Effects of vasopressin and isoprenaline infusions on the distribution of blod flow in the intestine; criteria for the validity of microsphere studies

Pancreatic islet blood flow and its measurement

Pancreatic islets are richly vascularized, and islet blood vessels are uniquely adapted to maintain and support the internal milieu of the islets favoring normal endocrine function. Islet blood flow is normally very high compared with that to the exocrine pancreas and is autonomously regulated through complex interactions between the nervous system, metabolites from insulin secreting β-cells, endothelium-derived mediators, and hormones. The islet blood flow is normally coupled to the needs for insulin release and is usually disturbed during glucose intolerance and overt diabetes. The present review provides a brief background on islet vascular function and especially focuses on available techniques to measure islet blood perfusion. The gold standard for islet blood flow measurements in experimental animals is the microsphere technique, and its advantages and disadvantages will be discussed. In humans there are still no methods to measure islet blood flow selectively, but new developments in radiological techniques hold great hopes for the future.

Effects of cholecystokinin on gastric injury and gastric mucosal blood flow

Cholecystokinin (CCK) is a vasodilator and prevents gastric injury from ethanol. Its effects against other irritants are unknown. This study was conducted to (1) assess whether CCK or oleate, a CCK secretagogue, could prevent gastric injury from other damaging agents and (2) examine the role of blood flow in CCK-induced gastroprotection. Conscious rats were pretreated for 10 minutes with intravenous saline solution or CCK (5 nmol/kg) or were given 1 ml of orogastric water or oleate (100 mmol/L) 30 minutes before a 1 ml orogastric bolus of acidified ethanol (150 mmol/L hydrochloric acid/50% ethanol), 0.75N hydrochloric acid, or 0.2N sodium hydroxide. Rats were killed 5 minutes after receiving an irritant and the total area (mm2) of macroscopic injury was quantified. The duration of CCK-induced gastroprotection against acidified ethanol was examined at 5, 10, 30, and 60 minutes after its administration. Other rats had gastric mucosal blood flow determined (fluorescent microspheres) at identical time points. CCK and oleate decreased gastric injury from all three luminal irritants. CCK-induced gastroprotection was present for 30 minutes but only enhanced gastric mucosal blood flow at 5 and 10 minutes. These data suggest that endogenous CCK may play a role in gastric mucosal defense and that blood flow alone does not fully explain CCK gastroprotection.

Regional intestinal blood flow and nitric oxide synthase inhibition during sepsis in the rat

OBJECTIVE

Regional circulatory changes in intestinal mucosa were evaluated after the onset of septic shock and the effect of nitric oxide (NO) inhibition on mucosal blood flow was investigated at different locations along the intestine.

SUMMARY BACKGROUND DATA

The response of intestinal blood flow to different physiologic and pharmacologic stimuli is known to vary along the intestine, but limited data are available on regional alterations in intestinal blood flow during septic shock. These regional variations in intestinal blood flow could become important because NO inhibition might restore the circulation of one segment of the gut or exacerbate ischemia that may be occurring concomitantly in another segment of the intestine.

METHODS

Mucosal blood flow was studied with fluorescent microspheres in conscious unrestrained rats before and 2, 4, and 6 hours after lipopolysaccharide (LPS, 20 mg/kg intraperitoneally) induced sepsis in the presence and absence of the nitric oxide synthase inhibitor N(G)-nitro-L-argininemethylester (L-NAME, 5 mg/kg subcutaneously).

RESULTS

Control mucosal blood flow was significantly higher in the ileum than in the duodenum, jejunum, or colon. During LPS-induced sepsis, mucosal blood flow to the ileum decreased and perfusion to the remaining gut was preserved. This was accompanied by hypotension throughout the experiment. L-NAME administration during sepsis prevented hypotension and decreased mucosal blood flow to all segments of small intestine at 2 hours. In this group, mucosal blood flow to the proximal small intestine but not to the ileum returned to baseline levels at 4 and 6 hours. L-NAME alone decreased mucosal blood flow to the small intestine throughout the experiment.

CONCLUSIONS

This study indicates that mucosal blood flow alterations during septic shock vary along the intestine, with a significant change only in the ileum, suggesting that perfusion in the small intestine is dependent on physiologic NO production.

