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Abstract
An ion chromatography system for the determination of glyphosate was described. Ion chromatograph was carried out by suppressed conductivity detection (DX-100). The eluent contained 9 mmol l-1 Na2CO3 and 4 mmol l-1 NaOH. The detection limit was 0.042 microgram ml-1 (S/N = 3). The relative standard deviation was 1.99% and the correlation coefficient of the calibration curve for area was 0.9995. The linear range was 0.042-100 micrograms ml-1. Common inorganic ion and organic acids did not interfere. The recovery was 96.4-103.2%. The method was simple, rapid, reliable and inexpensive.
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Tong C, Fenton M, Hall M. Using Agenerase. Nutritional considerations affect bioavailability of new P.I. POSITIVE LIVING (LOS ANGELES, CALIF.) 1999; 8:6, 62. [PMID: 12492049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Cheng L, Tong C, Xiao Z. [Low doses of mifepristone for emergency contraception]. ZHONGHUA FU CHAN KE ZA ZHI 1999; 34:335-8. [PMID: 11360608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
OBJECTIVE To investigate the efficacy of three different low doses of mifepristone for emergency contraception, the side effects and the influence to the next menstruation. METHODS A randomized multicentre trial was conducted in Shanghai. 639 women with regular cycles and history of unprotected intercourse within 120 h of attendance were recruited, and they were randomly assigned to three groups. Group I (n = 214) mifepristone 50 mg was given, group II (n = 214) 25 mg and group III (n = 211) 10 mg. RESULTS There were eight pregnancies totally, 2 cases in group I, 1 in group II and 5 in group III. After correction for method failure there was only 1 pregnancy in each group and the contraceptive effectiveness rate were 93.4%, 93.3% and 93.8% respectively. The side effects of mifepristone were slight and tolerable and there was significant difference between the 50 mg group and the lower doses (25 mg and 10 mg) groups (P < 0.05) in women with no complaints. There were about 12%-14% women had a early onset of menses and about 25%-28% had a late one, but no significant differences were found among the 3 groups. The average days of delayed onset of next menstruation were significant longer in group I than that in group III (P < 0.05). CONCLUSION All the 3 doses of mifepristone could be used as an effective emergency contraception.
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Tong C, Su Z, Zhuang L. [Study on the safety after cesarean section]. ZHONGHUA FU CHAN KE ZA ZHI 1999; 34:225-7. [PMID: 11326921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
OBJECTIVE In order to assess the safety after cesarean section, the complications and morbidity rate within 2 years after delivery between cesarean section and spontaneous delivery were compared. METHODS A retrospective cohort study was used in this study. RESULTS The prevalence of anemia, mobility restriction of uterus, chronic pelvic pain and wound ache during the 2 years postpartum in cesarean section group were 11.1%, 9.6%, 4.3% and 5.1% respectively, which were significantly higher than those in women with spontaneous delivery. CONCLUSION In order to protect women's health, the indications for cesarean section must be mastered strictly.
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Grimes CA, Stoyanov PG, Liu Y, Tong C, Ong KG, Loiselle K, Shaw M, Doherty SA, Seitz WR. A magnetostatic-coupling based remote query sensor for environmental monitoring. JOURNAL OF PHYSICS D: APPLIED PHYSICS 1999; 32:1329-1335. [PMID: 11963955 DOI: 10.1088/0022-3727/32/12/308] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A new type of in situ, remotely monitored magnetism-based sensor is presented that is comprised of an array of magnetically soft, magnetostatically-coupled ferromagnetic thin-film elements or particles combined with a chemically responsive material that swells or shrinks in response to the analyte of interest. As the chemically responsive material changes size the distance between the ferromagnetic elements changes, altering the inter-element magnetostatic coupling. This in turn changes the coercive force of the sensor, the amplitude of the voltage spikes detected in nearby pick-up coils upon magnetization reversal and the number of higher-order harmonics generated by the flux reversal. Since the sensor is monitored through changes in magnetic flux, no physical connections such as wires or cables are needed to obtain sensor information, nor is line of sight alignment required as with laser telemetry; the sensors can be detected from within sealed, opaque or thin metallic enclosures.
