P选择素在胃癌,肾癌中表达及其意义

目的：Ｐ选择素可介导血小板、内皮细胞与肿瘤细胞相互粘附和作用，本研究探讨了Ｐ选择素与肿瘤转移的关系。方法：用Ｐ选择素单抗和免疫组化技术，检测６０例胃癌和２０例肾癌组织Ｐ选择素表达，并对５５例胃癌作５年以上随访。结果：６０例胃癌组织中Ｐ选择素阳性表达为３２例，阳性率为５３．３％；２０例肾癌的阳性表达１１例，阳性率为５５．０％。Ｐ选择素不仅在肿瘤血管内皮上表达，也可在肿瘤细胞膜上表达。胃癌淋巴结转移者     

P53、nm23基因变化与胃癌转移及预后的研究

目的:探讨P53、nm23基因在人胃癌组织中的表达及其与淋巴转移和预后的关系。材料和方法:胃癌切除术的手术标本(共93例)。采用免疫组织化学法。结果:P53阳性率为49.4％(46/93),nm23为56％(52/93)。P53阳性表达与胃癌患者的年龄、性别、肿瘤组织学分型、浸润深度、淋巴结转移之间无显著性差异,但与胃癌患者预后有统计学意义。nm23低表达与淋巴结转移及预后有显著的相关性。93例胃癌组织中的淋巴结转移者63例,其中nm23表达阳性28例(44％),无转移者30例,其中nm23阳性表达24例(80％),二组之间有非常显著的差异(P<0.01)。nm23表达阳性组1,3,5年生存率分别为80％、65％和24％,而表达阴性者1,3,5年生存率为68％、41％和21％。二组间生存分布差异有显著性(P<0.05)。结论:胃癌nm23低表达有发生淋巴结转移倾向,P53高表达和nm23低表达患者预后差。P53、nm23基因变化对胃癌淋巴结转移和预后起重要作用。     

葡萄糖转运蛋白1在胃癌组织及转移淋巴结中的表达及其与预后的关系

目的研究葡萄糖转运蛋白1（GLUT1）在胃癌组织及转移淋巴结中的表达特点,探讨其与肿瘤生物学特征和患者预后之间的关系。方法采用免疫组织化学方法对79例胃癌组织及癌旁正常胃组织GLUT1表达特征进行分析.并分析其预后与GLUT1表达的关系。结果高、中、低分化腺癌患者GLUT1表达阳性率分别为56.5％、33.3％和36.0％;黏液腺癌和印戒细胞癌GLUT1表达阳性率分别为1／6和7.7％（1／13）。GLUT1表达阳性率与肿瘤最大直径（P〈0.01）、有无淋巴结转移（P=0.032）和胃癌临床分期（P=0.007）等因素相关。转移淋巴结GLUT1阳性表达率为12.6％。GLUT1阳性组和阴性组1年生存率分别为64.3％和90.2％（P=0.035）。结论GLUT1表达与胃癌的侵袭性指标相关,可能是胃癌预后不良的一个标志。     

细胞间粘附分子-1在胃癌组织中的表达及临床意义

目的:探讨细胞间粘附分子-1(ICAM-1)在胃癌中的表达及其临床意义。方法:采用免疫组织化学法检测胃癌组织中ICAM-1的表达情况,并与临床病理参数作相关分析。结果:58例胃癌组织中,ICAM-1的阳性表达率为34.5%,其表达率与肿瘤浸润深度、肝转移及血管侵犯无明显相关(P＞0.05);ICAM-1表达阳性率在肠型胃癌显著高于弥漫型胃癌(P＜0.01),淋巴结转移者显著低于无淋巴结转移者(P＜0.01);随肿瘤TNM分期的增高,ICAM-1的阳性表达率也逐渐下降(P＜0.05)。结论:胃癌组织中ICAM-1表达与淋巴结转移和肿瘤分期密切相关。     

