葡萄籽多酚对人乳腺癌细胞MCF-7/ADR在裸鼠体内的多药耐药逆转作用

目的　研究葡萄籽多酚 (GSP)对人乳腺癌耐阿霉素细胞MCF 7/ADR的体内多药耐药逆转作用。方法　采用人乳腺癌裸鼠移植瘤模型研究GSP对肿瘤多药耐药的体内逆转作用 ;采用流式细胞术测定不同用药P 糖蛋白 (Pgp)表达变化及肿瘤细胞凋亡率变化。 结果　体内裸鼠抑瘤实验显示GSP有一定抑瘤作用 ,抑制率为 18 35 % ,联合应用阿霉素 (ADR)可显著抑制肿瘤生长 ,2 0mg/kgGSP可有效逆转MCF 7/ADR细胞的耐药性 ,抑瘤率为 5 4 6 4 %。流式细胞术结果显示应用GSP后肿瘤细胞Pgp表达显著降低 ( 32 0 3± 2 0 9) ,与对照组 ( 5 5 13± 2 12 )相比差异有显著意义 (P <0 0 5 )。平均凋亡率为 15 12 %± 1 0 4 % ,显著高于对照组 9 0 7%± 0 4 3% (P <0 0 5 )。结论　GSP能在体内逆转MCF 7/ADR细胞的耐药性 ,其机制可能是通过抑制Pgp表达 ,并可能通过诱导肿瘤细胞凋亡来起作用     

PTEN和p27Kip1共表达对前列腺癌PC-3细胞增殖和凋亡的影响

目的　通过腺病毒介导转染前列腺癌PC 3细胞 ,探讨人 10号染色体上缺失的磷酸酶和张力蛋白类似物 (PTEN)和p2 7Kip1对肿瘤细胞增殖和凋亡等方面的影响及二者的协同作用。方法　构建携带人PTEN和p2 7Kip1基因的腺病毒载体 ,体外转染PC 3细胞 ,通过RT PCR、Westernblot检测目的基因不同水平的表达。采用细胞生长试验、流式细胞仪检测PC 3转染前后细胞增殖、细胞周期和早期凋亡率的变化。结果　病毒滴度Ad PTEN为 1 8× 10 7pfu ml、Ad p2 7Kip1为 1 2× 10 9pfu ml,RT PCR检测有PTEN mRNA(46 2bp)和p2 7Kip1 mRNA (32 0bp) ,Westernblot检测有PTEN蛋白 (6 0KD)和P2 7蛋白 (2 7KD)特异表达 ,可明显抑制PC 3细胞的增殖 ,诱导细胞凋亡 ,联合基因治疗组与单基因组相比差异有显著意义。结论　成功构建携带人PTEN和p2 7Kip1的重组腺病毒载体 ,在前列腺癌细胞株PC 3得到了稳定、特异的高表达 ,联合基因疗法有望成为治疗前列腺癌的有效方法。     

雌激素受体真核表达质粒对乳腺癌耐药细胞耐药性和细胞增殖的影响

目的　研究雌激素受体 (ER )表达质粒对MCF 7/ADR乳腺癌阿霉素耐药细胞耐药性和细胞增殖的影响。方法　Westernblot法检测MCF 7细胞和MCF 7/ADR细胞ER状态。构建ER的真核细胞表达质粒 pCER ,导入MCF 7/ADR细胞 ,流式细胞仪检测细胞周期分布 ,MTT法检测细胞生长。结果　MCF 7细胞ER为阳性 ,MCF 7/ADR细胞ER为阴性。成功构建真核细胞表达质粒 pCER ,转染MCF 7/ADR细胞 ,获得阳性克隆MTER/ADR。与对照组相比 ,MTER/ADR生长速度增快 ,S期细胞为 17.2 3 % (对照组为 14 .66% ) ,细胞对阿霉素的耐药性下降 ,阿霉素为 3mg/L时对细胞的抑制率为 45 % ,大于对照组细胞的抑制率 (为 2 4% ) ;且雌二醇 (E2 )能增加阿霉素对MTER/ADR细胞生长的抑制作用。结论　MCF 7/ADR乳腺癌耐药细胞的耐药性与其雌激素受体的表达缺失有一定关系。     

c-myc靶向小干扰RNA诱导乳腺癌细胞凋亡的作用

目的构建小干扰RNA(siRNA)表达载体,体外观察其诱导乳腺癌细胞凋亡效应。方法基因克隆技术构建人cmyc癌基因特异性siRNA表达载体,体外转染MCF7,48h后检测c-myc癌基因表达状况并观察MCF7凋亡诱导效应。结果(1)成功构建siRNA表体载体:pEGFP-C1/U61、pEGFP-C1/U62和pEGFP-C1/U63;(2)siRNA表达载体转染MCF748h后,pEGFP-C1/U62组显著抑制胞内c-myc表达(80%);(3)转染24h和48h后,pEGFP-C1/U62组凋亡率分别为11.01%和21.30%,明显高于对照组(P<0.01)。结论构建的cmyc靶向siRNA表达载体能显著下调cmyc在MCF7中的过表达,诱导乳腺癌细胞株MCF7凋亡。     