Hepatic and gastrointestinal oxygen and lactate metabolism during low cardiac output in lambs

We previously observed young lambs to be more tolerant of hypoxia; compared with older lambs, they accumulate lactate at a slower rate during comparable reduction in cardiac output, and have a greater percent decrease in cardiac output before onset of systemic lactate accumulation. To determine the mechanism of lactic acidosis and the cause for this "tolerance," we reduced cardiac output progressively in seven chronically catheterized conscious lambs (16.4 + 5.1 d) and measured hepatic and gastrointestinal (GI) blood flow (radioactive microspheres) and delivery, uptake, and extraction of lactate and O2. Hepatic O2 consumption declined proportionately below a critical hepatic O2 delivery (approximately 2 mL O2/min/kg), corresponding to the systemic O2 delivery associated with the onset of systemic lactate accumulation. As hepatic O2 delivery decreased below the critical value, there was initially net hepatic lactate uptake and then a change to net production when the O2 delivery decreased below approximately 1 mL O2/min kg. The GI tract had net lactate production at rest, but surprisingly switched to lactate uptake as cardiac output decreased. The mechanism of lactic acidosis was failure of hepatic lactate uptake to increase despite increased hepatic lactate delivery, as reported in adults subjects. However, in contrast, there was "true" hepatic dysfunction and lactate production only at the lowest levels of cardiac output, after onset of systemic lactate accumulation. Moreover, we speculate that tolerance of young lambs to hypoxia is at least due to two factors: 1) hepatic lactate uptake is maintained beyond the "critical" O2 delivery and fall in hepatic O2 consumption, and 2) there is a switch to lactate uptake by the GI tract serving to buffer the lactate.

Hemodynamic and metabolic effects of vasopressin blockade in endotoxin shock

BACKGROUND

Arginine vasopressin V1 receptor antagonist (AVPRA) was administered to investigate the influence of vasopressin blockade on hemodynamics and metabolism during endotoxin shock.

METHODS

Anesthetized rats were divided into four groups: control (0.9% saline solution, n = 5), drug control (AVPRA, n = 5), endotoxin (endotoxin, 5 mg/kg, n = 10), and pretreatment (AVPRA and endotoxin, n = 10). Hemodynamics and oxygen transport were evaluated for 2 hours. Terminal arterial and portal venous concentrations of endotoxin, pyruvate, lactate, and ketone bodies were determined.

RESULTS

The endotoxin group maintained blood pressure levels similar to those of control animals. AVPRA pretreatment decreased vascular resistance and resulted in lower blood pressure than endotoxin alone. Endotoxin decreased oxygen consumption and the oxygen extraction ratio and increased arterial lactate concentration and the lactate/pyruvate ratio. Endotoxin also decreased arterial ketone body concentration and markedly decreased ketone body availability in the mesenteric circulation. AVPRA pretreatment improved oxygen consumption, oxygen extraction ratio, and ketone body availability; arterial lactate concentration, lactate/pyruvate ratio, and arterial ketone body concentration were not affected. Pretreatment with AVPRA also decreased arterial and portal venous concentrations of endotoxin.

CONCLUSIONS

Vasopressin receptor blockade during endotoxemia resulted in lower blood pressure than endotoxin alone. Vasopressin receptor blockade also maintained oxygen extraction ratio and ketone body availability in the mesenteric circulation. Vasopressin may play a key role in the response to endotoxemia.

[Significance of therapy timing for the effects of systemic and local therapy with the ACE inhibitor captopril on intestinal microcirculation in manifest mesenteric ischemia. An animal experiment study in the swine]

We present the results of a study based on an animal model concurring whether captopril can improve microcirculation in the small intestine in nonocclusive mesenteric ischemia dependent on when therapy is begun. Cardiogenic shock was produced by pericardial tamponade with starch solution. The flow in the carotid artery could be reduced to 43% of the preshock value. In four therapy groups and a control group the intestinal microcirculation was examined by laser Doppler flowmetry in the serosa and mucosa. The measurements were taken at regular intervals during the 4 h of the experiments. Captopril was either given systemically or locoregionally through the upper mesenteric artery. Therapy was given at the beginning of the shock or 1 h after induction of shock at a dosage of 0.25 mg/kg body weight as a bolus and continuous application of 10 micrograms/kg body wt. Concerning the hemodynamic changes during shock the group receiving captopril systemically at the beginning of shock showed a significant (P = 0.05) improvement in microcirculation compared to the controls and other therapy groups. Flow reduction was seen in the controls (156-32 relative flow units = RFU) in group Ia (systemic therapy 1 h after shock), as well as the controls (129 to 12 RFU) and, in group Ib (systemic therapy beginning with shock) a flow rise could be seen (307 to 481 RFU). In group IIa (local therapy 1 h after shock) (a steady flow was seen (168-170 RFU) and in group IIb (local therapy beginning with shock) and group Ib an increase in flow was also measured (226-303 RFU). This positive effect of captopril on the intestinal perfusion was observed when applied 1 h after the induction of shock.