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Shafer SL, Eisenach JC, Hood DD, Tong C. Cerebrospinal fluid pharmacokinetics and pharmacodynamics of intrathecal neostigmine methylsulfate in humans. Anesthesiology 1998; 89:1074-88. [PMID: 9821995 DOI: 10.1097/00000542-199811000-00007] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study defines the cerebrospinal fluid (CSF) pharmacokinetics of neostigmine after intrathecal injection in humans and its effect on CSF acetylcholine, and it correlates physiologic effects with neostigmine dose and CSF acetylcholine concentrations. METHODS The CSF was sampled via an indwelling spinal catheter in 12 volunteers receiving intrathecal neostigmine (50-750 microg) and analyzed for neostigmine and acetylcholine. Pharmacokinetic and pharmacodynamic analyses were performed with NONMEM. Effect-site models linked the time course of the neostigmine concentration with the time course of analgesia. RESULTS Acetylcholine concentrations increased from <20 pmol/ml at baseline to >100 pmol/ml within 15 min of neostigmine injection. The pharmacokinetics of intrathecal neostigmine were best described by a triexponential function with an absorption phase. Individual predicted concentrations varied 100-fold. Post hoc Bayesian estimates described the observed neostigmine concentrations with a median error of 22% and did not show systematic model misspecification. Individual estimates of effect site concentration producing a 50% maximal effect for foot visual analog scale analgesia correlated with the magnitude of individual CSF neostigmine concentrations. CONCLUSIONS Intrathecal neostigmine concentrations can be well described by a triexponential disposition function, but the intersubject variability is large. The correlation between intersubject variability in concentration and intersubject variability in 50% maximal effect for foot analgesia suggests that both are offset by a common scalar, possibly the distance from the site of injection to the sampling and effect sites. These data provide the basis for the hypothesis of "observation at a distance" to describe the pharmacodynamics of intrathecally administered drugs.
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Xu Z, Tong C, Pan HL, Cerda SE, Eisenach JC. Intravenous morphine increases release of nitric oxide from spinal cord by an alpha-adrenergic and cholinergic mechanism. J Neurophysiol 1997; 78:2072-8. [PMID: 9325374 DOI: 10.1152/jn.1997.78.4.2072] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Systemic opioids produce analgesia in part by activating bulbospinal noradrenergic pathways. Spinally released norepinephrine (NE) has been suggested to produce analgesia in part by stimulating alpha2-adrenoceptors on cholinergic spinal interneurons to release acetylcholine (ACh). We hypothesized that this spinally released ACh would stimulate synthesis of nitric oxide (NO), and that spinally released NO after intravenous (IV) opioid injection thus would depend on a cascade of noradrenergic and cholinergic receptor stimulation. To test these hypotheses, IV morphine was administered to anesthetized sheep, and neurotransmitters in dorsal horn interstitial fluid were measured by microdialysis. IV morphine increased NE and ACh in dorsal horn microdialysates, and these increases were inhibited by IV naloxone or cervical spinal cord transection. IV morphine also increased dorsal horn microdialysate concentrations of nitrite, a stable metabolite of NO. Increases in NE, ACh, and nitrite were antagonized by prior intrathecal injection of the alpha2-adrenergic antagonist idazoxan, the muscarinic antagonist atropine, or the NO synthase inhibitor N-methyl--arginine (NMLA). To examine the concentration-dependent effects of spinal adrenergic stimulation, isolated rat spinal cord tissue was perfused with the alpha2-adrenergic agonist clonidine. Clonidine increased nitrite in the spinal cord tissue perfusate, an effect blocked by coadministration of idazoxan, atropine, and NMLA. These data support a previously hypothesized cascade of spinally released NE and ACh after systemic opioid administration. These data also suggest that spinally released NO plays a role in the analgesic effects of systemic opioids. In addition, these data imply a positive feedback whereby spinally released nitric oxide increases NE release and that has not previously been described.
