关节冲洗术联合透明质酸钠治疗K-L Ⅱ、Ⅲ期膝关节骨性关节炎疗效分析

目的观察关节冲洗术联合膝关节腔注射透明质酸钠治疗膝关节骨性关节炎的临床疗效。方法纳入自2018-12—2020-02诊治的77例Kellgren-LawrenceⅡ、Ⅲ期膝关节骨性关节炎,40例采用关节冲洗术联合透明质酸钠注射治疗(观察组),37例单纯于关节腔注射透明质酸钠治疗(对照组)。比较2组治疗后1周、2周、12周疼痛VAS评分、Lequesne指数评分及WOMAC评分。结果治疗中及治疗后所有患者均未出现关节感染、出血及下肢运动感觉障碍等并发症。治疗后疼痛VAS评分、Lequesne指数评分及WOMAC评分均较治疗前明显改善。观察组治疗后1周、2周、12周疼痛VAS评分、Lequesne指数评分及WOMAC评分均低于对照组,差异有统计学意义(P0.05)。结论关节冲洗术联合透明质酸钠治疗可有效改善膝关节骨性关节炎患者的疼痛症状及膝关节功能,其疗效优于单纯透明质酸钠注射。     

体外冲击波联合富血小板血浆注射治疗膝关节骨关节炎的前瞻性临床对比研究

目的采用前瞻性临床对比研究,探讨体外冲击波联合富血小板血浆(platelet-rich plasma,PRP注射治疗膝关节骨关节炎(knee osteoarthritis,KOA)的疗效。方法以2015年6月—2018年6月收治且符合选择标准的180例KOA患者作为研究对象,随机分为3组,每组60例。A组膝关节腔穿刺注射自体PRP,B组体外冲击波治疗,C组膝关节腔穿刺注射自体PRP联合体外冲击波治疗;每周治疗1次,共5次。3组患者年龄、性别、病程、侧别及Kellgren-Lawrence分级比较,差异均无统计学意义(P0.05)。治疗前及首次治疗后第1、3、5周,采用疼痛视觉模拟评分(VAS)、Lequesne指数评分、美国西部Ontario与McMaster大学骨关节炎指数评分(WOMAC)及膝关节活动度评定膝关节疼痛和功能情况。结果 3组治疗后第1、3、5周VAS评分、Lequesne指数评分、WOMAC评分及膝关节活动度与治疗前比较,差异均有统计学意义(P0.05);随治疗时间延长,VAS评分、Lequesne指数评分和WOMAC评分逐渐降低(P0.05),但膝关节活动度各时间点间差异均无统计学意义(P0.05)。治疗前3组间VAS评分、Lequesne指数评分、WOMAC评分及膝关节活动度比较,差异均无统计学意义(P0.05);治疗后第1、3、5周,C组上述3项评分明显优于A、B组(P0.05),但3组间膝关节活动度差异均无统计学意义(P0.05)。结论体外冲击波联合PRP注射治疗KOA具有协同作用,能进一步缓解关节疼痛。     

体外冲击波联合塞来昔布治疗早中期膝关节炎的临床疗效

目的 探讨体外冲击波联合塞来昔布治疗早中期膝关节炎的临床疗效。方法 2017年10月-2019年10月收治膝关节炎患者共132例,根据就诊顺序随机分为对照组和观察组,每组66例。对照组：口服塞来昔布治疗,1次/d,200 mg/次,连续服用8周。观察组：对照组方案+体外冲击波进行治疗。设置参数：调整冲击频率为10 Hz,能量强度0.18 mJ/mm2,每周1次,连续治疗8周,比较两组的临床疗效。采用VAS评分评估患者膝关节疼痛程度、WOMAC骨关节炎评分、Lequesne评分评估关节炎症反应、SF36量表评估其生活质量。结果 在治疗4周、8周、治疗结束后4周,组内VAS评分、WOMAC评分、Lequesne指数、SF 36评分均较治疗前减小（P <0.05）;组间比较,观察组在治疗4周、8周、治疗结束后4周的VAS评分、WOMAC评分、Lequesne指数、SF 36评分均小于同时期对照组（P <0.05）。结论 体外冲击波联合塞来昔布治疗早中期膝关节炎的疗效确切,联合使用效果更佳,可显著改善膝关节功能,防止膝关节炎进展,值得临床推广使用。     

