PC was higher or if the breeding objective put some emphasis on PB performance. The benefit of adding CB individuals to an existing PB reference population was limited for high r_PC.

Conclusions

Using CB rather than PB individuals in a reference population for genomic selection can provide substantial advantages, but only when correlations between PB and CB performances are not high and PB performance is not part of the breeding objective.     

Exercise prevents leptin-induced increase in blood pressure in Sprague–Dawley rats

Although leptin has been shown to increase blood pressure (BP), it is however unclear if this increase can be prevented by exercise. This study therefore investigated the effect of leptin treatment with concurrent exercise on blood pressure (BP), sodium output, and endothelin-1 (ET-1) levels in normotensive rats. Male Sprague–Dawley rats weighing 250–270 g were divided into four groups consisting of a control group (n?=?6), leptin-treated (n?=?8), non-leptin-treated exercise group (n?=?8), and a leptin-treated exercise group (n?=?8). Leptin was given subcutaneously daily for 14 days (60 μg/kg/day). Animals were exercised on a treadmill for 30 min at a speed of 0.5 m/s and at 5° incline four times per week. Measurement of systolic blood pressure (SBP) and collection of urine samples for estimation of sodium and creatinine was done once a week. Serum samples were collected at the end of the experiment for determination of sodium, creatinine and ET-1. At day 14, mean SBP and serum ET-1 level in the leptin-treated group was significantly higher than that in the control group whereas mean SBP and serum ET-1 level was significantly lower in the leptin-treated exercise group than those in leptin-treated and control groups. Creatinine clearance, urinary sodium excretion, and urine output were not different between the four groups. Regular treadmill exercise prevents leptin-induced increases in SBP in rats, which might in part result from increased urinary sodium excretion and preventing the leptin-induced increases in serum ET-1 concentration.     

Time Space Translation: A Hox Mechanism for Vertebrate A-P Patterning

The vertebrate A-P axis is a time axis. The head is made first and more and more posterior levels are made at later and later stages. This is different to the situation in most other animals, for example, in Drosophila. Central to this timing is Hox temporal collinearity (see below). This occurs rarely in the animal kingdom but is characteristic of vertebrates and is used to generate the primary axial Hox pattern using time space translation and to integrate successive derived patterns (see below). This is thus a different situation than in Drosophila, where the primary pattern guiding Hox spatial collinearity is generated externally, by the gap and segmentation genes.