Biomedical subjects
Publications and source records attributed to J Schier.
A diagnostically difficult case of Boerhaave's syndrome is reported. The patient gave a history of subcutaneous emphysema of the anterior chest wall as the only sign. Aspiration drainage through thoracotomy opening and artificial alimentation through jejunostomy were used with success.
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After controlled bleeding 20 ml/kg enriched infusion fluid containing 0.005 mol/1 adenine, 0.1 mol/1 pyruvate, 0.1 mol/1dibasic sodium phosphate and 0.15 mol/1 sodium chloride was given to 14 dogs. Three dogs received after bleeding the same infusion fluid without adenine. One dog received only dextran after blood withdrawal and served as control Before and after bleeding and 1, 4, 24, 48 and 72 hours after infusion the levels of 2,3-DPG, ATP and P50 index were determined. After infusion of enriched fluid with and without adenine the level of 2,3-DPG and the value of P50 index increased. No rise in the ATP level was observed.
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The effect of transfusions of 500 ml of 5-6% stroma-free haemoglobin solutions on the blood-clotting system of dogs was studied. Slight lowering of the fibrinogen level and of the activity of clotting factors V, VII, VIII, IX and X was observed, together with some prolongation of the thrombin time. In vitro investigations indicate that prolongation of the thrombin time may depend on disturbed polymerization of fibrin monomers. After transfusion of stroma-free haemoglobin preparation, no signs of haemorrhagic diathesis were observed.
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The ability of stroma-free haemoglobin solutions to transport oxygen was investigated by determining the oxygen consumption by the liver using Warburg's microrespirator. 50 ml of blood were removed from the rabbit under general anaesthesia and replaced by an identical volume of a non-oxygenated or oxygenated haemoglobin solution. The control rabbits received no transfusions. It was found that arterial hypotension produced by blood-letting caused a significant rise in oxygen consumption by the hepatic tissue. The rise was increased even more when the rabbits received no transfusions. Transfusion of non-oxygenated haemoglobin solutions caused likewise a rise in oxygen consumption immediately after transfusion. This rise was, however, not so significant as in the control group. On the other hand, transfusion of oxygenated haemoglobin solutions produced no rise in the oxygen consumption by the liver as compared to its value after blood-letting.
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