[Xenon and sevoflurane anti stress activity comparative assessment during elective anaesthesia in pediatric patients].

UNLABELLED: Research objective was to compare Xenon and Sevoflurane anti stress activities during elective anaesthesia in Pediatric patients. MATERIAL AND METHODS: The results of anaesthesia in 42 patients in age from 1 to 18 years were analyzed. The clinical sings, BIS-index, Somatotropinum hormone and Cortisol levels in patient's blood were studied. RESULTS: Xenon and Sevoflurane provide sufficient level of sedation, analgesia and do not cause Somatotropinum hormone and Cortisol levels increase. CONCLUSION: Xenon and Sevoflurane have the same high anti stress activity However Xenon anaesthesia is characterized by more stable haemodynamics.

Cortical visual areas process intestinal information during slow-wave sleep.

BACKGROUND: Previously we have shown that, during sleep, electrical and magnetic stimulation of areas of the stomach and small intestine evoked neuronal and EEG responses in various cortical areas. In this study we wanted to correlate natural myoelectrical activity of the duodenum with cortical neuronal activity, and to investigate whether there is a causal link between them during periods of slow-wave sleep. METHODS: We have recorded the myoelectrical activity from the wall of the duodenum and activity of single neurons from three cortical visual areas in naturally sleeping cats and investigated causal interrelationship between these structures during slow-wave sleep. KEY RESULTS: About 30% of the cortical neurons studied changed their firing rate dependent on the phases of the peristaltic cycle and demonstrated selectivity to particular pattern of duodenal myoelectrical activity during slow-wave sleep. This interrelationship was never seen when awake. CONCLUSIONS & INFERENCES: This observation supports the hypothesis that, during sleep, the cerebral cortex switches from processing of exteroceptive and proprioceptive information to processing of interoceptive information.

[Medical care provision to the victim children of Haiti].

Treatment and diagnostic measures, including anesthesia during catastrophes and natural disasters are a world known problem. The paper presents the experience of anesthetic care provision during specialized surgical care to the victim children of the earthquake in Haiti. The materials of analysis were 529 anesthesias conducted to 72 children, who were in the treatment for crush syndrome, skeletal and concomitant injury. The peculiarities of anesthesia during the treatment of wound process depending on the stage of surgery are brought into view. During the preparatory phase the optimal type of anesthesia is inhalation and intravenous anesthesia, whereas for the defect closure (main stage) all types of anesthesia, including balanced endotracheal and combined anesthesia were used.

[Procedure for determining the initiation of tube feeding in children in an intensive care unit].

A procedure is proposed to determine the timing of tube feeding in children treated in an intensive care unit, which records the hypertonia of the pyloric sphincter and consists in the determination the time of gastric administration of distilled water before its evacuation into the duodenal lumen (water evacuation test) visualized in the real-time mode through abdominal ultrasonography. The proposed procedure was successfully applied to 42 children aged 3 months to 14 years who had severe brain injury, appendicular peritonitis, polytrauma, and polysegmental pneumonias. This determining procedure makes it possible to exclude radiation exposure in patients treated in intensive care units and to improve the outcomes of treatment, by prescribing the artificial feeding, that is adequate to the patients' status, in the periods optimal for each specific clinical case.

Visceral-related area in the rat insular cortex.

The insular cortex interacts with the bulbar autonomic nuclei providing autonomic manifestations accompanying several neurological and psychosomatic disorders. The aim of our study was to identify the sites within the insular cortex, which could be responsible for the gastrointestinal, respiratory and cardiovascular responses. The main methods used were microinjections of HRP into several parts of the bulbar dorsal vagal complex and microstimulation of the insular cortex. It has been found that a compact group of neurons located in the middle level of the rat insular cortex projects directly to the specific "gastric" part of the dorsal vagal complex. Retrograde labelled cell bodies were revealed in the V layer of the disgranular and agranular insular cortex. Microstimulation of the sites within the middle level of the rat insular cortex produced gastric motor responses and a decrease in inspiratory airflow without significant alteration in respiratory cycle duration. More caudal microstimulation produced an increase in respiratory airflow and decreased respiratory cycle duration. These responses were usually accompanied by changes in the level of blood pressure. It is concluded that autonomic representation in the rat insular cortex is organised in a viscerotopic manner. The inhibitory respiratory zone overlaps with the gastrointestinal control area in the middle part of the insular cortex. More caudally, the excitatory respiratory zone overlaps with the cardiovascular area. On the basis of these experimental results and the data of others authors the general scheme of autonomic representation in the rat insular cortex is discussed.

