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Novel 384-well population patch clamp electrophysiology assays for Ca2+-activated K+ channels.

Planar array electrophysiology techniques were applied to assays for modulators of recombinant hIK and hSK3 Ca2+-activated K+ channels. In CHO-hIK-expressing cells, under asymmetric K+ gradients, small-molecule channel activators evoked time- and voltage-independent currents characteristic of those previously described by classical patch clamp electrophysiology methods. In single-hole (cell) experiments, the large cell-to-cell heterogeneity in channel expression rendered it difficult to generate activator concentration-response curves. However, in population patch clamp mode, in which signals are averaged from up to 64 cells, well-to-well variation was substantially reduced such that concentration-response curves could be easily constructed. The absolute EC50 values and rank order of potency for a range of activators, including 1-EBIO and DC-EBIO, corresponded well with conventional patch clamp data. Activator responses of hIK and hSK3 channels could be fully and specifically blocked by the selective inhibitors TRAM-34 and apamin, with IC50 values of 0.31 microM and 3 nM, respectively. To demonstrate assay precision and robustness, a test set of 704 compounds was screened in a 384-well format of the hIK assay. All plates had Z' values greater than 0.6, and the statistical cutoff for activity was 8%. Eleven hits (1.6%) were identified from this set, in addition to the randomly spiked wells with known activators. Overall, our findings demonstrate that population patch clamp is a powerful and enabling method for screening Ca2+-activated K+ channels and provides significant advantages over single-cell electrophysiology (IonWorks(HT)) and other previously published approaches. Moreover, this work demonstrates for the 1st time the utility of population patch clamp for ion channel activator assays and for non-voltage-gated ion channels.

Animals↗

Assessment of insulin resistance in newborn beagles with the euglycemic hyperinsulinemic clamp.

The developmental response to the euglycemic hyperinsulinemic clamp was assessed among newborn and adult beagles to investigate neonatal insulin resistance. Both neonatal dogs and adults were clamped at euglycemic blood glucose concentrations while receiving insulin at a rate of 3.75, 15, 30, 60, 75 or 100 mU/kg/min to generate a dose-response curve. Blood glucose levels, plasma insulin concentrations and glucose turnover rates during the basal preclamp fasting period were similar in pups and adult dogs. During the clamp period, blood glucose levels were equivalent to the preclamp period whereas plasma insulin concentrations increased. Total glucose utilization increased from 28.7 +/- 18 to a plateau level of 114 +/- 52.3 mumol/kg/min in adult dogs and from 30.9 +/- 10.9 to 53.9 +/- 28.9 mumol/kg/min in newborn dogs. Suppression of endogenous glucose production during euglycemic hyperinsulinemia was close to 100% among adult dogs, whereas in the newborn pups, endogenous glucose production was suppressed 80%. To determine if the newborn was unable to increase glucose uptake because of a saturation effect on glucose utilization independent of insulin, another group of adult and newborn dogs received a hyperglycemic hyperinsulinemic clamp. In response to the hyperglycemic clamp, adults demonstrated an increase of glucose utilization to 261 +/- 83, and newborn dogs increased utilization to 227 +/- 76 mumol/kg/min.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Improvement of insulin sensitivity after renal transplantation measured by a glucose clamp technique].

There is much evidence indicating that indicates end-stage renal failure induces insulin resistance. We examined the effects of renal transplantation on insulin resistance with an insulin clamp technique. Insulin sensitivity and insulin secretion rates were measured in 13 renal transplant patients, 7 hemodialysis patients, and 6 healthy controls. Insulin sensitivity was assessed with the euglycemic insulin clamp technique. The clamp was applied for 120 minutes and the average of the glucose disposal rates measured from 90 to 120 minutes was regarded as insulin sensitivity. There was a significant increase in the glucose disposal rate in the renal transplantation patients (6.67 +/- 1.44 mg/kg/min) compared to the hemodialysis patients (4.54 +/- 1.44 mg/kg/min) (p < 0.05). Also, there was a significant decrease in the glucose disposal rates in the hemodialysis patients (4.45 +/- 1.44 mg/kg/min) compared to the healthy controls (7.25 +/- 2.07 mg/kg/min) (p < 0.05). There was no significant difference in the glucose disposal rates between the renal transplant patients and the healthy controls. However, patients treated with beta-blockers had lower glucose disposal rates compared to patients without beta-blockers (4.67 +/- 1.58 vs 6.67 +/- 1.44 mg/kg/min, p < 0.05). In this study, we found that insulin resistance, shown by the euglycemic insulin clamp technique, was recovered after successful renal transplantation that but, beta-blockers affected insulin resistance. In conclusion shows that, the hyperglycemic clamp technique, although many factors such as medication may affect insulin sensitivity, renal transplantation restores insulin resistance found in renal failure patients, but not insulin secretion.

