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At least 919 records · Page 51Linked to original sources
PubMed1991

Pentafraction-Du Pont versus albumin for resuscitation of a lethal intestinal ischemic shock in rats.

This study compares the effect of pentafraction-Du Pont 6% (PF), albumin 5% (ALB), and Ringer's lactate (RL) on plasma volume (PV) expansion and survival in a lethal intestinal ischemic shock model. Shock was induced by exteriorizing the small intestines and occluding the mesenteric vessels for 75 min. Changes in PV were estimated using hematocrit (Hct). The solutions were administered continuously for 6 hr in volumes to maintain a stable Hct, or 15 ml/100 g body weight (bwt) for PF and ALB and 44 ml/100 g bwt for RL. Hct and bwt were measured hourly during the infusion and at 24 h. Untreated animals in shock developed hemoconcentration (Hct 62%) corresponding to a PV of 41% of baseline preshock level, with 9% (3/35) of the animals surviving 72 hr. RL expanded PV to 87% of preshock level, with a 57% (20/35) 72 hr survival rate and 46% (16/35) surviving greater than 7 days. Only 34% as much ALB was needed to induce a greater PV expansion of 101% with a 72 hr survival rate of 51% (18/35) and 46% (16/35) surviving greater than 7 days. When PF was used, PV expanded to 109% of preshock level with survival rates improving to 80% (28/35) at 72 hr and 71% (25/35) greater than 7 days compared to RL and ALB (P less than 0.05). There were no significant differences in survival rates between RL and ALB treated animals. We conclude that PF improves survival following intestinal ischemic shock compared to ALB and RL. PF is a safe and effective alternative to albumin for resuscitation in this shock model.

Albumins↗
PubMedDate not supplied

[Laparoscopic surgery of colon cancer. State of art and literature review].

Over the past decade advances in laparoscopic surgery have revolutionized the surgical approach to many diseases. Although the first case series on laparoscopic segmental colectomy in patient with sigmoid cancer was described in 1991, this technique has not been readily accepted. Despite reduced morbidity and improved convalescence after laparoscopic surgery for benign disorders, surgeons have been sceptical about similar advantages of laparoscopic colectomy for cancer. The safety of the procedure has been questioned because of early reports of port-site metastases and there has been uncertainty about whether minimally invasive surgery for colonic malignancies would achieve adequate oncologic resection. Open surgical resection of the primary tumor, until just recently, has been widely considered the most effective treatment of colon cancer. The adherence to the principles of complete abdominal exploration, high ligation of mesenteric vessels, lymphnodal clearance and adequate bowel resection margins is essential. Several randomized trials were initiated in the early 1990s to compare the short- and long-term outcomes of patients undergoing minimally invasive and conventional open surgery for colon cancer. Today the results of this large multiinstitutional randomized trials have been reported. This review examines recent data from randomized, controlled trials and meta-analysis, that report the short- and long-term outcomes after laparoscopic colectomy for cancer.

Colonic Neoplasms↗
PubMed1991

Use of the free jejunal loop to replace cervical oesophagus in an experiment.

The paper presents the results of experimental studies exploring the possibility to replace the cervical oesophagus with a free intestinal loop. The experiments were carried out in dogs and cervical oesophagus replacement was performed using a jejunal loop. Nutrition was provided by mesenteric vessels anastomosed by means of a microsurgical operative technique. The intestinal segment was subsequently used to replace the resected segment of the cervical oesophagus. The results of our experiments indicate this new operative technique can be used in clinical practice.

Anastomosis, Surgical↗
PubMed1991

[Role and significance of S. S. Iudin in the development of reconstructive surgery of the esophagus].

Merits can be conferred upon S. S. Yudin not only in the improvement of the method of esophagoplasty with the small intestine suggested by C. Roux in 1907, but also in the development of reconstructive surgery of the esophagus on the whole. Although new methods for esophagoplasty have been suggested and new technical possibilities have appeared, many elements of surgical tactics, operative techniques, and instruments suggested by S. S. Yudin are still applied in reconstructive surgery of the esophagus. Among them are the detailed description of jejunal architectonics from the surgeon's point of view, the wide use of test compression of the mesenteric vessels to evaluate the adequacy of blood supply to the graft, description of the clinical signs of disturbed blood supply to the graft, etc. S. S. Yudin laid the foundations of scientific research into the morphological and functional reorganization of organs and tissues in prolonged existence under unusual conditions, which is of great theoretical importance. Twenty-year experience in reconstructive surgery of the esophagus allow the author of this article to appraise at their true worth the technical procedures and physiological approaches suggested by S. S. Yudin, which are being developed further under modern conditions. This applies to substantiation of the most reliable and physiological method of retrosternal esophagoplasty with the colon with isoperistaltic position of the graft, transpleural resection of a cicatricially deformed esophagus, surgical treatment of achalasia of the superior esophageal sphincter.

