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1.
Alcohol Clin Exp Res ; 25(8): 1087-97, 2001 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-11505038

RESUMEN

BACKGROUND: Investigations of oral ethanol self-administration in nonhuman primates have revealed important parallels with human alcohol use and abuse, yet many fundamental questions concerning the individual risk to, and the biological basis of, excessive ethanol consumption remain unanswered. Moreover, many conditions of access to ethanol in nonhuman primate research are largely unexplored. This set of experiments extends within- and across-session exposure to ethanol to more fully characterize individual differences in oral ethanol self-administration. METHODS: Eight male and eight female adult cynomolgus monkeys (Macaca fascicularis) were exposed to daily oral ethanol self-administration sessions for approximately 9 months. During the first 3 months, a fixed-time (FT) schedule of food delivery was used to induce the consumption of an allotted dose of ethanol in 16-hr sessions. Subsequently, the FT schedule was suspended, and ethanol was available ad libitum for 6 months in 16- or 22-hr sessions. RESULTS: Cynomolgus monkeys varied greatly in their propensity to self-administer ethanol, with sex and individual differences apparent within 10 days of ethanol exposure. Over the last 3 months of ethanol access, individual average ethanol intakes ranged from 0.6 to 4.0 g/kg/day, resulting in blood ethanol concentrations from 5 to 235 mg/dl. Males drank approximately 1.5-fold more than females. In addition, heavy-, moderate-, and light-drinking phenotypes were identified by using daily ethanol intake and the percentage of daily calories obtained from ethanol as criteria. CONCLUSIONS: Cynomolgus monkeys displayed a wide intersubject range of oral ethanol self-administration with a procedure that used a uniform and prolonged induction that restricted early exposure to ethanol and subsequently allowed unlimited access to ethanol. There were sex and stable individual differences in the propensity of monkeys to consume ethanol, indicating that this species will be important in characterizing risk factors associated with heavy-drinking phenotypes.


Asunto(s)
Etanol/administración & dosificación , Autoadministración , Caracteres Sexuales , Animales , Etanol/sangre , Femenino , Macaca fascicularis , Masculino , Fenotipo , Factores de Tiempo
3.
Anesthesiology ; 94(6): 1074-81, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11465600

RESUMEN

BACKGROUND: Indirect evidence supports a role of spinal cholinergic neurons in tonically reducing response to noxious mechanical stimulation and in effecting analgesia from alpha2-adrenergic agonists. This study directly assessed the role of cholinergic neurons in regulating the level of mechanical allodynia and in participating in the antiallodynic effect of the clinically used alpha2-adrenergic agonist, clonidine, in an animal model of neuropathic pain. METHODS: Allodynia was produced in rats by ligation of the left L5 and L6 spinal nerves. Rats received a single intrathecal injection of saline or one of three different doses of the cholinergic neurotoxin, ethylcholine mustard aziridinium ion (AF64-A; 2, 5, and 15 nmol). Seven days later, allodynia was assessed before and after intrathecal injection of 15 microg clonidine. The spinal cord was removed, and spinal cord acetylcholine content, cholinergic neuron number and distribution, and alpha2-adrenergic receptor expression were determined. RESULTS: AF64-A administration reduced both the number of cholinergic cells and the acetylcholine content of the lumbar dorsal spinal cord by 20-50% but did not affect level of mechanical allodynia. AF64-A did, however, completely block the anti-allodynic effect of clonidine. AF64-A did not reduce alpha2-adrenergic ligand binding in dorsal lumbar cord. CONCLUSIONS: These data suggest that spinal cholinergic tone does not affect the level of mechanical allodynia after peripheral nerve injury. There is a quantitative reliance on spinal cholinergic neurons in the allodynia relieving properties of intrathecal clonidine, and this reliance does not depend on alpha2-adrenergic receptors colocalized on spinal cholinergic interneurons.


Asunto(s)
Agonistas alfa-Adrenérgicos/farmacología , Analgésicos no Narcóticos/farmacología , Clonidina/farmacología , Neuronas/fisiología , Sistema Nervioso Parasimpático/fisiología , Traumatismos de los Nervios Periféricos , Acetilcolina/metabolismo , Antagonistas Adrenérgicos alfa/metabolismo , Animales , Aziridinas/toxicidad , Conducta Animal/efectos de los fármacos , Colina/análogos & derivados , Colina/toxicidad , Inmunohistoquímica , Masculino , Neurotoxinas/toxicidad , Sistema Nervioso Parasimpático/citología , Ratas , Receptores Adrenérgicos alfa 2/efectos de los fármacos , Médula Espinal/efectos de los fármacos , Médula Espinal/metabolismo , Yohimbina/metabolismo
4.
Anesth Analg ; 93(1): 45-52, 2001 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-11429337

