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Biomedical subjects

F Gottrup

Publications and source records attributed to F Gottrup.

At least 91 records · Page 5Linked to original sources

Directly measured tissue oxygen tension and arterial oxygen tension assess tissue perfusion.

Mean subcutaneous tissue PO2 (PsqO2) measurements were obtained in dogs with an unheated electrode placed in an implanted Silastic tonometer, while PaO2 was increased in increments from 40 to 600 torr during normal, increased, and reduced blood volume. These changes reflect that the mean PsqO2 is approximately 10 torr below the PO2 of venous blood draining that tissue. Since PaO2 was already known, the oxygen content of arterial and venous blood entering and leaving this tissue could be determined by reference to blood-oxygen dissociation curves. Therefore, relative changes in blood flow could be calculated using the Fick principle. After a 20% blood loss, the PsqO2 measured during breathing of room air fell to 20% of baseline, corresponding to an 80% fall in sc blood flow; it remained low until the shed blood was returned despite compensatory changes in cardiac output. Rapid infusion of electrolyte solutions in normovolemic animals produced a temporary increase in local blood flow. Subcutaneous oximetry seems capable of quantifying peripheral perfusion and may be clinically useful.

Animals↗

Enzymatic wound cleaning and absorbable sutures. An experimental study on Varidase and Dexon sutures.

The effect of an enzymatic preparation for wound cleaning (Varidase) on the mechanical properties of absorbable sutures (Dexon) was studied in vitro and in vivo in a rat model. In vitro the sutures demonstrated a significant decrease in strength (breaking strength and energy absorption) and extensibility after 12 days of incubation in saline. Incubation in Varidase, however, further decreased the mechanical properties significantly. The stiffness of the sutures was independent of treatment and time. In vivo changes of mechanical properties of the sutures resemble those of the in vitro study, except for a decrease in stiffness of the sutures. The sutures in a primary closed wound had the same strength (energy absorption) as the sutures of an open wound treated by saline, while the sutures of an open wound treated by Varidase tended to have a decreased strength (p = 0.08). This study supports the hypothesis that an enzymatic process may be involved in the degradation of Dexon. The continuous use of Varidase in Dexon-sutured wounds for a period longer than a few days is, therefore, questioned.

Animals↗

Prophylaxis with whole gut irrigation and antimicrobials in colorectal surgery. A prospective, randomized double-blind clinical trial.

In a prospective, randomized double-blind trial, the efficacy of whole gut irrigation as preoperative bowel preparation for elective colorectal surgery was evaluated alone and in combination with two antimicrobial agents in 148 patients. The antimicrobial regimens were metronidazole alone or metronidazole and ampicillin administered systemically preoperatively and continued for 3 days. Whole gut irrigation was completed without any discomfort in 87 percent of the patients. In 3 percent, the irrigation was stopped and the patients were excluded from the study. Abdominal wound infection developed in 32 percent of the patients after whole gut irrigation, and the addition of metronidazole decreased this incidence to 22 percent (not significant). The incidence in wound infections in the group receiving metronidazole as well as ampicillin was 2 percent, and this difference was highly significant compared with both other groups. No significant difference was found for the incidence of intraabdominal abscesses (p = 0.06), infection of the perineal wound, or anastomotic leakage. No difference in the postoperative infection rate was found between a bowel containing fecal fluid or fecal masses, but when a bowel was clean, significantly fewer infectious complications were found. Whole gut irrigation is a rapid, well-tolerated, easily performed, and safe form of preoperative bowel preparation in elective colorectal surgery if combined with systemic antimicrobial prophylaxis consisting of antimicrobial agents effective against anaerobic and aerobic organisms.

Adult↗

A comparative study of skin blood flow in musculocutaneous and random pattern flaps.

The present study in dogs was performed to evaluate the development of blood flow in cranial-based, rectus abdominis musculocutaneous (MCF) and random pattern (RPF) flaps and in adjacent intact skin before and after operation. Prior to raising of the flaps the intact skin area had the same blood flow in all the test injections. Following flap elevation blood flow in the MCF increased and on the second postoperative day (POD) it was 2.6 times the preoperative value. From POD 2 through POD 15 only minor changes were found for blood flow in MCF. Blood flow in the RPF immediately after surgery was only 31% of the preoperative value and 24% of the MCF value. After POD 2-3 blood flow in RPF, however, increased and reached the preoperative level and continued to increase through POD 15. Intact adjacent skin showed changes similar to those of MCF through POD 6, however, by POD 15 blood flow had decreased and was lower than that in MCF and RPF. Blood flow rates at remote sites in the groin and shoulder were identical and showed only a slight increase during the first two postoperative days. It is concluded that MCF have an early and continuous increase in blood flow after raising, while RPF have an early decrease. RPF, however, develop a subsequent increase in flow lasting through POD 15. Intact adjacent skin also showed increased blood flow which could not be attributed to a generalized increase in skin blood flow.

