免疫分选软骨前体细胞并诱导永生化的研究

目的建立永生化大鼠软骨前体细胞株,为细胞移植和转基因治疗提供稳定的细胞来源。方法利用免疫磁珠技术分离纯化具有特异性表面标志成纤维生长因子受体-3(FGFR-3)的软骨前体细胞,用基因转染技术将含有猿肾病毒40大T抗原基因(SV40Tag)的重组质粒pEGFP- IRES2-SV40Tag转染原代培养的新生大鼠软骨前体细胞,经G418筛选,抗性克隆扩大培养。应用FGFR-3、Ⅱ型胶原和X型胶原抗体进行细胞鉴定,检测其分化能力,观察细胞的形态及其生长状况,绘制生长曲线。用逆转录-聚合酶链反应(RT-PCR)、Southern blot和免疫细胞化学法鉴定SV40Tag在转染细胞中的表达。结果获得1个阳性细胞克隆,免疫细胞化学证实为FGFR-3阳性的具有较强增值能力和多分化潜能的软骨前体细胞。经Southern印迹杂交证实,SV40Tag已稳定转染入软骨前体细胞,表达mRNA及其蛋白。贴壁培养的永生化软骨前体细胞株(IPSC),群体倍增时间为23.62 h,传代、冻存和复苏对细胞形态及生长无明显影响。结论SV40Tag导入可诱导软骨前体细胞永生化,为软骨前体细胞的实验研究及其介导的细胞移植治疗提供了稳定的细胞来源。     

猿肾病毒40介导的人前软骨干细胞永生化的实验研究

目的 构建猿肾病毒40大T抗原基因(SV40Tag)介导的永生化人前软骨干细胞株,为下一步基因打靶研究其分化分子机制提供稳定的细胞来源. 方法采用脂质体介导的基因转染技术将含有SVd0Tag的质粒pCMVSV40T/PUR转染人前软骨干细胞(PSCs),经嘌呤霉素筛选,阳性克隆扩大培养并连续传代.用免疫组化、RT-PCR、Southern印迹杂交法对转染细胞进行鉴定,并检测SV40Tag在转染细胞中的表达及其与基因组的整合情况. 结果 筛选获得的阳性克隆扩大培养,命名为永生化前软骨干细胞(IPSCs),能连续传代培养,细胞生长迅速.免疫组化和RT-PCR证实IPSCs成纤维生长因子受体-3阳性,并可检测到SV40Tag mRNA及其蛋白的表达.Southern印迹杂交显示IPSCs基因组中存在SV40Tag cDNA. 结论 成功构建了SV40Tag介导的永生化人前软骨干细胞株.     

大鼠骨骺干细胞的分离鉴定及其永生化细胞株的构建

[目的]分离、鉴定大鼠骨骺干细胞并建立永生化的大鼠骨骺干细胞株,为细胞移植和转基因治疗提供稳定的细胞来源.[方法]采用Percoll不连续密度梯度离心法分离骨骺干细胞,利用电穿孔转染技术将含有猿肾病毒40大T抗原基因（SV40Tag）的质粒pCMVSV40T/PUR转染骨骺干细胞,经嘌呤霉素筛选,抗性克隆扩大培养.应用FGFR-3抗体和PCNA抗体进行免疫细胞化学染色,观察细胞的形态及其生长状况并绘制细胞生长曲线.用免疫细胞化学法和RT-PCR检测SV40Tag在转染细胞中的表达.[结果]转染后获得一个阳性细胞克隆,免疫细胞化学结果显示FGFR-3抗体染色阳性.SV40Tag抗体染色和RT-PCR结果显示SV40Tag已稳定转染入骨骺干细胞.转染细胞经扩大培养,命名为永生化骨骺干细胞.[结论]成功纯化大鼠骨骺干细胞并构建了SV40Tag永生化的骨骺干细胞株.     

猿肾病毒40大T抗原基因永生化大鼠星形胶质细胞株的构建

目的 构建永生化大鼠星形胶质细胞，为转基因细胞移植镇痛提供细胞载体。方法 采用差速粘附法体外分离和培养大鼠大脑皮层星形胶质细胞。利用脂质体将含有猿肾病毒40大T抗原(SV40Tag)基因的质粒pCMVSV40T／PUR转染培养的大鼠星形胶质细胞。经嘌呤霉素1．5μg／ml筛选后，挑选阳性细胞克隆扩大培养并连续传代。PCR、RT-PCR及免疫组化检测阳性细胞克隆中SV40Tag基因的整合情况及其表达，并对传代细胞的胶质原纤维酸性蛋白(GFAP)进行检测。结果 成功获得体外培养的大鼠星形胶质细胞，GFAP阳性表达；筛选获得阳性细胞克隆，连续传代培养近50代；PCR、RT-PCR产物经1．5％琼脂糖凝胶电泳分析显示558bp处有一特异性扩增条带，与阳性对照条带相同，而未转染pCMVSV40T／PUR的细胞无扩增条带，回收片段经测序、比对与SV40Tag的基因序列一致(100％)；同时转染的阳性细胞克隆SV40Tag和GFAP免疫染色阳性。结论 成功地构建了SV40Tag基因永生化的大鼠星形胶质细胞株。     

