Drug manufacturer must obtain approval from the FDA before the manufacturer may lawfully begin selling a new or pioneer ; drug in the United States. 21 U.S.C. 355 a ; . In order to obtain FDA approval, the manufacturer must file a New Drug Application "NDA" ; demonstrating that the drug is safe and effective for its intended use . 14. An FDA-approved new drug can be covered by one or more patents. A patent.
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When it comes to coping with asthma or allergies, most experts say that an ounce of prevention is worth a pound of cure. That means getting rid of allergens. Allergens like house dust, pollen grains, dust mites and their dirty droppings, and saliva-coated cat hair. Allergens are the reason your eyes itch, your nose runs and why you sniffle and sneeze with hay fever. What's more, they can trigger asthma attacks. You can now fight back with Miele's Ultra Performance 2100 vacuum cleaner and enjoy true power where it counts. Boasting an output that equals that of 2100 W, its unique triscopic suction tube adjusts from 55.5 cm to 111.5 cm making it ideal for short and tall people. The Ultra Performance's powerful suction lifts allergens off floors, carpets and even finer fabrics like mattress covers and pillows. What's more those microscopic particles can't escape the vacuum's absolutely airtight hose couplings and motor compartment or its four-component filtration system. So it can pick up more tiny particles and hold on.
How does epidemiology relate to pharmacy? The number of times I've been asked this question is, I suppose, a hidden driver of my desire to write this column. If you take out parts of the definition of epidemiology you can easily place the use of medications in the application to control health problems since many medications are used in primary and secondary disease prevention. Medications and vaccines are among the determinants of health related states. From a public health perspective, pharmacoepidemiology can be utilized to assess the impact that vaccines and drugs have on the overall patterns of morbidity and mortality in well-defined populations. Pharmacoepidemiology is defined by John M. Last * as: "the study of the distribution and determinants of the drug related events in populations and the application of this study to efficacious drug treatment."1, for example, rxlist.
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Could you carry a diaper bag with you everywhere you go? Could you change your diaper in a public restroom? Could you wear them in front of anyone? Not just them, under clothes! Are you willing to wear diapers at all times, or wet your clothes if you decide to not wear? Are you willing to follow a diet? Avoid certain foods and drugs? Follow a schedule? Keep your pubic area completely shaved? If you are single, could you tell that new date that you need to wear diapers? If you are married, could you tell your spouse "This is it, diapers for me from now on." Could you deal with the fact that your body as a whole is going to change over the next year? IF you answered "no" to any of these, this program may not work for you as it has worked for me. I on month 14, and I can tell you now as my diaper grows warm as I type, this does work.
Ctsnetjournals cgi content abstract 126 2 448 next » view 45 more » medical journals medical journals cerebral infarction in the mongolian gerbil exacerbated by phenoxybenzamine treatment - mcgraw et al 7 485 - stroke five sham-operated animals were given 2 mg per kilogram of phenoxybenzamine , five were given 20 mg per kilogram of phenoxybenzamine and ten were and valsartan.
In MTT viability tests, doxazosin induced loss of cells and metabolic activity, and this effect was not altered by prior exposure to the irreversible -blocker phenoxybenzamine, which did not itself reduce cell viability Figure 2B1 prazosin behaved similarly results not shown ; . Terazosin and 5-methylurapidil did not decrease cell viability Figure 2B1 ; . Cell death was not affected by the presence of - and -adrenergic agonists epinephrine, norepinephrine, phenylephrine, and isoprenaline, equimolar with doxazosin ; Figures 2B2 and 2B3 ; . Doxazosin and prazosin also reduced the MTT-assessed viability of NIH 3T3 cells, which have no -adrenoceptors, whereas terazosin and 5-methylurapidil had no effect Figure 2B4 ; . In view of reports that in cardiomyocytes the Ca2 calmodulin-activated phosphatase calcineurin can act both proapoptotically9 and antiapoptotically, 10 we investigated whether it is involved in the action of doxazosin on cardiomyocytes. The fact that it is not is shown by the action of doxazosin being unaffected by the presence of the calcineurin inhibitors cyclosporin A and FK506 Figure 2B5.
