摘要:

AbstractA pulmonary artery cannula allows the determination of free and wedge pulmonary artery pressures and mixed venous oxygen tension. These indices have been reported to provide useful information in the assessment of the haemodynamic status of the ill patient. The purpose of this study was to compare them with systemic arterial and central venous pressures as predictors of cardiac output during acute continuous haemorrhage in the dog. Pulmonary artery pressure changed almost linearly with cardiac output, and the percentage changes in each were similar; by contrast, systemic arterial pressure was an inferior predictor of cardiac output. Pulmonary artery wedge pressure fell rapidly in the initial phase of bleeding, but right atrial pressure more gradually. The oxygen tension of blood in the pulmonary artery fell steadily during haemorrhage. These findings suggest that data derived from the use of a pulmonary artery cannula may be more useful than systemic arterial and central venous pressures in the detection of hypovolaemia and reduced cardiac output; more frequent use of a pulmonary artery cannula should be made in patients in whom blood volume may fluctuate rapidly.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640102

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractGlyceryl trioleate has been injected into greyhounds as a model of the fat embolism syndrome. Pulmonary vascular pressures, systemic arterial pressure and cardiac output were determined at regular intervals over an 8‐hour period. It has been shown that glyceryl trioleate causes an increased pulmonary vascular resistance and a fall in cardiac output. These effects are mediated partly by a direct mechanical block of pulmonary vessels and partly through a thrombogenic property of the injected fat. The relevance of these findings to the clinical situation is discussed and a sequence of events for the fat embolism syndrome is propose

ISSN:0007-1323    

DOI:10.1002/bjs.1800640103

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractInjection125I‐glyceryl trioleate (0.5 mg/kg) into the right atrium of anaesthetized greyhounds caused the following changes: sequestration of fat in the right side of the heart; 95 per cent removal by the lungs in a single passage through the pulmonary circulation; subsequent release of fat into the systemic circulation; rapid overall turnover of fat trapped in the lungs and slow removal of recirculating fat by other tissues.We believe that if there is release of unemulsified fat into the circulation in traumatic fat embolism these findings are of significance in interpreting the subsequent pulmonary event

ISSN:0007-1323    

DOI:10.1002/bjs.1800640104

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractCoagulation changes within kidney homotransplants to sensitized canine recipients have been studied by assessing the arteriovenous gradients of formed blood elements and coagulation factors across the organ. It is confirmed that hyperacute rejection is accompanied by evidence of intravascular coagulation within the graft, which is maximal during the first 20 minutes after revascularization. Attempts were made to prolong the survival of the grafts by the use of cytotosine arabinoside, methylprednisolone, heparin and azathioprine. In some instances, the severity of the intravascular coagulation was reduced but it did not prove possible to extend the survival of the kidneys beyond 24 hours.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640105

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe changes in blood fibrinolytic activity before and after operation have been investigated in 56 patients. The results have been analysed to assess the effect of the presence of malignant disease and the development of deep vein thombosis.The results show that patients with malignant disease and those with thrombosis have a fibrinolytic shut‐down. This shut‐down appears to be secondary to these two conditions and not the cause of the thrombosis. Patients without carcinoma and without thrombosis do not have a significant shut‐down. The fibrinolytic shut‐down results from a reduced release of activator from the peripheral store, not a reduction in the size of the store

ISSN:0007-1323    

DOI:10.1002/bjs.1800640106

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractA sensitive animal model was used to investigate treatment designed to improve vascular graft patency. A Dacron graft was inserted into the infrarenal vena cava of 30 rabbits. Half were treated with subcutaneous Arvin for 28 days after operation. This produced a significant lowering of the postoperative plasma fibrinogen. The patency rate of the grafts in the treated rabbits was significantly greater than in the control rabbits.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640107

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractSixteen patients with arteriosclerosis and pre‐gangrene of a lower limb were treated for 5 days by intravenous injection of Arvin. The effects of the injection on plasma fibrinogen, the viscosity of blood and the patient's symptoms were measured. There was a 90 per cent reduction in plasma fibrinogen and a significant reduction in the viscosity of blood. Five patients experienced some relief of pain during the treatment. In only one patient were the symptoms relieved permanentl

ISSN:0007-1323    

DOI:10.1002/bjs.1800640108

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe vagal influence on gastroduodenal content of gastrin was studied in duodenal ulcer patients. Endoscopic biopsies were assayed for total concentrations of gastrin, and fractionated for measurements of gastrin components before and after total vagotomy. Antral concentration was 17.0±2.0 μg gastrin/g mucosa (mean±s.e.m.) in 52 unoperated patients compared with 25.2 ± 3.2 μg in 32 vagotomized patients. In 14 patients studied before and 3 months after vagotomy antral content was almost doubled (10.9 ± 2.3 and 20.4 ± 2.9 μg respectively). In the duodenal bulb the concentration was 2.4 ± 0.3 μg in 37 unoperated patients and 2.2 ± 0.4 μg in 19 vagotomized patients. In 6 patients in whom measurements were made throughout the duodenum, gastrin concentrations were slightly but significantly lower 3 months after vagotomy. Fractionations of pooled homogenates on Sephadex G‐50 showed that gastrin component III (gastrin‐17) made up 95 per cent of the antral gastrins before and after operation. In the duodenum component III constituted more than half of the gastrins preoperatively but only one‐third postoperatively. The total amount of gastroduodenal gastrin was considerably increased by vagotomy, and it is well established that in serum the gastrin concentration is also higher postoperatively. The most likely implication of these findings is that in man the vagus, directly or indirectly, suppresses g

ISSN:0007-1323    

DOI:10.1002/bjs.1800640109

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractFourteen instances of gastric ulceration following 415 vagotomies for duodenal ulcer have been reviewed with special reference to the relative incidence of this complication after different types of vagotomy, and to its clinical and radiological features and treatment. The aetiology is discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640110

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractFactors thought to be important in the development of recurrent ulcer after proximal gastric vagotomy were investigated 1–4 years after operation in 211 patients with duodenal ulcer and in 49 with pre‐pyloric ulcer. Recurrent ulcer was found in 25 patients with duodenal ulcer (12 per cent) and in 6 with pre‐pyloric ulcer (12 per cent). Recurrence was not related to age, sex, duration of dyspepsia, radiological findings or peak acid output before and 10 days after vagotomy. Fiftysix patients were operated upon by the method of Amdrup and Jensen (1970), including skeletonization of about 2 cm of the oesophagus. The remaining 204 patients were operated on by a technique in which the dissection of the lesser curve was begun at the ‘crow's foot’ and the oesophageal dissection was extended, in most cases, to more than 4 cm above the cardia. Recurrence was more frequent among the 56 patients in the first group than among the remaining patients with duodenal ulcer. Recurrence was positively related to basal acid output after vagotomy. An increase of peak acid output of 50 per cent was seen in a smaller group with recurrence and patients with dyspepsia within 18 months of vagotomy.It was concluded that the risk of recurrence is not related to the number of parietal cells, as expressed by peak acid output to histamine. The risk may probably be reduced by extension of the oesophageal skeletonization. A marked increase in peak acid output may be seen during the first year after proximal gastric vagotomy in patients with recurrence or

ISSN:0007-1323    

DOI:10.1002/bjs.1800640111

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY