Nudging hand hygiene compliance: a large-scale field experiment on hospital visitors.

BACKGROUND: Hospital-care-associated infections (HCAIs) represent the most frequent adverse event during care delivery, affecting hundreds of millions of patients around the world. Implementing and ensuring conformity to standard precautions, particularly best hand hygiene practices, is regarded as one of the most important and cheapest strategies for preventing HCAIs. However, despite consistent efforts at increasing conformity to standard hand hygiene practices at hospitals, research has repeatedly documented low conformity levels amongst staff, patients and visitors alike. AIM: The behavioural sciences have documented the potential of adjusting seemingly irrelevant contextual features in order to 'nudge' people to conform to desirable behaviours such as hand hygiene compliance (HHC). In this field experiment we investigate the effect on HHC amongst visitors upon entry of a hospital by varying such features. METHODS: Over 50 days, we observed the HHC of a total of 46,435 hospital visitors upon their entry to the hospital in a field experimental design covering eight variations over the salience, placement and assertion of the hand sanitizer in the foyer, including the presence of the yearly national HHC campaign and a follow up during the COVID-19 pandemic. FINDINGS: Our experiment found that varying seemingly irrelevant features increased HHC from a baseline of 0.4%-19.7% (47.6% during COVID-19). The experiment also found that the national HHC-campaign had no direct statistically significant effect on HHC. CONCLUSION: Varying seemingly irrelevant contextual features provides an effective, generic, cheap and easy to scale approach to increasing HHC relative to sanitizing one's hands at hospitals.

Electronic structure of Cu(3)N films studied by soft x-ray spectroscopy.

Soft x-ray emission spectroscopy was used to characterize the electronic structure of seven copper nitride films, one synthesized with atomic layer deposition (ALD) and six grown with chemical vapor deposition (CVD) at different preparation temperatures. Interpretation of the x-ray emission spectra was supported by calculations of the electronic structure for bulk pure Cu(3)N and Cu(3)N with: an excess of Cu atoms, oxygen or carbon impurities, and N vacancies. The calculations are shown to describe the experimental spectra quite well. Analysis of the x-ray spectra suggests that films grown in copper rich environments and above a cut-off temperature of approximately 360 °C have a growing fraction of copper enriched areas, while films prepared below this temperature do not have these areas with excess copper.

[Functional insufficiency of the venous valve apparatus and venous return from the lower extremities in humans during the standing test].

The studies were performed with participation of 16 normal subjects with the US Doppler evidence of functional insufficiency of the deep vein valves in a lower extremity. Valve insufficiency was of the latent clinical form without symptoms of chronic venous insufficiency. Functioning of the contralateral leg venous valves was normal in all subjects. Linear velocities of blood flow in the femoral vein in both extremities in the horizontal and vertical position were compared. In the horizontal position, outflow from the deep vein with valve disfunction was 1.5 times (p<0.01) higher comparing with the other leg as the control. In vertical subjects, outflow from the compromised vein was, on the contrary, reduced almost by half as compared with the healthy leg. These features of local phlebohemodynamics at the outlet of insufficient vein appear to determine the intensity of passive mechanic blood redistribution driven by the gravity.

[Phlebohemodynamics in the femoral vein and postcava during a voluntary quick single contraction of shin muscles in supine and standing humans].

Effects of a voluntary single quick shin contraction on quantitative parameters of the venous outflow in the femoral vein and postcava were investigated in 65 normal males and females with the Doppler ultrasonic and duplex blood pool scanning techniques. Measured were linear spontaneous blood flow, mean linear and peak velocites of the transport of blood after the muscle contraction, baseline linear cross sections of the femoral vein and postcava cross section, and their extension in the course of mobilized blood evacuation. Based on these measurements calculated were weight power space velocities of the spontaneous blood flow and volumes of mobilized venous blood The investigations were made in supine and standing subjects. According to our data, hemodynamic productivity of the muscle contraction in vertical subjects was much higher than in horizontal with the peak and mean linear blood evacuation outrunning the mean spontaneous outflow from the femoral vein in 25.7 and 10.3 times, respectively. Besides, the weight power space velocity of the contraction-induced outflow exceeded that of the spontaneous blood flow 12.5 times. Simultaneous contraction of the muscles on both legs increased four times the weight power space velocity in the subdiaphragmatic part of the postcava.