RESUMEN

UNLABELLED: Dopamine has a wide spectrum of receptor and pharmacologic actions that may affect cerebral blood flow (CBF). A new, selective dopamine-1 agonist, fenoldopam, is a potent systemic vasodilator with moderate alpha(2)-receptor affinity. However, the effects of fenoldopam on the cerebral circulation are undefined. We therefore hypothesized that infusion of fenoldopam would decrease mean arterial blood pressure (MAP) and might concurrently decrease CBF via vascular alpha(2)-adrenoreceptor activation in awake volunteers. We studied nine healthy normotensive subjects, using positron emission tomography to measure CBF in multiple cortical and subcortical regions of interest. In addition, bioimpedance cardiac output and middle cerebral artery blood flow velocity were determined during fenoldopam-induced hypotension. Three men and four women, aged 25-43 yr, completed the study. Fenoldopam infused at 1.3 +/- 0.4 microg. kg(-1). min(-1) (mean +/- SD) reduced MAP 16% from baseline: from 94 (89-100) mm Hg (mean [95% confidence interval]) to 79 [74-85] mm Hg (P < 0.0001). During the fenoldopam infusion, both cardiac output (+39%), and heart rate (+45%) increased significantly, whereas global CBF decreased from baseline, 45.6 [35.6-58.5] mL. 100 g(-1). min(-1), to 37.7 [33.9-42.0] mL. 100 g(-1). min(-1) (P < 0.0001). Despite restoration of baseline MAP with a concurrent infusion of phenylephrine, global CBF remained decreased relative to baseline values at 37.9 [34.0-42.3] mL. 100 gm(-1). min(-1) (P < 0.0001). Changes in middle cerebral artery velocity did not correlate with positron emission tomography-measured changes of CBF induced by fenoldopam, with or without concurrent phenylephrine. IMPLICATIONS: In awake volunteers with (presumably) intact cerebral autoregulation,fenoldopam-induced hypotension significantly decreased global cerebral bloodflow (CBF). Clinicians should be aware of these pharmacodynamic effects when choosing a vasodilator to control blood pressure, especially in situations where control of CBF, cerebral blood volume, and intracranial pressure are therapeutic priorities.


Asunto(s)
Antihipertensivos/farmacología , Presión Sanguínea/efectos de los fármacos , Circulación Cerebrovascular/efectos de los fármacos , Agonistas de Dopamina/farmacología , Fenoldopam/farmacología , Adolescente , Adulto , Encéfalo/diagnóstico por imagen , Gasto Cardíaco/efectos de los fármacos , Depresión Química , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Receptores Adrenérgicos alfa 2/efectos de los fármacos , Receptores de Dopamina D1/efectos de los fármacos , Tomografía Computarizada de Emisión , Ultrasonografía Doppler Transcraneal
5.
Pain ; 91(1-2): 139-45, 2001 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11240086

RESUMEN

Positron emission tomography (PET) imaging of spinal cord in monkeys with a cholinergic tracer demonstrates increased spinal cholinergic activity in response to an analgesic dose of morphine, and this PET result correlates with measurement of acetylcholine spillover into spinal cord extracellular space induced by morphine, as measured by microdialysis. Previous studies in rats, mice, and sheep demonstrate activation of spinal cholinergic neurons by systemic opioid administration, and participation of this cholinergic activity in opioid-induced analgesia. Testing the relevance of this observation in humans has been limited to measurement of acetylcholine spillover into lumbar cerebrospinal fluid. The purpose of this study was to apply a recently developed method to image spinal cholinergic terminals non-invasively via PET and to test the hypothesis that the tracer utilized would reflect changes in local cholinergic activity. Following Animal Care and Use Committee approval, seven adult male rhesus monkeys were anesthetized on three separate occasions. On two of the occasions PET scans were performed using [(18)F] (+)-4-fluorobenzyltrozamicol ([(18)F]FBT), which selectively binds to the vesicular acetylcholine (ACh) transporter in the presynaptic cholinergic terminals. PET scans were preceded by injection of either saline or an analgesic dose of IV morphine (10 mg/kg). On the third occasion, microdialysis catheters were inserted in the spinal cord dorsal horn and acetylcholine concentrations in dialysates determined before and after IV morphine injection. Morphine increased cholinergic activity in the spinal cord, as determined by blood flow corrected distribution volume of [(18)F]FBT in the cervical cord compared to the cerebellum. Morphine also increased acetylcholine concentrations in microdialysates from the cervical cord dorsal horn. The one animal which did not show increased spinal cholinergic activity by PET from this dose of morphine also did not show increased acetylcholine from this morphine dose in the microdialysis experiment. These data confirm the ability to use PET to image spinal cholinergic terminals in the monkey spinal cord and suggest that acute changes in cholinergic activity can be imaged with this non-invasive technique. Following preclinical screening, PET scanning with [(18)F]FBT may be useful to investigate mechanisms of analgesic action in normal humans and in those with pain.


