THE EFFECT OF DIMFTHYL SULFOXIDE ON THE CARDIOVASCULAR SYSTEM OF CATS by Maureen E. ,atman Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science in the Eiological Sciences Program - - 8/10 /s 3 - Advi Date / .->dL m. at c I&, - ,953 Dean of the Graduate School 9a.t e - - YOUNGSTGlrDJ STATE UNIVERSITY ABSTRACT THE EFFECT OF DIMETHYL SULFOXIDE ON THE CARDIOVASCULAJ? SYSTEM OF CATS Maureen E. Altman Master of Science Youngsto~vn State University, 1983 Diastolic pressure (DP), systolic pressure (SP), pulse pressure (PP), mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), and. the R and T wave amp1itud.e~ iK:ere measured to determine the effect of intravenous d.imethy1 su1foxid.e (DMsO) on the card.iovascular system of anesthetized cats over a 15 minute period. A statistical analysis (t-test for paired comparisons) re- -- vealed a significant effect of the drug on all of these variables. An increase in the R and T 1:Tave amplitude som after administration of the drug 1vas indicative of a direct effect on myocardial cells. The HR and MAW decreased rapidly, . and the CVP became elevated. As the homeostatic mechanisms - -- of the body compensated, the HR gradually returned to normal, while the MAP eventually became significantly elevated and remained so until the end of the experiment, probably due to increased cardiac output. The author wishes to express her sincere thanks to her adviser, Dr. James Re Toepfer, for his encouragement and guidance throughout the course of this research. -Thanks to Dr. David E. MacLean for sharing his knowledge and time for the statistical analyses. Thanks to Dr. Dale 17. Fishbeck for his advice, faith and encouragement. iv TABLE OF CONTENTS PAGE ABSTRACT....... . ............. ii ACKNO1,'lLEDGEMENT S . . . . . . . . . . . . . . . . . iii TABLEOF CONTENTS . . . . . . . . . . . . . . . . iv LIST OF ABEREVIATIONS . . . . . . . . . . . . . . V% - LIST OF FIGURES . . . . . . . . . . . . . . . . . ~3-i LISTOFTABLES ... . ovtii CHAPTER I. INTRODUCTION . 1 11. MATERIALS Al!TD METHODS . . . . . . . . . . 7 Animals. . . . . . . . . . . . . . . . . 7 Drugs and Solutions . . . . . . . . . . . 7 Equipment. . . . . . . . . . . . . . . . 8 Anesthesia . . . . . . . . . . . . . . . 9 - - Surgical and. Experimental Procedure . . . 10 Measurement of Data . . . . . . . . . . 12 - 111. RESULTS . . . . . . . . . . . . . . 13 Descriptive Analysis . . . . . . . . . . 13 Mean Arterial Pressure . . . . . . . . 42 Central Venous Pressure . . . . . . . . --4 2 T IT!ave Magnitude . . . . . . . . . . . . . 44 -~ Pearson Correlation . . . . . . . . . . . 45 .- 2- v TABLE OF CONTENTS (Continued) PAGE IV . DISCUSSION ......em...e... 48 .................... APPENDIX 54 BIBLIOGRAPHY ............~..... 103 LIST OF ABBREVIATIONS ABBREVIATION DEFINITION UNITS C. 0. Cardiac output b~m Beats per minute CVP Central venous pressure mmHg DMSO DP ECG HR IV MAP Max Min PP R to R interval R wave S. E. SF SV TPR Time T wave Dimethyl sulfoxide Diastolic pressure mmHg Electrocardiogram Heart rate bpm Intravenously Mean arterial pressure mmHg Maximum l?ini mum Pulse pressure mmIig - - Dist,mce between R nave peaks mms ECG deflection corresponding mvs - to ventricular depolarization Standard error Systolic pressure mmHg Stroke volume -- Total peripheral resistance minutes: seconds ECG deflection corresponding to ventricular repolarization Volume per volume - A LIST OF FIGURES FIGURE PAGE 1 . Graph o f Mean M.AP (+ S. E. ) vs. Time . . . . . . . . 29 - 2. Graph of Nean CVP (+S.E.) vs. Time . . . . . . . . 30 - 3. Graph of Mean HR (+S.E.) vs. Time . . . . . . . . 31 - I$. Graph of Mean R !'iave Nagnitude (+s.E.) vs. Time . 32 - 5. Graph of Mean T :'lave Nagnitude (+s.E.) vs. Time . 33 - TABLE LIST OF TABLES PAGE .... 1 . Statistics for Control and . Treatment MAP 14 2 . Statistics for Control and Treatment CVP .... 17 3 . Statistics for Control and . Treatment HR ... 