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Hormonal studies in pregnancy. I. Total unconjugated estrogens in maternal peripheral vein, cord vein, and cord artery serum at delivery.

The concentration of unconjugated total estrogens (primarily estrone, estradiol-17beta, and estriol) were measured by rapid radioimmunoassay method in serum samples from maternal peripheral vein, cord vein, and cord artery in normal pregnancies at delivery. The serum concentration of total free estrogens found in cord vein was four to five times higher than in maternal peripheral vein and cord artery. Levels obtained in maternal peripheral vein, cord vein, and cord artery were 47.8+/-1.8, 140.1+/-8.57, 31.8+/-2.15 ng. per millilitre (+/-standard error of the mean), respectively. These values are compared with those reported by others.

Collateral Circulation↗

[The effects of centrifugal pump on liver support system with porcine liver perfusion].

The effects of vaneless centrifugal pump (Bio-pump P-80) on energy metabolism were studied, as compared with the roller pump, in an isolated porcine liver perfused with human blood for 6 hours. According to preliminary examination, flow rates were decided to 0.4, 0.8 ml/min/g in roller pump group, in Bio-pump pump group, respectively, not to increase more than 15 mmHg in initial portal pressure. During the perfusion, actual portal pressure was measured and circulatory resistance (portal pressure/flow rate) was calculated before perfusion and hourly after perfusion. Acetoacetate, beta-hydroxybutyrate, lactate and pyruvate, were measured at same times, from which values the ketone body ratio (acetoacetate/beta-hydroxybutyrate, KBR), reflecting the redox state of liver mitochondria, was calculated. In the Bio-pump group, in spite of its high flow, circulatory resistance was low at every hour during the perfusion. KBR was increased rapidly from 0.40 to 1.39, 2.59, 2.75, 2.38, 2.41, and 1.82 and lactate was decreased rapidly from 7.96 to 3.90, 1.77, 1.29, 1.33, 1.34, and 1.25 mmol/L at the respective hours after perfusion. There were significant differences at 2 and 4 hours after perfusion in KBR and after 2 hours of perfusion in lactate as compared with the roller pump group (p < 0.05). These results suggested that the Bio-pump is available for constant and high flow to the liver and helpful to elevate the mitochondrial NAD/NADH ratio (oxidized and reduced forms of free nicotinamide-adenine dinucleotides), leading to and enhancement of metabolic capacity of the perfused liver.

Adult↗

[The improvement of the tolerance of the kidney for ischemia with the prostacyclin analog iloprost].

Operative trauma, ischemia, release of catecholamines and thermal stimuli in consequence of harvesting, preservation and transplantation deteriorate the renal capillary circulation. By crossing of tolerance limits arises an irreversible transplant damage. The conditions of our examinations were placed in this field. By pre- and postischemic application of Iloprost was demonstrable an improvement of the ischemic tolerance of the kidney. Correction of renal hemodynamics, antiplatelet action and cytoprotection are the reasons of the protective influence of Iloprost in our opinion.

Acute Kidney Injury↗

[The obese patient].

Anaesthesia to obese patients is a challenge due to specific changes in respiratory and circulatory functions. Obese patients have a higher risk of acquiring nosocomial infections, including wound sepsis. The place for minimal invasive surgery to limit complications in these patients is unresolved. There is need for prophylactic administration of antitrombotics and antibiotics administered on a weight-adjusted basis. The risk induced from anaesthesia and surgery correlates with comorbidity rather than BMI. Obese patients should not be discriminated against when considering a surgical option.

Anesthesia↗

[Humoral factors in the modulation of sustained discharges of polymodal nociceptors].

By using a model of sustained discharges of polymodal nociceptors (PMN) due to injection of a compound algogenic substance into the skin in anesthetized rats, it was found that stimulation of the sciatic nerve inhibited or facilitated at first and then inhibited the PMN sustained discharges markedly. In a crossperfused preparation, stimulation of the sciatic nerve of donor rat caused the similar effects on sustained discharges of PMN of the recipient rat. Injection of the animal serum after stimulation of the sciatic nerve affected PMN activity obviously. The inhibitory course of most units could not be reversed by naloxone. In the animal tolerance to morphine, the effects of stimulation of the sciatic nerve could still be obtained. Preadministration of reserpine almost completely abolished the facilitatory effect. The results indicate that sustained activity of PMN could be modulated by some humoral factors due to somatic afferents. The inhibitory substances in the humoral factor seem to be both opioid and nonopioid in nature. The facilitatory substance seem to be a catecholamine.

Acupuncture Analgesia↗

[Prevention of cerebral complications during thoracic aortic aneurysms operation: study of preoperative selective cerebral arteriography].

Preoperative selective cerebral arteriography is carried out in order to determine if the circle of Willis is intact in the cases of the thoracic aortic aneurysms. As regard to the bilateral vertebrobasilar communications, 26 of 30 patients (86.7%) have good condition, 4 of 30 patients (13.3%) have poor, and in 2 cases the left vertebral artery supplied broad area of posterior cranial fossa. We believe that in the cases in whom the left vertebral artery is dominant, and cross collateral circulation is absent, perfusion of the left subclavian artery is necessary to prevent vertebrobasilar ischemia during aortic aneurysms operation under normothermia.

Adult↗

[Extracorporeal xenospleen perfusion in vial-bacterial pneumonia in children].

Extracorporeal perfusion of xenospleen was used in the management of 11 critically ill children with acute multisegmental pneumonia. The first 24 h were characterized by progressive mounting in blood O2 saturation, optimization of hemodynamics and immune status, decrease of toxemia. On days 4-7 after perfusion stabilization of clinical, laboratory and functional indexes was observed. Radiological findings of pulmonary infiltration disappeared 10-14 days after sorption and all the patients were transferred to a somatic unit.

Acute Disease↗