Changes In Pulse Amplitude Research Articles

Evidence That Orphanin FQ Is Important for Progesterone Negative Feedback in Ewes.

The gonadotropin-releasing hormone (GnRH) network is the final common pathway for neuroendocrine control of the reproductive axis. During the estrous cycle of the ewe, episodic release of GnRH, and subsequently luteinizing hormone (LH), is under the control of steroid negative feedback. Since GnRH neurons are devoid of the appropriate steroid receptors, this feedback must occur through indirect input from other neurons. Neurons that release orphanin FQ (OFQ), a member of the opioid family, may be involved. OFQ has been shown to exist within many areas of the hypothalamus and when given centrally OFQ inhibits episodic LH secretion in ovariectomized sheep. Based on these data, we hypothesize that OFQ mediates the inhibitory effects of estradiol and/or progesterone. To test our hypothesis, we examined the effects of an OFQ antagonist, UFP-101 (Tocris Bioscience, Ellisville, MO). Eight adult ewes were ovariectomized and had a chronic guide tube inserted into the lateral ventricle. Ewes also received a 1cm long estradiol implant and 2 progesterone packets sc at the time of surgery. Following a recovery period of 10 days, we infused UFP-101 (30 nmol/hr) or saline (120 μl/hr) into the lateral ventricle and collected blood samples every 12min via a jugular catheter for 6 hr. Treatments were administered in a crossover design with all eight sheep receiving antagonist and control at random, with 3 days between treatments. Progesterone packets were removed and treatments were repeated ten days later in ewes treated only with the sc estradiol implant using the same crossover design with blood samples collected every 12min for 5 hr. Ewes with luteal concentrations of progesterone showed a significant increase in LH pulse frequency during infusion of UFP-101 (4.6 ± 0.6 pulses/6 hr) compared to saline infusion (2.5 ± 0.5 pulses/6 hr). Ewes implanted with only estradiol displayed no significant difference in LH pulse frequency during infusion of UFP-101 (3.5 ± 0.5 pulses/5 hr) compared to saline infusion (3.9 ± 0.5 pulses/5 hr). Changes in LH pulse amplitude following infusion of UFP 101 were inconsistent, with 3 of 8 estradiol-treated ewes showing an increase. Therefore, we conclude that OFQ mediates, at least in part, the negative feedback action of progesterone in sheep. (poster)

Women's sexual arousal: Effects of high alcohol dosages and self-control instructions

The basic relationship between alcohol and women's sexual arousal – especially genital arousal – received little research attention for nearly 30 years (e.g. Wilson and Lawson, 1978) until very recently (e.g. George et al., 2009). To investigate hypotheses based on earlier findings and Alcohol Myopia Theory (AMT), two experiments evaluated the effects of high blood alcohol concentrations (BACs) and arousal instructional demands on indices of vaginal responding and self-reported sexual arousal. In Experiment 1, self-control instructions to maximize (versus suppress) arousal increased peak and average Vaginal Pulse Amplitude (VPA) change. Self-control also interacted with a target BAC of .08% (versus .00%) to influence latency to peak arousal onset: Intoxicated women instructed to maximize showed a shorter latency to peak arousal than did intoxicated women instructed to suppress; however, sober women showed an undifferentiated pattern. Also, in Experiment 1, the target BAC of .08% had no effect on VPA or subjective arousal measures. In Experiment 2, a target BAC of .10% (versus .00%) attenuated peak change and average change in VPA, but this dosage had no effects on latency to peak achieved arousal, or on subjective arousal. Instructions to maximize arousal (versus no instruction) had no effect on any arousal measures. Overall, among young moderate drinking women, alcohol had attenuating effects but only at the higher dosage. Maximize versus suppress instructions about arousal had predicted effects on arousal and interactive effects on latency, but only at the lower dosage. The findings highlight the importance of dosage and contextual factors in alcohol's impact on the variability of women's sexual responding.

Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals

To evaluate ocular pulse amplitude (OPA), IOP values, and hemodynamic changes in the ophthalmic artery, central retinal artery, and short posterior ciliary artery in dipper and non-dipper patients. A total of 59 right eye measurements of healthy subjects with normotensive were included to the study. Ambulatory blood pressure (BP) monitoring measurement (ABPM), Doppler imaging, and OPA measurements were performed in the same day. The patients in which systolic BP decreased during the nocturnal time by 10% of the diurnal BP or more were called dippers. A patient whose nocturnal systolic BP fell by <10% or even rose was defined as non-dipper. Color Doppler imaging was used for blood flow velocity assessment of ophthalmic, central retinal, and posterior ciliary arteries. For each artery, peak systolic and end-diastolic velocities (PSV and EDV, respectively), resistive index (RI), and pulsalite index (PI) were automatically calculated by the machine. Mean IOP and OPA values were calculated after three consecutive measurements. The mean OPA in non-dipper patients was significantly lower compared with that of dipper patients (P=0.011). There was no significant difference in IOP levels between groups. There was no significant difference in the PSV, EDV, RI, and PI in the ophthalmic, posterior ciliary, and central retinal arteries between the groups. Our study demonstrated that OPA level in non-dippers is lower than dippers. This may give additional information about the effect of BP changes on OPA values.

The ocular pulse amplitude at different intraocular pressure: a prospective study

To investigate changes in ocular pulse amplitude (OPA) during a short-term increase in intraocular pressure (IOP) and to assess possible influences of biometrical properties of the eye, including central corneal thickness (CCT) and axial length. In a prospective, single centre study, OPA and IOP as measured by dynamic contour tonometry (DCT) were taken before baseline- and post-OPA (delta) intravitreal injection of 0.05 ml anti-vascular endothelial growth factor agents. Analysis was performed employing linear regression with baseline- and post (delta)-OPA differences as the dependent and post-IOP as well as delta IOP as the independent variable. A multilinear regression analysis with delta OPA as the dependent variable and baseline IOP, post-IOP, CCT and axial length as independent variables was conducted. Forty eyes of 40 patients were included. IOP and OPA increased significantly after injection (IOP mean increase ± SD: 17.83 ± 9.83 mmHg, p < 0.001; OPA mean increase ± SD: 1.39 ± 1.16 mmHg, p < 0.001). For every mmHg increase in IOP, the OPA showed a linear increase of 0.05 mmHg (slope 0.05, 95% CI: 0.02-0.09, p = 0.003, r(2) = 0.20). Multiple regression analysis with delta OPA as the dependent variable revealed a partial correlation coefficient of 0.47 (p = 0.003) for post-IOP as the only significant contribution. A clear positive relationship between OPA measurements and IOP levels was shown in a clinical routine setting using DCT focusing on baseline and postinterventional comparisons of OPA values after intravitreal injections in patients with exudative age related macular degeneration. When considering the OPA for diagnostic purposes, we recommend indication of corresponding IOP values.

Changes in intraocular pressure and ocular pulse amplitude with accommodation

AimsTo investigate the change that occurs in intraocular pressure (IOP) and ocular pulse amplitude (OPA) with accommodation in young adult myopes and emmetropes.MethodsFifteen progressing myopic and 17 emmetropic young adult...

Determination of aortic valve opening time and left ventricular peak filling rate from the peripheral pulse amplitude in patients with ectopic beats

Ectopic beats are common in patients who have heart disease and are associated with reduced peripheral pulse amplitude. This study determined the start of the peripheral pulse increase and from it the opening of the aortic valve. The left ventricular peak filling rate was also estimated from the peripheral pulse. Results were compared with published invasive and cardiac imaging data. Twenty-five subjects with ectopic beat electrocardiograms (ECGs) were studied. The ECGs and the peripheral pulses, detected optically at the right index finger by a simple photoplethysmography (PPG) technique, were recorded for subsequent analysis. Peripheral pulse amplitudes for ectopic beats, post-ectopic sinus beats and normal sinus beats were determined. Ectopic beats induced a mean 68% decrease in pulse amplitude in comparison with sinus beats (p < 0.001). In contrast, the mean pulse amplitude for post-ectopic sinus beats increased by 20% (p < 0.01). Pulse amplitude changes were comparable with the published stroke volume differences for ectopic beats and post-ectopic sinus beats. The range of shortest coupling interval (CI) for ectopic beats with observable pulses was from 373 to 531 ms, with the mean value equivalent to 55% of the mean sinus RR interval, comparable with the opening of the aortic valve. Finally, as the CI increased, the pulse amplitude increased quickly from zero. The average rate of increase was equivalent to 4.8 times the normal sinus amplitude in 1 s, equal to 50% filling in 208 ms, showing diastolic rapid filling, comparable with published left ventricular peak filling rate data. In conclusion, the effect of ectopic beat CI on peripheral pulse amplitude has been determined, providing useful information for developing a technique to determine the opening of the aortic valve and the peak filling rate non-invasively and peripherally in patients with frequent ectopic beats.

