Modified Leucotomy Assessed Clinically, Physiologically and Psychologically at Six Weeks and Eighteen Months

1972 ◽  
Vol 120 (554) ◽  
pp. 19-29 ◽  
Author(s):  
Desmond Kelly ◽  
C. J. S. Walter ◽  
Nita Mitchell-Heggs ◽  
William Sargant
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Clinical Outcome ◽  
Forearm Blood Flow ◽  
Surgical Techniques ◽  
Good Clinical Outcome ◽  
Diagnostic Categories ◽  
Operative Result ◽  
Manifest Anxiety ◽  
Previous Prospective Study

After more than thirty years the operation of leucotomy still remains a controversial treatment, and its value is questioned by many. This scepticism, and the advent of new surgical techniques, have emphasized the need for careful appraisal of the results of psychosurgery. In a previous prospective study 40 patients were assessed six weeks after modified leucotomy, and 75 per cent of these patients were found to be clinically improved (Kelly, Walter and Sargant, 1966). They were less neurotic on the M.P.I., had lower Taylor Manifest Anxiety scores and rated themselves as less anxious; a good clinical outcome was associated with diminution of physiological arousal as measured by forearm blood flow and heart rate. This group has now been followed-up and reassessed 18 months after operation, and a further group of 38 patients has been examined before, and again six weeks after, leucotomy. The data from the two groups have been combined to determine the immediate outcome for various diagnostic categories, and a multiple regression has been performed to elicit which of the pre-operative factors predict a favourable post-operative result.

Effects of caffeine on blood pressure, heart rate, and forearm blood flow during dynamic leg exercise

1998 ◽  
Vol 85 (1) ◽  
pp. 154-159 ◽  
Author(s):  
Jason W. Daniels ◽  
Paul A. Molé ◽  
James D. Shaffrath ◽  
Charles L. Stebbins
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Systolic Blood Pressure ◽  
Skin Temperature ◽  
Rectal Temperature ◽  
Forearm Blood Flow ◽  
Dynamic Exercise ◽  
Ang Ii ◽  
Leg Exercise

This study examined the acute effects of caffeine on the cardiovascular system during dynamic leg exercise. Ten trained, caffeine-naive cyclists (7 women and 3 men) were studied at rest and during bicycle ergometry before and after the ingestion of 6 mg/kg caffeine or 6 mg/kg fructose (placebo) with 250 ml of water. After consumption of caffeine or placebo, subjects either rested for 100 min (rest protocol) or rested for 45 min followed by 55 min of cycle ergometry at 65% of maximal oxygen consumption (exercise protocol). Measurement of mean arterial pressure (MAP), forearm blood flow (FBF), heart rate, skin temperature, and rectal temperature and calculation of forearm vascular conductance (FVC) were made at baseline and at 20-min intervals. Plasma ANG II was measured at baseline and at 60 min postingestion in the two exercise protocols. Before exercise, caffeine increased both systolic blood pressure (17%) and MAP (11%) without affecting FBF or FVC. During dynamic exercise, caffeine attenuated the increase in FBF (53%) and FVC (50%) and accentuated exercise-induced increases in ANG II (44%). Systolic blood pressure and MAP were also higher during exercise plus caffeine; however, these increases were secondary to the effects of caffeine on resting blood pressure. No significant differences were observed in heart rate, skin temperature, or rectal temperature. These findings indicate that caffeine can alter the cardiovascular response to dynamic exercise in a manner that may modify regional blood flow and conductance.

Age alters regional distribution of blood flow during moderate-intensity exercise

1995 ◽  
Vol 79 (4) ◽  
pp. 1112-1119 ◽  
Author(s):  
W. L. Kenney ◽  
C. W. Ho
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Renal Blood Flow ◽  
Skin Blood Flow ◽  
Forearm Blood Flow ◽  
Regional Distribution ◽  
Splanchnic Blood Flow ◽  
Moderate Intensity ◽  
Plasma Norepinephrine ◽  
Moderate Intensity Exercise