[Structural organization of neurons of spinal ganglia innervating the colon].

The localization and morphological features of viscerosensory neurons of sacral spinal ganglia (SSG), innervating the colon, were investigated. In urethane anaesthetized cats, the solution of horseradish peroxidase was injected under the serosa of ascending and descending parts of the colon as well as of the rectum. After 48 hours animals were repeatedly anesthetized and transcardially perfused. Sections of SSG were stained according to Mezulam protocol (1978). All the regions of the colon studied were shown to receive afferent innervation from neurons of SSG SI, SII and SIII. Maximum number of the labeled cells was detected in SSG SII. The intensity of afferent innervation of the colon by the neurons of SSG was found to increase along its length in cranio-caudal direction.

Muscarinic modulation of nitrergic neurotransmission in guinea-pig gastric fundus.

Muscarinic receptor activation by (4-Hydroxy-2-butynyl)-1-trimethylammonium-m-chlorocarbanilate chloride (McN-A-343) was investigated both on NADPH-d staining and on electrically induced responses in guinea-pig gastric fundus. McN-A-343 (10 micromol L(-1)) significantly increased the optical density of NADPH-d positive neurones, while blockade of nitric oxide synthase with N(omega)-nitro-L-arginine (L-NA) decreased it, suggesting facilitation of nitric oxide (NO) production. Electrical field stimulation (EFS; 2 Hz, 0.2 ms, supramaximal current intensity, 10 s train duration) elicited on-contraction followed by off-relaxation in the circular muscle strips. McN-A-343 (10 micromol L(-1)) transformed the EFS-evoked response from on-contraction into on-relaxation, which was neurogenic, tetrodotoxin-sensitive and hexamethonium-resistant. L-NA partly reduced the EFS-evoked relaxation, revealing two components: a nitrergic and a non-nitrergic one. The effect of McN-A-343 on the amplitude of the EFS-evoked relaxation was not changed by the M(3) receptor antagonist para-fluoro-hexahydro-sila-difenidol hydrochloride, but was significantly enhanced by M(1) receptor blockade with telenzepine. In the presence of telenzepine, the L-NA-dependent nitrergic component of the EFS-induced relaxation predominates. We suggest that cholinergic receptor activation has a dual effect on nitrergic neurotransmission: (i) stimulation of NOS by muscarinic receptor(s) different from M(1) and M(3) subtype, (ii) prejunctional inhibition of NO-mediated relaxation via M(1) receptors. In addition, M(1) receptors may facilitate the non-nitrergic relaxation.

[The enteral feeding during the treatment of appendicular peritonitis in children]. / Enteral'noe pitanie pri lechenii peritonita appendikuliarnogo proiskhozhdeniia u detei.