Adult↗

Ion channel drug discovery and research: the automated Nano-Patch-Clamp technology.

Unlike the genomics revolution, which was largely enabled by a single technological advance (high throughput sequencing), rapid advancement in proteomics will require a broader effort to increase the throughput of a number of key tools for functional analysis of different types of proteins. In the case of ion channels -a class of (membrane) proteins of great physiological importance and potential as drug targets- the lack of adequate assay technologies is felt particularly strongly. The available, indirect, high throughput screening methods for ion channels clearly generate insufficient information. The best technology to study ion channel function and screen for compound interaction is the patch clamp technique, but patch clamping suffers from low throughput, which is not acceptable for drug screening. A first step towards a solution is presented here. The nano patch clamp technology, which is based on a planar, microstructured glass chip, enables automatic whole cell patch clamp measurements. The Port-a-Patch is an automated electrophysiology workstation, which uses planar patch clamp chips. This approach enables high quality and high content ion channel and compound evaluation on a one-cell-at-a-time basis. The presented automation of the patch process and its scalability to an array format are the prerequisites for any higher throughput electrophysiology instruments.

Drug Design↗

Circulating endothelin-1 levels increase during euglycemic hyperinsulinemic clamp in lean NIDDM men.

OBJECTIVE: To evaluate whether or not insulin stimulates endothelin (ET)-1 secretion in vivo. RESEARCH DESIGN AND METHODS: Plasma ET-1 levels were evaluated in 16 lean normotensive men with non-insulin-dependent diabetes mellitus (NIDDM) (mean age 50.3 +/- 4.1 years) during either a 2-h euglycemic hyperinsulinemic clamp (40 mU insulin.m-2.min-1) or placebo infusion (50 ml isotonic saline) according to a single-blind randomized crossover protocol. RESULTS: Circulating ET-1 levels increased during the euglycemic hyperinsulinemic clamp (from 0.88 +/- 0.38 pg/ml at time 0 to 1.66 +/- 0.22 pg/ml and 1.89 +/- 0.99 pg/ml at 60 and 120 min, respectively [P < 0.05 vs. time 0]) and returned to baseline levels after the discontinuation of insulin infusion (0.71 +/- 0.22 pg/ml after a 30-min period of recovery [NS]). Compared with placebo, the euglycemic hyperinsulinemic clamp induced a significant increase in plasma ET-1 levels at 60 min (P < 0.0001) and 120 min (P < 0.0001). Changes in basal insulin levels and corresponding changes in circulating ET-1 levels after a 2-h euglycemic hyperinsulinemic clamp were significantly correlated (r = 0.771, P < 0.0001). A possible unfavorable effect of ET-1 on the tissue sensitivity to insulin-stimulated glucose uptake was suggested by the presence of a negative correlation between total glucose uptake and baseline ET-1 levels (r = -0.498, P < 0.05). CONCLUSIONS: Our findings indicate that circulating ET-1 levels significantly increase during euglycemic hyperinsulinemic clamp in men with NIDDM. The negative correlation between total glucose uptake and circulating ET-1 levels suggests that the peptide might exert negative effects on the insulin sensitivity of target tissues. The consequent increase in insulin secretion as well as the insulin-related ET-1 release from endothelial cells could favor the development of diabetes-related vascular lesions.

Blood Glucose↗

Patch clamp recording of the responses to three bitter stimuli in mouse taste cells.

