腹腔镜下切除肾上腺节细胞神经瘤

目的:探讨经腹腹腔镜手术治疗肾上腺节细胞神经瘤的适应症和可行性.方法:肾上腺节细胞神经瘤9例,男5例,女4例,平均年龄42(14～52)岁,左侧6例,右侧3例.行B超,CT,MRI检查提示肾上腺占住,其中肾上腺节细胞神经瘸6例.9例均行经腹腹腔镜下肾上腺肿瘤切除术.结果:术中除1例出现血压波动(升高至178/118mmHg),降压处理后恢复正常.术中无大血管及邻近脏器损伤,9例手术均顺利完成.手术时间75(50～110)min,估计出血量20(10～25)ml.术后1～3d排气,2～3d拔引流管,平均7d出院,均无明显外科并发症.肿瘤大小2.5cm×2.5cm×2.0cm～6.0cm× 6.5cm× 6.5cm,病理诊断均为肾上腺节细胞神经瘤.术后随访0.5～5年,复童彩超和CT均未见肿瘤复发及恶性变.结论:腹腔镜手术切除肾上臃节细胞神经瘤安全可靠,创伤小、恢复快,为治疗本病的理想方法.     

腹腔镜下切除肾上腺间质性肿瘤(附27例报告)

目的:探讨经腹腹腔镜手术治疗肾上腺间质性肿瘤的适应证和可行性。方法:回顾性分析27例肾上腺间质性肿瘤患者的临床资料,行B超,CT或MRI等影像学检查,术前诊断为肾上腺囊肿10例,肾上极囊肿2例,髓性脂肪瘤7例,神经鞘瘤3例,嗜铬细胞瘤2例,肾上腺占位3例(其中错构瘤1例)。27例均行经腹腔途径腹腔镜下肾上腺肿瘤切除术,术中采用超声刀游离瘤体及肾上腺组织,行肾上腺切除时采用Hem-o-lock结扎中央静脉。结果:27例手术均顺利完成,无中转开放手术。术中2例血压出现波动,最高升至178/118mmHg(1mmHg=0.133kPa),降压处理后恢复正常。平均手术时间75(50～110)min,平均术中出血量20(10～50)ml。术后1～3d肠功能恢复,2～3d拔除引流管,无明显外科并发症,术后平均7d出院。切除肿瘤2.0cm×2.0cm×2.5cm～10.0cm×10.0cm×13.0cm,病理诊断为肾上腺囊肿12例,髓性脂肪瘤9例,神经鞘瘤5例,错构瘤1例。25例术后随访0.5～4年,复查彩超和CT未见肿瘤复发及恶性变。结论:腹腔镜手术切除肾上腺间质性肿瘤安全可靠,且创伤小、恢复快,为治疗本病的理想方法。     

腹腔镜下切除肾上腺髓性脂肪瘤疗效观察

目的:探讨经腹腹腔镜下手术切除肾上腺髓性脂肪瘤的临床疗效.方法:回顾性分析8例肾上腺髓性脂肪瘤患者的临床资料.行彩超、CT及MRI等影像学检查,术前诊断为肾上腺髓性脂肪瘤6例,嗜铬细胞瘤1例,肾上腺腺瘤1例.8例均行腹腔镜下肾上腺肿瘤切除术.结果:7例标准腹腔镜下切除肿瘤顺利完成,1例行手助腹腔镜下切除.术中1例血压出现波动,升高至180/116mmHg,余患者血压均稳定.平均手术时间1.5h,平均术中出血量60 ml.术后2～3d肠功能恢复,1～3d拔尿管,2～3d拔引流管,无明显外科并发症,术后平均7d顺利出院.切除肿瘤3.0 cm×3.5 cm×4.0cm～5.5 cm×5.5 cm×6.0cm,病理诊断均为肾上腺髓性脂肪瘤.术后随访0.5～4年(平均2年),所有患者临床症状消失,彩超及CT检查未见肿瘤复发及恶性变.结论:经腹腹腔镜下手术切除肾上腺髓性脂肪瘤创伤小、疗效满意,为治疗本病的理想方法.     