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The following histaminergic compounds were used: Histamine 2HCl HA; purchased from Sigma Chemical Co., St. Louis, MO ; , the H1 receptor agonist 2-thiazolylethylamine 2HCl 2-TEA; gift from SmithKline Beecham, Welwyn Garden City, UK ; , the H2 receptor agonist 4-methylHA 2HCl 4-meHA; gift from SmithKline Beecham ; , the H3 receptor agonist imetit 2HBr Ime; gift from professor H. Timmerman, Free University, Amsterdam, The Netherlands ; , the H1 receptor antagonist mepyramine maleate Mep; gift from DAK, Copenhagen, Denmark ; , and the H2 receptor antagonist cimetidine 2HCl Cim; gift from GEA, Copenhagen, Denmark ; . The doses of Mep, Cim, or Ime have previously been found to inhibit the AVP or responses to HA, dehydration or suckling 14, 16, 30, ; . The following catecholaminergic compounds were used: the receptor agonist epinephrine bitratrate E ; , the 1 receptor agonist norepinephrine bitratrate NE ; , the 1 2 receptor antagonists phenoxybenzamine HCl Phb ; and phentolamine mesylate Pht ; , the 1 receptor antagonist prazocin Hcl Pra ; , the 2 receptor antagonist yohimbine HCl Yoh ; , the 1 2 receptor antagonist propranolol HCl Pro ; , the 1 receptor antagonist atenolol HCl Ate ; , and the 2 receptor antagonist ICI-118, 551 ICI ; . The adrenergic agonists and antagonists were purchased from Research Biochemical International Natick, MA ; . The adrenergic antagonists were administered in a dose of 1 mmol as some of the antagonists in that dose have been found to inhibit the AVP or OT responses to catecholamines, suckling or stress 20 25, 2729 ; . All compounds were dissolved in saline except Pra and Cim, which were dissolved in saline acidified with 0.1 n HCl and adjusted with 0.1 n NaOH to pH 7.4, and were administered intracerebroventricularly icv ; . However, Ime was injected ip as the compound by this administration route has been found to inhibit stress-induced release of pituitary hormones 32 and didanosine.
From the Department of Internal Medicine and Division of Hematology, Special Coagulation DNA Diagnostic Laboratory, and Comprehensive Hemophilia Center, Mayo Clinic College of Medicine, Rochester, Minn. Address correspondence to Rajiv K. Pruthi, MBBS, Division of Hematology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905 email: pruthi.rajiv mayo ; . Individual reprints of this article and the entire series on Genetics in Clinical Practice will be available for purchase from our Web site mayoclinicproceedings . 2005 Mayo Foundation for Medical Education and Research.
Abbreviations: SVR sustained virological response; ALT alanine aminotransferase; AST aspartate aminotransferase; HAI histological activity index; F fibrosis; BMI body mass index. Table 5. Comparison of pre-treatment nonparametric parameters between patients with and without sustained virological response Parameter Male gender, n % ; Naive, n % ; Patients without cirrhosis, F4 Metavir ; Patients without steatosis, n % ; Patients, consuming alcohol, n % ; Smoking patients, n % ; Patients with SVR n 28 18 64.3% ; 15 53.6% ; 5 17.8% ; 12 18.8% ; 14 50% ; 8 28.6% ; Patients without SVR n 91 48 52.7% ; 53 58.2% ; 12 13.2% ; 28 30.1% ; 54 59.3% ; 32 36.2% ; p p 0.05 p 0.05 p 0.05 p 0.05 p 0.05 p 0.05 and videx.
Physicians interested in knowing how their practices compare to others may wish to use performance measures. For further information, see healthplanning.gov.bc cdm, for example, phenoxybenzamine dose.
