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Biomedical subjects

K A Rein

Publications and source records attributed to K A Rein.

12 recordsLinked to original sources
PubMed1989

The influence of thoracic epidural analgesia on transcapillary fluid balance in subcutaneous tissue. A study in patients undergoing aortocoronary bypass surgery.

Clinical observation and calculation of fluid balance have shown that patients undergoing aortocoronary bypass surgery with thoracic epidural analgesia (TEA) in addition to general anesthesia retain less fluid than patients having general anesthesia only. The present study was designed to investigate whether this effect could be explained by thoracic epidural analgesia influencing the transcapillary fluid balance, i.e. the transcapillary forces (COPpl, COPif, Pif). Interstitial fluid colloid osmotic pressure (COPif) and interstitial fluid pressure (Pif) were measured subcutaneously at heart level by the blister suction technique and the wick-in-needle technique, respectively. Simultaneously plasma colloid osmotic pressure (COPpl) was recorded. Sixteen male patients were allocated to two groups, one having general anesthesia only (controls, n = 8). The other group (TEA, n = 8) received, at the induction of anesthesia, bupivacaine 50 mg via an epidural catheter as an adjunct to general anesthesia. TEA was maintained by continuous infusion for 24 h postoperatively. Preoperatively no intergroup differences were observed in "the Starling forces" (COPpl, COPif, Pif). At the start of extracorporeal circulation COPpl was significantly lower in the TEA-group than in controls. During extracorporeal circulation the transcapillary COP-gradient (COPpl-COPif) was reversed in both groups. At the end of extracorporeal circulation Pif increased to a minor degree in the TEA-group and remained significantly lower than in controls from 3 to 24 h postoperatively. The subcutaneous interstitial tissue could be less expanded postoperatively in the TEA-group, also reflected by a lower increase in Pif.

Aged↗
PubMed1988

Time-related changes in the Starling forces following extracorporeal circulation.

The intra- and postoperative variations of the transcapillary forces [colloid osmotic pressure of plasma (COPpl), colloid osmotic pressure of interstitial fluid (COPif), average hydrostatic pressure in the interstitium (Pif)] were studied in the subcutaneous tissue as a function of time in 13 patients operated on for coronary artery disease using extra-corporeal circulation (ECC). The measurements were performed before operation, during ECC, and during the first 24 hours postoperatively. COPif was measured subcutaneously on the chest both by the wick method and by a noninvasive blister suction method. The latter technique allowed several consecutive measurements in the same individual during the postoperative period. Pif was measured by "wick-in-needle" technique in the same area as the COPif measurements. COPpl was measured in a blood sample collected from a cubital vein. COPpl was reduced about 50% during ECC returned to pre-ECC level within the first 6 hours postoperatively. During ECC COPif was higher than COPpl, reaching its minimum level 4 to 5 hours postoperatively. Measurements performed following ECC showed return of the transcapillary COP-gradient to the normal direction (COPpl greater than COPif). Pre-ECC level of COPif was not entirely obtained during the first postoperative day. Pif increased gradually during ECC and continued to increase the first 2 to 3 hours following ECC. Pre-ECC level was reached within 24 hours postoperatively. The present investigation has demonstrated major dynamic variations in the transcapillary forces in patients undergoing open heart surgery with ECC. There was an increased net capillary filtration (F) intraoperatively predisposing to interstitial edema formation in subcutaneous tissue until several hours following the termination of ECC.

Adult↗
PubMed1988

Interstitial fluid colloid osmotic pressure of the subcutaneous tissue in controls and patients before and after open-heart surgery: a comparison between the wick technique and the blister suction technique.

The purpose of this study was to compare the blister suction technique and the wick technique for measuring interstitial colloid osmotic pressure of subcutaneous tissue (COPif). Eight healthy volunteers and 14 patients undergoing aortocoronary bypass using extracorporal circulation (ECC) were included in the investigation. Colloid osmotic pressure was measured in fluid collected either from blisters (COPbl) developed by application of subatmospheric pressure to the chest skin, or from nylon wicks (COPw) implanted subcutaneously on the chest in the same area as the blisters were formed. Colloid osmotic pressure was then recorded on a colloid osmometer made for 5 microliter samples. In the patients, the measurements were performed 12-18 h pre-operatively (mean 15 h) and, on average, 4 h (range 1.5-7 h) following termination of extracorporal circulation. In the control subjects as well as in the patients, COPbl was significantly lower than COPw. However, the two types of measurements were found to change in the same direction, as a highly significant positive correlation exists between the two methods.