5 f -shell correlation effects in dioxides of light actinides studied by O 1s x-ray absorption and emission spectroscopies and first-principles calculations.

Soft x-ray emission and absorption spectroscopic data are reported for the O 1s region of a single crystal of UO2, a polycrystalline NpO2 sample, and a single crystal of PuO2. The experimental data are interpreted using first-principles correlated-electron calculations within the framework of the density functional theory with added Coulomb U interaction (DFT+U). A detailed analysis regarding the origin of different structures in the x-ray emission and x-ray absorption spectra is given and the effect of varying the intra-atomic Coulomb interaction-U for the 5 f electrons is investigated. Our data indicate that O 1s x-ray absorption and emission spectroscopies can, in combination with DFT+U calculations, successfully be used to study 5 f -shell Coulomb correlation effects in dioxides of light actinides. The values for the Coulomb U parameter in these dioxides are derived to be in the range of 4-5 eV.

Nitric oxide synthase in the pig autonomic nervous system in relation to the influence of NG--nitro-L-arginine on sympathetic and parasympathetic vascular control in vivo.

Nitric oxide synthase, the enzyme responsible for the formation of nitric oxide, was demonstrated by an indirect immunofluorescence technique to be present in both the sympathetic and parasympathetic nervous system of the domestic pig. In the sympathetic nervous system, nitric oxide synthase was mainly present in preganglionic neurons projecting to postganglionic neurons, some of which contained neuropeptide Y in the superior cervical, the coeliac and the lumbar ganglia of the sympathetic chain. A minor population of postganglionic sympathetic neurons contained nitric oxide synthase, vasoactive intestinal polypeptide and peptide histidine isoleucine. In the densely sympathetically innervated vascular beds such as the spleen, kidney and skeletal muscle, many neuropeptide Y- but no nitric oxide synthase-positive fibres were found. The nitric oxide synthase inhibitor NG-nitro-L-arginine reduced cardiac output by 40% and caused profound vasoconstriction in a variety of vascular beds. Furthermore, no or minor changes in plasma catecholamines, neuropeptide Y or endothelin-1 were observed up to 20 min after NG-nitro-L-arginine. Milrinone (a phosphodiesterase III inhibitor) prevented this NG-nitro-L-arginine-induced reduction in cardiac output, and the regional vasoconstriction was reduced, whereas some elevation of the blood pressure was still observed. Sympathetic nerve stimulation, with single impulses of 10 Hz for 1 s in the presence of NG-nitro-L-arginine, evoked vasoconstrictor responses which were largely in the same range as in control conditions. Parasympathetic postganglionic neurons to the submandibular salivary gland contained nitric oxide synthase, vasoactive intestinal polypeptide, peptide histidine isoleucine and neuropeptide Y. The vasodilatation evoked by parasympathetic nerve stimulation (10 Hz for 1 s) in the presence as well as in the absence of atropine was, on the other hand, markedly reduced by NG-nitro-L-arginine administration. Milrinone attenuated the inhibitory effect of NG-nitro-L-arginine on the parasympathetic vasodilation. In conclusion, nitric oxide synthase can be demonstrated in preganglionic sympathetic and postganglionic parasympathetic neurons. The main effect of nitric oxide synthase inhibition seems to be related to attenuation of basal endothelial nitric oxide production and parasympathetic transmission. Inhibition of phosphodiesterase counteracts both the haemodynamic and the neuronal effects of NG-nitro-L-arginine.

Inhibition of sympathetic vasoconstriction in pigs in vivo by the neuropeptide Y-Y1 receptor antagonist BIBP 3226.