Circulatory mechanisms of gastric mucosal damage and protection

The history of exploring the circulatory mechanisms underlying chemical injury of the gastric mucosa and protection against such damage is reviewed. Special emphasis is placed on recent findings in the areas of inflammatory mediators and the role of local neuropeptides. Attention is also given to the methods used to assess mucosal blood flow and structural injury in the tissue. After weighing the evidence for and against vascular mechanisms in damage and cytoprotection, it is concluded that the local circulation is involved in both processes, but simple changes in mucosal blood flow or microvascular permeability do not adequately explain the early pathophysiology of injury and protection against damage.

The microvascular anatomy of the canine stomach. A comparison between the body and the antrum

To investigate whether there is a difference in the microvascular architecture between the body and the antrum of the canine stomach, these two locations were compared with respect to microsphere entrapment and the microvascular architecture and diameter in relation to histology by corrosion casting and by intraarterial injection of india ink. There was 63% shunting of 9-micron microspheres in the antrum, but none in the body. Corrosion cast and Indian ink studies showed that in the body there was a single microvascular network of capillaries that appeared to originate from the arterioles in the submucosa and were in close apposition to the epithelial cells of the gastric glands. The diameter of these capillaries was 8.6 +/- 0.2 microns. In contrast, there were two distinct capillary networks in the antrum: a basal and a superficial. The capillaries of the basal network of the antrum originated from the arterioles at the level of the muscularis mucosa and drained into the capillaries of the superficial mucosa. The capillaries of the superficial network had a significantly larger diameter (10.8 +/- 0.4 microns) than those of the basal network (7.3 +/- 0.2 microns). In many instances the capillaries of the superficial network originated directly from the ascending arterioles passing through the basal network. These direct arteriocapillary connections may have permitted the shunting of 9-microns spheres in the antrum.

Lack of protective effect of thromboxane synthetase inhibitor (CGS-13080) on single dose radiated canine intestine

The effect of a thromboxane A2 synthetase inhibitor (CGS-13080) on canine intestine was studied using a single dose of radiation, and radioactive microspheres were used to determine resultant blood flow. Thromboxane A2 causes vasospasm and platelet aggregation and may play a dominant role in radiation injury. However, there was no effect on the intestinal blood flow diminution occurring after radiation in this laboratory model using this thromboxane A2 synthetase inhibitor.

Blood flow to the rat rectum: its intramural distribution and the response to injury

Rectal blood flow was measured in rats using radioactive microspheres. Subsequent sectioning of the material allowed the intramural distribution of that flow to be assessed. Total flow increased with increasing distance from the anorectal junction but the distribution of flow remained the same with the mucosa receiving slightly less than two thirds of the total. Injury to the mucosa, produced by a surfactant administered as a suppository, doubled total flow in areas where the damage was most severe and revealed an ability of the intramural vascular beds to react independently. Flow to the mucosa increased both absolutely and proportionately and this entirely accounted for the increase in total flow. Flow to the muscularis externa was unaltered in absolute terms, but fell as a percentage of total flow.

Effects of fluid-percussion brain injury on regional cerebral blood flow and pial arteriolar diameter

The effects of two levels of fluid-percussion brain injury on cerebral blood flow (CBF) and pial arteriolar diameter were investigated in cats. Regional CBF was measured using the radioactive microsphere technique. Experimental brain injury resulted in changes in arterial blood pressure, CBF, and pial arteriolar diameter that were related to the severity of the injury. Low-level injury (1.88 +/- 0.11 atm, mean +/- standard error of the mean) resulted in a slight transient increase in CBF which had returned to preinjury levels by 30 minutes. High-level injury (2.68 +/- 0.19 atm) resulted in larger, statistically significant (p less than 0.01) increases in whole-brain CBF, decreases in cerebrovascular resistance, and increases in pial arteriolar diameter 1 minute postinjury. One hour after injury, CBF had returned to preinjury levels while cerebral perfusion pressure was significantly (p less than 0.01) reduced. There was no evidence of reduced CBF in any region studied. Pial arterioles dilated during the posttraumatic hypertensive period and then returned to control diameters within 1 hour after injury. Changes in the diameter of pial arterioles were significantly correlated with posttraumatic changes in CBF.