Autoantibodies in major psychoses Janusz Rybakowski, University of Medical Sciences, Dept. of Adult Psychiatry, Szpitalna 27 33, 60-572 Poznan, Poland, Email: rybakows wlkp.top M. Wojtanowska-Bogacka and digoxin.
40. Gu B, Reiter JP, Schwinn DA, et al. Effects of 1-adrenergic receptor subtype selective antagonists on lower urinary tract function in rats with bladder outlet obstruction. J Urol. 2004; 172: 758-762. Ford AP, Arredondo NF, Blue DR Jr, et al. RS-17053 N-[2- 2cyclopropylmethoxyphenoxy ; ethyl]-5-chloro-, -dimethyl-1H-indole-3ethanamine hydrochloride ; , a selective 1A-adrenoceptor antagonist, displays low affinity for functional 1-adrenoceptors in human prostate: implications for adrenoceptor classification. Mol Pharmacol. 1996; 49: 209-215. Williams TJ, Blue DR, Daniels DV, et al. In vitro 1-adrenoceptor pharmacology of Ro 70-0004 and RS-100329, novel 1A-adrenoceptor selective antagonists. Br J Pharmacol. 1999; 127: 252-258. Blue DR Jr, Grino PB, Jung DT, Harbison MP, Ford APDW. Evaluation of Ro 70-0004, a selective 1A-adrenoceptor antagonist, in men with benign prostatic hyperplasia BPH ; [abstract]. In: Proceedings of the Fifth International Consultation on BPH; June 25-28, 2000; Paris, France: Geneva, Switzerland: World Health Organization; 2000: 550. 44. Ishizuka O, Perrson K, Mattiason A, Naylor A, Wyllie M, Andersson K. Micturition in conscious rats with and without bladder outlet obstruction: role of spinal alpha 1-adrenoceptors. Br J Pharmacol. 1996; 117: 962-966. Rudner XL, Berkowitz DE, Booth JV, et al. Subtype specific regulation of human vascular 1-adrenergic receptors by vessel bed and age. Circulation. 1999; 100: 2336-2343. Lee E, Lee C. Clinical comparison of selective and non-selective 1Aadrenoreceptor antagonists in benign prostatic hyperplasia: studies on tamsulosin in a fixed dose and terazosin in increasing doses. Br J Urol. 1997; 80: 606-611. de Mey C. Cardiovascular effects of alpha-blockers for the treatment of symptomatic BPH. Eur Urol. 1998; 34 suppl 2 ; : 18-28. 48. de Mey C. 1-Blockers for BPH: are there differences? Eur Urol. 1999; 36 suppl 3 ; : 52-63. 49. Harada K, Ohmori M, Kitoh Y, Sugimoto K, Fujimura A. A comparison of the antagonistic activities of tamsulosin and terazosin against human vascular alpha1-adrenoceptors. Jpn J Pharmacol. 1999; 80: 209-215. Souverein PC, Van Staa TP, Egberts AC, De la Rosette JJ, Cooper C, Leufkens HG. Use of alpha-blockers and the risk of hip femur fractures. J Intern Med. 2003; 254: 548-554. Roehrborn CG, Schwinn DA. [Alpha]1-adrenergic receptors and their inhibitors in lower urinary tract symptoms and benign prostatic hyperplasia. J Urol. 2004; 171: 1029-1035. O'Leary MP. Lower urinary tract symptoms benign prostatic hyperplasia: maintaining symptom control and reducing complications. Urology. 2003; 62 3, suppl 1 ; : 15-23. 53. Nickel JC. The use of 1-adrenoceptor antagonists in lower urinary tract symptoms: beyond benign prostatic hyperplasia. Urology. 2003; 62 3, suppl 1 ; : 34-41. 54. Kakizaki H, Koyanagi T. Current view and status of the treatment of lower urinary tract symptoms and neurogenic lower urinary tract dysfunction. BJU Int. 2000; 85 suppl 2 ; : 25-30. 55. Kakizaki H, Matsuura S, Mitsui T, Ameda K, Tanaka H, Koyanagi T. Questionnaire analysis on sex difference in lower urinary tract symptoms. Urology. 