Experimental model of respiratory distress syndrome by lung lavage with fluorocarbon

The purpose of this study was to determine how much alveolar surfactant is washed out by lung lavage with fluorocarbon and also to find out whether or not instillation of artificial surfactant can restore pulmonary function after lung lavage in rats. The lung lavage was performed manually, administering a tidal volume 5 mg (2 mg/100g body weight) of fluorocarbon for about eight seconds. This process was repeated more than 40 times. In the study group, 4 ml/kg (120 mg/kg) of artificial surfactant was instilled into the trachea, and the same amount of normal saline was instilled in the control group. The amount of phospholipids extracted in lung lavage was 16.6 +/- 3.6 mg/kg body weight in the control group and 18.9 +/- 3.7 mg/kg body weight in the experimental group. Immediately after instillation of the surfactant, arterial oxygen pressure increased from 84 +/- 17 mmHg to 195.1 +/- 26.7 mmHg, and remained high, at about 170-260 mmHg. In contrast the physiological saline treated group did not show any change. We conclude that lung lavage with fluorocarbon is an adequate ideal experimental model of respiratory distress syndrome and suggests that combination of artificial surfactant treatment after lung lavage with fluorocarbon might be a new pulmonary washing method for severe lung disease.     

Role of platelets in microembolism-induced acute lung injury.

The role of platelets in acute lung injury has not been well defined. In the present study of isolated perfused rat lungs, a significant increase in pulmonary arterial pressure (PAP), lung weight and the lung lavage fluid protein concentration occurred when 3 mL of a CaCl2 suspension (25 mg/mL) was mixed with blood-KHB (Krebs-Henseleit Buffer) perfusate; or when platelets were added instead of blood. However, such an increase was not observed (p > 0.05) when only KHB was used. When a comparatively small amount (0.75 mL) of the CaCl2 suspension (50 mg/mL) was added to the KHB perfusate, PAP, lung weight and the lung lavage protein concentration increased only when PAF (platelet activating factor) and platelets were both added before, but not separately. The above phenomena show that platelets are actively involved in the mechanism of acute lung injury and play an extremely important role in this microembolic model.     

肝素治疗胎儿生长受限的临床观察

目的探讨肝素用于治疗胎儿生长受限(FGR)的临床疗效及安全性.方法将107例FGR患者分为3组,标准肝素治疗组37例,将标准肝素50～75 mg溶于5%葡萄糖氯化钠注射液500 ml中静脉滴注,6～8 h滴完;低分子肝素治疗组31例,给予低分子肝素(商品名速避凝)0.2～0.4 ml皮下注射;对照组39例,给予低分子右旋糖酐500 ml加复方丹参注射液20 ml静脉滴注. 治疗前后及终止妊娠前,行彩色超声(彩超)检查,监测胎儿生长情况和脐血流变化,并进行生物物理评分,同时监测血小板计数(PLT)、凝血酶原时间(PT)、部分凝血活酶时间(APTT);记录新生儿情况并进行随访.结果 (1)标准肝素治疗组、低分子肝素治疗组,平均每周宫高均增长(0.7±0.6) cm,高于对照组的 (0.5±0.4) cm,差异有显著性(P＜0.05);平均每周双顶径分别增长[(2.4±0.7) mm、(2.5±0.8) mm,显著高于对照组的(1.7±0.6) mm,差异也有显著性(P＜0.05).(2)标准肝素治疗组、低分子肝素治疗组、对照组胎儿生物物理评分别为(9.7±0.8) 分、(9.6±0.6) 分、(8.9±0.7)分,差异有显著性(P＜0.05).(3)标准肝素治疗组及低分子肝素治疗组,脐动脉收缩期最大血流速度(S)与舒张末期血流速度(D)的比值(S/D比值)分别为2.5±0.5、2.4±0.5,显著低于对照组的2.9±0.6,差异有显著性(P＜0.05);搏动指数(PI)、阻力指数(RI)也显著低于对照组,差异也有显著性(P＜0.05).(4)标准肝素治疗组、低分子肝素治疗组新生儿出生后1分钟Apgar评分8～10分者分别占86%、87%,显著高于对照组的74%(P＜0.05);新生儿出生体重分别为(3100±256)g、(3080±225)g,显著高于对照组的(2580±304)g,差异有显著性(P＜0.05);胎龄均为(38±4)周,也显著长于对照组的(37±4)周,差异均有显著性(P＜0.05).(5)标准肝素治疗组及低分子肝素治疗组足月小样儿均为2例(分别占5%、6%),显著低于对照组的7例(18%),差异均有显著性(P＜0.05).(6)各组孕妇治疗前后PLT、PT、APTT比较,差异均无显著性(P＞0.05).(7)标准肝素治疗组及低分子肝素治疗组,治疗后孕妇的宫高、胎儿的股骨长度、头围、腹围、脐血流各指标、新生儿出生体重、胎龄等变化比较,差异均无显著性(P＞0.05).结论肝素可改善胎盘血流,使胎儿体重增加,减少足月小样儿的发生率,改善围产儿的预后,且肝素治疗FGR对母、儿都较安全.     