铍针与扶他林乳胶剂治疗膝骨关节炎疼痛的病例对照研究

目的:观察铍针与扶他林治疗早中期膝骨关节炎疼痛的临床疗效。方法:将67例早中期膝骨关节炎患者分为铍针治疗组34例和外用扶他林对照组33例,治疗结束1个月后随访,共60例完成随访(共脱落7例,其中治疗组4例,对照组3例)。其中治疗组男5例,女25例;年龄40～68岁,平均(55.90±9.34)岁;病程0.25～1年,平均(0.87±0.34)年;对照组男6例,女24例;年龄40～70岁,平均(58.67±7.39)岁;病程0.25～2年,平均(0.93±0.60)年。治疗组采用铍针治疗,每周治疗1次,3周为1个疗程;对照组采用扶他林乳胶剂局部痛点涂抹,每日3次,3周为1个疗程。两组治疗前后通过软组织张力测试仪测量局部软组织位移值、香蕉面积,用压痛测量仪测量压痛值,用疼痛视觉模拟量表记录治疗前后的VAS评分,并评价治疗前后膝关节功能HSS评分及疗效,最后对上述结果进行统计分析。结果:两组软组织位移值、香蕉面积、压痛测量值、主观VAS评分及HSS评分治疗前后比较差异有统计学意义,且治疗组软组织位移值、压痛值和HSS评分高于对照组,香蕉面积和VAS评分低于对照组。根据膝关节HSS评分结果及VAS疼痛指数综合评定疗效,治疗组治愈3例,显效8例,有效18例,无效1例;对照组治愈1例,显效4例,有效20例,无效5例。两组疗效比较差异无统计学意义。结论:铍针治疗的优势在于有效降低膝骨关节炎患者局部软组织的高张力状态,进而减轻疼痛症状,改善膝关节功能。     

射频针刀联合臭氧注射治疗对膝骨关节炎软组织张力特征影响的临床研究

目的:观察射频针刀联合臭氧注射对II级膝骨性关节炎(KOA)周围软组织张力的改善作用。方法:选择天津中医药大学第一附属医院骨伤科收治的单侧KOA患者60例,治疗组采用射频针刀联合臭氧治疗,对照组采用手法治疗,治疗前后采用疼痛VAS评分、骨关节炎WOMAC指数进行疗效评价,用软组织张力测试仪测量健患侧治疗前后膝周4个点在200×g压力时所对应的位移值(FDD值)。结果:治疗组与对照组治疗后患者VAS评分减小,WOMAC指数较治疗前改善,差异均有统计学意义(P0.05)。治疗组VAS评分和WOMAC指数较对照组明显改善,差异有统计学意义。治疗组与对照组治疗后髌上2 cm处股内侧肌、股中间肌、股外侧肌,髌韧带中点的FDD值均较治疗前改善,差异有统计学意义(P0.05)。结论:射频针刀联合臭氧注射与手法治疗KOA均能改善患者膝关节疼痛、功能,但在疼痛、功能改善程度以及临床疗效方面前者要优于后者。两种治疗均能对膝关节周围软组织张力产生影响,使膝关节周围软组织张力降低,改善力学微环境。     

风湿液联合玻璃酸钠治疗老年膝骨关节炎临床观察

目的:观察风湿液联合玻璃酸钠治疗老年膝骨关节炎的临床疗效。方法:将90例老年膝骨关节炎患者随机分为治疗组和对照组,每组45例。对照组给予玻璃酸钠膝关节腔内注射,每次20 mg,每周1次。治疗组在对照组治疗基础上加服风湿液,每次10 m L,每日3次。两组均以5周为1个疗程。观察两组治疗前后视觉模拟评分法(VAS)评分、Lequesne指数及实验室指标。结果:治疗后,两组患者VAS评分、Lequesne指数、红细胞沉降率和C-反应蛋白较治疗前均有改善(P0.05),且治疗组优于对照组(P0.05)。结论:风湿液联合玻璃酸钠治疗老年膝骨关节炎能够有效地缓解关节疼痛、改善关节功能,值得临床推广应用。     

丹杞颗粒联合硫酸氨基葡萄糖治疗骨性关节炎的疗效研究

目的探索丹杞颗粒联合硫酸氨基葡萄糖治疗膝骨关节炎(knee osteoarthritis,KOA)患者的临床疗效。方法对2014年7月至2017年6月期间在我院治疗的128例KOA患者随机分为对照组和治疗组,每组64例患者,治疗组患者给予丹杞颗粒联合硫酸氨基葡萄糖治疗,对照组患者予以硫酸氨基葡萄糖治疗。比较治疗前后两组患者临床疗效和Lequesne、VAS、WOMAC及SF-36评分改善情况,同时检测两组患者的血清白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-ɑ(TNF-α)的水平变化,并记录治疗期间两组患者出现的药物不良反应情况。结果治疗前,两组患者的Lequesne、VAS、WOMAC及SF-36评分和血清IL-1β、IL-6和TNF-α的水平比较无统计学差异(P0.05)。经过6个月的治疗,两组患者的Lequesne、VAS、WOMAC及SF-36评分和血清IL-1β、IL-6和TNF-α水平较治疗前均有显著改变(P0.05),而治疗组上述指标改变幅度较对照组更为明显(P0.05);治疗组有效率显著高于对照组(P0.05),而两组的药物不良反应比较无统计学意义(P0.05)。结论丹杞颗粒结合硫酸氨基葡萄糖可以显著改善膝骨关节炎的临床症状。     

