Clinical use of oxygen stores: pre-oxygenation and apneic oxygenation.
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Biomedical subjects
Publications and source records attributed to R Zander.
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The influence of an increasing protein supply in combination with soybean oil upon the IGF-I concentration in the serum in correlation with growth was measured on 8 x 10 male Wistar rats. With a casein content of 0% in the food, the IGF-I level was 0.13 +/- 0.02 rU/ml. An IGF-I plateau of 0.74 +/- 0.07 rU/ml was reached at some 15% casein. The additional application of 3% soybean oil increased the IGF-I concentration significantly (P less than 0.01) up to 0.95 +/- 0.16 rU/ml. The investigations show a specific increase of the IGF-I synthesis by the addition of oil, which is paralleled by a further stimulation of the growth of the rats. The nutrition-dependent IGF production in the peripheral tissues (mainly liver) represents the connection link between the growth hormone axis (genetically potential growth) and the growth realizable depending on the supply with nutrients.
Capnometry, i.e. measurement of CO2 concentration (cCO2, vol%) and calculation of the respective CO2 partial pressure (pCO2, mmHg), is simple to apply, but the user must understand its principles of operation in order to appreciate its power and its limitations. However, sidestream capnometers use to dry the humidified respired gas (37 degrees C, pH2O 47 mmHg) for methodological reasons, thus increasing pCO2 by ca. 6% which, in turn, requires correction. With infrared spectroscopy, overestimation of pCO2 in presence of N2O and underreporting of pCO2 in presence of O2 also require to be corrected. These require either knowledge of the respective gas concentrations (mainstream analyzers) or adequate (i.e. correct) measurement (some sidestream capnometers). Changes in barometric pressure (pB) must be also either known or be measured automatically. Evaluation of the precision of capnometers must therefore focus on, (1) the possible pH2O correction, (2) the possible effects exercised by O2 and N2O, and (3) the possible dependence on barometric pressure. Two mainstream (Capnolog D/Dräger; Sirecust 404-1/Siemens) and eight sidestream capnometers (AGM 1304/Brüel & Kjaer; SARAcap A. G. and SARA-trans/Biomedical Systems/Hellige; Capnomac and Normocap 200/Datex/Hoyer; CO2 Monitor/Dräger; Nellcor N-1000/Nellcor/Dräger; Multinex/Datascope) were investigated. Dry and humidified gases (37 degrees C) of defined composition in respect of CO2, O2, N2, N2O, and H2O, were used for evaluation. The results prove reproducibility of ca. =/- 1 mmHg for the 10 capnometers within the 30-50 mmHg pCO2 range.(ABSTRACT TRUNCATED AT 250 WORDS)
In two digestibility and N-balance experiments the following solvent extracted meals were examined in a grain (barley and wheat in equal parts) or in a starch diet with four female pigs/group fitted with urethra catheters during the 5 days sampling period: 48% soyabean meal (SBM) (1), 24% conventional rapeseed meal (RSM) (2), 24 (3) or 48% (4) RSM from a newly bred low glucosinolate variety, groups 1 to 4 with grain, 48% low glucosinolate RSM (5) or 48% SBM (6) both with starch. In numeric order of the groups 88, 85, 86, 84, 79 and 89% N were digested. Pigs responded to the additional faecal N excretion from RSM diets by a lower urinary N excretion and thus they reached the N-balance of the animals fed on SBM. In numeric order of the groups 86, 79, 80, 73, 73 and 92% of the organic matter of the solvent extracted meals were digested. In comparison with SBM even 48% RSM in the feed significantly lowered the digestibility of organic matter. Using detergents the additional faecal organic matter excretion of RSM versus SBM could quantified as two third lignin. In the case of 24% RSM in the diet--i.e. 15% of the carbohydrates given--the carbohydrate digestibility is estimated with a high error, that an energetic feed value should not calculated. Investigating 48% SBM or RSM respectively in a grain diet the net energy content was 9.8 MJ (666 Energetic Feed Units, EFU pig) or 8.3 MJ (569 EFU pig)/kg dry matter (DM). Based on the starch diet, however, little relevant for estimation of normal pig diets, there were evaluated 10.6 MJ (720 EFU pig) for SBM and 8.3 MJ (567 EFU pig) net energy/kg DM for RSM.
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Ion-selective electrodes (ISE) from various manufacturers were tested with regard to their accuracy in determining the concentrations of sodium, potassium and calcium in aqueous solutions when uni- or polyvalent, inorganic or organic anions are being present in physiological concentrations. The results obtained by all measuring instruments using ISE revealed that the presence of anions such as acetate, citrate, malate, lactate, phosphate or sulfate, either in physiological or therapeutic concentrations, may lead to considerable errors when determining the concentrations of sodium and calcium. A certain caution is therefore recommended in order to minimize the risk when using ISE for the electrolyte diagnosis of infusion solutions, blood derivatives, dialysates and urine samples.
