Impact of Smoking on Coronary Volume-to-Myocardial Mass Ratio: An ADVANCE Registry Substudy

Purpose To examine the relationship between smoking status and coronary volume-to-myocardial mass ratio (V/M) among individuals with coronary artery disease (CAD) undergoing CT fractional flow reserve (CT-FFR) analysis. Materials and Methods In this secondary analysis, participants from the ADVANCE registry evaluated for suspected CAD from July 15, 2015, to October 20, 2017, who were found to have coronary stenosis of 30% or greater at coronary CT angiography (CCTA) were included if they had known smoking status and underwent CT-FFR and V/M analysis. CCTA images were segmented to calculate coronary volume and myocardial mass. V/M was compared between smoking groups, and predictors of low V/M were determined. Results The sample for analysis included 503 current smokers, 1060 former smokers, and 1311 never-smokers (2874 participants; 1906 male participants). After adjustment for demographic and clinical factors, former smokers had greater coronary volume than never-smokers (former smokers, 3021.7 mm3 ± 934.0 [SD]; never-smokers, 2967.6 mm3 ± 978.0; P = .002), while current smokers had increased myocardial mass compared with never-smokers (current smokers, 127.8 g ± 32.9; never-smokers, 118.0 g ± 32.5; P = .02). However, both current and former smokers had lower V/M than never-smokers (current smokers, 24.1 mm3/g ± 7.9; former smokers, 24.9 mm3/g ± 7.1; never-smokers, 25.8 mm3/g ± 7.4; P < .001 [unadjusted] and P = .002 [unadjusted], respectively). Current smoking status (odds ratio [OR], 0.74 [95% CI: 0.59, 0.93]; P = .009), former smoking status (OR, 0.81 [95% CI: 0.68, 0.97]; P = .02), stenosis of 50% or greater (OR, 0.62 [95% CI: 0.52, 0.74]; P < .001), and diabetes (OR, 0.67 [95% CI: 0.56, 0.82]; P < .001) were independent predictors of low V/M. Conclusion Both current and former smoking status were independently associated with low V/M. Keywords: CT Angiography, Cardiac, Heart, Ischemia/Infarction Clinical trial registration no. NCT02499679 Supplemental material is available for this article. © RSNA, 2024.

Ultrasound assessment of the posterolateral elbow ulnohumeral gap in normal subjects with and without posterolateral drawer testing

Background

Posterolateral rotator instability (PLRI) is the most common pattern of recurrent elbow instability, and current imaging to aid PLRI diagnosis is limited. Thus, we sought to define use of ultrasound (US) to determine normal lateral ulnohumeral joint measurements, with and without posterolateral drawer testing to provide an insight into how US may aid diagnosis.

Methods

Sixty elbows were evaluated in thirty healthy volunteers. The lateral ulnohumeral gap (LUHG) was measured with US in the resting position while the posterolateral drawer stress test maneuver was applied. Joint laxity was calculated as the difference between maximum stress and average rest measurements. Two independent readers assessed each elbow with comparison performed between stress and rest positions.

Results

Differences in the LUHG were evident between stress and rest conditions (reader 1: P < .0001 and reader 2: P = .0002). At rest, median LUHG values were 2.31 mm and 2.05 mm for readers 1 and 2 respectively, while at stress 2.88 mm and 2.9 mm for readers 1 and 2. Median joint laxity was 0.8 mm for reader 1 and 1.1 mm for reader 2. Pearson correlation was r = 0.457 (absolute intraclass correlation coefficient [ICC] = 0.608) while under stress and r = 0.308 (absolute intraclass correlation coefficient [ICC] = 0.417) at rest. Median joint laxity demonstrated a Pearson correlation of r = 0.161 and absolute intraclass correlation coefficient [ICC] = 0.252.

Conclusions

This study demonstrates a dynamic US assessment for PLRI, which aimed to assess the usefulness and feasibility of a laxity measurement after the application of a posterolateral drawer stress maneuver in a healthy population. Although establishing concordance between readers in measuring an LUHG under stress, the utility of a laxity measurement alone is not clear as correlation of measurements is not excellent; hence, an upper limit of normal for the ulnohumeral gap under stress may be more useful. Further evaluation of this technique is required in patients with PLRI.

Practical Approach to Radiopaque Jaw Lesions

Radiopaque lesions of the jaw are myriad in type and occasionally protean in appearance. In turn, the radiologic analysis of these lesions requires a systematic approach and a broad consideration of clinical and imaging characteristics to enable reliable radiologic diagnosis. Initially categorizing lesions by attenuation pattern provides a practical framework for organizing radiopaque jaw lesions that also reflects important tissue characteristics. Specifically, the appearance of radiopaque lesions can be described as (a) densely sclerotic, (b) ground glass, or (c) mixed lytic-sclerotic, with each category representing a distinct although occasionally overlapping differential diagnosis. After characterizing attenuation pattern, the appreciation of other radiologic features, such as margin characteristics or relationship to teeth, as well as clinical features including demographics and symptoms, can aid in further narrowing the differential diagnosis and lend confidence to clinical decision making. The authors review the potential causes of a radiopaque jaw lesion, including pertinent clinical and radiologic features, and outline a simplified approach to its radiologic diagnosis, with a focus on cross-sectional CT. An invited commentary by Buch is available online. ^©RSNA, 2021.