The role of endothelin-1 during ischemia-reperfusion injury.

In order to investigate the role of endothelin-1 during ischemia-reperfusion injury, 80 adult male Wistar rats were subjected to three hours of ischemia and one hour of reperfusion. Animals were evenly divided into eight groups. The rats in group 1 served as the normal control group, while the rats in group 2 received an intravenous infusion of endothelin-1 in a dosage of 0.5 ng/kg/min, group 3 in a dosage of 5 ng/kg/min, and group 4 in a dosage of 50 ng/kg/min. The rats in group 5 were infused with angiotensin II (10 ng/kg/min). The rats in group 6 received an intravenous infusion of 10,000 units of superoxide dismutase and 10,000 units of catalase. Group 7 rats were infused with endothelin-1 (50 ng/kg/min), superoxide dismutase (10,000 units), and catalase (10,000 units). Group 8 rats received an infusion of angiotensin II (10 ng/kg/min), superoxide dismutase (10,000 units) and catalase (10,000 units). The infusions were given during the reperfusion period. After one hour of reperfusion, the gastrocnemius and soleus muscles of the experimental animals were excised and assayed for ischemia-reperfusion injury by measuring triphenyltetrazolium chloride (TTC) reduction. The results showed that the limb activity of the ischemic extremity was 40.33 +/- 2.75% in group 1, 41.62 +/- 4.08% in group 2, 14.42 +/- 3.14% in group 3, 4.43 +/- 1.05% in group 4, 23.81 +/- 3.51% in group 5, 57.23 +/- 4.52% in group 6, 31.79 42- 3.63% in group 7, and 27.39 +/- 3.95% in group 8. Endothelin-1 reduced the limb activity in a dose-dependent manner.(ABSTRACT TRUNCATED AT 250 WORDS)     

Epinephrine inhibits tracheal occlusion induced lung growth in fetal sheep

OBJECTIVE: Although the mechanisms responsible for lung growth following tracheal occlusion (TO) are not fully understood, lung fluid accumulation is a requirement for growth to occur. It is known that betamimetics such as epinephrine (Epi), terbutaline, and ritodrine inhibit fetal lung fluid production late in gestation. We hypothesized that continuous infusion of Epi would have a detrimental effect on lung growth following TO in the fetal sheep model. METHODS: Twenty fetal lambs were divided into four groups. Group 1: no TO without Epi (n = 4); group 2: TO without Epi (n = 4); group 3: no TO with Epi (n = 5), and group 4: TO with Epi (n = 7). TO was performed on days 130-134 of gestation (full term = 145 days). In groups 3 and 4, Epi was infused into the fetus at a rate of 2 microg/min using a miniosmotic pump implanted subcutaneously at the time of TO. The fetuses were sacrificed after 4 days, and lung volume (LV, ml/kg), drained lung fluid (LF, ml/kg), wet lung weight/body weight ratio (LW/BW, %), whole right-lung dry weight per body weight ratio (dRLW/BW, g/kg), volume density of lung parenchyma (v(Vp)), and right-lung DNA and protein contents were compared among the four groups by one-way Anova. RESULTS: LW/BW and dRLW/BW of group 4 (3.91 +/- 0.52 and 2.10 +/- 0.28, mean +/- SD) were significantly lower than those of group 2 (5.18 +/- 0.57 and 2.67 +/- 0.15) and were not statistically significantly different from those of group 1 or 3. LV, LF, V(Vp), and DNA and protein contents all showed a similar trend. CONCLUSIONS: Continuous infusion of Epi to the fetus results in less fluid accumulation within the TO lungs and abolishes significant lung growth after TO in the late-gestation fetal lamb. Drugs affecting lung fluid secretion may have a major impact on TO-induced lung growth.     

