[Drug-induced gastrointestinal hemorrhage. It is possible to reduce the occurrence?].
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Adult↗
Biomedical subjects
A Revhaug
Publications and source records attributed to A Revhaug.
Effect of haemorrhagic shock and duodenal instillation of blood on the plasma profiles of somatostatin and motilin in pigs. A study of molecular plasma components.
A severe haemorrhage inducing a deep hypovolaemic shock in six anaesthetized pigs effected a plasma somatostatin increase in the superior caval and the portal vein together with a plasma motilin decrease in the portal vein (p less than 0.05). In contrast, the shed blood volume simultaneously instilled intraduodenally in another six anaesthetized pigs in haemodynamic balance induced only an insignificant bimodal somatostatin increase and a modest but significant motilin decrease in plasma from the portal vein (p less than 0.05). Plasma somatostatin immunoreactivity was eluted in four peaks from a Sephadex G-50 Fine column, of which the first peak probably represents somatostatin bound to plasma proteins; the second peak, aggregates of somatostatin-14 and somatostatin degradation products; the third peak, somatostatin-28; and the fourth peak, somatostatin-14. Plasma motilin immunoreactivity eluted in two peaks, of which the first peak possibly represents motilin bound to plasma proteins, and the second peak free plasma motilin. The major changes in portal vein plasma somatostatin and motilin concentrations during the haemorrhagic shock occurred in their free molecular fractions.
Animals↗
[Increase of plasma cholecystokinin by Escherichia coli endotoxin-induced shock in swine].
The gastrointestinal tract is the source of numerous peptide hormones. Since the gut will be altered severely during prolonged general circulatory low flow states, the reactions of the gut hormones are of great interest. In this study 18 anesthetized pigs were put into shock states to get first informations about the changes of the plasma levels of cholecystokinin (CCK). 12 pigs (group I and II) were exposed to a general circulatory shock state by a 2-hr intravenous infusion of a sublethal dose of Escherichia coli endotoxin. 6 of them (gr. II) first received a gastroenterectomy apart from a small duodenal remnant proximal and distal to the papilla of Vater. The remaining 6 pigs (gr. III) suffered a severe hemorrhagic-hypovolemic shock over a 150-min period by arterial bleeding. Plasma CCK increased significantly (p less than 0.05) in the aorta (gr. I, II), the portal vein (gr. I, II), the superior caval vein (gr. I), and the internal jugular vein (gr. I) at the end of the 2-hr endotoxin infusion. In group II, the rise of CCK levels in the superior caval vein was also marked, but insignificant. The CCK-concentrations in the internal jugular vein were measured only in group I. By contrast, no changes in plasma CCK were seen in hemorrhagic shock (gr. III). Within each group plasma samples taken from the various blood vessels at identical time points showed no significant differences. Since the plasma concentrations of CCK remained unchanged during hemorrhagic shock, the release of CCK by E. coli endotoxin is not due to the general circulatory low flow state.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Metabolic burst and motility in granulocytes following trauma and endotoxinaemia in the anaesthetized pig.
The early effects of trauma and endotoxinaemia in pigs have been studied with regard to granulocyte motility and metabolic burst (chemiluminescence). Increased spontaneous chemiluminescence was observed following a moderate aseptic trauma (osteotomies) or endotoxin infusion in healthy pigs. Zymosan-opsonized chemiluminescence was increased post trauma. Endotoxin infusion, however, led to unchanged values during infusion but a significant decreased Zymosan-opsonized chemiluminescence 3 h after ended infusion. Migration capacity was unchanged by trauma, but markedly reduced following endotoxin infusion. When traumatized pigs had an endotoxin infusion 24 h post trauma, the increase in spontaneous chemiluminescence was significantly more pronounced than following endotoxin infusion in healthy pigs, and Zymosan-opsonized chemiluminescence less decreased. Motility, however, was equally reduced as following endotoxin infusion in healthy pigs. These findings correspond well with the known decreased phagocytic capacity of granulocytes in septicaemia, but also indicate a rapid post-traumatic reaction which might be an attempt to reduce the lethal danger of a subsequent infection.
