The Nervous Factor in the Circulatory Failure Induced in Adrenalectomized Dogs by Intestinal Stripping and a Single Stage Bilateral Adrenalectomy

Kleinberg, William; Remington, J. W.; Drill, Victor A.; Swingle, W. W.

doi:10.1152/ajplegacy.1942.137.2.362

Cited by 11 publications

(5 citation statements)

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“…Thus, corticosteroid disappearance actually preceded impairment of work performance. The lack of corticosteroids in the presence of elevated catecholamine concentrations and excessive sympathetic nervous activity has been thought to compromise the integrity of the small blood vessels leading to a state of hypotension (4,13,20,21). In this regard, the glucocorticoids are viewed as agents which are essential for normal vasomotor regulation, and in their absence, catecholamines are presumed to exert deleterious effects on the unprotected vasculature (20).…”

Section: Discussionmentioning

confidence: 99%

Cardiac Performance in Experimental Adrenal Insufficiency in Cats

Lefer

Verrier

Carson

1968

Circulation Research

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Cardiac function was evaluated by ventricular function curves during the cardiovascular collapse observed in acute and chronic adrenal insufficiency. A progressive decline in peak cardiac work was observed in the acutely adrenalectomized cat (303; decrease at 1.8 hours and 50% at 3.5 hours after adrenalectomy). This impairment in cardiac work paralleled the decrease in mean arterial blood pressure which reached 50 mm Hg 3.5 hours after adrenalectomy. Cortisol and d-aldosterone, and the volume-expander, dextran, prevented a significant fall in mean arterial blood pressure and in peak cardiac work. When the mean arterial blood pressure of nonadrenalectomized cats was adjusted to follow the changes seen in adrenalectomized cats, a 49% depression in cardiac work resulted 3.5 hours after the initial decline in arterial blood pressure. The data suggest that the time course of the hypotension and presumed reduction in coronary perfusion pressure is sufficient to account for the large impairment in peak cardiac work observed. Cardiac work was reduced 56% in chronically adrenalectomized cats 8 to 10 days after adrenalectomy. Dexamethasone and deoxycorticosterone acetate, administered separately, prevented significant-myocardial impairment. Since the mean arterial blood pressure of conscious, chronically adrenalectomized cats was normal, the myocardial depression was not secondary to inadequate coronary perfusion in chronic adrenal insufficiency and thus represents direct impairment of myocardial performance. ent circulatory disturbance than does chronic adrenal insufficiency (5), both must be investigated. The purposes of the present study were to evaluate cardiac performance in acute and chronic adrenal insufficiency using a direct technique, to determine the relative efficacy of glucocorticoids and mineralocorticoids in protecting against post-adrenalectomy circulatory collapse, and to determine whether any observed changes in ventricular performance are independent of changes in systemic arterial pressure. MethodsOne hundred and twenty-four mongrel cats of both sexes and of mean weight 2.71 kg (1.9 to 3.8 kg) were studied. The control cats were anesthetized with 30 mg/kg of sodium pentobarbital, but the adrenalectomized cats without steroid support required only 15 mg/kg.

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Section: Discussionmentioning

confidence: 99%

Cardiac Performance in Experimental Adrenal Insufficiency in Cats

Lefer

Verrier

Carson

1968

Circulation Research

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“…Other workers using varying techniques to achieve sympathetic denervation subsequently verified these observations (Kleinberg et al, 1942;Eversole et al, 1944).…”

Section: Introductionmentioning

confidence: 85%

Sympatho-adrenal hyperactivity—the key to irreversible shock?

Irving

1969

Postgraduate Medical Journal

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SummaryThere would appear sound evidence on which to incriminate sustained sympatho-adrenal hyperactivity as a deleterious factor of prime importance in hypovolaemic shock. The use of sympathomimetics in the treatment of shock of this type is irrational and deleterious. Their rational use in those few cases of clinical shock where they are indicated will have to await knowledge of plasma catecholamine levels in such cases.Experimental studies involving a-and P-adrenergic blockade, unilaterally and in combination, have revealed that, contrary to previous theories, deterioration is mediated through both receptor types.Many of the current concepts of the pathophysiology of shock will need reassessment in the light of as yet unappreciated facets of catecholamine activity. IntroductionOf all the homeostatic mechanisms initiated by acute hypovolaemic hypotension the most important would appear to be an intense activation of the sympatho-adrenal system. Outpourings of adrenaline from the adrenal medulla and noradrenaline from the post-ganglionic sympathetic nerve-endings constitute the most immediate and most effective protective mechanism and are responsible for the majority of the physical signs observed in clinical shock.This activation of the sympatho-adrenal system has been the subject of extensive experimental investigation, the results of which have led to the incorporation into current clinical therapy of techniques involving both adrenergic stimulation and adrenergic blockade.It is the purpose of this communication to discuss some facets of sympatho-adrenal function in shock and to consider both its place in the development of the so called 'irreversible' state and its relationship to clinical therapy.