腹腔镜下巨大肾上腺肿瘤切除术7例报告

目的：探讨腹腔镜下肾上腺巨大肿瘤（直径≥6 cm）切除术的技术方法和应用价值.方法：7例肾上腺肿瘤患者均行腹腔镜下肾上腺肿瘤切除术,在瘤体表面相对无血管区处切开包膜,沿包膜与瘤体之间迅速分离,切除肿瘤,填塞纱布止血.结果：5例腹腔镜下肾上腺肿瘤切除术顺利完成,1例手助腹腔镜下完成,1例粘连明显转开放手术.平均手术时间120 min;平均术中出血量200 ml.术后1～4天肠功能恢复,3～5天拔除引流管;无明显外科并发症,术后住院平均10天.术后病理诊断嗜铬细胞瘤4例,肾上腺囊肿1例,神经节细胞瘤1例,畸胎瘤1例.术后随访6（3～18）个月,临床症状消失,复查彩超及SCT未见肿瘤复发及恶性变.结论：腹腔镜下肾上腺肿瘤切除术创伤小、恢复快、效果满意,是治疗巨大肾上腺肿瘤的一种理想术式.     

后腹腔镜手术切除肾上腺节细胞神经瘤疗效观察

目的 :探讨后腹腔镜微创手术治疗肾上腺节细胞神经瘤的适应证和可行性。方法 :采用后腹腔镜手术治疗肾上腺节细胞神经瘤患者 5例 ,其中左侧肾上腺节细胞神经瘤 2例 ,右侧 3例。结果 :5例后腹腔镜手术全部获得成功 ,4例肾上腺肿瘤为单发 ,1例为多发 (4个肿瘤 ) ;肿瘤最大直径 2 .5～ 8.0 (4 .2± 1.8)cm ;手术时间35～ 10 5 (5 9± 2 7)min ,估计出血量 10～ 30 (19± 7)ml,术后镇痛剂吗啡用量 0～ 2 0 (8± 8)mg ,2例未用镇痛剂 ;排气、恢复进食时间 1～ 3(1.4± 0 .5 )d ;术后住院时间 4～ 7(5 .4± 1.5 )d。无围手术期并发症发生。结论 :后腹腔镜手术切除肾上腺节细胞神经瘤是安全可行的 ,能充分体现腹腔镜手术创伤小、恢复快的优点。肾上腺节细胞神经瘤是腹腔镜手术很好的适应证。     

后腹腔镜治疗肾上腺肿瘤的优势和手术技巧

目的探讨后腹腔镜肾上腺肿瘤切除术的优势和手术技巧。方法分别行后腹腔镜（33例）和传统开放手术（10例）治疗肾上腺肿瘤,患者平均年龄37．6岁,平均瘤体大小1．2～6．4cm。结果33例后腹腔镜手术均获成功,手术时间50～130min,平均（80．5±21．3）min;术中失血50～150ml,平均（65．2±11．6）ml;术后引流管留置1～2d,平均住院5d。随访6个月～3年无并发症发生。与开放手术相比有明显的优势。结论后腹腔镜肾上腺肿瘤切除术安全,疗效好,疼痛轻,患者术后恢复快。     