导入PTEN基因抑制胰腺癌细胞体外生长的研究

目的　研究PTEN基因转染对胰腺癌细胞体外生长的生物学效应。方法　以 pBP、pBP PTEN HA、pBP PTENG 12 9R HA质粒分别转染体外培养胰腺癌细胞株JF 30 5 ,并以未转染组为对照 ,Westernblot分析目的基因的表达 ,噻唑蓝比色法 (MTT)检测细胞活力 ,流式细胞术检测细胞凋亡。结果　westernblot示pBP PTEN HA和 pBP PTENG 12 9R HA转染组有HA的表达 ,并分别有PTEN的过表达和PTENG 12 9R的表达 ;MTT示pBP PTEN HA转染组活细胞数较其他各组均低 (pBP PTEN HA组 0 .6 787± 0 .0 785 ;pBP PTENG 12 9R HA组 0 .9847± 0 .10 0 2 ;pBP组1.0 987± 0 .14 80 ;对照组 1.2 0 40± 0 .15 31,P <0 .0 5 ) ,流式细胞术则显示其凋亡率较其他各组明显增高 ( pBP PTEN HA组 11.6 8% ;pBP PTENG 12 9R HA组 4.45 % ;pBP组 3 .5 1% ;对照组 2 .2 7%。P <0 .0 5或P <0 .0 1)。结论　PTEN基因转染可抑制胰腺癌细胞体外生长 ,而这种抑制作用有赖其磷酸酯酶活性并与其促发肿瘤细胞凋亡有关。     

乙型肝炎病毒x蛋白对人肝癌细胞增殖和凋亡的影响

目的探讨乙型肝炎病毒x蛋白 (hepatitisBvirusxprotein ,HBx)在体内外对人肝癌细胞增殖和凋亡的影响。方法将携带HBx基因的表达质粒 pHA HBx转染HepG2细胞 ,通过检测细胞生长曲线、倍增时间和3 H TdR掺入率观察HBx对细胞增殖活性的影响 ;将整合HBx基因的HepG2细胞接种裸鼠 ,建立表达HBx的人肝癌裸鼠模型 ,用阿霉素进行裸鼠腹腔化学药物治疗 ,观察肝癌组织的生长状况 ;用TUNEL方法检测切除的裸鼠癌标本中凋亡细胞的比例。结果转染HBx基因的HepG2细胞倍增时间为 2 8 5h ,对照组为 32 5h ;3 H TdR掺入率 :转染HBx基因组为 (10 2 1± 78)cpm ,对照组为 (85 9± 6 9)cpm ,转染组细胞明显高于对照组细胞 (t =2 5 4 ,P <0 0 1) ;转染HBx基因的细胞在裸鼠体内形成的癌重量为 (3 10± 0 39) g ,对照组癌重量为 (2 6 1± 0 2 8) g ,两组之间差异有显著意义 (t=2 0 3,P <0 0 5 ) ;裸鼠腹腔化学药物治疗后 ,转染组的癌细胞凋亡为 3 5±0 75 ,对照组为 2 2 5± 6 5 ,转染HBx基因的细胞凋亡明显减少 (χ2 =6 6 9,P <0 0 1)。结论HBx可以提高HepG2细胞的增殖活性 ,促进裸鼠体内肝癌生长 ,对阿霉素诱导的肝癌细胞凋亡具有抑制作用。     

