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PubMedDate not supplied

[Ischemic preconditioning improves post-ischemic function but not energy metabolism of skeletal muscles].

Ischemic preconditioning (IP) refers to a phenomenon whereby short periods of ischemia reduce tissue damage after a subsequent sustained ischemia. The effect of IP before tourniquet ischemia of the extremities has not yet been evaluated. We developed a rat model of skeletal muscle ischemia and measured the effect of IP on postischemic function and high-energy phosphate levels. IP consisted in three cycles of 10 min ischemia and 10 min reperfusion each. IP improved significantly skeletal muscle function after 3 hours of ischemia and 2 hours of reperfusion. High-energy phosphate levels, however, remained unchanged. This study shows a protective effect of IP in skeletal muscles. These results furthermore suggest that the protection of energy metabolism is not a mechanism of IP in this model. IP could be easily performed before surgery of the extremities under tourniquet ischemia. The protective effect on postischemic skeletal muscle has therefore to be further investigated.

Animals↗

PubMedDate not supplied

[Laparoscopic cholecystectomy during pregnancy].

BACKGROUND: We evaluated the advantages and risks of laparoscopic cholecystectomy during pregnancy in symptomatic patients. MATERIAL AND METHODS: Three gravid women at an estimated 14 to 26 weeks gestational age underwent laparoscopic cholecystectomy for symptomatic cholelithiasis or biliary pancreatitis. One patient was obese. The operation was successfully completed under tocolytic medication. DISCUSSION: Although rare, gallbladder disease is the second most common abdominal condition during pregnancy requiring operation, being second only to appendicitis. Medical management is the most common approach to treatment, and the surgical intervention is reserved for patients who fail to respond to conservative methods or who have choledocholithiasis, biliary obstruction or pancreatitis. The laparoscopic approach is controversial, and some authors still agree that pregnancy is a contra indication to laparoscopic cholecystectomy. We report our experience with three laparoscopic cholecystectomies performed without complication during pregnancy. On the basis of our experience and a review of the literature, we believe that the laparoscopic cholecystectomy, undertaken preferentially during the second trimester, is a valid alternative to classic management in terms of risks for the foetus and comfort for the mother.

Adolescent↗