Animals↗
Fibronectin, complement and immunoglobulins in serum after surgery.
In recent years it has been suggested that fibronectin is a non-specific opsonic protein of significance in host resistance against septic complications following trauma and surgery. The aim of the present study was to investigate the fluctuations in serum levels of fibronectin, immunoglobulins IgG and IgM, and complement factors C3 and C4 postoperatively. Serum samples were obtained pre-operatively and at different intervals postoperatively in 72 patients admitted for elective surgical procedures on the alimentary tract, the heart and the hip joint. The mean pre-operative fibronectin values were 257 +/- 79 micrograms/ml. The lowest values (166 +/- 65 micrograms/ml) were found immediately after the operation, followed by an increase which did not reach pre-operative levels within 120 h. Five patients who developed postoperative complications and 14 patients with malignant disease did not differ significantly either in their pre- or postoperative fibronectin levels, compared with the whole group. The lowest fibronectin levels seen were also significantly above the concentrations necessary to promote binding of gelatinized test particles to macrophages and monocytes in vitro. There was a significant decrease in C3, C4 and IgG levels postoperatively whereas IgM levels were unaltered. The observed reduction did not extend below the lower normal levels for these proteins. The probable mechanism behind the reduction in serum levels seems to be a sequestration at the site of tissue injury. The postoperative reduction in circulating fibronectin levels has probably no implications for host resistance against septic complications. When sequestered into the site of injury, it may, however, be of significance for normal wound healing, due to its cell-matrix interactions.
Adolescent↗
Release of gastrointestinal hormones in cardiodepressive shock.
In previous studies increased plasma levels of vasoactive intestinal polypeptide (VIP), somatostatin and pancreatic polypeptide (PP) were demonstrated in a porcine endotoxin shock model. Unchanged levels of gastric inhibitory polypeptide (GIP) and secretin point to a specific shock reaction of peptide release and not to a diffuse mucosal leakage. A porcine model of cardiodepressive shock was developed to enable discrimination to be made between a general low-flow state and endotoxin reaction. Infusion of the tricyclic antidepressive agent nortriptyline 15 mg/kg bodyweight resulted in a grave shock state. Increased plasma levels of somatostatin, PP and insulin were found. No increase in VIP levels could be demonstrated. Endotoxin given after nortriptyline administration resulted in the increase of VIP levels regularly seen during endotoxinaemia. VIP release during endotoxin shock is related to endotoxin and not to a general low flow state.
Animals↗
The origin and fall of plasma motilin during Escherichia coli endotoxin shock in pigs.
Plasma motilin decreased significantly during a 120 min intravenous Escherichia coli endotoxin infusion which induced deep shock in six anaesthetized pigs. Plasma motilin was significantly higher in the portal vein and significantly lower in the internal jugular vein than in the aorta and the superior caval vein. Following gastrointestinal resection with blood sampling from the portal vein, the aorta and the superior caval vein in another six pigs, motilin almost disappeared in non-portal plasma, while it decreased significantly in portal plasma in which it also fell further during E. coli endotoxin infusion. The results support the opinion that the gastrointestinal tract is the main source of plasma motilin.
Animals↗
Increased plasma levels of vasoactive intestinal polypeptide in pigs during endotoxinaemia.
Vasoactive intestinal polypeptide (VIP) is a highly potent vasodilatator. Cardiovascular changes and plasma VIP levels were studied during endotoxinaemia (Escherichia coli endotoxin 1 mg/kg) in a carefully monitored porcine model. Endotoxin infusion resulted in a profound but reversible shock and a substantial rise in plasma VIP levels. Increased levels of VIP could be demonstrated already after 30 min of endotoxin infusion and increased further during the infusion. Animals followed for a period of 60 h demonstrated slowly declining levels of VIP after endotoxin infusion but significantly elevated levels were usually found 24 h after infusion. Control animals did not show any changes in VIP during a similar procedure. Release of gastrointestinal peptides may be of importance during septic shock.
