Reperfusion injury induced by augumented oxygen uptake in the initial reperfusion period. Possible efficacy of extreme hemodilution

This study was designed to investigate the relationship between myocardial oxygen consumption and oxygen-induced myocardial injury. Dog hearts were exposed to 40 min normothermic ischemia and then reperfused for 10 min with three oxygenated perfusates containing different hemoglobin concentrations and with moderate hemodilution. The experimental groups consist of a moderate hemodilution group (Group M) receiving 8 g/dl of hemoglobin, an extreme hemodilution group (Group E) given 4 g/dl of hemoglobin, and a hemoglobin-free autologous plasma group (Group F). Hearts in the non-ischemic control group (Group C) were also perfused with moderate hemodilution throughout. In Group C, Group M and Group E, the O2 tension of perfusates was maintained at about 100 mmHg and in Group F, at over 300 mmHg. Oxygen extraction at 5 min after reperfusion in Group C was 14%, in Group M and Group E less than 10%, but in Group F 70%. Oxygen consumption in Group F was more than twice that in Group E and surpassed that in Group C. Group M also showed a significant increase in oxygen consumption compared with Group E at 5 min after reperfusion. Among the ischemic groups, Group E showed improvement of left ventricular function almost comparable to Group C accompanied by a rapid decrease in myocardial lactate, improved preservation of myocardial adenine nucleotides and prevention of myocardial lipid peroxidation. In contrast, Group F showed persistently higher values of lipid peroxides and lactate, the poorest recovery of adenine nucleotides, and impairment of left ventricular function.(ABSTRACT TRUNCATED AT 250 WORDS)     

Fetal pulmonary maturity: Relationship between optical density (650 nm) to the lecithin/sphingomyelin ratio and phosphatidylglycerol in amniotic fluid

An optical density value ?0.15 at A_{650 nm} of amniotic fluid obtained through transabdominal amniocentesis from a high risk obstetrical population, which excluded diabetes mellitus, isoimmunization, and amniotic fluid infection, correlated 98.6% with a mature lecithin to sphingomyelin ratio ($\text{L}\text{S}$) ? 2.0% and 41.6% with the presence of phosphatidylglycerol (PG). The corresponding false positive rates were 1.4% and 16.8%, respectively. In 30 infants delivered within 48 h of testing, A_{650 nm} ?0.15 correlated 100% with absence of respiratory distress syndrome. A_{650 nm} is not recommended for Rhesus immunized gestations, diabetic pregnancies and amniotic fluid infection due to a high false positive rate with A_{650 nm} compared to $\text{L}\text{S}$ and PG.     

Inner perineurial cell vulnerability in ischemia

The perineurium of peripheral nerve plays important roles in anatomical organization of fiber groups, in endoneurial fluid homeostasis and in maintenance of tensile strength but little is known about the functional and structural alterations of the perineurium with injury. Large arteries of supply to lower limb of Sprague-Dawley rats were ligated to study the structural reactions of perineurium at 36 h and at 7 days after induction of ischemic injury. Lipid droplets were found to be an early reactive change to ischemia in multiple cell types including perineurial, endothelial and Schwann cells. In peripheral nerve levels showing early myelinated fiber injury the inner perineurial sheath was widened and was undergoing degeneration. The inner layers of perineurial cells showed swelling, organelle disruption and membrane dissolution while outer layers remained intact. Inner perineurial cell degeneration is a prominent early feature of ischemic injury and may be an important mechanism of altered endoneurial homeostasis, fiber function and structure.     