2002; 59: 58-62. Oades GM, Eaton JD, Kirby RS. The clinical role of alpha-blockers in the treatment of benign prostatic hyperplasia. Curr Urol Rep. 2000; 1: 97-102. MacDonald D, McNicholas TA. Drug treatments for lower urinary tract symptoms secondary to bladder outflow obstruction: focus on quality of life. Drugs. 2003; 63: 1947-1962. Caine M, Perlberg S, Meretyk S. A placebo-controlled double-blind study of the effect of phenoxybenzamine in benign prostatic obstruction. Br J Urol. 1978; 50: 551-554. Kirby RS, Coppinger SW, Corcoran MO, Chapple CR, Flannigan M, Milroy EJ. Prazosin in the treatment of prostatic obstruction: a placebo-controlled study. Br J Urol. 1987; 60: 136-142. von Bahr C, Lindstrom B, Seideman P. Alpha-receptor function changes after the first dose of prazosin. Clin Pharmacol Ther. 1982; 32: 41-47. Debruyne FM. Alpha blockers: are all created equal? Urology. 2000; 56 5, suppl 1 ; : 20-22. 62. Fulton B, Wagstaff AJ, Sorkin EM. Doxazosin: an update of its clinical pharmacology and therapeutic applications in hypertension and benign prostatic hyperplasia [published corrections appear in Drugs. 1995; 49: 554, Drugs. 1995; 49: 295-320. Wilde MI, Fitton A, Sorkin EM. Terazosin: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in benign prostatic hyperplasia. Drugs Aging. 1993; 3: 258-277.
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The dangerous effects of the excess catecholamines secreted by the tumor can almost always be blocked by continuing to take phenoxybenzamine or a similar drug and beta-blockers.
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12 Formulation patents typically expire years after the basic patent on the active ingredient. A generic version can usually be made that will not infringe such a patent. The Eli Lilly case makes evergreening extremely easy to do, because a brand company will have, or can get, many patents on potential or experimental formulations of its drug that it is not actually using. If it can list such patents, it can repeatedly trigger automatic injunctions under the Regulations, and extend its monopoly indefinitely. This is particularly so, since the timing restrictions have been interpreted to be largely meaningless in practice. Timing restrictions Section 4 3 ; provides a patent list must be submitted at the time the brand files its initial new drug submission of health and safety approval. s. 4 ; creates an exception to the above: a patent may be listed if the "filing date" of the patent was prior to the brand's health and safety "submission", and the brand submits the patent to Health Canada within 30 days after the patent issues. There has been much litigation over what the relevant terms "filing date" and "submission" mean. Neither is defined in the Regulations. The term "filing date" does not include a priority date, the date on which the equivalent patent was filed in another country.24 Section 4 ; has been interpreted in such a way as to render the time limit meaningless: a supplemental submission SNDS ; 25 has been held to be a "submission".26 The Federal Court of Appeal said that a supplement to a submission may not be used to list a patent if the submission does not "change the drug".27 At present, the practice of the Minister appears to be that patents can be listed with a supplemental submission except an SNDS for a mere product name change28 or company name change.29 and disopyramide and phenoxybenzamine, because antagonist.
LICENSURE AND CERTIFICATION 1996 1999 Massachusetts Medical License, No. 151786 Neurology with Special Qualification in Child Neurology, No. 1135 Clinical Neurophysiology, No. 1080.