机器人辅助腹腔镜手术治疗巨大肾上腺肿瘤的经验总结

目的:总结机器人辅助腹腔镜手术治疗巨大肾上腺肿瘤(6cm)的临床经验并观察疗效。方法:回顾性分析2015年2月～2018年2月我院22例行经腹腔途径机器人辅助腹腔镜巨大肾上腺肿瘤根治性切除术患者的临床资料。结果:22例经腹腔途径机器人辅助腹腔镜巨大肾上腺肿瘤(直径6.4～10.9cm,平均8.2cm)根治性切除手术均取得成功,无中转开放手术。手术时间85～220min,平均155min;术中出血10～500ml,平均158ml,术中无输血。术后住院时间4～7d,平均5.5d。术后病理诊断:嗜铬细胞瘤9例,肾上腺髓脂肪瘤4例,肾上腺皮质腺瘤4例,神经节细胞瘤2例,肾透明细胞癌肾上腺转移1例,原始神经外胚层肿瘤1例,肾上腺皮质癌1例。术后随访3～39个月,2例失访,1例肾透明细胞癌左肾切除术后肾上腺转移的患者于术后10个月因肿瘤复发转移死亡,其余患者在随访期间未发现复发。结论:机器人辅助腹腔镜巨大肾上腺肿瘤切除术切实可行、安全有效。     

简易手助腹腔镜下肾及肾上腺切除术(附37例报告)

目的　介绍简易手助腹腔镜下肾及肾上腺肿瘤切除术的方法和特点。　方法　 1999年 6月至 2 0 0 4年 4月采用简易手助装置实施手助腹腔镜下肾及肾上腺肿瘤切除术 ,共 37例。男 2 2例 ,女 15例 ,平均年龄 5 2岁。肾切除组 2 9例 ,其中肾癌 13例 ,肾盂癌 2例 ,肿瘤分期均为T1N0 M0 ,肿瘤大小平均 3cm× 3cm× 2cm ,巨大肾积水 (肾无功能 ) 8例 ,肾结核肾自截 2例 ,肾性高血压肾萎缩 4例 ;肾上腺肿瘤切除组 8例 ,肿瘤大小平均 4cm× 5cm× 6cm。　结果　除 1例肾癌患者改行开放手术外 ,36例患者手术成功 ,无损伤肠管及其他腹内重要脏器等并发症。肾切除术平均手术时间 14 5min ,平均出血量 115ml;肾上腺肿瘤切除术平均 12 5min ,平均出血量 10 5ml。术后恢复好 ,7～ 8d出院。术后随访 3个月～ 5年 ,健康存活 35例 ;死亡 2例 ,均为肾癌患者 ,其中 1例术后 2年死于脑血管意外 ,1例术后 3年死于肺及脑部转移。　结论　简易手助腹腔镜下肾及肾上腺肿瘤切除术具有简便易行、节省费用、手术时间短、术后恢复快等优点 ,值得推广。     

后腹腔镜及手助腹腔镜肾上腺切除术治疗肾上腺肿瘤(附21例报告)

目的 :探讨腹腔镜微创手术治疗肾上腺肿瘤的适应证及手术方法。方法 :对 18例直径小于 6cm的肾上腺肿瘤患者行后腹腔镜肾上腺切除术 (后腹腔镜组 ) ;对 3例最大直径为 10～ 17cm的肾上腺肿瘤患者行手助腹腔镜肾上腺切除术 (手助腹腔镜组 ) ,并观察手术时间、术中出血量、胃肠功能恢复时间和住院时间。结果 :2 1例患者中 ,2 0例成功。其中后腹腔镜组手术时间 2 5～ 135min ,平均 (82 .8± 31.1)min ,术中出血量 6 5～ 16 0ml,平均 (113.4± 31.8)ml,均未输血。手助腹腔镜组手术时间 180～ 2 10min ,术中出血量 80～ 6 0 0ml。两组患者均于术后 2天排气 ,1～ 3天下床活动 ,术后住院 3～ 7天。结论 :与开放手术相比 ,后腹腔镜肾上腺手术具有创伤小、出血少、恢复快等优点 ;手助腹腔镜为巨大肾上腺肿瘤切除提供了微创手术的新方式。     