A total of 65 patients, aged 3 to 14, with different forms of appendicular peritonitis, in whom the intestinal insufficiency syndrome (IIS), stage 2, was diagnosed, were investigated. 35 patients were in the main group, and 30 patients were in the control group; the subjects of the latter group had a similar form of peritonitis, i.e. IIS, stage 2, it was confirmed clinically and by ultrasound examinations. The laparoscopic operations were carried out in all patients. The patients of both groups received postoperatively a similar therapy, i.e. the antibacterial, metabolic and infusive ones, as well as vitamins and parenteral feeding (daily caloric values--50-120 kcal/kg, protein--2-3 g/kg/day) according to a child's age and a clinical course of peritonitis. All children of the main group received postoperatively an early enteral therapy (EET), which involved 4 stages. Stage 1: introduction of the salt solution with added glutamine through the naso-gastric probe by increasing volumes and with respect to an individual tolerability of a patient; stage 2: introduction of semi-element mixtures; stage 3: introduction of 10% solutions of polymer balanced mixture; stage 4: introduction of 20% solutions of polymer mixtures. Ultrasound scanning and clinical methods were used to assess the efficiency of the recovery of intestinal peristalsis. The conducted investigations showed that the mean duration of the gastric-type EET amounted to 3-4 days, and the IIS was, on the average, arrested by days 6 or 7. The duration of infusive therapy and parenteral feeding went down, in the main group, by 2 days. A trend towards an increase of the erythrocyte level was noted in these patients. No differences were registered in the values of concentrations of total protein and albumin in the blood serum of patients in both groups from the 1st to 7th postoperative days, however, the infusions of plasma and albumin were made by 2 times more often in the main group as compared to the control one. The EET technique preserved the gastric mucous tunic intact, which cut the postoperative complications 2-fold, and consequently, it reduced the stay of patients in hospital on the average by 8 days. A conclusion was made, on the basis of the conducted study, that EET is a pathophysiologically substantiated treatment method for IIS, stage 2, in children with appendicular peritonitis; EET ensures a rapid recovery of gastric-tract functions, it reduces the frequency rate of postoperative complications and cuts the length of both the infusive therapy and of the patients' stay in hospital.

Amygdalofugal modulation of the vago-vagal gastric motor reflex in rat.

In experiments on urethane anaesthetized rats the influence of electrical stimulation of the central nucleus of the amygdala (CNA) on gastric motility and activity of gastric-related neurons of the dorsal vagal complex was studied. Stimulation of the CNA effected spontaneous gastric motility and caused both excitatory and inhibitory changes of vagal-induced gastric relaxation. The most significant effects, mainly inhibitory, were observed under stimulation of the medial CNA. This amygdaloid area was found to influence activity of gastric-related neurons of the dorsal vagal complex. Excitatory and inhibitory changes of their vagal-induced responses under the amygdala stimulation manifested as general modulation of all phases of the reaction or selective modulation of some of them. These mechanisms may lie at the base of amygdalofugal modulation of gastric reflex activity.

Identification of a respiratory related area in the rat insular cortex.

The aim of this study was to map areas within the rat insular cortex from which respiratory responses originate and compare those sites with gastrointestinal control regions. The insular cortex was systematically microstimulated and histological location of responsive sites determined. Increased inspiratory airflow and decreased respiratory cycle duration were considered to be respiratory excitatory responses. The responses were localized in dysgranular and agranular insular cortex at levels caudal to the joining of the anterior commissure. More rostrally, respiratory inhibitory responses were elicited: these were manifested as a decrease in inspiratory airflow without a significant alteration in respiratory cycle duration. Respiratory inhibitory responses were usually accompanied by changes in gastric motility. These results suggest that the respiratory area in the rat insular cortex consist of two distinct zones which overlap a region modulating the gastrointestinal activity.

[Visceral field of the rat insular cortex]. / Vitseral'noe pole insuliarnoi oblasti kory mozga krys.

Structural-functional organisation of the cortical insular area relating to processes of the visceral functions control, was analysed. Representation of gastrointestinal, respiratory, and cardiovascular systems in the area, is given. Sites of respective neuronal groups and specifics of their spatial organisation within the area, were found. The data obtained suggest a scheme of the rat insular cortex's visceral field.

[The neurons of the medial vestibular nucleus initiating the relaxation of the rat's stomach wall]. / Neirony medial'nogo vestibuliarnogo iadra, initsiiruiushchie relaksatsiiu stenki zheludka u krys.