Effect of transient hypothyroidism during infancy on the postnatal ontogeny of luteinising hormone release in the agonadal male rhesus monkey (Macaca mulatta): implications for the timing of puberty in higher primates.

The present study examined whether a transient thyroid hormone (T(4)) deficit during infancy in male monkeys would compromise the arrest of luteinising hormone (LH) secretion during the infant-juvenile transition, and/or interfere with the pubertal resurgence of LH. Animals were orchidectomized and thyroidectomized (n = 3; Tx) or sham Tx (n = 3) within 5 days of birth. T(4) replacement was initiated in two Tx monkeys at age 19 weeks to reestablish a euthyroid condition. Blood samples were drawn weekly for hormone assay. Body weight, crown-rump length, and bone age were assessed throughout the study. Within a week of Tx, plasma T(4) declined to undetectable levels and, by 6-8 weeks of age, signs of hypothyroidism were evident. Transient hypothyroidism during infancy failed to prevent either arrest of LH secretion during the infant-juvenile transition or the pubertal resurgence of LH secretion, both of which occurred at similar ages to sham Tx animals. Although body weight exhibited complete catch-up with T(4) replacement, crown-rump length and bone age did not. Thus, bone age at the time of the pubertal LH resurgence in Tx animals was less advanced than that in shams. Although Tx did not influence qualitatively the pattern of gonadotrophin secretion, LH levels during infancy and after pubertal LH resurgence were elevated in Tx monkeys. This was not associated with changes in LH pulse frequency and amplitude, but half-life (53 versus 65 min) of the slow second phase of LH clearance was greater in Tx animals. These results indicate that hypothalamic mechanisms dictating the pattern of gonadotrophin-releasing hormone release from birth to puberty are not dependent on T(4) action during infancy, and fail to support the notion that onset of puberty is causally coupled to skeletal maturation. They also indicate that LH renal clearance mechanisms may be programmed in a T(4) dependent manner during infancy.

One- and two-dimensional standing pressure waves and one-dimensional travelling pulses using the US-NRC nuclear systems analysis code TRACE

A variety of nuclear system transients can lead to rapid and large local pressure changes that propagate along the hydraulic system at the speed of sound, both in single phase and in two-phase fluids. Because of the relevance for safety issues, nuclear system codes like TRACE need to be assessed with respect to their capabilities to predict pressure wave behaviour. Therefore, we have analyzed the propagation of pressure waves in one-dimensional and two-dimensional configurations, i.e. a pipe and a slab, filled with liquid water. The pressure waves are driven by one-sided pressure boundary conditions, in the one-dimensional case of harmonic or Gaussian shape and in the two-dimensional case also of harmonic shape. The selected harmonic pressure boundary conditions lead to standing pressure waves, while using the Gaussian shape boundary conditions one-dimensional pressure pulses are injected and propagate through the pipe. The agreement of the TRACE results with the analytical solutions are, in general very good to good for the one-dimensional cases with respect to the pressure maxima and a small difference is only obtained in the wave speed. At the resonance frequencies of the one-dimensional standing waves, the code is tested to the extreme and shows that enforcing small time step sizes is crucial for the performance of the code. Non-linear effects are observed in the code results for the large amplitudes encountered at the closest neighborhood of the resonances, where the analytical linear standing wave solution diverges and the linear approximation is outside of its validity range. Also for these non-linear standing waves TRACE yields qualitatively physically correct behaviour as the pressure amplitudes are limited and a plateau is reached. For the one-dimensional pressure pulse of Gaussian shape the change of pulse amplitude and shape was analyzed in a longer system. The maximum amplitude of the pulse is slightly reduced as the pulse travels along the pipe. The effect of numerical diffusion on leading and trailing fronts is slightly asymmetric due to the donor-cell approach used in the numerical integration scheme of TRACE. The accuracy of the code is not negatively influenced by the reflections of the pulse at the boundaries of the pipe. As for the standing waves, the accuracy of the travelling pulse solution calculated by TRACE is negatively affected when the time steps are too large, while the effects of the spatial discretization are rather minor. For the case of two-dimensional standing waves in a slab, a lowest spatial harmonic generated with one wave node in the direction parallel to the pressure driving boundary is considered. TRACE results show an overall good agreement with the linear analytical solution. This good agreement includes for low to medium excitation frequencies the damping properties of the skin effect perpendicular to the pressure boundary, which does not exist in one-dimensional pressure wave propagation, the transition to a harmonic shape of the wave also perpendicular to the pressure boundary and the frequency dependence of the resonance spectrum for further increased frequencies with the rapid changes of the wavelengths encountered. Effects of the model set-up and code limitations with respect to the two-dimensional TRACE model set-up using a TRACE VESSEL component in connection with pressure boundary conditions are discussed, in particular with respect to the underestimation of the damping in the skin effect frequency range and the numerical damping for higher frequencies. All in all, the TRACE code is able to calculate one- and two-dimensional pressure wave propagation in liquid water, when an appropriate spatio-temporal numerical discretization is chosen.