Cerebrovascular Resistance in Healthy Aging and Mild Cognitive Impairment

Measures of cerebrovascular reactivity (CVR) are used to judge the health of the brain vasculature. In this study, we report the use of several different analyses of blood oxygen dependent (BOLD) fMRI responses to CO₂ to provide a number of metrics of CVR based on the sigmoidal resistance response to CO₂. To assess possible differences in these metrics with age, we compiled atlases reflecting voxel-wise means and standard deviations for four different age ranges and for a group of patients with mild cognitive impairment (MCI) and compared them. Sixty-seven subjects were recruited for this study and scanned at 3T field strength. Of those, 51 healthy control volunteers between the ages of 18–83 were recruited, and 16 (MCI) subjects between the ages of 61–83 were recruited. Testing was carried out using an automated computer-controlled gas blender to induce hypercapnia in a step and ramp paradigm while monitoring end-tidal partial pressures of CO₂. Surprisingly, some resistance sigmoid parameters in the oldest control group were increased compared to the youngest control group. Resistance amplitude maps showed increases in clusters within the temporal cortex, thalamus, corpus callosum and brainstem, and resistance reserve maps showed increases in clusters within the cingulate cortex, frontal gyrus, and corpus callosum. These findings suggest that some aspects of vascular reactivity in parts of the brain are initially maintained with age but then may increase in later years. We found significant reductions in all resistance sigmoid parameters (amplitude, reserve, sensitivity, midpoint, and range) when comparing MCI patients to controls. Additionally, in controls and in MCI patients, amplitude, range, reserve, and sensitivity in white matter (WM) was significantly reduced compared to gray matter (GM). WM midpoints were significantly above those of GM. Our general conclusion is that vascular regulation in terms of cerebral blood flow (CBF) responsiveness to CO₂ is not significantly affected by age, but is reduced in MCI. These changes in cerebrovascular regulation demonstrate the value of resistance metrics for mapping areas of dysregulated blood flow in individuals with MCI. They may also be of value in the investigation of patients with vascular risk factors at risk for developing vascular dementia.

Impaired dynamic cerebrovascular response to hypercapnia predicts development of white matter hyperintensities

Purpose

To evaluate the relationship between both dynamic and steady-state measures of cerebrovascular reactivity (CVR) and the progression of age-related white matter disease.

Methods

Blood oxygen level-dependent (BOLD) MRI CVR scans were acquired from forty-five subjects (age range: 50–90 years, 25 males) with moderate to severe white matter disease, at baseline and one-year follow-up. To calculate the dynamic (τ) and steady-state (ssCVR) components of the BOLD signal response, the P_ETCO₂ signal waveform was convolved with an exponential decay function. The τ corresponding to the best fit between the convolved P_ETCO₂ and BOLD signal defined the speed of response, and the slope of the regression between the convolved P_ETCO₂ and BOLD signal defined ssCVR. ssCVR and τ were compared between normal-appearing white matter (NAWM) that remains stable over time and NAWM that progresses to white matter hyperintensities (WMHs).

Results

In comparison to contralateral NAWM, NAWM that progressed to WMH had significantly lower ssCVR values by mean (SD) 46.5 (7.6)%, and higher τ values by 31.9 (9.6)% (both P < 0.01).

Conclusions

Vascular impairment in regions of NAWM that progresses to WMH consists not only of decreased magnitude of ssCVR, but also a pathological decrease in the speed of vascular response. These findings support the association between cerebrovascular dysregulation and the development of WMH.

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Vascular responses are slower in normal white matter that progresses to disease.

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Steady-state cerebrovascular reactivity is reduced in normal white matter that progresses to disease.

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Cerebrovascular dysregulation occurs before development of leukoaraiosis.

In vitro study of heat production during power reduction of equine mandibular teeth

OBJECTIVE

To measure the amount of heat generated during 3 methods of equine dental reduction with power instruments.

DESIGN

In vitro study.

SAMPLE POPULATION

30 premolar and molar teeth removed from mandibles of 8 equine heads collected at an abbatoir.

PROCEDURE

38-gauge copper-constantan thermocouples were inserted into the lingual side of each tooth 15 mm (proximal) and 25 mm (distal) from the occlusal surface, at a depth of 5 mm, which placed the tip close to the pulp chamber. Group-NC1 (n = 10) teeth were ground for 1 minute without coolant, group-NC2 (10) teeth were ground for 2 minutes without coolant, and group-C2 (10) teeth were ground for 2 minutes with water for coolant.

RESULTS

Mean temperature increase was 1.2 degrees C at the distal thermocouple and 6.6 degrees C at the proximal thermocouple for group-NC1 teeth, 4.1 degrees C at the distal thermocouple and 24.3 degrees C at the proximal thermocouple for group-NC2 teeth, and 0.8 degrees C at the distal thermocouple and -0.1 degrees C at the proximal thermocouple for group-C2 teeth.

CONCLUSIONS AND CLINICAL RELEVANCE

In general, an increase of 5 degrees C in human teeth is considered the maximum increase before there is permanent damage to tooth pulp. In group-NC2 teeth, temperature increased above this limit by several degrees, whereas in group-C2 teeth, there was little or no temperature increase. Our results suggest that major reduction of equine teeth by use of power instruments causes thermal changes that may cause irreversible pulp damage unless water cooling is used.

Microcystin-LR decreases hepatic and renal perfusion, and causes circulatory shock, severe hypoglycemia, and terminal hyperkalemia in intravascularly dosed swine

Cross-bred, anesthetized female swine were given intravascularly a lethal (72 microg/kg; n = 6) or toxic-sublethal (25 microg/kg; n = 6) dose of microcystin-LR (MCLR), from Microcystis aeruginosa, or the vehicle (n = 4). At the high dose, from 12 to 18 min after administration, central venous pressure and hepatic perfusion were significantly lower, and shortly thereafter, portal venous pressure was significantly higher and aortic mean pressure was significantly lower than controls. By 45 min postdosing, serum bile acids, lactate, potassium, and total bilirubin, as well as blood pO2, were significantly higher, while hematocrit, platelet count, and blood bicarbonate, pCO2, and base excess were significantly lower than controls. By 90 min, serum arginase, urea nitrogen, inorganic phosphorus, and creatinine were significantly higher, while glucose and blood pH were significantly lower than in controls. By 150 min, serum alanine and aspartate aminotransferases, alkaline phosphatase, lactate dehydrogenase, and creatinine phosphokinase activities were significantly higher than controls. At the low dose, significant differences from controls occurred in hemodynamic, organ perfusion, and serum chemistry parameters, but such changes generally took longer to occur and were of a lesser magnitude than at the high dose. Livers of the high-dose swine were swollen and dark red-purple, and exuded excessive blood on the cut surface. Based on increases in liver weight and liver hemoglobin, 38% of the total blood volume was lost into the liver. Terminally, all high-dose swine experienced hyperkalemia, and most had severe hypoglycemia. Death due to acute MCLR toxicosis in intravascularly dosed swine appears to result from severe intrahepatic hemorrhage, partial obstruction of blood flow through the liver, circulatory shock, severe hypoglycemia, and/or terminal hyperkalemia.

