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Biomedical subjects

H Redl

Publications and source records attributed to H Redl.

208 records · Page 12Linked to original sources

Leukocyte activation by isolated hyperthermic liver and limb perfusion due to malignancy.

Fourteen patients with liver tumor malignancy and sixteen patients with malignant melanoma localized to one limb were studied regarding leukocyte activation with the release of polymorphonuclear neutrophilic (PMN) elastase and of neopterin and formation of cytokines (TNF-alpha and IL-6) during the surgical treatment. Patients undergoing liver resection (n = 10), abdominal hysterectomy (n = 10), or hip replacement surgery (n = 10) served as control groups. Isolated hyperthermic liver perfusion was performed with cytostatic-containing perfusate (melphalan and cisplatinum). Patients with recurrent malignant melanoma confined to one limb underwent isolated hyperthermic limb perfusion with cytostatic-containing perfusate (melphalan). Blood samples for determination of PMN elastase, neopterin, TNF-alpha, and IL-6 were drawn from the patients preoperatively, 1 minute before the start of the perfusion, 60 and 120 minutes after the start of the perfusion, and 24 hours postoperatively. Samples from the perfusate were drawn 60 minutes after the start of the perfusion. High concentration of plasma PMN elastase were found in both patients undergoing liver and limb perfusion and in patients undergoing liver resection surgery. Elevated concentrations of IL-6 were found in the patients undergoing liver perfusion and in patients undergoing liver resection. In none of the patients were there increased concentrations of neopterin or TNF-alpha. The perfusate contained high concentrations of PMN elastase, neopterin, and IL-6. This study also demonstrated that major surgery leads to elevated concentrations of PMN elastase and IL-6. An increase of PMN elastase and IL-6 was seen in response to perfusion and to surgical trauma.

Adult↗

Free radical activity and loss of plasma antioxidants, vitamin E, and sulfhydryl groups in patients with burns: the 1993 Moyer Award.

This study examines the relationship of burn injury and plasma levels of conjugated dienes, total sulfhydryl groups, and vitamin E in patients with thermal injuries. Plasma neopterin levels were determined as an index of macrophage activity and serine elastase as an index of polymorphonuclear cell activation. Thirteen patients with burns, six survivors and seven nonsurvivors, were studied for the first 4 days, then every other day until postburn day 14. Twelve healthy volunteers served as the control group. Survivors had 56% +/- 4% total body surface area burned, and nonsurvivors had 63.9% +/- % total body surface area burned. The patients with burns, compared with the control group, showed elevated plasma levels of the lipid peroxidation products conjugated dienes (0.767 +/- 0.045 vs 0.269 +/- 0.013 Abs at 233 nm) and reduced levels of the natural scavengers of free radicals, vitamin E (196.2 +/- 12.6 vs 841.1 +/- 22.7 micrograms/dl) and total sulfhydryl groups (54.0 +/- 0.4 vs 15.8 +/- 1.0 mumol/dl). The total sulfhydryl groups/conjugated dienes ratio fell at a greater rate (9.8% +/- 3.2% vs 3.2% +/- 0.7%/day) in nonsurvivors than in survivors (p < 0.05 by Mann-Whitney). The levels of elastase were slightly elevated in the patients with burns, but there was no difference between survivors and nonsurvivors. Normal neopterin levels are 3 to 10 nm/L; peak levels were 119 +/- 48 nm/L in nonsurvivors and 37.4 +/- 10 nm/L in survivors. Patients with burns demonstrated evidence of increased oxygen free radical activity and activation of polymorphonuclear cell and macrophages. Nonsurvivors demonstrated increased consumption of antioxidants compared with survivors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Biodegradable nanomats produced by electrospinning: expanding multifunctionality and potential for tissue engineering.

With increasing interest in nanotechnology, development of nanofibers (n-fibers) by using the technique of electrospinning is gaining new momentum. Among important potential applications of n-fiber-based structures, scaffolds for tissue-engineering represent an advancing front. Nanoscaffolds (n-scaffolds) are closer to natural extracellular matrix (ECM) and its nanoscale fibrous structure. Although the technique of electrospinning is relatively old, various improvements have been made in the last decades to explore the spinning of submicron fibers from biodegradable polymers and to develop also multifunctional drug-releasing and bioactive scaffolds. Various factors can affect the properties of resulting nanostructures that can be classified into three main categories, namely: (1) Substrate related, (2) Apparatus related, and (3) Environment related factors. Developed n-scaffolds were tested for their cytocompatibility using different cell models and were seeded with cells for to develop tissue engineering constructs. Most importantly, studies have looked at the potential of using n-scaffolds for the development of blood vessels. There is a large area ahead for further applications and development of the field. For instance, multifunctional scaffolds that can be used as controlled delivery system do have a potential and have yet to be investigated for engineering of various tissues. So far, in vivo data on n-scaffolds are scarce, but in future reports are expected to emerge. With the convergence of the fields of nanotechnology, drug release and tissue engineering, new solutions could be found for the current limitations of tissue engineering scaffolds, which may enhance their functionality upon in vivo implantation. In this paper electrospinning process, factors affecting it, used polymers, developed n-scaffolds and their characterization are reviewed with focus on application in tissue engineering.

Absorbable Implants↗

Influence of parenteral nutrition on phospholipid metabolism in posttraumatic rat lungs.