Tissue blood flow and localization of arteriovenous anastomoses in pigs with microspheres of four different sizes

Using microspheres of 10, 15, 25 and 35 micron diameters we have compared blood flows to a large number of tissues and the complete distribution of common carotid arterial blood in an attempt to localize the site of arteriovenous shunting in anaesthetized pigs. Blood flow values obtained with the spheres of the four sizes were similar in the brain, heart, kidneys, skeletal muscles, stomach, small and large intestines, spleen, adrenals, liver, bones, fat and salivary glands. In the ears and skin from several regions, blood flow measured with 35 micron spheres was substantially higher than those measured with smaller spheres. Blood flow pattern in the eye and tongue was such that 10 micron flow value was moderately less and the 25 and 35 micron values were only slightly higher than the corresponding 15 micron value. These data indicate that a considerable number of arteriovenous anastomoses, large enough to let microspheres of up to 25 micron pass through, are present in the ears and skin. Only smaller arteriovenous anastomoses may be present in the eyes and tongue. This conclusion is supported by the observation that 5-hydroxytryptamine, which causes constriction of arteriovenous anastomoses, negated the difference in the blood flows measured with 15 and 35 micron spheres in the ears and skin.

Effects of glucagon and prostacyclin in acute occlusive and postocclusive canine mesenteric ischemia

Effects of glucagon and prostacyclin (PGI2) were studied in anesthetized dogs during sequential occlusive and postocclusive mesenteric ischemia induced by 90 min of tourniquet stenosis of the superior mesenteric artery (SMA). After 30 min of SMA stenosis, glucagon (1 microgram/kg/min, n = 7), PGI2 (30 ng/kg/min, n = 7), or saline (1 ml/min, n = 3) was infused intravenously for 30 min, followed by 30 min of continued ischemia. SMA flow and distal SMA pressure ( SMAP ) decreased 76% with SMA stenosis (P less than 0.01). Ileal wall flow measured by radiolabeled microspheres decreased from 45 to 13 ml/min/100 g (P less than 0.01); mesenteric AV O2 difference ( AVDO2 ) increased from 5.1 to 10.1 ml/dl (P less than 0.01); and mesenteric O2 consumption (VO2) decreased by 48% (P less than 0.05). Glucagon infusion caused a further decrease in ileal wall flow, to 10 ml/min/100 g (P less than 0.05), and an increase in AVDO2 to 11 ml/dl (P less than 0.05), despite a 22% increase in cardiac output. PGI2 caused a similar decrease in ileal wall flow and an increase in AVDO2 , although these were not statistically significant. Saline infusion caused no change in measured variables. In the second phase of this study, SMA blood flow was restored by tourniquet release. After animals had stabilized for 30 min, a repeat 30-min drug infusion was studied. In this postocclusive period, persistent gut ischemia was indicated by a reduction in VO2 to 76% of original baseline, associated with a 50% decrease in both CO and SMAQ . Intravenous infusion of glucagon at this time increased SMAQ by 195% (P less than 0.05) and resulted in a return of VO2 to its original baseline level. PGI2 infusion caused a 21% increase in SMAQ and a 16% decrease in AVDO2 (NS), but had no significant effect on VO2. Glucagon was effective in the management of postocclusive mesenteric ischemia but appeared to have a detrimental effect on ileal blood flow in severe occlusive ischemia.

The effect of carcinoid levels of serotonin and substance P on hemodynamics

Serotonin and substance P circulate in high concentrations in patients with the carcinoid syndrome. These studies were performed to evaluate the effects of intravenous infusions of serotonin and substance P to reproduce carcinoid levels of these agents on central hemodynamics, regional blood flow (using the radioactive microsphere technique), and endogenous hormone release. Serotonin did not affect mean arterial pressure but it significantly increased cardiac output, decreased systematic vascular resistance, and redistributed regional blood flow, increasing blood flow to the heart, adrenals, fundus, and antrum. Substance P significantly decreased mean arterial pressure and systemic vascular resistance, increased cardiac output, and increased blood flow to adrenal, fundus, antrum, liver, and all muscular layers of the stomach and small bowel. Neither serotonin nor substance P affected skin blood flow, nor altered circulating levels of glucose, insulin, or gastrin. Although both of these agents seem to participate in the pathogenesis of the carcinoid syndrome, our studies suggest that it is not possible to ascribe all the hemodynamic abnormalities to either.