Animals↗
Effect of hemorrhagic and nortriptyline-induced shock on the porcine pancreas as evaluated by changes in serum cationic trypsin-like immunoreactivity.
Hemorrhagic shock caused by gastrointestinal bleeding in seven pigs and by external bleeding in another six pigs and cardiogenic shock induced by intravenous infusion of the tricyclic antidepressant drug nortriptyline in yet another eight pigs caused a significant increase in serum cationic trypsin-like immunoreactivity together with formation of complexes between cationic trypsin, on the one hand, and alpha-2-macroglobulin and alpha-1-antitrypsin, on the other hand, compatible with what happens in acute pancreatitis.
Animals↗
Effect of intravenous and intraduodenal administration of Escherichia coli endotoxin on the porcine pancreas as evaluated by changes in the serum cationic trypsin-like immunoreactivity.
In six pigs intravenous administration of Escherichia coli endotoxin caused septic shock and a significant increase in serum cationic trypsin-like immunoreactivity (CTLI), with activation of cationic trypsinogen to trypsin and formation of complexes between cationic trypsin, on the one hand, and alpha 2-macroglobulin and alpha 1-antitrypsin, on the other, compatible with acute pancreatitis. In contrast, intraduodenal infusion of E. coli endotoxin to seven other pigs was without effect on the general circulation and on the serum CTLI.
Animals↗
Changes in plasma levels of gastrointestinal regulatory peptides during hemorrhagic shock in pigs.
In an experimental study of hemorrhagic shock, systemic and portal plasma levels of vasoactive intestinal polypeptide (VIP), somatostatin, pancreatic polypeptide (PP), gastric inhibitory peptide (GIP), secretin and insulin were measured with radioimmunoassay methods. Six pigs (30-40 kg) in general anesthesia were submitted to severe hemorrhage (approximately 30% of the blood volume) for 60 min, followed by reinfusion of the shed blood. Aortic blood pressure and cardiac output fell significantly during the shock state and recovered after the infusion. Plasma levels of somatostatin, PP, insulin and secretin rose significantly. The portal levels always presented earlier and greater elevation than did the systemic levels, except as regards secretin. No change was seen in the levels of VIP and GIP.
Animals↗
Vasoactive intestinal polypeptide and somatostatin in leucocytes.
Vasoactive intestinal polypeptide (VIP) was measured in extracts from polymorphonuclear (PMN) and mononuclear (MN) leucocytes from 14 healthy persons and 12 pigs. In addition, extracts from PMN and MN cells from eight pigs were studied for possible contents of somatostatin. Immunoreactive VIP was present in the PMN and MN leucocytes from man and pigs with a significantly higher level in the MN cells. Similarly, immunoreactive somatostatin was found in both cell lines from pigs with a significant higher amount in the MN leucocytes. Furthermore, extracts from pure populations of human PMN and MN leucocytes were separately applied on a Sephadex G-50 Fine column, and VIP, somatostatin, secretin, GIP and motilin were measured in the eluted fractions. Only VIP and somatostatin were found to be present in detectable amounts. Immunoreactive VIP eluted corresponding to the elution volume for pure porcine VIP in extracts from both PMN and MN cells, while immunoreactive somatostatin eluted corresponding to the elution volume for the synthetic tetradecapeptide somatostatin in extracts from MN cells only. Possible physiological implications of these findings are briefly discussed.
Adult↗
Lysosomal hydrolases in neutrophils, mononuclear cells and serum during Escherichia coli endotoxinaemia in pigs.