Differential and non-uniform tissue and brain distribution of two distinct 14C-hexachlorobiphenyls in weanling rats

Excretion and tissue retention of a coplanar and a non-coplanar hexachlorobiphenyl (HxCB) were determined 48 h after a single intraperitoneal (ip) dose of 8 mg/kg radiolabeled [14C]-HxCBs to weanling male and female Long-Evans rats. The objective was to understand the involvement of initial target organs of chlorobiphenyl (CB) accumulation following acute exposure in immature animals. During the short interval, both HxCBs remained sequestered predominantly in mesenteric fat (compared to subcutaneous fat) and less than 1% of the doses were excreted. Excretion was 4- to 8-fold lower than adult rats. Coplanar CB 169 (3,3',4,4',5,5'-HxCB) did not accumulate appreciably in the brain, but was retained at 3-fold higher levels in the liver than was non-coplanar CB 153 (2,2',4,4',5,5'-HxCB). Accumulation of 14C-CB 153 in brains was 4- to 9-fold higher than that of 14C-CB 169 and was adequate to detect non-uniform distribution in serial cryostat sections by phosphor imaging autoradiography. The autoradiographs showed a higher CB 153-derived radioactivity associated with fiber tracts throughout the brain. Specifically, the corpus callosum, internal and external capsules, medial lemniscus, tegmentum of the mesencephalon and metencephalon, and cerebellar peduncles showed significantly higher 14C-CB 153 than the other structures. The 14C-CB 153 was not found in the ventricular system and vascular spaces. These results suggest for the first time that an ortho-substituted PCB congener accumulated preferentially in brain in a structure-specific manner when compared to a non-ortho-substituted PCB congener.

Morphometry of the canine prostate vasculature

Morphometric data of the tissue vasculature are fundamental to the development of models for blood perfused tissue mass and heat transfer. Vascular casts of six canine prostates were made and morphometry was performed on 14 transverse sections. The region sampled was restricted to the midsection within the parenchyma. General vascular features that were observed include the radially arranged arteries and veins within the parenchyma, the axially oriented periurethral venous plexae, and the parenchymal arteries ramifying less than the veins. The arterial and venous lumen diameters (mean +/- SD) are 84 +/- 31 (N = 42) and 125 +/- 51 (N = 117), respectively. The lengths for a single vessel generation are 2147 +/- 1196 microm (N = 14) and 1265 +/- 693 microm (N = 39) for the arteries and veins, respectively. Intervessel distances are 4056 +/- 2350 microm (N = 33) between arteries, 1526 +/- 982 microm (N = 330) between veins, and 1498 +/- 874 microm (N = 108) between arteries and veins. A simple vasculature model of evenly distributed vessels imbedded in tissue for heat transfer analysis was developed. The artery-artery distance being about three times that of the vein-vein distance suggested a rete-like configuration of arteries surrounded by veins. An effective distance of 1519 microm between vessels was used. Based upon this vasculature model, the vessel density was calculated to be 5.6 arteries/cm(2) and 44.5 veins/cm(2).

Blood perfusion measurements in the canine prostate during transurethral hyperthermia

Using a thermal pulse decay technique, blood perfusion rates were measured within different regions in the canine prostate under normal and hyperthermic conditions induced either by the microwave or the radio frequency heating. Results indicate that, under the normal condition, the periurethral region is most highly perfused with an average rate of 0.60 +/- 0.25 ml/min/gm (n = 4) while the perfusion rate is 0.34 +/- 0.22 ml/min/gm (n = 10) in parenchyma. An approximately 3.5 fold increase in perfusion from the respective baselines was observed in both regions when the local tissue temperature was raised to 41.5 degrees C by the microwave heating. Another 0.5 fold increase was found in parenchyma after the tissue was further heated to 43.1 degrees C at which oscillatory behaviors in tissue temperature have been observed. To further study the cause of these oscillatory behaviors, the instantaneous blood perfusion response to changes in local tissue temperature was investigated using the radio frequency heating. It has been revealed that blood flow acts as a feedback of local tissue temperature in a closed control system. The thermally stimulated blood perfusion increase appeared to be a function of tissue temperature and its temporal gradient. Results from this study have shown experimental evidences of local thermoregulation in the prostate during hyperthermia.

Comparison of push-pull versus discard method from central venous catheters for blood testing

This article evaluates recent research results comparing two different methods for obtaining complete blood cell counts and chemistry profiles from central venous catheters. Complete blood cell count and chemistry profile samples were obtained from 25 patients at three hospital-based infusion clinics. The results indicate no appreciable difference between these two methods. Minimizing risks of blood loss, blood exposure to healthcare personnel, potential specimen contamination, and erroneous reporting are benefits of the push-pull method.

Risks associated with 72- and 96-hour peripheral intravenous catheter dwell times

BACKGROUND

The risk of complications in peripheral intravenous therapy is higher on the second day of therapy and may continue to increase with time, making routine restarts after 3 days a common practice. The objective of the study was to determine whether the risks of complications after a peripheral i.v. catheter restart after 72 hours are less than the risks of complications if the therapy is continued to 96 hours.

METHODS

A retrospective chart review was completed for 722 patients in a community hospital with peripheral i.v. catheters for i.v. fluids or saline locks. Measurements collected were i.v. therapy start date, number of restarts, termination date, and reason for termination; the data were analyzed using risk models.

RESULTS

There were 596 uncomplicated therapies. Complications prompted termination in 188 cases. The average duration of therapy was 1.8 days. The probability of complications was least in the first 24 hours, (0.074; standard deviation [SD], 0.013), and increased to 0.176 (SD, +/- 0.026) in the 24- to 48-hour period. The probability of a complication in the 48- to 72-hour period and the 72- to 96-hour period was 0.130 (SD, 0.026). A restarted catheter has a significantly higher risk of complication in its first 24 hours than does an initial catheter.

CONCLUSIONS

From these results, the authors conclude that restarting catheters at 72 hours does not reduce the risk of complication in the next 24 hours when compared with simply continuing the therapy with the original catheter. Additional studies should be conducted to justify a policy of automatically restarting therapy after 72 hours.