粘附分子P选择素在肾癌中的表达

为探讨Ｐ选择素在肾癌中的表达意义，应用免疫组化链菌素抗生物素蛋白生物素酶标法（ＬＳＡＢ）法检测２０例肾癌患者肾组织中Ｐ选择素表达。结果发现，Ｐ选择素阳性表达率为５５５％（１１／２０），不仅在肿瘤血管内皮上表达，也在肿瘤细胞膜上表达。晚期肾癌（Ⅲ、Ⅳ期）阳性表达率为８７５％（７／８），明显高于早期肾癌（Ⅰ、Ⅱ期）的３３３％（４／１２），Ｐ＜００５。提示Ｐ选择素与肾癌浸润转移有关，并可能是一种新的肾癌转移及预后指标。     

CD_(15)和P_(-gp)在胃癌组织中表达的临床意义

目的:探讨胃癌CD_(15)表达的意义及其与P-gp表达之间的关系。方法:应用微波-LSAB免疫组织化学法对95例胃癌组织进行CD_(15)和P-gp检测。结果:CD_(15)和P-gp表达阳性率分别为86.3％和70.7％。CD_(15)和P-gp均与肿瘤浸润、转移相关。CD_(15)阳性表达率在胃癌浸润至肌层和浆膜层者明显高于浸润至粘膜层及粘膜下层(P<0.05),伴有淋巴结转移组明显高于无转移组(P<0.05)。P-gp阳性表达率在胃癌浸润至浆膜层者明显高于浸润至肌层和粘膜层及粘膜下层者(P<0.05),伴有淋巴结转移组明显高于无转移组(P<0.05)。CD_(16)表达与P-gp表达有一定关联。结论:CD_(15)与P-gp在胃癌表达具有一致性。     

胃粘膜上皮异型增生和胃癌组织CD44V6表达的免疫组化研究

探讨CD44V6表达与胃癌发生发展的关系。方法:采用免疫组化染色方法,检测20例正常胃粘膜上皮、43例异型增生和85例胃癌组织CD44V6的表达情况。结果:正常胃粘膜无CD44V6表达;异型增生CD44V6的阳性表达率为30.2％(13/43),CD44V6表达阳性率与异型增生严重程度密切相关(P<0.05);胃癌组织阳性率为74.1％(63/85),其表达阳性率和染色强度均显著高于异型增生(P<0.05),CD44V6表达强度与胃癌浸润深度(P<0.05)、淋巴结转移(P<0.01)、肿瘤生长方式(P<0.05)、静脉和淋巴管侵袭(P<0.05)及远处转移(P<0.05)密切相关,且Ⅰ、Ⅱ期胃癌CD44V6染色强度和阳性率均显著低于Ⅲ、Ⅳ期(P<0.05)。结论:CD44V6上调表达与胃癌的发生发展密切相关,并发生于癌变的早期阶段,检测CD44V6表达有助于胃癌的早期诊断和转移潜能的评估。     

肾透明细胞癌组织中T细胞淋巴瘤侵袭和转移诱导蛋白1表达及其临床意义

目的 探讨肾透明细胞癌组织中T细胞淋巴瘤侵袭和转移诱导蛋白l( T-lymphomainvasion and metastasis 1,Tiam1)的表达与临床病理特征及预后的关系. 方法 选取原发性肾透明细胞癌组织标本107例.男78例,女29例.年龄32～87岁,平均59岁.肿瘤大小按手术切除标本测量.肿瘤最大径1.4～7.6 cm,平均4.5 cm.≤2.5 cm者23例,2.6 ～5.0 cm者65例,＞5.0 cm者19例.有淋巴结转移者46例,有血管浸润者32例.Fuhrman分级:Ⅰ级22例,Ⅱ级41例,Ⅲ级27例,Ⅳ级17例.2002 AJCC TNM分期:T129例,T244例,T3 16例,T4 18例.20例正常肾组织标本作为对照组.免疫组织化学方法检测标本中Tiam1蛋白表达,结合临床病理学资料进行分析.随访5～8年,生存分析采用Kaplan-Meier法,组间差异采用Log-rank检验. 结果 20例正常肾组织中Tiam1蛋白阳性表达率为15.0％ (3/20),肿瘤组织中Tiam1蛋白阳性表达率为73.8％ (79/107),组间差异有统计学意义(P＜0.01);Ⅰ～Ⅱ级与Ⅲ～Ⅳ级肾癌组织中Tiam1蛋白高表达阳性率分别为47.6％( 30/63)、72.7％( 32/44),T1～T2期与T3 ～T4期肾癌组织分别为49.3％(36/73)、76.5％ (26/34),无淋巴结转移组与有淋巴结转移组分别为47.5％ (29/61)、71.7％ (33/46),无血管浸润组与有血管浸润组分别为48.0％(36/75)、81.3％(26/32),组间差异均有统计学意义(P＜0.01).Tiam1蛋白高表达组与低表达组患者术后5年生存率分别为46.8％(29/62)、84.4％( 38/45),组间差异有统计学意义(P＜0.05). 结论 肾癌组织中Tiam1蛋白阳性表达率明显高于正常组织,Tiam1蛋白高表达与肾癌的分期、分级、淋巴结转移、血管浸润有关,与患者性别、年龄、肿瘤大小无相关性.检测Tiam1蛋白有助于肾癌的诊断及预后评估.     