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Talke P, Tong C, Lee HW, Caldwell J, Eisenach JC, Richardson CA. Effect of dexmedetomidine on lumbar cerebrospinal fluid pressure in humans. Anesth Analg 1997; 85:358-64. [PMID: 9249114 DOI: 10.1097/00000539-199708000-00021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
UNLABELLED Dexmedetomidine's potential for analgesia without respiratory depression and its opioid- and anesthetic-sparing properties make it an attractive choice as an anesthetic adjunct for patients undergoing neurosurgery. However, the effects of dexmedetomidine on intracranial pressure are not known. We therefore studied the effect of dexmedetomidine on lumbar cerebrospinal fluid (CSF) pressure in patients after transphenoidal pituitary tumor surgery. Sixteen transphenoidal pituitary tumor surgery patients were randomized to receive placebo (n = 9) or dexmedetomidine (n = 7) for 60 min in the postanesthesia care unit. The study drug was administered by a continuous computer-controlled infusion to achieve an estimated plasma dexmedetomidine concentration of 600 pg/mL, the highest plasma concentration that has been used for clinical purposes. Patient-controlled analgesia was used to administer morphine for postoperative discomfort. Lumbar CSF pressure (via lumbar intrathecal catheter), intraarterial blood pressure, and heart rate were monitored continuously. There was no change in lumbar CSF pressure in either group. The highest values obtained were 19 mm Hg in the dexmedetomidine group and 20 mm Hg in the placebo group. During infusion, mean arterial pressure decreased from 103 +/- 10 mm Hg to 86 +/- 6 mm Hg (P < 0.05), heart rate decreased from 77 +/- 12 bpm to 64 +/- 7 bpm (P < 0.05), and cerebral perfusion pressure decreased from 95 +/- 8 mm Hg to 78 +/- 6 mm Hg (P < 0.05) in the dexmedetomidine group, but not in the placebo group. We conclude that dexmedetomidine does not have an effect on lumbar CSF pressure in patients with normal intracranial pressure who have undergone transphenoidal pituitary hypophysectomy. IMPLICATIONS The effects of dexmedetomidine (an alpha2-agonist) or placebo on lumbar cerebrospinal fluid pressure, measured via an intrathecal catheter, were studied postoperatively in 16 patients. Dexmedetomidine had no effect on lumbar cerebrospinal fluid pressure. We will continue to investigate the potential utility of dexmedetomidine for neurosurgical anesthesia.
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Yang J, Tong C, Jie N, Wu X, Zhang G, Ye H. Study on the fluorescence system of chlortetracycline-Eu-TOPO-sodium dodecyl sulfonate and the determination of chlortetracycline. J Pharm Biomed Anal 1997; 15:1833-8. [PMID: 9278887 DOI: 10.1016/s0731-7085(96)02035-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The fluorescence system of Eu-chlortetracycline-TOPO-sodium dedecyl sulfonate was studied. It was found that chloretetracycline formed a complex with Eu(III) at pH 8.0-9.0 and then emitted the characteristic fluorescence of Eu(III). TOPO and sodium dodecyl sulfonate greatly enhanced the fluorescence intensity of the system. The experiments indicated that under the optimum determining conditions a linear relationship was obtained between the fluorescence intensity and chlortetracycline concentration in the range of 2.0 x 10(-8)-1.0 x 10(-5) M. The detection limit was 6.0 x 10(-9) M. In addition, the luminescence mechanism of the complex system has been discussed.
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Klimscha W, Tong C, Eisenach JC. Intrathecal alpha 2-adrenergic agonists stimulate acetylcholine and norepinephrine release from the spinal cord dorsal horn in sheep. An in vivo microdialysis study. Anesthesiology 1997; 87:110-6. [PMID: 9232141 DOI: 10.1097/00000542-199707000-00015] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Intrathecal injection of clonidine and dexmedetomidine produce behavioral analgesia by an alpha 2-adrenergic mechanism. Functional and anatomic studies suggest that this analgesia is mediated by cholinergic activation. This hypothesis was directly tested by measuring extracellular acetylcholine concentrations in spinal cord interstitial fluid by means of microdialysis after intrathecal injection of these alpha 2-adrenergic agonists in sheep. METHODS Twelve sheep with chronically implanted thoracic intrathecal catheters were anesthetized with halothane. Multiple 200-micron-diameter dialysis fibers were inserted surgically at a mid-thoracic level through the dorsal horn and perfused with artificial cerebrospinal fluid. After baseline sampling, either clonidine (100 micrograms), dexmedetomidine (100 micrograms), or saline were injected intrathecally. Microdialysis samples were analyzed by high-pressure liquid chromatography for acetylcholine and norepinephrine. RESULTS Both alpha 2-adrenergic agonists increased acetylcholine in microdialysate, whereas intrathecal saline had no effect. Analysis of the raw data showed that all groups differed significantly, with greater levels of acetylcholine following administration of dexmedetomidine than clonidine or saline. Unexpectedly, intrathecal clonidine also increased microdialysate norepinephrine levels. CONCLUSIONS These data are consistent with previous experiments measuring acetylcholine concentrations in cerebrospinal fluid and support analgesia from alpha 2-adrenergic agonists mediated in part by cholinergic activation. In addition, the increase in norepinephrine concentrations after intrathecal administration of clonidine suggest stimulation of norepinephrine release by this agent.