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Two lactating pony mares were given oral offers of 20 g 15N urea [95 atom-% 15N-excess (15N')] on 6 subsequent days. About 80% of the consumed 15N' were excreted via urine and faeces, but only about 2% via milk. The 15N' secreted via milk-lysine only amounted to 0.04% of the 15N' intake. The recovery was about 90% in each case. Tissues with active metabolism had an unexpectedly high labelling (greater than 0.3 atom-% 15N'). The low extent of the conversion of oral urea N into milk-lysine speaks against an essential participation of the enteral synthesis in meeting the amino acid requirement of lactating mares. It was already concluded from this results that the determination of the amino acid requirement will be necessary for this group of performance.
A computerized pO2 measurement system with a novel electrode motion pattern (Sigma-pO2-histography) was evaluated in vitro and in vivo. The system was found to be reliable in 0.9% saline and 10% hydroxyethylene starch solution and in fresh donor blood. Marked deviations were found in lipid and hemoglobin solutions and in fluorocarbon emulsions. Histograms obtained in rat liver, mouse muscle, and subcutis were similar to previously reported distributions. Direct comparison between Sigma-Eppendorf and self-constructed Whalen-type electrodes in hypoxic tumors gave similar results. A large series of measurements indicated that hypoxic and anoxic tissue areas were frequently found both in isografted rodent and in xenografted human tumors. The extent of oxygen deprivation depended on the cell line studied, tumor size, implantation site, the vascularity, and the actual tissue perfusion. Pentobarbital anesthesia redistributed the tumor oxygenation without affecting the median pO2 value. Tumors growing in a pre-irradiated bed were less oxygenated than those at untreated sites. Hyperthermia at therapeutically relevant temperatures reduced pO2 levels in adequately oxygenated tumors whereas little change was detected in poorly oxygenated tumors. First measurements in tumors in patients revealed marked inter- and intratumor heterogeneity. It is concluded that this novel technique is suitable for routine measurements of tissue oxygenation of solid tumors in situ.
Five groups of five colostomized laying hens each received 0 g, 15 g, 30 g, 45 g and 60 g peas of the variety Grapis per animal and day with Triticum rations. The apparent digestibility of the crude nutrients of the rations and the peas was determined, ascertained according to the difference method in dependence on their quotas in the rations. The digestibility of the N-free extracts of the peas increases by 3 digestion units each under the influence of the increasing intake of peas, so that the digestibility of the organic matter of the peas increases with the growing quota. On an average of the 20 individual values the following digestion values for the pea variety Grapis are indicated: organic matter 66.9%, crude protein 78.5%, crude fat 48.7%, N-free extracts 70.3%. Energy concentration amounts to 572 EFU-hen/kg dry matter.
Definitions and symbols for relevant parameters of the oxygen status of arterial blood are recommended. The recommendations are as simple as possible, easy to understand, and devoid of misinterpretations and double meanings. The authors propose no new definitions for limited new methods, no combination of symbols and methods, and no association between definition, symbol and commercial name.
The oxygen status of arterial human blood is described at least by four variables: Oxygen partial pressure (pO2, mmHg), oxygen saturation (sO2, %), hemoglobin content (cHb, g/dL) and oxygen content (cO2, mL/dL). Beside perfusion, however, the oxygen supply of all organs is decisively determined by the mean capillary pO2 which itself is primarily dependent on the arterial cO2. Therefore, the oxygen availability (cardiac output x caO2, mL/min) may be described by the cO2 value in arterial blood or those variables who determine the latter one. The diagnostic significance of the O2 variables of the oxygen status consequently increases in the order of pO2, sO2 (cHb) and cO2. In arterial blood, oxygen partial pressure is the result of O2 diffusion within the lungs into the blood (lung function). Oxygen saturation describes the portion of chemically bound oxygen expressed as O2Hb in relation to total Hb (Hb + O2Hb + COHb + MetHb). Oxygen content is the total amount of oxygen in blood chemically bound plus physically dissolved. Under pathophysiological conditions the diagnostic significance becomes very clear. Disturbances of lung function decreases all three variables, pO2 (hypoxia), sO2 (hypoxygenation) and cO2 (hypoxemia), to produce hypoxic hypoxemia. Carbon monoxide poisoning or methemoglobin formation decreases two variables, sO2 and cO2, where the pO2 remains normal and results in toxic hypoxemia. Anemia with a decrease in the hemoglobin content lowers cO2 only, while pO2 and sO2 remain normal (anemic hypoxemia).
