摘要:

The myocardial (arterial-coronary sinus) balance of oxygen and lactate was studied before a cardiopulmonary bypass and during the first 5 min of a normothermic bypass in two patient groups undergoing coronary revascularization for multiple coronary artery disease. The hemodilution (HD) group was hemodiluted before the bypass with dextran 70 (15 ml/kg; resulting mean hematocrit 32%) and further at the beginning of the bypass due to nonhemic priming of the oxygenator (mean hematocrit 15%). The control (C) group was not diluted before the bypass, and four units of red blood cells were included in the oxygenator priming (mean hematocrit 27% after the beginning of the bypass). The preoperative dilution produced a decline in the coronary sinus blood oxygen tension and oxygen saturation, but no change in the arterial-coronary sinus lactate balance. After the first 5 min of the bypass, the heart produced lactate in both the HD group and the C group, but the lactate production was more pronounced in the HD group. At the same time, the coronary sinus blood oxygen saturation was lower in the HD group than in the C group. Hypotension frequently accompanied the beginning of the bypass in both groups. It is concluded that the hemodilution to a hematocrit level of 32% in patients undergoing coronary revascularization for multiple stable coronary artery disease produces compensatory changes in myocardial oxygen extraction, but no changes of a generalized ischemia can be demonstrated. The hemodilution to a hematocrit level of 15 % produces myocardial ischemia in patients with a normothermic unloaded heart, adding to the effect of hypotension at the beginning of the bypass.

ISSN:0014-312X    

DOI:10.1159/000128401

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Liver mitochondrial phosphorylative activity, hepatic adenine nucleotides, and hemodynamic parameters were studied in 23 pigs with peritonitis induced by cecal ligation and perforation. Between 2 and 7 days after treatment, the onset of an apparent hyperdynamic state, characterized by an increased cardiac index and decreased total peripheral resistance index, occurred. In this period, the energy charge level was barely maintained and the occurrence of liver mitochondrial enhancement was observed. However, 10–14 days after treatment, the onset of a hypodynamic state with its inverse patterns in hemodynamics took place. In this period, the energy charge level fell to 0.68, concomitant with a marked decrease in mitochondrial function. Further, a high positive correlation between the cardiac index and liver mitochondrial phosphorylative activity was noted (r = 0.85, p < 0.01). These results suggest that liver mitochondria play a major role in the metabolic and hemodynamic adaptations occurring during sepsi

ISSN:0014-312X    

DOI:10.1159/000128402

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Serum activities of amylase, lipase, phospholipase A2 and transaminases were measured in mice with diet-induced acute pancreatitis. To study the role of choline deficiency, one control group received only a choline-deficient diet (CD diet), another group received the choline-deficient diet with 0.5% DL-ethionine (CDE), and a third group received the choline-deficient diet and was given ethionine intrapentoneally. Serum amylase activities increased after 1 day of treatment in all experimental groups. In contrast, lipase activity rose later in the groups receiving ethionine either in the diet or intrapentoneally. In the CDE group there were significant changes in phospholipase A2 on the fourth day after test feeding was started, but no rise was seen in the other groups. Conespondingly, in the group receiving the CD diet alone and the group receiving intraperitoneal ethionine the mortality was significantly lower than in the group receiving ethionine in the diet. In all experimental groups there was a significant rise in serum transaminases (ASAT, ALAT). The rise in ALAT on day 4 was significantly higher in the CDE group than in the other two groups. The mortality rate in the CDE diet group on day 4 was 91 %. In the animals to which ethionine was given intraperitoneally the conesponding mortality was 21 %. In the CD diet group all animals survived for more than 4 days. The present results suggest that serum lipase and phospholipase A2 activities conelate better with the severity of diet-induced pancreatitis than do serum amylase levels. The most severe cases of the disease seemed to be associated with a rise in serum phospholipase A2 activity. The significant rise in serum transaminases in all experimental groups indicates liver damage, which cannot be ignored when this experimental model is used for studying acute pancreatitis.

ISSN:0014-312X    

DOI:10.1159/000128403

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Efficacy of transplanted hepatocytes was evaluated in rats with a surgically induced acute hepatic failure. After 75% liver resection and portacaval shunt, the intrasplenic or intraperitoneal injection of 20 million isolated fresh hepatocytes was shown to significantly reduce the mortality rate. These results confirm that the transplantation of isolated hepatocytes may prevent death in rats with acute hepatic failure, and suggest that hepatocyte transplantation acts by a mechanism of hepatic support.