Asunto(s)
Analgésicos Opioides/farmacología , Fibras Colinérgicas/efectos de los fármacos , Fibras Colinérgicas/fisiología , Morfina/farmacología , Médula Espinal/efectos de los fármacos , Médula Espinal/fisiología , Acetilcolina/metabolismo , Animales , Fibras Colinérgicas/diagnóstico por imagen , Radioisótopos de Flúor , Fluorobencenos/farmacocinética , Macaca mulatta , Masculino , Microdiálisis , Piperidinas/farmacocinética , Flujo Sanguíneo Regional/efectos de los fármacos , Médula Espinal/irrigación sanguínea , Tomografía Computarizada de Emisión
6.
Synapse ; 39(1): 95-100, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11071714

RESUMEN

In the present study, the radiotracer [(18)F] (+)-4-fluorobenzyltrozamicol ((+)-[(18)F]FBT) and positron emission tomography (PET) were used to examine the vesicular acetylcholine transporter and determine if presynaptic cholinergic activity was altered with age in 23 rhesus monkeys that varied in age from 10 to 37 years. Binding of (+)-[(18)F]FBT in the basal ganglia was reduced significantly with increasing age of the monkeys. However, there were individual differences noted in that some middle-aged and aged monkeys demonstrated levels of (+)-[(18)F]FBT binding that were comparable to the binding measured in adult monkeys. These data indicate that presynaptic cholinergic function may decrease with age, but that there may be a differential susceptibility of the cholinergic system to the aging process in different individuals.


Asunto(s)
Acetilcolina/metabolismo , Envejecimiento/metabolismo , Ganglios Basales/metabolismo , Proteínas Portadoras/metabolismo , Proteínas de Transporte de Membrana , Terminales Presinápticos/metabolismo , Proteínas de Transporte Vesicular , Animales , Ganglios Basales/citología , Cerebelo/citología , Cerebelo/metabolismo , Radioisótopos de Flúor , Fluorobencenos/farmacocinética , Macaca mulatta/anatomía & histología , Macaca mulatta/metabolismo , Masculino , Fármacos Neuromusculares Despolarizantes/agonistas , Piperidinas/agonistas , Piperidinas/farmacocinética , Terminales Presinápticos/ultraestructura , Tomografía Computarizada de Emisión , Proteínas de Transporte Vesicular de Acetilcolina
7.
Brain Res ; 872(1-2): 301-7, 2000 Jul 28.
Artículo en Inglés | MEDLINE | ID: mdl-10924712

RESUMEN

Although nitric oxide (NO) participates in development of hypersensitivity states in the spinal cord thought to underlie chronic pain, it also participates in analgesia produced by various drugs. In rats with a hypersensitivity state following peripheral nerve injury, spinal administration of an NO donor or l-cysteine alone produced no effect, whereas their combination, which yields s-nitroso-l-cysteine (SNC) powerfully reduced hypersensitivity. In the current study, we examined the ability of SNC to stimulate release of a known spinal analgesic neurotransmitter, norepinephrine (NE), as a possible mechanism of analgesic action of NO in the spinal cord. SNC (but not the NO donor alone or decomposed SNC) produced a concentration-dependent release of NE from rat spinal cord synaptosomes. The d-isomer of SNC was less potent than the l-isomer, and the effect of SNC was partially blocked by l-, but not d-leucine, implicating an interaction with the l-amino acid transporter. SNC-induced NE release was partially Na(+) dependent, but largely Ca(2+) independent. NE uptake inhibitors partially antagonized the effect of SNC, but guanylate cyclase inhibitors were without effect. These data are therefore consistent with NO stimulating NE release in the spinal cord via reaction with thiol containing compounds, such as cysteine, entry into NE terminals via active transport, and production of both exocytotic and carrier mediated release.


Asunto(s)
Cisteína/análogos & derivados , Cisteína/farmacología , Compuestos Nitrosos/farmacología , Norepinefrina/metabolismo , Penicilamina/análogos & derivados , S-Nitrosotioles , Médula Espinal/química , Sinaptosomas/efectos de los fármacos , Sinaptosomas/metabolismo , Inhibidores de Captación Adrenérgica/farmacología , Animales , Unión Competitiva/efectos de los fármacos , Calcio/metabolismo , Calmodulina/antagonistas & inhibidores , Desipramina/farmacología , Inhibidores de Captación de Dopamina/farmacología , Relación Dosis-Respuesta a Droga , Ácido Egtácico/farmacología , Leucina/metabolismo , Leucina/farmacología , Magnesio/farmacología , Masculino , Níquel/farmacología , Óxido Nítrico/metabolismo , Donantes de Óxido Nítrico/metabolismo , Nomifensina/farmacología , Norepinefrina/análisis , Penicilamina/metabolismo , Ratas , Ratas Sprague-Dawley , Sodio/antagonistas & inhibidores , Sodio/metabolismo , omega-Conotoxinas/farmacología
8.
J Pharmacol Exp Ther ; 292(3): 895-9, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10688602

RESUMEN

Nitric oxide has been shown to react under physiologic conditions with norepinephrine (NE) to produce 6-nitro-norepinephrine (6-NO(2)-NE), a compound that enhances NE release in the brain. Previous studies suggest that 6-NO(2)-NE is formed in the spinal cord and stimulates spinal NE release to produce analgesia. The purpose of the current studies was to examine the mechanisms by which 6-NO(2)-NE stimulates NE release in the spinal cord. Crude synaptosomes were prepared from spinal cords of male Sprague-Dawley rats and loaded with [(3)H]NE. Incubation of synaptosomes with 6-NO(2)-NE resulted in a release of NE, with a threshold of 1 microM 6-NO(2)-NE and a maximum effect of 30% fractional release. NE transporter inhibitors desipramine and nomifensine blocked NE release from 6-NO(2)-NE, and desipramine exhibited an IC(50) of 9.6 microM. NE release from 6-NO(2)-NE was dependent on external Na(+), but not Ca(2+) or the activity of guanylate cyclase. 6-NO(2)-NE also blocked uptake of [(3)H]NE into synaptosomes, with an IC(50) of 8.3 microM. These data are consistent with a direct action of 6-NO(2)-NE on noradrenergic terminals in the spinal cord to release NE. This action is independent of guanylate cyclase activation, and most likely shares a common mechanism with classic monoamine releasers such as amphetamine that cause direct release of NE from vesicles into the nerve terminal cytoplasm, leading to extracellular release by reverse transport.


Asunto(s)
Norepinefrina/análogos & derivados , Norepinefrina/metabolismo , Médula Espinal/efectos de los fármacos , Sinaptosomas/efectos de los fármacos , Animales , Calcio/farmacología , Relación Dosis-Respuesta a Droga , Masculino , Óxido Nítrico/biosíntesis , Norepinefrina/farmacología , Ratas , Ratas Sprague-Dawley , Sodio/farmacología , Médula Espinal/metabolismo , Sinaptosomas/metabolismo
9.
J Nucl Med ; 41(12): 2069-76, 2000 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11138694

RESUMEN

UNLABELLED: [18F](+)-4-fluorobenzyltrozamicol (FBT), which selectively binds to the vesicular acetylcholine transporter in the presynaptic cholinergic neuron, has previously been shown to be a useful ligand for the study of cholinergic terminal density in the basal ganglia with PET. The goal of this study was to assess the test-retest variability of [18F]FBT and PET measurements under baseline conditions in the basal ganglia. METHODS: After approval from the Animal Care and Use Committee, 6 rhesus monkeys underwent a series of 2 [18F]FBT PET scans (time between scans, 32-301 d) under isoflurane anesthesia. Each scan was initiated on the bolus injection of the radiotracer and consisted of 26 frames acquired during 180 min. Arterial blood samples were collected over the course of each scan to determine the metabolite-corrected arterial input function. Tissue time-activity curves were obtained from the scan data by drawing regions of interest over the basal ganglia and cerebellum. The distribution volume ratio for the basal ganglia was then determined for each scan by taking the ratio of the basal ganglia (specific binding) to cerebellum (nonspecific binding) distribution volume. Distribution volumes were derived using the Logan graphic analysis technique as well as a standard 3-compartment model. Additionally, the radioactivity concentration ratio was calculated as the ratio of the average [18F]FBT concentration in the basal ganglia to that in the cerebellum during the last half of the study (85-170 min). The constant K1, determined using the standard 3-compartment model, was used as an index of blood flow changes between studies. RESULTS: For all subjects, the test-retest variability was less than 15% for the distribution volume ratio and 12% for the radioactivity concentration ratio. Good agreement was found between the distribution volume ratio calculated using the graphic technique and the standard 3-compartment model. Using K1 as an index, the variability in blood flow seen in both the basal ganglia and the cerebellum was significantly reduced in their ratio. CONCLUSION: These results show the reproducibility of [18F]FBT and PET measurements in the basal ganglia.


Asunto(s)
Encéfalo/diagnóstico por imagen , Fibras Colinérgicas/diagnóstico por imagen , Radioisótopos de Flúor , Fluorobencenos , Terminaciones Nerviosas/diagnóstico por imagen , Piperidinas , Radiofármacos , Tomografía Computarizada de Emisión , Animales , Ganglios Basales/diagnóstico por imagen , Cerebelo/diagnóstico por imagen , Macaca mulatta , Masculino , Reproducibilidad de los Resultados
10.
Anesthesiology ; 91(5): 1447-54, 1999 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10551597