不同剂量地塞米松对早产胎鼠肺成熟度及生长发育的影响

目的　探讨不同剂量的地塞米松促进胎鼠肺成熟的效果及其对孕鼠和仔鼠的影响。方法　 6 0只定时受孕的Wistar大鼠 ,随机分为安慰剂组、小剂量组、中剂量组及大剂量组 4组 ,每组 15只。于妊娠第 15、16天分别给予如下处理 :安慰剂组孕鼠皮下注射生理盐水 0 8ml、小剂量组孕鼠皮下注射地塞米松 0 2mg、中剂量组孕鼠皮下注射地塞米松 0 4mg、大剂量组孕鼠皮下注射地塞米松0 8mg ,药物均分 4次皮下注射。妊娠 17d时 ,每组随机选择 10只孕鼠行剖宫术取胎 ,其余 5只孕鼠等待自然分娩。观察各组早产仔鼠的呼吸能力、肺组织学评分及羊水板层小体 (LB)记数 ,比较不同剂量的地塞米松对胎肺成熟的影响 ;观察孕鼠的围产期情况及仔鼠体重、肝脏和肾上腺结构等 ,比较不同剂量地塞米松对母、胎的副作用。结果　小剂量组、中剂量组及大剂量组仔鼠的 3种肺成熟度指标显著高于安慰剂组 (P <0 0 5 )。安慰剂组、小剂量组、中剂量组及大剂量组仔鼠的呼吸评分依次为1 4± 0 5、3 6± 0 7、4 2± 0 5及 4 5± 0 5 ;肺组织学评分依次为 1 4± 0 6、3 9± 0 9、4 2± 0 7及 4 4±0 6 ;羊水LB记数依次为 (8 6± 3 0 )× 10 9 ml、(30 2± 4 2 )× 10 9 ml、(33 0± 3 4 )× 10 9 ml及 (35 8±2 7)× 10 9 ml     

硫酸镁对胎儿生长受限孕鼠胎盘组织半胱氨酸天冬氨酸蛋白酶3表达的影响

目的探讨硫酸镁对胎儿生长受限(FGR)孕鼠胎盘组织半胱氨酸天冬氨酸蛋白酶3(caspase-3)表达的影响,及硫酸镁治疗FGR的机理。方法烟熏法构建FGR模型。实验对象分为对照组(10只)、治疗组(18只)、FGR组(10只)。治疗组中低剂量(硫酸镁300 mg／kg)治疗10只、高剂量(硫酸镁600 mg／kg)治疗8只,皮下注射给药。络合指示剂方法测孕鼠血清Mg2+(血镁)浓度。物理测量胎鼠的各项生理指标。链霉菌抗生物素蛋白-过氧化物酶连接(SP)法及RT-PCR法检测胎盘组织caspase-3的表达情况。结果(1)FGR组孕鼠血镁浓度为(0．55±0．03)mmol／L,高、低剂量治疗组孕鼠血镁浓度分别为(0．72±0．13)、(0．61±0．03)mmol／L,高、低剂量治疗组分别与FGR组比较,差异均有统计学意义(P<0．01)。(2)FGR组孕鼠胎盘重量为(0．63±0．05)g,其胎鼠体重为(2．95±0．46)g,高剂量治疗组分别为(0．80±0．16)、(3．58±0．10)g,两组分别比较,差异均有统计学意义(P<0．05、P<0．01)。(3)FGR组胎盘组织caspase-3 mRNA表达量为0．626±0．036,其蛋白表达量为199．5±4．7,高剂量治疗组分别为0．361±0．030、183．0±3．3,差异均有统计学意义(P< 0．05),低剂量治疗组caspase-3 mRNA表达量为0．525±0．029,与高剂量治疗组比较,差异也有统计学意义(P<0．05)。(4)孕鼠血镁浓度与胎鼠重量、胎盘组织caspase-3 mRNA及蛋白表达量有显著相关性(r=0．899,P=0．038;r=-0．747,P=0．033;r=-0．915,P=0．001)。结论硫酸镁能降低胎盘组织caspase-3 mRNA及蛋白表达,硫酸镁可能通过抑制胎盘caspase-3的表达,减少胎盘滋养细胞、血管内皮细胞等功能细胞的凋亡,从而改善FGR胎鼠的低体重现象。     

New helical incision for removal of large uteri during laparoscopic-assisted vaginal hysterectomy

The objective of our study was to evaluate the feasibility of a new incision technique for vaginal removal of large uteri during laparoscopic-assisted vaginal hysterectomy (LAVH). The helical uterine incision with uterine arteries preligation was performed during LAVH. The medical records for 522 women with uterine tumors who underwent LAVH from January 2001 through November 2003 were studied retrospectively. The mean uterine weight of all 522 patients was 325 +/- 213 g (range 32-1350 g), and the mean operation duration was 73 +/- 21 minutes. The patients were divided into three subgroups: patients with uteri weighing less than 300 g (group A), patients with uteri weighing between 300 and 500 g (group B), and patients with uteri weighing more than 500 g (group C). The mean uterine weight was 172 +/- 69 g, 374 +/- 56 g, and 678 +/- 181 g for groups A, B, and C, respectively; and the mean operation duration was 67 +/- 17 minutes, 73 +/- 19 minutes, and 90 +/- 24 minutes for groups A, B, and C, respectively. No linear relationship between uterine weight and operation duration was noted in the regression analysis and analysis of variance testing in group B. Uteri weighing between 300 and 500 g were extracted vaginally without difficulty using the new helical uterine incision technique. Use of the helical incision technique reduced operation duration, and restoration of the uterine anatomy for pathologic examination was made easily. The complication rate was 0.8%, which is relatively low compared with our previous report (1.38%) in 580 LAVH procedures. In conclusion, the helical transvaginal uterine incision proved to be an efficient and safe procedure for removal of large uteri during LAVH.     

