摘要:

It is well recognized that reperfusion causes tissue damage in excess of that produced by ischemia alone. The present study was designed to test this and to evaluate the role of the calcium antagonist, diltiazem (400 μg/kg body weight administered intravenously over 95 min), in ischemia-reperfusion injury of the intestine. Intestinal ischemia was produced by occlusion of the superior mesenteric artery (SMA) with interruption of the collateral flow for 30 min. Reperfusion was established by declamping the SMA for 1 h, and mucosal injury was assessed using a grading scale from 0 to 5. The severity of mucosal damage increased significantly after 1 h of reperfusion, from a mean grade of 2.1 in the ischemia group to 3.8 in the ischemia-reperfusion group (p < 0.01). Diltiazem was effective in the amelioration of histologic changes of reperfusion injury and reduced the degree of mucosal injury from a mean grade of 3.8 in the ischemia-reperfusion group to 2.5 in the diltiazem group (p < 0.05). This study strongly suggests that calcium ions are involved in the pathogenesis of ischemia-reperfusion injury and that diltiazem attenuates this injury by preventing the intracellular calcium influx that occurs during reperfusion.

ISSN:0014-312X    

DOI:10.1159/000129354

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The rapid changes in extracellular oxygenation and intracellular oxidation during ischemia and reflow were measured in deep liver tissue by a novel method combining tissue near-infrared spectroscopy with multicomponent curve-fitting analysis. This method enabled us to make real-time measurements of oxygen saturation (SO2) and amount (THB) of hemoglobin in the liver sinusoid as parameters of extracellular oxygenation state and of redox transition of cytochrome aai as intracellular oxidation state. Clamping of the hepatic artery in rabbit decreased the THB with a transient fall of SO2. Clamping of the portal vein decreased both SO2 and THB. The decreases of SO2 and THB caused by Pringle’s maneuver were larger than the sum of decreases by hepatic artery and portal vein. These changes in SO2 were correlated with intramito-chondrial oxidation state as measured by cytochrome aa3. These results indicate the presence of an interrelationship of oxygen supply by hepatic artery and portal vein. This method was clinically applied during and after clamping of hepatic artery and portal vein in 19 cases of hepatic resection with or without chronic hepatic diseases. The decrease in SO2 values before and after clamping (SO2D) and the slope of SO2 recovery (SO2R) after release were calculated. SO2D and SO2R values of the portal vein in cirrhotics were significantly higher and lower, respectively, than those in the normal liver. These data indicate that the present method provides a rapid and reliable method of quantifying hepatic oxygenation during liver surgery and its perioperative management.

ISSN:0014-312X    

DOI:10.1159/000129355

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The rapid changes in extracellular oxygenation and intracellular oxidation during ischemia and reflow were measured in deep liver tissue by a novel method combining tissue near-infrared spectroscopy with multicomponent curve-fitting analysis. This method enabled us to make real-time measurements of oxygen saturation (SO2) and amount (THB) of hemoglobin in the liver sinusoid as parameters of extracellular oxygenation state and of redox transition of cytochrome aai as intracellular oxidation state. Clamping of the hepatic artery in rabbit decreased the THB with a transient fall of SO2. Clamping of the portal vein decreased both SO2 and THB. The decreases of SO2 and THB caused by Pringle’s maneuver were larger than the sum of decreases by hepatic artery and portal vein. These changes in SO2 were correlated with intramito-chondrial oxidation state as measured by cytochrome aa3. These results indicate the presence of an interrelationship of oxygen supply by hepatic artery and portal vein. This method was clinically applied during and after clamping of hepatic artery and portal vein in 19 cases of hepatic resection with or without chronic hepatic diseases. The decrease in SO2 values before and after clamping (SO2D) and the slope of SO2 recovery (SO2R) after release were calculated. SO2D and SO2R values of the portal vein in cirrhotics were significantly higher and lower, respectively, than those in the normal liver. These data indicate that the present method provides a rapid and reliable method of quantifying hepatic oxygenation during liver surgery and its perioperative management.

