Thesis (Ph. D.)--Georgia State University, 2007. / Title from file title page. Chun Jiang, committee chair; Delon Barfuss, Deborah Baro, Teryl Frey, committee members. Electronic text (226 p. : ill. (some col.)) : digital, PDF file. Description based on contents viewed Nov. 1, 2007. Includes bibliographical references (p. 210-226).

Thesis (M.S.)--University of North Texas, Dec., 2007. / Title from title page display. Includes bibliographical references.

Maintenance of normal health requires an intact stress system capable of mounting the metabolic, autonomic, behavioural and motor responses required for coping with or avoiding physiological and pathological challenges. The neuroendocrine component of this response principally involves the hypothalamic-pituitary-adrenal (HPA) and sympatho-adrenomedullary (SAM) axes. Impaired regulation of these axes has been implicated in the pathogenesis and expression of numerous disease states, however, it has proved very difficult to reproducibly activate the HPA and SAM axes and no single test exists that can reliably and safely be used to study these systems in man. Carbon dioxide (CO2) is the principal regulator of respiration, acid-base balance and behavioural-state arousal in humans. Paradigms of CO2 inhalation have been used in psychiatric research to investigate panic and anxiety disorders, but evaluation of other components of the stress response to CO2 has not previously been performed. I hypothesised that a single breath of 35% CO2 would be a simple and reliable tool for the evaluation of the stress response in humans. A single breath of four doses of CO2 (5%, 25%, 35% and 50%) was administered to 9 healthy volunteers in a randomised, single blind fashion. Subjective symptoms of anxiety increased in a dose-dependent manner. Inhalation of a single breath of 35% CO2 stimulated significant ACTH (p = 0.006), noradrenaline (p < 0.0001), cortisol (p = 0.02) and prolactin (p = 0.002) release. It also provoked an acute pressor response and an associated bradycardia (p < 0.0001 for both). No significant habituation of psychological, HPA or cardiovascular responses was seen when this dose was repeated after one week (n = 10) or 6 months (n = 5). It was apparent that a single breath of 35% CO2 reliably and safely produced SAM and HPA axis activation and further studies were then undertaken to assess the mechanism by which the observed responses occurred and its potential clinical implications. Administration of naltrexone (an opiate antagonist) to 10 normal volunteers disinhibited the HPA axis (p < 0.0004), whilst administration of metyrapone (a cortisol synthesis inhibitor) significantly reduced baseline cortisol (p < 0.03) levels. However, this alteration in HPA axis activity had no effect on either cardiovascular or psychological responses. Further, in a study of 8 breastfeeding mothers (a state associated with physiological suppression of the HPA axis) suckling significantly reduced plasma cortisol levels compared with control (p = 0.002) and bottle-feeders (p = 0.003). Despite this cortisol, systolic blood pressure (SBP), heart rate and psychological responses to 35% CO2 were not affected

Pulse oximeters are used in operating rooms and recovery rooms as a monitoring device for oxygen in the respiratory system of the patient. The advantage of pulse oximeters over other methods of oxygen monitoring is that they are easy to use and they are non-invasive, which means it is not necessary break the skin to extract blood for information to be obtained. The standard for the measurement of partial pressure of CO2 and O2 is an arterial blood gas analysis (ABG). However routine monitoring using this method on a continuous basis is impractical since it is slow, painful and invasive. Measuring carbon dioxide is critical to preventing ailments such as carbon dioxide poisoning or hypoxia. The problem is, currently there is no known effective non-invasive method for accurately measuring carbon dioxide in the body to properly assess the adequacy of ventilation. The objective of this study was to experimentally use spectroscopy in the visible spectrum and the principles of operation of a pulse oximeter to incorporate a method of non-invasive real-time carbon dioxide monitoring that is as quick and easy to use.