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M Belz

Publications and source records attributed to M Belz.

5 recordsLinked to original sources

Effects of bradykinin, histamine and serotonin on pulmonary vascular resistance and permeability.

The effects of bradykinin, histamine and serotonin on vascular resistance and microvascular permeability were investigated in isolated cell-free perfused rabbit lungs. The capillary filtration coefficient was determined from the slope of lung weight changes over periods of venous pressure elevation before application of bradykinin (n = 6), histamine (n = 6) and serotonin (n = 6), and 5, 20 and 50 min afterwards. To prevent rapid inactivation of bradykinin by the angiotensin-converting enzyme in the pulmonary circulation, the bradykinin effects were additionally studied in the presence of the angiotensin-converting enzyme inhibitor captopril (n = 6). Bolus application of each substance resulted in a short-lasting increase in the pulmonary vascular resistance (3.7-9.1 mmHg). Which was most pronounced in the bradykinin+captopril group. The capillary filtration coefficient was significantly increased after histamine application, and to an even greater extent after serotonin application, whereas bradykinin on its own, as well as bradykinin given in the presence of captopril, had no measurable influence on capillary filtration in the lung. As a result of the bradykinin challenge, there was an immediate massive generation of prostacyclin, which could not be further augmented by a application. Histamine injection entailed a delayed onset of prostacyclin generation after the second stimulation, whereas no prostacyclin increase was measured in the serotonin-treated lungs. Thromboxane A2 generation was exclusively observed after the first serotonin application. The data exemplify different pathophysiological characteristics of bradykinin, histamine and serotonin on lung barrier function. Histamine and serotonin induce oedema formation by enhancing microvascular permeability, whereas bradykinin does not.

6-Ketoprostaglandin F1 alpha↗

Portable cardiopulmonary bypass: resuscitation from prolonged ice-water submersion and asystole.

Accidental hypothermia associated with near-drowning and cardiac arrest has a high mortality, especially in the adult. We report the resuscitation of a 31-year-old man who suffered extended ice-water submersion, severe hypothermia (23 degrees C), and prolonged (> or = 78 minutes) cardiac asystole. A modified portable cardiopulmonary bypass system and femoral-femoral cannulation in the Emergency Department permitted the rapid institution of core rewarming, oxygenation, and controlled reperfusion, with a successful outcome. Rapid initiation of cardiopulmonary bypass outside the operating room can be an initial treatment option in this unique clinical situation.

Adult↗

Subclavian balloon angioplasty in the management of the coronary-subclavian steal syndrome.

The syndrome of coronary-subclavian steal presenting with angina pectoris after coronary revascularization with the mammary arteries is not common. This disorder should be suspected in post LIMA patients with blood pressure differences between the arms and confirmed by angiography. PTA of the subclavian artery via the brachial approach, in appropriately selected patients, offers potential advantages over carotid subclavian bypass including an apparent lower complication rate with equally good results. Recurrences, which are apt to be more common after PTA versus carotid subclavian bypass, are easily managed with repeat dilatation. This course of management in our patient resulted in an excellent clinical outcome without complication. This report emphasizes the importance of considering subclavian stenosis in patients with prior LIMA bypass grafting, particularly when the ipsilateral arm blood pressure is reduced. In such cases, subclavian PTA offers a reasonable nonsurgical approach for correction.

Aged↗