Although several pathways of bitter taste signal transduction have been proposed in taste cells, these mechanisms have not been elucidated in detail. To investigate the diversity of responses to bitter stimuli, we recorded the electrophysiological responses to quinine, denatonium and naringin using whole-cell patch clamp technique in isolated taste cells of C57BL/6J mice. Ten mM quinine induced depolarizing response under the current clamp mode, and inward current response under the voltage-clamp mode (holding potential -80 mV) using both K+ (with pseudo intracellular solution) and Cs+ (K+ was substituted by Cs+ in the pseudo intracellular solution) pipettes. However, when the K+ pipette was used, the membrane conductance was suppressed and activated in succession. On the other hand, the membrane conductance was only activated when the Cs+ pipette was used. Half to one mM denatonium induced depolarizing response under the current clamp mode, and outward current response under the voltage clamp mode with both pipettes. Using these pipettes, the membrane conductance was activated or suppressed in the individual case. Naringin-induced responses were not detected in these measurements. These electrophysiological recordings suggest that multiple transduction mechanisms are involved in bitter taste perception in mouse taste cells.

Animals↗

Comparison of simple indices of insulin sensitivity using the euglycemic hyperinsulinemic clamp technique.

BACKGROUND: Insulin resistance is an important factor in the pathogenesis of type 2 diabetes mellitus and other diseases, collectively known as "metabolic syndrome". The gold standard in measuring insulin resistance is glucose clamp, but this method is difficult to apply in large studies. Therefore, indirect indices of insulin sensitivity are proposed. The aim of the present study was to compare these simple indices with data from clamp studies. MATERIAL/METHODS: We examined 51 obese subjects, 23 with impaired glucose tolerance (IGT), 28 with normal (obese-NGT), and 37 healthy lean controls. Insulin sensitivity was determined with the euglycemic hyperinsulinemic clamp technique. We estimated indices of insulin sensitivity: fasting plasma insulin (INS), logarithm INS (log [INS]), homeostasis model assessment (HOMA), logarithm HOMA (log [HOMA]) and quantitative insulin sensitivity check index (QUICKI). RESULTS: With clamp technique, we demonstrated a decrease in insulin sensitivity in both obese groups vs controls, and also in IGT compared to NGT subjects. The differences were significant when we used other indices of insulin sensitivity, except those for INS, log [INS] and HOMA between the two obese groups. Indirect indices correlated with insulin sensitivity derived from clamp in the whole population and in the subgroups of control and NGT-obese subjects. In the IGT group, only the correlations with log [INS], log [HOMA] and QUICKI were significant. CONCLUSIONS: Simple indices may give valuable information about insulin sensitivity in large studies. Indices based on log-transformed plasma glucose and insulin levels are recommended in subjects with IGT.

Adult↗

The effects of weight loss in obese subjects on the thermogenic, metabolic and haemodynamic responses to the glucose clamp.

The aim of this work was to examine the effects of weight loss in obese subjects on the thermogenic, metabolic and cardiovascular responses to a glucose clamp. Resting measurements were made, followed by a hyperinsulinaemic (100 mU/m2/min) euglycaemic clamp (4.5 mmol/l). The subjects were six healthy, obese subjects (mean body mass index before weight loss 37.0 +/- 1.7 kg/m2 and after weight loss 31.4 +/- 2.3 kg/m2). The following measurements were made: indirect calorimetry, blood pressure, heart rate, forearm blood flow, plasma catecholamines, plasma deuterated glucose turnover before and during a glucose clamp. Glucose disposal during the clamp increased from 2.53 +/- 0.40 to 3.31 +/- 0.42 mmol/min after weight loss (P < 0.01). Glucose-induced thermogenesis rose from 0.15 +/- 0.09 to 0.50 +/- 0.12 kJ/min (P < 0.05). The apparent cost of glucose storage was not significantly different from zero prior to weight loss, but increased to 11.0 +/- 2.2% after weight loss. In response to the clamp endogenous glucose production was suppressed by 66 +/- 7% initially and this was not affected by weight loss. Weight loss was accompanied by increased peripheral insulin sensitivity and glucose-induced thermogenesis, but it did not affect hepatic insulin sensitivity.

Adult↗

Estimates of insulin action in normal, obese and NIDDM man: comparison of insulin and glucose infusion test, CIGMA, minimal model and glucose clamp techniques.