20 4 . Statistics for Control and Treatment R la!ave ................... Magnitude 23 5 . Statistics for Control and Treatment T !7ave Magnitude ................... 26 ...... . . 6 T-Test for Paired Comparisons: DP 34 ....... 7 . T-Test for Paired . Comparisons: SP 35 ....... 8 . T-Test for Paired . Comparisons: PP 36 ...... . 9 T-Test for Paired Comparisons: MW 37 ...... . 10 T-Test for Paired Comparisons: CVP 38 . . . ...... . 11 T-Test for Paired Comparisons: HR 39 12 . T-Test for Paired . Comparisons: R Magnitude . . 40 . 13 .. T-Test for Paired . Comparisons: T l4agnitud.e . . 41 • .............. 14 Pearson Correlation 47 INTRODUCTION Dimethyl sulfoxide is a relatively new and very controversial drug. In recent years it has been hailed as a 1lmiracle drugv and the long awaited cure for arthritis. This derivative of lignin and by-product of the paper - industry so far has proven extraordinary and diverse, and much work is currently in progress to further explore its potentials. Its analgesic, antiinflammatory, antiedamatous and bacteriostatic properties have made it a valuable tool of the veterinary profession. Use by physicians in the United States has only been approved for treatment of interstitial cystitis, although it is used extensively throughout Eurasia. This research attempts to establish a pattern be- -- tween the intravenous injection of DMSO in the anesthetized cat and the resulting effects on the cardiovascular syste& namely the MAP, CVP, HR, and R and T wave amplitudes. The latter three are obtained from electrocardiogram (ECG) analysis. -- A brief background of the chemical and pharmaco- logical properties of DMSO is necessary for a more complete understanding of its actions. First of all, DMSO is a prominant member of the family of polar but aprotic sol- -~ vents, being extremely versatile because it can act as a - -- nucleophilic reagent at either the oxygen or sulfur terminal. Its structure can be visualized as a tetrahedron: P CH3-d-CH3 0. The compound's polar nature, capacity to accept hyd.rogen bond.s, and small, compact structure result in its ability to associate with water, proteins, carbohyd.rates, nucleic acids, ionic substances and. other constituents of living systems. This combination, as theorized. by Szmant (1975)~ may be related. to its ability to penetrate living tissues without causing significant damage. Klingman (1965), using varying concentrations of DMSO, demonstrated its ability to easily cross most mem- branes (except nails and tooth enamel) by a reversible process. The integrity of the membranes appeared unaf- fected, except when very concentrated (90-100%) doses - - came in direct contact sith the membrane, Rapid movement and generalized distribution of DIiISO into nearly every - tissue of the body was shown by Denko et ale (1967), Gerhards and Gibian (1967)~ and Kolb et al. (1967). This penetrating ability makes it a useful vehicle for many d.rugs, often enhancing their actions. For ex- - ample, Klingman (1965) mixed dyes and 5teroid.s with DMSO and. reported. enhanced. penetration through human skin. It has also served. as a carrier to treat viral infections, such as herpes simplex in man (~shton et al., 1971) and feline panleukopenia (Dalce, 1967), and certain cancer chemoth%-apy models (Elzay, 1967). But because of this carrier effect, care must be ta.ken ahen determining the dosages of drugs used in conjunction with DIISO, especially those affecting the cardiovascular and central nervous systems (Upson, 1980). For example, nhen Smith et a-1. (1967) injected DPISO IV into unanesthetized cats, the LD 50 \?:as approx- imately 4 g/kg; but, in experiments by ~i~tefa'o and. Iilahn in 1965 with cats anesthetized using a barbituate -urethane solution, the LD 50 aas'less than 0.4 g/kg. Rabbits anesthetized with sodium pentobarbital required only 1.8 g/kg of DMSO IV as a lethal dose (Domer et al,, 1977), while 19.2 g/kg was required to kill unanesthetized rab- - - bits (Caujolle et