RESUMEN

BACKGROUND: Cholinergic agents produce analgesia after systemic and intrathecal administration. A retrospective review showed that intrathecal neostigmine was more potent in women than in men, suggesting a sex difference in this response. The purpose of this study was to determine whether such a sex difference exists in normal rats and to examine the pharmacologic mechanisms that underlie this difference. METHODS: Male and female rats with indwelling intrathecal catheters received injections of neostigmine, bethanechol (muscarinic agonist), or RJR-2403 (neuronal nicotinic agonist) alone or with atropine (muscarinic antagonist), mecamylamine (nicotinic antagonist), or phentolamine alpha-adrenergic antagonist) with antinociception determined to a noxious heat stimulus to the hind paw. Time versus subcutaneous paw temperature relationships were defined for males and females. RESULTS: Neostigmine produced dose-dependent antinociception with five times greater potency in female than in male rats. Neostigmine-induced antinociception was reversed in male rats by atropine and unaffected by mecamylamine, whereas it was partially reduced by each antagonist alone in females and completely reversed after injection of both. RJR-2403 was more potent in females than in males, whereas there was no sex difference to bethanechol. Phentolamine partially reversed antinociception from RJR-2403 in females. Paw temperature increased more rapidly in females than in males for the same lamp intensity. CONCLUSIONS: These data demonstrate a large sex difference in antinociception to intrathecal neostigmine that is primarily the result of a nicotinic component in females. Phentolamine reversal suggests that part of this nicotinic component may rely on spinal norepinephrine release. A better understanding of this sex difference could lead to development of novel pain therapy for women.


Asunto(s)
Analgésicos/farmacología , Colinérgicos/farmacología , Neostigmina/farmacología , Receptores Nicotínicos/efectos de los fármacos , Analgésicos/administración & dosificación , Animales , Colinérgicos/administración & dosificación , Relación Dosis-Respuesta a Droga , Femenino , Inyecciones Espinales , Masculino , Agonistas Muscarínicos/administración & dosificación , Agonistas Muscarínicos/farmacología , Antagonistas Muscarínicos/administración & dosificación , Antagonistas Muscarínicos/farmacología , Neostigmina/administración & dosificación , Agonistas Nicotínicos/administración & dosificación , Agonistas Nicotínicos/farmacología , Antagonistas Nicotínicos/administración & dosificación , Antagonistas Nicotínicos/farmacología , Dimensión del Dolor , Ratas , Ratas Sprague-Dawley , Valores de Referencia , Factores Sexuales
11.
Anesth Analg ; 88(4): 737-41, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10195514

RESUMEN

UNLABELLED: We conducted a survey of Society for Pediatric Anesthesia anesthesiologists practicing within the United States to determine the frequency of tracheal intubation of healthy infants and children using an inhaled anesthetic without muscle relaxation (IAWMR). We also examined reasons for the use of this technique. Of all responders who listed their most often used technique for tracheal intubation of healthy infants and children, IAWMR was chosen over intubation with a muscle relaxant by 38.1% and 43.6%, respectively. Anesthesiologists who most often used IAWMR for tracheal intubation of healthy infants and children had over twice the odds (odds ratio [OR] 2.30 for infants, 95% confidence interval [CI] 1.18-4.50; P = 0.015) of classifying their own practice as nonacademic, and one-third the odds (OR 0.34 for infants, 95% CI 0.17-0.68; P = 0.002) of conducting more than half of their cases in a supervisory role. Anesthesiologists who use IAWMR to tracheally intubate healthy pediatric patients most commonly selected as their reasons the lack of need for a muscle relaxant and the desire to avoid both succinylcholine and the excessive duration of nondepolarizing muscle relaxants. IMPLICATIONS: Inhaled anesthetic without muscle relaxation is the most often used method of intubation for more than one third of Society for Pediatric Anesthesia anesthesiologists when tracheally intubating healthy, fasted pediatric patients undergoing elective procedures. The frequency of this practice seems to be highest in nonacademic practices.


Asunto(s)
Anestesiología , Anestésicos por Inhalación , Intubación Intratraqueal/estadística & datos numéricos , Relajantes Musculares Centrales , Análisis de Varianza , Niño , Preescolar , Humanos , Lactante , Intubación Intratraqueal/métodos , Seguridad , Estadística como Asunto , Encuestas y Cuestionarios
12.
Anesth Analg ; 86(4): 712-6, 1998 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-9539589

RESUMEN

UNLABELLED: Continuous epidural infusions are widely used for postoperative analgesia in children. We prospectively studied the incidence of bacterial colonization of caudal and lumbar epidural catheters, as well as the incidence of serious systemic and local infection, in 210 children after short-term epidural analgesia. Using aseptic technique, epidural catheters were inserted into either the lumbar or the caudal epidural space based on the preferences of the anesthesia team and/or clinical indication. The integrity of the catheter and overlying transparent dressing site was evaluated by a member of the pediatric pain service at least once a day. The catheters were aseptically removed if the patient had a fever greater than 39 degrees C, if the dressing was compromised, or when epidural analgesia was no longer required. The subcutaneous portion of the catheter was semiquantitatively cultured. Cellulitis (erythema, swelling, purulent discharge, pustule formation, or tenderness) was diagnosed by examination of the epidural insertion site. The mean (+/- SD) age of patients in the caudal catheter group (n = 170) was 3 +/- 3 yr; their mean weight was 13 +/- 11 kg. The mean (+/- SD) age of patients in the epidural catheter group (n = 40) was 11 +/- 4 yr; their mean weight was 36 +/- 23 kg. All catheters remained in place for 3 +/- 1 days (range 1-5 days). There was no serious systemic infection (meningitis, epidural abscess, or systemic sepsis). Of all epidural catheters, 35% (73 of 210) were colonized. Gram-positive colonization was similar in caudal (25%; 43 of 170) and lumbar (23%; 9 of 40) catheters. Gram-negative organisms were cultured from 16% of the caudal catheters (27 of 170) and 3% of the lumbar catheters (1 of 40). In patients treated with caudal epidural catheters, children aged >3 yr were less likely to have colonized epidural catheters than younger children. Age did not affect the probability of developing cellulitis at the insertion site. Although patients aged <3 yr with caudal catheters had a slightly greater risk of cellulitis than children aged >3 yr (14% vs 9%), this association was very weak (P = 0.33). We observed that, despite bacterial colonization of caudal and lumbar epidural catheters, serious systemic and local infection after short-term epidural analgesia did not occur in our study. IMPLICATIONS: Continuous epidural infusions are widely used for postoperative analgesia in children. We found no serious systemic infections after short-term (3 days) continuous epidural analgesia in children.