Ataxia teleangiectatica; elektronenmikroskopische Biopsiebefunde des Nervus suralis von 2 Fällen

Zusammenfassung Nach zahlreichen klinischen, elektromyographischen, bioptisch-lichtmikroskopischen und autoptischen Erfahrungen ist auch das periphere Nervensystem häufig am Krankheitsprozeß der Ataxia teleangiectatica (AT) beteiligt. Elektronenmikroskopisch zeigen Suralisbiopsien eines Brüderpaares mit AT eine Speicherung diverser Lipidartikel in Schwannschen Zellen bemarkter und unbemarkter Nervenzellen sowie leichte axonale Degenerationen. Diese Befunde bestätigen weitgehend die Ergebnisse, die Gardner u. Goodman (1969) bei der bisher einzigen derartigen Biopsie beschrieben. Gestützt auf die dargestellten morphologischen Beobachtungen wird eine enzymatische Störung des Lipidmetabolismus oder eine lysosomale Fermentanomalie als pathogenetischer Faktor der AT diskutiert.

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Ataxia teleangiectasia; electron microscopic study of two nerve biopsies

Summary Neumerous clinical, electromyographic and morphological findings are indicating that the peripheral nerve is often involved in ataxia teleangiectasia (AT). Electron micrographs of sural nerves of two brothers with AT reveal various lipid-containing particles within Schwann cells of myelinated fibers and, in addition, a slight axonal degeneration. These results confirm the findings of Gardner and Goodman (1969) in the only biopsy to be reported to date. The morphological alterations demonstrated raise the question whether an enzymatic error of lipid metabolism or a lysosomal enzyme anomaly represent a pathogenetic factor in AT.

     

Ultrastructure and X-ray microanalysis of siderosome

Summary Comparative ultrastructural examination and energy-dispersive electron probe X-ray microanalysis were performed on a long standing skin lesion of hemosiderotic histiocytoma. Iron-containing fine particles present in siderosome were the main element of interest. Qualitative study of spectra over the siderosomes clearly demonstrated the characteristic X-ray energy emitted by iron, whereas spectra obtained from adjacent cytoplasm revealed minimal iron peak. On quantitative evaluation of the spectra yielded from various siderosomes, iron counts intensity was found to be proportionally increased with increment in amount and electron opacity of the siderosomal inclusion. Accounts on chemical nature of the siderosomal inclusion and on the presence of lipid residue in cytoplasm were noted.Supported in part by research funds from the Japanese Dermatological Association and the Japanese Ministry of Education.     

Basic experiments on oral administration of 5-fluorouracil emulsion as adjuvant chemotherapy to surgical treatment for gastric cancer

Oral administration of 5-fluorouracil (5-FU) emulsion was compared experimentally with that of 5-FU aqueous solution as to the degree of absorption and tissue distribution. After oral administration of both the 5-FU emulsion and the 5-FU solution, 5-FU was detected at the highest level in both the stomach and the duodenum. This seems to suggest that 5-FU is strongly affinitive to the tissues of the gastrointestinal tract. As to the relative concentration of these two forms of the drug, the oral administration of the 5-FU emulsion resulted in a maximum value 1.5 times higher than that of the 5-FU solution. An appreciable concentration of 5-FU was maintained for a considerably long time with the administration of 5-FU emulsion. In the lymph, the maximum level of the 5-FU emulsion was three times higher than that of the 5-FU solution. The drug concentration of the 5-FU emulsion remained higher than that of the 5-FU solution through the entire duration of the experiment. Regarding the drug concentration in the regional lymph nodes, the pattern demonstrated was almost the same as in the lymph itself. It is expected that the oral administration of 5-FU emulsion may be useful as an adjuvant to the surgical treatment of gastric cancer, because of the high drug concentration resulting both in the gastrointestinal tract and in the regional lymph nodes.     

Colour Doppler signal enhancement of intrarenal vasculature of the rabbit with Perflubron

