Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

CONTEXT: Management of patients with obstructed defecation syndrome is still controversial. OBJECTIVE: To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. METHODS: The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. RESULTS: Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associated with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. CONCLUSIONS: Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts.

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HEPATIC CIRRHOSIS

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.03.2360 ◽

2011 ◽

Vol 18 (03) ◽

pp. 426-429

Author(s):

SALMA TANWEER ◽

TARIQ PERVEZ ◽

IJAZ-UL-HAQUE TASEER ◽

Abdul Qadir Khan ◽

Muhammad Arshad

Keyword(s):

Platelet Count ◽

Esophageal Varices ◽

Oesophageal Varices ◽

Group Iii ◽

Group I ◽

Low Platelet Count ◽

Grade Ii ◽

Group Ii ◽

Splenic Size ◽

Grade Iii

Objective: To see the association of platelet count, splenomegaly and development of oesophageal varices. Study Design: Observational study. Duration of study: One year from January 2010 to December 2010. Setting: Gastroenterology Department, Medical Unit III, Nishtar Hospital Multan. Methodology: One hundred ten cirrhotic patients were included. The record of these patients was scrutinized and data collected was entered and analyzed through SPSS 11. The patients were divided into three groups according to platelet count. Group I with platelet count less than 50000/mm3, group II with platelet count of 50000 to 100000/mm3 and group III with platelet count of 100000 to 150000/mm3. Similarly patients were also divided into three groups according to splenic size. Group I with splenic size 11 – 13 cm, group II with splenic size 13–16 cm and group III splenic size more than 16 cm. In each group presence of esophageal varices along with grading was noted. Results: The age of the patients varied from 15 to 80 years and mean age was 48.55 ± 13.88 years. Sixty five (59.1 %) were male and 45 (40.9%) were female. The hemoglobin level of these patients varied from 6.0 to 14.3 gm/100 ml with mean level of 9.23 ± 2.11gm/100ml. The platelet count varied from 22000 to 385000/mm3. The splenic size varied from 9 to 18 cm with mean of 12.53 ± 2.14 cm. Esophageal varices were detected in 102 cases. Seventeen cases were of grade I varices, 25 cases were of grade II varices, 40 cases were in grade III varices and 4 cases were in grade IV varices. Maximum number of grade-III (22 patients) and grade IV (3patients) esophageal varices occurred in patients having platelet count less than 50000/mm3. As the splenic size increases the grade of esophageal varices also increases. Maximum number of esophageal varices occur in grade II (25) followed by grade-III (37) in patients with splenic size in the range of 13 to 16 cm. Conclusions: A low platelet count and large splenic size are good non-invasive predictors of esophageal varices. These parameters can also accurately assess the presence of large varices. So a patient of cirrhosis with low platelet count and large spleen has an increased diagnostic yield of esophageal varices on upper GI endoscopy.

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Clinical and Pathologic Comparison of Simple Left-to-Right Shunt Congenital Heart Disease and Transposition of the Great Arteries with Ventricular Septal Defect

The Heart Surgery Forum ◽

10.1532/hsf98.20111127 ◽

2012 ◽

Vol 15 (2) ◽

pp. 97 ◽

Cited By ~ 1

Author(s):

Jing-bin Huang ◽

Jian Liang ◽

Ming Du

Keyword(s):