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Berg WP, Alessio HM, Mills EM, Tong C. Circumstances and consequences of falls in independent community-dwelling older adults. Age Ageing 1997; 26:261-8. [PMID: 9271288 DOI: 10.1093/ageing/26.4.261] [Citation(s) in RCA: 703] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND knowledge of the circumstances and consequences of falls in older adults is important for understanding the aetiology of falls as well as for effective clinical assessment and design of fall prevention strategies. Such data, however, are relatively scarce, especially in community-dwelling elders. METHOD accidental falls (including their circumstances and consequences) occurring in 96 male and female participants between 60 and 88 years of age were monitored prospectively for 1 year. After the monitoring period, participants were divided into three groups based on fall status: non-fallers (n = 46), one-time fallers (n = 27) and recurrent fallers (n = 23). Frequency distributions were created for selected circumstances and consequences of falls and the prevalence of these consequences were examined. RESULTS 50 participants (52%) fell during the 1 year period, amassing 91 falls. Trips and slips were the most prevalent causes of falls, accounting for 59% of falls. Falls most often occurred during the afternoon and while subjects walked on level or uneven surfaces. Fallers most commonly attributed falls to hurrying too much. Fractures resulted from five of the 91 falls and eight other falls resulted in soft tissue injuries that required treatment by a physician. There were no differences between one-time and recurrent fallers in the circumstances and consequences of falls. However, several notable differences were found between men (n = 20) and women (n = 30) who fell. Falls by men most often resulted from slips whereas falls by women most often resulted from trips. Moreover, women and men differed in the time of the year in which falls occurred, with men falling most often during winter and women during summer. CONCLUSIONS the results of this study provide insight into the circumstances and consequences of falls among independent community-dwelling older adults and suggest some possible ways of preventing falls. Preventive services, however, should not solely target recurrent fallers, nor should the type of services necessarily differ for one-time and recurrent fallers.
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Eisenach JC, Hood DD, Curry R, Tong C. Alfentanil, but not amitriptyline, reduces pain, hyperalgesia, and allodynia from intradermal injection of capsaicin in humans. Anesthesiology 1997; 86:1279-87. [PMID: 9197296 DOI: 10.1097/00000542-199706000-00008] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Intradermal injection of capsaicin produces brief pain followed by hyperalgesia and allodynia in humans, and the latter effects are mediated by spinal N-methyl-D-aspartate mechanisms. Amitriptyline recently was shown to antagonize N-methyl-D-aspartate receptors, and in this study, the authors sought to determine the effect of amitriptyline alone and with the opioid alfentanil on hyperalgesia and allodynia produced by intradermal injection of capsaicin. METHODS Forty-six healthy volunteers in the general clinical research center received repeated intradermal injections of capsaicin (100 microg) alone or before and after systemic injection of 4 mg midazolam, 25 mg amitriptyline, alfentanil by computer-controlled infusion, or amitriptyline plus alfentanil. Acute pain and areas of mechanical hyperalgesia and allodynia were determined at specified intervals. Blood was obtained for alfentanil and amitriptyline assay. RESULTS Capsaicin injection produced acute pain followed by hyperalgesia and allodynia. Alfentanil reduced these pain responses in a plasma-concentration-dependent manner, and reduction in hyperalgesia and allodynia correlated with reduction in acute pain. Amitriptyline alone had no effect and did not potentiate alfentanil. Alfentanil produced concentration-dependent nausea, an effect diminished by amitriptyline. DISCUSSION These data correspond with previous studies in volunteers demonstrating reduction in hyperalgesia and allodynia after intradermal injection of capsaicin by systemically administered opioids, and they suggest that this reduction may be secondary to reduced nociceptive input by acute analgesia. These data do not support the use of acute systemic administration of amitriptyline for acute pain, hyperalgesia, and allodynia, although the roles of chronic treatment and spinal administration are being investigated.