Esophagoplasty↗
PubMed1991

[Erroneous laparotomy in emergency surgery].

The authors studied the data concerning 101 patients who had undergone erroneous laparotomy for suspected acute surgical disease; these accounted for 0.4% of all the patients who were operated on for emergency indications in the same period. Eleven patients died. The operation was undertaken for an erroneous diagnosis of acute appendicitis (32 patients), acute cholecystitis (18), perforating gastric ulcer (15), peritonitis of unknown etiology (14), acute intestinal obstruction (5), strangulated hernia (3), destructive pancreatitis (3), tumor of the large intestine complicated by obstruction (3), abdominal abscess (2), thrombosis of the mesenteric vessels (1), ovarian apoplexy (1), closed abdominal trauma with injury to the viscera (4 patients). Diseases simulating the clinical picture of "acute abdomen" but not requiring an emergency operation were as follows: female reproductive (20 patients), pancreatic (11), renal diseases (11), hepatitis, cirrhosis of the liver (10), cardiovascular (9), pulmonary diseases (5), mesoadenitis (5), Crohn's disease (3), chronic colitis (3), carcinomatosis of the peritoneum (3), herpes zoster (3), and other diseases and injuries (20 patients). The main causes of the diagnostic and tactical errors were objective difficulties in the differential diagnosis due to similar symptomatology, as well as errors in the examination of the patient and haste in making a decision to make an operation.

Abdomen, Acute↗
PubMedDate not supplied

[The effect of a polypeptide complex isolated from the animal prostate on thrombus formation].

The authors studied the effect of polypeptides, which were obtained from the prostate of cattle and were related to the class of cytomedines, on the formation of thrombi in the venules of the mesentery in rats. Thrombosis of the venules was induced by laser irradiation, the thrombogenesis parameters were measured with a TV microscope. Intramuscular injection of the preparation and its local action on the mesenteric vessels reduced the time of growth and the size of the thrombi in the experimental animals as compared to that in the controls. The obtained data are evidenced that the preparation produces an inhibiting effect on the thrombocyte-vascular mechanism of hemostasis by increasing the thromboresistance of the vascular wall.

Animals↗
PubMed1991

Raised intracranial pressure of obscure cause: prospective clinical review on African Tanzanian patients.

This paper reports a clinical review of 13 patients with raised intracranial pressure of obscure cause seen over a six-year period. Patients were young in the 8 to 40 years age range. Female patients accounted for 54 pc. About half of the females had menstrual abnormalities. 15 pc were obese while the rest were normal or underweight. A previous long history of headache was present in patients with focal neurological signs. The main presenting symptoms were headache and reduction in visual acuity. Main signs were papilloedema and reduced visual Acuity. After a short term follow-up period of one to six years, (mean three years), the general outcome was good with recurrence in one patient. Headache and visual symptoms recovered early after treatment. Focal long tract signs recovered rather slowly. Twelve patients are at present free of symptoms. One died from mesenteric vessel thrombosis and was presumed to have pregnancy related sagittal sinus thrombophlebitis.

Adolescent↗
PubMed1976

[Effect of microvessel injury on the frequency of tumor cells' lodging in them].

The action of local laser-induced microvascular injury on the frequency of tumour-cell lodgement and on the ability of these cells to migrate out of the microvessel lumen was studied. Intravital TV-microscope with a videotape recorder and an ultra-voilet laser was used. Ascites Saidel hepatoma cells were injected into the blood stream of rats. Lodgement of tumour cells in the mesenteric vessels was observed but rarely (11%). The lodged cells adhered to the microvascular wall and gradually migrated from the lumen. The injury of the wall with laser beam results in the formation of microthrombi and in increase in the frequency of lodgement of the tumour cells in these vessels: 82% against 11%, but migration of these cells decreased. The data obtained supported the significance of the microthrombus formation in the metastatic process. However, this role is not one-sided since on the background of increased frequency of adhesion of the tumour cells there was noted a decrease in their motility in the course of several hours after the lodgement in the microvessels.

Animals↗
PubMed1990

Role of endothelin in mechanisms of local blood pressure control.

