ISSN:0014-312X    

DOI:10.1159/000129563

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The optimal temperature of the pulmonary flush perfusate is still a matter of controversy. At present, a temperature of 10 °C is favored. This study deals with the structural and functional impact of different perfusate temperatures on lung preservation. In an extracorporeal rat heart-lung model lungs were preserved with Perfadex® solution of 4, 15 and 25 °C and submitted to 2 h ischemia. Heart-lung blocks harvested from male rats were perfused with Krebs-Henseleit solution and ventilated with room air. Lungs were perfused with deoxygenated perfusate via the working right ventricle while the coronary arteries were retrogradely perfused with oxygenated perfusate. Oxygenation capacity (dPO2), peak inspiratory pressure (PIP) and pulmonary vascular resistance were measured. After establishment of baseline functional parameters hearts were arrested with 10 ml St. Thomas cardioplegia and lungs were flushed with 20 ml Perfadex solution. The heart-lung block was then stored for 2 h at 10°C. Reperfusion was performed thereafter under the same conditions. At the end of the trial the lung tissue water was measured by the wet/dry ratio. The perfusion time of the groups flushed with 15 or 25 °C perfusate was significantly lower than that of the 4°C group. After 20 min reperfusion dPO2 of the groups flushed with 15 or 25°C was superior to those submitted to a 4°C flush perfusion. PIP was significantly lower in the 15 ° C group than in the 4 and 25°C groups. The wet/dry ratio revealed the smallest water content in the 15°C group. We conclude that the post-ischemic lung function is dependent on the temperature of the flush perfusate. Among the tested temperatures, perfusion at 15 °C showed the best results. The optimum may therefore lie in

ISSN:0014-312X    

DOI:10.1159/000129501

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Aim of this experimental study was to evaluate acute rejection in a porcine single-lung transplantation model by using 133Xe radiospirometry. Left lung allotransplantation was performed on 11 and autotransplantation on 5 piglets. Postoperative monitoring consisted of 77 radiospirometric examinations with assessments of regional perfusion (Qtx), ventilation (V) and ventilation/perfusion ratio (V/Qtx). Results were compared with transbronchial biopsy. A significant decrease in Qtx (p < 0.01) and an increase in V/Qtχ (p < 0.01) were observed during acute rejection, whereas V remained unaltered. These changes were significant already at minimal rejection (grade A1), and further increased at moderate rejection (grade A3). Sensitivity and specificity of Qtx were 82 and 74%, and those of V/Qtx, 87 and 65%. 133Xe radiospirometry detects even minimal acute rejection after single lung transplantation

ISSN:0014-312X    

DOI:10.1159/000129502

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0014-312X    

DOI:10.1159/000318655

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Maldistribution of multidose blood cardioplegia (BCP) continues to be a problem causing perioperative subendocardial damage. However, it is not known whether α-adrenergic stimulation contributes to the maldistribution of multidose BCP. We have evaluated the effects of phenoxybenzamine (POB) on multidose BCP distribution, with a right heart bypass model in 14 dogs. Although gradual increases in coronary vascular resistance (CVR) were noted in the control group (CP-1: 0.53 ± 0.08, CP-2: 0.57 ± 0.07, CP-3: 0.78 ± 0.10 mm Hg/ml/ min/100 g), there was no significant rise in CVR in the POB group (CP-1: 0.36 ± 0.03, CP-2: 0.37 ± 0.04, CP-3: 0.42 ± 0.04 mm Hg/ml/min/100 g). Improved delivery of BCP was observed in the POB group during CP-3 (endo/epicardial flow ratio 1.72 ± 0.07 vs. 1.21 ± 0.18 in the control group; p < 0.05). These data indicate that improved delivery of BCP can be obtained by α-adrenergic blockade, if multiple injections of BCP are used for cardia

ISSN:0014-312X    

DOI:10.1159/000129503

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0014-312X    

DOI:10.1159/000318656

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

A prospective study of serum cytokine levels was performed in patients randomly assigned to undergo either laparoscopic cholecystectomy (LC) or open cholecystectomy (OC). The kinetics of serum interleukin-1 β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and cortisol were studied in both groups of patients. Cytokine and cortisol levels were measured in serum samples from patients who underwent either LC (n = 14) or OC (n = 14) using enzyme-linked immunosorbent assay and radioimmunoassay, respectively. Serum samples were obtained 24 h before surgery and 24 h and 7 days after surgery. IL-6 levels differed significantly (p 0.05). Kinetic studies of IL-6, IL-1β and TNF-α levels revealed them to behave similarly. 24 h after surgery the levels of these cytokines were higher than those 24 h before surgery. These levels normalized by 7 days after surgery. Cytokine concentrations were always higher in the OC group than in the LC group. IL-1 β and IL-10 levels were the most stable in both groups, though cortisol levels were also fairl

ISSN:0014-312X    

DOI:10.1159/000129504

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We investigated p53 overexpression and the proliferative activity of the primary lesion as well as the clinicopathological features of 75 patients with gastric cancer invading the submucosa (sm cancer), of whom 14 (18.7%) had lymph node metastasis. Among the clinicopathologic features studied, only lymphatic invasion by the primary tumor was related to lymph node metastasis. There was no relationship between immuno-histochemical staining for p53 protein or Ki-67 and lymph node metastasis. The p53-positive rate was 35.7 and 57.1% in patients with and without metastasis, respectively, while the mean Ki-67 labeling index was 38.9 and 38.1%, respectively. Our results suggest that p53 mutation or the proliferative activity of sm cancer do not influence lymph node metastasis, even though p53 mutation may enhance the proliferative activity and metastatic potential of advanced gastric cancer.

ISSN:0014-312X    

DOI:10.1159/000129505

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0014-312X    

DOI:10.1159/000318657

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In this study 20 patients suffering from chronic constipation due to spastic anal sphincters were operated upon using a new surgical technique. The technique aimed at constructing an active anal dilator mechanism using the obturator internus muscles mobilized from both sides and sutured to the side wall of the anal canal in order to overcome the spastic anal sphincters during defaecation. This series included 3 failures (15%), 16 successful cases (80%), and 1 dissatisfied patient despite normal postoperative investigations (5%). Eleven patients (55%) showed immediate postoperative normalization of their defaecation. Five patients (25%) showed normalization of their defaecation after 10 sessions of electric stimulation of the transposed muscles given 1 month postoperatively for 10 successive days. All the successful cases (16 patients) maintained their good results during the period of follow-up which ranged from 16 to 45 months (average = 30.31 months). For the successful cases, follow-up was from 16 to 42 months (average = 26.72 months). Immediate postoperative complications included 3 cases of wound infection and 2 cases of transient incontinence to gases which responded completely to postoperative Faradic stimulation. No cases of persistent incontinence of any degree were detected among the 20 patients studied. The 3 failures were mainly due to avoidable technical problems. The technique was safe, easy, and physiological, using a strictly perineal approach.

ISSN:0014-312X    

DOI:10.1159/000129506

出版商:S. Karger AG    

年代:1997

数据来源: Karger