Adult↗
PubMed1988

Transcapillary fluid balance in subcutaneous tissue of patients undergoing aortocoronary bypass with extracorporeal circulation.

Colloid osmotic pressure in plasma (COPpl) from a cubital vein and in interstitial fluid (COPif) in the subcutaneous tissue at heart level, and interstitial fluid pressure (Pif) at the same level, were measured in 18 healthy subjects and in 28 patients requiring aortocoronary bypass. Interstitial fluid was collected via subcutaneously implanted double nylon wicks and Pif was measured with the 'wick-in-needle' technique. Measurements were made preoperatively and 1 1/2 to 8 hours (mean 4 hours) after termination of extracorporeal circulation. Pif rose to 2.3 mmHg above the pre-bypass level. COPpl concomitantly fell from 22.2 to 14.4 and COPif from 12.4 to 10.1 mmHg. These changes were statistically significant. Although the relatively large COPpl drop resulted in a net rise of 3.2 mmHg in filtration pressure, the incidence of pulmonary complications was low and no subcutaneous edema was discernible. The fall in COPif and rise in Pif may be regarded as important edema-preventing mechanisms.

Adult↗
PubMed1987

Surgical treatment of aneurysms of the descending thoracic aorta.

Six patients were operated on for aneurysm of the descending thoracic aorta in 1983-1985 by use of simple cross-clamping and interposition of a Dacron tube graft without extracorporeal circulation. The aneurysm had ruptured in three cases. The patients' mean age was 69 years. Anesthesia and muscle relaxation were obtained by drugs with only minor myocardial depressant action. There was no postoperative mortality or morbidity. Five of the patients have been followed up for at least a year. Careful pharmacologic control of the blood pressure is essential during such surgery. Despite the smallness of the series, it indicates that simple cross-clamping and Dacron graft interposition can be used for treatment of aneurysm of the descending thoracic aorta.

Adult↗
PubMed1979

Arsenite inhibits beta-oxidation in isolated rat liver mitochondria.

A partial inhibition of acylcarnitine oxidation by arsenite in rat liver mitochondria has been studied. This inhibition is confined to the thiolase(s). The inhibition was observed also in the presence of malate, indicating no selective effect on ketogenesis. Ketogenesis from acetyl-CoA was inhibited by arsenite. Mitochondrial CoA was acylated by acylcarnitine nearly as rapidly in the presence of arsenite as in its absence. Thus, arsenite did not interfere with the availibility of CoA in the mitochondria. No effect of arsenite on enzymes of beta-oxidation other than the thiolase(s) was observed. When arsenite and acylcarnitine were added simultaneously to mitochondria, there was a delay before maximal inhibition of oxygen uptake occurred. When the mitochondria were preincubated with arsenite before addition of acylcarnitine, the inhibitory effect on oxygen utilization was initially large, but then partially repealed. Similar time delays were observed in the activity of acetoacetyl-CoA thiolase of disrupted mitochondria depending on the sequence of arsenite and acetoacetyl-CoA addition. It is suggested that substrate and arsenite complete for the reactive sulfhydryl group at the active site of the thiolase(s).

Acetyl-CoA C-Acetyltransferase↗
PubMedDate not supplied

[Histological and bacteriological examination of uterus from the repeat breeder gilt and sow (author's transl)].

The investigation comprised sexual organs from 25 gilts and 97 sows culled because of repeat breeding. Among the gilts 24.0 per cent and among the sows 25.8 per cent had endometritis. The following germs were present in uterus from gilts and sows with signs of endometritis: Staphylococcus aureus, Corynebacterium pyogenes, alpha-hemolytiske streptococcer, Escherichia coli, Pasteurella sp., Aeromonas sp., Acinetobacter sp. and Citrobacter sp. Among gilts and sows with germs present in uterus 40.9 per cent had endometritis. The corresponding per cent among gilts and sows without germs present was 25.0.

Animals↗