大鼠蛛网膜下腔移植超顺磁性氧化铁纳米离子标记永生化神经前体细胞后的磁共振成像追踪

目的观察大鼠蛛网膜下腔移植超顺磁性氧化铁纳米粒子（SPIO）标记永生化神经前体细胞后的磁共振成像追踪。方法用SPIO-多聚赖氨酸复合物（SPIO-PLL）标记永生化神经前体细胞。采用普鲁士蓝染色鉴定SPIO-PLL标记永生化神经前体细胞的效率，采用MTT法检测标记前后细胞活力，用免疫细胞化学法对标记后1周的细胞进行抗巢蛋白、微管相关蛋白和胶质纤维酸性蛋白（GFAP）染色，检测标记细胞的分化能力。蛛网膜下腔置管成功的SD大鼠10只，随机分为2组（n=5），标记细胞组和未标记细胞组，蛛网膜下腔分别移植标记后2d的永生化神经前体细胞和未标记细胞，移植后30min及移植后1周用MRI对蛛网膜下腔的细胞进行活体追踪，用组织切片进行普鲁士蓝染色和抗猿肾病毒40大T抗原染色。结果SPIO可以高效率地标记永生化神经前体细胞，普鲁士蓝染色显示SPIO—PLL标记永生化神经前体细胞质内出现细小的天蓝色铁颗粒，SPIO-PLL标记对永生化神经前体细胞的活力没有明显的影响，标记后1周，抗巢蛋白、微管相关蛋白染色阳性，GFAP染色阴性。标记细胞组移植后30min及移植后1周MRI活体检查发现标记细胞在磁共振成像上呈明显的低信号改变，脊髓组织学切片结果普鲁士蓝、抗猿肾病毒40大T抗原染色阳性；未标记细胞组磁共振成像上无明显低信号改变。结论利用MRI技术可以对蛛网膜下腔移植后的标记细胞进行活体追踪。     

低氧/复氧后星形胶质细胞对永生化神经前体细胞增殖与分化的影响

目的 探讨低氧/复氧后星形胶质细胞对永生化神经前体细胞增殖与分化的影响.方法 24 h内新生SD大鼠,断头处死,分离、培养和传代星形胶质细胞,取本室构建的永生化神经前体细胞,根据培养条件的不同分为3组,每组24孔,对照组永生化神经前体细胞在正常培养条件下培养(O2 17%-CO2 5%-N2 78%);共培养组取第三代星形胶质细胞孵育24 h后接种永生化神经前体细胞,培养条件同对照组;低氧/复氧后共培养组取第三代星形胶质细胞,先置入低氧培养箱(O2 2%-CO25%-N2 93%)中孵育12 h后,恢复正常培养条件12 h,再接种永生化神经前体细胞.3组以相同密度接种永生化神经前体细胞(1×104/cm2),隔天半量置换培养基,培养时间为6 d.共培养6 d后每组取6孔,采用免疫荧光细胞化学法,观察共培养后永生化神经前体细胞的增殖与分化情况,计算其增殖倍数、神经元阳性率和星形胶质细胞阳性率.结果 与对照组和共培养组相比,低氧/复氧后共培养组永生化神经前体细胞增殖倍数升高(P＜0.05),神经元阳性率和星形胶质细胞阳性率差异无统计学意义(P＞0.05).结论 低氧/复氧后星形胶质细胞可促进永生化神经前体细胞增殖,但对其分化无影响.     