1. Recently, a potent non-peptide antagonist of neuropeptide Y (NPY)-Y1 receptors has been developed. In this study, the selectivity of this compound, BIBP 3226, as a functional Y1 receptor antagonist, and the possible role of endogenous NPY in sympathetic vasoconstriction in different vascular beds have been investigated in anaesthetized pigs. 2. BIBP 3226 specifically displaced [125I]-NPY binding with an IC50 value of 7 nM in membranes of pig renal arteries, which also were responsive to a Y1 receptor agonist, but had only minor effects in the pig spleen (IC50 55 microM), where instead [125I]-NPY binding was markedly inhibited by a Y2 receptor agonist. IC50 values in the same nM range for BIBP 3226 were also observed in rat and bovine cortex and dog spleen. 3. In anaesthetized control pigs in vivo BIBP 3226 (1 and 3 mg kg-1) markedly inhibited the vasoconstrictor effects of the Y1 receptor agonist [Leu31, Pro34] NPY(1-36), without influencing the responses to the Y2 receptor agonist N-acetyl [Leu28, Leu31] NPY(24-36), or to noradrenaline, phenylephrine, alpha,beta-methylene adenosine triphosphate or angiotensin II. 4. High frequency stimulation of the sympathetic trunk in control pigs caused a biphasic vasoconstrictor response in nasal mucosa, hind limb and skin: there was an immediate, peak response, followed by a long-lasting vasoconstriction. BIBP 3226 (1 and 3 mg kg-1) reduced the second phase by about 50% but had no effect on the peak response. In the spleen, kidney and mesenteric circulation (which lack the protracted response) BIBP 3226 was likewise without effect on the maximal vasoconstriction, and did not influence noradrenaline overflow from spleen and kidney. 5. The corresponding S-enantiomer BIBP 3435 had only marginal influence on [125I]-NPY binding (microM range) and did not inhibit the vasoconstrictor effects of any of the agonists used, including the Y1 receptor peptide agonist. Furthermore, BIBP 3435 did not affect the response to sympathetic nerve stimulation. Both BIBP 3435 and BIBP 3226 caused a slight transient decrease in mean arterial blood pressure (by about 5 and 15 mmHg at 1 mg kg-1 and 3 mg kg-1, respectively), accompanied by splenic and mesenteric vasodilatation, suggesting that this effect was unrelated to Y1 receptor blockade. 6. The peptide YY (PYY)- and NPY-evoked vasoconstriction in the kidney of reserpine-treated pigs was markedly reduced (by 95%) by BIBP 3226 while the vasoconstrictor effect in the spleen was attenuated by only 20%. BIBP 3226 did not influence stimulation-evoked NPY release. The vasoconstrictor response in reserpine-treated pigs to single impulse stimulation, which is observed only in nasal mucosa and hind limb, was unchanged regarding maximal amplitude and the integrated effect was only moderately reduced (by about 25%) in the presence of BIBP 3226 (1 mg kg-1). BIBP 3226 (1 mg kg-1) markedly reduced (by 55-70%) the long-lasting vascular response (total integrated blood flow reduction) evoked by sympathetic nerve stimulation at high frequency (40 impulses at 20 Hz) in spleen, kidney, nasal mucosa and hind limb. Furthermore, the maximal amplitude of the vasoconstriction was reduced mainly in the kidney (by 60%) and also in the spleen (by 40%). 7. It is concluded that BIBP 3226 can act as a selective Y1 receptor antagonist in the pig. Endogenous NPY via Y1 receptor activation may play a role in evoking the long-lasting vasoconstriction seen in nasal mucosa, hind limb and skin after high frequency stimulation of sympathetic nerves in control pigs. Furthermore, NPY via Y1 receptor mechanisms seems to be of major importance for the long-lasting component of the reserpine resistant sympathetic vasoconstriction in many vascular beds, and for the maximal vasoconstrictor response in the kidney. Circulating NPY and PYY induce splenic vasoconstriction via Y2-receptors in contrast to neuronally released NPY which mainly activates Y1 receptors.