Stimulation by glucose of the blood flow to the pancreatic islets of the rat

Blood flow to the pancreatic islets of the rat was estimated with the microsphere technique. Experiments with microspheres of different sizes (diameter 10, 15 or 50 micron) showed that optimal results were obtained with 10-micron spheres. Localization of microspheres either within or outside the islets was accomplished by freeze-thawing of the pancreas, making it transparent, so that both islets and microspheres could be distinguished in dark field illumination. Thus, microscopic examination of the freeze-thawed pancreas allowed the microspheres to be counted separately in both the endocrine and exocrine parenchyma. Under basal conditions, pancreatic blood flow was calculated as 0.60 ml X min-1 X g-1 (w/w). The islets accounted for about 10% of the total pancreatic blood flow, corresponding to 0.069 ml/min per whole pancreas. A bolus dose of glucose increased pancreatic blood flow to 0.75 ml X min-1 X g-1 (p less than 0.05), while the fractional islet blood flow rose to 15.1% (p less than 0.001) corresponding to 0.125 ml X min-1 X pancreas-1 (p less than 0.001). The glucose-induced increase in pancreatic blood flow mainly resulted from increased flow to the pancreatic tail, while the corresponding increase in islet blood flow was uniformly distributed throughout the pancreas. Injection of the non-metabolizable glucose-derivate. 3-0-methyl-D-glucose, affected neither the pancreatic nor the islet blood flow. The data indicate that the islets receive more of the pancreatic blood flow than would be accounted for by their relative volume and that glucose preferentially stimulates blood flow to the islets.

Blood flow redistribution by dopamine in the feline gastrointestinal tract

The effect of intravenous infusion of dopamine (10 and 25 micrograms X kg-1 X min-1 consecutively) on visceral blood flow distribution was examined in anesthetized cats using the microsphere technique and electromagnetic flowmetry. Arterial blood pressure did not change in response to dopamine infusion, but blood flow through the superior mesenteric artery, and blood flow in the mucosa-submucosa of the gastric antrum and various gut segments increased significantly. During infusion of the high dose the increase was most marked in the mucosa-submucosa of the antrum (+355%) and distal colon (+371%). By contrast, blood flow decreased in the muscularis-serosa of the gut segments investigated, in the spleen, pancreas, and the hepatic arterial bed. The increase in blood flow through the superior mesenteric artery was blocked by the dopamine antagonist bulbocapnine (10 mg/kg i.v.). The results suggest that the receptors mediating the dopamine-induced vasodilation in the gastrointestinal tract are located in the resistance vessels of the mucosa-submucosa.

Dopamine produces vasodilation in specific regions and layers of the rabbit gastrointestinal tract

The effect of intravenous dopamine infusion (25 and 60 micrograms per kg and min consecutively) on blood flow distribution in the splanchnic region of anesthetized rabbits was studied applying the microsphere technique. During infusion of the low dose, blood flow increased most markedly in the stomach, less in the pancreas, jejunum and descending colon, and decreased in the spleen. In the stomach the increase was confined to the mucosa-submucosa. Raising the dose of dopamine resulted in a slight fall of arterial blood pressure, a further increase in blood flow through the mucosa-submucosa of the gastric fundus (+493 % as against control), but not through the other tissues studied. In another series, blood flow through the left gastric artery was measured with an electromagnetic flowmeter. The infusion of dopamine produced a dose-dependent increase in regional blood flow, which was inhibited by the dopamine antagonist bulbocapnine. Furthermore, the control blood flow was transiently decreased, and resistance to flow was increased by bulbocapnine. The results indicate that the dopamine-induced vasodilation in the gastrointestinal tract of the rabbit is largely restricted to the gastric circulation and suggest that specific receptors mediating this vasodilation are located in the mucosa-submucosa. It is hypothesized that endogenous dopamine functions as a vasodilatory tissue hormone in the gastric mucosa of the rabbit.