皮肤来源的前体细胞培养和向神经元分化的观察

目的 研究皮肤来源的前体细胞(SKPs)的体外培养方法，为神经移植提供一种新的细胞来源。方法 分离培养小鼠皮肤组织的细胞，在无血清的培养基中培养，用机械方法对细胞进行传代，免疫细胞化学方法对细胞进行鉴定。结果 从成年和幼年的小鼠皮肤组织中分离培养出SKPs,这种细胞在体外可以长期增殖和传代，体外培养可超过8代，这种细胞大部分表达纤维粘连蛋白，约50％的细胞表达巢蛋白。在有血清的培养基中培养，约5％的细胞分化为神经元样细胞，表达神经元特异性烯醇化酶和神经微丝，部分细胞分化为脂肪细胞，其余的细胞分化为成纤维细胞样细胞。结论 皮肤组织中存在的前体细胞可在体外稳定增殖，能够分化为神经细胞、脂肪细胞和成纤维细胞样细胞。这种前体细胞有潜力成为神经移植的一种细胞来源。     

破骨细胞转基因永生化问题的初步探讨

目的：通过转基因技术建立破骨细胞永生化细胞系，方法：经1，25（OH）2D3诱导，获得小鼠骨髓来源的破骨前体细胞，脂质体法（Fugene6）将猿猴病毒40（SV40）和绿色荧光蛋白（GFP）质粒分别转染入破抽前体细胞，G418筛选抗性克隆；同时将GFP转染入逆转录病毒包装细胞（P167）中，作为方法对照，继而，用含有GFP的逆转录病毒感染破骨前体细胞，G418筛选抗性克隆。结果：获得小鼠骨髓来源的破骨前体细胞，Fugene6转染SV40和GFP到破骨前体细胞后，G418筛选未获得阳性克隆，但GFP转染PT67细胞获得阳性克隆和含有GFP的逆转录病毒。将含有GFP的逆转录病毒感染破骨前体细胞，G418筛选未获得阳性克隆，结论：通过破骨细胞转基因永生化，建立破骨或破骨前体系细胞系的方法是一个非常有意义的研究课题，但是难度较大。可以初步认为：脂质体和逆转录病毒载体的方法不是破骨细胞转基因的最佳方法。     

血清对神经干细胞分化的影响北大核心CSCD

目的探讨血清对神经干细胞分化过程的影响。方法取孕14 d SD大鼠胚胎脑组织,分离培养神经干细胞并传代。取第3代细胞倒置相差显微镜下观察细胞形态,并行巢蛋白(Nestin)免疫细胞化学染色鉴定。将鉴定后的细胞分为A、B、C 3组,各组细胞培养基除FBS浓度不同(分别为5%、1%、0)外,其余成分均一致。培养第8天,行活/死细胞染色观察细胞生长情况;培养第4、8天,行免疫细胞化学染色以及实时荧光定量PCR检测,观察胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、Ⅲ型β神经元微管蛋白(β-Ⅲ Tubulin)表达。结果经细胞形态及免疫细胞化学染色鉴定培养细胞为神经干细胞。培养第8天,活/死细胞染色示A、B、C组细胞均无死亡现象。免疫细胞化学染色示,培养第4、8天,A、B、C组GFAP蛋白表达随FBS浓度降低而逐渐减弱,但β-Ⅲ Tubulin表达逐渐增强;各组第8天时染色均较第4天时增强。实时荧光定量PCR检测示,培养第4天和第8天3组间GFAP mRNA及β-ⅢTubulin mRNA相对表达量比较,差异均有统计学意义(P<0.05)。结论血清能促进神经干细胞向胶质细胞分化,并减缓其向神经元分化速度,且血清浓度越低,该影响越小。     

血清对神经干细胞分化的影响

目的探讨血清对神经干细胞分化过程的影响。方法取孕14 d SD大鼠胚胎脑组织,分离培养神经干细胞并传代。取第3代细胞倒置相差显微镜下观察细胞形态,并行巢蛋白(Nestin)免疫细胞化学染色鉴定。将鉴定后的细胞分为A、B、C 3组,各组细胞培养基除FBS浓度不同(分别为5%、1%、0)外,其余成分均一致。培养第8天,行活/死细胞染色观察细胞生长情况;培养第4、8天,行免疫细胞化学染色以及实时荧光定量PCR检测,观察胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、Ⅲ型β神经元微管蛋白(β-Ⅲ Tubulin)表达。结果经细胞形态及免疫细胞化学染色鉴定培养细胞为神经干细胞。培养第8天,活/死细胞染色示A、B、C组细胞均无死亡现象。免疫细胞化学染色示,培养第4、8天,A、B、C组GFAP蛋白表达随FBS浓度降低而逐渐减弱,但β-Ⅲ Tubulin表达逐渐增强;各组第8天时染色均较第4天时增强。实时荧光定量PCR检测示,培养第4天和第8天3组间GFAP mRNA及β-ⅢTubulin mRNA相对表达量比较,差异均有统计学意义(P0.05)。结论血清能促进神经干细胞向胶质细胞分化,并减缓其向神经元分化速度,且血清浓度越低,该影响越小。     

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 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.     

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.     

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.     

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.     

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.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.     

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.