Bosentan-improved cardiopulmonary vascular performance and increased plasma levels of endothelin-1 in porcine endotoxin shock.

1. To evaluate the possible contribution of endothelin-1 (ET-1) to the pathophysiology of porcine septic shock, the non-peptide, mixed ET-receptor antagonist, bosentan (RO 47-0203) was administered (5 mg kg-1, i.v.) 30 min before infusion of lipopolysaccharide (LPS) (E. coli., serotype 0111:B4) (15 micrograms kg-1 h-1) and at 3.5 h of endotoxaemia in six anaesthetized and mechanically ventilated pigs. Six other pigs served as controls and received only LPS infusion. Pulmonary and systemic haemodynamics as well as splenic, renal and intestinal blood flows were measured continuously. Release and synthesis of ET-1 and Big ET-1 were also measured. 2. Only three of the six pigs in the control group survived 3 h of LPS infusion while in the bosentantreated group all six pigs were alive at that time. A biphasic increase in mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR) was seen in control pigs. Pretreatment with bosentan did not influence the first peak but markedly attenuated the second, more prolonged increase in MPAP and PVR. The second dose of bosentan completely restored these parameters to pre-LPS levels. The LPS-induced changes in mean arterial blood pressure, heart rate and systemic vascular resistance were similar in both groups, while cardiac output (CO) was significantly higher in the bosentan-treated group. The second bosentan dose increased CO and splenic and intestinal blood flow without further lowering of blood pressure. 3. Bosentan caused an increase of the basal arterial plasma levels of ET-1-like immunoreactivity (LI), from 16.8 +/- 1.3 pM to 49.6 +/- 10.0 pM (n = 6, P < 0.01). However, the rate of the increase of ET-1 levels during the LPS infusion was not affected by bosentan. Repeated administration of bosentan during LPS infusion caused an additional increase of ET-1-LI levels. Neither the basal levels of Big ET-LI nor the LPS induced 8 fold increase in Big ET-LI were changed by bosentan. The level of preproET-1 mRNA in the lung was increased about 3 fold after 4.5 h of LPS treatment. This elevation was not influenced by bosentan. 4. From these studies using bosentan, a non-peptide, selective and mixed ET-receptor antagonist, we conclude that during LPS-induced shock bosentan can abolish the late phase pulmonary hypertension and improve cardiac output as well as increase blood flow to the splenic and intestinal vascular beds without causing a further decrease in mean arterial blood pressure. Further investigations in the clinical setting are needed to evaluate the use of ET-receptor antagonists, such as bosentan, in treatment of septic shock.

Comparison of the acute influence of neuropeptide Y and sympathetic stimulation on the composition of blood cells in the splenic vein in vivo.

The acute influence of exogenous transmitters and sympathetic nerve stimulation on the composition of blood cells in the splenic vein in relation to the splenic vascular effects was investigated in anaesthetized pigs. Intra arterial bolus injections of 720 pmol neuropeptide Y (NPY), 4.9 nmol noradrenaline (NA) and 20 nmol alpha,beta-methylene adenosine triphosphate (mATP) in the spleen were given and these doses caused arterial vasoconstriction in the same range, and increase in splenic venous haematocrit. NPY administration evoked a decrease in splenic venous blood flow and an unchanged leukocyte outflow from the spleen. mATP and NA, on the other hand, evoked increases in splenic venous blood flow and leukocyte outflow. Sympathetic nerve stimulation caused increases in haematocrit and leukocyte outflow in control pigs as well as in pigs with reserpine-induced depletion of tissue NA, although these effects, as well as the vascular effects, were significantly reduced after reserpine treatment. For comparison, the vasodilator calcitonin gene-related peptide increased leukocyte outflow without change in haematocrit. It is concluded that haematocrit and leukocyte concentration in the splenic venous blood are acutely modulated in different ways by vascular changes evoked by different sympathetic mediators. Furthermore, the capacitance function seems to be regulated by adrenergic and possibly purinergic transmission, whereas the non-adrenergic mediator NPY seems to be involved mainly in splenic arterial vasoconstriction.