腹腔镜手术切除巨大肾上腺肿瘤的临床探讨

目的：探讨腹腔镜手术切除巨大（直径≥8cm）肾上腺肿瘤的可行性。方法：采用经腹途径腹腔镜切除术治疗巨大肾上腺肿瘤患者6例,左侧4例,右侧2例,肿瘤最大径8．5～12cm。结果：6例腹腔镜手术均获得成功,无中转开放手术。手术时间平均120min（90～185min）,术中出血量平均150ml（50～400m1）。术后胃肠功能恢复时间1～2天,术后2～3天拔除引流管,术后住院6～lO天。随访4～24个月,未发现异常。病理检查报告肾上腺嗜铬细胞瘤2例,神经节细胞瘤1例,神经鞘瘤1例,髓性脂肪瘤2例。结论：肿瘤大小并不是选择腹腔镜手术的决定性因素。在技术娴熟的条件下,腹腔镜治疗巨大肾上腺肿瘤是安全、可行的。     

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.     

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.     

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.     

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.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

The analgesic effect of racemic ketamine in patients with chronic ischemic pain due to lower extremity arteriosclerosis obliterans

Background : Ketamine in sub-dissociative doses has been shown to have analgesic and phantom-Limb pain, where conventional treatment has often failed. Chronic ischemic pain due to lower extremity arteriosclerosis obliterans often responds poorly to analgesics, and the pain-generating mechanisms are not well understood.
Methods : Eight patients with rest pain in the lower extremity due to arteriosclerosis obliterans were given sub-dissociative doses of 0.15, 0.30, or 0.45 mg/kg racemic ketamine and morphine 10 mg as a 5-min infusion on four separate days in a cross-over, double-blind, randomised protocol. Plasma levels of (S)- and (R)-ketamine and their nor-metabolites were analysed with an enantioselective high-performance liquid chromatography (HPLC) method. Pain levels were evaluated with a visual analogue scale (VAS).
Results : Individual pain levels were highly variable during and after all the infusions but the pooled pain levels showed a dose-dependent analgesic effect of ketamine with a transient but complete pain relief in all patients at the highest dose (0.45 mg/ kg). Side-effects, mainly disturbed cognition and perception, were pronounced and dose-dependent. Morphine 10 mg had an analgesic peak at 20 min and 5/8 patients had complete pain relief. The remaining 3 patients also had high baseline pain scores, indicating a higher analgesic potency for the 0.30 and 0.45 mg/ kg ketamine doses than for morphine 10 mg.
Conclusion : We have demonstrated a potent dose-dependent analgesic effect of racemic ketamine in clinical ischemic pain. Due to a narrow therapeutic window, this analgesic effect is probably best utilised in combination with other analgesics.     

Intravenous endotoxin does not increase tissue extravasation of albumin in rats

Background : It is unclear whether activation of the inducible nitric oxide synthase (iNOS) increases or decreases the extravasation of plasma.
Methods : Chloralose anaesthetised male Wistar rats received E. coli lipopolysacharide (LPS), 3 mg kg^-1 i.v., or the corresponding volume of saline, 3 or 5 h before the end of the experiment. Mean arterial pressure (MAP) and heart rate (HR) were recorded. Tissue clearance of radio-labelled albumin, during the last 2 h of each experiment, was determined by a double-isotope method. In separate animals, the serum concentration of nitrite and nitrate was determined, 5 h after LPS or the solvent.
Main Results : LPS initially decreased MAP and lastingly increased HR. In the 3-h LPS animals (n=8), tissue plasma clearance was lower in the heart and calf muscle and increased only in diaphragm, compared to corresponding control animals (n=8). In the 5-h LPS rats, clearance was lowered (n=8) in the entire gastrointestinal tract and in testes, compared to controls (n=8). The serum nitrite/nitrate concentration was higher in animals given LPS (n=6) than in controls (n=6).
Conclusion : After LPS, tissue clearance of albumin was not increased in any major tissue, in spite of increased serum levels of NO end products. Apparently, after activation of iNOS, the augmented release of NO is not necessarily associated with increased albumin extravasation.