Effects of intraluminal pressure on regional blood flow in obstructed and unobstructed small intestines in the rat

Small bowel circulation in the rat was studied with the microsphere technique before and after 10 minutes of elevated intraintestinal pressure. A distal small bowel loop consisting of 10 vascular arcades was used. The specimens were inflated with nitrogen gas. Regional blood flow in both obstructed and unobstructed small bowels was significantly diminished by an intraintestinal pressure of 40 mm Hg. A pressure of 20 mm Hg impaired circulation only in the obstructed small intestine, whereas the unobstructed intestine did not show a similar decrease. These findings suggest that moderate intraluminal pressures can imply a potential hazard to the vulnerable capillary bed of an obstructed intestine. Hence, it is suggested that intraoperative decompression should be performed to avoid this postoperative threat to bowel viability.

The effects of gastric hyperosmotic glucose feedings on regional perfusion in the neonatal piglet

Regional blood flow and intestinal wall perfusion were studied in 13 anesthetized 1-5 day old neonatal piglets before and after gastric glucose infusion. The radionuclide labeled microsphere technique was used with 15 +/- 3 mu microspheres (85Sr, 141Ce) given in two separate left atrial infections. The 10% glucose with a patent blue dye marker did not affect CO but produced significant increases in blood flow to the adrenals bilaterally, to all layers of the proximal small intestine and to the mucosa of the distal small intestine. The glucose also caused a significant reduction in the animals' arterial pH, PaO2, and total CO2 with an increase in the blood glucose level. This response to gastric glucose infusion is different from adult animals since lower glucose concentrations produced blood flow changes in all layers of the exposed small intestine and the adrenals in our neonatal animals.

Measurement of mucosal blood flow by assay of absorption of 125I from the intestinal lumen

A method which utilized the absorption of 125I as a measure of intestinal mucosal blood flow was developed. In the pentobarbital anesthetized dog a segment of mid-jejunum was isolated from adjacent vasculature and perfused with 125I solution. Superior mesenteric artery flow, blood flow to the isolated segment of intestine and 125I absorption were measured. Changes in 125I absorption were found to correlated closely with changes in blood flow (r = 0.95). Using an autoradiographic technique 125I absorption was found to be localized to the intestinal mucosa.

Action of sauvagine on the mesenteric vascular bed of the dog

Sauvagine, a linear peptide of 40 amino acids, produced hypotension when administered intravenously to anesthetized dogs. Diastolic pressure was always more affected than systolic pressure. Aortic blood flow and venous return both increased to the same extent. The mechanism of the hypotensive response was mainly, if not exclusively, due to dilatation of the superior and inferior mesenteric arteries. Intravenous infusion of sauvagine in doses ranging from 3 to 10 ng . kg-1 . min-1 produced a dose-related increase of mesenteric blood flow up to 400% control values. Mucosal-submucosal blood flow of ileum and colon was increased, while blood flow in muscle was unaffected or slight decreased. The mesenteric vasodilator response was not prevented by adrenergic or muscarinic receptor blockade. The hypotensive response was more marked and sustained in dibenamine-propranolol treated dogs.

Capillary blood flow in the canine colon and other organs at normal and raised portal pressure

Capillary blood flow in the canine colon and other organs has been assessed over a wide range of portal pressures using radio-labelled microspheres. The proximal colon received a greater proportionate flow than the distal region. At both normal and raised pressures, the mucosa received 90% of the total colonic capillary flow. A highly significant negative correlation (P less than 0.001) was found between colonic capillary blood flow and portal pressure. A highly significant positive correlation (P less than 0.001) was found between colonic capillary blood flow in the superior mesenteric artery.

Effect of 16, 16-dimethyl PGE2 on resting and histamine-stimulated gastric mucosal blood flow

Using [14C]aminopyrine clearance as a measure of mucosal blood flow, 16,16-dimethyl PGE2 was administered orally as a single bolus and its effects on resting and histamine-stimulated gastricmucosal blood flow assessed in conscious dogs with vagally denervated gastric pouches. No effect on resting mucosal flow was observed with any of the doses (ie, 2, 10, and 50 microgram/kg) of prostaglandin given. In histamine-stimulated experiments, intravenous infusion of histamine dihydrochloride (1 mg/hr) elicited a significant (P < 0.0005) increase from basal in gastric acid production, volume output, and gastric mucosal blood flow which remained unchanged for the duration of the study. Prostaglandin (50 microgram/kg) significantly decreased (P < 0.0005) these secretory responses and markedly inhibited (P < 0.005) mucosal blood flow without altering the ratio (R) of flow to the volume rate of secretion. The observation that R was unchanged suggests that this inhibitory action of 16,16-dimethyl PGE2 on gastric secretion and blood flow was mediated through direct effects on gastric parietal cells rather than any primary alteration in the gastric microcirculation. We conclude that 16,16-dimethyl PGE2 given orally has no effect on the resting gastric mucosal circulation and that any reduction in mucosal flow during histamine stimulation is secondary to its inhibitory effects on gastric acid secretion.

