不同剂量维生素K_3对大鼠肾骨桥蛋白表达的影响

目的探讨不同剂量的维生素K3对大鼠肾骨桥蛋白(osteopontin,OPN)表达分布的影响。方法对饮用相同诱石剂的50只大鼠分6组分别给予4.0、3.0、2.0、0.8mg/d和0.4mg/d剂量的维生素K3,观察肾OPN表达分布变化。结果正常饮食鼠肾OPN表达部位集中在远曲小管,应用诱石剂后OPN表达部位扩展到近曲小管,维生素K3能够减少OPN表达量,随着维生素K3剂量由0.4mg/d增加到4mg/d,肾脏OPN表达量从(70±22)%逐渐减少到(20±8)%。结论维生素K3可减少诱石剂导致的肾曲小管OPN表达分布的变化。     

维生素D和维生素K对大鼠结石模型尿晶体成分的影响

目的进一步明确维生素D和维生素K与肾结石的关系,探讨成石机制。方法将健康成年雄性SD大鼠24只随机分成4组,即对照组、诱石组、维生素D组和维生素K组,收集第1、3、7天约24小时尿,测定尿晶体成分的浓度。结果维生素D组尿钙和草酸明显高于对照组和诱石组,尿镁和柠檬酸显著降低（P＜0．05）。维生素K组尿草酸明显低于诱石组（P＜0．05）。结论维生素D可能通过多种机制促进肾结石形成,而维生素K有抑制结石形成的作用。     

表达甲酰辅酶A转移酶的大肠杆菌对大鼠尿草酸浓度的影响

目的探讨喂饲表达甲酰辅酶A转移酶（FCoAT）的大肠杆菌Nissle1917（EcN-Frc）对大鼠尿草酸浓度的影响。 方法将30只雄性SD大鼠随机分为六组（编号A-F）,每组5只。除A组外,其余五组在食物中每克添加1%草酸。B组每次喂食前30 min,喂食1 ml EcN-Frc培养液,C、D、E、F组喂食1 ml EcN-Frc悬液（活细菌数10³）。C、D、E、F组喂饲细菌的方式分别为每日1次,每3 d一次,每周一次和观察期内首日喂养一次。实验周期为2周,分别于喂养当日,喂养后3、6、9、14 d分别记录大鼠健康情况和24 h尿草酸排泄量。 结果口服ECN-Frc能有效减低高草酸饮食大鼠的24 h尿草酸排泄量。含10³活菌数的EcN-Frc在喂养后3 d即可发挥作用。1次喂服10³个活菌数的ECN-Frc,2周后仍能有效降低大鼠尿中草酸浓度。所有大鼠观察期内均体健,未见明显异常。 结论低剂量口服EcN-Frc能有效降低高草酸饮食大鼠的24 h尿草酸排泄量,且安全,耐受性好。     

钙拮抗剂抑制大鼠肾草酸钙结石生成的实验研究

目的观察不同剂量硝苯地平灌喂对大鼠肾草酸钙结石生成的影响。方法选用60只雄性SD大鼠,体重200~250g,随机分为6组,分别为空白对照组、单纯硝苯地平组、单纯诱石组、诱石 3、6、10mg·kg-1·d-1硝苯地平干预组,每组各10只。应用乙二醇诱导大鼠产生肾草酸钙结石,4周后观察大鼠肾小管结晶沉积情况、肾组织自由基水平、细胞凋亡情况和大鼠血和尿多项生化指标的变化。结果与单纯诱石组相比,各硝苯地平干预组的肾小管草酸钙结晶评分分别降低37.0%、55.6%、66.7%(P均<0.05),肾小管上皮细胞凋亡数分别减少30.2%、44.6%、48.7%(P均<0.05),两者有显著相关性(r=0.8251);肾组织中MDA含量也分别减少14.5%、20.4%、21.8%,而SOD活性增加3.5%、8.7%、12.6%(P均<0.05);量效关系呈正相关。结论硝苯地平通过减少高尿草酸所致的肾小管上皮细胞凋亡,能有效抑制饮用诱石剂大鼠的肾小管结石生成。     