Thermoregulation in the canine prostate during transurethral microwave hyperthermia, Part II: Blood flow response

Recent studies on transurethral-applied local hyperthermia in both the canine and human prostate have revealed significant effects of natural thermoregulation on the therapeutical results in the prostate. Using a thermal clearance method, blood perfusion rates were measured within different regions in the canine prostate under normal and hyperthermic conditions. It has been found that the canine-prostatic blood perfusion is strongly linked to the geometrical location within the gland, the local tissue temperature, and the imposed thermal dosage. Results from this research are expected to provide a better understanding of the thermoregulatory behaviour in the canine prostate, and thus lay an important foundation for predicting tissue temperature in the human prostate during transurethral microwave hyperthermia.

Thermoregulation in the canine prostate during transurethral microwave hyperthermia, Part I: Temperature response

In this research, experiments were performed to study thermoregulation in the canine prostate during microwave hyperthermia. The transurethral thermal therapy (T3) system provided by Urologix, Inc. was used to impose microwave heating in the canine prostate. Five types of temperature responses to different microwave power levels as time varies, including both damped and sustained oscillatory temperature responses, have been observed. Decreases in prostatic tissue temperature during the microwave heating are believed to be caused by the increase in local blood flow stimulated by tissue temperature elevations. In this study, the characteristic temperatures and time associated with each response. This work will help to provide a better understanding of how tissue temperature is regulated within the canine prostate during transurethral microwave hyperthermia. Results of the present study offer an experimental foundation for a more detailed theoretical analysis on the temperature distribution based on the power input and local blood perfusion.

Microvascular architecture within the pig kidney cortex

Corrosion casts of the plastic (Mercox Cl-2B) filled pig kidney cortex vasculature were sliced either parallel or perpendicular to the kidney surface. Scanning electron microscopy photographs were taken of the casts. Montages of the photographs were analyzed using a digitizing tablet and microcomputer-based software. For vessels having diameters larger than 0.05 mm, their sizes, numbers per unit area, and branching patterns were studied with respect to the kidney cortex depth. Vascular branching diameters and angles within the cortex compare favorably with those reported for other major vascular systems. The microvascular dimensions and densities were used to predict the average blood flow velocity within the kidney cortex. It is expected that the results will facilitate a better insight into the contribution of flowing blood to the heat transfer process in perfused tissues.

Recent developments in modeling heat transfer in blood perfused tissues

Successful hyperthermia treatment of tumors requires understanding the attendant thermal processes in both diseased and healthy tissue. Accordingly, it is essential for developers and users of hyperthermia equipment to predict, measure and interpret correctly the tissue thermal and vascular response to heating. Modeling of heat transfer in living tissues is a means towards this end. Due to the complex morphology of living tissues, such modeling is a difficult task and some simplifying assumptions are needed. Some investigators have recently argued that Pennes' interpretation of the vascular contribution to heat transfer in perfused tissues fails to account for the actual thermal equilibration process between the flowing blood and the surrounding tissue and proposed new models, presumably based on a more realistic anatomy of the perfused tissue. The present review compares and contrasts several of the new bio-heat transfer models, emphasizing the problematics of their experimental validation, in the absence of measuring equipment capable of reliable evaluation of tissue properties and their variations that occur in the spatial scale of blood vessels with diameters less than about .2 mm. For the most part, the new models still lack sound experimental grounding, and in view of their inherent complexity, the best practical approach for modeling bio-heat transfer during hyperthermia may still be the Pennes model, providing its use is based on some insights gained from the studies described here. In such cases, these models should yield a more realistic description of tissue locations and/or thermal conditions for which the Pennes' model might not apply.

Theoretical analysis of the large blood vessel influence on the local tissue temperature decay after pulse heating

The influence of a large blood vessel (larger than 500 microns in diameter) on the local tissue temperature decay following a point source heating pulse was determined numerically using a sink/source method. It was assumed that the vessel was large enough so that the temperature of blood flowing within it remained essentially constant and was unaffected by any local tissue temperature transients. After the insertion of a point source heating pulse, the vessel influence on the local tissue transient temperature field was estimated by representing the vessel as a set of negative fictitious instantaneous heat sources with strength just sufficient to maintain the vessel at a constant temperature. In the surrounding tissue, the Pennes' tissue heat transfer equation was used to describe the temperature field. Computations have been performed for a range of vessel sizes, probe-vessel spacings and local blood perfusion rates. It was found that the influence of a large vessel on the local tissue temperature decay is more sensitive to its size and location rather than to the local blood perfusion rate. For a heating pulse of 3s duration and 5mW of power, there is a critical probe-vessel center distance 7R (R, vessel radius) beyond which the larger vessel influence on tissue temperature at the probe can be neglected.

Insonation of fixed porcine kidney by a prototype sector-vortex-phased array applicator

The sector-vortex applicator, an ultrasound phased array with a geometric focus having multiple sectors and tracks, can directly synthesize, without scanning, diffuse focal patterns useful for hyperthermia. A perfused tissue phantom, consisting of an alcohol-fixed porcine kidney with thermocouples placed in the cortex, is insonated by a prototype sector-vortex applicator with 16 sectors and two tracks at an ultrasound frequency of 750 kHz. Steady-state temperature distributions are measured for a wide range of perfusion rates. Results demonstrate that the radius of the heated region can be controlled effectively by choosing the focal mode of the applicator as it is predicted by theoretical analysis.

Vascular anatomy of the pig kidney glomerulus: a qualitative study of corrosion casts

Pig kidney glomerular vascular anatomy was studied by scanning electron microscopy of vascular corrosion casts. A generalized vascular architecture is presented to describe the pig kidney glomerulus based upon the observation of 3,800 vascular cast glomeruli. The relative simplicity of the pig glomerular vascular architecture has allowed the characterization of different vascular segments more completely than has been possible in other mammals. Based upon relationships to the afferent arteriole, a nomenclature and definition of primary, secondary, tertiary and anastomotic vessels is proposed for the distributing vessels comprising the glomerular tuft. The existence and formation of a large central hemispheric vessel deep within the confines of a glomerular hemisphere is micrographically documented. Micrographic evidence is presented supporting the formation of the single efferent arteriole by the merging of two central hemispheric vessels within the confines of the glomerular tuft. Failure of the merging of these two vessels may result in multiple efferent arterioles.