Vascular neuropeptide Y Y1-receptors in the rat kidney: vasoconstrictor effects and expression of Y1-receptor mRNA.

Neuropeptide Y (NPY) -receptor subtypes were studied in the rat kidney in vivo by systemic administration of NPY, the two agonists [Leu(31), Pro(34)]NPY (Y1-receptor agonist) and NPY (13-36) (Y2-receptor agonist), or the Y1-receptor antagonist BIBP 3226. Effects on mean arterial blood pressure (MAP) and renal arterial blood flow were recorded. The Y1-receptor agonist evoked a dose-dependent increase in MAP concomitantly with a reduction in renal blood flow. At the largest dose administered (1.42 pmol/g), the Y1-agonist [Leu(31), Pro(34)] NPY increased MAP by 20 +/- 6 mmHg and reduced the renal vascular conductance by more than 50%. The same dose of the Y2-agonist NPY (13-36) did not evoke any clear-cut effects on the renal blood flow or MAP. Furthermore, administration of the Y1-receptor antagonist BIBP 3226 reduced the NPY-induced renal vasoconstriction, but did not affect the response to angiotensin II or phenylephrine. The effects evoked by 0.71 pmol/g NPY were almost abolished by 3 mg/kg BIBP 3226. In situ hybridization histochemistry was used to study the expression of Y1-receptor mRNA in the developing rat kidney. The levels of Y1-receptor mRNA expression in the vascular smooth muscle of the rat kidney varied at different ages, with low levels at postnatal day 10 and high levels at 20 days and again low levels at 40 days. In summary, the present study show a maturation-specific expression pattern of NPY Y1-receptor mRNA as well as functional effects of vascular NPY receptors of the Y1-subtype in the rat kidney.

Endothelial regulation of coronary vascular tone in vitro: contribution of endothelin receptor subtypes and nitric oxide.

The functional effects of endothelin-1, endothelin-3 and the ETB receptor agonist [Ala1,3,11,15]endothelin-1 on pig coronary arteries were characterized in vitro by using the ETA receptor antagonist BQ-123 and the nitric oxide synthesis inhibitor N-nitro-L-arginine. Endothelin-1 (EC50 value 8.8 nM), endothelin-3 (EC50 11.6 nM) and [Ala1,3,11,15]endothelin-1 (EC50 42 nM) evoked concentration-dependent contractions with maximal responses that were 151 +/- 21, 85 +/- 12 and 11 +/- 2%, respectively, of contractions evoked by 127 mM K+. BQ-123 (0.1-10 microM) induced concentration-related rightward shift of the response to endothelin-1. The response to the highest concentration of endothelin-1 was reduced by 62% in the presence of 10 microM BQ-123. Application of BQ-123 to vessels precontracted with endothelin-1 caused relaxation by 53%. BQ-123 also inhibited the contractile effect of endothelin-3, whereas the contractile responses to [Ala1,3,11,15]endothelin-1, serotonin or neuropeptide Y (Y1 receptor-mediated) were unaffected. In the presence of N-nitro-L-arginine (50 microM) the responses to [Ala1,3,11,15]endothelin-1 and low concentrations of endothelin-3 were significantly enhanced. The present results show that endothelin-induced contractions of porcine coronary arteries are efficiently prevented and reversed by BQ-123 indicating that the responses are evoked by ETA receptors. A portion of the contraction seems to be mediated by ETB receptors. The contractile response to ETB stimulation is in part counteracted by release of nitric oxide.

Evidence for two neuropeptide Y receptors mediating vasoconstriction.