al., 1967). Cardiovascular effects of DMSO sere examined by - Klingman ( 1965), who found topically applied DMSO to be a potent histamine-releasing agent, Histamine has a vasodilating effect on the arterioles and increases cap- illary porosity. This permits leakage of both fluid and - plasma proteins between the blood vessels and the tissue&. In a study by Bradham and Sample (1967) involving topical- DMSO application in dogs, the plasma volume showed a mean decrease of 6.476, and in another experiment the extra- cellular fluid showed a mean decrease of 4,376. - -. The nature of the cardiac inotropic response to DMSO is highly variable in the literature researched. In experiments by Spilker in 1972, cat and dog myocardium exhibited only inhibited contractile strength in response to very modest concentrations of DMSO (O.O7M), while Shlafer and Karoa (1975)~ using rat and guinea pig myo- cardium, found concentrations of 0.7T4 or below produced positive inotropy. DMSO appears to alter the myocardial contractile strength by several mechanisms, including osmotic stress placed on the myocardial cell (Shlafer and Karovr, 1975), a change in membrane permeability to nater and electrolytes (Franz and Bruggen, 1967), and changes in enzyme activity (Rammler, 1967;,Burges et ale, 1769) - - In vivo experiments examining the effects on chronotropy produced variable results also. Using - anesthetized cats, DiStefano (1965) found the IIR fell transiently immediately after administration of DNSO IV (200 mg/kg), but returned to normal values within five minutes. PBterson and Robertson (1967)~ hoeever, mcorde-d an increase in HR of approximately 20-30 bpm at 5000 mg and 10,000 mg DMSO IV to anesthetized dogs. After injecting 1.1-3.3 g/kg DI4SO IV to anesthetized cats, Spilker (1972) observed a trcansient increase in HR, follov~ed by a decrease - - for one or tao minutes, then a return to control level. Blood, pressure experiments also yield.ed. variable results. DPISO vas administered IV to anesthetized cats at 200 mg/kg at 15 minute intervals by DiStefano in 1965. At a cumulative d.osage of 1 g/kg, the increment vras d.oubled.. The blood. pressure fell transiently imrned.ia.tely after administration, and. returned to normal within five minutes. The repeated IV administration mhere each dose nas doubled led to grad.ually lowered. blood. pressure, until d.eath at 4 g/kg. In another experiment using anesthetized cats, Spilker (1972) injected 1.1-3.3 g DMSO/kg and obtained a biphasic response. A transient increase was followed by prolonged blood pressure depression. It returned to control level in dne to two minutes, then became slightly - - elevated. In a study involving brain edema reduction by - Camp et al. in 1981, a transient increase in CVP mas observed after DNSO administration. This increase peaked at five minutes, then returned to normal. However, this result was khought to be due to the large volume of-10% - DMSO solution injected (approximately 27 ml to a 3 kg rabbit). I'lhen Del Bigio et al. (1982) injected the same dosage over a three hour interval, no significant change in CVP was noted. - -- Since several of the above experiments demonstrated a variablity of response to DTvISO , this research was und.ertaken using carefully controlled, experimental con- d.itions and. using a large number of repiicated trials. In ad.d.ition, to evaluate the total cardiovascu1a.r response, multiple parameters were examined simultaneously. MATERIALS AND METHODS Animals Thirty-two healthy cats of varying age, sex, and weight were rand.omly selected., then paired accord.ing to sex and. weight. One member of each pair lxas d.esignated a control, the other an experimental (DMSO-treatment) animal. The control and, experimental groups each consisted of eleven females, two males and. three neutered. males, All cats were fed. commercial dry cat food, and supplied with fresh water 9 libitum. Drugs and. Solutions Normal saline (0.9%) was used. either for injection - - or as a medium for other solutions. This solution was sterilized and, kept refrigerated., but was warmed to room - temperature at least one hour before use, Fresh solutions were prepared ~veekly. Sodium citrate solution, used in the blood pressure detection apparatus, was prepared by dissolving 10-g of - sodium citrate crystals per liter normal saline. Heparin, used as the anticoaggulant, was prepared by dissolving 50 mg heparin per milliliter normal saline. DMSO solution was prepared by diluting one part - - -- DMSO (1.100g/ml) to one part sterile normal saline to obtain a 50:50 v/v solution for injection. Methoxyflurane meto fane--Pitman-Moore) was the inhalant anesthetic used during the experiments. The principal response to the drug is central nervous system d.epression and. skeletal muscle relaxation. Light anes- thetic d.epth mas maintained. by monitoring respiratory rate and skeletal muscle relaxation. This level of anesthesia had. no noticeable affect on card.iovascular parameters, and, correlates most closely with plane ii of ether anesthesia. Equipment Two Gilson table- top Polygraphs (Mo d.el #ICT-5H) were used. for the experiments. One recorded the MAP, CVP, and. ECG at a chart paper speed, of 2.5 mm/sec. The - - other record.ed, the ECG at 10 mm/sec. The machines were turned. on at least 10 minutes prior to use to ensure - proper warm-up. Stand.ard, lead. I was used for record.ing the ECG. The positive record.ing need.le e1ectrod.e was placed. in the upper left -thoracic v~all, the negative recording electrode in the upper right thoracic wall, and the ground electrode was placed in the ventral abdominal wall. These three electrodes then connected to the respective leads of the ECG chaanels from each polygraph. The MAP and CVP were each measured using a separate - blood pressure apparatus. Each apparatus consisted of a sodium citrate-filled. reservoir fitted with a calibrated. pressure gauge and. a pressure bulb. This reservoir was connected via a 3-way valve to a Stratham P23AA pressure transducer and. to a PE 50 polyethylene tube which, turn, was attached. to a ca.theter inserted into a blood. vessel. The 3-vray valve was used. to select one of three important functions: (1) calibration, (2) sodium citrate flush of the catheter tip, and. (3) record.ing of blood. pressure. To calibrate, the 3-~1ay valve was set so that the reservoir was connected to the pressure transducer. Thus, knovm pressures could be recorded on the Polygraph by using the pressure bulb and pressure gauge. The MAP channel sensi- tivity could then be adjusted so that 200 mmHg pressure (as indicated by the gauge) resulted in a 4 cm pen deflec- - - tion. To flush the catheter tip (to prevent clotting) the 3-way valve was set so that the reservoir vas connected to the catheter. Pressure aas then increased in the reservoir using the bulb so that sodium citrate could be forced into the catheter tip. To record blood pressure, the 3-way valve was set so that the catheter was connected te- the - pressure transducer. The pressure could then be recorded by the Polygraph. Anesthesia Each cat mas weighed to the nearest 10 gm, then - - anesthesia was induced with Metofane by inserting the head into a plastic chamber attached to a Connel 201 Anesthetic Machine. After induction, an endotracheal tube was inserted and the cuff inflated.. This tube was then attached. to the anesthetic machine and. the amount of Meto fane delivered to the animal nas adjusted throughout the experiment to maintain a constant plane of anesthesia. An oxygen flow regulator, connected. to the anesthetic machine, was ad,justed to deliver 15 ml 02/kg body weight. Suction was applied. as necessary to remove excess fluid, from the lungs and. air-passage mays. Surgical and Experimental Procedure Hair was clipped. from the right and. left med.ia.1 thighs and from the ventral neck region. The left femoral - - vein, right femoral artery, and left jugular vein dissected free from surrounding fascia, blood vessels - and nerves. The femoral vein and artery were cannulated using Abbocath-T, 20-gauge, 3.2 cm IV catheters (Abbott). The catheters aere tied to the blood vessels to prevent chance dislbdgement. The venous catheter was fitte'd with- a male adapter plug (Abbott), to be use d as an injection portal. The arterial catheter was attached. to the poly- ethylene tubing of the pressure transd.ucer for MAP measurements. The jugular vein was catheterized. using -~ - -- a Venocath-18, 28 cm IV catheter (~bbott) for CVP measure- ments. This catheter was advanced until the tip was just superior to the opening of the right atrium, as determine d by: (1) measurement of the d.istance to the heart as determined. by palpation of the heart beat, (2) the slight resistance felt on the catheter when the heart mas actually entered, and (3) the recordings on the CVP channel. If, by chance, the ventricle was entered, the pressure became noticeably greater, and the catheter was then withdrawn until these pressures disappeared. After the conclusion of several of the experiments, the animals were dissected and the catheter was noted, always to be correctly positioned.. Immediately after catheterization was complete, heparin (5 mg/kg) vras injected into the femoral port'al and then forced into the circulation, as were all inject- ions, with an injection of 0.2 ml saline. - - The arterial and jugular catheters sere flushed ~rith sodium citrate solution from their respective res- - ervoirs, and checked for clots. Needle electrodes ?!ere attached in lead I position by insertion through the skin, and sample MAP, CVP and ECG recordings were made. The MU and CVP calibrations were checked and the catheterz flushed once more. YIhen the tracings stabilized, either 1.0 ml/kg of sterile saline solution (control) or 1.0 ml/kg of DIISO (experimental) vras injected into the venous portal. Event markers on both Polygraphs sere depressed at the beginning - - -- of the injection (time O), and were released upon com- pletion. of the injection. In this manner an accurate record.ing of the injection time was obtained.. At the end. of the experiment (15 minutes), the MAP and. CVP calibrations were once more checked. to make sure of the record.ing stab- ility. The cat vas then euthanized.. ~ea2rement of Data Values for the DP, SP, PP, MAP, CVP, HR, R and T waves are tabulated in the appendix. DP and SP values, in mmHg, were measured directly from the traces. PP was calculated using the formula PP=W - E-P. MAP values obtained from the formula MAP=DP + 1/3(PP). Increased precision of measurements was obtained by using a dissecting microscope (7X magnification) with a calibrated ocular scale. The CVP trace often fluctuated - - due to respiratory and heart-induced pressures, so the value recorded was an average. - The HR, in bpm, was calculated using the formula HR=GO/(R to R interval)/chart paper speed. The R to R interval was measured with the aid of the dissecting microscope,-and the chart paper speed was 10 mm/seand. - R and T wave magnitudes were taken from the ECG recorded at 10 mm/second. Again, the microscope was used to increase accuracy. The values were recorded in mvs. T waves could be positive or negative, and were occasion- - ally diphasic. If the later was the case, the height of - -- the tallest peak was recorded. RESULTS Descriptive Analysis The mean, minimum, maximum, range, standard. error and variance are presented. in Tables 1-5. for MAW, CVJ?, HR, R-wave magnitud.e and. T-wave magnitude for each of the 63 time peri0d.s measured. Missing values were eliminated. from the calculations. In ad.d.ition, graphs of the mean values (+s.E.) for each of these variables against the - independent variable time are plotted. in Figures 1-5, respectively. A two-tailed t-test for paired comparisons was used to analyze each of the above