全身骨密度与肌肉、脂肪的相关性分析

目的 旨在进一步分析脂肪、肌肉与骨密度的相关性。方法 200例受检者,男性62例,女性138例,年龄20~84 (48. 9 ± 14. 2) y,体质量 42. 5 ~ 112. 0(61. 29 ± 9. 89) kg,BMI 15. 62~33.58( 23. 03 ± 2. 93) kg/ m2,应用 DXA (dual-energy X-ray absorptiometry,DXA)测量全身骨密度、肌肉、脂肪,并分析全身骨密度与肌肉、脂肪的相关性。结果 200例受检者,全身骨密度与体重、BMI的相关性有统计学意义(分别为r = 0. 530,P<0. 01;r = 0. 221,P<0.01),进一步分析发现,全身骨密度与肌肉呈正相关(r =0. 559,P < 0. 01),与脂肪的相关性无统计学意义(r =0. 018,P = 0. 803)。按性别分析,62例男性,全身骨密度与肌肉、脂肪均呈正相关(r =0. 535,P <0. 01;r =0.274,P = 0. 031)。138例女性,全身骨密度与肌肉呈正相关(r =0. 506,P < 0.01),而与脂肪的相关性无统计学意义(r =0. 088,P =0. 305)。结论（1)全身骨密度与体重、体质量指数呈正相关,其中,起主要作用的是肌肉组织,体现了“骨肉相连”的规律。（2)全身骨密度与脂肪的关系,在男性有相关性,而在女性无相关性, 体现了“男女有别”的规律。     

老年男性骨密度与身体成分相关性的研究

目的分析老年男性骨密度(bone mineral density,BMD)与身体成分的关系。方法记录166名80~94岁老年男性的年龄、身高、体重、BMI,检测L1-4、左侧股骨颈、Wards三角、大粗隆、左侧股骨上端的BMD及总肌肉含量(total lean mass,TLM)和总脂肪含量(total fat mass,TFM),根据BMD水平将受试者分为骨量正常组(n=50)、骨量低下组(n=91)和骨质疏松组(n=25)。结果 (1)骨量低下组及骨质疏松组的BMD均明显低于正常骨量组(P0.01),骨质疏松组又明显低于骨量低下组(P0.01);(2)骨质疏松组体重、TLM、TFM及BMI均明显低于正常骨量组(P0.01);(3)TLM与左侧股骨颈、Wards三角、左侧股骨上端的BMD相关系数分别为0.227、0.203及0.193(P0.05),TFM与腰椎1-4、左侧股骨颈、Wards三角、大粗隆、左侧股骨上端的BMD相关系数为0.269、0.222、0.206、0.246及0.242(P0.01)。结论大部分老年男性BMD与年龄呈显著负相关;与体重、BMI及TFM、TLM呈显著正相关,适当的运动和适度的肥胖,增强肌肉量和维持一定的脂肪量,保持健康的体重,可能有利于预防老年性骨质疏松症。     

绝经后骨质疏松症妇女血清痩素水平与骨密度的关系

目的 观察绝经后骨质疏松症妇女血清瘦素水平与骨密度(BMD)、骨矿含量(BMC)的相关性。方法 ELISA法检测32名绝经后骨质疏松症妇女(绝经组)和27名体重指数(BMI)相匹配的非绝经正常对照者(非绝经组)的空腹血清瘦素浓度,双能X线骨密度仪测定受试者腰椎BMD、BMC、T值、Z值。结果 绝经组和非绝经组的血清瘦素浓度分别为12.43±7.90ng/ml和11.76±4.42ng/ml,两组之间无差异;两组血清瘦素浓度均与体重、BMI和脂肪含量(Fat％)显著正相关,绝经组的瘦素水平与BMD及BMC无相关性,非绝经组瘦素浓度与BMDIL3和BMCL5相关(r=0.132,P<0.05;r=0.140,P<0.05),但调整BMI后瘦素浓度与BMD及BMC:的相关性消失(r=0.079,P>0.05;r=0.067,P>0.05)。结论成年妇女瘦素水平与体重、体脂及脂肪含量显著相关,瘦素不是绝经后妇女骨质疏松症的主要影响因素。     

脂肪分布对不同年龄正常人群骨密度的影响

目的 探讨体质指数(BMI)、腹部脂肪、臀部脂肪对不同年龄正常人群骨密度的影响.方法 采用双能X线BMD仪和医用身高体重测量仪测定393名正常体检人群腰椎松质骨密度、腹部脂肪含量、臀部脂肪含量、全身其他部位脂肪含量和身高、体重、腰围、臀围,并计算BMI和腰臀比.然后将人群按不同年龄分为青年组、中年组和老年组,分析骨密度与不同部位脂肪含量的关系.结果 (1)体内脂肪含量随年龄增加而增加,女性比男性的变化趋势更明显(P＜0.05);(2)在中年患者中,BMI与骨密度成正相关(男性组r=0.237,P=0.018;女性组r=0.279,P=0.024);(3)老年男性患者腹部脂肪含量和臀部脂肪含量与骨密度成正相关(P＜0.05).而老年女性患者腹部脂肪含量与骨密度成负相关(r=0.263,P＜0.05).结论 脂肪分布对骨密度的影响是复杂的,其中腹部脂肪和臀部脂肪可能是影响老年男性骨密度的主要因素,腹部脂肪是中老年女性骨密度的重要负调节因素.因此对中老年患者需注意减肥方式,以避免骨量的丢失和骨质疏松的形成.     

