骨形态发生蛋白-7在幼年大鼠肾小管间质损伤中的表达及意义

目的：探讨单侧输尿管梗阻（UUO）幼年大鼠肾间质纤维化形成过程中骨形态发生蛋白-7（BMP-7）的表达趋势及其与转化生长因子-β1（TGF-β1）、α-平滑肌肌动蛋白（α-SMA）的相关关系;观察血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体拮抗剂（ARB）的干预作用。方法：采用单侧输尿管结扎制备UUO模型。3～4周龄幼年Wistar雄性大鼠随机分为对照组、模型组和干预组。于实验第3、7、14、28天取大鼠8只处死。HE及Masson染色观察肾组织的病理改变;免疫组化半定量检测各组大鼠肾组织BMP-7、TGF-β1及α-SMA蛋白表达。了解BMP-7与TGF-β1、α-SMA、肾间质纤维化程度的关系。结果：随梗阻时间延长,模型组BMP-7表达逐渐下降,TGF-β1、α-SMA表达进行性增高,干预组BMP-7表达较模型组显著增加（P〈0.05）;TGF-β1、α-SMA表达较模型组明显减少（P〈0.05）。模型组肾小管间质TGF-β1、α-SMA表达明显增高（P〈0.05）,BMP-7表达显著减少（P〈0.05）。与模型组相比,干预组肾小管间质TGF-β1、α-SMA表达显著减少（P〈0.05）,而BMP-7表达显著增多（P〈0.05）。BMP-7与TGF-β1、α-SMA、肾间质纤维化程度成负相关（r分别为-0.844、-0.787、-0.952,P均〈0.01）。结论：BMP-7表达减少伴随着肾小管上皮细胞转分化出现,提示BMP-7可能具有维持小管上皮细胞表型作用。苯那普利联合氯沙坦可能通过下调TGF-β1、α-SMA蛋白的异常高表达,上调BMP-7蛋白的异常低表达,直接或间接负性调控肾小管上皮细胞转分化,阻止肾间质纤维化进展。     

输尿管逆向注射重组腺病毒介导的BMP-7对大鼠肾间质纤维化的作用

目的：构建出具有转染后能表达活性的骨形成蛋白-7（BMP-7）的重组腺病毒,将其直接导入肾纤维化大鼠肾脏,观察其抗肾纤维化的作用。方法：无菌级雄性SD大鼠48只随机分为假手术组、单侧输尿管梗阻（UUO组）组、BMP-7治疗组,以免疫组织化学方法检测肾组织中α-SMA蛋白的表达水平,以逆转录-多聚酶链反应技术检测TGF-β1的表达水平。结果：免疫组化结果示：BMP-7组肾小管间质α-SMA表达显著减少（P〈0.05）。RT-PCR结果显示：TGF-β1随梗阻时间延长而逐渐增多,第28天,有所下降,但无统计学意义。在治疗组,BMP-7组比同一识相点UUO组TGF-β1表达减少（P〈0.05）。结论：BMP-7能够明显减轻肾间质纤维化,下调TGF-β1的表达,从而发挥其在单侧输尿管结扎模型中对肾脏的保护作用,延缓和抑制了肾间质纤维化的发展。     

维甲酸抑制大鼠单侧输尿管梗阻模型肾间质纤维化

目的探讨维甲酸对大鼠单侧输尿管梗阻(UUO)模型肾间质纤维化的影响。方法建立大鼠UUO模型前2d治疗组和对照组分别每天给予10mg/kg全反式维甲酸或溶媒皮下注射。观察模型第3、7和12天肾小管损害百分比、肾间质纤维化程度、肾间质巨噬细胞数、肾间质α-平滑肌肌动蛋白(α-SMA)、胶原Ⅲ和单核细胞趋化蛋白-1(MCP-1)mRNA的表达。结果维甲酸显著减轻肾小管损害和肾间质纤维化(P<0.01)。治疗组肾间质巨噬细胞数和肾间质α-SMA表达显著低于对照组(P<0.01)。维甲酸显著抑制胶原Ⅲ和MCP-1mRNA表达(P<0.01)。结论维甲酸减少大鼠UUO模型肾间质巨噬细胞浸润、降低胶原Ⅲ和MCP-1mRNA表达、抑制α-SMA蛋白的表达,从而减轻肾间质纤维化。     