维生素D3和维生素K3对实验性肾结石的影响

目的：探讨维生素C3和维生素K3与尿石症的关系。方法SD大鼠36只,随机分为对照组（A组）、成石组（B组）、维生D3组（C组）、成石＋维生素D3组（D组）、维生素K3组（E组）和成石＋维生素K3组（F组）,用免疫组化和原位杂交技术检测各组大鼠肾脏骨桥蛋白（OPN）及其mRNA的表达量,并测定尿晶体成分的浓度。结果：免疫组化结果显示,OPN主要表达于肾脏远曲小管和集合管,B、C、E组鼠肾和OPN的表达强度明显高于A组（P均＜0．05）;D、F组OPN的表达强度明显高于C、E组（P均＜0．05）,即维生素D3或维生素K3与诱石剂合用时呈相加效应。应用诱石剂后,D组尿钙排泄量明显增加,而F组草酸盐明显低于B组（P＜0．05）。维生素K3可减少尿划石剂后,D组尿排泄量明显增加,而组草酸盐明显低于B组（P＜0．05）。维生素K3可减少尿草酸盐的分泌和草酸钙晶体的沉积。结论：维生素D3可能通过多种机制种促进肾结石殂成,而维生素K3有抑制结石形成的作用。     

维生素D_3和维生素K_3对实验性肾结石的影响

目的　探讨维生素D3 和维生素K3 与尿石症的关系。　方法　SD大鼠 36只 ,随机分为对照组 (A组 )、成石组 (B组 )、维生素D3 组 (C组 )、成石 维生素D3 组 (D组 )、维生素K3 组 (E组 )和成石 维生素K3 组 (F组 ) ,用免疫组化和原位杂交技术检测各组大鼠肾脏骨桥蛋白 (OPN)及其mRNA的表达量 ,并测定尿晶体成分的浓度。　结果　免疫组化结果显示 ,OPN主要表达于肾脏远曲小管和集合管 ,B、C、E组鼠肾OPN的表达强度明显高于A组 (P均 <0 .0 5 ) ;D、F组OPN的表达强度明显高于C、E组 (P均 <0 .0 5 ) ,即维生素D3 或维生素K3 与诱石剂合用时呈相加效应。应用诱石剂后 ,D组尿钙排泄量明显增加 ,而F组草酸盐明显低于B组 (P <0 .0 5 )。维生素K3 可减少尿草酸盐的分泌和草酸钙晶体的沉积。　结论　维生素D3 可能通过多种机制促进肾结石形成 ,而维生素K3 有抑制结石形成的作用。     

苄丙酮香豆素对实验性大鼠肾草酸钙结石形成的影响

目的：探讨Vit．K拮抗剂苄丙酮香豆素(商品名华法令)对大鼠肾草酸钙结石形成的影响。方法：采用乙二醇饮水和氯化铵灌胃作成石剂，30只Wistar大鼠随机分为对照组(A组)、成石组(B组)、华法令组(C组)。饲养4周后，检测大鼠肾组织钙含量和草酸钙晶体形成、24h尿钙、尿草酸含量及血生化指标。结果：成石组和华法令组肾组织中钙、镁含量，24h尿草酸及尿钙、镁排泄量差异无显著性意义；镜下观察发现：华法令组大鼠肾脏草酸钙结晶形成多于成石组，但组间比较差异无显著性意义。结论：苄丙酮香豆素对大鼠肾草酸钙结石的形成无显著影响。     

西梅汁预防大鼠草酸钙肾结石的实验研究

目的 研究西梅汁对乙二醇诱导的大鼠草酸钙肾结石形成的影响及其量效关系.方法 40只wistar大鼠随机分为8组:A空白对照组、B单纯乙二醇诱石组、C～E为西梅汁干预组[分别灌喂西梅汁2、4、8 mL· (kg·d)-1],每组8只.除空白对照组外,余皆用含1％乙二醇去离子水作为大鼠的唯一饮用水源并自由饮用,以诱导生成草酸钙肾结石.分别于实验前日和实验第4周末,检测大鼠尿钙、镁、草酸及枸橼酸浓度;血钙、镁、肌酐和尿素氮浓度;肾脏组织丙二醛(MDA)含量及总超氧化物歧化酶(T-SOD)活性;偏光显微镜观察HE染色肾脏组织草酸钙结晶形成情况;TUNEL法检测肾小管上皮细胞凋亡,以此分析西梅汁及西梅干预防肾结石的量效关系.结果 所用三种剂量的西梅汁均能明显减轻乙二醇所致的各项血尿生化指标和肾小管上皮细胞凋亡指数的改变,大幅增加尿镁浓度,明显减少乙二醇诱导的大鼠草酸钙肾结石的生成,且效果呈剂量依赖性.结论 所用的三种剂量的西梅汁均可明显干预乙二醇诱导的大鼠草酸钙肾结石的生成,且呈正相关的量效关系.     