Many methods of varying complexity are available for the measurement of insulin resistance (action) in man. No study has previously compared several of these in the same subjects to establish which is the most appropriate for routine use. We have, therefore, compared six methods: the hyperinsulinemic eu(iso)-glycaemic clamp (Eu), insulin glucose infusion test (IGI), hyperglycaemic clamp (Hy), continuous infusion of glucose with model assessment (CIGMA), minimal model (Min) and modified minimal model (Mod). Nineteen subjects with varying degrees of glucose tolerance were studied. Eight normal (BMI 22.5 +/- 1.5 kg/m2), six obese (BMI 38 +/- 5 kg/m2) and five NIDDM subjects (BMI 27 +/- 3 kg/m2) were investigated, in a randomized fashion, on separate days. The ratio of metabolic clearance rate of glucose (MCRG) and Insulin (I) was used as the measure of insulin action during Eu, Hy and IGI. Si was calculated as the index of insulin sensitivity from (Min) and (Mod) and CIGMA was obtained as previously described. MCRG was converted to Si to allow for direct comparison with (Min). Methods requiring incremental endogenous insulin secretion (which was highly variable) to calculate an index of insulin action (Si Min, Si Hy and CIGMA) failed to find an overall difference between groups. Only Si Eu (p = 0.007) and Si IGI (p = 0.001) demonstrated a significant overall group difference when Si was used. When MCRG/I was used, Eu, IGI and Hy were able to distinguish a significant overall group difference. With the exception of CIGMA and SiHy all other methods found a significant difference in insulin action between normals and NIDDM subjects. Only Eu and IGI could distinguish obese from normal, while only Si Min, could distinguish obese from NIDDM subjects. Eu and IGI were the only methods to be significantly correlated: normals Rs = 0.75, p < 0.05, obese Rs = 0.9, p < 0.05, and NIDDM Rs = 1.0, p < 0.05. In conclusion we have demonstrated that: 1) The insulin-glucose infusion test and the eu(iso)glycaemic clamp were significantly correlated in normals, obese and NIDDM subjects. 2) Only the eu(iso)glycaemic clamp and insulin glucose infusion test could significantly separate obese from normal subjects. 3) the IGI appears to be a practical, simple and precise method for measuring in vivo insulin action in man and gives results closely similar to those found with the hyperinsulinemic eu(iso)glycaemic clamp.

Adult↗

Insulin sensitivity relates to other cardiovascular risk factors in young men: validation of some modifications of the hyperinsulinaemic, isoglycaemic glucose clamp technique.

Reduced peripheral sensitivity to insulin-stimulated glucose disposal, insulin resistance, is considered to be central in the metabolic cardiovascular syndrome. The hyperinsulinaemic euglycaemic glucose clamp technique was introduced by DeFronzo in 1979 and is regarded as the reference method for quantifying insulin resistance in skeletal muscle tissue. Recently, we used this technique in young men to relate insulin resistance (inverse of insulin sensitivity) to a number of established cardiovascular risk factors. The method has undergone numerous modifications since 1979 which have not been extensively validated. Therefore, we now describe the modified hyperinsulinaemic, isoglycaemic glucose clamp procedure performed in our laboratory and validate some of the modifications. Five young/middle-aged men were examined twice in three weeks and then re-examined after 4 years in the same way. The intrasubject day-to-day variability in insulin sensitivity was 5%. The average reduction in insulin sensitivity after 4 years was 21%. The last 60 min of the clamp offered a better basis for calculating glucose disposal rate (GDR) than the last 20 min. The variation in glucose measurements during clamp was 5%. We thus found that our modified isoglycaemic hyperinsulinaemic glucose clamp technique for assessing insulin sensitivity in skeletal muscle tissue is accurate and reproducible when performed in young/middle-aged men.

Adult↗

Determination of a safe vascular clamping method for liver surgery: evaluation by measuring activation of calpain mu.

OBJECTIVE: To determine the safest method of hepatic vascular clamping associated with the least ischemia-reperfusion injury of the liver during liver surgery. SETTING: University laboratories. SUBJECTS: Sixty-five adult male Wistar rats. METHODS: The hilar area of the left lateral and median lobes of rat liver was clamped for 10 minutes (group 1), 15 minutes (group 2), or 20 minutes (group 3) followed by 5 minutes of reperfusion. The procedure was repeated for a total period of ischemia of 60 minutes in each group. Control rats underwent laparotomy without vascular clamping. In addition to histological examination, we determined calpain mu activity, a marker of liver injury, by Western blotting using specific antibodies against the intermediate (activated) and proactivated forms of calpain mu. Measurements were performed at the end of ischemia and after 2 hours of reperfusion. We also determined the degradation of talin, an intracellular substrate of calpain mu, by Western blotting. RESULTS: The level of adenosine triphosphate and energy charge at 2 hours after reperfusion did not change after ischemia-reperfusion irrespective of the duration of ischemic cycle. After 60 minutes of intermittent ischemia followed by 2 hours of reperfusion, cell membrane bleb formation, calpain mu activation, and talin degradation were detected in groups 2 and 3 but not in group 1. CONCLUSION: The safest method of hepatic vascular clamping that produces a minimum or no ischemia-reperfusion injury is 60 minutes of 6 cycles of 10-minute vascular clamping interrupted by 5 minutes of reperfusion.