The presence of receptor subtypes mediating the vascular and prejunctional effects of neuropeptide Y (NPY) was investigated using the Y2 receptor agonist, NPY-(13-36), and the Y1 agonist, [Leu31,Pro34]NPY. NPY-(1-36) and [Leu31,Pro34]NPY administered i.v. to anesthetized pigs evoked dose-dependent increases in mean arterial blood pressure and splenic and renal vascular resistance, and a decrease in heart rate. The potency of [Leu31,Pro34]NPY was 10-30% that of NPY-(1-36). In the spleen, NPY-(13-36) evoked vasoconstriction similar to that evoked by [Leu31,Pro34]NPY, but did not significantly increase renal vascular resistance or mean arterial blood pressure. Local intra-arterial administration of [Leu31,Pro34]NPY caused an increase in nasal mucosal vascular resistance with a potency similar to that of NPY-(13-36) evoked only a minor (17%) increase in nasal mucosal vascular resistance. The NPY analogues were further characterized in receptor binding studies on pig spleen membranes. Compared to NPY-(1-36), 800 times higher concentrations of [Leu31,Pro34]NPY, and 7 times higher concentrations of NPY-(13-36) were required to achieve the same 50% displacement of [125I]NPY-(1-36). Electrically evoked contractions in rat vas deferens were inhibited by 50% by 0.05 microM NPY-(1-36) and 0.3 microM NPY-(13-36), while [Leu31,Pro34]NPY only slightly attenuated the contractions (by 24% at 1 microM). The present data suggest the existence of subtypes of NPY receptors mediating vasoconstriction. Thus, the splenic vascular bed of the pig contains both Y1 and Y2 receptors while the Y1 subtype predominates in the kidney, nasal mucosa and for blood pressure control. The prejunctional receptor in rat vas deferens seems to be of the Y2 subtype.

No effect of D-myo-inositol-1,2,6-triphosphate on vasoconstriction evoked by neuropeptide Y and non-adrenergic sympathetic nerve stimulation.

The effects of the proposed neuropeptide Y (NPY) antagonist, D-myo-inositol-1,2,6-triphosphate (PP56), on vasoconstrictor responses evoked by NPY and non-adrenergic sympathetic nerve stimulation were investigated in the pig in vivo. Under control conditions, exogenous NPY evoked a dose-dependent increase in arterial blood pressure and vasoconstriction in spleen, kidney and skeletal muscle. After administration of PP56 (50 mg/kg), which transiently reduced systemic blood pressure by 18 +/- 5 mm Hg, the vascular responses evoked by NPY did not differ from those observed under control conditions. Stimulation of the splenic nerve and the lumbar sympathetic chain with 20-Hz burst activity in reserpine-pretreated pigs, which are devoid of their noradrenaline content, decreased splenic and hindlimb vascular conductance by 67 +/- 7 and 57 +/- 7%, respectively, under control conditions. In the presence of PP56 the nerve stimulation-evoked reductions in splenic and hindlimb vascular conductance were slightly but not significantly reduced to 59 +/- 9 and 48 +/- 7%, respectively. It is concluded that PP56 in the presently used high dose, which causes non-selective inhibition of vasoconstriction in the rat, cannot be used as an antagonist of vasoconstrictor responses evoked by NPY or non-adrenergic sympathetic nerve stimulation in the pig.

Nitric oxide regulates peptide release from parasympathetic nerves and vascular reactivity to vasoactive intestinal polypeptide in vivo.

The possible involvement of nitric oxide (NO) in the vasodilator response to parasympathetic nerve stimulation in the pig submandibular gland in vivo was studied using the NO synthase inhibitor, NG-nitro-L-arginine. The atropine-resistant vasodilation elicited by parasympathetic stimulation (10 Hz, 30 s) and the response elicited by i.v. injection of vasoactive intestinal polypeptide (VIP) were markedly reduced by NG-nitro-L-arginine. Furthermore, peptide release from the gland elicited by nerve stimulation was attenuated after NG-nitro-L-arginine administration. Addition of the NO donor, nitroprusside, reversed the NG-nitro-L-arginine evoked attenuation of the response to nerve stimulation and VIP. Also the cholinergic parasympathetic component and the vascular effect of acetylcholine were reduced by NG-nitro-L-arginine. Furthermore, the NG-nitro-L-arginine-induced attenuation of the vascular responses was partially prevented by milrinone, an inhibitor of the cyclic GMP-regulated phosphodiesterase III. The present results suggest that NO may be crucial for parasympathetic vasodilatation by regulating peptide release and second messenger systems for VIP and acetylcholine.