ISSN:0014-312X    

DOI:10.1159/000316364

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We studied the histomorphological changes of organs in an animal model of endotoxin tolerance (ETT). ETT was induced by pretreating pigs with increasing doses of endotoxin (ET) before challenging them with a continuous lethal ET infusion. In the ETT group the survival time was prolonged significantly versus controls, so that in the ETT group on an average double the ET challenge dose was administered. In this histomorphological study the lung, kidney, and intestine of almost all animals (ETT group n = 12, controls n = 11) showed about the same unspecific histological shock features. In the liver, however, we diagnosed partly disseminating, partly confluent, but obviously ET-induced, neutrophil liver cell necrosis in 10/12 ETT pigs and in 10/11 controls. We conclude that ETT in our model was not a protective factor against serious liver cell injury after ET administration. Our results may indicate that the ETT phenomenon can be overcome by raising the ET challenge dosage.

ISSN:0014-312X    

DOI:10.1159/000129356

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In this prospective study, we investigated gallbladder (GB) contraction and plasma cholecystokinin (CCK) levels in response to food intake before and 1 month after vagotomy in 27 patients with complicated duodenal ulcer. Highly selective vagotomy (HSV) was carried out in 6 patients, truncal vagotomy and pyloroplasty (TVP) in 4, truncal vagotomy and antrectomy (TVA) in 7, selective vagotomy and pyloroplasty (SVP) in 5 and selective vagotomy and antrectomy (SVA) in another 5 patients with pyloric stenosis. The results of our studies indicated that (1) basal plasma CCK levels increased significantly after vagotomy, (2) none of the vagotomy operations altered the integrated CCK response, (3) unlike HSV, SVA and TVA, SVP and TVP decreased GB emptying and (4) antrectomy significantly enhanced CCK release after food intake. We concluded from these findings that the operative procedure of HSV, SVA or TVA to circumvent bile stasis-related postvagotomy cholelithiasis is superior to SVP or TVP in the surgical treatment of complicated duodenal ulcer.

ISSN:0014-312X    

DOI:10.1159/000129357

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Conjunctival oxygen tension (PcjO2) and routine cardiorespiratory parameters were measured in 8 patients during pulmonary surgery. In each patient we found a close relationship between PcjO2 and arterial blood oxygen tension (PaO2), and for all patients the correlation coefficient was 0.962. The mean values of the ratio between PcjO2 and PaO2 in each patient were ranging between 0.46 and 0.55. We conclude that PcjO2 measurements represent a useful and reliable method for evaluation of peripheral oxygenation and perfusion during pulmonary surgery. Furthermore, the method has been found useful for estimation of arterial blood oxygen tension in hemodynamically stable patients during anesthesia.

ISSN:0014-312X    

DOI:10.1159/000129358

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The effect of 15-deoxyspergualin (DSG) on accelerated rejection was evaluated using a rat heart transplantation model. Lewis rats (LEW, RT1n) served as the organ recipient and Brown Norway rats (BN, RTln) as the donor. In the accelerated rejection model, the LEW recipient was sensitized with BN skin and BN heart was transplanted 7 days later; the heart graft was rejected within 2 days (n = 7). Histologically, the graft showed coagulation necrosis and hemorrhage throughout the myocardium. DSG (2.5 mg/kg/day) was administered to the recipient under the following three protocols: group 1: during the sensitization period (7 days); group 2: from 3 days after the sensitization to 2 days after grafting (7 days), and group 3: immediately after heart transplantation. The mean graft survival period in groups 1 2, and 3 was 4.3 ± 0.8 days (n = 7, p < 0.01, vs. untreated host), 11.7 ± 2.1 days (n = 7, p < 0.001, vs. untreated host), and 2.0 ± 0 days (n = 6), respectively. The rejected grafts in groups 1 and 3 histologically showed coagulation necrosis and hemorrhage. By contrast, in group 2, the major histological change was interstitial lymphocyte infiltration and there were few findings such as coagulation necrosis or hemorrhage. In the complement-dependent cytotoxicity test, serum obtained at the second posttransplant day from the recipients treated in group 1 showed a high cytotoxicity level, although the cytotoxicity level of serum obtained from the recipients treated in group 2 was consistently low. Flow cytometric study revealed that DSG could suppress the proliferation of OX3- and OX33-positive cells if the recipients were treated in group 2. In conclusion, the heart graft survival period was markedly prolonged and the humoral reaction was suppressed by maintaining the recipient serum cytotoxicity level low only when DSG was administered both during the sensitization period and after heart grafting.

ISSN:0014-312X    

DOI:10.1159/000129359

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0014-312X    

DOI:10.1159/000129360

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0014-312X    

DOI:10.1159/000129361

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0014-312X    

DOI:10.1159/000129353

出版商:S. Karger AG    

年代:1994

数据来源: Karger