Hisashi Yanagida

The Effects of Stellate Ganglion Block on the Idiopathic Prolongation of the Q-T Interval with Cardiac Arrhythmia (The Romano-Ward Syndrome)

The association of a prolonged Q-T interval, congenital deafness, and syncopal attacks due to ventricular fibrillation following emotional or physical stress is known as the Jervell-Lange-Nielsen syndrome. Absence of the congenital deafness characterizes the otherwise identical Romano-Ward syndrome. Both conditions have a high mortality rate and are recognized as contributing to sudden death in children. Although the pathogenetic factors are not yet completely elucidated, the condition is well enough understood to permit effective treatment. The authors performed a left stellate ganglion block in a 12-year-old girl with a mild form of the Romano-Ward syndrome, shortening the Q-T interval and eliminating the ventricular tachyarrhythmia. The left stellate ganglion block should be considered by anesthesiologists as an emergency measure, effective in interrupting the attack.

Respiratory Distress and Beta-Endorphin-Like Immunoreactivity in Humans

Beta-endorphin-like immunoreactivity was determined in the plasma of twenty patients suffering from hypoxia of various etiologies and in twenty healthy adult volunteers who served as controls. Mean beta-endorphin-like immunoreactivity in the hypoxic patients was 53.2 +/- 5.5 (SEM) pg/ml, as compared to the volunteer subjects in whom the mean level was 6.2 +/- 1.9 pg/ml (P less than 0.01). Significant negative correlations were present between both arterial pH (r = -0.85; P less than 0.01) and arterial PO2 (r = -0.80; P less than 0.01) and beta-endorphin-like immunoreactivity. These findings seem to lend support to the hypothesis that hypoxia and acidosis represent stressful conditions which may stimulate the release of beta-endorphin in humans.

Effects of Anesthetics on P onto-geniculo-occipital Waves from the Oculomotor Nucleus of the Cat

Effects of anesthetics and doxapram on pontogeniculo-occipital (PGO) waves from the oculomotor nucleus were studied in acute experiments in cats paralyzed by gallamine triethiodide. The anesthetic agents studied in the present experiment (thiopental, ketamine, Innovar, nitrous oxide, and halothane) decreased, while doxapram increased, the total number of PGO waves. As the doses of anesthetics increased, PGO waves were abolished, but they returned to control levels or below control levels when the concentrations of anesthetics were decreased. The results indicate that the anesthetics studied inhibit the activity of the central mechanism associated with the oculomotor system. PGO waves may prove a useful index of the level of anesthesia.

Nitrous oxide content in the operating suite.

Nitrous oxide (N2O) concentrations in the ambient atmosphere were measured by gas chromatography during surgical anesthesia. Levels in the recovery room were affected not only by the N2O content in the expiratory air of postanesthetic patients and personnel but also by N2O levels in the operating rooms. With the onset of N2O anesthesia in operating rooms, gases blow into all adjacent areas; while this level is relatively low, operating-suite personnel cannot escape some exposure to N2O.

The electroencephalogram and the site of action of pentazocine on the brain

SummaryThe electroencephalogram during anaesthesia with pentazocine and nitrous oxide-oxygen and the site of action of pentazocine in the brain were investigated. The activated pattern ofeeg was observed following administration of pentazocine intravenously during nitrous oxide-oxygen anaesthesia in clinical cases. In chronic animal experiments, the activated pattern ofeeg was also obtained by local application into the mesencephalic reticular formation, pontine reticular formation and ventropostero-lateral thalamic nucleus. The animals were responsive to pin-prick stimuli. Following the injection into the posterior hypothalamus, neocortical deactivation was obtained while a hippocampal seizure pattern was observed, and following the application into the centro-median thalamic nucleus, both the neocortical and hippocampal deactivated patterns were observed. In the case of local application into the posterior hypothalamus and centro-median thalamic nucleus, the animals became unresponsive to pin-prick stimuli.RésuméNous avons étudié les effets de lanesthésie avec la pentazocine, protoxyde dazote et oxygène sur le tracé électroencéphalographique ainsi que le site daction de la pentazocine dans le cerveau. Dans les cas cliniques, nous avons observé un type activé deeg à la suite de linjection par voie endoveineuse de pentazocine an cours de lanesthésie au protoxyde dazote et oxygène. Chez les animaux dexpérience, nous avons également obtenu un type activé deeeg en faisant une application locale dans la formation réticulée mésencéphalique, la formation réticulée pontine et le noyau thalamique ventropostéro-latéral. Les animaux répondaient aux stimulations par piqûres dépingle. Après injection dans lhypothalamus postérieur, nous avons obtenu une déactivation néocorticale et avons observé un type deeg de convulsion hippocampale et après lapplication dans le noyau thalamique centro-médian nous avons observé les deux types deeg: néocortical et hippocampal déactivé. Lors de lapplication locale dans lhypothalamus postérieur et le noyau thalamique centromédian, les animaux ont cessé de répondre aux stimulations par piqûre dépingle.