In acute rat experiments the technique of retrograde axonal transport of horseradish peroxidase in the medial vestibular nucleus allowed to identify a group of neurones sending axons to the "stomach" region of a single tract nucleus. These neurones and, accordingly, the descending vestibular/solitary links can be viewed as the morphologic basis for vestibular influences on the gastric motor activity. As was shown, local irritation of the neurones initiates relaxation of the stomach wall. Activation of the anterior limbic cortex modulates the vestibular/autonomous responses of the intragastric pressure reduction. Irritation of the infralimbic cortex of the rat's brain may have a preventive effect on the stomach wall relaxation stimulated by the vestibular neurones projecting on the "stomach" region of single tract nucleus.

Gastric related neurons in the rat medial vestibular nucleus.

Some structural and functional peculiarities of the rat vestibular nuclei neurones involved in realisation of vestibular-gastrointestinal reflectory reactions were studied. After microinjection of a horseradish peroxidase solution in the 'gastric' area of the nucleus tractus solitarius, retrogradely-labelled cell bodies were found in caudal part of the medial vestibular nucleus. Electrical stimulation of these neurons resulted in the decrease of gastric tone. The respiratory arrest was registered simultaneously. The results suggest that activation of the identified vestibular neurons can induce coordinated changes in visceral systems which are peculiar to a vomiting reaction.

[Possible mechanisms of the anterior limbic cortex influence on the neuron activity of the vago-solitary complex]. / Analiz vozmozhnykh mekhanizmov limbicheskoi kory na aktivnost' neironov vago-solitarnogo kompleksa.

In ananesthetized cats, neurons of the nucleus of the tractus solitarius (NTS) and the dorsal motor nucleus of the vagus nerve (DMNV) revealed phasic excitatory responses to separate single vagal and cortical stimuli. Stimulation of the anterior limbic cortex combined with vagal stimulation resulted in inhibitory or excitatory modification of the vagal induced responses of the NTS and DMNV neurons. The data obtained suggest that complete inhibitory effects are related to general cortical mechanisms of control of the functional state of the brain stem visceral neurons. Selective inhibition of the vagal induced responses by limbic cortex stimulation is due to particular cortical mechanisms of the visceral sensory transmission control via the NTS neurons.

[The dorsal motor nucleus of the vagus nerve and its role in innervating the digestive tract]. / Dorsal'noe motornoe iadro bluzhdaiushchego nerva i ego rol' v innervatsii pishchevaritel'nogo trakta.

Findings on topography of dorsal motor vagal nucleus neurons from which axons towards functionally different regions of digestive tract extend were analysed. Based on that and on the data available in literature main peculiarities of these cells topical organization were formulated. It is noted that "gastrointestinal" neurons are localised in dorsal motor nucleus as narrow stripes oriented caudo-rostrad. Stripes (or columns) of neurons from axons towards the digestive trace different parts arise do not cross. Digestive tract oral parts receive parasympathetic efferent inputs from neurons of medial and dorsomedial parts of the nucleus and caudal--from ventromedial cells of dorsal motor nucleus. Sites of maximal accumulation of initial "gastrointestinal" neurons that occupy an area within +0.5-(+)2.0 mm of functionally different regions of stomach and gut were demonstrated in cat and rat.

Identification of gastric related neurones in the rat insular cortex.

Location peculiarities of insular neurones implicated in the regulation of gastrointestinal motility have been studied in acute experiments on rats. After microinjection of a horseradish peroxidase solution in a part of the dorsal vagal complex that receive gastric afferent inputs, retrogradely labelled cell bodies are observed in a certain area of the agranular and disgranular insular cortex. Electrical stimulation of the insular cortex area had no significant effect on heart and respiration rate but had evoked gastric tone changes. These results suggest that the insular cortex contains a specific cell group that provides direct output to the bulbar 'gastric' centre and takes part in regulation of gastrointestinal functions.

[The afferent link in the system of the bulbar regulation of gastric motor function]. / Afferentnoe zveno v sisteme bul'barnoi reguliatsii motornoi funktsii zheludka.

The data obtained suggest a possible participation of neurons of the tractus solitarius' nucleus in mechanisms of the stomach motility control. These neurons seem to be involved in an afferent link of the bulbar "gastric" centre participating in regulation of the stomach motor activity.