The colour Doppler signal enhancement of the intrarenal vasculature of the kidney was studied after intravenous infusion of Perflubron. This enhancement was evaluated qualitatively and semi-quantitatively. Nine rabbits received 1 g/kg of a 100% w/v Perflubron emulsion [perfluorooctylbromide (PFOB), Alliance Pharmaceutical] intravenously. Then, two groups of 2 rabbits received 2 and 3 g/kg respectively, and 1 rabbit received 4 g/kg. The kidneys were imaged longitudinally on a colour Doppler unit with a 7.5 MHz transducer. Signal enhancement was evaluated semi-quantitatively by counting the levels of signal threshold that had to be subtracted to reproduce the baseline image. This measurement was performed 1, 3, 5, 10, 30, 45, 60, 90 and 120 min after infusion. We found that detection of very small vessels deep into the parenchyma was possible with Perflubron. In the group that received 1 g/kg Perflubron significant variations in signal enhancement were noted. The curve of mean signal enhancement showed a maximum Doppler signal at about 15 min, which slightly and progressively decreased during the next hour. With the 2, 3 and 4 g/kg doses, enhancement was constant and proportional to the infused dose. Perflubron emulsion allows significant Doppler enhancement on colour flow imaging, providing better visualisation of deep parenchymal small vessels. A dose of 1 g/kg seems adequate for this purpose.Correspondence to: N. Grenier     

钳夹损伤对周围神经脂质过氧化影响的实验研究

周围神经损伤后的自由基变化研究极少，为了探索自由基在神经损伤及其再生过程中的变化规律，设计了本研究。用钳夹法制作大鼠坐骨神经损伤模型，测定对照组及实验组５个时间点（２，４，６，１１及２１天）坐骨神经脂质过氧化物丙二醛（ｍａｌｏｎｄｉａｌｄｅｈｙｄｅ，ＭＤＡ）和超氧化物歧化酶（ｓｕｐｅｒｏｘｉｄｅｄｉｓｍｕｔａｓｅ，ＳＯＤ）的含量，结果显示实验组５个时间点ＭＤＡ含量均极显著高于对照组，随时间延长呈渐升趋势；ＳＯＤ含量亦均极显著高于对照组，且随时间延长呈渐降趋势。研究提示，钳夹及线扎坐骨神经可引发产生大量的自由基，这对周围神经再生的影响尚不清楚，有待进一步研究。     

Preventive effect of simultaneously infused lipid emulsion against thrombophlebitis during postoperative peripheral parenteral nutrition

A prospective, randomized study was conducted to determine whether simultaneous infusion of lipid emulsion with an amino acid-dextrose-electrolyte solution would reduce the incidence of thrombophlebitis (TP) during postoperative peripheral parenteral nutrition (PPN). Thirty patients who had undergone gastric resection for adenocarcinoma were randomly divided into two groups according to whether they were infused with 10% lipid emulsion (group A) or 5% glucose solution (group B) simultaneously with the amino acid-glucose solutions. The total osmolarity of the infusion solutions in each group was 853 mOsm/l. The incidence of complications due to TP, namely, redness and/or edema beneath the cannula insertion site and/or pain, was investigated. There were no differences in the background characteristics of the patients in groups A and B, except regarding concurrent resection of other organs (P=0.03). The incidence of edema in group A was significantly lower than in group B on postoperative days 2 and 4, although there was no difference in the incidence of redness and pain between the two groups. These findings suggest that the simultaneous infusion of lipid emulsion has a preventive effect against TP during postoperative PPN, and may be a practical means of providing PPN after gastrointestinal surgery.     

Simultaneous assessment of fetal lung maturity and sebaceous gland function by gas chromatography

Lipid profiles were analysed by gas chromatography of underivatised extracts from pellets and supernatant fractions of amniotic fluid (AFP and AFS). Peaks, identified as diglycerides resulting from on column decomposition of phosphoglycerides at high temperature, were obvious in gas chromatograms of AFS. The C₃₂ diglyceride, mainly derived from dipalmityl lecithin, was not a prominent peak in AFS from pregnancies from which babies subsequently developed respiratory distress syndrome. There was evidence of a moderate increase of squalene in AFS and AFP for 10 pregnancies of 36–38 weeks gestation resulting in the birth of small for gestational age babies. The increase was not obvious for 21 out of 22 control pregnancies delivering appropriate for gestational age babies. This demonstrated that we had an assessment of two fetal functions in one chromatographic run, the ratio of C₃₂/C₃₄ diglycerides providing a measure of lung maturity and squalene providing an index of proximity to term or of the presence of intrauterine growth retardation.