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Cerda SE, Tong C, Deal DD, Eisenach JC. A physiologic assessment of intrathecal amitriptyline in sheep. Anesthesiology 1997; 86:1094-103. [PMID: 9158359 DOI: 10.1097/00000542-199705000-00013] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Intrathecal injection of amitriptyline enhances antinociception from intravenous morphine and reduces neuropathic pain behavior in animals. This study represents part of a preclinical assessment of intrathecal amitriptyline to determine its safety for use in humans. METHODS Low thoracic intrathecal, femoral, and pulmonary arterial catheters were inserted in 18 adult ewes, followed 96 h later by intrathecal injection of saline or 5 mg amitriptyline and by determination of spinal cord blood flow, hemodynamic variables, behavioral changes, cerebrospinal fluid concentrations of catecholamines and amitriptyline, and spinal tissue concentrations of amitriptyline. In six other ewes, low thoracic intrathecal and femoral arterial catheters were inserted and blood pressure and heart rate were measured after intrathecal injection of saline or 0.25, 1, or 5 mg amitriptyline. Four other ewes received cervical intrathecal injection of 5 and 10 mg amitriptyline, and antinociception was determined. RESULTS Thoracic intrathecal injection of amitriptyline produced dose-dependent sedation but did not significantly affect spinal cord blood flow or hemodynamic variables. Spinal cord tissue concentrations of amitriptyline were 100 times greater in tissue near the tip of the thoracic intrathecal catheter compared with cervical cord tissue. Cerebrospinal fluid concentrations of catecholamines did not significantly change after amitriptyline was administered. Cervical intrathecal injection of 5 mg amitriptyline produced mild antinociception, whereas 10 mg produced intense sedation and, in one sheep, seizures and death. CONCLUSIONS Although other preclinical toxicity studies are necessary before introducing intrathecal amitriptyline for use in humans, this study did not reveal dangerous changes in blood pressure or spinal cord blood flow from this agent.
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De Kock M, Eisenach J, Tong C, Schmitz AL, Scholtes JL. Analgesic doses of intrathecal but not intravenous clonidine increase acetylcholine in cerebrospinal fluid in humans. Anesth Analg 1997; 84:800-3. [PMID: 9085961 DOI: 10.1097/00000539-199704000-00019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Epidural clonidine increases acetylcholine (ACh) concentrations in cerebrospinal fluid (CSF) in humans, and experiments in animals support a cholinergic link in spinal alpha2-adrenoceptor-mediated antinociception. The purpose of the present study was to evaluate whether intravenous (I.V.) clonidine is also able to increase CSF ACh in humans. Accordingly, we studied 20 patients scheduled for resection of an acoustic neuroma under general anesthesia. Anesthesia was induced with propofol and maintained with propofol and N2O. After induction, an intrathecal catheter was inserted at the L3-4 interspace. Patients were then assigned, in a random, blind manner to receive either a bolus of 1 microg/kg intrathecal (I.T.) clonidine and an I.V. infusion of saline (n = 10) or an I.V. infusion of 4 microg/kg clonidine given in 20 min and an I.T. injection of saline (n = 10). CSF samples for ACh and clonidine concentration determination were drawn immediately before I.T. injection (time -20), at the end of the I.V. injection (time 0), then every 10 min thereafter. CSF ACh concentrations were determined by high-pressure liquid chromatography and CSF clonidine by radioimmunoassay. There was no significant difference between the groups with respect to age, gender, weight, and ASA physical status. I.T. but not I.V. administration of clonidine increased the CSF ACh concentration. We conclude that I.V. administration of four times the dose of clonidine delivered spinally failed to induce a significant increase of ACh in the CSF. These observations indicate that the analgesic effects observed after I.V. clonidine administration are not mediated by a cholinergic mechanism at the spinal level.
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De Kock M, Eisenach J, Tong C, Schmitz AL, Scholtes JL. Analgesic Doses of Intrathecal but Not Intravenous Clonidine Increase Acetylcholine in Cerebrospinal Fluid in Humans. Anesth Analg 1997. [DOI: 10.1213/00000539-199704000-00019] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Rose G, Xu Z, Tong C, Eisenach JC. Spinal neostigmine diminishes, but does not abolish, hypotension from spinal bupivacaine in sheep. Anesth Analg 1996; 83:1041-5. [PMID: 8895282 DOI: 10.1097/00000539-199611000-00024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Spinal neostigmine causes analgesia in animals and humans and abolishes hypotension from spinal bupivacaine in rats. Since drug distribution and action can vary with the size of the spinal cord, we tested the effects of the maximum tolerated dose of spinal neostigmine alone and with bupivacaine in conscious sheep. Neostigmine alone increased arterial blood pressure by 10%, with a statistically significant increase beginning 30 min after injection. Compared with spinal bupivacaine alone, addition of neostigmine resulted in hypotension of slower onset (15 vs 5 min), shorter duration (45 vs 105 min), and smaller magnitude (-18% +/- 3% vs -37% +/- 6%). Addition of neostigmine did not affect height of sensory block from spinal bupivacaine. These data agree with preliminary clinical reports that spinal neostigmine diminishes, but does not abolish, hypotension from spinal bupivacaine in humans.