Monte Carlo simulations of pulse propagation in massive multichannel optical fiber communication systems

We study the combined effect of delayed Raman response and bit pattern randomness on pulse propagation in massive multichannel optical fiber communication systems. The propagation is described by a perturbed stochastic nonlinear Schr\"odinger equation, which takes into account changes in pulse amplitude and frequency as well as emission of continuous radiation. We perform extensive numerical simulations with the model and analyze the dynamics of the frequency moments, the bit-error rate, and the mutual distribution of amplitude and position. The results of our numerical simulations are in good agreement with theoretical predictions based on the adiabatic perturbation approach.

Finger photoplethysmogram pulse amplitude changes induced by flow-mediated dilation

This study was conducted to investigate the utility and efficacy of finger photoplethysmogram pulse amplitude (PPG-AC) in comparison with the standard Doppler ultrasound in assessing an endothelial function via flow-mediated dilation (FMD). High-resolution B-mode scanning of the right brachial artery (BA) of 31 healthy subjects aged 39.7 ± 11.3 (range 22–64) years and 52 risk subjects aged 47.7 ± 10.8 (range 30–65) years were performed before and after 4 min of upper arm occlusion. Concurrent with the ultrasound measurement (where color Doppler imaging was used to enhance arterial boundary detection), PPG signals were recorded from both index fingers for cross evaluation and comparison. Our results show that the finger PPG-AC exhibits a similar response to that of the well-known BA dilation: following the release of pressure (cuff around the BA), the PPG-AC increases abruptly before slowly decreasing toward the baseline. The peak PPG-AC is reached significantly faster than the peak FMD measured by ultrasound among healthy and risk groups (P < 0.001). The proposed technique using a finger photoplethysmogram can be applied in a rapid and non-invasive assessment of peripheral vascular functions as an alternative low-cost and less operator-dependent tool compared to ultrasound.

The Inhibitory Effects of Nicotine on Physiological Sexual Arousal in Nonsmoking Women: Results from a Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial

Extensive research suggests that long-term cigarette smoking is an independent risk factor for the introduction of sexual dysfunction in men. However, results of limited data investigating this relationship in women are mixed. No studies have examined the acute effects of tobacco or nicotine on physiological sexual response in women. Controlled experimental studies examining acute effects of isolated nicotine intake on female physiological sexual responses are necessary in order to help elucidate tobacco's potential role in the development and/or maintenance of sexual impairment in women. To examine whether isolated nicotine intake acutely affects sexual arousal responses in nonsmoking women. Twenty-five sexually functional women (mean age = 20 years) each with less than 100 direct exposures to nicotine completed two counterbalanced conditions in which they were randomized to received either nicotine gum (6 mg) or placebo gum, both administered double-blind and matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film. Physiological (changes in vaginal pulse amplitude via vaginal photoplethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood. Nicotine significantly reduced genital responses to the erotic films (P = 0.05), corresponding to a 30% attenuation in physiological sexual arousal. This occurred in 11 of 18 women with valid physiological assessments. Nicotine had no significant effect on continuous self-report ratings of sexual arousal (P = 0.45), or on mood (all Ps > 0.05). Acute nicotine intake significantly attenuates physiological sexual arousal in healthy nonsmoking women. Our findings provide support to the hypothesis that nicotine may be the primary pharmacological agent responsible for genital hemodynamic disruption, thereby facilitating a cascade of biochemical and vascular events which may impair normal sexual arousal responses.