中药熏洗加中药封包联合关节腔内注射玻璃酸钠治疗膝骨关节炎临床观察

目的:观察中药熏洗加中药封包联合关节腔内注射玻璃酸钠治疗膝骨关节炎的疗效。方法:将92例膝骨关节炎患者随机分为对照组44例和治疗组48例,对照组给予关节腔内注射玻璃酸钠,治疗组在对照组基础上加用中药熏洗及中药封包治疗。两组疗程均为5周。观察两组临床疗效、VAS评分、WOMAC评分及晨僵时间改善情况。结果:治疗组临床治愈23例,显效13例,有效11例,无效1例,总有效率为97.92%;对照组临床治愈13例,显效11例,有效8例,无效12例,总有效率为72.73%。两组比较,差异有统计学意义(P0.05)。两组VAS评分、WOMAC评分及晨僵时间均有改善(P0.05),且治疗组优于对照组(P0.05)。结论:中药熏洗加中药封包联合关节腔内注射玻璃酸钠治疗膝骨关节炎疗效满意。     

铍针治疗膝骨关节炎疼痛的病例对照研究

目的:探讨铍针治疗膝骨关节炎疼痛的作用机制,并进行分析。方法:按随机数字表法入组的85例(85膝)膝骨关节炎患者(如为双膝骨关节炎患者只选其中较严重的一侧入组),其中试验组35例,男6例,女29例,脱落1例,平均年龄(56.65±4.89)岁;对照组50例,男6例,女44例,平均年龄(57.54±4.91)岁。分别采用铍针治疗和关节腔注射玻璃酸钠治疗。用疼痛视觉模拟评分(VAS)及膝关节周围最明显压痛点的压痛仪测量数据作为评定指标。结果:试验组各项评分与治疗前比较差异均有统计学意义(P<0.01);对照组各项评分与治疗前比较差异均有统计学意义(P<0.01)。两组治疗后在VAS评分及压痛仪测量方面差异均无统计学意义(P>0.01)。患者主观感受的VAS评分和压痛仪客观测试数据之间具有相关性,可用线性回归方程表示两者间的相关关系。结论:铍针通过减轻关节局部痛点的软组织张力,解除神经压迫和刺激,从而有效缓解膝骨关节炎患者的疼痛症状,是治疗膝骨关节炎疼痛的有效方法。     

体外冲击波对膝骨关节炎IL-32、DKK-1水平的影响

目的观察体外冲击波联合玻璃酸钠治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效及对关节液中白介素-32(interleukin-32,IL-32)、Dickopff相关蛋白1(Dickopff-1,DKK-1)水平的影响。方法将50例KOA患者随机分为治疗组和对照组,各25例。治疗组男16例,女9例;平均年龄(57.4±10.1)岁,病程(3.1±2.3)年。对照组男18例,女7例;平均年龄(58.3±10.2)岁,病程(3.3±1.7)年。对照组给予关节腔内注射玻璃酸钠,每周1次,共治疗5周。治疗组在对照组基础上加用体外冲击波治疗,每周1次,共治疗5周。在干预前和干预第5周采用活动时疼痛视觉模拟评分(visual analogue scale,VAS)、骨关节炎严重程度评分法(lequesne指数)和美国西部Ontario与McMaster大学骨关节炎指数(western Ontario and McMaster University osteoarthritis index,WOMAC)评分评价两组患者疗效,检测并比较两组患者关节液中IL-32、DKK-1水平的变化。结果两组患者治疗后VAS评分、Lequesne指数评分、WOMAC评分均明显降低(P0.05或0.01),治疗后治疗组各评分明显低于对照组(P0.05或0.01)。治疗后两组患者关节液中IL-32水平比治疗前显著下降(P0.01),治疗组DKK-1水平较治疗前增高(P0.01);治疗后治疗组关节液中IL-32水平显著低于对照组(P0.05),而治疗后治疗组DKK-1水平则显著高于对照组(P0.05)。结论体外冲击波联合玻璃酸钠治疗KOA疗效显著,可明显减轻关节疼痛,改善膝关节活动功能,其作用机制可能与降低关节液中IL-32水平、提高DKK-1水平有关。     

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.     

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.     

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.     

Immunomodulation in Transplantation with Photopheresis

Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.