variables as well as the DP, SPY and PP.at the time of maximum effect (ta) and at the - - end. of the experiment (tb). The data and. the results of the statistical analyses are presente d in Tables 6-13. - For this analysis, the animals were paired. by sex and., as closely as possible, by weight. Each pair, consisting of an experimental and. a control animal, was assigned to one of 16-blocks. The t-test was performed using the. difference between the values at time 0 and ta or tb, so that normal variations among control and. treatment animals did not affect the results. Missing values were estimated. using the method, of Yates as d.escribed, in Steel and -. - -- Torie (1960). TABLE 1.--Statistics for Control and. Treatment MAP (mrnHg) N= 16 Unless Otherwise Indicated. Control Data Analysis TIME 00 : 00 00:02 00:04 00:06 00:08 00: 10 00: 12 00: 14 00: 16 00: 18 00: 20 00:22 00: 24 00: 26 00:28 00: 30 MEAN 80.8 81.1 81.2 82.0 81.8 8 1.2 80.2 80.4 80.7 80.5 80.5 80.4 80.7 80.7 80.5 80.6 80.8 80.9 81.1 81.0 80.7 80.9 81.2 80.6 80.9 81.1 80.8 80.6 80.4 80.7 81.3 76.3 81 05 81.0 81.3 81.4 81.6 81.7 81.5 81.6 81.0 81.1 MIN 55.7 55.7 55.7 55.7 56.0 53.7 55.0 55.0 54.0 55.0 54.7 54.7 55.0 54.7' 55.0 55.0 55.7 55.3 55.0 56.0 54.0 55.0 55.0 55.0 55.7 54.7 54.7 54.7 54.7 55.0 54.7 53.7 53.7 53.0 52.7 52.0 52.0 51 07 50.0 49.7 49.7 50.0 MAX --- RANGE 101.3 100.6 102.6 101.3 101.7 104.6 102.3 103.7 104.7 103.3 104.0 104.0 103.0 102.0 192.3 103.3 100.6 101.0 103.0 101.7 103.7 102.7 103.0 100.7 101.3 103.3 101.6 100.6 102.3 101.7 101.6 70.3 103.3 104.3 103.3 104.3 102.7 104.6 105.3 103.0 102.0 101.7 -- - -- S.E. -7xK 7.003 7.020 6.987 7.017 7.055 6.991 6.971 7.124 7.041 7.054 6.945 6.994 6.938 6.933 6.943 6.886 7.018 7.074 6.984 6 909 7.061 7.116 6,895 7.017 7.131 7.086 6.953 7.014 6.999 7.070 2: ;A; 6 945 6.974 7.084 6.868 6.985 6.870 6.918 6.776 6.727 VARIANCE *N= 15 observations TABLE 1 .--Continued TIME MEAN MIN MAX DMSO Treatment Data Analysis RANGE 99.0 100.3 100.7 100.6 102.0 103.7 106.4 104.4 106.6 107.0 107.3 109.0 108.7 109.0 109.7 109.0 11 1.0 111.3 110.0 111.4 110.3 71.7 72#6 74.3 75.0 70.0 56.3 57.4 57.6 58.3 59.6 64.6 64.0 65.4 66.0 71.4 71 .O 73.6 81.3 81.0 85.4 89.3 91.6 93.0 VARIANCE TABLE 1.--Continued VARIANCE TIME MEAN MIN MAX 1 12.0 113.0 111.7 111.7 1 12.0 122.7 111.3 108.7 114.7 114.7 112.7 112.7 108.3 109.3 106.3 110.7 110.3 135.0 118.7 RANGE *N= 15 observations 17 TABLE 2.--Statistics for Control and. Treatment CVP (mmHg) N= 16 Unless Otherwise Indicated. Control Data Analysis TIME MEAN O0:OO 0.9 00:02 1.1 00~04 1.4 00:06 1.5 00:08 1.6 00: 10 1.6 00: 12 1.5 00: 14 1.5 00: 16 1.4 00:18 1.4 00:20 1.4 O0:22 1.4 00~24 1.4 00~26 1.3 00:28 1.3 MIN MAX RANGE *N= 15 observations 18 TABLE 2. --Continued. TIME MEAN MIN MAX 04:30* 0.8 -0.5 2.5 05:00* 0.7 -1.2 2.5 05:30 0.6 -1.2 2.5 06:OO 0.7 -1.5 2.5 06:30 0.7 -1.0 3.0 07:oo 0.6 -1.5 3.0 07:30* 0.6 -1.7 3.0 08:OO 0.7 -1.5 3.0 O8:30 0.7 -1.0 2.7 09:OO 0.6 -1.5 3.0 09:30 0.6 -0.7 3.0 1O:OO 0.5 -1.2 3.0 10:30 0.6 -1.5 2.7 11:OO" 0.6 -1.0 3.0 11:30 0.5 -1.2 2.8 12:OO 0.6 -1.0 2.7 12:30 0.6 -1.2 3.0 13~00 0.5 -1.0 3.0 13:30 0.5 -1.3 3.2 14:OO 0.5 -1.5 3.1 14:30 0.5 -1.3 3.0 15:OO 0.5 -1.6 2.9 DMSO-Treatment Data Analysis RANGE S.E. VARIANCE *N=15 observations 19 TABLE 2. --Continued. TIME MEAN MIN MAX RANGE S.E. VARIANCE *N= 15 observations TABLE 3.--Statistics for Control and. Treatment HR (bpm) ~=16 Unless Otherwise 1nd.icated. Control Data Analysis -- - -- TIME MEAN 0O:OO 146.9 00:02 147.2 OO:O4 147.8 00:06* 148.6 00:08* 149.0 0O:lo 147.6 00:12 147.5 OO:l4* 146.0 00:16 148.2 00:18 147.0 00:20 147.6 00:22 147.3 00:24 147.0 00:26* 146.2 00:28 146.0 00:30 147.2 OO:32 147.1 00:34 146.5 00:36 146.7 00:38* 149.0 OO:4O 146.8 00:42 146.6 00:44 146.3 00:46 147.4 00:48 146.6 00:50 146.8 00:52 146.8 00:54 146.5 00:56* 144.4 00:58* 145.5 0l:OO 146.4 0l:lO 146.5 01:20 -146.8 01:30 146.5 01:40 146.3 01:50* 144.8 MIN MAX 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200 . 