Effects of pentoxifylline in the prevention of ovarian hyperstimulation syndrome in a rabbit model.

Tumor necrosis factor alpha (TNF-alpha) and other cytokines have been implicated in the pathogenesis of ovarian hyperstimulation syndrome (OHSS). Pentoxifylline, a methylxanthine derivative, was found to inhibit TNF-alpha synthesis. The aim of this study was to evaluate whether the use of pentoxifylline would prevent the occurrence of OHSS in a rabbit model. Thirteen rabbits were divided into two groups. The first group (n = 6) were given pentoxifylline 15 mg/kg intravenously and the second group (n = 7) were given physiological serum 15 mg/kg before ovulation induction. Ovarian hyperstimulation was induced in rabbits by 200 IU equine chorionic gonadotropin on day 1 and 100 IU human chorionic gonadotropin on day 3. Blood samples were analyzed for TNF-alpha on days 1, 3 and 5. All animals were autopsied on day 6 to evaluate the ovarian weight, ascites formation and histopathological changes. There was no difference between groups regarding weight gain, ascites formation and plasma TNF-alpha levels (p < 0.05). Ovarian weight and number of ovulations were significantly lower in the pentoxifylline group than the control group (p < 0.05). Pentoxifylline did not prevent ascites formation despite the observed decrease in ovarian weight and number of ovulations in OHSS in a rabbit model.     

The value of Ureaplasma urealyticum tracheal culture and treatment in premature infants following an acute respiratory deterioration.

OBJECTIVE: To determine if treatment of Ureaplasma urealyticum (Uu), found at the time of an acute respiratory deterioration, decreases the incidence of chronic lung disease (CLD) in very low birth weight infants (VLBW). STUDY DESIGN: Between 1996 and 1999, medical records of all mechanically ventilated VLBW infants, who had an acute respiratory deterioration, were reviewed for gestational age (GA), birth weight (BW), gender, presence of CLD, Uu tracheal cultures, and erythromycin treatment. RESULTS: A total of 100 patients met our inclusion criteria (GA: 26.2+/-1.7 weeks, BW: 737+/-167.1 g (mean+/-SD)). Uu was present in 46.3% (38/82) of patients with CLD versus 50% (9/18) of patients without CLD (odds ratio 0.86 (CI: 0.31 to 2.39); p=0.77). Erythromycin treatment was not found to be protective against the development of CLD (odds ratio: 1.46 (CI: 0.25 to 8.31); p=0.66). CONCLUSION: Following an acute respiratory deterioration, tracheal isolation, and treatment of Uu may not decrease the incidence of CLD in VLBW infants.     

Effects of acute hypermagnesemia on the threshold for lidocaine-induced seizures in the rat

The effects of acute changes in plasma magnesium concentration on the threshold for lidocaine-induced seizures were evaluated in mechanically ventilated rats receiving 70% nitrous oxide and 30% oxygen. In experiment 1, male rats were intravenously administered either 0.9% sodium chloride (group I) or 5.0% magnesium sulfate to elevate plasma magnesium levels to 5.8 +/- 0.1 (group II) or 10.5 +/- 1.0 mg/dl (group III). In experiment 2, pregnant rats were intravenously administered either 0.9% sodium chloride (normomagnesemia) or magnesium sulfate, resulting in a plasma magnesium concentration of 7.8 +/- 1.4 mg/dl. Thirty minutes later, a continuous intravenous infusion of lidocaine (2.3 mg/kg per minute) was begun in both experiments. Biparietal electroencephalographic activity was monitored continuously. At the onset of electroencephalographic seizure activity, arterial plasma magnesium and lidocaine concentrations were measured. In groups I and III (experiment 1), brain parenchymal magnesium was also assayed. There were no differences in plasma lidocaine concentrations (in experiments 1 or 2) between saline solution and hypermagnesemic groups at onset of seizures. Brain magnesium level was unaltered by magnesium sulfate infusion. We conclude that acute administration of magnesium sulfate alters neither brain magnesium level nor the plasma lidocaine concentration associated with onset of electroencephalographic seizures.     

