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Biomedical subjects

L M Flint

Publications and source records attributed to L M Flint.

141 records · Page 8Linked to original sources

Dopexamine maintains mesenteric blood flow during systemic hypoxemia in the neonatal piglet.

In adults, dopexamine is a specific dopaminergic and Beta2-adrenergic agonist; its effects in neonates are unknown. Ultrasonic flow probes were placed around the ascending and descending aorta and cranial mesenteric artery of 0- to 2-day-old and 2-week-old piglets. Animals of each age group (9 to 14 per group) were subjected to (1) dopexamine infusion (5 microg/kg/min); (2) 30 minutes of hypoxia (inspired oxygen content 0.12) followed by 30 minutes of reoxygenation; and (3) dopexamine infusion during hypoxia and reoxygenation. In both age groups dopexamine alone increased ascending aorta blood flow (cardiac output minus coronary artery blood flow), mildly decreased mean arterial pressure, and increased cranial mesenteric artery blood flow. Compared to baseline values, 30 minutes of hypoxia produced significant (P <0.05, analysis of variance) decreases in cranial mesenteric artery blood flow in 0- to 2-day-old (58 +/- 13 ml/min vs. 30 +/- 8 ml/min) and 2-week-old (125 +/- 18 ml/min vs. 60 +/- 11 ml/min) piglets. In all cases blood flow returned to baseline values after reoxygenation. In both animal groups treated with dopexamine before hypoxia, the decreases in cranial mesenteric artery blood flow were eliminated (47 +/- 5 ml/min vs. 44 +/- 6 ml/min in 0- to 2-day-old piglets; 140 +/- 27 ml/min vs. 117 +/- 18 ml/min in 2-week-old piglets). Dopexamine may prove to be of clinical benefit when neonates are threatened by hypoxemia-induced decreases in intestinal blood flow.

Adrenergic beta-2 Receptor Agonists↗

Lymph isolated from a regional scald injury produces a negative inotropic effect in dogs.

Large surface-area burns in patients have been associated with a severe impairment in cardiac performance, as evidenced by a decline in cardiac output. The mechanisms responsible for this profound myocardial dysfunction are largely unknown. We investigated the effects of lymph isolated from the scalded hind limb of dogs on regional myocardial blood flow, coronary vascular reactivity, and contractile performance. Dogs were instrumented with ultrasonic dimension crystals in the myocardium supplied by the left anterior descending (LAD) and by the left circumflex (LCx) coronary arteries. After cannulating a hind limb lymphatic, lymph was infused directly into the LAD before and after a 10-second 100 degrees C hind limb scald. Scalding alone did not alter myocardial contractile performance in the LAD or LCx regions, coronary artery blood flow, or systemic hemodynamics. Interestingly, postburn lymph infused into the LAD resulted in a 38% decline in LAD zone segment shortening (p < 0.01 vs baseline) that lasted throughout the 5-hour observation period. In contrast, segment shortening in the (control) LCx region was unaffected by postburn lymph injections into the LAD. Regional myocardial blood flow (radiolabeled microspheres) in the LAD and LCx regions was unchanged after scald injury or intracoronary injection of postburn lymph. In addition, LAD coronary artery vascular reactivity to acetylcholine and nitroglycerin was also unaffected by the regional thermal injury or by injection of lymph into the LAD. These data suggest that a regional scald injury results in the production and release of a potent myocardial depressant factor(s) that produces a direct negative inotropic effect on the canine myocardium.

Animals↗

Postburn vitamin C infusions do not alter early postburn edema formation.

To determine whether vitamin C would alter burn induced edema accumulation, hind paw venous pressure, lymph flow (QL), and lymph-to-plasma protein ratio (CL/CP) were monitored in groups of 5 dogs before and 4 hours after 1) a 5 sec 100 degrees C or 90 degrees C foot paw scald; 2) intravenous vitamin C given 30 min before or after a 100 degrees C scald; and 3) vitamin C given 30 min after a 90 degrees C scald. Throughout the experiments, hind paw venous pressure was elevated and maintained by outflow restriction until steady state QL and (CL/CP)min were reached. Changes in protein permeability (CL/CP), fluid conductance properties (Kf) of the capillary membrane, and paw weight gain were determined. Compared with preburn values, scald uniformly produced significant (P < .05, ANOVA) increases in QL, CL/CP and Kf. Although preburn infusion of vitamin C significantly (P < .01) attenuated burn-induced increases in paw weight gain (36 +/- 3% vs 19 +/- 4%), neither of the groups that received vitamin C postburn experienced significant modulations in paw weight gain (28 +/- 4% vs 36 +/- 3% in 100 degrees C burn only; 23 +/- 4% vs 28 +/- 3% in 90 degrees C burn only) or in any of the variables used to monitor capillary membrane integrity. Vitamin C infusions initiated after graded scald produced no changes in the burn-induced increases in microvascular permeability or in edema formation measured at the injury site.