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Hood DD, Mallak KA, Eisenach JC, Tong C. Interaction between intrathecal neostigmine and epidural clonidine in human volunteers. Anesthesiology 1996; 85:315-25. [PMID: 8712447 DOI: 10.1097/00000542-199608000-00013] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND alpha 2-Adrenergic agonists are thought to produce analgesia, in part, by activating spinal acetylcholine release. The purpose of the current study was to examine the interaction between intrathecal neostigmine and epidural clonidine for analgesia and side effects in humans. METHODS A total of 58 volunteers received an intrathecal injection of 5% dextrose in normal saline (D5NS) or neostigmine (50, 100, or 200 micrograms in D5NS), followed in 1 h by epidural saline or clonidine (computer-controlled infusion targeted to 50, 100, 200, or 400 ng/ml in cerebrospinal fluid) using an isobolographic design. Visual analog scale pain to a noxious cold stimulus, nausea, weakness, sedation, and other safety variables was measured before and at specified intervals after drug administration. RESULTS The first 21 volunteers randomized to receive intrathecal hyperbaric neostigmine rather than D5NS received the drug while in the sitting position, and had none-to-minimal analgesia 1 h later. The remaining volunteers received the drug while in the lateral position, and demonstrated dose-dependent analgesia in the foot 1 h later. Epidural clonidine also caused dose-dependent analgesia. The combination of neostigmine and clonidine resulted in an additive enhancement for analgesia, but no enhancement of each drug's side effects, and a reduction in clonidine-induced hypotension. Neostigmine injected into subjects in the lateral position diminished clonidine-induced reductions in blood pressure and plasma norepinephrine. CONCLUSION These results support enhancement of alpha 2-adrenergic analgesia by intrathecal neostigmine, but do not demonstrate synergy, as observed in animals. Lack of enhancement of side effects suggests this combination may be clinically useful.
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Miao N, Tao H, Tong C, Xuan H, Zhamg G. [The Selaginella tamariscina (Beauv.) Spring complex in the treatment of experimental diabetes and its effect on blood rheology]. ZHONGGUO ZHONG YAO ZA ZHI = ZHONGGUO ZHONGYAO ZAZHI = CHINA JOURNAL OF CHINESE MATERIA MEDICA 1996; 21:493-5, 512. [PMID: 9642416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Experiments have revealed that in treating rats for diabetes induced by alloxan, the Selaginella tamariscina complex injection given intraperitoneally (25g/kg) for 12 days helps lower the levels of blood sugar and serum lipid peroxide, as well as increase the concentration of serum insulin. Histologic observation has shown that this injection could repair the structure of pancreatic inlet B cells injured by alloxan.
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Abstract
BACKGROUND Acetylcholine causes synthesis of nitric oxide in vascular endothelium, and presumptive evidence in vivo suggests spinally released acetylcholine causes antinociception and increased sympathetic nervous system activity via a nitric oxide mechanism. The purpose of this study was to determine, using a recently described bioassay system, whether acetylcholine stimulates nitric oxide release from spinal cord tissue in vitro. METHODS Rat thoracolumbar spinal cord slices were incubated in a tissue chamber and perfused with Krebs-Henseleit solution. The perfusate was then passed through endotheliumdenuded rat aortic rings and their tension was measured. Vascular rings were preconstricted with phenylephrine, then were exposed to spinal cord perfusate with increasing concentrations (10(-12)-10(-4)M) of acetylcholine alone or with various antagonists. RESULTS Acetylcholine perfusion of spinal tissue caused concentration-dependent relaxations of the aortic rings, an effect blocked by each of the muscarinic antagonists, atropine, pirenzepine, and AFDX-116. Acetylcholine-induced relaxation also was antagonized by an inhibitor of nitric oxide synthase (N-methyl-L-arginine), a nitric oxide scavenger (hemoglobin) and an inhibitor of guanylate cyclase (methylene blue). CONCLUSIONS These results demonstrate release of a vasorelaxant from spinal cord tissue by acetylcholine, which results from an action on muscarinic receptors and exhibits a pharmacology consistent with nitric oxide. Although precise anatomic localization of acetylcholine's action is not possible with this system, these results add to evidence that acetylcholine causes nitric oxide synthesis in the spinal cord.
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Xu Z, Li P, Tong C, Figueroa J, Tobin JR, Eisenach JC. Location and characteristics of nitric oxide synthase in sheep spinal cord and its interaction with alpha(2)-adrenergic and cholinergic antinociception. Anesthesiology 1996; 84:890-9. [PMID: 8638844 DOI: 10.1097/00000542-199604000-00017] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
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.