SR 120107A antagonizes neuropeptide Y Y1 receptor mediated sympathetic vasoconstriction in pigs in vivo.

The effects of the neuropeptide Y Y1 receptor antagonist SR 120107A (1-[2-[2-(2-naphtylsulfamoyl)-3-phenylpropionamido]-3-[4-[N- [4- (dimethylaminomethyl)-cis-cyclohexylmethyl]amidino]phenyl]propiony l] pyrrolidine, (S,R) stereoisomer) on sympathetic non-adrenergic vasoconstriction in a variety, of vascular beds were studied in reserpinized anesthetized pigs in vivo. The rapid vasoconstrictor response evoked by single impulse stimulation, in hind limb and nasal mucosa, was not affected by SR 120107A (1.5 mg kg-1 i.v.). In contrast, SR 120107A potently inhibited the long-lasting phase of vasoconstriction evoked by high frequency (60 impulses at 20 Hz) sympathetic nerve stimulation, in the main and deep femoral, the saphenous and the internal maxillary arteries, leaving merely the initial rapid peak of vasoconstriction in these vessels. Furthermore, the vasoconstrictor response was nearly abolished in the kidney and was attenuated in the spleen and main femoral artery, despite maintained neuropeptide Y overflow. The vasoconstrictor response evoked in the kidney by peptide YY, a neuropeptide Y Y1 and Y2 receptor agonist, was also nearly abolished in the presence of SR 120107A. This inhibitory effect on the response to exogenous agonist correlated well with the long-lasting inhibition of the response to nerve stimulation in the same tissue. The peptide YY-evoked vasoconstriction in the spleen was not altered by SR 120107A, in accordance with the view that the neuropeptide Y receptor population in this organ consists mainly of neuropeptide Y Y2 receptors. SR 120107A did not influence the vasoconstrictor effects of alpha, beta-methylene ATP (mATP) or phenylephrine in any of the tissues studied. We conclude that SR 120107A is a potent neuropeptide Y Y1 receptor antagonist with long duration of action in vivo. Endogenous neuropeptide Y acting on the neuropeptide Y Y1 receptor is likely to account for the long-lasting component of the reserpine-resistant sympathetic vasoconstriction upon high frequency stimulation in hind limb and nasal mucosa. Furthermore, the peak vasoconstriction in kidney, and to some extent in spleen, is also neuropeptide Y Y1 receptor mediated.

Effects of Ro 47-0203 and PD155080 on the plasma kinetics, receptor binding and vascular effects of endothelin in the pig.

The effects of the mixed endothelin ET(A)/endothelin ET(B) receptor antagonist Ro 47-0203 (bosentan, 4-tert-butyl-N-[6-(2-hydroxy-ethoxy)-5-( 2-methoxy -phenoxy)-2,2'-bipyrimidin-4-yl] -benzenesulfonamide) and the selective endothelin ET(A) receptor antagonist PD155080 (sodium 2-benzo[1,3]dioxol-5-yl-3-benzyl-4-(4-me thoxy-phenyl)-4-oxobut+ ++-2-enoate) on plasma half-life and regional extraction of exogenous endothelin-1 as well as on the regional vascular effects of endothelin-1 were investigated in the pig in vivo. Bosentan but not PD155080 (5 mg/kg, i.v. bolus, both drugs) increased the arterial plasma levels of endothelin-1-like immunoreactivity. Neither of the drugs affected the plasma half-life of infused endothelin-1. In the spleen, both the extraction and vascular effects of exogenous endothelin-1 were attenuated by both bosentan and PD155080 whereas renal extraction and vascular effects in the kidney were unaffected by both drugs. In the lung, only bosentan decreased pulmonary extraction of endothelin-1. In conclusion, the bosentan-induced increase of circulating endothelin-1 seems to be related to blockade of endothelin-1 binding to endothelin ET(B) receptors. Blockade of these receptors does not influence the overall elimination of endothelin-1, however.