人抑癌基因PTEN对前列腺癌细胞系生物学行为的影响

目的　探讨外源性人抑癌基因PTEN表达对前列腺癌细胞系LNCaP、DU 14 5细胞增殖和侵袭转移能力的影响。　方法　利用携带人PTEN基因的可调控性腺病毒 (Ad PTEN ) ,体外转染人前列腺癌细胞系LNCaP、DU 14 5,RT PCR、Westernblot检测目的基因不同水平的表达 ,通过细胞生长试验、流式细胞仪分析技术以及Boyden小室法检测LNCaP、DU 14 5转染前后细胞增殖、细胞周期、细胞凋亡和细胞体外侵袭力的变化。　结果　转染Ad PTEN后LNCaP、DU 14 5细胞的PTEN表达由阴性转为阳性 ,转染后对LNCaP、DU 14 5细胞生长有抑制作用 ,阻滞于G0 ～G1期 ,早期细胞凋亡率增加 ,LNCaP细胞 (6.89± 0 .51) % ;DU14 5细胞 (5.44± 1.13 ) % ,与对照组相比差异有显著性 ,Boyden小室法检测转染后体外侵袭力受到明显抑制。 　结论　重组腺病毒介导的人PTEN基因在体外对前列腺癌细胞系LNCaP、DU 14 5的细胞增殖和体外侵袭力有明显抑制作用 ,可望作为前列腺癌基因治疗的有效工具     

Bax对HCC-9204细胞系的凋亡及化疗敏感性的影响

目的研究Bax对HCC-9204细胞系凋亡和对阿霉素敏感性的影响。方法采用脂质体转染法将Bax基因转入HCC-9204细胞中。免疫组织化学分析Bax在HCC-9204细胞中的表达,TUNEL及细胞周期分析细胞凋亡,MTT实验判断肿瘤细胞的活力。结果免疫组化结果显示转染Bax基因的HCC-9204/Bax细胞的Bax表达显著增加。TUNEL检测显示,HCC-9204/Bax细胞的凋亡指数在ZnSO4诱导后24、48h明显增加(3·6±5·3vs27·2±10·5,t=63·45,P<0·05;4·2±4·1vs32·3±8·6,t=93·27;P<0·05),流式细胞仪分析显示,诱导后48h出现显著的“亚二倍体峰”。MTT实验显示Bax基因的过表达能够降低阿霉素处理后的细胞活力,呈时间依赖性。结论Bax基因不仅可以诱导HCC-9204细胞的凋亡,而且能够增加HCC-9204细胞对阿霉素杀伤作用的敏感性。     

葡萄籽多酚逆转人乳腺癌多药耐药性及其机制的研究

目的探讨葡萄籽多酚 (grapeseedpolyphenols ,GSP)逆转肿瘤多药耐药的作用及其相关机制。方法以人乳腺癌MCF 7细胞及其耐药株MCF 7/ADR细胞作为实验对象 ,用MTT法观察GSP对MDR的逆转作用 ,采用Westernblot、Northernblot检测GSP对MDR1基因表达的影响 ;流式细胞术 (FCM)观察GSP对P 糖蛋白 (P gp)功能的影响。结果非细胞毒性剂量GSP 1 2mg/L、2 4mg/L均能逆转MCF 7/ADR细胞的多药耐药性 ,逆转倍数分别为 5 77和 9 79倍 ;1 2mg/L、2 4mg/LGSP分别使P gp表达降至对照组的 80 83% (t=5 5 8,P <0 0 5 )和 5 0 81% (t =10 96 ,P <0 0 1) ;1 2mg/L、2 4mg/LGSP下调MDR1mRNA表达 ,降至对照组的 6 0 92 % (t =16 0 3,P <0 0 0 5 )和 4 2 0 5 % (t =2 1 70 ,P <0 0 0 5 ) ;2 4mg/LGSP可增加细胞内阿霉素 (ADM)的积累。结论体外试验证实GSP具有多药耐药逆转作用 ,是一种潜在的化疗增敏剂。     

RNAi对GBC-SD细胞survivin基因表达及阿霉素敏感性的影响

目的 利用RNA干扰(KNAi)技术沉默人胆囊癌GBC-SD细胞中抗凋亡基因survivin,观察survivin基因表达的变化以及其对阿霉素的敏感性.方法 将靶向survivin的基因片段插入到栽体后构建重组质粒,将其导入GBC-SD细胞,RT-PCR及Westem-blotting法检测转染前后GBC-SD细胞survivin mRNA及蛋白水平的表达情况,MTT法检测转染前后GBC-SD细胞对阿霉素的敏感性变化.结果 成功构建重组质粒.转染重组质粒后,GBC-SD细胞survivin mRNA和蛋白的表达明显降低;转染前后阿霉素对GBC-SD细胞生存率具显著影响.结论 靶向survivin的RNAi表达载体能下调survivin基因表达,进而增强阿霉素对GBC-SD细胞化疗敏感性.     

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.     

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.     

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.