0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 200.0 RANGE 80.0 80.0 80.0 80.0 80.0 80.0 80.0 80.0 82.9 82.9 80.0 82.9 82.9 82. 9 82.9 82.9 82.9 82.9 82.9 80.0 82.9 80.0 82.9 80.0 80.0 80.0 80.0 80.0 85.7 80.0 80.0 80.0 80.0 80.0 82.9 85.7 82.9 85.7 85.7 85.7 85.7 S.E. VARIANCE *N= 15 observations **N=14 observations TABLE 3.--Continued TIME MEAN MIN MAX RANGE S.E. VARIANCE DMSO Treatment Data Analysis *N= 15 observations **N= 14 observations 22 TABLE 3.--Continue d TIME MEAN MIPT MAX RANGE S.E. VARIANCE 03:oo 152. I 72.7 03:30 131.7 70.6 O4:OO 132.1 71.6 04:30 132.4 70.6 05:OO 133.8 70.6 05:30 132.7 70.6 06:OO 133.1 68.6 06:30 132.9 68.6 07:00* 130.7 68.6 07:30* 131.5 70.6 08:00* 136.8 70.6 08:30* 135.0 70.6 09:OO 135.1 68.6 09:30 136.4 68.6 10:00* 155.4 68.6 10:30* 134.9 68.6 11:00**140.4 106.7 - 11:30* 135.7 68.6 12:00x 134.1 68.6 12:30 134.6 69.6 13:OO 135.4 69.6 13:30 135.2 67.6 14:OOx 135.8 70.6 14:3**133.4 70.6 15:OO 135.0 69.6 *N= 15 observations **&I4 observations TABLE 4.--Statistics for Control and. Treatment R Wave (mvs) N= 16 Unless Otherwise 1nd.icated. Control Data Analysis TIME MEAN MIN MAX 0O:OO 041 0.12 0.85 00:02 0.41 0.06 0.83 00:04 0.41 0.11 0.87 00:06 0.41 0 0.90 00:08* 0.44 0.1 1 0.91 00: 10 0.43 0.14 0.87 00: 12 0.42 0.12 0.85 00: 14" 0.39 0.14 0.77 00: 16 0.42 0.13 0.83 00:18 0.42 0.07 0.87 00:20 0.42 0.10 0.85 00:22 0.42 0.09 0.84 00:24 0.42 0.15 0.85 00:26* 0.41 0.11 0.86 00:28 0.43 0.15 0.85 00:30 0.41 0.07 0.85 00:32 0.42 0.15 0.85 00:34 0.41 0.09 0.85 00:36 0.42 0.09 0.85 00:38* 0.44 0.07 0.85 00:40 0.42 0.12 0.85 00:42 0.41 0.14 0.85 00:44 0.41 0.10 0.82 00:46 0.42 0.09 0.86 00:48 0.42 0.10 0.85 00:50 0.42 0.14 0.84 00:52 0.42 0.11 0.85 00:54* 0.42 0.09 0.85 00:56* 0.40 0.12 0.85 00:58* 0.40 0.12 0.83 01:OO 0.43 0.14 0.85 01:10 0.41 0.11 0.82 01:20 0-42 0,07 0.85 01:30 0.41 0.12 0.82 01:40 0.41 0.12 0.85 01:50* 0.43 0.10 0.84 02:OO 0.41 0.10 0.85 02:30 0.42 0.15 0.85 03:00**0.43 0.14 0.86 03:30* 0.44 0.14 0.85 04:OO 0.42 0.12 0.85 *N= 15 observations **N= 14 observations RANGE 0.73 0.77 0.76 0.75 0.80 0. 73 0.73 0.63 0.70 0.80 0.75 0.75 0.70 0.86 0.85 0.78 0.70 0.76 0.76 0.78 0.73 0.71 0.72 0.77 0.75 0.70 0.74 0.76 0.73 0.71 0.71 0.71 0.78 0.70 0.73 0. 74 0.75 0.70 0.72 0.71 0.73 S.E. 0.061 0.060 0.065 0.063 0.066 0.062 0.061 0.059 0.062 0.065 0.063 0.063 0.062 0.064 0.063 0.068 0.064 0.064 0.062 0.065 0.063 0.063 0.063 0.064 0.063 0.061 0.061 0.069 0.064 0.065 0.061 0.063 0.066 0.061 0.064 0.066 0.064 0.063 0.071 0.066 0.066 VARIANCE 24 TABLE 4. --Continued. TIME MEAN MIN MAX RANGE 04:30* 0.44 0.10 0.87 0.77 05:OO 0.43 0.09 0.86 0.77 05:30 0.44 0.14 0.89 0.75 06:OO 0.42 0.14 0.90 0.76 06:30 0.43 0.08 0.87 0.79 07:OO 0.44 0.11 0.88 0.77 07:30 0.44 0.10 0.91 0.81 08:OO 0.44 0.07 0.87 0.80 08:30 0.43 0.06 0.90 0.84 09:OO 0.42 0.11 0.88 0.77 09:30 0.44 0.11 0.87 0.76 10:00* 0.42 0.17 0.86 0.69 10:30* 0.44 0.11 0.87 0.76 DMSO Treatment Data Analysis VARIANCE 0.071 0.066 0.066 0.066 0.071 0.066 0.069 0.064 0.066 0.062 0.063 0 052 0.072 0.065 0.063 0.072 0.070 0.065 0.076 0.072 0.075 0.069 *N= 15 observations **N=14 observations TABLE 4.--Continued. TIME MEAN 00:36 0.45 00:38 0.45 00:40 0.44 00:42 0.45 00:44* 0.40 00:.46 0.44 00:48 0.44 00:50 0.44 00:52 0.42 00:54 0.43 00:56 0.41 00:58* 0.45 01:00* 0.42 01: 10 0.42 01:20 0.39 01:30 0.37 01:40 0.37 01:50 0.35 02:OO 0.35 02:30 0.34 03:OO 0.34 03:30* 0.32 04:OO 0.35 04:30 0.36 05:OO 0.36 05:30 0.36 06:OO 0.38 06:3O 0.38 07:00* 0.38 07:30* 0.39 08:00* 0.37 08:30* 0.39 09:OO 0.40 09:30 0.40 10:00* 0..41 10:30* 0.41 MIN MAX RANGE VARIANCE *N= 15 observations **N= 14 observations TABLE 5.