定量CT研究成年女性腰部椎后肌群体质成分与腰椎骨密度的相关性

目的探讨成年女性腰部椎后肌群体质成分与腰椎骨密度的相关关系。方法将518名21~81岁的成年女性按年龄分为青中年组(≤50岁)和老年组(50岁),使用定量CT(QCT)测量L2~L4椎体骨密度(BMD)及L3椎体中部层面椎后肌群的脂肪面积、肌肉面积、脂肪肌肉比。使用独立样本T检验比较两组间差异,使用偏相关及多元线性回归分析研究BMD与年龄、BMI及椎后肌群体质成分的相关关系。结果青中年组BMI、椎后肌群脂肪面积及脂肪肌肉比低于老年组,而BMD及椎后肌群肌肉面积高于老年组,差异有统计学意义(P0.01)。控制年龄、BMI因素偏相关分析结果显示,青中年组及老年组BMD与椎后肌群脂肪面积呈负相关(r=-0.178、-0.200,P0.05),与脂肪肌肉比呈负相关(r=-0.138、-0.177,P0.05),而与肌肉面积无显著相关性(r=-0.050、0.066,P0.05)。回归分析显示,椎后肌群脂肪面积、年龄、BMI是BMD的主要影响因素。结论成年女性腰部椎后肌群脂肪浸润程度与腰椎骨密度存在相关性,且相关性随年龄而增加。     

中老年人腹主动脉钙化与腰椎骨密度的相关性研究

目的研究中老年人腹主动脉钙化(AAC)与腰椎定量CT(QCT)骨密度(BMD)的相关性。方法纳入2013年至2016年间招募的593名40~80岁(男性230人,女性363人)的健康志愿者测量受检者身高、体质量、腰围,计算体重指数(BMI);进行腰椎QCT骨密度测量,将原始图像传至图像后处理工作站,采用Mindways QCT pro软件,分别测量L1-3椎体骨密度。应用Image J软件测量腹主动脉钙化面积比。结果男、女性AAC患病率分别约为45.65%、28.37%;与无AAC组比较,男性、女性AAC组年龄更大,并且与腰椎BMD的差异均有统计学意义(P均0.05);男女腰椎BMD均与年龄呈负相关(r=-0.49、r=-0.73,P0.05),与BMI均无明显相关性(r=0.02、r=0.01,P0.05);男、女性AAC均与年龄呈正相关(r=0.39、r=0.42,P0.05),与BMI均无明显相关性(r=-0.03、r=-0.03,P0.05);男性BMD与AAC无明显相关性(P=0.15),女性BMD与AAC呈低度负相关(r=-0.32,P0.05),校正年龄以后,女性BMD与AAC也无明显相关性(P=0.08)。结论年龄为腹主动脉钙化和骨质疏松发病的共同独立的危险因素,校正年龄后,男性、女性腰椎BMD与AAC均无显著相关性。     

2型糖尿病患者促甲状腺激素与骨质疏松关系的研究

目的研究2型糖尿病患者中骨密度(BMD)与促甲状腺激素水平的关系,探讨2型糖尿病中骨质疏松的可能危险因素。方法收集西安市中心医院内分泌科2017年1月至2018年5月住院的2型糖尿病患者151例,其中男性79例,女性72例。测定一般生化指标、甲状腺功能及骨代谢指标,双能X线骨密度仪测定BMD。对比不同性别之间非骨质疏松(non-OP)及骨质疏松(OP)患者上述指标的差异;Pearson相关分析法分析腰椎及股骨颈BMD与各临床指标之间的关系,多因素logistic回归分析方法探索不同性别组2型糖尿病患者骨质疏松的可能危险因素。结果 1.男性2型糖尿病患者中,non-OP组FT_3较OP组明显升高,女性2型糖尿病患者组OP患者TSH明显高于对照组,BMI明显低于对照组(P0.05);2.女性腰椎及股骨颈BMD均与TSH负相关(r=-0.290及-0.239 P0.05),男性BMD与TSH无相关性,无论男女,股骨颈BMD与年龄呈负相关(r=-0.242及-0.363 P0.05)、与BMI呈正相关(r=0.263及0.469 P0.05); 3.多因素logistic回归分析示,TSH是女性2型糖尿病患者骨质疏松的主要影响因素(OR=2.581, 95%CI 1.210-5.504,P=0.014。结论 2型糖尿病患者中,随着年龄的增大和BMI的降低骨质疏松发生的风险增高;女性2型糖尿病患者中TSH升高是OP发生的主要危险因素。     