During dynamic exercise in warm environments, requisite increases in skin and active muscle blood flows are supported by increasing cardiac output (Qc) and redistributing flow away from splanchnic and renal circulations. To examine the effect of age on these responses, six young (Y; 26 +/- 2 yr) and six older (O; 64 +/- 2 yr) men performed upright cycle exercise at 35 and 60% of peak O2 consumption (VO2peak) in 22 and 36 degrees C environments. To further isolate age, the two age groups were closely matched for VO2peak, weight, surface area, and body composition. Measurements included heart rate, Qc (CO2 rebreathing), skin blood flow (from increases in forearm blood flow (venous occlusion plethysmography), splanchnic blood flow (indocyanine green dilution), renal blood flow (p-amino-hippurate clearance), and plasma norepinephrine concentration. There were no significant age differences in Qc; however, in both environments the O group maintained Qc at a higher stroke volume and lower heart rate. At 60% VO2peak, forearm blood flow was significantly lower in the O subjects in each environment. Splanchnic blood flow fell (by 12–14% in both groups) at the lower intensity, then decreased to a greater extent at 60% VO2peak in Y than in O subjects (e.g., -45 +/- 2 vs. -33 +/- 3% for the hot environment, P < 0.01). Renal blood flow was lower at rest in the O group, remained relatively constant at 35% VO2peak, then decreased by 20–25% in both groups at 60% VO2peak. At 60% VO2peak, 27 and 37% more total blood flow was redistributed away from these two circulations in the Y than in the O group at 22 and 36 degrees, respectively. It was concluded that the greater increase in skin blood flow in Y subjects is partially supported by a greater redistribution of blood flow away from splanchnic and renal vascular beds.

Effects of posture on peripheral vascular responses to lower body positive pressure

2007 ◽  
Vol 293 (1) ◽  
pp. H670-H676 ◽  
Author(s):  
Takeshi Nishiyasu ◽  
Shigeko Hayashida ◽  
Asami Kitano ◽  
Kei Nagashima ◽  
Masashi Ichinose
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Forearm Blood Flow ◽  
Positive Pressure ◽  
Upper Limbs ◽  
Lower Body ◽  
Peripheral Vascular ◽  
Vascular Responses ◽  
Lower Body Positive Pressure ◽  
Body Positive

We tested the hypothesis that peripheral vascular responses (in the lower and upper limbs) to application of lower body positive pressure (LBPP) are dependent on the posture of the subjects. We measured heart rate, stroke volume, mean arterial pressure, leg and forearm blood flow (using the Doppler ultrasound technique), and leg (LVC) and forearm (FVC) vascular conductance in 11 subjects (9 men, 2 women) without and with LBPP (25 and 50 mmHg) in supine and upright postures. Mean arterial pressure increased in proportion to increases in LBPP and was greater in supine than in upright subjects. Heart rate was unchanged when LBPP was applied to supine subjects but was reduced in upright ones. Leg blood flow and LVC were both reduced by LBPP in supine subjects [LVC: 4.8 (SD 4.0), 3.6 (SD 3.5), and 1.4 (SD 1.8) ml·min−1·mmHg−1 before LBPP and during 25 and 50 mmHg LBPP, respectively; P < 0.05] but were increased in upright ones [LVC: 2.0 (SD 1.2), 3.4 (SD 3.4), and 3.0 (SD 2.0) ml·min−1·mmHg−1, respectively; P < 0.05]. Forearm blood flow and FVC both declined when LBPP was applied to supine subjects [FVC: 1.3 (SD 0.6), 1.0 (SD 0.4), and 0.9 (SD 0.6) ml· min−1·mmHg−1, respectively; P < 0.05] but remained unchanged in upright ones [FVC: 0.7 (SD 0.4), 0.7 (SD 0.4), and 0.6 (SD 0.5) ml·min−1·mmHg−1, respectively]. Together, these findings indicate that the leg vascular response to application of LBPP is posture dependent and that the response differs in the lower and upper limbs when subjects assume an upright posture.

