Study of the mode of operation of the equipment for membrane extraction of substances from the blood in emulsions

The authors suggest an apparatus make-up for cholesterol extraction in multiple emulsion from blood. It is intended for homeostasis correction according to the hemoperfusion scheme with the use of this apparatus instead of the hemoperfusion one. The influence of the velocity of the blood flow, the rate of stirring and emulsion volume on the modes of operation of the apparatus was investigated. The most efficient mode of operation was chosen, according to which the entry of the extracting agent into the body was completely excluded whereas emulsion saturation with cholesterol was reached after 1.5 h. A series of animal experiments were carried out using the same apparatus but 10 times smaller, with the emulsion containing ethanol and diethyl ether in the internal phase. The mean degree of cholesterol extraction amounted to 22.4%, while the main biochemical components of blood remained unchanged.     

University of Wisconsin solution with butanedione monoxime and calcium improves rat lung preservation

BACKGROUND: A limitation to fully using lung transplantation for patients with end-stage lung diseases is short, safe preservation time (4 to 6 hours). Our goal is to extend this to 24 hours or more, which would greatly improve clinical lung transplantation. METHODS: We used the isolated perfused rat lung to test how two preservation solutions (low potassium dextran and University of Wisconsin solution) affected quality of lungs after 6, 12, and 24 hours of preservation. Also, we tested modifications of the University of Wisconsin solution, including reversing the ratio of Na/K, the addition of 1.5 mmol/L calcium, and the combination of calcium and butanedione monoxime, agents that improve cardiac preservation. After preservation at 4 degrees C, lungs were reperfused at 37 degrees C with a physiologically balanced solution. Pulmonary artery flow rate, airway peak inspiratory pressure, and tissue edema were used to assess degree of preservation and reperfusion injury. RESULTS: Low potassium dextran solution gave poor preservation (decreased pulmonary artery flow, tissue edema) after 12 hours of cold storage. There were no differences between regular and reversed Na/K ratio University of Wisconsin solutions at 12 or 24 hours of preservation. Addition of calcium had no beneficial effect on lung preservation. However, University of Wisconsin solution with calcium and butanedione monoxime gave excellent 24-hour cold storage, with pulmonary artery flow rate, tissue edema, and airway peak inspiratory pressure equal to control (0 hours of preservation) lungs. CONCLUSIONS: The University of Wisconsin solution appears capable of lung preservation for up to 24 hours if modified to contain calcium and butanedione monoxime. The mechanism of action of butanedione monoxime may be related to the suppression of smooth muscle contraction resulting in vasodilation of the cold-stored lung on reperfusion.     

Pre-operative diagnosis of obturator hernia: a report of two cases

Obturator hernias are rare, accounting for less than 1.5% of all hernias, and usually present with acute intestinal obstruction requiring emergency surgery. They are rarely diagnosed in the elective setting. We discuss two cases, a 52-year-old man and a 71-year-old woman, both presenting electively with a history suggestive of occult groin hernia; neither had a palpable lump. They both underwent out-patient herniography which demonstrated obturator hernia and both patients subsequently had elective laparoscopic repair, with good results. A high index of suspicion along with appropriate use of imaging modality allows for early identification of this rare condition. Early intervention can prevent the morbidity and mortality associated with complicated obturator hernia.     

Changes in Surface Charge of Low-Density Lipoproteins during Oxidative Modification

The negative surface charge of low-density lipoproteins increased during their oxidative modification induced by autooxidation at 37°C. The degree of changes depended on the time of autooxidation: the surface charge remained practically unchanged after short-term oxidation (6-h incubation), but then progressively increased and after 24-h oxidation it 2-fold surpassed the initial level. Long-term incubation of low-density lipoproteins in the presence of EDTA inhibiting lipid peroxidation did not change their surface charge. These changes probably contribute to atherogenic activity of oxidized low-density lipoproteins. The degree of oxidative modification of low-density lipoproteins was precisely estimated using fluorescence probes.     

Correlations between electrophysiological myocardial remodeling and parameters of free radical oxidation in patients with various forms of ischemic heart disease

AIM: To investigate potentialities of a novel biochemical test assessing oxidative resistance of plasma as a marker of ischemic damage to the myocardium and to study this marker correlation with high-performance ECG parameters reflecting electrophysiological remodeling of the myocardium in patients with ischemic heart disease (IHD). MATERIAL AND METHODS: A total of 145 IHD patients entered the trial: 32 patients free of effort angina, 67patients with stable effort angina of functional class (FC) II-III, 56 patients with acute coronary syndrome (ACS) and 32 healthy controls. ACS patients were examined according to the following protocol: stage 1--6-12 hours since the disease onset, stage 2--at the end of the first 24 hours, stage 3--day 5-7 of the disease. In ACS patients the following outcomes (end points) were evaluated: recurrent myocardial infarction (MI), hospitalization because of exacerbation of IHD, documented potentially harmful arrhythmias and death within 1 year. High-performance ECG and a novel biochemical test of plasma oxidizability were used. The latter was determined by accumulation of malonic dialdehyde after 24 hours of incubation with 20 mcM of copper sulphate. RESULTS: A correlation was found between activity offree radical processes and electrophysiological remodeling of the myocardium by high-performance ECG. Amplitude and temporal characteristics of QRS complex and P wave can be used for follow-up of progression and severity of IHD in addition to standard electrocardiography. CONCLUSION: Unidirectional changes of high-performance ECG, plasma oxidizability and severity of IHD course allow using them as novel diagnostic tests of ischemic lesion and electrophysiological remodeling of the myocardium, for estimation of IHD severity.     

THe role of portal bacteremia and endotoxinemia in the pathogenesis of multiple organ failure in peritonitis]

The indices of portal bacteremia and endotoxinemia, parameters of metabolism, hepatic hemodynamics, the phagocytic function of the liver and leukocyte reaction were studied in 13 patients with diffuse peritonitis of different etiology. Close interconnections of the level of portal toxemia is shown with the degree of activation of the phagocytic function of the liver, changes in hepatic hemodynamics, degree of metabolic disturbances playing an important role in pathogenesis of polyorganic insufficiency as well as the role of leukocytic reaction in microendocrinous regulation of metabolism in peritonitis.     

Activity of certain enzymes in cadaver renal transplants

Enzyme studies are valuable additional methods of investigation and may be useful in early diagnosis of rejection after cadaver kidney transplantation. The complex enzyme activity should be studied. The determination of urinary enzyme activity is of greater diagnostic importance than that in blood.