摘要:

A radioimmunoassay for porcine, cationic, pancreatic elastase (irPE) is described. Normal porcine serum contains only small amounts of irPE (<3 µg/l). IrPE in serum and peritoneal exudate from 6 pigs with experimental pancreatitis was found mainly in a molecular form corresponding to free pro-enzyme. The presence of α1-, α2-macroglobulin-bound elastase-like enzymatic activity in the peritoneal exudates from pigs with pancreatitis, however, indicates that the proteinase is to some extent released as the active enzyme. In some pigs with pancreatitis, the elastase-like activity against Succ(Ala) in the peritoneal exudates increased during the experiment, arguing for a progressive activation of pro-elastase. Free proteolytic activity was not observed in any of the peritoneal exudates. This low degree of activation of elastase and the fact that the elastase inhibiting capacity is substantially larger than the trypsin inhibiting capacity in serum and biological fluids, leads us to the conclusion that active elastase is not a factor of principal importance in the pathogenesis of proteinase inhibitor consumption and tissue damage in our experimental pancreatitis mod

ISSN:0014-312X    

DOI:10.1159/000129139

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In a standardized porcine model of acute, hyperdynamic endotoxemia the distribution of intraorgan blood flow within heart, kidney and brain was analyzed. Twelve pigs received either short-term (23 min) or long-term (205 min) continuous intravenous infusion of endotoxin (Salmonella abortus equi). A high cardiac output/low peripheral resistance state was maintained throughout the 3.5 h observation period. Total organ blood flow in heart, kidney and brain remained high; however, already small amounts of endotoxin provoked a significant redistribution of intraorgan blood flow within the left ventricle and the kidney. These characteristic alterations were absent in a control group of 5 animals subjected to the same protocol, but receiving 0.9% saline instead of endotoxin. Deterioration of respiratory function developed exclusively after continuous intravenous endotoxin infusion over 205 min, indicating incipient organ failure. Using electron microscopy, endothelial cell swelling and entrapment of blood cells in capillaries of the midmyocardium as well as severe ultrastructural damage in the kidney could be demonstrated already after 90 min of endotoxemia in two additional animals. It is concluded that already in the initial phase of acute endotoxemia, in presence of high cardiac output and high global organ blood flow microcirculatory deterioration and organ failure develops. As small amounts of endotoxin are capable of inducing these alterations, earliest possible diagnosis of endotoxemia should be achieved in critically ill patients.

ISSN:0014-312X    

DOI:10.1159/000129140

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

An experimental randomized prospective study was carried out in 64 dogs to evaluate the effect of intraluminal fecal matter at the anastomosis with/without peritonitis on the healing of a colonic anastomosis. The animals, none of whom had bowel preparation, were randomized in four groups: group I sigmoid resection and anastomosis, group II sigmoid resection and intraluminal fecal diversion from the anastomosis, group III induced fecal peritonitis, sigmoid resection and anastomosis and group IV induced fecal peritonitis, sigmoid resection and intraluminal fecal diversion from the anastomosis. Forty-eight hours before sacrifice at 5, 10 and 15 days, 10 µCi/kg C14 proline was given intravenously. Specimens were analyzed for hydroxyproline content, tissue counts and specific activity. The tissue counts and specific activity were analyzed by three-way analysis of variance. Overall, regardless of the groups, there was a statistically significant decrease in specific activity and tissue count from day 5 to day 15 and day 10 to day 15 at the anastomosis (p < 0.05). When comparing groups II and IV to groups I and III, there was a significant increase in specific activity and tissue count at the anastomosis of group II and IV (p < 0.05). This experimental study demonstrates that early anastomotic healing can occur even in presence of treated peritonitis as long as the fecal matter is diverted and prevented from coming in contact with the anastomotic site without disrupting the bowel continuity or function

ISSN:0014-312X    

DOI:10.1159/000129141

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The anatomy and histology of the rectal muscular cuff was studied in 15 dogs with an ileal pouch-anal anastomosis. Eight channel, three-dimensional anal manometry showed normal maximal squeeze presure (128 ± 20 mm Hg) compared to a control group (135 ± 4 mm Hg). The rectal muscular cuff showed complete absence of the cuff in three cases. In 12 dogs, the rectal cuff was retracted to a length of less than 1 cm, the muscle fibers were degenerated and fibrotic. The results in the canine model and the clinical results of patients with an ileal pouch-anal anastomosis with a cuff demonstrated that a rectal muscular cuff is not essential to maintain continence after ileal pouch-anal anastomosi

ISSN:0014-312X    

DOI:10.1159/000129142

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

4’-Epidoxorubicin (Epi-A) administered immediately prior to liver resection has been suggested as treatment for patients with primary liver carcinoma. Long-term toxicity was studied in rats given a single dose of Epi-A intravenously immediately prior to a standard partial hepatectomy (PH). After 52 weeks only 9% of the rats given 5 mg/kg+PH were alive, 79% of the rats given 2 mg/kg+PH and 92% of the PH control survived. The weight gain of the rats given 5 mg/kg+PH was only 17% of that of PH controls. Signs of congestive heart failure were observed in some rats while in others moderate kidney lesions. No histopathological lesions were detected by light microscopy in heart, liver, spleen and bone marrow. For the rats given 2 mg/kg+PH body weight gain, microscopic observations and blood chemistry data (total protein, albumin, alkaline phosphatase, alanine aminotransferase, total bilirubin, creatinine and urea) were comparable to the PH controls. No significant differences in survival were registered between partially hepatectomized and sham-operated rats. The results indicate that Epi-A may be given preoperatively to liver resection without inducing long-term toxic effects on vital organ

ISSN:0014-312X    

DOI:10.1159/000129143

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The efficacy of intravenous or intraosseous infusion of 250 ml of 7.5% NaCl and 6% dextran 60 (H/H) was compared with intravenous Ringer’s lactate (RL) for the initial treatment of patients with hemorrhagic shock due to upper gastrointestinal bleeding. 49 patients were randomly assigned to receive either H/H (n = 26) or RL (n = 23). In the first 16 patients with H/H and in all RL patients, solutions were infused by the intravenous route, while the intraosseous route through sternal puncture was chosen for the last 10 H/H subjects. H/H patients were analyzed together since no differences were noticed between the routes of infusion. The H/H group also received 2.3 ± 0.7 liters of intravenous cristalloid solutions in the first hour and 4.4 ± 0.1 liters in the 24-hour period, while RL received 3.3 ± 0.7 and 7.3 ± 2.4 liters, respectively. Blood pressure (BP) increased during the first 15 min in the H/H group (from 61 ± 17/30 ± 12 to 85 ± 30/48 ± 14 mm Hg) and thereafter, while remaining unchanged in the RL group (from 75 ± 18/40 ± 12 to 75 ± 17/40 ± 14 mm Hg; p < 0.05). The differences between groups were significant throughout 24 h. Urine output and improvement of the Glasgow Coma Score were also higher in H/H patients than in the control group (p < 0.05). There were 5 deaths in RL group and 1 in the H/H group. Sternal of peripheral vein infusion of 250 ml of 7.5% NaCl/6% dextran 60 is an effective initial treatment of hemo

ISSN:0014-312X    

DOI:10.1159/000129144

出版商:S. Karger AG    

年代:1991

数据来源: Karger

ISSN:0014-312X    

DOI:10.1159/000129145

出版商:S. Karger AG    

年代:1991

数据来源: Karger