Use of a thermal pulse decay system to assess avian renal blood flow during reduced renal arterial perfusion pressure

Using a simplified avian kidney model, renal arterial perfusion pressure (RAPP) was reduced from 120 (control) to 70 mmHg (near the glomerular filtration rate autoregulatory limit) and then to 46 mmHg (below the glomerular filtration rate autoregulatory range) in kidneys with ambient or partially restricted renal portal flow. Renal blood flow (RBF) was measured with a thermal pulse decay (TPD) system, using TPD thermistor probes inserted at three locations to evaluate regional differences in RBF. The clearance (CPAH) and extraction of p-aminohippuric acid were used to calculate renal plasma flow (RPF). CPAH, RPF, and RBF values were consistently lower for kidneys with restricted portal flow than for kidneys with ambient portal flow. Reducing RAPP to 46 mmHg did not significantly reduce CPAH, RPF, or RBF in the ambient group but did significantly reduce CPAH and RPF (regressed on RAPP) in the restricted group. RBF was not significantly affected when RAPP was reduced in the restricted group, although significant regional differences in blood flow were recorded. Renal vascular resistance decreased significantly as RAPP was reduced to 46 mmHg in the ambient group, confirming the renal autoregulatory response. In separate validation studies, significant reductions in RBF were detected by the TPD system during acute obstructions of portal and/or arterial flow. Overall, the results support previous evidence that avian RBF remains constant over a wide range of RAPPs. Observations of nonuniform intrarenal distributions of portal blood flow suggest that the portal system maintains the constancy of RBF in regions with proportionately high portal-to-arterial flow ratios.

Indomethacin attenuation of hepatic perfusion and plasma 6-ketoPGF1 alpha elevations following glutathione depletion in rabbits

Glutathione (GSH) is important in detoxification and regulating cyclooxygenase activity. Since the liver has high levels of GSH, xenobiotic-induced changes in hepatic GSH could affect hepatic tissue blood perfusion (HP) via alterations in prostaglandin synthesis. In anesthetized male New Zealand rabbits, elevating GSH with GSH monoethyl ester had no affect on HP. Treatment of rabbits with diethyl maleate to deplete GSH also had no affect on HP in animals previously given GSH monoethyl ester. However, HP increased within 20 min in rabbits treated with diethyl maleate prior to GSH monoethyl ester. In another experiment, a similar rise in HP following GSH depletion was accompanied by arterial plasma 6-ketoPGF1 alpha (the stable metabolite of prostacyclin) levels that were 4-times higher than in the controls. Plasma TxB2 (the stable metabolite of thromboxane) also increased following diethyl maleate, but only to levels that were 25-times lower than for 6-ketoPGF1 alpha. Since indomethacin blocked the rise in HP, as well as the increases in 6-ketoPGF1 alpha and TxB2, these results indicate changes in HP may occur following GSH depletion as a result of increased synthesis of one or more arachidonic acid metabolites and implicate prostacyclin as a possible mediator of this phenomenon.

A perfused tissue phantom, for ultrasound hyperthermia

A perfused tissue phantom, developed as a tool for analyzing the performance of ultrasound hyperthermia applicators, was investigated. The phantom, consisting of a fixed porcine kidney with thermocouples placed throughout the tissue, was perfused with degassed water by a variable flow rate pump. The phantom was insonated by an unfocused multielement ultrasound applicator and the temperatures in the phantom were recorded. The results indicate that for testing protocols where tissue phantoms are needed, the fixed kidney preparation offers an opportunity to use a more realistic phantom than has previously been available to assess the heating performance of ultrasound hyperthermia applicators.

A technique for measuring the thermal conductivity and evaluating the "apparent conductivity" concept in biomaterials

A simple technique for measuring thermal conductivity of biomaterials is described. The method is based on depositing a pulse of heat into the material of choice, and fitting the subsequent local temperature decay to that predicted by a theoretical model. This transient method is most suitable in situations where frequent measurements of the thermal conductivity are desired. The method was evaluated by calculating the thermal conductivity of several inert materials. The measured conductivities compared well with published values. The developed technique was also used to examine the applicability of the "apparent conductivity" index to combine both conductive and blood-convective thermal effects in living, blood perfused tissues. Using both simulated and experimental results, it was shown that the changes in the apparent conductivity are highly correlated with changes in blood flow. However, quantitative application of this index must be restricted to conditions that are similar to those which existed at the time the apparent conductivity was measured.

Relationships between renal hemodynamics and plasma levels of arginine vasotocin and mesotocin during hemorrhage in the domestic fowl (Gallus domesticus)

1. Renal tissue blood flow (renal perfusion) and plasma levels of arginine vasotocin (AVT) and mesotocin (MT) were measured in anesthetized chickens before and during hemorrhage. 2. Renal perfusion did not decrease (P less than 0.05) until nearly 50% of the blood volume had been removed. The decrease in renal perfusion was not related to arterial blood pressure but was concomitant with an increase (P less than 0.05) in plasma AVT levels. 3. Renal perfusion during hemorrhage was positively correlated with plasma MT levels by the regression equation: renal perfusion = 0.091 (MT)-1.1459 which was highly significant (P less than 0.001, r2 = 0.95). 4. The results of this study suggest that MT as well as AVT may participate in regulating blood flow in the avian kidney.

Effect of hemorrhage on hepatic tissue blood flow in the domestic fowl (Gallus domesticus)

1. Thermal Pulse Decay (TPD) methodology was used to monitor hepatic tissue blood flow (hepatic perfusion) in anesthetized birds prior to and during hemorrhagic hypotension. 2. Hemorrhage was accomplished by periodic removal of blood through a carotid cannula. Reducing the estimated blood volume (BV) from 100 to less than 50% decreased hepatic perfusion from 4.36 +/- 0.7 to 1.88 +/- 0.7 ml/min/g. 3. Changes in hepatic perfusion during the experiment were related to mean arterial blood pressure (MABP) by the following linear regression equation: hepatic perfusion = -1.79 +/- 0.0807x (r2 = 0.57).

