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PubMed1977

Twenty-four hour canine renal preservation by pulsatile perfusion, hypothermic storage, and combinations of the two methods.

A comparison of the effectiveness of two renal preservation techniques was studied in 30 cannine renal pairs. In the absence of warm ischemia, 24-hr preservation by pulsatile perfusion was not significantly superior to hypothermic storage. When 15 min of warm ischemia was added as an additional insult, pulsatile perfusion afforded significantly better early function than cold storage. Combinations of pulsatile perfusion and hypothermic storage following 15 min of warm ischemia were superior to hypothermic storage alone, but inferior to pulsatile perfusion. Kidneys initially perfused for 6 hr and then cold-stored functioned slightly better than kidneys perfused for 18 hr after initial cold storage.

Animals↗
PubMed1979

Raynaud's phenomenon: primary and secondary causes.

The terms "Raynaud's disease" and "Raynaud's phenomenon" are often used interchangeably, as if they were a single problem. Because prognosis and therapy are different with each of these entities, 86 patients with episodic digit ischemia were evaluated over the past five years. All patients were evaluated similarly with plethysmography, angiography, and other studies for underlying causes of the digital ischemia. From the study, it was concluded that the majority of the patients had an underlying cause for the problem even though they satisfied the commonly accepted criteria for the diagnosis of Raynaud's disease. It is clear that the diagnosis of Raynaud's disease must be one of exclusion, because it is more uncommon than is generally appreciated by the medical community.

Cold Temperature↗
PubMed1978

Evaluation of hypertonic citrate flushing solution for kidney preservation using the isolated perfused rat kidney.

The isolated perfused rat kidney has been used to study the effects of cold ischaemia during ice storage. Tissue adenine nucleotide levels in freeze-clamped kidneys were closely correlated with their function after circulation had been reestablished in the perfusion circuit. The ATP content was depleted to a greater extent than total adenine nucleotide after 8 hr of cold ischaemia but both were considerably diminished after 24 hr. The model was also used to compare four solutions which are available clinically for preliminary flushing of organs in the ice storage preservation technique. The results indicated that for periods of 8 and 24 hr of cold ischaemia, renal function and adenine nucleotide content were significantly better maintained with a solution based on hyperosmolar citrate than with Collins, Sacks, or Perfudex solutions. This study confirmed recent observations of the clinical efficacy of citrate solution, while demonstrating how the isolated perfused rat kidney could be used for rapid screening of modifications in preservation techniques.

Adenine Nucleotides↗
PubMed1976

Disturbances in voluntary recruitment order of low and high frequency motor units on blockades of proprioceptive afferent activity.

The voluntary recruitment order of anterior tibial motor units was studied in electromyographic recordings using both low and high impedance electrodes. It was shown in previous papers, that the recruitment order in sustained voluntary contraction is normally stable and that motor units with low thresholds discharge at low, regular frequencies and that motor units with high thresholds discharge at higher and more irregular frequencies. In this paper the consequences for the discharge properties of reduced afferent inflow in sustained voluntary contraction were studied, using partial ischemic or lidocain blockades of the muscle nerve and local cooling of the muscle belly. 1. The recruitment order of certain low and certain high frequency units was reversed. 2. The muscle tension and sense of effort necessary for tonic firing were increased for certain low frequency units but decreased for certain high frequency units. 3. On severe reduction of the afferent inflow, the differences in discharge pattern between low and high frequency units were decreased. It is concluded that the recruitment of low frequency units before high frequency units in sustained voluntary contraction is partly due to proprioceptive afferent activity favouring low frequency units and disfavouring high frequency units. It is also concluded that the afferent inflow is involved in restricting certain units to low frequency discharge and others to high frequency discharge.

Action Potentials↗
PubMed1979

Effects of cooling and intraluminally administered antiseptics on surgically induced ischemia of the intestine in dogs.

The efficacy of surface cooling and intraluminal antiseptic solutions for short term preservation of intestinal segments in preparation for free tissue transfer were investigated. Five segments of the small intestine and five segments of the colon were allocated to each group as follows: group 1, ischemia at 37 degrees C.; group 2, ischemia at 6 to 12 degrees C., and group 3, ischemia at 6 to 12 degrees C. plus povidone-iodine intraluminally. Histologic grading of segments allowed assessment of the efficacy of short term protection against ischemic changes. Surface cooling effectively prevented histologic evidence of ischemia. No additional benefit was observed using povidone-iodine intraluminally. Significant changes in tissue water content and evidence of bacterial invasion were not observed.

Animals↗
PubMed1979

Cold-blood potassium cardioplegia: evaluation of glutathione and postischemic cardioplegia.

Potassium (34 mEq/L) cardioplegia was induced with cold blood (CBK) in three groups of six dogs undergoing 60 minutes of myocardial ischemia at a systemic temperature of 27 degrees +/- 2 degrees and a myocardial temperature of 7 degrees +/- 2 degrees C (crushed ice). Group 1 (CBK) animals were reperfused initially with 400 ml cold blood over 8 to 10 minutes at increasing pressures of up to 75 mm Hg. Group II (CBK-K) dogs were reperfused in the same manner as Group I with the addition of potassium chloride, 30 mEq/L. In Group III (CBKG-KG) glutathione, 30 mg/100 ml, was added to both the pre- and postischemic perfusions with CBK. After 30 minutes of reperfusion control studies were repeated. Heart rate, peak systolic pressure, rate of rise of left ventricular pressure, maximum velocity of contractile element, pressure-volume curves, coronary flow distribution, muscle stiffness, and heart water were not significantly different from control values. Total coronary flow and myocardial uptake of oxygen, lactate, and pyruvate did not serve to separate the three groups; the same was true for right ventricular creatine phosphate, adenosine triphosphate, and adenosine diphosphate during ischemia and recovery. Ultrastructural myofibrillar lesions were noted in all groups. thus, postischemic cardioplegia and use of a physiological reducing agent do not enhance CBK cardioplegia with topical and systemic hypothermia.

Adenosine Diphosphate↗
PubMed1976

Assessment of a test of renal viability.

A test of renal viability using the uptake of 125I-iodohippurate by kidney biopsy specimens has been developed. It is applicable to all kidneys irrespective of the method of storage. The uptake of 125I-iodohippurate in experimental kidneys correlated well with warm or cold ischaemia time and subsequent renal function. The test was used for human cadaver kidneys offered for transplantation and there was good correlation between iodohippurate uptake and warm ischaemic time. With this test, prediction of renal function was accurate in 85% of human cadaver kidneys transplanted. Pulsatile perfusion had no effect on cadaver kidneys as measured by this test.

Animals↗