Interactions of Marijuana and Induced Stress: Forearm Blood Flow, Heart Rate, and Skin Conductance

1976 ◽  
Vol 13 (6) ◽  
pp. 517-522 ◽  
Author(s):  
Bruce D. Naliboff ◽  
William H. Rickles ◽  
Michael J. Cohen ◽  
Robert S. Naimark
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Skin Conductance ◽  
Forearm Blood Flow ◽  
Induced Stress

Cardiovascular and Sympatho-Adrenal Responses to Mental Stress in Primary Hypertension

1993 ◽  
Vol 85 (4) ◽  
pp. 401-409 ◽  
Author(s):  
Madeleine Lindqvist ◽  
Thomas Kahan ◽  
Anders Melcher ◽  
Paul Hjemdahl
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Cardiac Output ◽  
Neuropeptide Y ◽  
Mental Stress ◽  
Forearm Blood Flow ◽  
Primary Hypertension ◽  
Hypertensive Patients ◽  
Control Subjects ◽  
Venous Plasma

1. Eleven untreated men with mild to moderate primary hypertension and 10 normotensive control subjects were studied at rest and during a mental stress test (Stroop colour word conflict test), which has previously been used in studies of hypertensive patients with regard to non-invasive cardiovascular variables and venous plasma catecholamine concentrations. 2. Heart rate, central cardiovascular pressures, cardiac output (thermodilution) and forearm blood flow (strain gauge plethysmography) were determined. Systemic and forearm vascular resistances were calculated. Arterial and venous plasma adrenaline and noradrenaline concentrations were measured by h.p.l.c., and arterial noradrenaline spillover and noradrenaline overflow from the forearm were assessed by isotope methodology ([3H]noradrenaline). Neuropeptide Y-like immunoreactivity was measured by radioimmunoassay. 3. In hypertensive patients heart rate, arterial blood pressure, cardiac output and forearm blood flow increased by 28%, 13%, 37% and 115%, respectively, and forearm and systemic vascular resistances decreased by 48% and 21%, respectively (P <0.001 for all responses), during stress. These responses were not different from those of the control group. 4. Arterial noradrenaline spillover rose by 63% and noradrenaline overflow from the forearm rose by 150% in the hypertensive patients in response to mental stress (P <0.001); no significant group differences could be demonstrated. However, the forearm noradrenaline overflow response to stress tended to be greater in the hypertensive group (P = 0.11). Arterial adrenaline concentrations doubled in both groups (P <0.001). 5. Arterial neuropeptide Y-like immunoreactivity increased slightly and similarly in the two groups (+7% in hypertensive patients and +9% in control subjects, P <0.05 for both) in response to mental stress. No net overflow of neuropeptide-Y-like immunoreactivity could be detected over the forearm. 6. It is concluded that the cardiovascular and sympatho-adrenal responses to mental stress evaluated in this study are similar in hypertensive patients and control subjects. Stress-induced vasodilatation occurs in the forearm despite signs of increased local sympathetic activity, indicating that powerful neurohormonal vasodilator mechanisms are activated by mental stress.

scholarly journals Cardiovascular and Autonomic Responses after a Single Bout of Resistance Exercise in Men with Untreated Stage 2 Hypertension

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Marcus Vinicius Machado ◽  
Thais de Paola Chequer Barbosa ◽  
Thais Camasmine Chrispino ◽  
Fabricia Junqueira das Neves ◽  
Gabriel Dias Rodrigues ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Resistance Exercise ◽  
Vascular Reactivity ◽  
Forearm Blood Flow ◽  
Area Under The Curve ◽  
Venous Occlusion ◽  
Antihypertensive Medications ◽  
Single Bout

The aim of this paper is to assess the integrated responses of ambulatory blood pressure (BP), cardiac autonomic modulation, spontaneous baroreflex sensitivity (BRS), and vascular reactivity after a single bout of resistance exercise (RE) in men with stage 2 hypertension who have never been treated before. Ten hypertensive men were subjected to a RE session of three sets of 20 repetitions and an intensity of 40% of the 1-repetition maximum (RM) test in seven different exercises. For the control (CTR) session, the volunteers were positioned on the exercise machines but did not perform any exercise. Forearm blood flow was measured by venous occlusion plethysmography. We also analyzed the heart rate variability (HRV), ambulatory BP, blood pressure variability (BPV), and BRS. All measurements were performed at different timepoints: baseline, 20 min, 80 min, and 24 h after both RE and CTR sessions. There were no differences in ambulatory BP over the 24 h between the RE and CTR sessions. However, the area under the curve of diastolic BP decreased after the RE session. Heart rate (HR) and cardiac output increased for up to 80 and 20 min after RE, respectively. Similarly, forearm blood flow, conductance, and vascular reactivity increased 20 min after RE ( p < 0.05 ). In contrast, HRV and BRS decreased immediately after exercise and remained lower for 20 min after RE. We conclude that a single bout of RE induced an increase in vascular reactivity and reduced the pressure load by attenuating AUC of DBP in hypertensive individuals who had never been treated with antihypertensive medications.