ISSN:0014-312X    

DOI:10.1159/000128404

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The pancreatic ascites of 2 patients and the drainage fluid collected adjacent to the pancreas postoperatively of 1 of them were analyzed for protein composition and enzyme activity. We did not find a proteolytic activity, especially enzymatically active trypsin and chymotrypsin in these fluids. Immunoreactive (inactive) trypsin was, however, present in rather high concentrations. The drainage fluid changed from an inflammatory exudate to a fluid similar in composition to pancreatic juice later on. Our results indicate that pancreatic ascites consist of a combination of enzyme-rich pancreatic fluid and protein-rich exudate from the inflamed pancreas. No evidence of peritonitis or of proteolytic activity capable of inducing peritonitis was found.

ISSN:0014-312X    

DOI:10.1159/000128405

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The influence of warm and cold ischemic time (WIT and CIT) on renal allograft function and allograft survival rates was analyzed from the Eurotransplant data. From 1977 through 1980 renal allograft recipients were divided into three groups, according to the length of the WIT of their graft: group I, 0–10 min (n = 2,636); group II, 11–20 min (n = 108); group III, 21–35 min (n = 17). Differences in graft function or graft survival have not been observed between these groups. It is concluded that donor kidneys with a WIT up to 20 min are acceptable for transplantation. The transplantation results in group III suggest that 35 min is a safe limit for acceptance, but the small number of transplantations in this group does not justify a firm conclusion. A combined analysis of warm and cold ischemia shows that simple cold storage up to 50 h is safe and acceptable, provided that warm ischemia is kept minimal ( < 10 min). It seems advisable to keep hypothermic preservation within the limit of 30 h, when WIT exceeds 1

ISSN:0014-312X    

DOI:10.1159/000128406

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The production of experimental cirrhosis in the rat, most commonly by multiple doses of carbon tetrachloride (CCl4), is a difficult process with a low yield of ‘cirrhosis’ of widely varied histology. This is due to an unpredictable variation in the response of the rat liver to CCl4. Using a method of monitoring the body weight change of the rat in response to intragastric CCl4 has produced a high yield (76%) of cirrhosis with 8–10 doses of CCl4. This improved control over liver damage has now made it possible to produce a ‘standardized’ type of decompensated micronodular cirrhosis. A simple non-invasive method of determining when this point has been reached, using a visual grading of ascites during light halothane/oxygen anaesthesia, is

ISSN:0014-312X    

DOI:10.1159/000128407

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The purpose of this study is to evaluate the permeability of a silicone rubber membrane to two toxic substances, ammonia and ethanol, under high vapor tension. A device was assembled for testing the diffusion of the substances through a silicone rubber membrane interposed between two aqueous phases. 9 experiences were carried out with ammonia at different temperatures: 3 at 11 °C, 3 at 24 °C and 3 at 37 °C. 8 experiences were carried out with ethanol at different temperatures: 3 at 11 °C, 3 at 24 °C and 2 at 37 °C. Mean transmembrane flow (µmol/m2·h) for ammonia was 43.99 at 11 °C, 59.18 at 24 °C and 145.45 at 37 °C. Mean transmembrane flow (mmol/m2·h) for ethanol was 6.48 at 11 °C, 12.54 at 24 °C and 22.51 at 37 °C. The results confirm that ammonia and ethanol in water solution can pass through a silicone rubber membrane. Better results could be expected with both aqueous phases in motion as in di

ISSN:0014-312X    

DOI:10.1159/000128408

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The effect of systemic penicillin G treatment on the local tissue damage 12 h after a high velocity missile injury in skeletal muscle has been studied in pigs (n = 13). Blood pressure, rectal temperature, hemoglobin concentrations, hematocrits, blood gases and acid base balances were followed and the tissue levels of ATP, creatine phosphate, glucose-6-phosphate, glucose and lactate were determined in control skeletal muscle as well as in muscle samples taken from the wound area. After 12 h all devitalized tissue was debrided and weighed. Penicillin G treatment slightly diminished the local tissue metabolic deterioration and significantly reduced the amount of debrided tissue as compared to untreated animals. It may be concluded that early treatment with penicillin G will considerably diminish the local tissue damage during the first 12-hour period following a high velocity missile injury.

ISSN:0014-312X    

DOI:10.1159/000128409

出版商:S. Karger AG    

年代:1984

数据来源: Karger