Animals↗

Effects of anti-inflammatory agents on hydrochloric acid-induced pulmonary injury.

To determine the effects of anti-inflammatory agents on hydrochloric acid lung injury, the heart and lungs were harvested from rats, placed in a lung chamber, constant flow perfused with whole blood, and ventilated. The following experiments were conducted: observation alone; intratracheal injection of normal saline; intratracheal hydrochloric acid; and intravenous meclofenamate or indomethacin before intratracheal hydrochloric acid. Wet-to-dry lung weights were measured. Peak airway pressures increased immediately (p < .001 vs. baseline; ANOVA) in all intratracheal groups, hydrochloric acid producing even greater (p < .05) increases than saline-effects unaltered by meclofenamate or indomethacin. The increased (p < .001 vs. baseline) 2-h pulmonary artery pressures in hydrochloric acid-treated groups were unaltered by meclofenamate or indomethacin. All hydrochloric acid-treated groups demonstrated increases (p < .05) in weight that were unchanged by meclofenamate or indomethacin. These data suggest that the beneficial effects of these medications described elsewhere, using a variety of in vivo lung injury experimental models, may be attributed to their experimental design, or to contributions from organs/systems outside the pulmonary circuit.

Acute Disease↗

Comparison of novel synthetic materials with traditional methods to repair exposed abdominal wall fascial defects.

Repair of large abdominal wall defects is a challenge, particularly when full-thickness tissue loss prohibits coverage of the fascial repair. Two novel synthetic materials (TMS-1 and TMS-2) have been shown to be better accepted than expanded polytetrafluoroethylene (Gore-Tex), and polypropylene (Marlex) in the closure of clean and contaminated fascial wounds that are immediately covered by skin/soft tissue. Therefore, 1-cm2 abdominal wall defects were created in each of the four quadrants of rat groups. Gore-Tex, Marlex, and TMS-1 or TMS-2 were used to repair three defects, the fourth being primarily closed. To ensure that each repair remained exposed, skin edges were sutured to underlying muscle. Additional animal groups underwent the same protocol; however, peritonitis was induced at surgery using a fecal inoculum technique. Animals were sacrificed 2 weeks later, at which time a blinded observer assessed the surface area and severity of adhesions. In clean wounds, the surface area of formed adhesions was less (p < .004) after primary closure than each synthetic material; among the synthetics, TMS-2 caused significantly (p < .01) less extensive adhesions than Marlex. In addition, the severity of adhesions to TMS-2 was comparable to that of defects closed primarily, and less severe (p < .02) than those formed to Gore-Tex and Marlex. In animals with peritonitis, primary closure caused less extensive (p < .03) adhesions than Marlex and Gore-Tex and significantly (p < .002) less severe adhesions than Marlex, Gore-Tex, and TMS-2. However, the severity of adhesions formed to TMS-1 repairs proved comparable to primarily closed wounds. These experiments reaffirm the tenet that, whenever possible, abdominal wounds should undergo primary fascial closure. When soft tissue coverage over the repair cannot be achieved, TMS-2 is well tolerated in clean wounds. However, the superiority of TMS-1 over the other synthetic materials in contaminated wounds suggests it may also ultimately prove to be of clinical utility.

Abdominal Muscles↗

Injuries to major vessels: an overview of current concepts.

Injuries to major arteries and veins continue to result in loss of life and limb. Successful management of such injuries requires an integrated team approach with careful attention given to resuscitation of shock, technical aspects of surgical procedures, and adjunctive management. This review addresses current concepts relating to the problem of vascular trauma.

Abdomen↗