Asunto(s)
Analgesia Epidural/instrumentación , Bacterias/crecimiento & desarrollo , Infecciones Bacterianas/etiología , Cateterismo/instrumentación , Absceso/etiología , Adolescente , Adulto , Factores de Edad , Celulitis (Flemón)/etiología , Distribución de Chi-Cuadrado , Niño , Preescolar , Edema/etiología , Eritema/etiología , Fiebre/etiología , Bacterias Gramnegativas/crecimiento & desarrollo , Bacterias Grampositivas/crecimiento & desarrollo , Humanos , Incidencia , Lactante , Recién Nacido , Modelos Logísticos , Meningitis Bacterianas/etiología , Apósitos Oclusivos , Probabilidad , Estudios Prospectivos , Factores de Riesgo , Sepsis/etiología , Supuración , Factores de Tiempo
15.
Synapse ; 25(4): 368-80, 1997 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-9097396

RESUMEN

The goal of the present set of studies was to characterize the in vitro binding properties and in vivo tissue kinetics for the vesicular acetylcholine transporter (VAcChT) radiotracer, [18F](+)-4-fluorobenzyltrozamicol ([18F](+)-FBT). In vitro binding studies were conducted in order to determine the affinity of the (+)- and (-)-stereoisomers of FBT for the VAcChT as well as sigma (sigma 1 and sigma 2) receptors. (+)-FBT was found to have a high affinity (Ki = 0.22 nM) for the VAcChT and lower affinities for sigma 1 (21.6 nM) and sigma 2 (35.9 nM) receptors, whereas (-)-FBT had similar affinities for the VAcChT and sigma 1 receptors (approximately 20 nM) and a lower affinity for sigma 2 (110 nM) receptors. PET imaging studies were conducted in rhesus monkeys (n = 3) with [18F](+)-FBT. [18F](+)-FBT was found to have a high accumulation and slow rate of washout from the basal ganglia, which is consistent with the labeling of cholinergic interneurons in this brain region. [18F](+)-FBT also displayed reversible binding kinetics during the 3 h time course of PET and produced radiolabeled metabolites that did not cross the blood-brain barrier. The results from the current in vitro and in vivo studies indicate that [18F](+)-FBT is a promising ligand for studying cholinergic terminal density, with PET, via the VAcChT.


Asunto(s)
Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Proteínas Portadoras/metabolismo , Radioisótopos de Flúor , Fluorobencenos , Proteínas de Transporte de Membrana , Piperidinas , Vesículas Sinápticas/metabolismo , Tomografía Computarizada de Emisión/métodos , Proteínas de Transporte Vesicular , Animales , Ganglios Basales/metabolismo , Proteínas Portadoras/análisis , Cerebelo/metabolismo , Radioisótopos de Flúor/farmacocinética , Lóbulo Frontal/metabolismo , Macaca mulatta , Imagen por Resonancia Magnética , Masculino , Fármacos Neuromusculares Despolarizantes/metabolismo , Lóbulo Occipital/metabolismo , Especificidad de Órganos , Piperidinas/síntesis química , Piperidinas/metabolismo , Piperidinas/farmacocinética , Ensayo de Unión Radioligante , Ratas , Ratas Sprague-Dawley , Receptores sigma/análisis , Receptores sigma/metabolismo , Estereoisomerismo , Lóbulo Temporal/metabolismo , Proteínas de Transporte Vesicular de Acetilcolina
16.
J Cereb Blood Flow Metab ; 17(1): 109-15, 1997 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-8978393