Animals↗

A comparison of the traumatic effects of vascular clamps.

The mature and extent of damage to the wall of the femoral artery of the dog caused by five different vascular clamps is reported. This is related to the ability of the clamp to both occlude the vessel and to hold the wall without slipping. Intimal damage was assessed by supravital staining, scanning electron microscopy of the surface and the histological appearance of sagittal sections of the arterial wall. The Atraugrip, Satinski and Potts clamps caused more apparent damage to the vessel wall and achieved occlusion by holding of the vessel at higher pressures than did the Blalock and Fogarty clamps. There is a difference between the damage produced when closure is sufficient to just occlude the vessel and that produced when the clamp is fully closed.

Animals↗

Comparative use of cold blood potassium cardioplegia in coronary bypass patients necessitating long (2.5-6 h) versus short (less than 1.5 h) aortic cross-clamp times.

In symptomatic patients with severe diffuse multivessel coronary disease undergoing bypass surgery, complete revascularization with multiple bypass grafts using saphenous vein and internal mammary conduits, and multiple endarterectomies may be necessary. Such complex surgeries may require long aortic cross-clamp times in excess of 2.5 h. To evaluate the myocardial preservation provided by cold potassium blood cardioplegia, two groups of consecutive patients using nearly similar surgical techniques were compared. Group A consisted of 100 patients who received an average of 3.8 grafts per patient and had a mean aortic cross-clamp time of 66 (range 15-90) min. Group B was comprised of 100 patients who received an average of 9.3 grafts per patient and had a mean cross-clamp time of 187 (range 150-351) min. Operative mortality and perioperative myocardial infarction were low (0-2%) and were not significantly different between the groups. In addition, the postoperative creatine kinase-MB isoenzyme levels, use of pharmacologic and/or mechanical (i.e., intra-aortic balloon) support, and follow-up exercise treadmill tests were not significantly different in the two groups. These findings suggest that cold potassium blood cardioplegia is equally protective of the myocardium during surgical revascularization in patients with short aortic cross-clamp times (less than 1.5 h) as in those with severe diffuse multivessel coronary artery disease requiring long cross-clamp times exceeding 2.5 h and up to 6 h.

Blood Transfusion, Autologous↗

Bipolar clamping improves the sensitivity of mutation detection by temperature gradient gel electrophoresis.

Temperature gradient gel electrophoresis (TGGE) is a rapid and sensitive screening method for point mutations and other small DNA alterations. Usually a polymerase chain reaction (PCR)-product of 150 to 500 bp that has been clamped at one end by a psoralen molecule or a "GC-clamp" is tested for abnormal melting characteristics by electrophoresis in a temperature gradient. Under optimal conditions, a heterozygous mutation within the fragment is detected through the presence of three additional bands in the TGGE gel, the mutant homoduplex and two heteroduplex bands. However, the ideal pattern of four sharp bands is not always found due to inconsistencies in melting behavior along the sequence of the DNA fragment under study. Some of these fragments show fuzzy bands that may impede or even prevent the detection of a mutation. Here, we describe a method to overcome this problem by utilizing one psoralen clamp at each end of the PCR product. Using TGGE assays established for exons 16, 17, and 18 of the NF1 gene and for exon 14 of the FBN1 gene as examples, we show that bipolar clamping may transform blurred bands into sharp ones and may visualize mutations that could not be detected by conventional single-sided clamping.

DNA↗

Optimal cycle of intermittent portal triad clamping during liver resection in the murine liver.