Congenital Heart Disease ◽

Congenital Heart ◽

Septal Defect ◽

Group Iii ◽

Repair Strategy ◽

Group I ◽

The Media ◽

Grade Ii ◽

Group Ii ◽

Grade Iii

Background: This study aimed to compare clinical and pathologic data for selected patients with congenital heart disease (CHD) and severe pulmonary hypertension (PH) treated with a diagnostic-treatment-and-repair strategy and to compare results for patients with pulmonary vascular disease (PVD) with simple left-to-right shunt CHD with patients with transposition of the great arteries (TGA) and ventricular septal defect (VSD).Methods: Group I comprised 38 patients with simple left-to-right shunt CHD and severe PH; group II included 11 older patients with TGA with VSD and severe PH; and group III comprised 6 autopsy cases of individuals with a normal circulation. The nature of the pulmonary arteries was determined by the Heath-Edwards classification system. All specimens were quantitatively analyzed.Results: Group I showed 31 patients with a change to grade I, 3 patients were grade II, 3 patients were grade III, and only 1 patient was grade IV. Group II showed 7 patients with a change to grade I, 2 patients were grade II, 1 patient was grade III, and only 1 patient was grade IV. The media wall thickness percentage (%MT), the media wall area percentage (%MS), and arteriole density were significantly higher in groups I and II than in group III. %MS was significantly higher in group II than in group I; no significant differences in %MT and arteriole density could be found between groups I and II.Conclusions: The PVD in these selected patients with CHD and severe PH who were cared for with a diagnostic-treatment-and-repair strategy is generally reversible, and the changes in PVD in the patients with TGA and VSD were similar to those in the patients with simple left-to-right shunt CHD.

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Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032011000400009 ◽

2011 ◽

Vol 48 (4) ◽

pp. 265-269 ◽

Cited By ~ 5

Author(s):

Sthela Maria Murad-Regadas ◽

Francisco Sergio P Regadas ◽

Lusmar Veras Rodrigues ◽

Débora Couto Furtado ◽

Ana Cecília Gondim ◽

...

Keyword(s):

Pelvic Floor ◽

Vaginal Delivery ◽

Mode Of Delivery ◽

Obstructed Defecation ◽

Delivery Mode ◽

Obstructed Defecation Syndrome ◽

Group I ◽

Vaginal Deliveries ◽

Grade Ii ◽

Group Ii

CONTEXT: The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. OBJECTIVES: To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. METHODS: Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/ sigmoidocele grade III). In addition, sphincter damage was evaluated. Patients were grouped according to age (<50y x >50y) and stratified by mode of delivery and parity: group I (<50y): 218 patients, 75 nulliparous, 64 vaginal delivery and 79 only cesarean section and group II (>50y): 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 - nulliparous (n = 135), 1 - vaginal (n = 46), >1 - vaginal (n = 166). RESULTS: Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001). The stratified groups (nulliparous, vaginal delivery and cesarean) did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group <50y and in the nulliparous and vaginal groups >50y. No correlation was found between rectocele and the number of vaginal deliveries. CONCLUSION: Higher age (>50 years) was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.

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Impact of environmental temperature to the content of protein on fresh, cold and frozen meat

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/922/1/012061 ◽

2021 ◽

Vol 922 (1) ◽

pp. 012061

Author(s):

C D Iskandar ◽

Zainuddin

Keyword(s):

Protein Content ◽

Environmental Temperature ◽

Quadriceps Muscle ◽

C Protein ◽

Group Iii ◽

Treatment Groups ◽

Protein Levels ◽

Group I ◽

Group Ii

Abstract This study aims to determine the amount of protein content in Aceh cattle beef in the quadriceps muscle (chuck) and to find out the best storage between cold and frozen to protein levels of beef. This study used 10 samples of Aceh cattle beef parts of the quadriceps (chuck) which were divided into 3 treatment groups, group I meat was treated in fresh condition, Group II meat was treated in cold at 8 °C and Group III meat will be treated in frozen at -19 °C. Protein content in meat was analysed by the Independent Samples Test. The results showed that the amount of Aceh beef protein in the quadriceps (chuck) in fresh; 15, 47%, cold 10, 20% and frozen; 9, 97. It was concluded that storing meat in cold and frozen ways is affect the protein content. Frozen meat storage is better to keep protein content than Cold meat storage.

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92 BLASTOCYST FORMATION FROM VITRIFIED BOVINE OOCYTES, ZYGOTES, AND TWO-CELL EMBRYOS

Reproduction Fertility and Development ◽

10.1071/rdv17n2ab92 ◽

2005 ◽

Vol 17 (2) ◽

pp. 196

Author(s):

A. Moisan ◽

E. Chamberlain ◽

S. Leibo ◽

B. Dresser ◽

K. Bondioli ◽

...