--Statistics for Control and. Treatment T Bave (mvs) TJ= 16 Unless Otherwise Indicated. Control Data Analysis TIME MEAN 0O:OO 0.19 00:02 0.19 00:04 0.21 00:-06 0.23 00:08* 0.23 0O:lO 0.22 00:12 0.22 00:14**0.19 00:16 0.20 00: 18 0.19 00:20 0.18 00:22 0.18 00:24 0.18 00:26* 0.18 00:28 0.18 00:30 0.18 00:32 0.19 00:34 0.18 00:36 0.18 MIN 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.00 0.01 0.01 0.01 0.01 0.00 0.01 0.01 0.00 0.00 0.01 0.01 0.01 0.00 0.01 0.01 0.01 0.00 0.00 0.01 0.01 0.01 0.01 0.00 0.01 0.01 0.01 0.01 0.01 0.01 0.00 0.00 0.00 0.01 MAX RANGE VARIANCE *N= 15 observations **N= 14 observations 27 TABLE 5.--Continued. TIME MEAN MIN MAX RANGE DMSO-Treatment Data Analysis 00:04 0.12 0.00 0.32 OO:O6 0.13 0.00 0.35 00:08* 0.14 0.00 0.40 00: 10 0.13 0.01 0.50 00: 12 0.14 0.01 0.51 00: 14 0.16 0.00 0.56 00:16 0.17 0.00 0.60 00: 18 -.Om 18 0.00 0.62 00:20 0.22 0.00 0.64 00:22 0.23 0.00 0.65 00:24* 0.25 0.00 0.65 00:26 0.24 0.00 0.65 00:28* 0.27 0.01 0.70 00:30 0.24 0.00 0.70 00:32* 0.22 0.00 0.74 00:34* 0.26 0.00 0.77 OO:36 0.23 0.00 Oe75 *N= 15 observations **N=14 observations S . E . VARIANCE 28 TABLE 5.--Continued. TIME MEAN MIN MAX RANGE 0.75 VARIANCE 0.045 0.059 0.055 0.036 0.056 0.054 0.039 0.037 0.033 0.029 0.028 0.028 0.021 0.019 0.012 0.01 1 0.013 0.010 0.008 0.008 0.008 0.007 0.007 *N= 15 observations **N= 14 observations On Erl -rl (d Q* C .v a, roe. C .rl -rl $4 cd a, hOPI a X Q) nw a 9) L I a, 3 +J mu- -- m LL TABLE 6.--T-Test for Paired. Comparisons: DP DPO=DP at Time 0, DPA=Minimum DP, DPB=DP at 15 Minutes CONTROL TREATMENT D BLOCK DPO - DPA = XI DPO - DPA = X2 X2-X1 1 85 70 15 65 27 38 23 2 66 66 0 5 1 32 19 19 3 - 145 137 8 50 2 1 29 21 - 4 65 60 5 35 18 17 12 5 47 45 2 65 27 38 36 6 55 50 5 43 35 8 3 7 44 39 5 42 16 26 18 11 8 56 54 2 35 17 16 9 82 68 14 77 68 9 -5 10 50 45 5 39 35 30 11 65 65 o 60 74 44 16 16 12 100 78 22 50 37 13 -9 13 40 30 10 80 0 46 34 80 36 14 50 50 100 20 80 15 46 41 5 6 1 30 3 1 26 16 8 Lt 83 1 55 15 40 39 t=Lt. 258** (P- "Significant **Highly significant TABLE 7. --T-Test for Paired. Comparisons: SP SPO=SP at Time 0, SPA=llinimum SP, SPB=SP at 15 Minutes CONTROL TREATMENT D BLOCK SPO - SPA = 1 SPO - SPA = X2 X2-X1 1 1 20 106 14 122 55 67 53 2 90 89 1 97 73 24 3 - 181 10 23 171 95 36 59 49 - 4 98 94 4 6 1 30 31 27 5 76 74 2 94 45 49 47 6 92 87 5 83 69 14 108 9 7 115 7 75 38 37 30 8 9 1 88 3 57 25 32 11 29 9 109 98 1 38 1 26 12 1 10 89 85 4 loo 64 36 32 11 90 90 0 100 79 21 21 12 132 43 90 69 2 1 -22 175 65 13 87 22 116 50 66 1 44 14 85 84 142 45 97 2 15 96 76 74 93 49 44 42 16 1 46 143 3 79 22 57 54 t=4.666** (pt0.001) BLOCK SPO - SPB = XI SPO - SPB = X2 D -- **Highly significant TABLE 8.--T-Test for Paired Comparisons: PP PPO=PPat Time 0, PPA=Minimwn PP, PPB=PP at 15 Minutes CONTROL TREATMENT D BLOCK PPO - PPA = X1 PPO - PPA = X2 X2-X1 1 35 27 8 57 25 32 24 2 24 20 4 46 40 6 2 3. 36 34 2 45 15 30 28 4 33 30 3 11 15 12 - 26 13 5 29 28 1 29 16 15 6 37 32 5 40 34 6 1 7 7 1 68 3 33 11 22 19 8 35 31 4 22 8 14 10 9 27 22 5 6 1 46 15 10 BLOCK PPO - PPB = XI PP0 - PPB = X2 D - - 1 35 33 2 57 67 -10 -12 2 24 23 I 46 64 -18 -17 3 36 37 - I 45 45 o 1 4 33 34 - 1 26 26 0 1 - 5 29 34 -5 29 30 - 1 0 4 6 37 37 40 48 -8 -8 7 7 1 75 -4 33 40 -7 -3 8 35 40 -5 22 28 -6 - 1 9 27 30 -3 6 1 6 1 O 3 10 39 40 - 1 26 30 -4 -- -3 - 11 25 24 1 40 42 -2 -3 12 75 57 18 40 38 2 -16 13 47 36 11 36 35 1 -10 14 35 36 - 1 42 37 5 6 15 30 3 1 - 1 32 36 -4 -3 16 62 64 -2 24 19 5 7 --- **Highly significant 37 TABLE 9. --T-Test for Paired Comparisons: MAP MAPO=MAP at Time 0, MAPA=Minimum MAP, MRPB=MAP at 15 minutes CONTROL TREATMENT D BLOCK MAP0 - MAPA = XI MAP0 - MATA = X2 X2-X1 1 96.7 82.0 14.7 84.0 37.0 47.0 32.3 2 74.0 73.7 0.3 66.3 45.7 20.6 200 3 3 157.0 148.3 8.7 65.0 26.0 39.0 30.3 4 - 76.0 71.3 4.7 43.7 22.0 21.7 17.0 5 56.7 54.7 2.0 74.7 33.0 41.7 39.7 6 67.3 62.3 5.0 56.3 46.3 10.0 5.0 7 67.7 62.0 5.7 53.0 30.0 23.0 17.3 8 67.7 66.3 1.4 42.3 19.7 22.6 21.2 9 91.0 78.0 13.0 97.3 87.3 10.0 -3.0 10 63.0 58.3 4.7 82.7 47.3 35.4 30.7 11 73.3 73.3 0.0 73.3 55.7 17.6 17.6 12 125.0 96.7 28.3 63.3 47.7 15.6 -12.7 13 55.7 41.7 14.0 92.0 393 52.7 38.7 14 61.7 6 0.4 114.0 28.3 85.7 85.3 15 56.0 52.0 4.0 71.7 36.3 35.4 31 04 16 104.7 103.0 1.7 63.0 17.3 45.7 44.0 t=4.684** (P