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1.1 Project Background and Study Scope The proposed Santa Barbara Ranch Project is an outgrowth of a Memorandum of Understanding MOU ; executed by the County and by the project applicant in 2002, as a step in resolving litigation that originated in the 1980s after adoption of the Local Coastal Program. An Official Map of the Naples Townsite recorded in October 1995 recognized 274 existing legal parcels Preface Figure 1.1.2 ; . Of these, 219 are within the boundaries of Santa Barbara Ranch. The proposal pursuant to the MOU consists of a large-lot residential development of 54 new rural residences and associated land use changes on 485 acres, including a major portion of an area known as the Naples Townsite Figure 1.1.4 ; . The applicant has also proposed an alternative project, which includes the Santa Barbara Ranch and the adjacent Dos Pueblos Ranch 2, 760 acres ; , which is referenced as ALT 1. This project would develop a total of 72 new rural residences and associated improvements Figure 1.1.5 ; . The MOU and ALT 1 proposals are referred to collectively as the "Santa Barbara Ranch Project." In either case, the development as proposed may not conform to current agricultural zoning and hence the County is considering the creation of a new zoning district, the Naples Planning District NPD ; for this area. When the Local Coastal Program was adopted by Santa Barbara County and approved by the California Coastal Commission, it included a policy Policy 2-13 calling on the county to discourage residential development in Naples and consider transferring development off the site. Policy 2-13 states: The existing townsite of Naples is within a designated rural area and is remote from urban services. The County shall discourage residential development of existing lots. The County shall encourage and assist the property owners in transferring development rights from the Naples site to an appropriate site within a designated urban area which is suitable for development. If the County determines the transferring development rights is not feasible, the land designation of Ag II 100 should be reevaluated. This study is designed to help the County assess whether it is feasible to comply with Policy 2-13 within the context of the LCP. In addition, this study will help to determine whether it is feasible to reduce densities to the level where the County can retain agricultural zoning and does not need to create the NPD zone. This analysis does not examine the feasibility of creating a TDR program for the 219 existing parcels. As the applicant has stated in application materials, the MOU 9 and norpace.
Of the observations to Uptake2 the effect of phenoxybenzamine and normetanephrine on the pattern of labeling was determined. It was hoped that more knowledge of the intracellular distribution of the N E taken up by cardiocytes may help resolve whether Uptake2 represents simply another mechanism in addition to Uptake1 ; of inactivation of N E whether it is involved in mediation of some of the cardiac effects of NE. MATERIALS AND METHODS 14 adult male bats Myotis lucifugus were used in this study. Four were in the homoiothermic or active phase of their annual life cycle and were caught in June. The animals were kept in the laboratory for 1 wk before use. During this time they were maintained on a diet of meal worms and hamburger meat. Ten animals were caught while they were hibernating. They were transported over ice to the laboratory. These bats were allowed to equilibrate in continued hibernation for 1 wk at 4C. Two animals were used while still hibernating and eight were aroused before use. Monoamine oxidase was inhibited with pheniprazine 10 mg kg ; which was injected intraperitoneally. 1 h later the animals were lightly anesthetized. Two active, two hibernating, and two aroused bats were each injected with 2.5 mCi 0.064 mg ; of tritiated DL-norepinephrine into a wing vein for autoradiography. Two active bats were given 0.1 mCi of tritiated NE for measurement of the radioactive compounds present in the heart. The animals were decapitated 2.5 h after administration of the label. Two aroused animals were given phenoxybenzaine 20 mg kg; intraperitoneally [i.p.] ; , two received normetanephrine 30 mg kg; i.p. ; , and two control animals were injected with saline 30 min before injection with tritiated NE 0.5 mCi ; . Pheniprazine was given as before and hearts were processed as above except that they were used both for autoradiography and for biochemical determinations. For autoradiography, tissues were fixed by perfusion of the anesthetized animals through the heart with hypertonic 6.5% glutaraldehyde containing 3% sucrose and 0.1 M phosphate buffer, pH 7.4 ; before decapitation. This procedure is similar to that used for the autoradiographic localization of tritiated 5-hydroxytryptamine 5-HT ; and preserves the labeled amine while permitting radioactive metabolites to wash out of the tissues Gershon and Nunez, 1973 ; . Aghajanian and Bloom 1967 ; have shown that not all of the labeled NE is preserved by methods like the ones used here. Autoradiography thus preferentially demonstrates bound NE and cannot be relied upon to reflect all of the physiological sites of residence of NE. After fixation tissues were postfixed in osmium tetroxide, dehydrated, and embedded in Epon 812 as described previously Gershon and Nunez, 1973 ; . Portions of the atria and the ventricle were embedded.