Keyword(s):

Volume Ratio ◽

Blastocyst Development ◽

Vitro Fertilization ◽

Group Iii ◽

Treatment Groups ◽

Group I ◽

Vitrification Solution ◽

Group Ii ◽

Bovine Oocytes

The objective of this study was to devise a protocol to preserve bovine oocytes and early cleavage-stage embryos by vitrification and to compare their subsequent embryonic development after in vitro fertilization (IVF). Mature bovine oocytes from a commercial source (BoMed; Madison, WI, USA) were randomly allocated (in four replicates) to four treatment groups. Group I: control oocytes were subjected to IVF and cultured in CR1aa medium in a humidified atmosphere of 5% O2/5% CO2/90% N2 at 38°C. Group II: MII-stage oocytes were subjected to vitrification and then fertilized by IVF. Group III: presumptive zygotes were vitrified after IVF. Group IV: two-cell embryos resulting from IVF that were cultured for ∼28 h before vitrification. The vitrification solution consisted of TCM199 medium supplemented with 10% fetal bovine serum (mTCM) and containing 20% ethylene glycol (EG)/20% dimethyl sulfoxide (DMSO)/0.65 M trehalose. The oocytes/embryos to be vitrified were rinsed in mTCM, then in 5% EG/5% DMSO, then in 10% EG/10% DMSO, and finally for 45 s in the vitrification solution. For vitrification, groups of 6 to 12 oocytes/embryos were pipetted in <1-μL volume of vitrification medium onto the tip of a CryoTop (Katayama et al. 2003 Fertil. Steril. 80, 223); plunged directly into liquid nitrogen (LN2), and stored for ∼2 h. Vitrified samples were warmed and liquefied by rapidly transferring the Cryotops from LN2 into 0.25 M trehalose in mTCM at 37°C and then sequentially at 1-min intervals into 0.188 M and 0.125 M trehalose. Cleavage was evaluated on Day 3 post-insemination, and blastocyst development was assessed on Days 7 and 9 post-insemination. Of the 251 oocytes in Group I, 71% cleaved by Day 3, 21% formed blastocysts by Day 7, and 29% did so by Day 9; 3% of the total hatched. Of the 116 oocytes in Group II, fewer cleaved (P > 0.05) by Day 3 (54%) and developed into blastocysts by Day 7 (4%) and by Day 9 (8%); none hatched. Group III zygotes (n = 131) responded like Group II oocytes, 53% cleaved, and 5% formed blastocysts on Day 7 and 7% on Day 9; none hatched. In contrast, 19% of the 122 two-cell embryos formed blastocysts by Day 7 and 28% by Day 9, and 3% hatched. Although significantly fewer oocytes/embryos in Groups II and III cleaved compared with Group I, more than 50% of them did so after vitrification. After fertilization and cleavage, the two-cell embryos were much more resistant to the deleterious effects of cryoprotectants and vitrification. Higher survival of two-cell embryos may result from their increased permeability to cryoprotectants, and to water due to their higher surface area to volume ratio.

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Eπώδυνες οστικές μεταστάσεις

10.12681/eadd/40759 ◽

2013 ◽

Author(s):