Theory on thermal probe arrays for the distinction between the convective and the perfusive modalities of heat transfer in living tissues

Recent suggestions for an improved model of heat transfer in living tissues emphasize the existence of a convective mode due to flowing blood in addition to, or even instead of, the perfusive mode, as proposed in Pennes' "classic" bioheat equation. In view of these suggestions, it might be beneficial to develop a technique that will enable one to distinguish between these two modes of bioheat transfer. To this end, a concept that utilizes a multiprobe array of thermistors in conjunction with a revised bioheat transfer equation has been derived to distinguish between, and to quantify the perfusive and convective contribution of blood to heat transfer in living tissues. The array consists of two or more temperature sensors one of which also serves to locally insert a short pulse of heat into the tissue prior to the temperature measurements. A theoretical analysis shows that such a concept is feasible. The construction of the system involves the selection of several important design parameters, i.e., the distance between the probes, the heating power, and the pulse duration. The choice of these parameters is based on computer simulations of the actual experiment.

Computer-based system for continuous on-line measurements of tissue blood perfusion

We describe a new system for an almost continuous, on-line measurement of local blood perfusion in living tissue. The technique uses a thermal method based on measurements of the tissue temperature decay after a short pulse (approximately equal to 3 s) of local heating. The instrumentation system consists of six small thermistor microprobes, a probe interface unit and a DEC LSI-11/23 microcomputer. The system is equipped with six thermistor channels, and the number can be increased with further signal conditioning modules, thereby increasing the locations at which blood perfusion can be measured. The results agree favourably with values for tissue blood flow obtained simultaneously using either the microspheres method or an electromagnetic probe. The system has been in use for three years and there is good reason to believe that it can be reliably applied in many situations where a continuous multichannel monitor of local blood perfusion is necessary.

Adaptive thermal modeling: a concept for measurement of local blood perfusion in heated tissues

A new Adaptive Thermal Modeling (ATM) method for the measurement of local tissue blood perfusion rate is introduced. The method is based on a two-phase numerical technique. The first phase includes a fast, finite difference scheme for solution of the transient temperature field. The second phase involves iterative corrections of the perfusion until the modeled temperatures coincide with those measured by the temperature sensors. The results obtained from computer generated "data", as well as from laboratory experiments demonstrate the potential capability of the ATM method to continuously measure local perfusion rates in heated tissues. Rigorous analysis of the technique is planned for the near future so that it can be applied to in vivo measurements of local tissue blood perfusions.

Thermal pulse decay method for simultaneous measurement of local thermal conductivity and blood perfusion: a theoretical analysis

Presented here is a theoretical analysis of the recently developed thermal pulse decay (TPD) method for a simultaneous measurement of local tissue conductivity and blood perfusion rate. The paper describes the theoretical model upon which the TPD method is based and details its capabilities and limitations. The theoretical aspects that affected the development of the measurement protocol are also discussed. The performance of the method is demonstrated with an experimental example which compares the measurements of local kidney blood perfusion rates made using the TPD method with the total renal blood flow obtained coincidentally using a blood flowmeter, in an anesthetized dog.

A sensitivity analysis of the Thermal Pulse Decay method for measurement of local tissue conductivity and blood perfusion

The Thermal Pulse Decay (TPD) method for the determination of local tissue thermal conductivity and blood perfusion rate is based on a comparison of measured with theoretically calculated temperatures. A sensitivity analysis of the theoretical model is performed. This analysis supports the establishment of an experimental protocol which reduces the measurement errors: An "optimal" measurement time interval for typical perfusion rates (up to 6 mL/mL/min) was found to be between 3 and 11 s after the heat pulse is turned off. Within this interval, the maximum error in determination of tissue conductivity and blood perfusion caused by experimental measurement errors is expected not to exceed 5 percent. The presently chosen pulse duration of 3 s is in agreement with the analysis as a good compromise between accuracy and excessive tissue heating.

Proposed methods for the measurement of regional renal blood flow using heat transfer analysis

The kidney, with its heterogeneous regional perfusion in the two anatomically and functionally distinct vascular beds of the renal cortex and medulla, and with its non-uniform blood vessel geometries, presents a unique challenge for measuring intrarenal blood flow distribution. Determining whole organ perfusion, on the other hand, is comparatively simple for the kidney, but it provides relatively little information about the suspected dependency of renal excretory function on local perfusion rate. Among the variety of methods proposed for gauging regional renal blood flow, some depend on measuring one or more of the tissue's thermal properties. The most straightforward, but least reliable, involve measurements either of focal tissue temperature alone, or of regional tissue thermal gradients. Simply using heat as a diffusible indicator, however, is unreliable as a measure of blood flow, for many of the same reasons that using an inert gas in a dilution technique is unreliable. Recently developed thermal analytical methods, though, hold promise for measuring local tissue blood flow with accuracy and precision. Two of them are reviewed here. One depends on measurement of the effective thermal conductivity of a small mass of tissue by evaluating the steady state ratio between regional unidirectional heat flux across it and the associated temperature gradient in one vector along a segment of it through an imposed spheroidal heat field. The other depends on analyses of tissue temperature decay subsequent to a controlled pulse of heat delivered through a small inserted thermistor bead. Both techniques use bioheat transfer equations to deduce regional blood flow by differentiating between heat dissipation due to local thermal conductivity and that attributable to the effects of regional convection. Although both methods are unavoidably invasive, neither produces debilitating damage in the tissue volume in which perfusion is measured, nor increases local temperature or metabolism enough to affect blood flow itself. Both techniques quantify local blood flow in small volumes of tissue by detailed evaluation of the many properties of tissue and blood which affect heat transfer, and both allow for a virtually unlimited number of nearly continuous sequential measurements at short (nom. 1 min) time intervals.

Effects of simulated increases in body weight on the growth of limb bones in hypophysectomized rats

The purpose of this study was to subject groups of hypophysectomized male and female rats each to a simulated specific 10% increase in body weight, to a maximum of a doubling of body weight, in order to study the effects of quantified, increased, intermittent, compressive forces on limb bone growth. Chronic centrifugation was employed. 21-day-old Sprague-Dawley rats were used. After 60 days of centrifugation, the rats were sacrificed. The humerus, radius, ulna, femur and tibia were removed from each animal, cleared of all soft tissues, and the bone lengths measured on Helios calipers with an accuracy of 1/20 mm. The data were corrected for differences due to individual body weight by dividing bone lengths by the cube root of the body weight of the same animal. Tukey's studentized multiple-range test was performed to identify aggregations (sets) of force groups between which there are significant differences. The data suggest that the simulated increases in body weight, within the range used for this study, enhance bone growth in hypophysectomized female and male rats similarly - hypophysectomy being a condition known to inhibit bone growth.