Heart contractility at pressure loads induced by ischemia of exercised muscle in humans

1982 ◽  
Vol 52 (2) ◽  
pp. 340-345 ◽  
Author(s):  
F. Bonde-Petersen ◽  
Y. Suzuki
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Vascular Tone ◽  
Forearm Blood Flow ◽  
Systolic Time Intervals ◽  
Bicycle Exercise ◽  
Time Intervals ◽  
Control Situation ◽  
Systolic Time ◽  
Heart Contractility

During one- or two-leg bicycle exercise in three subjects the exercised limb(s) were made ischemic by occlusion cuffs inflated to 300 Torr immediately at, or 30 s before, end of 7-min exercise and kept inflated for 3 min of recovery. Mean arterial pressure (MAP) remained elevated during occluded recovery, whereas heart rate (HR) and forearm blood flow tended to recover at the same rate as in the control situation without occlusion. Systolic time intervals (STI) were negatively correlated to HR in the interval 60–120 beats/min. In spite of a variation in afterload of 30 Torr induced by occlusion the correlation between HR and STI fitted the same equations. The involvement of different size of muscle mass did not change these relationships. The elevation of MAP during ischemia of exercised muscles is due to an increased vascular tone reflexly induced from muscle chemoreceptors and not cardiac in origin. The results also demonstrate that heart contractility adapts well to the induced afterload.

Hypohydration affects forearm vascular conductance independent of heart rate during exercise

1992 ◽  
Vol 73 (4) ◽  
pp. 1232-1237 ◽  
Author(s):  
C. G. Tankersley ◽  
D. H. Zappe ◽  
T. G. Meister ◽  
W. L. Kenney
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Mean Arterial Pressure ◽  
Forearm Blood Flow ◽  
Body Core Temperature ◽  
Esophageal Temperature ◽  
Vascular Conductance ◽  
Cutaneous Vasodilation ◽  
Forearm Vascular Conductance ◽  
Body Core

Elevated body core temperature stimulates cutaneous vasodilation, which can be modified by nonthermal factors. To test whether hypohydration affects forearm vascular conductance discretely from relative alterations in heart rate (HR), eight trained cyclists exercised progressively for 20 min each at 60, 120, and 180 W [approximately 22, 37, and 55% of maximal cycling O2 consumption (VO2peak), respectively] in a warm humid environment (dry bulb temperature 30 degrees C; wet bulb temperature 24 degrees C). Esophageal temperature and forearm blood flow were measured every 30 s, and mean arterial pressure and HR were measured at rest and during each exercise intensity (minutes 15, 35, and 55). In the hypovolemic (HP) compared with the euvolemic (EU) state, blood volume was contracted by 24-h fluid restriction an average of 510 ml, and this difference was sustained throughout exercise. The esophageal temperature and HR responses were similar between EU and HP states at 60 and 120 W but were significantly (P < 0.05) higher in HP by the end of 180 W. In contrast, the forearm blood flow response was significantly (P < 0.05) depressed during exercise at 120 and 180 W in HP, whereas mean arterial pressure remained similar between conditions. When body core temperature is elevated in a hypohydrated state, forearm vascular conductance is reduced at exercise intensities of approximately 37% VO2peak, which is independent of relative changes in HR. These findings are consistent with the notion that during exercise an attenuated cutaneous vasodilation is elicited by alterations in regionalized sympathetic outflow, which is unaccompanied by activation of cardiac pacemaker cells.

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