Application of optical coherence tomography, pulsed photoacoustic technique, and time-of-flight technique to detect changes in the scattering properties of a tissue-simulating phantom

Intralipid is a well-known emulsion used as a tissue-simulating phantom in developing optical imaging and diagnostic techniques for medical applications. The optical coherence tomography (OCT), pulsed photoacoustic (PA), and time-of-flight (TOF) techniques were used to detect glucose-induced changes in the optical properties of Intralipid. A comparison of the applicability of these techniques to register changes in the scattering properties of Intralipid samples showed that OCT is the most effective method, whereas the sensitivity of the PA technique was less pronounced. Photon migration studies with the TOF technique showed changes in pulse amplitude, pulse width, and arrival time of the pulse maximum as a function of changes in Intralipid concentration. Also the measured signal parameters showed changes when measuring high glucose concentrations.

Using Pulse Oximetry Waveform Analysis to Guide Fluid Therapy: Are We There Yet?

In Response: I thank Dr. Michard (1) for his feedback and acknowledge his excellent review on this topic (2). I also agree that analysis of the photoplethysmographic (PPG) waveform requires care. In the past, there has been a tendency to view the PPG as a “poor man’s” arterial pressure waveform. In reality it is a volumetric signal that is the result of complex physiology which incorporates both arterial and venous components (3). Dr. Michard is correct with his assessment that the method of Fourier analysis I used in my paper (4) measures baseline (DC) modulation (which I believe would be a more accurate term then “systolic/peak value variation”). On the other hand, I disagree with his interpretation that such baseline modulation is the result of systolic pressure variation. The more common interpretation is that changes in the DC component are reflective of changes in venous blood volume. If this assertion is correct, one is left with the exciting possibility that modulation of the baseline gives access to information regarding the venous pool and pre-load status. As per Dr. Michard’s request, Figure 1 is a simple time domain analysis (Chart v 5.5, ADInstruments) of a PPG from a patient undergoing a hysterectomy, which resulted in a high estimated blood loss (approximately 1500 mL). This demonstrates that both types of modulation are present. The middle trace corresponding to fluctuations in the mean PPG value with ventilation and the bottom trace demonstrates simultaneous change in pulse amplitude (AC). It has been my observation that the modulation of the pulse amplitude is a late finding occurring with blood losses of greater than 500 mL and reflects pulse pressure variation.Figure 1.: Time domain analysis of a photoplethysmographic (PPG) waveform from a patient with significant blood loss due to a surgical procedure. The top waveform is the original PPG, the middle trace reflects changes in the mean of the waveform and the bottom trace demonstrates fluctuations in the pulse amplitude…adicht indicates ADInstruments Chart.Figure 2 shows the Fourier spectrum of the same patient demonstrating how these two types of modulation are expressed in frequency space. The solid arrow points out the effects of baseline (DC) modulation and hollow arrows point out the impact of amplitude (AC) modulation on the spectrum. This type of harmonic analysis can become particularly interesting when studied over time, using methods of joint time frequency analysis (5).Figure 2.: The Fourier analysis of the photoplethysmographic waveform from the same patient as Figure 1. The solid arrow corresponds to the modulation of the baseline (DC) component and the hollow arrows to the modulation of the pulse amplitude (AC). The cut off peak (at 1.8 Hz) corresponds to the pulse frequency (heart rate = 108) which dominates the spectrum.In answer to Dr. Michard’s letter titled “Using pulse oximetry waveform analysis to guide fluid therapy: are we there yet?” I would say “no, but we are close.” I believe we need: (1) equipment better geared to collecting the respiratory information contained in the PPG waveform, (2) algorithms refined to isolate and quantify the various types of modulation, and (3) verified interpretation of the physiology that creates the phenomenon. At that point, clinical studies focused on the sensitivity and specificity of this method over a wide range of clinical conditions can be undertaken to determine its ultimate utility. Kirk H. Shelley, MD, PhD Denis H. Jablonka, MD Aymen A. Awad, MD Robert G. Stout, MD Hoda Rezkanna, MD David G. Silverman, MD Department of Anesthesiology Yale University New Haven, Connecticut Department of Anesthesia Benha Faculty of Medicine Zagazig University Egypt [email protected]