Animals↗

Adrenergic receptors and gastric secretion in dogs. Is a "tonic balance" relationship between vagal and beta 2-adrenergic activity a possibility?

The relative influence of adrenergic receptors on gastric acid secretion in the dog stomach with different vagal activity or "tone" is almost unknown. beta-adrenoceptors seem to be most important for the direct effect of adrenergic stimulation on acid secretion. In this study the effects of vagotomy and beta 2-adrenoceptor activity were studied in conscious gastric fistula dogs. Pentagastrin stimulated acid output was increased slightly in non-vagotomized dogs and to its prevagotomy level in vagotomized dogs after propranolol infusion. Practolol showed no such effect. Histamine stimulated acid secretion was not influenced significantly by beta-blockade. Similar dose-response curves were found for non-vagotomized dogs with high beta 2-adrenergic tone and dogs with low vagal tone (vagotomy) after pentagastrin and histamine stimulated acid secretion. This study indicates that a counterbalance between beta 2-adrenergic and cholinergic vagal tone exists. A "tonic balance theory" is suggested and is probably involved in the resulting acid secretion after vagotomy.

Adrenergic beta-Antagonists↗

Adrenergic influence on pentagastrin and bethanechol stimulated gastric acid secretion in dogs with gastric fistula.

The purpose of this study was to elucidate the effect of alpha-, beta- and dopaminergic receptor stimulation and blockade on pentagastrin and bethanechol stimulated gastric acid secretion in conscious dogs with gastric fistula. Gastric acid secretion was found to be subject to a dose related inhibition by isoprenaline. The dose of isoprenaline producing approximately 50% inhibition was higher in the bethanechol--than the pentagastrin experiments (0.10 vs. 0.03 micrograms/kg/min.) and slightly lower after parietal cell vagotomy. The antisecretory effect was mediated via the beta 1-receptors alone. The inhibitory effect of isoprenaline on pentagastrin stimulated acid secretion showed the characteristics of competitive type and on bethanechol stimulated acid secretion of non competitive type. An increasing and dose-dependent stimulation of bethanechol stimulated gastric acid secretion was found for dopamine 1, 5 and 10 micrograms/kg/min. Dopamine (40 micrograms/kg/min.) exerted an inhibitory effect on pentagastrin and bethanechol stimulated gastric acid secretion mediated, via the beta 1-receptors. The stimulatory effect of low doses of dopamine during bethanechol stimulation could not be defined as an effect via beta-receptors. This dual response, the weak inhibitory effects and the potent decreasing effect on antral gastric motility indicate that dopamine has no physiologic relevant effect on gastric acid secretion. One may conclude that beta 1- and beta 2-receptors may exert an influence on gastric acid secretion in dogs. The main effect of dopamine seems to be on gastric motility, while the effect on gastric acid secretion is of minor importance.

Adrenergic beta-Agonists↗

Adrenergic influence on gastric mucosal blood flow in gastric fistula dogs.

The aim of this study was to examine the influence of alpha-, beta- and dopaminergic receptors on gastric mucosal blood flow during "high", "normal", and "low" vagal conditions obtained by stimulation with bethanechol and pentagastrin and by parietal cell vagotomy respectively. During pentagastrin and bethanechol stimulation, a linear relationship between gastric acid secretion and mucosal blood flow was observed. During pentagastrin stimulation, dopamine (40 micrograms/kg/min) did not change the blood flow values while a decrease in acid secretion was found. During bethanechol stimulation dopamine (10 micrograms/kg/min) induced an increase in mucosal blood flow and a similar increase in acid secretion. If the dopamine infusion was preceded by alpha-receptor blockade, a pronounced increase in mucosal blood flow was observed without a similar increase in acid secretion. beta-adrenergic stimulation (isoprenaline) reduced the pentagastrin and bethanechol stimulated gastric acid secretion without a similar decrease in mucosal blood flow. beta-blockade (propranolol) increased the pentagastrin stimulated gastric acid secretion in parietal cell vagotomized dogs. This increase in acid output was preceded by an initial increase in mucosal blood flow and in the last two periods a decrease in blood flow. alpha-Blockade (phentolamine) reduced the pentagastrin stimulated gastric acid secretion and gastric mucosal blood flow but the ratio between blood flow and acid secretion was increased, indicating a relatively increasing effect on mucosal blood flow. One may conclude that blood flow and acid secretion are not unconditionally linked and that at least two different mechanisms are involved in blood flow changes in the stomach.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Dopaminergic and beta-adrenergic effects on gastric antral motility.