Normovolemic hemodilution under normoxic conditions (arterial oxygen partial pressure normal) at rest is limited by the critical arterial oxygen content of about 10 ml/dl corresponding to a hemoglobin concentration of 7.5 g/dl. This critical oxygen content is derived from the arteriovenous oxygen difference of the myocardium, assumed that the coronary blood flow is increased by 33% and the available oxygen is utilized nearly totally. Furthermore, stored blood (blood bag) seems to be of minor therapeutic effect because of the left shifted oxygen content curve combined with a reduced effective Hb concentration.
Over a period of 4 days 12 colostomized laying hens daily received 36 g 15N labelled wheat with 15N excess (15N') of 14.37 atom-% together with a conventional feed mixture for laying hens. The labelling of the lysine N in the wheat was 13.58 atom-%, that of histidine N 14.38 and that of arginine 15N' 13.63 atom-% 15N'. Three hens each were butchered 12, 36, 60 and 108 h after the last 15N' feeding. The first three hens did not receive any feed before being butchered. The following three hens each received the unlabelled feed ration for another 1, 2 or 4 days resp. after the main period until they were butchered. The total of skeleton muscles, the heart and the stomach muscle (without inner skin) of each hen were combined into one sample, cut thinly, drenched with fluid nitrogen and pulverized. N, 15N' and the basic and non-basic amino acids as well as their 15N' were determined in the individual samples. In contrast to the organs, the proteins in the muscle tissue have a long half life so that a slight decrease of atom-% 15N' in the muscles could only be detected after 108 h. The 14N and 15N' quota of the non-basic amino acids in the total nitrogen of the muscles is 50%. The 14N quota of the basic amino acids is 30% and the 15N' quota only 22.5% in the total muscle N. The heavy nitrogen of the free lysine in the TCA soluble N fraction is hardly detectable 36 h and 60 h after the last 15N' supply and not at all after 108 h. In contrast to this, the other two free basic amino acids remain significantly higher labelled in dependence on the last butchering time.
The nylon-bag method was applied for determination of the rumen degradation of dry matter and nitrogen of 15N-labelled wheat straw. For the experiment 4 wethers fitted with a rumen cannula were used. The bags containing 15N straw were introduced into the rumen and withdrawn 3, 6 or 12 h after incubation. In a second experiment the apparent 15N-digestibility of the same straw was determined in wether and pony. The dry matter disappearance varied between 6 and 23%. For 15N-labelled straw the disappearance of 15N was higher than that of total N. 12 h after incubation 71% of 15N and only 25% of total N were disappeared. It was calculated that after incubation rumen microbial-N in the nylon bag increased from 31% (3 h) to 45% (6 h) and 61% (12 h) resp. The apparent 15N digestibility amounted 53 +/- 2% for wethers and 51 +/- 2% for ponies.
In order to compare the accuracy of haemoglobin (Hb) determination methods, the commonly used cyanhaemiglobin (HiCN) method and the recently developed alkaline haematin D-575 (AHD) method (R. Zander, W. Lang & H. U. Wolf (1984) Clin. Chim. Acta 136, 83-93; H. U. Wolf, W. Lang & R. Zander (1984) Clin. Chim. Acta 136, 95-104) were tested with respect to method-related errors such as plasma, cell, and Hb errors. Both methods yield a series of more or less significant errors which generally lead to an overestimation of the Hb concentration in the order of 1%. However, in all three cases of plasma errors, i.e. normal plasma error, plasma error in lipaemic blood, and plasma error in bilirubinaemic blood, the AHD method shows significantly lower values of errors than the HiCN method. In the case of cell errors such as ghost and leukocyte errors, the overestimation of the Hb concentration by the HiCN method is 60% higher than that by the AHD method. In the case of Hb errors such as fetal Hb and carboxy Hb errors, there is a significant overestimation of the Hb concentration by the HiCN method, which amounts 3 min after mixing of blood and HiCN solution to 0.7% in the case of fetal Hb and to 13.2% in the case of carboxy Hb. The latter value yields an overestimation of 1.3%, when 10% carboxy Hb in a blood sample is present. In contrast, there is no detectable overestimation after 3 min in the case of the AHD method. Thus, the AHD method provides a higher accuracy in Hb determination than the commonly used HiCN method.
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Six healthy human subjects were given 15N-labelled wheat bran in addition to a normal diet. The apparent digestibility of 15N was 84%. The gastrointestinal transit time varied between 25 and 35 h.