摘要:

The commonly accepted sequence of low blood flow, tissue hypoxia, lacticacidosis and death does not apply to all patients dying from shock. The hyperdynamic circulation characteristic of severe sepsis is not likely due to peripheral arteriovenous shunts, since in skeletal muscle at least, capillary blood flow is increased and varies directly with cardiac index. A hyperdynamic circulatory state is seen in many patients with sepsis and may be related to metabolic changes rather than changes in oxygen transport. Skeletal muscle capillary blood flow is increased in fasting normal subjects and septic postoperative patients, both of whom are catabolic. Therefore, elevated blood flow, which is characteristic of severe sepsis, may be a response to or necessary for the catabolism of body protein required for energy production. Profound metabolic abnormalities resulting in rapid catabolism may be responsible for the demise of the septic patient. If this concept of sepsis is accepted, it follows that treatment which heretofore has been aimed at increasing blood flow and blood pressure should be redirected to therapy which provides energy substrates and alters hormonal patterns to favor anabolism.

ISSN:0014-312X    

DOI:10.1159/000127935

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Inactivation of gastrin was studied (a) in vitro by incubation with a high-speed supernatant fraction of rat small bowel mucosa and (b) in vivo by perfusing gastrin through the small bowel vascular bed in anaesthetized dogs. In both types of experiment there was a highly significant loss in the bioactivity of gastrin, but no significant change in its immunoreactivity. This showed that gastrin was inactivated by a subtle chemical change which rendered the molecule biologically inactive, yet left its immunoreactivity unimpaired.

ISSN:0014-312X    

DOI:10.1159/000127936

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

In mongrel dogs, the horizontal part of the pancreas was infiltrated with collagenase, cut in pieces, incubated with collagenase, rinsed twice by centrifugation or sedimentation, and implanted into the spleen of the same animal. The operations were terminated by the removal of the rest of the pancreas. Of 26 operated dogs, one died because of a duodenal perforation, five developed severe hyperglycaemia without remission, and 20 were long-term normoglycaemic survivors followed for up to 10 weeks. These 20 animals became spontaneously normoglycaemic in the course of the first 10 postoperative days. Later, during glucose loading tests, the pattern of blood sugar values was the same in the transplanted animals as in those of a group of non-operated dogs, but the insulin release, although immediate, attained half the control values. The plasma insulin in the splenic vein was more than seven times higher than in the peripheral circulation. Splenectomies performed in seven animals were followed by severe hyperglycaemia and death. Light and electron microscopy demonstrated the presence of the intact endocrine and exocrine pancreatic tissues in the spleens of all animals investigated. It is concluded that laborious separations of endocrine from exocrine tissue are not mandatory for ulterior endocrine function, and that in an animal larger than rodents it is possible to obtain a diabetes-preventing function after the transplantation of only a part of the gland.

ISSN:0014-312X    

DOI:10.1159/000127937

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

The uptake and utilization of amino acids in dog kidneys during hypothermic perfusion were studied. 21 kidneys were perfused in a Gambro perfusion machine for 6 days with perfusates based on human albumin with and without addition of 17 L-amino acids. Net glucose uptake by the kidney was lower during perfusion with amino acids in the perfusate than during perfusion without amino acids. A decrease in specific activity of labelled glucose was found during perfusion with amino acids in the perfusate indicating a considerable gluconeogenesis which could explain the difference in net glucose uptake. A higher uptake of fatty acids by the kidney was found during perfusion with amino acids in the perfusate than during perfusion without amino acids. In perfusion without amino acids the concentration in the perfusate of almost all amino acids and ammonia increased and thus a net release of nitrogen was found indicating degradation of protein. In perfusion with amino acids in the perfusate a considerable uptake and release of amino acids by the kidney were found. The most pronounced uptake was registered for glutamine, proline and glycine. The most pronounced release was registered for glutamate, alanine and ammonia. During perfusion with amino acids in the medium, the uptake and release of nitrogen were balanced as distinguished from perfusion without amino acids in the perfusate.

ISSN:0014-312X    

DOI:10.1159/000127938

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

The incorporation of [14C]leucine and [14C]threonine into kidney cortex proteins was studied during 6 days’ hypothermic perfusion of dog kidneys at 8–10 °C and during in vitro incubation of dog kidney cortex slices at 37 °C. Leucine carbon was incorporated into proteins at a higher rate than threonine carbon both during in vitro incubation of kidney cortex slices and during hypothermic kidney perfusion. The incorporation of leucine and threonine during hypothermic perfusion was linear for 6 days but 50–100 times lower than the incorporation of leucine and threonine in kidney cortex slices at 37 °C. During hypothermic perfusion there was a decrease in specific activity of leucine and threonine in the perfusate corresponding to a degradation of proteins which was greater than protein synthesis as calculated from the incorporation of label into proteins. Leucine carbon was recovered in CO2 during hypothermic perfusion and in vitro incubation of kidney cortex slices at 37 °C. The incorporation of threonine carbon into CO2 was about 10% of the corresponding value for leucine both during hypothermic kidney perfusion and during in vitro incubation of kidney cortex slices at 37 °C. It is concluded that there is a turnover of kidney proteins during hypothermic perfusion with a perfusate containing a

ISSN:0014-312X    

DOI:10.1159/000127939

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

The effect of exogenous factor XIII on fracture healing has been tested. It could be shown that after administration of the fibrin stabilizing factor, the concentration of fibrin fibres in the fracture haematoma increases. The resistance against breaking is thus enhanced in treated animals as compared to untreated controls, mainly during the early phases of fracture healing. X-ray diagnosis demonstrated an enhanced healing process of the treated fractures. The accelerated fracture healing by factor XIII administration could also be substantiated through histological examinations.

ISSN:0014-312X    

DOI:10.1159/000127940

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Fresh collagen fibers prepared from rabbit tendons or aponeurosis were inserted in either median or sciatic nerves of the same animal. The tissue reactions induced by the autologous fibers were compared histologically with those caused by similarly inserted silk, catgut and homograft sutures in contralateral nerves. Sham operations, passing empty needles, were performed on control nerves. The treated nerves were removed on the 5th to the 30th postoperative day, and histological sections were prepared. The insertion of the different sutures in peripheral nerves resulted in tissue reactions of varying types and degrees, depending on the material used. Catgut and silk thread induced extensive degenerative and inflammatory reactions which persisted for more than 4 weeks. Homograft sutures underwent rapid organization with a minor degree of degeneration and inflammation, which persisted for only a short time. Autograft fibers resulted in minimal myelin degeneration and mild inflammatory processes for 5–10 days, which was only slightly different from the regular course of healing seen in sham-operated control nerves. These initial observations suggest that sutures of autograft fibers may prove advantageous in nerve repai

ISSN:0014-312X    

DOI:10.1159/000127941

出版商:S. Karger AG    

年代:1977

数据来源: Karger