Παναγιώτης Σιδεράς

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Pain Relief ◽

Karnofsky Performance Scale ◽

Pain Palliation ◽

Group Iii ◽

Group I ◽

Group Ii ◽

Grade Iii

Aim: The consecutive administration of two different bone seeking radio-pharmaceuticals such as 186Re-HEDP and 89Sr-Cl was compared with 89Sr-Cl plus chemotherapy and 186Re-HEDP alone were investigated to determine the effectiveness and toxicity in pain palliation of bone metastases in patients with prostate, breast and lung cancer.Material and Methods: The effect of treatment with consecutive infusions with 186Re-HEDP and 89Sr-Cl was compared with 89Sr-Cl plus chemotherapy and 186Re-HEDP alone on pain symptoms, quality of life and bone marrow function. In total, we treated 32 patients of which 11 (Group I) were treated (5 men with prostate cancer and 6 women with breast cancer) with consecutive infusions with 186Re-HEDP and 89Sr-Cl, 12(Group II) were mostly men with prostate cancer that received 89Sr-Cl plus chemotherapy and 9 patients (Group III) 6 women with stage IV breast cancer, 1 man with lung cancer and 2 men with hepatocellular cancer with 186Re-HEDP alone. The follow up period was 16 weeks. In Group I the patients received an infusion of 186Re-HEDP [(dose of 1200MBq (32.4 mCi) ±96.21 MBq (2.6mCi)] followed by bi-weekly blood counts until 8 weeks to measure myelotoxicity. At the end of this period 89Sr-Cl was infused at a dose of 137 MBq (3.7mCi) ± 3.63MBq (0.098mCi) followed in the same manner with bi-weekly measurement in blood counts to estimate overall patient responsiveness to therapy, increase in performance and toxicity. In Group II all patients received a standard dose of 89Sr-Cl [148MBq(4 mCi) ± 2.2 MBq (0.06 mCi). In Group III all patients received a standard 186Re-HEDP dose of 1480 MBq (40 mCi) ± 3.7MBq (0.01 mCi) and Zolendronate. All patients were interviewed using standardized form of questions before and after therapy weekly for 16 weeks.Results: In Group I 91%(10/11) of the patients reported pain relief after the end of 16 weeks whereas 18% (2/11) reported discontinuation of their analgesics and remained pain-free. Pain showed a decrease from 7.8±1.7 to a value of 2.8±1.2 on a visual analogue scale (p<0.0001). Patients also described an improvement on Karnofsky performance scale from 68±6 to 79±4 (p<0.005), 16 after completion of therapy. Myelotoxicity was observed in 2 patients (18%) manifesting as thrombocytopenia grade III, 4(36%) stage II and 5(45%) as stage I. The maximum nadir of platelets and leukocyte counts were observed at the end of 4 weeks of each therapy and was completely reversible at the end of each therapy. In Group II which was comprised mainly from prostate cancer patients 67%(8/12) reported pain relief at the end of 16 weeks with only 1 patient (8%) discontinued all analgesics. Pain score on VAS decreased from 8.3±1.8 to 3.7±1.7 (p<0.0001), improvement on Karnofsky performance scale was from 75 to 80. Myelotoxicity was seen in 4/12 (33%) of the patients and this could be attributed likely to the combined affect of chemotherapy and radioisotope treatment manifesting as grade III thrombocytopenia, grade II in 6/12 (50%) and only in 2/12 (16%) as grade I. In group III, which appeared a slightly more heterogenous than the other two groups, 1 lung cancer patient expired within the 16 weeks of follow up likely secondary to type I respiratory failure and 1 patient with hepatocellular carcinoma was lost to follow up. All other patients mainly breast cancer showed adequate analgesia with decrease of pain on VAS from 8.2±1.3 to 4.1±1.9 (p<0.008) with none discontinuing all analgesics. Improvement on Karnofsky scale was recorded as 75-80(p>0.2). Myelotoxicity was seen in 2/9 (22%) manifesting as grade III thrombocytopenia, 4/9 (44) as grade II and 3/9 (33%) as grade I.Conclusion: All radiopharmaceuticals used either consecutively or in combination with chemotherapy or alone were effective in metastatic bone pain palliation. There was no significant induction of Myelotoxicity except with a percentage of 33% seen in 89Sr-Cl plus chemotherapy group. In this small prospective study we achieved bone pain palliation with consecutive administration of 2 different radiopharmaceuticals. We modified slightly the dose of 186Re-HEDP such as to avoid serious and potentially lethal myelotoxicity. We achieved a greater and longer analgesic response as compared to the other two groups based on the fact that faster induction of analgesia was attained with the relatively low beta emitter 186Re-HEDP and greater pain relief with a longer duration of pain control the high beta emitter 89Sr-Cl.