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“…In four cases much better results were obtained with hypophysectomy by the method of MARKOWITZ and ARCHIBALD (1964). The first successful operation was done in the Dachshund "Patty".…”

Section: Exophthalmos Producing Substancementioning

confidence: 94%

“…Trauma to adjacent nervous structures is an initiating factor in the production of circulatory collapse subsequent to bilateral adrenalectomy in a single stage operation (KLEINBERG, REMINGTON, DRILL and SWINGLE, 1942).…”

Section: Exophthalmos Producing Substancementioning

confidence: 99%

Canine Cushing's Syndrome

Rijnberk

Kinderen

Thijssen

2010

Zentralblatt Für Veterinärmedizin Reihe A

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Summary This report deals with 21 dogs with spontaneous hyperadrenocorticism. The clinical picture was characterized by abdominal enlargement, polyphagia, polydipsia, muscular weakness, obesity and alopecia. Slight diabetes mellitus was encountered sporadically. In the bitches oestrus was usually absent for a long time. Features indicative of hypersensitivity to higher temperatures were frequently observed. Determination of the excretion of 17‐hydroxycorticosteroids in 24‐hour urines was of great diagnostic significance. There was a considerable overlap of plasma 11 β‐hydroxycorticosteroids in normal dogs and those suffering from canine Cushing's disease. Results of dexamethasone suppression tests have been given. In the sera of four exophthalmic patients and in one pituitary obtained at necropsy, elevated levels of Exophthalmos Producing Substance (EPS) were found. Pathological findings have become available in a number of cases. Preliminary results with hypophysectomy in four patients are encouraging. Zusammenfassung Cushing‐Syndrom beim Hund Es werden 21 Fälle von Hyperkortizismus beim Hund beschrieben. Klinische Symptome: Vergrößerung des Abdomens, Polyphagie, Polydipsie, Muskelschwäche, Obesitas, Alopezie. Sporadisch wurde ein leichter Diabetes mellitus beobachtet. Hündinnen waren oft lange Zeit anöstrisch. Symptome von Wärme‐Intoleranz wurden manchmal beobachtet. Diagnostisch aufschlußreich war die Bestimmung der 17‐Hydroxykortikosteroide im 24‐Stundenharn. Die Konzentrationen der 11 β‐Hydroxysteroide des Plasmas zeigten hingegen bei normalen Hunden und solchen mit Morbus Cushing oft Überlappungen. Wertvoll war auch der Dexamethason‐Unterdrückungstest. In den Seren von 4 Patienten mit Exophthalmus und in einer Hypophyse, welche bei der Sektion entnommen wurde, wurden erhöhte Werte an Exophthalmus produzierender Substanz (EPS) gefunden. Bei 4 Patienten wurde die Hypophyse zu therapeutischen Zwecken entfernt. Die Ergebnisse dieser Behandlungsmethode sind ermutigend. Résumé Maladie de Cushing chez le chien Cette publication a pour sujet 21 chiens atteints d'hypercorticosurrénalisme spontané. L'image clinique est caractérisée par un élargissement abdominal, de la polyphagie, de la polydipsie, une adynamie musculaire, de l'obésité et de l'alopécie. On rencontre sporadiquement un léger diabète sucré. Chez les femelles, l'oestre ne se manifeste généralement plus pendant une longue période. On observe fréquemment des signes d'une hypersensibilité aux températures élevées. La détermination des 17‐hydroxycorticostéroïdes excrétés dans les urines de 24 heures est extrêmement significative pour le diagnostic. Les valeurs des 11‐β‐hydroxycorticostéroïdes chez les chiens normaux et ceux atteints de la maladie de Cushing sont pratiquement identiques. Nous indiquons les résultats des tests de suppression de la dexamenthasone. On trouve des taux élevés de substance induisant l'exophtalmie (EPS) dans le sérum de 4 animaux exophtalmiques et dans le tissu hypophysaire d'un chien autopsiés. Dans plusieurs cas, on peut tirer des...

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The Nervous Factor in the Circulatory Failure Induced in Adrenalectomized Dogs by Intestinal Stripping and a Single Stage Bilateral Adrenalectomy

Cited by 11 publications

References 0 publications

Cardiac Performance in Experimental Adrenal Insufficiency in Cats

Cardiac Performance in Experimental Adrenal Insufficiency in Cats

Sympatho-adrenal hyperactivity—the key to irreversible shock?

Canine Cushing's Syndrome

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