孕鼠营养异常对子鼠成年后激素抵抗影响的实验研究

目的 探讨孕鼠营养异常对子鼠成年后胰岛素、瘦素抵抗的影响。方法 36只孕鼠随机分成低蛋白组（低蛋白饲料喂养）、高营养组（高营养饲料喂养）及正常营养组（普通饲料喂养）,每组12只,各组孕鼠均足月自然分娩。正常营养组子鼠为正常体重组,低蛋白组子鼠体重小于孕龄（SGA）为SGA组（体重小于正常体重组子鼠平均体重2s以下）,高营养组子鼠体重大于孕龄（LGA）为LGA组（体重高于正常营养组子鼠平均体重2s以上）,每组子鼠36只。于子鼠出生后4周、12周龄时采用酶联免疫吸附试验测定其胰岛素、瘦素水平及胰岛素敏感指数（ISI）。结果 （1）低蛋白组子鼠体重明显低于正常体重组（P〈0．01）,69％的子鼠为SGA。高营养组子鼠体重明显高于正常体重组（P〈0．01）,38％的子鼠为LGA。（2）子鼠出生4周时,SGA组子鼠与正常体重组比较,体重已无显著差异,肾脏周围脂肪重量（FW）、Fw与体重（BW）比值分别为（0．36±0．14）g．6．5±0．3,显著高于正常体重组的（0．19±0．13）g,3．4±0．3（P〈0．01,P〈0．05）;LGA组子鼠FW／BW比值与正常体重组比较,差异无统计学意义（P〉0．05）。子鼠出生12周时,SGA组子鼠体重为（222±19）g,LGA组子鼠体重为（257±24）g,均明显高于正常体重组的（215±25）g（P〈0．05,P〈0．01）。SGA组子鼠FW／BW比值为10．5±5．1,LGA组子鼠为11．8±3．6,均明显高于正常体重组的7．2±3．6（P〈0．01）。（3）SGA组子鼠在出生4周时,胰岛素、瘦素水平分别为（5．5±0．9）μg/L、（6．1±0．7）μg／L,ISI为3．4±0．3,与正常体重组比较,差异有统计学意义（P〈0．05）;出生12周时,胰岛素、瘦素水平及ISI的变化与正常体重组比较,差异有统计学意义（P〈0．01）。LGA组子鼠在出生4周时,胰岛素、瘦素水平及ISI分别为（4．0±1．0）μg／L、（5．0±0．3）μg／L及4．1±0．5,与正常体重组比较,差异无统计学意义（P〉0．05）;出生12周时的胰岛素、瘦素水平及ISI与正常体重组比较,差异有统计学意义（P〈0．01）。结论 孕鼠营养异常将导致子鼠出生体重异常,体重异常子鼠在成年后可发生腹型肥胖以及胰岛素、瘦素抵抗。     

Blood coagulation and fibrinolysis activities during normal pregnancy and fetal growth--study based on estimated fetal body weight

There are many factors influencing the growth of the fetus. Since these factors have complex interrelations, they are difficult to clarify. The authors studied the effects of blood coagulation and fibrinolysis on the growth of the fetus during pregnancy, especially from the 2nd trimester into the 3rd trimester. The subjects were 86 normal pregnant women, and the subjects of study were blood coagulation, fibrinolysis activity of the mother, and estimated fetal birth weight after the 28th (2nd trimester) and 36th weeks of gestation (3rd trimester) in each case. 1. Changes in blood coagulation activity and fibrinolysis varied from the 2nd trimester into the 3rd trimester. The percentage of cases showing lowered platelets was 68.6% of the total, and the percentages of cases with reduced platelet ADP, epinephrine, and collagen aggregation were 60.5%, 55.8%, and 51.2%, respectively. The percentages of cases showing shortened prothrombin time and activated partial thromboplastin time were 58.1% and 51.2% of the total, respectively. The percentage of cases with reduced fibrinogen was 24.4% of the total. The percentages of cases with reduced antithrombin III, plasminogen, and alpha 2-plasmin inhibitor activity were 66.3%, 55.8%, and 75.6% of the total, respectively. 2. The birth weight of babies in a group with shortened prothrombin time was 2,935.1 +/- 395.2g(n = 50, mean +/- SD), while that in a group with prolonged prothrombin time was 3,106.2 +/- 357.9g(n = 36). The estimated fetal birth weight gain from the 2nd trimester to the 3rd trimester was 1,431.6 +/- 296.5g in the former group and 1,644.5 +/- 390.5g in the latter group. The differences were significant (p less than 0.05, p less than 0.01). The birth weight of babies in a group with lowered antithrombin III activity was 2,960.1 +/- 341.3g(n = 57), and that in an acceleration group was 3,157.8 +/- 370.0g(n = 29). The estimated fetal weight gain from the 2nd trimester to the 3rd trimester was 1,477.7 +/- 281.9g in the former group and 1,637.1 +/- 390.6g in the latter group. The differences were significant (p less than 0.02, p less than 0.05). 3. The estimated fetal weight gain from the 2nd trimester to the 3rd trimester in the group showing prolongated prothrombin time and activated partial thromboplastin time in this period was significantly larger than in the group showing shortened prothrombin time and activated partial thromboplastin time (p less than 0.001). These results suggested that the changes in blood coagulation and fibrinolysis activity of mothers from the 2nd trimester to the 3rd trimester affected the growth of the fetus.     