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Eisenach JC, Detweiler DJ, Tong C, D'Angelo R, Hood DD. Cerebrospinal fluid norepinephrine and acetylcholine concentrations during acute pain. Anesth Analg 1996; 82:621-6. [PMID: 8623972 DOI: 10.1097/00000539-199603000-00034] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Painful stimulation increases spinal cord norepinephrine (NE) in animals, and spinally released NE induces acetylcholine (ACh) release to cause analgesia. The purpose of this study was to determine the relationship between NE and ACh in cerebrospinal fluid (CSF) in sheep and humans during painful stimulation. CSF was sampled in anesthetized sheep before and during electrical nerve stimulation at an intensity sufficient to increase mean arterial pressure 15%-20%. To determine whether spinally released NE caused ACh release by stimulation of alpha(2)-adrenoceptors, seven sheep received intrathecal (IT) idazoxan whereas seven sheep received IT saline before stimulation. To examine the effect of pain on CSF NE and ACh in humans, CSF was sampled in 33 women after at least 4 h of painful labor and in 22 pregnant women without pain. Painful stimulation in sheep increased CSF NE and ACh. IT idazoxan blocked the increase in both NE and ACh. Although mean concentrations of CSF NE and ACh did not differ between parturients with and without pain, there was a significant correlation between NE and ACh concentrations only in those with pain. These data provide evidence in animals for activation of spinal cord noradrenergic-cholinergic systems in response to pain. There is only weak evidence for such activation, however, in women with painful labor.
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97
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Ziegler SI, Haberkorn U, Byrne H, Tong C, Kaja S, Richolt JA, Byrne H, Tong C, Schosser R, Krieter H, Kaja S, Richolt JA, Lammertsma AA, Price P. Measurement of liver blood flow using oxygen-15 labelled water and dynamic positron emission tomography: limitations of model description. EUROPEAN JOURNAL OF NUCLEAR MEDICINE 1996; 23:169-77. [PMID: 8925852 DOI: 10.1007/bf01731841] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
To date no satisfactory method has been available for the quantitative in vivo measurement of the complex hepatic blood flow. In this study two modelling approaches are proposed for the analysis of liver blood flow using positron emission tomography (PET). Five experiments were performed on three foxhounds. The anaesthetised dogs were each given an intravenous bolus injection of oxygen-15 labelled water, and their livers were then scanned using PET. Radioactivity in the blood from the aorta and portal vein was measured directly and simultaneously using closed external circuits. Time-activity curves were constructed from sequential PET data. Data analysis was performed by assuming that water behaves as a freely diffusible tracer and adapting the standard one-compartment blood flow model to describe the dual blood supply of the liver. Two particular modelling approaches were investigated: the dual-input model used both directly measured input functions (i.e. using the hepatic artery and the portal vein input, determined from the radioactivity detected in the aorta and portal vein respectively) whereas the single-input model used only the measured arterial curve and predicted the corresponding portal input function. Hepatic arterial flow, portal flow and blood volume were fitted from the PET data in several regions of the liver. The resulting estimates were then compared with reference blood flow measurements, obtained using a standard microsphere technique. The microspheres were injected in a separate experiment on the same dogs immediately prior to PET scanning. Whilst neither the single- nor the dual-input models accurately reproduced the arterial reference flow values, the flow values from the single-input model were closer to the microsphere flow values. The proposed single-input model would be a good approximation for liver blood flow measurements in man. The observed discrepancies between the PET and microsphere flow values may be due to the inherent temporal and spatial heterogeneity of liver blood flow. The results presented suggest that adaptation of the standard one-compartment blood flow model to describe the dual blood supply of the liver is limited and other flow tracers have to be considered for quantitative PET measurements in the liver.