转化生长因子-β1 在梗阻性肾病大鼠肾小管间质纤维化中的作用

目的探讨转化生长因子 (TGF) -β1在梗阻性肾病(UUO)大鼠梗阻肾中致肾小管间质进行性纤维化的作用.方法成年SD大鼠制成UUO模型,在梗阻后3、7、10、14 d处死.免疫组织化学染色法对其肾内α-平滑肌肌动蛋白(SMA)沉积量及侵入肾内的单核巨噬细胞数进行分析;逆转录多聚酶链反应(RT-PCR)对大鼠TGF-β1 mRNA、金属蛋白酶组织抑制剂(TIMP)-1 mRNA及IV型胶原(Col-IV) mRNA转录量进行分析.结果随梗阻时间延长,侵入梗阻肾内单核巨噬细胞数、α-SMA沉积、Col-IV mRNA及TIMP-1 mRNA含量增加;示肾小管间质存在进行性纤维化.同时TGF-β1 mRNA含量明显增加,差异统计学意义(P<0.05).结论 TGF-β1促使梗阻性肾病大鼠肾小管间质进行性纤维化.     

金属蛋白酶组织抑制剂1在大鼠肾小管间质损害中的表达及其意义

目的 观察单侧输尿管梗阻(UUO)大鼠模型中金属蛋白酶组织抑制剂1(TIMP-1)在肾小管间质中的表达部位、动态变化及其与肾小管问质损害的关系。方法 制备UUO大鼠模型,采用免疫组织化学方法检测UUO术后第1、3、5、7、14天肾小管间质中TIMP-1、α-平滑肌肌动蛋白(SMA)、增殖细胞核抗原(PCNA)和单核巨噬细胞抗原(ED)-1的表达及其与输尿管梗阻后肾小管间质损害的关系。结果 UUO术后第1天肾间质可见少量TIMP-1表达细胞,第3～7天TIMP-1表达明显增加,主要表达于肾小管上皮细胞和肾间质。UUO术后第3天肾小管PCNA表达达高峰,随后下降,而肾间质PCNA水平于第7～14天仍较高。UUO术后第3天肾间质成纤维细胞及肾小管上皮细胞可检出α-SMA表达并随时间递增。α-SMA阳性面积与肾间质相对面积成正相关(r=0.924,p<0.01)。TIMP-1表达与间质相对面积(r=0.835,P<0.05)及α-SMA阳性面积(r=0.922,P<0.01)成正相关。结论 TIMP-1蛋白质于肾小管间质病变早期表达于肾小管间质,早于肾间质纤维化出现,其表达量与肾间质α-SMA表达及肾间质相对面积呈正相关并随病变进展逐渐增加。TIMP-1在肾小管上皮细胞和问质细胞的高表达及肾小管上皮细胞和间质细胞增殖可能参与介导UUO术后肾小管间质损害。     

丹参注射液对大鼠梗阻性肾间质纤维化的保护作用

目的：探讨丹参注射液对梗阻性大鼠肾间质纤维化的影响。方法：30只雌性SD大鼠，随机分为假手术组，造模组和丹参组，以单侧输尿管结扎术建立输尿管梗阻的动物模型。术后第10d取术侧肾组织做HE，PAS染色及TFG-β1，α-SMA，I型胶原免疫组化检测并以反转录-PCR（RT-PCR）方法对肾皮质TGF-β1mRNA表达作半定量分析。结果：丹参组显改善梗阻侧肾组织病理变化。下调TGF-β1mRNA及蛋白表达，减少α-SMA表达及Ⅰ型胶原沉积，结论：丹参注射液对梗阻性大鼠肾间质纤维化有保护作用。     

丹酚酸B对输尿管梗阻大鼠肾小管上皮细胞转分化的影响

目的:探讨丹酚酸B对输尿管梗阻大鼠肾小管上皮细胞转分化影响及作用机制.方法:雄性SD大鼠,建立单侧输尿管梗阻模型(UUO).设假手术组、模型组、治疗组(丹酚酸B 30 mg·kg-1·d-1)术后第9天处死各组大鼠.采用光镜观察肾间质纤维化、炎细胞浸润,免疫组化观察肾组织转化生长因子-β1(TGF-β1)、α平滑肌肌动蛋白(α-SMA)和Vimentin蛋白表达的变化.结果:(1)治疗组大鼠肾间质纤维化程度较模型组明显减轻;(2)UUO模型第9天时大鼠肾组织TGF-β、α-SMA和Vimentin表达明显增强,炎细胞浸润明显增加.采用丹酚酸B治疗后,肾组织TGF-β1、α-SMA和Vimentin表达的异常增强能得到有效抑制,炎细胞浸润明显减少.结论:丹酚酸B具有减轻肾组织纤维化的作用,而这一作用与其能有效抑制炎细胞浸润和TGF-β1过度表达,进一步阻押肾小管上皮细胞转分化(EMT)有关.     