Increased polymorphonuclear infiltration and iatrogenic amniotic band after closure of fetoscopic access sites with a bioactive membrane in the rabbit at midgestation

OBJECTIVE: This study was undertaken to evaluate the efficacy and safety of closing the fetoscopy access site in a midgestational rabbit model by using a commercially available bioactive membrane. STUDY DESIGN: Fetoscopy was performed in a total of 100 gestational sacs in 20 does at midgestation (23 days, term = 31 days). In 50 cases (group 1), the fetoscopic access port was closed with a 5-mm patch of biocompatible matrix derived from porcine small intestine containing growth factors (transforming growth factor-beta and fibroblast growth factor-beta). Fifty sacs served as positive controls (group 2) and 55 unoperated fetuses were used as negative controls (group 3). At 30 days of gestation, a second-look laparotomy was performed. Outcome parameters were fetal weight, fetal lung weight, fetal lung-to-body weight ratio, and microscopy of the plugging site. RESULTS: Membrane integrity after fetoscopy was restored in 28 of the 40 (70%) of cases in group 1 versus 13 of the 32 (41%) in group 2 (P =.012). Birth weights were comparable (group 1: 30.65 +/- 5.68 g; group 2: 29.70 +/- 5.05 g; group 3: 29.52 +/- 6.25 g; NS), but fetal lung weight (group 1: 0.964 +/- 0.20 g; group 2: 0.798 +/- 0.17 g; P <.01) and fetal lung-to-body weight ratio (group 1: 0.032 +/- 0.0067; group 2: 0.027 +/- 0.0082; P <.05) were significantly higher in the study group. In group 1, cellular proliferation was significantly increased. Polymorphonuclear infiltration was observed in 19 of the 40 (48%) cases in group 1 versus 5 of the 32 (16%) cases in group 2 (P <.05). In one treated sac, a fibrous band joining the two fetal legs without constriction was present. CONCLUSION: The use of a bioactive membrane improved fetal membrane repair rates and decreased incidence of pulmonary hypoplasia in the rabbit but increased polymorphonuclear infiltration. In one amniotic sac, a situation comparable to amniotic band syndrome was documented.     

Intrauterine growth restriction in spontaneously hypertensive rats.

We examined the test profile of changes in systolic blood pressure (SBP), urinary volume, urinary sodium, and protein excretion in normotensive (Sprague Dawley) and spontaneously hypertensive rats (SHR) up to the 18th day of pregnancy. On days 6, 11, and 18 of pregnancy, the number of implantation sites, number of embryos, litter size, placenta, and litter weight were determined. In SHR, SBP (mmHg) increased significantly from the start of the test and remained high throughout the experiment. There was also a significant increase in urine volume (mL per 24 hrs) and urinary sodium excretion (mEq per 24 hrs) but no significant changes in protein excretion rate. The number of implantation sites on day 6 of pregnancy and the number of embryos on day 11 were similar in both groups. Uterus weight in SHR on days 6 and 11 of pregnancy was significantly lower than in normotensive rats. On day 18 of pregnancy in SHR, a substantial decrease in litter weight (7.10 +/- 0.40 vs. 12.00 +/- 0.92 g; p < 0.001) and weight of placenta (2.35 +/- 0.07 vs. 4.74 +/- 0.21 g; p < 0.001) was observed, with no modification in litter size. The hypertension associated with pregnancy in SHR increased urine volume and urinary sodium excretion and decreased weight of uterus, litter, and placenta relative to control rats.     

The influence of myocardial edema after coronary perfusion on left ventricular compliance of isolated ischemic porcine hearts.