The appearance of 10 different lysosomal enzymes in leucocytes and serum were studied during various stages of Escherichia coli endotoxinaemia in pigs. The animals were monitored in halothane anaesthesia and ventilated with a mechanical ventilator. The endotoxin infusion induced a marked increase in pulmonary artery pressure while the systemic blood pressure was significantly lowered. A pronounced decline in circulating leucocytes occurred. There was a general trend of intracellular reduction of lysosomal enzymes in both PMN and mononuclear cells, whereas increasing serum levels of the same enzymes occurred. Significantly higher serum levels of all lysosomal enzymes were found 5 h after start of endotoxin infusion compared to preinfusion values, while a significant acidosis in the aorta blood was registered. These results indicate that lysosomal enzymes are released from white blood cells following endotoxin stimulation. When local pH values allow enzyme activity, they may contribute to the tissue destruction seen in endotoxinaemia.
Animals↗
Release of gastrointestinal peptides during E. coli endotoxinaemia.
We have earlier reported an elevation of vasoactive intestinal polypeptide (VIP) plasma levels during endotoxinaemia in pigs (Revhaug et al., 1983). In the present study the plasma levels of pancreatic polypeptide (PP), somatostatin, gastric inhibitory peptide (GIP) and insulin have been measured by sensitive Ria methods during E. coli endotoxin (Difco) shock in six anaesthetized pigs. The plasma samples were drawn from the vena porta, cava superior, internal jugular vein and the aorta. A significant increase in plasma levels of PP, somatostatin, and insulin was observed in this model. The increased plasma levels were higher in the portal vein than in the other sampling site. GIP did not present any change in this model.
Animals↗
Portal and systemic plasma VIP and secretin during intravenous infusion of Escherichia coli endotoxin in pigs.
Plasma vasoactive intestinal polypeptide (VIP) increased significantly in the portal vein, the superior caval vein, the internal jugular vein, and the aorta during an intravenous infusion of E. coli endotoxin in six anesthetized pigs, which all developed a deep shock, with fall in aortic blood pressure and urinary output. Plasma VIP peaked simultaneously with the most pronounced shock symptoms, and the level in the portal vein was significantly higher than in blood from the other sampling sites. In contrast, no significant change in plasma secretin was noted. It is suggested that the gastrointestinal tract is the main source of the high plasma VIP levels seen during endotoxinemia and that VIP may play a significant role in endotoxin shock.
Animals↗
Adjuvant therapy of secondary peritonitis.
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Adrenal Cortex Hormones↗
Controlled endotoxinemia in pigs. A suitable model for in vivo studies of some haemodynamic, humoral and cellular reactions.
To study the haemodynamic, cellular and humoral changes seen during septicemia-endotoxinemia a relatively large animal is needed. Pigs are satisfactory in size but have a tendency to develop malignant hyperthermia reaction to stress situations and certain anaesthetic agents. This problem was solved using a screening test of halothane exposure. When later used for experiments, the nonresponding pigs developed the typical hypokinetic low-flow state after endotoxin challenge seen in the advanced stage of septicemia in man. Decreased number of circulating leucocytes and platelets, increased tissue thromboplastin production in monocytes, and a significant coagulation disorder (DIC) were observed. Release of oxygen radicals and lysosomal enzymes from leucocytes could be estimated. Endotoxin levels in plasma were easily measured. This pig model of controlled endotoxinemia correlates well with some important haemodynamic, cellular and humoral reactions observed during human in vivo observations and in vitro studies. This model may thus be a valuable tool in clinical research of endotoxinemia and septicemia.
Animals↗
Fasting and postprandial GIP values in pigs, rats, dogs, and man measured with five different GIP antisera.
Fasting and postprandial blood samples were collected from pigs, rats, dogs, and man and the gastric inhibitory polypeptide (GIP) immunoreactivity measured with five different antisera. The mean GIP values in rats, dogs, and man varied considerably, depending on the antiserum used, whereas all the antisera recorded fairly similar GIP values in pigs. These findings demonstrate immunological differences between rat, dog, human, and porcine GIP. One should therefore be careful when evaluating physiological effects of porcine GIP infused intravenously in species other than the pig.
Adult↗