Phosphoramidon inhibits the vasoconstrictor effects evoked by big endothelin-1 but not the elevation of plasma endothelin-1 in vivo.

Intravenous injections of big endothelin (ET)-1 (700 pmol/kg) in the pig increased arterial plasma levels of ET-1-like immunoreactivity (ET-1-LI) from 11.1 +/- 0.7 pM to 46.3 +/- 6.7 pM in the control situation and from 11.5 +/- 0.4 pM to 58.2 +/- 17 pM in the presence of the neutral endopeptidase inhibitor phosphoramidon (3 mg/kg). Big ET-1 increased splenic vascular resistance by 29% in the control situation. The vasoconstriction evoked by big ET-1 in the spleen was reduced after phosphoramidon treatment whereas the elevation of arterial ET-1-LI was not influenced. Furthermore the splenic vasoconstriction evoked by ET-1 was reduced after phosphoramidon without influencing plasma ET-1-LI. Also in rats the pressor effect of big ET-1 (1 nmol/kg) was inhibited by phosphoramidon (5 mg/kg) whereas the elevation of plasma ET-1 was not influenced. It is concluded that the vasoconstrictor effects of both big ET-1 and ET-1 are inhibited, but the increase in plasma ET-1 is unaffected by phosphoramidon.

[Ultrasonographic evaluation of the venous tone in humans in the clinical pharmacology of venotropic drugs]. / Ul'trazvukovoi sposob otsenki tonusa ven cheloveka primenitel'no k zadacham klinicheskoi farmakologii venotropnykh lekarstvennykh sredstv

A new ultrasonographic method of evaluation of the venous tone in humans is described and experimentally justified. The method is based on the principles of venous occlusion plethysmograhy and ultrasonographic two-dimensional imaging of the cross section of cubital veins. It is found that an increment of the cross-sectional area of the vein is correlated with a change in the volume of distal segment of the upper extremity according to the data of aqueous plethysmography. The tests with nitroglycerin and dihydroergotamine (vasoactive drugs producing opposite effects upon the venous tone) confirmed the possibility of using this technique in the clinical pharmacology of venotropic drugs.

[The problems of the experimental and clinical pharmacology of venotropic drugs]. / Voprosy éksperimental'noi i klinicheskoi farmakologii venotropnykh lekarstvennykh sredstv.

The article deals with problems of phenomenology of the selective vasomotor response of veins to the effect of drugs, analyses the peripheral and central hemodynamic effects of venotropic drugs, discusses and systematizes the principles of correct quantitative evaluation of venomotor reactions. Some representatives of the group of venotropic drugs are characterized and the main problems of their clinical use are discussed. The problems of promising trends of research are formulated.

[Specifics of the stroke volume distribution in man before and after 3 day immersion]. / Osobennosti raspredeleniia udarnogo ob"ema serdtsa u cheloveka do i posle trekhsutochnoi immersii.

Central blood circulation and local blood flow in the brain and lower extremities were studied in six healthy male subjects with the tetrapolar rheography before and after 3-day water immersion. Standing test was applied for functional evaluation. After immersion, distribution of the stroke volume along the arterial bed was modified as evidenced by relative growth of pulse filling in the lower extremities and relative reduction of pulse filling in the cranial vessels equally in horizontal and orthostatic position. Minute blood flow was unchanged in the brain and significantly increased in the lower extremities following immersion. Immersion did not alter the amplitude of the orthostatic reaction of pulse blood flow in the lower extremities but it was considerably behind the orthostatic reduction in the stroke volume in the brain. Possible mechanisms of this hemodynamic phenomenon are discussed.