血小板衍生生长因子-D和缺氧诱导因子-1α在肾间质纤维化小鼠肾组织的表达

目的:探讨血小板衍生生长因子-D(PDGF-D)与缺氧诱导因子-1α(hypoxia-inducible factor-1α,HIF-1α)在单侧输尿管梗阻小鼠肾间质纤维化模型中肾组织的表达。方法:60只雄性SD大鼠随机分为假手术组(sham-operated rats,SOR)和单侧输尿管梗阻(ulilateral ureteral obstruction,UUO)模型组。术后第3天、7天、14天各处死大鼠10只,肾组织行HE染色并观察病理变化。采用免疫组织化学和荧光定量逆转录一聚合酶链反应(Q-RT-PCR)法检测肾脏组织中PDGF-D、HIF-1α、TGF-β_1蛋白和mRNA表达。结果:与假手术组相比,模型组大鼠肾脏病理损害进行性加重;PDGF-D、HIF-1α、TGF-β_1蛋白表达随梗阻时间的延长逐渐增加;与假手术组相比,PDGF-D、HIF-1α、TGF-β_1mRNA表达明显增加(P0.05),相关分析显示,模型组第3天PDGF-D mRNA表达与HIF-1αmRNA,TGF-β_1mRNA表达分别呈正相关(r=0.748,0.659,P0.05)。结论:PDGF-D可能通过调节HIF-1α,TGF-β_1的表达参与了肾间质纤维化发生和发展的过程。     

依那普利对单侧尿路梗阻大鼠肾组织Smad 2/3活性的影响

目的:研究血管紧张素转换酶抑制剂(ACEI)依那普利对单侧尿路梗阻大鼠肾组织Smad2/3信号蛋白活性的影响.方法:采用单侧输尿管结扎(UUO)模型,治疗组从造模前24 h至造模后28 d以依那普利10 mg·kg-1·d-1灌胃,另设假手术组作正常对照.分别于造模后1,3,7,14,21和28 d取肾组织,应用免疫组化法检测肾组织TGF-β1、磷酸化Smad2/3和α-SMA表达.结果:正常大鼠肾组织具有基础的TGF-β1(4.32±1.72)%和磷酸化Smad 2/3(19.31±5.37)个/mm2的表达,α-SMA只表达于血管平滑肌,肾小管-间质无表达.UUO术后1 d,TGF-β1的表达无明显增加(5.15±2.08)%,第3 d明显增加(13.55±6.33)%,第7 d达高峰(26.78±8.77)%,此后表达减少;UUO术后3 d,磷酸化Smad2/3的表达明显增加(67.95±13.87)个/mm2,并持续增加到第7 d(150.61±27.34)个/mm2,此后表达减少;而UUO术后3 d,肾组织α-SMA表达亦明显升高(5.58±1.23)%,第7 d达到高峰(13.43±3.32)%,14 d表达开始下调.依那普利治疗可以明显抑制肾组织TGF-β1信号蛋白Smad2/3活性(降低39%～55%,P＜0.01),显著下调肾组织α-SMA的表达(降低44%～58%,P＜0.01),减轻肾间质纤维化.结论:依那普利可显著抑制梗阻肾肾组织α-SMA的表达,减轻梗阻肾间质纤维化,这一作用可能与其抑制肾组织TGF-β1信号蛋白Smad2/3的活性有关.     

绞股蓝总皂苷防治单侧输尿管结扎大鼠肾间质纤维化的实验研究

目的探讨绞股蓝总皂苷(GPs)对单侧输尿管结扎(UUO)大鼠肾组织结缔组织生长因子(CTGF)表达及肾间质纤维化的影响。方法采用UUO大鼠模型,将大鼠随机分为3组假手术组、模型组、GPs组。假手术组和模型组仅给予标准饲料30g,GPs组于术前3d至术后9d每天给予GPs200mg·kg-1·d-1灌胃,第9d处死各组大鼠。免疫组化法检测各组肾组织CTGF、转换生长因子β1(TGF-β1)和α-平滑肌肌动蛋白(α-SMA)的表达;RT-PCR方法检测各组CTGFmRNA含量;Masson染色评定各组肾小管间质损害程度。结果模型组CTGF、TGF-β1、α-SMA的表达及肾小管间质损伤指数明显高于假手术组(P<0.01),而GPs组各项指标明显低于模型组(P<0.01)。各项指标作相关分析,CTGF与肾小管间质损伤指数(r=0.788,P<0.01)、TGF-β1(r=0.879,P<0.01)、α-SMA(r=0.940,P<0.01)为正相关关系。结论绞股蓝总皂苷可以抑制肾纤维化时结缔组织生长因子表达,从而遏制肾纤维化的进展。     

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.