胃良性和恶性病变组织中β-半乳糖凝集素3和接骨木凝集素的表达及其临床病理意义

目的研究胃良性和恶性病变组织中β-半乳糖凝集素-3（gal-3）和接骨木凝集素（SNA）的表达水平及其临床病理意义。方法将49例胃癌、20例癌旁组织、36例淋巴结转移灶和80例不同类型胃良性病变手术切除或胃镜活检标本常规制作石蜡包埋切片,gal-3染色方法为EnVision^TM免疫组织化学（免疫组化）法,SNA染色方法为ABC亲和组化法。结果胃癌组织gal-3和SNA表达阳性率明显高于癌旁组织及不同类型胃良性病变者（P〈0.05,P〈0.01）.阳性表达的胃良性病变标本和癌旁组织均呈不同程度不典型增生;淋巴结转移灶gal-3和SNA阳性率分别为63.9％和55.6％,与其相应的原发病灶gal-3和SNA阳性率（72.2％和66.7％）比较,差异无统计学意义（P〉0.05）。组织学分级Ⅱ级、浸润深度T1和T2及无区域淋巴结转移的胃癌组织gal-3和SNA表达阳性率明显低于组织学分级Ⅲ、Ⅳ级和浸润深度T3、T4及区域淋巴结转移者（P〈0.05）;淋巴结转移N1及无远处器官转移胃癌组织gal-3和SNA表达阳性率低于淋巴结转移N2、N3,站及远处器官转移的胃癌组织。但差异均无统计学意义（P〉0.05）;胃癌组织中,31例gal-3表达阳性病例中SNA阳性22例,两者表达呈明显一致性（X^2=6.59,P〈0.05）。结论gal-3和SNA表达水平可能是反映胃癌发生、进展及其临床生物学行为的重要凝集素分子标记物。     

胃良恶性病变组织中TAG72和GRP94表达及其临床病理意义

目的研究胃良恶性病变组织中肿瘤相关糖蛋白72(TAG72)和葡萄糖调节蛋白94(GRP94)表达水平及其临床病理意义。方法将49例胃癌,20例癌旁组织,36例淋巴结转移灶及80例不同类型胃良性病变患者手术切除标本或胃镜活检标本行常规石蜡切片,采用免疫组化法检测TAG72和GRP94的表达。结果胃癌组织TAG72和GRP94表达阳性率高于癌旁组织及各类型胃良性病变(P<0.05或P<0.01);TAG72和/或GRP94阳性表达的癌旁组织及胃良性病变黏膜上皮均呈轻至重度不典型增生;胃癌原发灶与相应淋巴结转移灶之间TAG72和GRP94表达阳性率均无统计学差异(均P>0.05);浸润深度T1+T2者、无区域淋巴结转移及无远处器官转移者TAG72和GRP94表达阳性率均明显低于浸润深度T3+T4者、区域淋巴结转移及远处器官转移者(P<0.05或P<0.01);组织学分级II级及N1站淋巴结转移者TAG72和GRP94表达阳性率低于组织学III+IV级及N2+N3站淋巴结转移者,但差异均无统计学意义(均P>0.05)。结论 TAG72和GRP94表达水平对胃癌发生、进展和临床生物学行为方面可能有促进作用,TAG72和...     

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.     

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.     

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.