Comparative effects of catecholamines in cardiac tamponade: experimental and clinical studies

In experimental cardiac tamponade, catecholamines improve hemodynamic variables. To determine whether hemodynamic changes result in increased blood flow to critical organs, tamponade was produced in nine spontaneously breathing, anesthetized dogs. Infusion of dopamine, isoproterenol or norepinephrine doubled cardiac output, but only norepinephrine increased mean arterial pressure. All catecholamines increased blood flow to the myocardium, but not to the brain or kidney. Isoproterenol caused a significant decrease in the endocardial/epicardial blood flow ratio, which was shown to be due to tachycardia. To determine whether catecholamines increase cardiac output and mean arterial pressure in patients with tamponade, eight patients with tamponade due to neoplasms were studied before therapeutic pericardiocentesis. Cardiac output increased only 50 percent with dopamine and isoproterenol and not at all with norepinephrine. Cardiac filling pressure did not decrease with isoproterenol or dopamine, as in experimental tamponade. Only norepinephrine increased mean arterial pressure. Thus, although catecholamines improve hemodynamics in experimental tamponade, the heart is the only critical organ to which blood flow is improved. The hemodynamic benefits of catecholamine administration to patients may be more limited than previous experimental studies have suggested.

The measurement of colonic mucosal-submucosal blood flow in man

1. A method is described for the measurement of colonic mucosal-submucosal blood flow in man, by studying surgically created colostomies. 2. A local radioisotopic clearance technique utilizing a stable preparation of [125I]4-iodoantipyrine is employed. The indicator is injected directly into the colostomy under study and its gamma emission is recorded by a scintillation detector. 3. A radioautographic study was carried out at laparotomy in humans to facilitate the interpretation of the recorded washout curves. This demonstrated that the tracer was cleared from both the mucosa and submucosa throughout the period of study. 4. Mucosal-submucosal blood flow was calculated according to Kety (1949) from the monoexponential clearance curves obtained, and amounted to 31.7 +/- 11 ml./min. 100 g (S.D. of an observation, n = 30). 5. The results from two consecutive measurements in seventeen patients showed that the mean change between first and second readings was not significant (t test). In addition the between-patient variation (12.2) was significantly greater than the within-patient variation (2.6) for consecutive recordings (F test; P less than 0.01). 6. The within-patient between-days variation (12.9; n = 10) was found to be similar to the between-patient variation. 7. It is concluded that the technique permits measurement of local colonic blood flow in man and by consecutive measurements, it may be used to evaluate local changes in blood flow following reflex or pharmacological stimulation.

Use of microspheres to measure small intestinal villus blood flow in the dog

The accuracy of using 7- to 10-micron microspheres to measure blood flow to dog small intestinal villi was studied. These spheres appear to pass unimpeded through the afferent arterioles of the villus and lodge at the villus tip because 1) virtually all villus spheres were located at the tip, 2) flow determined by visually counting spheres did not differ significantly from flow determined from radioactivity of the sheared-off villus layer, 3) the size distribution of spheres in the villus and subvillus layers was virtually identical to that administered, indicating no premature impaction of the larger spheres, and 4) spheres lodging in the submucosa during vasoconstriction did not subsequently migrate to the villi during vasodilatation. Studies with 25-micron spheres indicated that 28% of the 7- to 10-micron spheres shunted through vessels greater than 10 micron. Double isotope studies showed that lodges spheres do not migrate and that the injection of 2--4 X 10(6) spheres does not alter villus flow. Thus, 7- to 10-micron microspheres pass to and lodge in villus vessels in proportion to capillary flow and should provide an accurate estimate of villus nutrient blood flow.