Disturbance of macro- and microcirculation: relations with pulse pressure and cardiac organ damage

Whereas large arteries dampen oscillations resulting from intermittent ventricular ejection, small arteries steadily deliver optimal blood flow to various organs as the heart. The transition from pulsatile to steady pressure is influenced by several factors as wave travel, damping, and reflections, which are mainly determined by the impedance mismatch between large vessels and arteriolar bifurcations. The mechanism(s) behind the dampening of pressure wave in the periphery and the links between central and peripheral pulsatile pressure (PP) may determine cardiac damage. Active pathways participate to pulse widening and changes in pulse amplitude in microvessels. Steady and cyclic stresses operate through different transduction mechanisms, the former being focal adhesion kinase and the latter being free radicals and oxidative stress. Independently of mechanics, calcifications and attachment molecules contribute to enhance vessel wall stiffness through changes in collagen cross-links, proteoglycans, integrins, and fibronectin. Enhanced PP transmission may thus occur and precipitate organ damage at each time that autoregulatory mechanisms, normally protecting the heart from vascular injury, are blunted. Such circumstances, observed in old subjects with systolic hypertension and/or Type 2 diabetes mellitus, particularly under high-sodium diet, cause cardiac damage and explain why increased PP and arterial stiffness are significant predictors of morbidity and mortality in the elderly.

How to assess arterial compliance in humans

How to assess arterial compliance in humans

Propagation of smooth and discontinuous pulses through materials with very large or verysmall group velocities

We investigate the propagation of optical pulses through two different solid-state opticalmaterials, ruby and alexandrite, for which the group velocity can be very small() or superluminal ( or negative). We find that for smooth pulses the fractional delay or advancement ismaximized through the use of pulses with durations comparable to the responsetime of the physical process—coherent population oscillations—that leads tothese extreme group velocities. However, we find that the transmitted pulse shapebecomes distorted unless the pulse is much longer or much shorter than thisresponse time. We also investigate the transmission of pulses that possess anabrupt change in pulse amplitude. We find that, to within experimental accuracy,this nearly discontinuous jump propagates at the usual phase velocity of lightc/n, even though the smoothly varying portions of the pulse propagate at the group velocity.

Prolactin Suppresses GnRH but Not TSH Secretion

Background/Aims: In animal models, prolactin increases tuberoinfundibular dopamine turnover, which has been demonstrated to suppress both hypothalamic GnRH and pituitary TSH secretion. To test the hypothesis that prolactin suppresses GnRH and TSH secretion in women, as preliminary evidence that a short-feedback dopamine loop also operates in the human, the effect of hyperprolactinemia on GnRH and TSH secretion was examined. Methods: Subjects (n = 6) underwent blood sampling every 10 min in the follicular phase of a control cycle and during a 12-hour recombinant human prolactin (r-hPRL) infusion preceded by 7 days of twice-daily subcutaneous r-hPRL injections. LH and TSH pulse patterns and menstrual cycle parameters were measured. Results: During the 7 days of r-hPRL administration, baseline prolactin increased from 16.0 ± 3.0 to 101.6 ± 11.6 µg/l, with a further increase to 253.7 ± 27.7 µg/l during the 12-hour infusion. LH pulse frequency decreased (8.7 ± 1.0 to 6.0 ± 1.0 pulses/12 h; p < 0.05) with r-hPRL administration, but there were no changes in LH pulse amplitude or mean LH levels. There were also no changes in TSH pulse frequency, mean or peak TSH. The decreased LH pulse frequency did not affect estradiol, inhibin A or B concentrations, or menstrual cycle length. Conclusion: These studies demonstrate that hyperprolactinemia suppresses pulsatile LH secretion but not TSH secretion and suggest that GnRH secretion is sensitive to hyperprolactinemia, but that TSH secretion is not. These data further suggest that the degree of GnRH disruption after 7 days of hyperprolactinemia is insufficient to disrupt menstrual cyclicity.