Bone mineral content of limb bones of male weanling rats subjected to 30 and 60 days of simulated increases in body weight

The purpose of this study was to subject groups of male rats each to a specific 10% simulated increase in body weight, ranging from 1.1 to 2.0 g. Constant centrifugation was employed. After 30 and 60 days, rats were sacrificed and perfused with 10% BNF. The humerus, radius, ulna, femur, and tibia were removed, cleared of all soft tissues, weighed, decalcified with EDTA, and reweighed. Bone mineral content (BMC) was determined using the formula: [(Wu - Wd) divided by Wu] X 100. Tukey's multiple range test was used. The data suggest that male weanling rats subjected to simulated increases in body weight, within the range used in this study, undergo enhanced BMC, a bimodal curve describing the relationship between BMC and simulated increases in body weight.

Effects of simulated increases in body weight from birth on the growth of limb bones in rats

The purpose of this study was to subject groups of newborn male and female Sprague-Dawley rats each to a specific 10% simulated increase in body weight, to a maximum of a doubling of body weight, to study the effects of quantified, increased, intermittent, compressive forces on limb bone growth. Chronic centrifugation was employed. After 90 days of centrifugation the rats were sacrificed. The humerus, radius, ulna, femur, and tibia were removed from each animal, cleared of all soft tissues, measured and weighed. Tukey's Studentized multiple range test was performed to identify aggregations (sets) of force groups between which there are significant differences. The data suggest that newborn male and female rats subjected to simulated increases in body weight, within the range used for this study, undergo enhanced general body growth and limb bone growth.

The effects of simulated increases in body weight on the developing rat tibia: a histologic study

Groups of weanling and newborn Sprague-Dawley rats were each subjected to a specific 10% simulated increase in body weight to a maximum of a doubling of body weight, using constant centrifugation, to study the effects of quantified, increased, intermittent, compressive forces on the histomorphology of the proximal tibial epiphysial growth plate. The weanling rats were sacrificed after 30 and 60 days of centrifugation; the newborn rats were sacrificed after 90 days of centrifugation. The results demonstrated no prominent changes in histomorphology, when compared to the controls, in the weanling rats sacrificed at 30 days of centrifugation, or in newborn rats subjected to 90 days of centrifugation; however, a prominent thinning of the growth plates was observed in the weanling rats sacrificed at 60 days of centrifugation.

Ruminal bypass of drinking water in lactating cows

Drinking water that does not equilibrate with ruminal fluid, i.e., bypasses the rumen, was studied qualitatively and quantitatively in eight rumen-fistulated lactating Holstein cows. Decreased temperatures in the sulcus omasi and abomasum shortly after initiation of drinking indicated that water had bypassed the rumen. Recovery of a water-soluble marker, included in drinking water offered after water was withheld for 4.5 or 9 h following feeding, was used to estimate ruminal bypass. For respective treatments, 18 and 5% of drinking water was calculated to have bypassed the rumen. Ruminal bypass in lactating cows drinking relatively large amounts of water could affect comparisons of water intake with total ruminal fluid outflow as measured by dilution of a water-soluble marker. Drinking water should not be assumed to equilibrate with ruminal fluid.

The effects of simulated increases in body weight from birth on bone robusticity of limb bones of rats

Groups of newborn rats were each subjected to a specific 10% simulated increase in body weight, ranging from 1.1G to 2.0G, to study changes in bone robusticity. (In this paper, "G" is the acceleration due to gravity.) Constant centrifugation was used. At 90 days of age, the rats were killed and the humerus, radius, ulna, femur, and tibia were removed, weighed, and measured. Bone robusticity was calculated using the ponderal index: bone length/3 square root bone weight. Tukey's Multiple Range Test was used. The data suggest that, for both males and females, bone robusticity is increased with simulated increases in body weight.

The effects of simulated increases in body weight for 60 days on robusticity and mineral content of limb bones of hypophysectomized rats

The purpose of this investigation was to subject separate male and female groups of weanling hypophysectomized rats each to a specific 10% simulated increase in body weight using constant centrifugation, ranging from 1.1G to 2.0G, to study changes in bone robusticity and bone mineral content. (In this paper, "G" is the acceleration due to gravity.) After 60 days of centrifugation at 24 rpm, the rats were killed and the humerus, radius, ulna, femur, and tibia were removed, cleared of soft tissues, weighed, measured, decalcified with EDTA, and reweighed. Bone robusticity was determined using the ponderal index: P.I. = bone length divided by 3 square root bone weight; and bone mineral content (BMC) was determined using the formula: BMC = [(Wu - Wd) divided by Wu] X 100. Tukey's Studentized Multiple Range T Test was used. The data suggest that, for both male and female hypophysectomized rats, bone robusticity is decreased with simulated increases in body weight; also, for males, a bimodal curve describing the relationship between BMC and simulated increases in body weight is suggested.

The effects of simulated increases in body weight for 30 and 60 days on bone robusticity of limb bones in rats

The purpose of this study was to subject groups of weanling male rats each to a specific 10% simulated increase in body weight, ranging from 1.1G-2.0G, using constant centrifugation. (In this paper, "G" is the acceleration due to gravity.) After 30 and 60 days, rats were killed and perfused with 10% buffered neutral formalin (B.N.F.). The humerus, radius, ulna, femur, and tibia were removed, cleared of all soft tissues, weighed, and the total length measured. Bone robusticity was calculated using the ponderal index: bone length/3 square root bone weight. Tukey's Multiple Range Test was used. The data suggest that the specific limb bone, G, and duration of centrifugation are each factors in the response of limb bones to simulated increases in body weight.

The effects of quantified amounts of increased intermittent compressive forces for 30 and 60 days on the growth of limb bones in the rat

The purpose of this study was to subject groups of rats each to a specific 10% increase in body weight, to a maximum of a doubling of body weight, to study the effects of quantified, increased, intermittent, compressive forces on limb bone growth. Chronic centrifugation was employed. 21-day-old male Sprague-Dawley rats were used. After 30 and 60 days of centrifugation, the rats were killed. The humerus, radius, ulna, femur, and tibia were removed from each animal, cleared of all soft tissues, measured and weighed. The data were corrected for differences due to individual body weight by dividing bone lengths by the cube root of the body weight of the same animal. Tukey's 'Studentized' Multiple Range Test was performed to identify aggregations (sets) of force groups between which there are significant differences. The data suggest that the value of g, together with the amount of time spent at centrifugation, are both significant factors in the effects of increased intermittent, compressive forces, produced by simulated increases in body weight, on limb bone growth.

