雌激素受体阴性乳腺癌HER-2和Ki-67表达分析

目的探讨雌激素受体(ER)阴性表达的浸润性乳腺癌PR、HER-2、Ki-67的表达情况与临床病理特征的关系。方法选取1339例浸润性乳腺癌,其中ER阴性乳腺癌403例,回顾性分析PR、HER-2、Ki-67的表达状况及其间的相关性,以及PR、HER-2、Ki-67的表达与临床病理特征关系。结果 PR、HER-2和Ki-67的阳性表达率分别为8.9%(36/403)、26.8%(108/403)和98.3%(396/403)。PR与患者年龄、肿瘤大小、P53表达有统计学意义(P0.05),与组织学分级、有无淋巴结转移无统计学意义(P0.05)。而HER-2与各项临床病理指标均有统计学意义(P0.05)。Ki-67表达与P53表达、淋巴结转移有关(P0.05),与患者年龄、肿瘤大小及组织学分级无关(P0.05)。PR、HER-2、Ki-67三者间表达呈正相关,其中Ki-67与HER-2表达呈高度正相关(r=0.941,P=0.000)。结论ER阴性乳腺癌HER-2表达与临床病理特征有关。Ki-67可作为预测HER-2表达状况的重要指标。     

乳腺癌C-erbB-2、ER及PR的表达与临床病理特征的相关性分析

目的 研究C-erbB-2、雌激素受体(ER)和孕激素受体(PR)在乳腺癌中的表达及其与患者年龄、肿瘤大小、淋巴结转移、组织病理学类型及肿瘤分期的关系和临床意义.方法 应用免疫组化法检测83例乳腺癌中C-erbB-2、ER和PR的表达,分析其与临床病理特征的关系.结果 83例乳腺癌中C-erbB-2、ER和PR的表达阳性率分别为78.3%、56.6%和55.4%.C-erbB-2、ER和PR的表达在患者不同的年龄、肿瘤大小、组织病理学类型及肿瘤分期之间的差异均无统计学意义(P>0.05); ER和PR的表达在有无淋巴结转移之间差异无统计学意义(P>0.05); C-erbB-2的表达在有无淋巴结转移之间的差异有统计学意义(P＜0.05),且它们之间呈正相关(r=0.387,P＜0.05).结论 C-erbB-2是判断乳腺癌淋巴结转移的重要指标之一,联合检测ER和PR更有助于乳腺癌患者的临床治疗和预后判断.     

Ki-67在人类表皮细胞生长因子受体-2阳性乳腺浸润性导管癌中的表达和意义

目的 研究Ki-67在HER-2阳性乳腺浸润性导管癌中的表达与组织学分级、TNM分期、淋巴结转移、肿瘤大小、患者年龄、月经史、ER、PR等的关系和临床意义.方法 应用免疫组织化学方法检测HER-2阳性乳腺浸润性导管癌56例中Ki-67的表达,分析其与临床特征的关系.结果 HER-2阳性56例中,Ki-67、HER-2不同阳性程度表达与TNM分期、淋巴结转移、PR之间差异无统计学意义(P>0.05);Ki-67表达与组织学分级、ER组之间差异有统计学意义(P<0.05),不同年龄、月经史组、肿瘤大小组HER-2阳性程度表达的差异有统计学意义(P<0.05);不同HER-2阳性程度组的Ki-67表达差异无统计学意义.结论 在HER-2阳性乳腺浸润性导管癌中,Ki-67仍是非常重要的生物学指标,同时检测HER-2、Ki-67等指标有助于准确的判断预后和为个体化靶向治疗提供参考,具有重要的临床意义.     

内质网分子伴侣GRP78在乳腺癌中的表达及其预后意义

目的 探讨乳腺癌中GRP78的表达及其与乳腺癌临床、病理特征的相关性及其预后意义.方法 采用免疫组化Envision法检测了172例乳腺癌石蜡标本中GRP78的表达并对其表达与乳腺癌患者的月经状况、肿瘤大小、淋巴结转移状况、病理类型、组织学分级、激素受体状况、Her-2、Ki-67表达状况等临床、病理特征的相关性以及与预后的关系进行统计分析.结果 在172例手术切除的乳腺癌标本中,GRP78普遍阳性表达于肿瘤细胞,其中71例(41.28％)为强表达,101例(58.72％)为弱表达.GRP78的表达与乳腺癌患者的月经状况、淋巴结转移状况、病理类型、组织学分级、激素受体状况、Ki-67表达状况等临床、病理特征无相关性(P＞0.05);其在T3、Her-2阳性乳腺癌患者中的表达显著高于在T1、T2和Her-2阴性患者中的表达(P＜0.05).生存分析结果表明,GRP78强表达患者的无病生存时间和总生存时间较弱表达患者差,差异有统计学意义(P＜0.05).Cox回归分析表明,GRP78的表达状况是乳腺癌患者无病生存时间的独立预后因素(P＜0.05),但不是总生存时间的独立预后因素(P＞0.05).结论 GRP78普遍阳性表达于乳腺癌,其表达增强,预示患者预后不良,GRP78的表达状况对判断乳腺癌患者的预后具有一定的参考价值.     