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After subtracting the reduction in body weight achieved during the placebo run-in period, the mean weight loss of 2– 9 kg depending on the statistical method used to account for patients who dropped out ; was similar to that reported for other antiobesity drugs, because pharmacology.
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HE FIRST programme of the BBC series Alternative Medicine, broadcast in January, attracted 3.8 million viewers, and was BBC2's second most watched programme of the week, says the British Medical Journal. But since then scientists involved in the series have complained that elements of the programmes were misleading, the production team was uninformed and scientists were used as "marionettes", according to Simon Singh in the Guardian. For example, in a sequence in which acupuncture was used instead of a general anaesthetic during open heart surgery in China, it has been claimed that the narrative exaggerated the role of the acupuncture, and underplayed the role of powerful sedatives and large doses of local anaesthetic that were used during the surgery. A televised experiment showing magnetic resonance scan images MRI ; of the brains of patients undergoing acupuncture was reported in national newspapes under headlines such as "Acupuncture does combat pain, study finds". Yet Professor George Lewith of Westminster University, leading acupuncture researcher on the team devising the BBC experiment, later said, "The interpretation of the science in this particular programme was not good and was inappropriately sensationalised by the production team." Edzard Ernst, professor of complementary medicine at Exeter University and a consultant for the series, complained about the programme on faith healing, which he felt was creating a false impression. "The journalists were at a complete loss to understand the difference between an anecdote and real evidence, " he told the Guardian. The BBC refutes the allegations and is understood to be considering commissioning a second series. Dr Jack Tinker, dean emeritus of the Royal Society of Medicine who was, along with Professor Ernst, scientific consultant for the series, is said to remain happy with the tone and content of the films. Nevertheless the programme on herbalism has already been exploited by vendors of unproven treatments, for example the herb sutherlandia is being promoted as a new weapon in the fight against HIV and Aids using direct references to the BBC programme; and Professor Ernst claims to have received letters from members of the public who want to be operated on by acupuncture anaesthesia. Guardian, 25 March 2006 British Medical Journal 2006; 332: 981 April.
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Crown raft0 in Roxboro is a cut and sew operation that manufactures comforters, sheets, pillow cases, and other bedding products. The 1000 employee k i l has a variety of solid wastes ranging fiom cotton cloth to cardboard tubes and metal scrap. Through a plantwide recycling edFort. Crawn Crafb has reduced the waste it sends to the landfill by 94 percent. This amounts to nearly 1, 616.000 pounds of solid waste for which the company would have had to pay almost $27, 500 for disposal. The company made a profit of more than $91, 000 &om the sale of its recyclables. Crown craffs has gotten its suppliers to use white or clear strapping atr instead of black since it bad no market for the l t e The company has also sent mailers in part of its product h e so the consumer can send back the product packaging materials. To close the recycling loop, Crown Crafts buys supplies and packaging materials made fPom recycled products, for example, phenoxyhenzamine hydrochloride.
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Figure 1 -Adrenergic antagonist inhibition of bacterial uptake of NE -Adrenergic antagonist inhibition of bacterial uptake of NE. Washed exponential cultures of E. coli O157: H7, S. enterica, or Y. enterocolitica were added at a cell density of around 2 108 CFU ml to DMEM containing 50 M NE plus 5 105 cpm ml of 3H-NE and the following: no additions Control ; , or 200 M phentolamine, ph3noxybenzamine or prazosin. Cultures were incubated statically for 6 hrs at 37C in a 5% CO2 humidified incubator, and analysed for growth and 3H-NE uptake as described in Materials and Methods. 3H-NE uptake assays were performed in duplicate on at least two occasions; variation within individual assay sets was 5% or less, and between experiments no more than 10%. Antagonist supplemented cultures showed statistically significant decreases in uptake of 3H-NE P 0.001 ; as compared with the Control.