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Prediction of oesophageal varices in cirrhotic patients by measuring liver stiffness with fibroscan

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v6i2.29121 ◽

2016 ◽

Vol 6 (2) ◽

pp. 85 ◽

Cited By ~ 2

Author(s):

Shahinul Alam ◽

Ahmed Lutful Moben ◽

A.K.M. Kborshed Alam

Keyword(s):

Predictive Value ◽

Liver Stiffness ◽

Oesophageal Varices ◽

Cross Sectional ◽

Group Iii ◽

Group I ◽

Grade Ii ◽

Cirrhotic Patients ◽

Group Ii ◽

Sensitivity Specificity

Background: Repeated endoscopy is required to detect & follow up of esophageal varices (OV) in cirrhotic patients. Objective: For discomfort and unwillingness lo do the endoscopy directed us to evaluate liver stiffness measurement (LSM) for lhe prediclion ofO V. Methods: A cross sectional observational study was conducted between July 2010 to July 2011. A total of 50 patients with cirrhosis were divided into three groups. Group-I patients had no varix (n=4), group-II had Grade-I OV (n=23) and group-UI had Grade-II/III OV (n=23 ) at endoscopy. Liver stiffness was measured by fibroscan & data was analyzed by SPSS.Results: Mean age were 35.20 ± 11.36 years with highest frequency 19 (38 %) in 21-30 years age group. Etiologies were different with leading causes includes HBV (76%) followed by HCV (6%), alcohol (2%) and 14% were unknown. Liver stiffness did not significantly differ from group-I & group-II, but was significantly higher in group III than group-II & group I. Liver stiffness was nol accurate in the prediction of grade-I oesophageal variees [Arca under the curve (AUC)] = 23.6%. Liver stiffness at a cut off value 32.52 kPa with sensitivity, specificity, positive predictive value, negative predictive value, accuracy respectively 82.6%, 77.8 %, 76 %, 84%, 80% can predict the Grade-II-Ill oesophageal varices (AUROC = 85.2%). Conclusion: Liver stiffness may be suitable for prediction of Grade-II-III oesophageal varices, not for the screening of the presence of oesophageal varices.

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Effects of short term clinoptilolite supplementation on weight gain in Holstein calves

Revista Mvz Córdoba ◽

10.21897/rmvz.923 ◽

2017 ◽

pp. 5631-5637 ◽

Cited By ~ 1

Author(s):

Deniz Alic Ural ◽

Kerem Ural

Keyword(s):

Weight Gain ◽

Control Group ◽

Short Term ◽

Group Iii ◽

Treatment Groups ◽

Group I ◽

Total Weight Gain ◽

Significant Difference ◽

Holstein Calves ◽

Group Ii

Objective. To determine whether short term supplemantation at two levels (1 or 2 g/kg) of clinoptilolite (CLNP) in the colostrum of dairy calves had any effect on total weight gain (TWG) and mean daily gain of weight (mdwg). Materials and methods. A total of 24 clinically healthy calves without diarrhea were assigned in a subset of three major groups of calves were studied: group I (n=8) received colostrum with clnp at the rate of 1/kg started immediately following calving at 12 and 24 hours, for a total of 2 doses. Group II consisted of calves (n=8) receiving colostrum with clnp at the rate of 2/kg within the same interval as the first experimental group. The last group III, which served as control, received solely colostrum. Results. Group had significant effect on weight (kg) of Holstein calves [twg (mean±SE)- control: 12.66±0.349, group I: 14.73±0.414, group II: 14.19±0.468, p<0.01; mdwg (mean±SE)-control: 0.338±0.0155, group I: 0.396±0.0189, group II: 0.397±0.0196, p<0.05]. There was a significant difference observed for twg (p<0.01) and mdwg (p<0.05) among control group and both clnp treatment groups. Conclusions. The results showed that the addition of both levels of clinoptilolite administration via colostrum appeared to enhance twg and mdwg in newborn calves without having any observable adverse effect.