A potent endothelium-derived vasoconstrictive peptide, endothelin (ET), is processed from a precursor, big endothelin, by an unknown converting enzyme. It stimulates calcium channels, phospholipase C and phospholipase A2 in smooth muscle cells through activation of the receptor specific for ET. The intracellular free calcium ion concentration is increased by ET, inducing vasoconstriction. The response to ET varies according to the type of blood vessel. Mesenteric small arteries and arterioles are sensitive to ET. It is likely that various factors, including adrenaline, angiotensin II and arginine vasopressin, induce synthesis and release of ET from the endothelium. A balance among ET, endothelium-derived relaxing factor (EDRF) and atrial natriuretic peptide (ANP) may control vascular tone and regulate peripheral blood flow.

Amino Acid Sequence↗
PubMed1990

[Hemosorption in the complex treatment of patients with suppurative peritonitis of appendicular etiology].

Analysis of the results of treatment of 240 patients with generalized peritonitis of appendicular origin showed that the application of hemosorption led to noticeable and stable diminution of intoxication in 84% of cases. In the ++post-sorption period, the severity of endotoxicosis did not change essentially in 12% of cases and increased in the remaining cases. The therapeutic effect of hemosorption was found to be unstable in patients with signs of multiple organ insufficiency developing in prolonged poorly effective therapy as well as in patients with unrecognized abdominal abscesses, incompetence of the sutures of anastomoses, thrombosis of the mesenteric vessels, and early intestinal obstruction due to adhesions. Endotoxicosis intensified during hemosorption in patients with extensive epifascial phlegmons. It is proved that hemosorption applied repeatedly in the early postoperative period with due account for the individual features of the course of the disease ensures an optimal therapeutic effect.

Acute Disease↗
PubMed1990

Non-occlusive ischaemic enteritis.

Non-occlusive infarction of the intestine without any associated medical disorder responsible for prolonged hypotension, is a rare clinical entity. A retrospective analysis of 46 cases revealed that the disease occurred predominantly in young, healthy, male patients. The classical presentation was of abdominal pain and persistent tachycardia out of proportion to the abdominal signs of distension, mild tenderness and reduced bowel sounds. The presenting features were of peritonitis due to perforation (63%) and intestinal obstruction (37%). A preoperative diagnosis was suspected only in six cases. Operative findings revealed that the bowel was infarcted without involvement of the mesenteric vessels, which were pulsatile up to the bowel wall. The characteristic findings of the disease, which mainly affected the jejunum (69.6%), were: (i) infarcted area of the bowel surrounded by skip lesions of purple, constriction bands; (ii) multiple small perforations in a paper-thin bowel: or (iii) a long linear perforation. Histologically, ischaemic changes were found to affect the mucosa and submucosa beyond the macroscopic limits. Mortality was high (19.6%).

Adult↗
PubMed1988

Inhibition of platelet activation by 2-mercaptopropionylglycin in vitro and in vivo.

2-mercaptopropionylglycin (2-MPG), a cell membrane penetrating thiol, was evaluated for its antithrombotic potential using in vitro and in vivo tests. 2-MPG was found to inhibit agonist-induced platelet aggregation and serotonin release as well as prostaglandin/thromboxane synthesis in platelet-rich plasma. Administration of 2-MPG to rats resulted in an inhibition of laser-induced thrombus formation in mesenteric vessels. When plasma was incubated with 2-MPG and then used for determination of various standard coagulation parameters, significant prolongation of the clotting times were observed.

Animals↗
PubMed1987

Pharmacology of ovine and human CRH.

In primates, ovine and human CRH cause ACTH- and cortisol secretion in a dose-dependent fashion. Ovine CRH has a half-life, which is about three times longer than that of human CRH and results in long lasting ACTH- and cortisol responses. Plasma ACTH- and cortisol rises after administration of human CRH mimic the spontaneously occurring secretory episodes of these hormones in man. Pulsatile administration of human CRH restores the diurnal secretory pattern of ACTH and cortisol to normal in patients with apparent CRH deficiency. Facial and upper body flush occur in about 20% of patients receiving intravenously a 1 microgram/kg dose of CRH. Higher doses result in hypotension due to a decrease in peripheral vascular resistance. The latter is primarily due to dilatation of the superior mesenteric vessels. In in vitro models desensitization of the pituitary corticotroph by continuous, high-dose CRH administration occurs. No down-regulation of ACTH- and cortisol secretion has been shown in vivo, however. Pituitary-adrenal responsiveness to CRH can be modulated by many factors. These factors are involved in the basal regulation of the hypothalamic-pituitary-adrenal axis and in its activation during the stress response. Such factors include AVP, morphine, DAMME, and drugs modulating the endogenous serotoninergic and GABA/benzodiazepine system. Glucocorticoid feedback inhibition of the pituitary is one of the most important factors modulating ACTH- and cortisol responses to CRH. A negative correlation exists between the net ACTH- and cortisol response to exogenous CRH and the basal cortisol plasma concentration. Replacement doses of glucocorticoid result in a drastic decrease of basal plasma concentrations of cortisol and adrenal androgens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗
PubMed1988

Application of a laser-induced endothelial injury model in the screening of antithrombotic drugs.