A biochemical evaluation of the activity of certain tranquilizers and their relationship to hormonal function The authors wish to investigate the physiological impact of the phenothiazines on the endocrine systems in order to find a biochemical rationale for their action. Studies of the effects of chlorpromazine on some aspects of amino acid metabolism, a function effected by a variety of hormones, are reported here. Comparable studies were carried out with insulin and with certain tranquilizers on the effects of these agents on the level of amino acids in cerebrospinal fluid. These effects were found to be of the same kind: there is a fall in the level of amino acids with insulin and with the various phenothiazines. The effect of other drugs Amytal, phenobarbital, Equanil ; and of saline or glucose on the level of amino acids in serum and spinal fluid in animals was also tested. Only glucose gave any significant changes, which probably reflects its action on endogenous insulin production. Current data suggest that compounds used for sedation and tranquilization fall into two separate categories: those drugs which have an immediate effect on the serum ammo acid nitrogen insulin and the phenothiazines ; , and those which do not the barbiturates and Equanil ; . This biochemical distinction is also demonstrated by EEG studies which have shown that Equanil produces fast EEG activity identical to that observed with barbiturates, whereas the phenothiazines do not, nor does insulin in the presence of glucose. With regard to the chronic administration of phenothiazines on serum ammo acids, the initial fall in level is soon more than compensated foi by a type of "rebound reaction" but a fresh drop can be induced by elevating the level of the drug These results raise the question of whether the changes in concentration of amino acids produce behavioral changes or do they merely reflect the biochemical changes significant for the production of behavioral change.--Am. ]. Psychiat.
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And pulmonary hypertension. J Pediatr 1988; 113: 474-9. Rychik J, Gullquist SD, Jacobs ML, Norwood WI. Doppler echocardiographic analysis of flow in the ductus arteriosus of infants with hypoplastic left heart syndrome: relationship of flow patterns to systemic oxygenation and size of interatrial communication. J Soc Echocardiogr 1996; 9: 166-73. Mora GA, Pizarro C, Jacobs ML, Norwood WI. Experimental model of single ventricle. Influence of carbon dioxide on pulmonary vascular dynamics. Circulation 1994; 90 5Pt2 ; : II43-6. 67. Weldner PW, Myers JL, Gleason MM, et al. The Norwood operation and subsequent Fontan operation in infants with complex congenital heart disease. J Thorac Cardiovasc Surg 1995; 109: 654-62. Kanter KR, Miller BE, Cuadrado AG, Vincent RN. Successful application of the Norwood procedure for infants without hypoplastic left heart syndrome. Ann Thorac Surg 1995; 59: 301-4. Jacobs ML, Rychik J, Murphy JD, Nicolson SC, Steven JM, Norwood WI. Results of Norwood's operation for lesions other than hypoplastic left heart syndrome. J Thorac Cardiovasc Surg 1995; 110: 1555-61. Whittenberger JL, McGregor M, Berglund E, Borst HG. Influence of state of inflation of the lung on pulmonary vascular resistance. J Appl Physiol 1960; 15: 878-82. Bradley SM, Simsic JM, Atz AM. Hemodynamic affects of inspired carbon dioxide after the Norwood procedure. Ann Thorac Surg 2001; 72: 2088-93. Riordan CJ, Randsbeck F Storey JH, Montgomery WD, Santamore WP Austin EH. Effects of oxygen, positive end-expiratory pressure, and carbon dioxide on oxygen delivery in an animal model of univentricular heart. J Thorac