Case 3--1997. Bilateral pulmonary edema after left modified Blalock-Taussing shunt.
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Biomedical subjects
Publications and source records attributed to G E Hirshberg.
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Twenty premature or high-risk infants received caudal epidural anesthesia for inguinal herniorrhaphy, orchiopexy, and circumcision. Mean gestational age at surgery was 48 +/- 12 weeks; mean weight at surgery was 4,100 +/- 1,400 g. Caudal anesthesia, performed with 1 mL/kg of 0.375% bupivacaine, was successful in 19 of 20 infants. Onset of anesthesia occurred in 14 +/- 1 minutes; duration of surgical anesthesia was 89 +/- 8 minutes. Surgical conditions were generally excellent and the infants tolerated anesthesia and surgery well. No postoperative complications were observed. Caudal epidural anesthesia is an acceptable alternative to general or spinal anesthesia in premature and high-risk infants.
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The articular cartilage of normal rats, of rats made diabetic with streptozotocin, and of rats made diabetic with streptozotocin and subsequently transplanted with isologous pancreatic islets was examined for the activities of enzymes engaged in the synthesis and degradation of glycosaminoglycans (mucopolysaccharides). The activities assayed were those of the degrading enzymes B-glucuronidase, B-acetyglucosaminidase, B-acetylgalactosaminidase, B-galactosidase, and those active in synthesis: uridine diphosphate dehydrogenase, glucose-6-phosphate dehyrogenase, and phosphofructokinase. In the diabetic animals all enzyme activities were increased, thos of the degrading enzymes more than those of the others. Implantation of pancreatic islets reversed the changes produced by diabetes, enzyme activities returning to near-normal levels.
Sufficient numbers of pancreatic islets transplanted into the splenic pulp of streptozotocin-induced diabetic rats can result in complete reversal of hyperglycemia, glycosuria, and polyuria while promoting weight gain. These changes are constant for at least 3 months. Animals transplanted in this way, however, fail to exhibit a normal biphasic insulin response during an intravenous glucose tolerance test. This lack of biphasic response is in marked contrast to that observed in portal-vein--transplanted animals. Basal serum insulin in intrasplenic-transplanted animals is twice that observed in normal animals and portal-vein--transplanted animals which have received the same number of islet isografts. Direct injection of islets into the splenic pulp does not insure that subsequently all islets will remain in the splenic pulp, and, in fact, subsequent splenectomy suggests that in some cases a majority of transplanted tissue lodges in other organs--most likely, the liver.