老年乳腺癌患者肿瘤组织ER和PR表达与临床病理特征的相关性分析

探讨老年乳腺癌患者肿瘤组织ER、PR表达与临床病理特征的相关性。选择2013年2月—2014年12月收治的156例老年乳腺癌患者为研究对象,回顾性分析ER、PR表达情况与肿瘤部位、淋巴结转移、组织学分级、肿瘤大小的关系。左侧乳腺癌组织ER、PR阳性率与右侧乳腺癌组织ER、PR阳性率差异无统计学意义(P0.05)。淋巴结转移患者ER、PR阳性率低于无淋巴转移患者,差异有统计学意义(P0.05)。组织学分级Ⅰ级、Ⅱ级、Ⅲ级患者ER、PR阳性率差异有统计学意义(P0.05)。肿瘤直径2 cm、2~5 cm、5 cm患者ER、PR阳性率差异无统计学意义(P0.05)。老年乳腺癌ER、PR表达情况与患者淋巴结转移、组织学分级有关,对临床诊断具有重要意义。     

趋化因子受体5表达与乳腺癌临床病理特征及预后的相关性研究

目的 探讨趋化因子受体5(CCR5)在乳腺癌病灶和腋窝转移淋巴结中的表达及其与临床病理意义.方法 收集72例乳腺导管浸润癌及其腋窝淋巴结组织,50例乳腺纤维腺瘤组织,40例正常乳腺组织石蜡标本切片.采用免疫组化方法检测CCR5的表达情况;同时检测乳腺癌组织中C-erbB-2,p53,Ki-67,ER,PR的表达情况,并与临床病理资料进行统计学分析.结果 (1)乳腺癌组织中CCR5蛋白表达阳性率达84.72%(61/72),乳腺纤维腺瘤组织中表达阳性率较低(14%,7/50),正常乳腺组织中不表达CCR5;(2)乳腺癌CCR5表达与腋窝淋巴结转移呈正相关(X<'2>=4.982,P=0.026,r=0.305);(3)50例伴腋窝淋巴结转移的患者中,乳腺癌原发灶及转移淋巴结同时表达CCR5阳性者39例,具有较高的同源性;(4)乳腺癌CCR5表达与癌基因C-erbB-2之间呈低度正相关(P<0.05,r=0.291);(5)乳腺癌CCR5表达与患者年龄、绝经与否、肿瘤最大径、肿瘤分期等临床特征无关(均P>0.05);(6)乳腺癌CCR5表达与p53,Ki-67,ER,PR无关表达(均P>0.05).结论 CCR5在乳腺癌的发生、发展及腋窝淋巴结转移方面起一定作用;CCR5可间接作为预测乳腺癌腋窝淋巴结转移及预后判断的指标之一.     

尿激酶型纤溶蛋白酶激活剂在浸润型乳腺癌中高表达的临床意义

目的:探讨尿激酶型纤溶蛋白酶激活剂(uPA)表达在乳腺浸润型导管癌中的表达及其与临床病理特征的关系。方法:采用免疫组织化学技术研究我院1990～2001年233例浸润型导管癌标本uPA、雌激素受体(ER)、孕激素受体(PR)及C-erbB-2的表达,探讨uPA表达与浸润型导管癌临床病理特征及与ER、PR、C-erbB-2表达的关系。结果:uPA表达与浸润型导管癌腋窝淋巴结转移、临床分期、C-erbB-2表达呈正相关(P<0.05);与ER、PR表达呈负相关(P<0.05)。uPA表达与病人年龄、肿瘤大小、组织学分级无显著相关。结论:uPA高表达对评价乳腺癌恶性程度和预测转移有重要作用,可作为评价乳腺癌预后的辅助指标,但需要进一步的随访研究。     

TOPO-II、Ki-67 在乳腺癌中的表达及意义

目的：探讨TOPO-II、Ki-67在乳腺癌中的表达及临床意义。 方法：收集2011年1月—2014年1月诊治的乳腺癌患者75例临床资料,采用免疫组化检测癌组织TOPO-II、Ki-67的表达,并分析其与临床病理参数、组织学分级、临床分期等的相关性。 结果：TOPO-II在乳腺癌中的阳性表达率为60.0%,Ki-67的阳性表达率为77.3%,TOPO-II的阳性表达与患者组织学分级、TNM临床分期、淋巴结转移有关（P<0.05）,与患者年龄、肿瘤的大小无关（P>0.05）;Ki-67与组织学分级有关（P<0.01）,与年龄、肿瘤的大小、TNM临床分期、淋巴结转移均无关（均P>0.05）。 结论：TOPO-II和Ki-67在乳腺癌中高表达,且均与组织学分级有关,检测两者水平对评估乳腺癌患者的预后和指导临床治疗有重要意义。     

Ki-67在乳腺癌中的表达及临床意义

目的:探讨乳腺癌中Ki-67的表达及意义。方法:采用免疫组织化学方法检测152例乳腺癌标本中Ki-67的表达及其与其它相关标记物、乳腺癌临床分期和预后的关系。结果:Ki-67在乳腺癌中的阳性表达率为66.54%,Ki-67的表达与肿瘤分期、E-钙黏蛋白(E-Cadherin)的表达有关(P<0.05);而与肿瘤大小及ER,PR,P53,C-erbB-2的表达无关(P>0.05)。结论:Ki-67作为乳腺癌常规病理检测指标可为临床治疗提供参考依据,有助于乳腺癌治疗方案的确定,并对其预后进行评价。     

影响乳腺癌雌激素受体表达的临床病理因素分析

目的探讨影响乳腺癌雌激素受体(ER)表达的临床病理因素。方法利用免疫组织化学方法检测76例乳腺癌组织中ER和Ki67、C-erbB-2及HIF-1α的表达,并与临床病理资料进行相关性分析。结果ER、Ki67、C-erbB-2及HIF-1α在乳腺癌组织中的阳性率分别为67.1%、39.5%、31.6%和54.0%。ER表达与Ki67、C-erbB-2及HIF-1α呈负相关(P<0.05),与癌组织高分化成正相关(P<0.05),而与年龄、腋窝淋巴结转移、肿瘤大小及组织学类型无显著相关。结论乳腺癌组织中Ki67、C-erbB-2及HIF-1α等的高表达可能参与了降低ER表达及原发性内分泌治疗抵抗的发生。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.