西梅干预防大鼠草酸钙肾结石的实验研究

目的研究西梅干对乙二醇诱导的大鼠草酸钙肾结石形成的影响及其量效关系。方法 40只Wistar大鼠分为5组:A组空白对照组、B组为单纯乙二醇诱石组、C~E组为西梅干干预组[分别灌喂西梅干匀浆2、4、8mL/(kg·d)],每组8只。除A组外,余皆用含1%乙二醇去离子水于大鼠自由饮用。于实验前日和实验第4周末,分别检测大鼠尿钙、镁、草酸及枸橼酸浓度;血钙、镁、肌酐和尿素氮浓度;肾脏组织丙二醛(MDA)含量及总超氧化物歧化酶(T-SOD)活性;偏光显微镜观察HE染色肾脏组织草酸钙结晶形成情况;TUNEL法检测肾小管上皮细胞凋亡。结果三种剂量的西梅干均能明显减轻乙二醇所致的各项血尿生化指标和肾小管上皮细胞凋亡指数的改变,大幅增加尿镁浓度,明显减少乙二醇诱导的草酸钙肾结石的生成。结论三种剂量的西梅干均可明显干预乙二醇诱导的大鼠草酸钙肾结石的生成,且呈正相关的量效关系。     

青藤碱对阿霉素肾病大鼠PI3K/mTOR信号通路及系膜增生的影响

目的探讨青藤碱对阿霉素肾病大鼠肾组织中磷脂酰-3激酶(phosphatidyl-3 kinase, PI3K)/雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)信号通路及系膜增生的影响,探究其保护作用机制。方法选用SD大鼠50只,随机取10只经尾静脉注射生理盐水作为正常(Control)组,其余40只大鼠经尾静脉注射阿霉素5 mg/kg,共注射7 d,制备肾病综合征(nephrotic syndrome, NS)模型,造模成功后,随机分为模型组(NS组)、青藤碱低剂量组(25 mg/kg)、青藤碱中剂量组(50 mg/kg)、青藤碱高剂量组(100 mg/kg),每组10只。Control组、NS组经腹腔给予生理盐水,青藤碱各剂量组经腹腔给予相应剂量药物1次/d,共给药28 d。末次给药24 h后,收集各组大鼠血液、尿液后处死大鼠,并取肾组织标本,检测各组大鼠血肌酐(serum creatinine, Scr)、尿素氮(urea nitrogen, BUN)、24 h尿蛋白定量;采用HE染色观察各组大鼠肾脏病理形态变化并计算系膜基质指数;采用透射电镜观察各组大鼠肾小球基底膜增厚情况;采用蛋白免疫印迹法检测各组大鼠肾组织p-PI3K/PI3K、p-mTOR/mTOR、纤维连接蛋白(fibronectin, FN)和Ⅳ型胶原蛋白(type IV collagen, COL4)蛋白表达情况。结果与Control组相比,NS组大鼠肾小球系膜基质增加、肾小管管腔扩张等病理损伤现象及肾小球基底膜增厚严重,且NS组大鼠系膜基质指数、Scr、BUN、24 h尿蛋白定量和肾组织p-PI3K、p-mTOR、FN、COL4蛋白表达量明显升高(P0.05)。与NS组相比,青藤碱高、中、低剂量组大鼠肾小球基底膜增厚等病理损伤缓解,系膜基质指数、Scr、BUN、24 h尿蛋白定量和肾组织p-PI3K、p-mTOR、FN、COL4蛋白表达明显降低(P0.05)。与青藤碱低剂量组比较,青藤碱中、高剂量组肾小球基底膜增厚及肾脏病理损伤最轻,系膜基质指数、Scr、BUN、24 h尿蛋白定量和肾组织p-PI3K、p-mTOR、FN、COL4蛋白表达明显降低(P0.05)。结论青藤碱可能通过抑制PI3K/mTOR信号通路激活,减轻肾小球系膜细胞增生,延缓NS进程。     

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.