Effect of altered intestinal water transport on rabbit ileal blood flow

A method is described for measuring ileal blood flow in the anesthetized (pentobarbital sodium) rabbit by the intraventricular injection of microspheres (15 micrometer) labeled with cerium-141 or chromium-51; with this method the amount of labeled microspheres lodging in the tissue is proportional to the blood flow. Blood flow to the ileal mucosa plus submucosa could be separated from flow to the ileal muscularis propria plus serosa by this technique. Simultaneous and sequential injections of radiolabeled microspheres gave similar measurements of ileal blood flow and did not affect ileal water absorption. Increasing ileal water absorption by treatment with the glucocorticoid methylprednisolone (3 mg/100 g per day for 3 days) increased blood flow to both compartments of the ileum and also to the colon, liver, and kidneys; methylprednisolone treatment did not alter blood flow when studies were performed before the methylprednisolone-induced increase in ileal water absorption had occurred. In contrast, intestinal secretagogues that induced both active ileal secretion (purified cholera toxin and serotonin) and passive ileal secretion (hypertonic mannitol) did not affect ileal blood flow. These studies indicate that increased ileal water absorption is associated with increased ileal blood flow, whereas intestinal secretion is not necessarily associated with an alteration in ileal blood flow.

Microsphere measurement of regional intestinal blood supply and cardiac output in the rat

The regional blood supply to consecutive segments of the small intestine in the anaesthetized rat was investigated with a radioactive microsphere technique. A blood flow gradient with the lowest flow in the distal segments (0.85--0.89 ml/min.g) and the highest in the proximal segments (1.13--1.15 ml/min.g) was observed. Very few microspheres were found in the portal vein blood, indicating negligible arteriovenous shunting in the splanchnic area. The mean cardiac outputs in two consecutive measurements were 27.9 and 28.7 ml/min . 100 g, respectively. The cardiac output and regional blood flow values were in accordance with those obtained with other techniques.

Sites of autoregulatory escape of blood flow in the mesenteric vascular bed

1. Stimulation of the sympathetic nerves to the intestinal vascular bed results in an initial decrease in blood flow followed by a recovery towards the control level. This recovery was termed autoregulatory escape by Folkow and his co-workers and they suggested it was associated with a redistribution of blood flow within the intestinal wall. This theory has been examined in cats anaesthetized with pentobarbitone sodium. 2. The sympathetic nerves to the intestinal vascular bed were stimulated for 4 min periods at a submaximal frequency (4 Hz). The blood flows to individual parts of the superior mesenteric arterial bed (whole intestine, mucosal and submucosal layer, muscle layer of intestine, mesentery and lymph nodes, appendix and colon) were measured using radioactive microspheres before, at the peak of the vasoconstriction (30 sec), after autoregulatory escape had occurred (3-5 min) and during the hyperaemia after cessation of nerve stimulation. 3. All parts of the mesenteric vascular bed showed a significant initial vasoconstriction followed by a recovery in the flow to a level not significantly different from the pre-stimulation control flow. All parts showed a significant hyperaemia after cessation of stimulation. The distribution of the superior mesenteric flow at the peak of the vasoconstriction, after autoregulatory escape had occurred and during the hyperaemia after cessation of nerve stimulation was not significantly different from that during the control period. 4. It is concluded that all parts of the mesenteric vascular bed show autoregulatory escape and that this phenomenon is not associated with a redistribution of blood flow within the intestinal wall. Autoregulatory escape must involve relaxation of the same vessels which were originally constricted and various theories on the mechanism of the escape are discussed.

The effect of carbon dioxide inhalation on cerebral blood flow: a two-hour duration study in dogs with microspheres

Dogs breathed one of four gas mixtures (5% CO 2 -95% O 2 , 5% CO 2 -95% air, 10% CO 2 -90% O 2 , and 10% CO 2 -90% air) for as long as two hours. Regional cerebral blood flow as well as flow in nasal, otic, pituitary and skin tissue were measured by means of 15 ± 5 µ radioactively labeled microspheres. The normal values for cerebral blood flow and arterial blood gases were very similar to those of other investigators. Inhalation of CO 2 induced an increase in cerebral blood flow that was significantly higher than is usually reported. Increases varied from 100% (with 5% CO 2 -95% air) to 250% (with 10% CO 2 -90% O 2 ). Blood flow in the temporal bone behaved much like that of brain in response to CO 2 . In most instances, the pituitary gland blood flow did not increase with inhalation of CO 2 .