体成分对男性2型糖尿病患者骨密度的影响

目的 应用双能X线骨密度仪（DXA）探讨体成分对男性2型糖尿病患者骨密度的影响。方法 选择年龄50～60岁在我科住院的男性2型糖尿病患者107例，分为正常体重组、超重组和肥胖组，分别测定其身高、体重，计算体重指数（BMI），利用全自动生化分析仪测定血糖、血脂，高压液相色谱法测定糖化血红蛋白（HbA1c），采用双能Ｘ线骨密度仪测定腰椎、左股骨大转子骨密度（BMD）及体成分，并进行统计学分析。结果 3组男性2型糖尿病患者腰椎BMD分别为1.12±0.05，1.21±0.07，1.36±0.09，左股骨大转子BMD分别1.12±0.06，1.22±0.08，1.41±0.08，与骨密度呈正相关；全身各部位肌肉含量与骨密度成正相关，且大腿＞上肢＞躯干；不同部位脂肪含量对骨密度的影响是不同的，其中上肢脂肪和大腿脂肪与骨密度成正相关，而躯干脂肪与骨密度成负相关；年龄、糖化血红蛋白、血脂对男性2型糖尿病患者骨密度无明显影响，而体重指数、肌肉含量及脂肪含量影响明显。结论 体重指数、肌肉含量和脂肪含量对男性2型糖尿病患者骨密度有直接影响。男性2型糖尿病患者加强锻炼，减少腹部脂肪含量，增加四肢肌肉含量，可以预防骨质疏松症的发生。     

成人无功能性垂体腺瘤患者术后垂体功能减退对骨密度和身体成分的影响

目的横断面调查成人无功能性垂体腺瘤(non-functional pituitary adenoma,NFPA)术后垂体功能减退患者骨密度(bone mineral density,BMD)及身体成分的改变,进一步分析BMD与身体成分的关系。方法收集2018年11月至2020年1月就诊于中南大学湘雅医院的成人NFPA术后垂体功能减退患者43例,并收集年龄、性别比、体质量指数(body mass index,BMI)匹配的健康对照组56例,测量所有研究对象BMI、腰围、腰臀比,采用双能X线骨密度仪(DEXA)评估腰椎及髋关节的BMD并分析骨骼肌质量及体脂含量。结果(1)垂体功能减退组腰椎L_1~4、股骨颈的BMD及Z值,全身总和骨矿含量均显著低于对照组(P<0.05)。(2)在男性,垂体功能减退患者的腰臀比、腰围身高比、躯干及全身脂肪百分比、脂肪指数显著高于对照组;在女性,垂体功能减退患者的腰围、腰臀比、躯干及全身脂肪百分比、A/G比率、躯干脂肪比/腿部脂肪比均显著高于对照组(P<0.05)。(3)Pearson相关性分析显示,四肢骨骼肌质量(ASM)、骨骼肌质量指数(SMI)与男性患者各部位的BMD呈显著正相关,躯干及全身脂肪百分比与女性患者髋部BMD呈显著负相关(P<0.05)。多元线性回归分析示,SMI是男性患者腰椎L_1~4 BMD、股骨颈BMD、全髋关节BMD、全身骨矿含量的独立保护因素(P<0.05)。结论(1)成人无功能性垂体腺瘤术后发生垂体功能减退的患者出现骨密度减低及腹部脂肪沉积的风险增加。(2)骨骼肌质量及体脂对骨密度有重要影响,SMI是男性垂体功能减退患者腰椎与髋部骨密度、全身骨矿含量的独立保护因素。     

肌肉含量指标对绝经后女性骨质疏松症发生风险的预测价值分析

目的 评价肌肉含量指标与骨密度(bone mineral density, BMD)的关联性,筛选预测绝经后女性骨质疏松(osteoporosis, OP)发生风险的最佳部位肌肉指标及其截止点。方法 选取2018年1月至2021年10月贵州医科大学附院健康管理中心的1366名绝经后女性,采用DXA和BIA测量BMD和四肢骨骼肌含量(ASM),以ASM算出各肌肉含量指标：ASMI、ASM_BMI及SMI。应用ROC曲线及Logistic回归分析验证肌肉指标对OP风险的预测能力及评估关联强度。结果 OP组的肌肉含量低于非OP组,除腰椎BMD间的SMI和股骨颈、腰椎BMD间的内脏脂肪面积及大粗隆、全髋BMD间的ASM_BMI差异无统计学意义(P>0.05),各部位不同BMD间脂肪、肌肉含量指标差异均有统计学意义(P<0.05)。Pearson分析显示,各部位BMD与SMI呈负相关(r=-0.095、-0.122、-0.195、-0.177);与ASM、ASM、ASM_BMI呈正相关(r=0.369、0.298、0.085...     

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.     

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.     

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.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.