Role of Noradrenergic Receptors in the Bed Nucleus of the Stria Terminalis in Regulating Pulsatile Luteinizing Hormone Secretion in Female Rats

The bed nucleus of the stria terminalis (BNST) is one of the brain areas densely innervated by noradrenergic neurons originating in the brain stem. The present study aims to determine the role of noradrenergic receptors in the BNST in regulating pulsatile luteinizing hormone (LH) secretion in female rats. Ovariectomized (OVX) or estrogen-primed OVX (OVX+E2) rats received three 1-h-interval injections of 0.05 micromol of noradrenaline (NA), phenylephrine (alpha1-adrenergic receptor agonist), clonidine (alpha2-agonist), or isoproterenol (beta-agonist) into the BNST. Injection of NA or alpha1-adrenergic agonist into the BNST strongly suppressed pulsatile LH secretion in OVX+E2 rats with a significant (P < 0.05) decrease in the mean LH level for 3 h and LH pulse frequency, but alpha2-and beta-agonists did not affect any of the LH pulse parameters. In OVX animals, alpha1- and alpha2-adrenergic agonists caused a significant change in LH pulse frequency and amplitude, respectively, though the effect was not as apparent as the NA- or alpha1-agonist-induced changes in OVX+E2 animals. These results indicate that NA inputs to the BNST suppress pulsatile LH secretion via alpha1-adrenergic receptors and that estrogen enhances this suppression.

Painful Stimulation of the Temple Induces Nausea, Headache and Extracranial Vasodilation in Migraine Sufferers

To determine whether painful stimulation of the temple would induce nausea, ice was applied to the temple for 30 s, three times at 4-min intervals in 23 migraine sufferers and 22 age- and sex-matched controls. On one occasion, the ice was applied in the presence of residual motion sickness induced by optokinetic stimulation. On another occasion, the ice application was not preceded by optokinetic stimulation (the baseline condition). In the baseline condition, nausea had developed in migraine sufferers but not controls by the third application of ice. In the presence of residual motion sickness, each painful stimulus intensified nausea and headache in migraine sufferers whereas symptoms were minimal in controls. Changes in frontotemporal pulse amplitude were monitored with photoelectric pulse transducers. The extracranial blood vessels dilated in migraine sufferers but not controls before the first application of ice in the baseline condition, presumably due to anticipatory anxiety. In contrast, the ice application did not provoke extracranial vasodilation in either group after optokinetic stimulation. The findings show that susceptibility to nausea and stress-induced extracranial vascular hyper-reactivity are associated with the migraine predisposition. They also suggest that head pain might intensify gastrointestinal disturbances during attacks of migraine.

Beneficial effects of small-incision cataract surgery in patients demonstrating reduced ocular blood flow characteristics.

To investigate intraocular pressure (IOP) and ocular haemodynamics following small incision cataract surgery. Systemic and ocular haemodynamics, and IOP, were measured pre-operatively and 1 month post-operatively, in 25 eyes of 25 patients (mean age 72.6+/-7.9 years) scheduled for small incision cataract surgery and intraocular lens implantation; these values were compared to an untreated age-matched healthy group (n=25, mean age 72.3+/-5.0 years). For each eye, the Ocular Blood Flow Analyser (OBFA, Paradigm Inc., UT, USA) was used to obtain measurements of IOP, pulsatile ocular blood flow (POBF), pulse volume (PV), ocular pulse amplitude (PA), and pulse rate (PR). Systemic blood pressure measurements were obtained at each visit. Pre- and post-operative values for the cataract group were compared using repeated measures analysis of variance, and compared to the normal group using analysis of variance. Pre-operatively, IOP was significantly higher in the cataract group compared to the age-matched normal control group (P<0.001). Cataract surgery resulted in a significant 16.7% reduction in IOP (P=0.001). Consequently, the post-operative IOP in the cataract group was similar to that of the normal group (P>0.05). Both pre- and post-operative POBF and PV values for the cataract group were significantly lower than for the normal age-matched group (P<0.0125). Small incision cataract surgery led to an 8.3% post-operative increase in POBF (P=0.0118) and 15.5% increase in PV (P<0.001). No changes in PA or PR were evident. These data suggest that cataract patients exhibit higher IOP and reduced ocular perfusion characteristics compared to an age-matched normal healthy group. Following cataract surgery, IOP reduced and ocular pulsatility improved.