RESUMEN

Nitric oxide synthase (NOS) participates in the regulation of cerebral blood flow and neurotransmitter release and as a second messenger of glutamatergic and cholinergic systems. Developmental differences in NOS activity have been described in the rat, but not in a species with longer gestation and a larger, lobulated brain at birth. We assayed NOS activity by conversion of [14C]L-arginine to [14C]L-citrulline in 50-mg tissue samples from eight brain regions in sheep at 70, 92, 110, and 135 days gestation (term = 145 days); newborns (< 7 days); and adults to test the hypothesis that NOS activity in the brain is developmentally regulated from midgestation through adulthood and matures along the neuroaxis in parallel with the known development of cerebral blood flow and neuronal activity. Three patterns of maturation of NOS activity were evident: increasing to or exceeding adult levels before 70 days gestation in the thalamus, cerebellum, and medulla; increasing to adult levels between 70 and 92 days in the hippocampus; and increasing to adult levels after 92 days in the cortex and caudate. Additionally, there were regional differences in cortical NOS activity: at 70 and 92 days of gestation, frontal cortex NOS activity was greater than parietal or occipital activity, and at 135 days gestation and in the newborn and adult, cortical and caudate activity exceeded that in most of the more caudal regions. The up to fourfold increase in regional cortical NOS activity between 92 and 135 days gestation was associated with twofold increases in cerebral blood flow and oxygen consumption during this period. Inhibition of NOS activity with administration of 60 mg/kg of NG-nitro-L-arginine methylester (L-NAME) resulted in 27% and 25% reductions in cerebral blood flow at 93 and 133 days gestation. While the associated increases in NOS activity with increases in CBF and CMRO2 do not appear causative, at various points in gestation the development of NOS activity may participate in the development of mature patterns of cerebral blood flow regulation in parallel with development of synaptic and electrical activity.


Asunto(s)
Encéfalo/embriología , Encéfalo/enzimología , Circulación Cerebrovascular/fisiología , Óxido Nítrico Sintasa/metabolismo , Ovinos/embriología , Animales , Encéfalo/crecimiento & desarrollo , Desarrollo Embrionario y Fetal , Femenino , Humanos , Recién Nacido , Flujo Sanguíneo Regional
17.
J Neurol Sci ; 138(1-2): 14-20, 1996 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-8791233

RESUMEN

Peripheral nerve injury may lead to a chronic neuropathic pain state that results from an increase in excitability of central neurons. This central sensitization is mediated via an N-methyl-D-aspartic acid (NMDA) receptor and may involve the production of nitric oxide (NO). As NO is suggested to play a role in nociceptive transmission following nerve injury, we examined for altered NO synthase activity at multiple levels of peripheral and spinal neural tissue in a rat model of neuropathic pain. Peripheral neuropathy was induced in rats (N = 12) by ligation of the left L5 and L6 nerve roots. Six other rats had sham surgery. An ipsilateral decrease in paw withdrawal threshold to mechanical stimuli confirmed the presence of a neuropathic pain state. Samples of the lumbar and thoracic spinal cords, L4, L5, and L6 dorsal root ganglia (DRGs), and the sciatic nerves were obtained from the lesioned and contralateral sides at 2 and 4 weeks after neuropathic surgery (N = 6 per group). In the lumbar spinal cord, a bilateral decrease in nitric oxide synthase (NOS) activity was observed 2 and 4 weeks after neuropathic surgery. NOS activity was increased in the ipsilateral L5 and 6 DRGs 2 weeks following neuropathic surgery. An increase in NOS activity in the DRG may be an early mechanism for inducing more central changes. The bilaterally decreased NOS activity in the lumbar spinal cord may be secondary to a negative feedback mechanism resulting from increased NO production in the spinal dorsal root ganglia. Multiple alterations in expression of NOS activity that occur in both peripheral and central processing may play a role in the pain behavior resulting from peripheral nerve injury. (Preliminary results of these studies have been presented in abstract form at the annual meetings of the Society for Neuroscience, 1994, and the American Society of Anesthesiologists, 1994).


Asunto(s)
Neuralgia/enzimología , Óxido Nítrico Sintasa/metabolismo , Nervios Periféricos/enzimología , Traumatismos de la Médula Espinal/enzimología , Análisis de Varianza , Animales , Reacción de Prevención/fisiología , Ganglios Espinales/enzimología , Masculino , Traumatismos de los Nervios Periféricos , Ratas , Ratas Sprague-Dawley , Nervio Ciático/enzimología , Sistema Nervioso Simpático/enzimología
18.
Am J Physiol ; 270(4 Pt 2): H1225-30, 1996 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8967360

RESUMEN

We examined the effects of total global ischemia on cerebral arteriolar responses to N-methyl-D-aspartate (NMDA) in anesthetized newborn pigs. Arteriolar responses to 10(-4) M NMDA were determined before and after 10 to 20 min of ischemia caused by increasing intracranial pressure. Before ischemia, NMDA dilated arterioles by 30 +/- 5% (baseline = 88 +/- 2 microns; n = 6). However, after 10 min of ischemia, arteriolar dilation was reduced to 10 +/- 3% at 1 h (P < 0.05). At 2 and 4 h, NMDA-induced dilation was not different from preischemia values. Twenty minutes of ischemia had similar effects. Coadministration of 100 U/ml of superoxide dismutase did not restore arteriolar dilation to NMDA at 1 h after ischemia. Sodium nitroprusside dilated by 14 +/- 3 and 40 +/- 5% at 10(-6) and 10(-5) M before ischemia, respectively, and arteriolar responsiveness was not changed by ischemia (n = 6). Cortical nitric oxide synthase (NOS) activity, measured by the in vitro conversion of L-[14C]arginine to L-[14C]citrulline, was unaffected by ischemia (n = 12). We conclude that decreases in cerebral arteriolar responsiveness to NMDA are not due to impairment of NOS activity, enhanced degradation or chelation of nitric oxide (NO), or reduced vascular smooth muscle responsiveness to NO.