The effects of myocardial edema on left ventricular (LV) compliance were studied in the isolated, arrested, hypothermic porcine heart. Myocardial water content, heart weight, and diastolic pressure-volume curves were measured before and after coronary perfusion with different coronary perfusates used to induce edema. Five control hearts without coronary perfusion showed no significant changes in LV compliance after 90 minutes of ischemia as assessed by the exponential ventricular stiffness constants, beta, (0.016 +/- 0.003 vs 0.018 +/- 0.007) and by corresponding volume at 15 mmHg LV filling pressure (LVV-15, 77 +/- 15 ml vs 77 +/- 14 ml). Sixteen pig hearts were divided into three experimental groups; after control measurements, each group underwent coronary perfusion with one liter of a solution of graded osmolarity, 380 (n = 6), 280 (n = 5), or 150 (n = 5) mOsm/L. Following perfusion, measurements were repeated. Each group demonstrated increasing heart weight (233 +/- 16 g vs 259 +/- 24 g, 380 group; 186 +/- 23 g vs 228 = +/- 24 g, 280 group; 190 +/- 20 g vs 254 +/- 34g, 150 group; p less than 0.05) and decreasing LVV-15 (81 +/- 13 mL vs 67 +/- 10 mL, 81 +/- 11 mL vs 57 +/- 16 mL, 77 +/- 14 mL vs 21 +/- 11 mL, respectively, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of effectiveness of intracellular and extracellular preservation solution on attenuation in ischemic-reperfusion lung injury in rats.

BACKGROUND: Human lung allografts can only be preserved for 6 hours. Experimental interventions that reduce ischemia-reperfusion (I/R) lung injury can be used to improve the properties of the preservation solution. The best solution for lung preservation is still a matter of controversy. The purpose of this study was to compare the protective effects of various solutions on I/R lung injury in Sprague-Dawley rats. METHODS: The following solutions were compared: a physiological salt solution; an intracellular preservation solution (the University of Wisconsin Solution, UW); an extracellular preservation solution (EP3); and the extracellular preservation solution with the addition of various protective agents--EP3 plus dexamethasone (Dex) (EP3-a), plus glutathione (GLU) and allopurinol (ALL) (EP3-b), and EP3 plus GLU, ALL, lactobionate (LACT), and raffinose (RAF) (EP3-c). I/R lung injury was induced by ischemia for either 45 or 60 minutes, followed by reperfusion for 60 minutes. Hemodynamic changes, lung weight gain (LWG), and capillary filtration coefficients were measured. RESULTS: Both EP3 and UW preservation solutions had partial attenuation effects on I/R lung injury, but UW produced a better attenuation effect than EP3. Use of modified EP3 solutions containing either protective agents (GLU, ALL, or Dex) or impermeants (LACT and RAF) improved the ability of EP3 to reduce I/R lung injury. The LWG using the modified EP3-c solution was the lowest among all groups. UW induced pulmonary hypertension. After I/R challenge, pulmonary arterial pressure with EP3-c was lower than with UW. Based on a lower LWG and the changes in hemodynamics, EP3-c is a better lung preservation solution than UW and EP3. CONCLUSIONS: Based on the attenuation of I/R injury, we conclude that there is no significant difference between intracellular UW and extracellular (EP3-a, EP3-b) preservation solutions in this rat model, but the addition of protective agents and impermeants to the solution are important. The findings suggest that EP3-c might be a better lung preservation solution than UW.     

Evaluation of the effect of pentoxifylline on white blood cell count in serum and peritoneal fluid in female rats with endometriosis

AIM: Endometriosis is defined as the growth of endometrium outside of the uterus in ectopic places. Immune system disturbances have an important role in endometriosis which may lead to infertility. It seems that inflammatory cytokines, specially tumor necrosis factor-alpha (TNF-alpha), which are produced by activated macrophages, play an important role in the pathology of endometriosis. Based on this theory, anti-TNF-alpha drugs are suggested as new drugs for endometriosis. This experimental study has been performed on female rats to determine the effect of pentoxifylline on the white blood cell count in serum and peritoneal fluid. METHODS: During the proestrous phase, one horn of the bicorn uterus of rats was removed surgically, and the endometrium implanted to different places as follows: subcutaneous, peritoneum and near the ovaries. After 2 months' observation, female rats were divided randomly into two groups. The treated group (n = 10) were given pentoxifylline (5 mg/kg twice a day), and the control group (n = 10) were given normal saline (the same dose), which was injected subcutaneously. Then via second laparotomy and in the same phase of the cycles, the size of implants and the white blood cell levels in the serum and peritoneum were measured. RESULTS: In the treated group, the total implant mass (mm2) decreased significantly in the right subcutaneous (8.05 mm2 vs 13.5 mm2; P = 0.01), left subcutaneous (7.64 mm2 vs 14.00 mm2; P = 0.01), right ovary (6.64 mm2 vs 15.22 mm2; P = 0.001) and left ovary (7.18 mm2 vs 14.56 mm2; P = 0.005). The total white blood cell count (5254.5455 +/- 178.73 vs 15,833.33 +/- 259.27; P = 0.02) and neutrophils (297.34 +/- 57.34 vs 2736.00 +/- 346.75; P = < 0.001) in the serum were decreased and the total count of lymphocytes (4967.92 +/- 696.194 vs 13,048.33 +/- 178.73; P = 0.003) in serum was increased. There were not any significant changes in the total white blood cell count in the peritoneum in both groups. The number of estrous cycles in both groups was similar. CONCLUSION: Based on our study, pentoxifylline could decrease the size of endometrial implants, especially in the ovaries and subcutaneous areas, and total white blood cell count in serum. Pentoxifylline could increase the lymphocyte count and decrease the neutrophil count in serum, and because these changes it might alter the immune system. Pentoxifylline did not have any adverse effect on rats' cycles and a good aspect of treatment with pentoxifylline was achieved.     

