Biomedical subjects
A E Baue
Publications and source records attributed to A E Baue.
Studies of peripheral glucose uptake during sepsis.
Glucose intolerance occurs in patients with sepsis, and resistance to insulin has been thought to be part of this process. To study this phenomenon, peritonitis was produced in rats by cecal ligation and puncture. One group was killed ten hours later (early sepsis). A second group of rats was killed 16 to 24 hours after ligation, just prior to their expected death (late sepsis). Insulin stimulated glucose uptake to the same extent in muscles from rats in early sepsis, late sepsis, and from control rats. Even at an insulin concentration that produced submaximal stimulation of glucose uptake, no difference in glucose uptake between the three groups of muscles was observed. Thus, there was no resistance to the stimulatory action of insulin on glucose uptake by skeletal muscle during early and late sepsis. However, basal glucose uptake by isolated soleus muscle from animals in late sepsis was significantly increased compared with controls when these muscles were incubated in an aerobic environment. Under anaerobic conditions, glucose uptake in these two groups of muscles increased to the same level. This indicates that there is some stimulus that increases glucose uptake in late peritonitis and may explain the hypoglycemia of late experimental or untreated sepsis. This stimulus could be hypoxia or some other factor resulting from decreased blood flow and increased anaerobic metabolism.
The new generation in surgical education and self-assessment--SESAP III.
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Early and lage results of coronary revascularization with saphenous vein and internal mammary artery grafts.
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Impairment of reticuloendothelial system function with sepsis and its improvement with ATP-MgCl2 plus glucose administration.
Peritonitis in rats was produced by cecal ligation and puncture. Sixteen hours following cecal ligation and puncture, the gangrenous cecum was removed and the animals received either 4 ml saline (nontreated), 0.75 ATP-MgCl2 (100 mumoles ATP plus 50 mumoles MgCl2), and 2.0 ml of 50% glucose or 2.0 ml of 50% mannitol and 1.25 ml saline. Two hours after the removal of the cecum, RES function was evaluated by measuring the intravascular clearance of a 131 I triolein-labeled gelatinized test lipid emulsion. The intravascular half-time (t1/2) in the nontreated animals was double that of sham-operated animals, suggesting that significant depression in RES function occurred during sepsis. Administration of ATP-MgCl2 plus glucose following sepsis resulted in t1/2 values similar to those of sham-operated animals, indicating that the impairment of pagocytic activity of the RES was reversed with treatment. The beneficial effect of treatment following sepsis does not appear to be due to hypertonicity, since administration of 50% mannitol failed to decrease the t1/2. The precise mechanism of the beneficial effect of ATP-MgCl2 + glucose on restoration of RES function is not known.
Effect of PEEP on pulmonary alveolar macrophage function.
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Effect of sepsis on tissue adenine nucleotide levels.
Tissue adenine nucleotides were measured in rats to determine if there is depletion of energy stores associated with sepsis. Peritonitis was produced by cecal ligation and cecal puncture. At 16 to 24 hours after ligation, rats which were lethargic but still normotensive (late sepsis) and showed clinical and laboratory confirmation of peritonitis-sepsis were stunned by a blow on the head, and small pieces of tissue were removed and frozen. Adenine nucleotides were measured enzymatically. In late sepsis adenosine triphosphate (ATP) levels in liver and kidney decreased significantly; however, no significant decreases were observed in the diaphragm or gastrocnemius muscle. Hydrogen polarograph measurements of hepatic blood flow indicated that flow was decreased markedly at this stage of peritonitis. A second group of rats was prepared in the same manner, except they were studied 10 hours after ligation (early sepsis). Most rats at this stage of sepsis appeared to be only mildly ill; however, blood cultures obtained from six rats so prepared all were positive. These rats did not show any decrease in either hepatic blood flow or tissue adenine nucleotides. Thus the changes in adenine nucleotides observed in late sepsis (lpw-flow septic rats) are similar to those seen during early hemorrhagic shock and suggest inadequate perfusion associated with peritonitis as the cause.
Giant paraesophageal hiatus hernia with intrathoracic stomach and colon: the case for early repair.
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Prostaglandin metabolism, synthesis, and blockade in hemorrhage and sepsis.
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Graded coronary stenosis and coronary flow during acute normovolemic anemia.
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Glucocorticoid effects on gluconeogenesis during hemorrhagic shock.
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Beneficial effect of ATP-MgCl2-glucose administration on survival following sepsis.
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Enhanced recovery from severe ischemic renal injury with adenosine triphosphate-magnesium chloride: administration after the insult.
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Improved hepatic function and survival with adenosine triphosphate-magnesium chloride after hepatic ischemia.
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The use of adenosine triphosphate with magnesium chloride in the treatment of post ischemic renal injury.
Minipigs (20 to 25 kg.) were subjected to bilateral renal artery occlusion for 60 minutes. Renal blood flow was reduced to 65 per cent and glomerular filtration rate to 40 per cent of normal in control animals. Administration of adenosine triphosphate with magnesium chloride intravenously immediately after the period of ischemia resulted in restoration of renal blood flow to normal and glomerular filtration rate to 74 per cent of normal 24 hours later. Bilateral renal artery occulsion for 90 minutes resulted in a more severe impairment of renal function, which was not improved by the administration of adenosine triphosphate with magnesium chloride. Adenosine triphosphate with magnesium chloride may exert its effect by improving renal blood flow through inhibition of post-ischemic intrarenal vasoconstriction or possible by enhancing restoration of intracellular adenine nucleotides. The exact mechanism remains unclear.
A tribute to Richard Warren, MD.
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Postichemic renal failure: accelerated recovery with adenosine triphosphate-magnesium chloride infusion.
Since previous studies have shown a protective effect of the administration of adenosine triphosphate-magnesium chloride (ATP-MgCl2) in shock, the present study was undertaken to determine the effect of the infusion of ATP-MgCl2 after 30 minutes of renal artery occlusion. In animals who received no infusion or only MgCl2, the combination of reduced glomerular filtration rate (GFR), marked diuresis, and reperfusion of the outer cortex suggested that these animals were in the early recovery phase of acute renal failure. In the animals who received ATP-MgCl2, there was improved GRF, no diuresis, and a normal pattern of cortical blood flow distribution. These findings would suggest that the infusion of ATP-MgCl2 appears to have either ameliorated the effect of renal ischemia, or to have accelerated the recovery process. While the precise mechanism of action of ATP-MgCl2 remains unknown, these observations may have important implications for future use in organ preservation and the management of acute renal failure.