Asunto(s)
Isquemia Encefálica/fisiopatología , Circulación Cerebrovascular/efectos de los fármacos , N-Metilaspartato/farmacología , Animales , Arteriolas/efectos de los fármacos , Arteriolas/fisiopatología , Encéfalo/enzimología , Femenino , Masculino , Óxido Nítrico Sintasa/metabolismo , Nitroprusiato/farmacología , Superóxido Dismutasa/farmacología , Porcinos , Vasodilatación
19.
Anesthesiology ; 84(4): 890-9, 1996 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8638844

RESUMEN

BACKGROUND: Nitric oxide synthase is located in the spinal cord dorsal horn and intermediolateral cell column, where it may modulate sensory and sympathetic neuronal activity. However, the biochemical characteristics of this enzyme have not been examined in these different areas in the spinal cord. Although alpha(2)-adrenergic agonists, muscarinic agonists, and nitric oxide may interact in the spinal cord to produce antinociception, these interactions have not been characterized. METHODS: Sheep spinal cord tissue was homogenized ad centrifuged at high sped to separate soluble and membrane-bound fractions. Nitric oxide synthase activity was determined by conversion of [(14)C]-L-arginine to [(14)C]-L-citrulline and its kinetic characteristics, dependency on cofactors, and sensitivity to inhibitors determined. Sheep spinal cord was stained for nicotinamide adenine dinucleotide phosphate diaphorase as a marker for nitric oxide synthase. Antinociception to a mechanical stimulus from intrathecal clonidine alone and with neostigmine was determined and the effects of L-arginine and n-methyl-L-arginine were determined. RESULTS: More than 85% of nitric oxide synthase activity was present in the soluble form and its kinetic, cofactor, and antagonist properties were similar to those of the neuronal isoform of nitric oxide synthase. Biochemical and histochemical studies localized nitric oxide synthase to the superficial dorsal horn and the intermediolateral cell column. Clonidine antinociception was enhanced by L-arginine and neostigmine, but not by D-arginine. Neostigmine's enhancement of clonidine antinociception was blocked by n-methyl-L-arginine. CONCLUSIONS: These results confirm those of previous studies demonstrating localization of nitric oxide synthase to superficial dorsal horn and intermediolateral cell column of mammalian spinal cord, and suggesting its identity as the neuronal isoform. Spinal alpha(2)-adrenergic agonist antinociception may be partly dependent on cholinergic and nitric oxide mechanisms.


Asunto(s)
Agonistas de Receptores Adrenérgicos alfa 2 , Agonistas alfa-Adrenérgicos/farmacología , Analgesia , Óxido Nítrico Sintasa/metabolismo , Sistema Nervioso Parasimpático/fisiología , Médula Espinal/enzimología , Animales , Clonidina/farmacología , Femenino , Neostigmina/farmacología , Ovinos , Médula Espinal/fisiología
20.
Brain Res ; 694(1-2): 177-82, 1995 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-8974642

RESUMEN

Nitric oxide (NO) is a candidate retrograde messenger involved in synaptic plasticity, and is linked to the cholinergic system in the brain. We examined the role of NO in the acquisition of visual and spatial discriminations by daily administration of either saline or 1-nitroarginine methyl ester (L-NAME), an NO synthase inhibitor. Brains were assayed for NO synthase activity and two presynaptic cholinergic markers: hemicholinium-3 (HC-3) binding, which determines the number of sodium-dependent high-affinity choline uptake sites, and activity of choline acetyltransferase (ChAT), which is the synthetic enzyme for acetylcholine. In both behavioral tasks, the acquisition rate was not different between groups. L-NAME reduced NO synthase activity by 85% in all brain areas assayed and HC-3 binding by 38% in hippocampus and 48% in posterior cortex. ChAT activity was not different between groups in any region assayed. These data suggest that NO does not play a role in visual or spatial discrimination learning. However, NO synthase inhibition may play a role in the regulation of cholinergic activity.


Asunto(s)
Aprendizaje Discriminativo/fisiología , Óxido Nítrico Sintasa/antagonistas & inhibidores , Percepción Espacial/fisiología , Percepción Visual/fisiología , Animales , Encéfalo/metabolismo , Hemicolinio 3/metabolismo , Masculino , NG-Nitroarginina Metil Éster/farmacología , Inhibidores de la Captación de Neurotransmisores/metabolismo , Óxido Nítrico Sintasa/metabolismo , Ratas , Ratas Endogámicas F344 , Distribución Tisular
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