Freud, evolution, and the tragedy of man

It is argued that Freud was not, as Sulloway (1979) contends, a "crypto-biologist" of the mind, but rather a cultural anthropologist of the mind. Freud's genetic conception of the psychic apparatus was neither exclusively nor critically derived from biology. Rather, it was based on an anthropogenetic approach to the archaic heritage of mind inspired in part by the moral philosophy of Nietzsche. The idea of tragedy was the unifying theme of Freud's cultural interpretation of evolutionary psychology. The historical search for the primal origins of neurosis led Freud to the unavoidable conclusion that neurosis was in the beginning a prehistoric moral dilemma which, over the course of mental evolution, eventually evolved into guilt, discontent, and neurosis as modern-day phylogenetically endowed facts of life. Freud (1930) made it clear that the source of man's biological and cultural evolutionary progress--self-denial--was also responsible for the tragedy of the human condition, namely, repression, eternal psychic ambivalence, and chronic mental illness. He believed that neurosis began, as Nietzsche (1887) exclaimed, with the "reduction of the beast of prey 'man' to a tame and civilized animal..." (p. 42). For both Freud and Nietzsche, the cause of the human tragedy was not merely the fall from Nature, but the inexorable knowledge that Man's denial of his biological heritage was the very basis for being human.

Pulse-decay method for measuring the thermal conductivity of living tissues

The present communication presents a single microprobe technique for measuring tissue thermal properties based on the dissipation of a measured amount of energy and the observation of the resulting temperature rise a given time later. An advantage of this method is that the effective sampling volume can be varied by varying the measurement time. Using a measurement time of a few seconds, the sampling volume was estimated to be several orders of magnitude greater than the probe volume. Hence artifacts due to probe-induced trauma or stress would be insignificant. Additional advantages of the technique are: the results were independent of the probe shape, size and properties, and hence represents absolute measurements without the need for calibration; the required electronics and computations are simple; the determination of thermal conductivity requires only a single measurement; and comparison of data at different measurement times yields a clear and unequivocal indication of nonconductive contributions of heat transfer, if present.

Thermal balance in ketamine-anesthetized rhesus monkey Macaca mulatta

A partitional calorimetry study compared thermoregulatory responses of unanesthetized adult rhesus monkeys (4 female, 1 male) to those anesthetized with ketamine HCl and exposed to ambient temperature (Ta) of 18, 29, 38 degrees C. Steady-state metabolic heat production (M), mean skin temperature (Tsk), rectal temperature (Tre), respiratory evaporative heat loss (Eres), and total evaporative heat loss (Etot) were measured at each Ta. Average Tre of anesthetized animals was reduced by approximately 1 degree C at Ta 18 degrees C, but thermal balance in anesthetized and control animals was maintained by reflexly decreased tissue conductance and shivering. For anesthetized animals, the average M increased 1.8 times over the lowest value of 40.13 W/m2 at Ta 29 degrees C, compared to a 1.5-fold increase for controls. Responses for both groups were not different at Ta 29 degrees C, both groups regulated body temperatures by vasodilation and increased sweating, but with ketamine sweating was reduced (35%). Effective tissue thermal conductance (K) was lowest at Ta 18 (10.8 W/m2 . degrees C) and increased to 39.4 W/m2 . degrees C at Ta 38 degrees C. No significant difference in K was found between ketamine and control groups at other Ta's.

Thermoregulation in Telazol (CI-744)-anesthetized rhesus monkey (Macaca mulatta)

Seven Telazol (CI-744)-[Telazol is an experimental drug (Parke, Davis) composed of two ingredients in equal amounts by weight: tiletamine HCl, designated chemically as 2-(ethylamino)-2-(2-thienyl)cyclohexanone-HCl, and zolazepam HCl, designated as 4-(o-fluorophenyl)-6,8-dihydro-1,3,8-trimethylpyrazolo-3,4-e 1,4 diazepin-7(IH)-one monohydrochloride] anesthetized rhesus monkeys (Macaca mulatta) were exposed to ambient temperatures (Ta) of 15, 23, 29, 35, and 38 degrees C to evaluate the effect of this dissociative anesthetic agent on thermoregulation. Thermal equilibrium in both anesthetized and control animals at Ta 15 degrees C was through peripheral vasoconstriction and metabolic heat production (M); shivering increased M in the anesthetized group to 1.7 times the resting M of 41.4 W x m-2. Both groups at Ta 38 degrees C regulated body temperature by vasodilation and increased skin evaporative heat loss (Esk) due to sweating. Anesthetized animals increased Esk from 6.4 W x m-2 at Ta 29 degrees C to 32.5 W x m-2 at Ta 38 degrees C. Panting was not observed in either group. Effective tissue thermal conductance was lowest at Ta 15 and 23 degrees C (6.9 and 7.6 W x m2 x degrees C-1, respectively), and increased with Ta's above 23 degrees C (45.0 W x m-2 at Ta 38 degrees C). These results indicate that Telazol-anesthetized monkeys maintain thermal balance at ambient temperatures from 15 to 38 degrees C, and that Telazol induces little or no impairment of thermoregulation in rhesus monkeys.

Sex determination of the lesser bushbaby (Galago senegalensis)

The gross anatomy of the external genitalia of newborn to adult lesser Galago was described. The penis is perpendicular to the body wall at birth and by about 8 wk of age the testes have descended into the scrotum. In the adult male the testes are permanently descended, the scrotum sessile, the penis is oriented obliquely rostral, and the genitalia are covered by luxuriant pelage. In the young female, the clitoris is also perpendicular to the body wall and the labia and vaginal orifice, although not obvious, are located at its caudal base. In the adult female, the clitoris remains perpendicular, is slender, essentially devoid of fur, and has the urethral opening in its tip. The labia and vaginal orifice are at its caudal base, obscured by fur. Effective and reliable methods for differentiating males from females were outlined.