In the current investigation, we studied two groups of rats--one group supplied exogenous phospholipid precursors (carbohydrate plus fat emulsion group) and the other given only calories (carbohydrate group)--to evaluate the effects on surfactant composition by normocaloric alimentation, using a hypovolemic-traumatic shock model. The total phospholipid (PHL) contents of lung tissue were similar in both groups. However, we found differences in the dipalmitoylphosphatidylcholine fraction (DPPC--the most important component of surfactant material) in both lung tissue and lavage fluid. With lipid emulsion, there was an increased fraction of saturated lecithins (mainly DPPC) both in lung tissue and lavage fluid, similar to former studies with hypocaloric alimentation. In this model, those findings suggest that the PHL pattern does not depend on the quantity of caloric supply, but, rather, on the infusion composition. The enhanced DPPC content is further reflected in improved surfactant status: lipid in parenteral nutrition (PN) may exert a direct salutary effect on lung mechanics.

1,2-Dipalmitoylphosphatidylcholine↗

Mechanical properties of the lungs of posttraumatic rats are improved by including fat in total parenteral nutrition.

Posttraumatic lung failure is often associated with alterations in lung surfactant composition and function. Our previous studies with total parenteral nutrition (TPN) have shown the effect of fat supply on phospholipid composition in pulmonary surfactant. Consequently, we attempted to determine whether fat supply would also improve the functional properties of the lung and surfactant. After polytrauma consisting of laparotomy, hypovolemia, and a single femur fracture, the animals were fed only parenterally for 14 days. Two groups of rats were infused via the jugular vein with isocaloric (260 kcal/kg/day) and isonitrogenous (5.62 gN/kg/day) regimens. The nonprotein calories were given either as glucose alone or 30% of calories as fat. Lung function was assessed by measurement of static lung compliance and total lung capacity. Surfactant isolated from lavage fluid was evaluated by means of a Wilhelmy balance. In agreement with our previous studies, in which we obtained a higher level of saturated lecithin in the fat groups, we found significantly (p less than 0.05) increased compliance (2.93 +/- 0.54 ml/cm H2O/kg BW) in the fat group compared to the carbohydrate group (2.02 +/- 0.36 ml/cm H2O/kg BW). Furthermore, a significantly (p less than 0.05) elevated total lung capacity was noted in the fat group (32.60 +/- 3.90 vs 26.00 +/- 1.45 ml/kg BW). The relatively improved surface tension properties as expressed by stability index (S = 0.89 +/- 0.24 vs 0.66 +/- 0.22) and minimum surface tension (gamma min = 18.5 +/- 5.01 vs 20.75 +/- 2.81) is a characteristic change, and was seen in the fat group.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Studies of the potential role of a semisynthetic surfactant preparation in an experimental aspiration trauma in rabbits.

The intratracheal administration of 2 mL of betaine hydrochloride-pepsin mixture (pH 1.78) per kilogram body weight in healthy rabbits leads to severe impairment of lung mechanics. This deterioration becomes significant after 6, 24, and 48 h for the parameters of static compliance and the difference in volume between 0 and 20 mmHg airway pressure. This model was used to investigate the efficacy of a surfactant preparation consisting of a combination of synthetic phospholipids and natural surface-active rabbit material containing the protein fraction. This mixture has been shown be superior to the single components alone with regard to their behavior in vitro in a Wilhelmy balance after extensive cycling. This preparation was able to reverse the deterioration of lung mechanics when applied 24 h after an aspiration injury. Instillation of Ringer's solution alone did not show any therapeutic effect. This aspiration injury model may be helpful in further studies of therapeutic effects of surfactant preparations designed on the basis of the preparations' properties in vitro as preselective criteria.

Animals↗

Early detection of anastomotic leaks after colorectal surgery by measuring endotoxin in the drainage fluid.

BACKGROUND/AIMS: Early detection of anastomotic leaks after colorectal anastomosis is essential for adequate intervention to prevent peritonitis. We investigated whether the measurement of endotoxin (LPS) concentrations in the drainage has any value for the early detection of anastomotic leaks. MATERIALS AND METHODS: Twenty two patients with colorectal anastomosis were enrolled in this study, 3 developed clinically established signs of anastomotic leaks and 19 recovered without complications. LPS concentrations in the drainage, the total daily excreted LPS amounts, leukocyte and thrombocyte counts, plasma urea and creatinine, and body temperature were measured for up to 8 days after surgery and tested for their value to detect anastomotic leaks. RESULTS: LPS concentrations in the drainage fluid and daily excreted LPS amounts of patients with anastomotic leaks were significantly higher compared to the group without anastomotic leaks. On the third postoperative day, LPS concentrations ranged from 5270 to 6750 pg/ml in patients with anastomotic leaks and from 1 to 1848 pg/ml in patients without complications. Total daily excreted LPS amounts were 270-675 ng/day in patients with anastomotic leak and 0-92 ng/day in patients without anastomotic leaks. Both LPS-related parameters allowed reliable detection of anastomotic leaks on day 3 after surgery (Student's t-Test, p < 0.0005), while leukocyte and thrombocyte counts, plasma urea and creatinine, and body temperatures of both patient groups were not significantly different at any time (p > 0.05). CONCLUSION: We found that the measurement of LPS concentrations in the drainage and the daily excreted LPS amount could be valuable parameters for the early detection of anastomotic leaks as early as on the third post-operative day.

Adult↗