Adverse pregnancy outcomes are associated with multiple maternal thrombophilic factors

OBJECTIVE: To determine to what extent adverse pregnancy outcomes are associated with thrombophilia. STUDY DESIGN: We studied 31 women who had HELLP syndrome, placental abruption, fetal growth restriction or unexplained stillbirth (study group), matched with 12 controls. All women were tested for: Factor V, Prothrombin, methylenetetrahydrofolate reductase gene (MTHFR) mutations; for Protein C, S and Antithrombin III deficiency; for lupus anticoagulant. Correlation with 24h BP monitoring and uterine Doppler velocimetry indexes at 22-24 weeks' gestation was performed. RESULTS: Women with multiple thrombophilic factors had a significant lower birth weight (1568.33+/-146.8 g versus 2546.45+/-438 g), higher 24 h mean diastolic blood pressure at second trimester (76.3+/-12.5 mmHg versus 65.2+/-7.8 mmHg) and higher RI of uterine arteries (0.69+/-0.05 versus 0.50+/-0.15) than women with single thrombophilic factor. CONCLUSION: Multiple thrombophilic factors carry a major additional risk for adverse maternal and fetal outcomes and correlate well with placental maladaptation as indicated by uterine Doppler velocimetry and 24h BP monitoring.     

同型半胱氨酸与谷氨酸联合诱发孕鼠妊娠期高血压疾病的实验研究

目的探讨同型半胱氨酸（Hcy）与谷氨酸钠（MSG）联合作用,建立孕鼠妊娠期高血压疾病模型的可行性。方法将成年妊娠Wistar雌鼠随机分为4组,每组10只。从孕第10天起,对照（PN）组和谷氨酸（PG）组孕鼠分别每日腹腔内注射生理盐水2ml,Hcy（PH）组、Hcy＋PG（PHG）组孕鼠分别每日腹腔内注射Hcy 200mg／kg;PN、PH组孕鼠隔日背部皮下注射生理盐水2ml,PG、PHG组孕鼠隔日背部皮下注射MSG 1g／kg;直至分娩。孕期测定大鼠血压、尿蛋白、肝肾功能及行为变化;分娩后测量胎盘湿重、仔鼠数量、仔鼠体重、身长,观察大脑皮层、肾脏及胸主动脉组织结构改变。结果（1）PH、PHG组孕鼠于孕第12天起,出现血压升高,分别为（107±8）、（109±10）mmHg（1mmHg=0．133kPa）,至孕第20天达最高峰,分别为（119±10）、（121±7）mmHg,与PN、PG组比较,差异均有统计学意义（P〈0．01）;（2）PH、PHG组孕鼠孕第15天时,尿蛋白含量分别为（1．42±0．53）、（1．53±0．24）g／L,与PN、PG组比较,差异也有统计学意义（P〈0．01）;（3）PH、PHG组丙氨酸转氨酶（ALT）分别为（57±15）、（69±24）U／L,天冬氨酸转氨酶（AST）分别为（265±61）、（293±118）U／L,尿素氮（BUN）分别为（9．5±0．8）、（9．5±1．6）mmol／L,肌酐（Cr）分别为（54±10）、（54±10）μmol／L,与PN、PG组分别比较,差异均有统计学意义（P〈0．05）;（4）PH、PHG组仔鼠体重分别为（3．5±3．9）、（3．3±3．7）g,胎盘湿重分别为（0．49±0．28）、（0．45±0．03）g、仔鼠身长分别为（3．6±1．5）、（3．5±1．5）cm。分别与PN、PG组比较,差异也均有统计学意义（P〈0．01）;（5）光镜下,PHG组孕鼠出现肾小球基底膜增厚,系膜细胞增生,肾小管上皮细胞水肿;大脑皮层神经细胞出现固缩性退行性变;电镜下,PHG组孕鼠出现主动脉内皮细胞细胞小器缺乏,中膜平滑肌细胞增生;（6）PHG组孕鼠可出现明显的行为改变,如阵发性凝视、动须、面部抽搐、一侧前肢震颤等。结论Hcy与MSG可联合作用,通过损伤血管内皮细胞及大脑皮层的神经细胞,诱发孕鼠妊娠期高血压疾病,特别是子痫前期的病理生理变化。