Afferent vagal stimulation via gastric electrical stimulation alters sympathetic-vagal balance in domestic pigs - a pilot trial.

The disturbance of the sympathetic-vagal balance with increasing sympathetic activity and consecutive increase in cytokine release is a major threat in numerous hyperinflammatory syndromes. Therapeutic interventions that modulate the activity in the sympathetic-vagal system are suggested as an effective treatment in these incidences. The purpose of this pilot study was to investigate the effect of electrical stimulation of the gastric wall on sympathetic-vagal balance. German domestic pigs (n=5) were prepared with a modified gastric tube (mGT) for repetitive gastric electrical stimulation (GES). Electrocardiogram was recorded continuously and heart rate variability (HRV) as measure of sympathetic-vagal activity was calculated for three-minute epochs at baseline condition before GES and during GES condition. In comparison to baseline, activity of the autonomic nervous system (ANS) shifted significantly toward increased dominance of vagal activity during GES with a decrease of normalized low frequency (nLF from 58.00 to 25.52) as marker of sympathetic dominance and parallel increase of normalized high frequency (nHF from 41.48 to 74.16) as marker of vagal dominance. During GES, compared to baseline, no difference in heart rate was found. These results indicate that electrical stimulation of the gastric wall may result in shifting the sympathetic-vagal balance toward a parasympathetic predominance.

[Eye changes in diabetes mellitus]. / Ubrt Augenveränderungen beim Diabetes mellitus

In ophthalmological examinations on 820 diabetics in 32% a diabetic retinopathy I or II was found. The frequency of retinopathy correlates with the duration of diabetes. A glaucoma (4.8%) or an increased intra-ocular pressure, respectively, was statistically significantly more frequent in diabetics than in the total population. Among 714 patients with glaucoma about 17% of diabetics were found. Compared with the morbidity of diabetes of adequate age groups of the total population this is statistically significant. The intraocular pressure of patients with glaucoma and diabetes is therapeutically worse to be influenced than in patients with glaucoma without diabetes. They need a particularly attentive control and therapy. By means of electon-microscope examinations as a possible cause for the association of glaucoma and diabetes mellitus similar changes in the iridocorneal angle could be found in the two diseases.