THE SITE OF ACTION OF INNOVAR IN THE BRAIN

SummaryDeep sedation and a laissez faire attitude occurs in cats when Innovar is placed into the posterior hypothalamus, the centro-median thalamic nucleus and the ventropostero-lateral thalamic nucleus through precise stereotaxically implanted recording cannulae. This sedation persists in the presence of pin-prick stimulation as observed by the persistence of neocortical deactivation and hippocampal activation or seizures.Following the application of Innovar into the mesencephalic reticular and pontine reticular formations, no persistent behavioural or electroencephalographic evidence of sedation was observed in the presence of pin-prick stimulation.RésuméIl se produit une sédation profonde et une attitude de “laisser faire” chez les chats lorsqu’on introduit de l’Innovar dans l’hypothalamus postérieur, dans le noyau thalamique centro-médian, et dans le noyau thalamique ventro-postéro-latéral, à l’aide de canules enregistreuses implantées avec précision par une technique stéréotaxique. Cette sédation persiste en présence d’une stimulation par piqure d’épingle comme on l’a observé par la persistance de déactivation néocorticale et d’activation ou attaque de l’hyppocampe.A la suite d’application d’Innovar dans les formations réticulaires mésencéphaliques et dans les formations réticulaires protubérentielles, on n’a observé aucune évidence de sédation persistante ni dans la conduite générale ni dans l’électroencéphalographie, même après stimulation par piqure d’épingle.

Hidden Factor of Cardiac Arrhythmia During Light Anesthesia

Effects of anesthetics on cardiac arrhythmias during parasleep were investigated in four cats. Parasleep was still observed under light anesthesia (80 % nitrous oxide, 0.5 % methoxyflurane and 0.5 % halothane), and cardiac arrhythmias occurred. When the concentration of anesthetics was increased (1.0 % methoxyflurane, 1.0 % halothane), parasleep was never observed. Cardiac arrhythmias did not occur during deep anesthesia. Judging from these results, parasleep must be regarded as one of the etiological factors in the development of cardiac arrhythmias during light anesthesia.

Electrophysiologic Evidence for Involvement of the Pituitary Region in Opiate Analgesia

In the past, various reports have discussed the relationship between the pituitary and analgesia. The purpose of the present study was to explore the possible role of the pituitary region in the mediation of pain by opioids. Tooth pulp evoked potentials recorded from primary somatosensory cortex and from the pituitary region of rabbits were recorded before and after an injection of opiates. Tooth pulp evoked potentials recorded from the primary somatosensory cortex were markedly inhibited after admission of fentanyl, while the tooth pulp evoked potentials recorded from the pituitary region were facilitated. It is concluded that the pituitary region plays a role in the mediation of pain and that this area is involved in the mechanism of opiate analgesia

Relationship of Oculomotor Nuclei to Midbrain Reticular Formation

INTRODUCTION tion which is closely related with consciousness*9 The movement of eyes plays an important role in the estimation of the various levels of the consciousness.4 During REM sleep, eye movements are accompanied by a specific pattern of electrical activity of various parts of the brain, which has been termed “ponto-geniculo-occipital activityPG0.”5 This was recorded from the pons at the level of the nucleus reticularis pontis caudalis,6 from the nucleus oculomotoriUS,^ and from the nucleus geniculatus lateralis.? This specific pattern consisted of periodic appearances of a few, essentially monophasic waves with a fairly uniform amplitude. The appearance of such activity in these regions suggests that these nuclei do not function simply as a relay of visual information. We may hypothesize, then, that the electrical activity of these regions represent the level of consciousness. The main purpose of the present study was to test this hypothesis. We attempted to establish a correlation between the activity of one of these regions, the oculomotor nucleus, and the EEG of the neocortex and hippocampus which accepted indicies of the level of consciousness. The activities of the oculomotor nucleus were also investigated with the correlation of midbrain reticular forma-

Polygraphic study of the effects of sodium 4-hydroxybutyrate and 4-butyrolactone in man

Abstract Polygraphic observations were made after intravenous or intracarotid administration of sodium 4-hydroxy utyrate and 4-butyrolactone in man. At first theta bursts, then large continuous delta waves appeared in the EEG with increased EMG, accelerated respiration and heart rate. Consciousness was maintained. This was followed by irregular slow waves with reduced EMG, slow and stable respiration and heart rate, and a loss in consciousness. In 7 cases among 19, changes resembling paradoxical sleep were observed during this phase. The whole course of events was changed suddenly at two or three hr after the onset of injection. No disorientation or noticeable side effects were observed. When blood concentration of butyrate was measured and correlated with the polygraphic recordings, the continuous large slow wave stage corresponded to the peak of the blood concentration level while the irregular slow wave stage corresponded to the declining phase of the blood level curve. The effects of these compounds in producing continuous large slow waves without a disturbance of consciousness was emphasized.