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2. Obstructive sleep apnea and blood pressure elevation: what is the relationship? Working Group on OSA and Hypertension

Author

Carlson, J, Davies, R, Ehlenz, K, Grunstein, R, Hedner, J, Podszus, T, Sinoway, L, Stradling, J, Telakivi, T, and Zwillich, C

Subjects
respiratory tract diseases
Abstract

Sleep disordered breathing has increasingly been recognised as a frequent cause of ill-health in the community. Moderate or severe forms of the most common condition, obstructive sleep apnea (OSA), occur in up to 12% of the adult male population. A substantial body of literature has been published on the potential relationship between OSA and cardiovascular disease. In particular, OSA has been associated with cardiac failure, stroke, myocardial infarction and hypertension. Part of this association may be explained by other confounders, mainly obesity, which is common in OSA patients. The present review was prepared following a workshop aimed to critically review available scientific evidence suggesting that hypertension is a direct consequence of OSA. In addition, pathophysiologic mechanisms that may be involved in the relationship between OSA and cardiovascular disease, particularly brief intermittent elevation of blood pressure and sustained systemic hypertension, are discussed.

Published
2016

3. Parathyroid function following ligation of the inferior thyroid arteries during bilateral subtotal thyroidectomy

Author

Christoph Nies, Andreas Zielke, Ehlenz K, Helmut Sitter, Th. Bandorski, J. Menze, and Matthias Rothmund

Subjects
Male, medicine.medical_specialty, Hypoparathyroidism, medicine.medical_treatment, Thyroid Gland, Parathyroid hormone, Parathyroid Glands, medicine.artery, Humans, Medicine, Hypocalcaemia, Ligature, Inferior thyroid artery, Ligation, Retrospective Studies, Parathyroidectomy, Calcium metabolism, Hypocalcemia, business.industry, Thyroid, Thyroidectomy, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, Parathyroid Hormone, Calcium, Female, business, Goiter, Nodular
Abstract

A randomized controlled trial was performed to compare two techniques of bilateral subtotal thyroidectomy for non-toxic nodular goitre with regard to postoperative parathyroid function. The 50 patients in group 1 underwent ligation of the trunks of the inferior thyroid arteries. In group 2 (50 patients) the branches of these arteries were suture-ligated at the thyroid capsule. Total calcium, ionized calcium and parathyroid hormone levels were determined before operation, and 6, 24 and 72 h after surgery. Ninety-one patients were seen at follow-up 5–10 months after operation. Ten patients in group 1 and 12 in group 2 required calcium and/or vitamin D supplementation for symptomatic hypocalcaemia in the immediate postoperative period. At follow-up only one patient in each group had mild hypoparathyroidism. No statistically significant differences were found between groups regarding total calcium, ionized calcium and parathyroid hormone levels. Truncal ligation of the inferior thyroid arteries during bilateral subtotal thyroidectomy does not cause hypoparathyroidism or hypocalcaemia.

Published
1994

10. Modulation by somatostatin of nerve-mediated activation of glycogenolysis in the perfused rat liver.

Author

Beckh K, Ehlenz K, and Arnold R

Subjects
Animals, Glucose metabolism, In Vitro Techniques, Lactates metabolism, Liver drug effects, Male, Norepinephrine metabolism, Rats, Rats, Inbred Strains, Liver innervation, Liver Glycogen metabolism, Somatostatin pharmacology
Abstract

Perivascular nerve stimulation of rat livers perfused in situ with erythrocyte-free Krebs-Henseleit buffer at constant pressure in a non-recirculating system resulted in an increase of glucose and lactate production and in a decrease of portal flow. Infusion of somatostatin in different concentrations (2 x 10(-7), 10(-8), 10(-9) mol.l-1) reduced the nerve-mediated activation of glucose release maximally to 66%. There was only a slight effect on the lactate output, the nerve-mediated reduction of portal flow was unaltered. In controls, somatostatin alone had no effect on the metabolic and hemodynamic parameters. In order to differentiate between a presynaptic and postsynaptic mechanism, the noradrenaline overflow was calculated. The unaltered release of the neurotransmitter in the presence or absence of somatostatin excluded a presynaptic mechanism. To mimic the nerve effects on the carbohydrate metabolism and on the hemodynamics, noradrenaline (2 x 10(-7) mol.l-1) was infused instead of the nerve stimulation over a period of 5 min. Somatostatin did not change the endocrine effects of the catecholamine under these conditions. The nerve-dependent effect of somatostatin suggests that other neurotransmitters (e.g. VIP) or mediators (e.g. prostanoids) may be influenced by somatostatin.

Published
1989
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