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Li P, Tong C, Eisenach JC. Pregnancy and ephedrine increase the release of nitric oxide in ovine uterine arteries. Anesth Analg 1996; 82:288-93. [PMID: 8561328 DOI: 10.1097/00000539-199602000-00012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Ephedrine is the preferred vasoconstrictor for the treatment of hypotension after epidural and spinal anesthesia in obstetrics because it preserves uterine perfusion better than pure alpha-adrenergic agonists. Previous studies of uterine vascular rings in vitro suggested that direct uterine vasoconstriction from ephedrine is reduced during pregnancy. This study examined the hypothesis that nitric oxide synthase (NOS) is up-regulated in uterine arteries during pregnancy, and that ephedrine stimulates NOS to release nitric oxide (NO) and diminish direct vasoconstriction. Uterine arterial vessels were obtained from 12 pregnant and 9 nonpregnant ewes, and vessel tension was monitored in vitro in response to escalating concentrations of ephedrine or metaraminol. In some experiments, vascular endothelium was mechanically removed, while in others antagonists of NO synthesis (N omega-nitro-L-arginine methyl ester [L-NAME], NO diffusion (hemoglobin [Hgb]), or guanylate cyclase (methylene blue [MB]) were included. In other experiments, solutions containing ephedrine were superfused over uterine arteries from pregnant ewes onto uterine arteries from nonpregnant ewes. Finally, NOS activity, determined by 14C-citrulline generation, was determined in uterine arteries from pregnant and nonpregnant ewes. Both ephedrine and metaraminol caused concentration-dependent constriction of uterine arterial rings from pregnant and nonpregnant animals. Pregnancy reduced maximum constriction from ephedrine more than metaraminol. Similarly, ephedrine-induced constriction was increased more than that of metaraminol in uterine arteries from pregnant animals treated to diminish the effects of nitric oxide (L-NAME, Hgb, MB, endothelium removal). Ephedrine's constriction of uterine arteries from nonpregnant animals was reduced when it was superfused over uterine arteries from pregnant animals. NOS activity was increased in uterine arteries from pregnant compared to nonpregnant animals. These studies confirm decreased direct uterine arterial vasoconstriction during pregnancy from ephedrine and support the hypothesis of increased release of an endogenous vasodilator (NO), either from the vascular endothelium or the vessel wall, as the cause for this decreased vasoconstriction.
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Watt TA, Tong C, Arnold AP, Collins JG. The selective B-A conformational transition of the central dinucleotide (CpG) segment of d(CAATCCGGATTG)2 induced by delta-Co(en)3(3+). BIOCHEMISTRY AND MOLECULAR BIOLOGY INTERNATIONAL 1996; 38:383-91. [PMID: 8850534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The binding of Co(NH3)6(3+), delta-Co(en)3(3+) and delta-Rh(en)3(3+) to the dodecanucleotide d(CAATCCGGATTG)2 has been studied by 1H NMR. Addition of Co(NH3)6(3+), delta-Co(en)3(3+) or delta-Rh(en)3(3+) to d(CAATCCGGATTG)2 induce a similar pattern of chemical shift movements of the dodecanucleotide base protons. Analysis of the chemical shift changes as a function of added metal-ion complex shows that the binding affinity for d(CAATCCGGATTG)2 decreases in the order: delta-Co(en)3(3+) > delta-Rh(en)3(3+) > Co(NH3)6(3+). Addition of a saturating ratio of delta-Co(en)3(3+) to d(CAATCCGGATTG)2 induces a selective B to A type-DNA transition for the central CpG segment of the dodecanucleotide, with all other nucleotide residues maintaining the B-type conformation.
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Bouaziz H, Tong C, Yoon Y, Hood DD, Eisenach JC. Intravenous opioids stimulate norepinephrine and acetylcholine release in spinal cord dorsal horn. Systematic studies in sheep and an observation in a human. Anesthesiology 1996; 84:143-54. [PMID: 8572328 DOI: 10.1097/00000542-199601000-00017] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Opioids produce analgesia by direct effects as well as by activating neural pathways that release nonopioid transmitters. This study tested whether systematically administered opioids activate descending spinal noradrenergic and cholinergic pathways. METHODS The effect of intravenous morphine on cerebrospinal fluid and dorsal horn microdialysate concentrations of norepinephrine and acetylcholine was examined in 20 sheep. Animals received either intravenous morphine or fentanyl alone, or morphine plus intravenous naloxone or intrathecal idazoxan. RESULTS Intravenous morphine (0, 0.5, 1 mg/kg, intravenous) produced dose-dependent increases in cerebrospinal fluid norepinephrine and acetylcholine, but not epinephrine or dopamine. Morphine's effect was blocked by intravenous naloxone and by intrathecal idazoxan. In microdialysis experiments, intravenous morphine increased the concentration of norepinephrine and acetylcholine, but not epinephrine or dopamine, in the dorsal horn. In contrast, intravenous morphine exerted no effect on any of these monoamines in the ventral horn. Intravenous naloxone and cervical cord transection each blocked morphine's effect on dorsal horn norepinephrine. CONCLUSIONS These results support functional studies that indicate that systematically administered opioids cause spinal norepinephrine and acetylcholine release by a naloxone-sensitive mechanism. Idazoxan blockade of morphine's effects on cerebrospinal fluid norepinephrine was unexpected, and suggests that both norepinephrine and acetylcholine release in the spinal cord may be regulated by alpha 2-adrenoceptors. Microdialysis experiments suggest increased norepinephrine and acetylcholine levels in cerebrospinal fluid resulted from intravenous morphine-induced activation of bulbospinal pathways.
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