A method of inducing microthrombi in small rat mesenteric vessels (approximately 20 to 30 micron) has been developed to study platelet reactions and to investigate antithrombotic drugs. For microscopy, a high-power water immersion system, based on a Leitz Orthoplan microscope, was used. In sodium pentabarbital anesthetized male Wistar rats and in fawn-hooded bleeder rats vascular lesions were produced with a Coherent CR-2 ion laser (argon laser). The laser induced vascular damage, without intravascular heat precipitates, which led to the adhesion, transformation, and aggregation of platelets at the damaged vessel wall. Fibrin threads were rarely formed in these early platelet thrombi. Thrombus formation was estimated by the number of laser injuries required to induce a defined thrombus. The first steps of thrombus formation, in particular the adhesion and reversible aggregation, were significantly reduced in this model in fawn-hooded bleeder rats. A number of different drugs modified thrombus formation in this model, for instance, ASA, defibrotide, unfractionated or low molecular heparins. It is unlikely that a single mechanism is responsible for the observed antithrombotic effects of each of these drugs. The inhibition of platelet adhesion by changes of membrane glycoproteins, interference with the early activation of plasma proteins, effects on prostaglandin metabolism, inhibition of activators stemming from damaged endothelial cells, and other effects have to be considered.

Animals↗
PubMed1988

Carcinoid tumor in Meckel's diverticulum.

Carcinoid tumor arising in a Meckel's diverticulum is a rare lesion with only 52 cases described in the literature. Most of these tumors are found incidentally at autopsy or during an operation performed for an unrelated reason. The lesion can, however, in about one-third of cases, be the cause of symptoms necessitating surgical intervention; the diagnosis is nearly never apparent till the specimen has been removed. When the signs do not match the symptoms, consideration of uncommon conditions such as this may help in making a correct preoperative diagnosis. Resection of the intestinal segment containing the diverticulum along with its mesentery to the level of the superior mesenteric vessels usually results in cure; however, metastatic disease and even carcinoid syndrome may still occur. Second primary malignancies are often found in patients with carcinoid of Meckel's diverticulum.

Aged↗
PubMedDate not supplied

Survival following rupture of a pancreatic abscess in a heart transplant recipient.

A 43-year-old man underwent orthotopic heart transplantation for end-stage ischemic cardiomyopathy. Immunosuppressive therapy consisted of cyclosporine and corticosteroids. The diagnosis of acute pancreatitis was made on the ninth postoperative day and was based on clinical symptoms and an upper gastrointestinal barium study. Both serum and urine amylase values were normal. Abdominal ultrasound examination was nondiagnostic. Two weeks postoperatively, the patient's clinical condition deteriorated sharply. Chest and abdominal roentgenograms revealed free intraperitoneal air, as well as air in the lesser sac. Diagnosis of a ruptured pancreatic abscess was made, and he underwent immediate exploratory laparotomy. Four liters of purulent fluid were present in the peritoneal cavity. A ruptured pancreatic abscess was found, and it had dissected above the superior mesenteric vessels and down the right gutter over the inferior vena cava. After extensive retroperitoneal debridement and copious irrigation, multiple surgical drains were placed. The patient is now well and is performing normal daily activities 16 months after the transplantation procedure. The incidence and proposed causes of pancreatitis occurring after heart transplant are reviewed, and we discuss our management of this complication.

Abscess↗
PubMed1988

[Self-regulation of the pump function of the lymphangion].

The pump function was studied in single isolated lymphangions of the bovine mesenteric vessels 2.5-3.5 mm in diameter. The lymphangion was found to be able to self-regulate the pump function. The terminal diastolic pressure 0.5-1.0 kPa was found to be optimal for the pump function. The ratio of the lymphangion power to its weight is 0.2 Wt/N at the pressure 1 kPa. i.e. the lymphangion is near to the heart of warm-blooded animals by this parameter. Mainly the myocytes of circular layer contribute to the lymphangion pump function, the myocytes carrying out the function of stretch receptors enabling the lymphangion to alter its efficacy in accordance with the level of lymph production.

Animals↗