Cardiovasc Surg 1996; 112: 644-54. Day RW, Barton AJ, Pysher TJ, Shaddy RE. Pulmonary vascular resistance of children treated with nitrogen during early infancy. Ann Thorac Surg 1998; 65: 1400-4. Shime N, Hashimoto S, Hiramatsu N, Oka T Kageyama K, Tanaka Y Hypoxic , . gas therapy using nitrogen in the preoperative management of neonates with hypoplastic left heart syndrome. Pediatr Crit Care Med 2000; 1: 38-41. Keidan I, Mishaly D, Berkenstadt H, Perel A. Combining low inspired oxygen and carbon dioxide during mechanical ventilation for the Norwood procedure. Paediatr Anaesth 2003; 13: 58-62. Bradley SM, Atz AM, Simsic JM. Redefining the impact of oxygen and hyperventilation after the Norwood procedure. J Thorac Cardiovasc Surg 2004; 127: 473-80. Nihill MR, McNamura DG, Vick RL. The effects of increased blood viscosity on pulmonary vascular resistance. Heart J 1976; 92: 65-72. McDonald DA. Arterial flow pattern in relation to changes in vascular resistance. J Physiol 1954; 125: 36. Hoffman GM, Tweddell JS, Ghanayem NS, et al. Alteration of the critical arteriovenous oxygen saturation relationship afterload reduction after the Norwood procedure. J Thorac Cardiovasc Surg 2004; 127: 738-45. De Oliveira NC, Van Arsdell GS. Practical use of alpha blockade strategy in the management of hypoplastic left heart syndrome following stage one palliation with a Blalock-Taussig shunt. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2004; 7: 11-5. De Oliveira NC, Ashburn DA, Khalid F, et al. Prevention of early sudden circulatory collapse after the Norwood operation. Circulation 2004; 110 Suppl II ; : II133-8. 82. O'Blenes SB, Roy N, Konstantinov I, Bohn D, Van Arsdell GS. Vasopressin reversal of phenoxybenzamine-induced hypotension after the Norwood procedure. J Thorac Cardiovasc Surg. 2002; 123: 1012-3. Imoto Y Kado H, Masuda M, Yasui H. Effects of chlorpromazine as a systemic , vasodilator during cardiopulmonary bypass in neonates. Jpn J Thorac Cardiovasc Surg 2002; 50: 241-5. Reddy VM, Liddicoat JR, Fineman JR, et al. Fetal model of single ventricle physiology: hemodynamic effects of oxygen, nitric oxide, carbon dioxide, and hipoxia in the early postnatal period. J Thorac Cardiovasc Surg 1996; 112: 43749. Norwood WI, Lang P Castaneda AR, Campbell DN. Experience with operation , for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg 1981; 82: 5119.
Figure 3. Effect of partial splenic vein ligation on MAP of intact n 7 ; , renal denervated Renal Denerv, n 6 ; , splenic denervated Splenic Denerv, n 6 ; and intrarenal phenoxybenzamine-treated PO, 12.5 g, n 6 ; rats , baseline values; , values during partial splenic venous occlusion. The data are presented as means S.E.M., Significant difference between baseline MAP and MAP during partial splenic vein ligation, P 0.05.
Figure 5. Hemodynamic effects of ANG in pithed and ganglionblocked rats. Intravenous bolus injections of ANG dosedependently increased MAP under control conditions OE ; and during adrenergic blockade by atenolol and phenoxybenzamine ; . ANG at doses 0.01 g kg increased MAP under either condition P 0.05 versus control stimulation ; . Heart rate HR ; was increased by ANG at doses 1 g kg the absence of adrenergic blockade only OE, P 0.05 versus control stimulation ; . Attenuation by - and -receptor blockade of responses in MAP or HR was consistently observed at ANG doses of 1 or 0.05 versus atenolol phenoxybenzamine group ; . MAP and HR values correspond to basal levels of 56 3 and 326 7 bpm in the control group, and of 62 3 and 338 6 bpm in the atenolol phenoxybenzamine group. Data represent mean SEM of 5 experiments.
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