Stimulation of splanchnic nerves and application of adrenergic drugs have been shown to give variable effects on gastric motor activity depending especially on the background activity. beta-adrenoceptors and dopaminergic receptors mediate inhibitory effect on proximal gastric motor activity. The purpose of the present study was to evaluate the effects of isoprenaline, a beta 1- and beta 2-agonist, and dopamine on gastric antral motility in gastric fistula dogs. Dopamine was used alone and in conjunction with selective blockade of adrenergic and dopaminergic receptors during infusion of bethanechol or pentagastrin inducing motor activity patterns as in the phase III of the MMC and the digestive state respectively. The stimulated antral motility was dose-dependently inhibited by dopamine. The effect was significantly blocked by specifically acting dopaminergic blockers, while alpha- and beta-adrenergic blockers were without any significant effects. Dose-response experiments with bethanechol and dopamine showed inhibition of a non-competitive type. Isoprenaline was used alone and in conjunction with selective blockade of beta 1- and beta 2-receptors during infusion of bethanechol which induces a pattern similar to phase III in the migrating myoelectric complex. The stimulated antral motility was dose-dependently inhibited by isoprenaline. The effect could be significantly blocked by propranolol (beta 1 + beta 2-adrenoceptor blocker) and by using in conjunction the beta 1-adrenoceptor blocker practolol and the beta 2-adrenoceptor blocker H 35/25. The dose-response experiments showed inhibition of a non-competitive type. These studies indicate that gastric antral motility is inhibited by isoprenaline through both beta 1- and beta 2-receptors and by dopamine through specific dopaminergic receptors.

Adrenergic beta-Agonists↗

Adrenergic receptors and gastric acid secretion in dogs. The influence of beta 2-receptors.

The action of adrenergic subtypes of receptors in gastric acid secretion is still uncertain. The purpose of this study was to establish the influence of beta 2-adrenoceptors in the regulation of gastric secretion in conscious gastric fistula dogs. A dose-related inhibitory effect of beta 2-adrenergic stimulation on gastric acid secretion was found. The rank order of this inhibition was: Pentagastrin greater than bethanechol greater than histamine stimulated acid output. The strong beta 2-adrenergic induced inhibition found for pentagastrin and bethanechol stimulated acid output followed the characteristics of a non-competitive mechanism, while the weaker inhibition of histamine induced acid output seemed to follow a competitive mechanism. The inhibitory effect was not mediated through a decreased gastrin release. Dopamine receptor blockade was found to be without any influence on the inhibitory effect of beta 2-adrenoceptors. It is concluded that beta 2-adrenoceptors inhibit gastric acid secretion through an effect on gastric mucosa. A working hypothesis involving an endogenous inhibitory substance is proposed.

Animals↗

The dynamic properties of tissue oxygen in healing flaps.

Oxygen delivery to random pattern and musculocutaneous flaps was investigated in a canine model. Oxygen tension was measured in the proximal and distal portions of each flap and in adjacent normal skin by means of a recently developed technique. The effect of delay techniques on tissue oxygen tension was also examined with modifications of the same flap model. All measurements were made over a range of inspired oxygen concentrations (21% to 100%) both before operation and at intervals up to 15 days after operation. Tissue oxygen tensions were significantly higher in the musculocutaneous flaps than in random pattern flaps up to 6 days after operation. They were higher in the proximal portions than in the distal portions in each flap type. This difference was greater in the random pattern flap. Delay techniques prevented the early dramatic decrease in postoperative oxygen tension seen in random pattern flaps. Differences in the pattern of oxygen delivery to random pattern and musculocutaneous flaps may in part explain the greater reliability of musculocutaneous flaps when transposed in the presence of infection.

Animals↗

Continuous direct tissue oxygen tension measurement by a new method using an implantable silastic tonometer and oxygen polarography.

A new method of tissue oxygen tension measurement that is suitable for human use has been described. An implanted Silastic tube tonometer is combined with polarographic oxygen electrodes. The techniques of preparation, insertion, and measurement have been described. The advantages and disadvantages of this method have been considered in relation to established methods of tissue oxygen tension measurement. The method is suitable for clinical use and can be used to aid clinical decision-making.

Oxygen↗

Direct measurement of wound and tissue oxygen tension in postoperative patients.

An implanted Silastic catheter technique was used to measure partial pressure of oxygen in mastectomy wounds and needle-induced wounds in the subcutaneous tissue of the arms of 33 postoperative patients to assess tissue-wound oxygenation and perfusion on the day of operation and daily through postoperative day five. Characteristic patterns were observed. Wound hypoxia was common and most pronounced after abdominal, vascular, and cardiac procedures. It was most severe immediately after operation. Tissue hypoxia was not easily detected by clinical evaluation and was unknowingly tolerated by experienced surgeons. The relationship between arterial and tissue PO2 is biphasic and presumably curvilinear at the lower range of PaO2 and rises linearly even above the point of full saturation of hemoglobin. Supplemental bolus fluid infusion elevated depressed tissue PO2 in 19 out of 19 measurements, implicating hypovolemia as a common cause of postoperative tissue hypoxia. Measurements of tissue oxygen tension, coupled with a single arterial oxygen determination, constitute a clinically useful means of monitoring tissue perfusion.

Abdomen↗