We designed this experimental study to determine the optimal cycle for intermittent inflow occlusion during liver resection. A cycle of intermittent clamping (IC) for 15 minutes of ischemia followed by reperfusion for 5 minutes during liver resection is currently the most popular protocol used by experienced liver centers. As each period of reperfusion is associated with bleeding, longer periods of clamping would be advantageous. However, the longest safe duration of successive ischemia is unknown. Three groups of mice were subjected to a total liver ischemic period for 90 minutes; 2 groups underwent IC for 15 or 30 minutes, respectively, followed by 5 minutes of reperfusion, while the control group was subjected to continuous inflow occlusion only. The degree of tissue injury was assessed using biochemical and histological markers, as well as animal survival. While serious injury was observed in the continuous clamping group, both IC groups were associated with minimal injury, including lesser degrees of apoptosis and necrosis. All animals survived in the IC groups, while all animals died following 90 minutes of continuous inflow occlusion. In conclusion, intermittent portal pedicle clamping with 15- or 30-minute cycles is highly protective. A period of 30 minutes clamping should be preferred, since this would decrease the amount of blood loss associated with each cycle. This data should be confirmed in humans, and may represent a change in the current practice of hepatic surgery.

Animals↗

Effect of t-tube clamping on the pharmacokinetics of mycophenolic acid in liver transplant patients on oral therapy of mycophenolate mofetil.

The aim of the study was to evaluate the effect of t-tube clamping on the pharmacokinetics of mycophenolic acid (MPA) after oral administration of mycophenolate mofetil (MMF) in primary liver transplant recipients treated with tacrolimus as the primary immunosuppressive drug. We evaluated the pharmacokinetics of MPA and its primary metabolite, mycophenolic acid glucuronide (MPAG), before and after clamping the t-tube in 8 primary liver transplant recipients treated with oral MMF and tacrolimus. The concentration of MPA and MPAG in plasma, bile, and urine samples obtained over one dosing interval was measured by high-pressure liquid chromatography. Pharmacokinetic parameters of MPA estimated before and after clamping the t-tube were compared to evaluate any significant differences at a P of.05 or less. There were no significant differences in the time to reach peak plasma concentration (1.8 +/- 1.7 v 1.0 +/- 0.5 hours), trough plasma concentration of MPA (1.1 +/- 1.4 v 1.4 +/- 1.1 microgram/mL), peak plasma concentration of MPA (10.6 +/- 7.5 v 11.1 +/- 4.6 microgram/mL), area under the plasma concentration-versus-time curve (AUC) (40.1 +/- 31.9 v 43.2 +/- 21.1 microgram/mL/h) of MPA, or the percentage of MPA that is free or unbound in the plasma (3.9% +/- 1.6% v 4.1% +/- 3.0%). There was also no significant difference in the ratio of the AUC of MPAG to MPA. These observations suggest that t-tube clamping does not affect the kinetics of MPA or MPAG and that no dosing alterations of MMF are required when the t-tube is clamped in liver transplant recipients.

Administration, Oral↗

"New" microvascular clamps for thoracic surgery in the rat.

The development of "new" microvascular clamps for lung transplantation in the rat was necessary because the generally used microclamps were found to be not feasible in preliminary experiments. A mosquito clamp modified in a Satinsky-like manner made lung transplantation in the rat possible. However, most suitable was the smallest Blalock pulmonary clamp with some modifications. This clamp has been used in over 500 left lung transplantations in the rat now, and is no longer subject to further innovations. This report shows that relatively large instruments can be appropriate microvascular clamps.

Animals↗

Immediate and short-term effect on arterial flow of clamping or stripping one vessel of a two vessel limb in a dog model.

The effect on distal blood flow in a 2 vessel limb of clamping one of the vessels or resecting it over a length is not known. Commonly this situation occurs clinically, for example, following lacerations to the radial or ulnar artery or as a result of removing a radial or ulnar artery flap. In a dog model established to mimic these clinical circumstances, a 2 vessel limb was created in which one vessel carried two-thirds of the total flow and the other one-third. Electromagnetic flow recordings were taken to measure the changes in flow in one vessel when the other was clamped or resected. Contrary to expectation, when one vessel was occluded the flow in the opposite vessel both immediately and for the following 30 minutes increased but remained well below the combined flow of 2 unclamped vessels. No increased flow was recorded in the dominant vessel when the smaller vessel was clamped, while an approximately 25% increase in flow was recorded in the smaller vessel when the larger one was clamped. This represents a reduction in total distal blood flow of one-half of the preclamping levels. Clamping of the vessel or its resection over a length resulted in the same degree of alteration in flow in the opposite vessel. The sacrifice of a dominant vessel in a 2 vessel limb whether by simple ligation or by radical stripping as for free tissue transfer significantly decreases distal flow in that limb at least in the immediate and short term.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