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Tongue scrapping as a means of reducing oral mutans streptococci

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.28.2.n18275821658263v ◽

2005 ◽

Vol 28 (2) ◽

pp. 163-166 ◽

Cited By ~ 4

Author(s):

George White ◽

Mirna Armaleh

Keyword(s):

Oral Hygiene ◽

Oral Care ◽

Tooth Brushing ◽

Post Treatment ◽

Mutans Streptococci ◽

Once Daily ◽

Group Iii ◽

Treatment Groups ◽

Group I ◽

Group Ii

Mutans streptococci (MS) are one of the most virulent cariogenic pathogens in the oral cavity. The effects of three oral hygiene techniques on salivary mutans streptococci levels were evaluated to see which mechanism would be most efficient in reducing salivary MS levels. Sixty patients, all in the permanent dentition, were selected and randomly distributed into three groups. Group I was asked to use a tongue scraper to brush the tongue once daily in the morning after normal tooth brushing routine. Group II was asked to place and let dissolve a Listerine Oral Care StripTM on the tongue once daily after normal oral hygiene routine. Group III was asked to rinse once every morning, for thirty seconds, with a saturated saline solution after routine tooth brushing. The instructions were done for a period of seven days. Baseline, one hour, three day, and seven day saliva samples were obtained and plated on CRT" by Vivadent MS-sensitive agar. All treatments groups show a significant reduction in colony counts from baseline and one or more post treatment periods and at one or more time periods between treatment groups. The most effective treatment in reducing colony counts was seen within Group I "Tongue Scraping" which demonstrated the greatest change from baseline to each of the post treatment periods. The least effective was Group II "Listerine Strip" which showed a statistically insignificant increase in colony count from baseline to 1-Hour and a significant decrease from baseline at the 7-day period only.

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Adenosine deaminase and BW A1433U attenuate hypoxia-induced ventricular ectopy

Journal of Applied Physiology ◽

10.1152/jappl.1993.74.4.1543 ◽

1993 ◽

Vol 74 (4) ◽

pp. 1543-1548 ◽

Cited By ~ 6

Author(s):

R. J. Leone ◽

G. S. Friedrichs ◽

G. F. Merrill

Keyword(s):

Adenosine Deaminase ◽

Adenosine Receptor ◽

Group Iv ◽

Group Iii ◽

Treatment Groups ◽

Adenosine Receptor Antagonist ◽

Arterial Blood ◽

Group I ◽

Ectopic Beats ◽

Group Ii

Twenty-six beagles of either sex, weighing 10.4 +/- 0.3 kg, were used to investigate the role of adenosine in the genesis of ventricular arrhythmias during systemic hypoxia. After instrumentation dogs were randomly assigned to one of four treatment groups: 14 dogs were pretreated before hypoxia with adenosine deaminase (n = 7, group I) or its vehicle (n = 7, group II) while 12 other dogs were pretreated with the A1 selective adenosine receptor antagonist BW A1433U (n = 6, group III) or its vehicle (n = 6, group IV). Each dog was exposed to a 3-min period of hypoxic ventilation [3% O2–5% CO2–92% N2; PO2 in arterial blood 96 +/- 3 Torr (before hypoxia), 21 +/- 1 Torr (during hypoxia)]. The percentages of ventricular ectopic beats (19) experienced in the four groups after 3 min of hypoxia were 21 +/- 10% (group I, P < 0.05 relative to group II), 50 +/- 2% (group II), 15 +/- 8% (group III, P < 0.05 relative to group IV), and 42 +/- 7% (group IV). Ventricular bigeminy, the most prominent arrhythmia seen in this study, was significantly reduced by adenosine deaminase and BW A1433U. No significant differences in other monitored cardiovascular variables were seen between adenosine deaminase and BW A1433U treatment groups and their corresponding vehicles. These findings implicate endogenous adenosine as an arrhythmogenic mediator during hypoxia and point to a mechanism involving the A1 adenosine receptor.

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