T Bilfinger | PubMed Health

PubMed2000

Endogenous morphine is produced in response to cardiopulmonary bypass in neonatal pigs.

BACKGROUND: Cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response. Endogenous morphine production has previously been demonstrated in humans after cardiac surgery with CPB. It has been hypothesized that morphine plays a role as an anti-inflammatory mediator in the systemic inflammatory response. The aim of this study was to investigate if the CPB procedure in itself elicits an endogenous morphine production in neonatal pigs. METHODS: Endogenous morphine production was measured in arterial blood in piglets exposed to sternotomy alone (sham group, n=10) or sternotomy and CPB (n=10). Blood samples were obtained immediately after the induction of anaesthesia, at the end of CPB and 4 h later. Morphine in arterial blood was detected by radioimmunoassay and confirmed by gas chromatography mass spectrometry. RESULTS: Animals undergoing CPB showed detectable endogenous morphine concentrations immediately after CPB, with increased concentrations postoperatively. There was no measurable morphine production in the sham operated pigs. CONCLUSION: The CPB procedures elicits an endogenous morphine production in neonatal pigs. This morphine response is analogous to the previously demonstrated response in patients subjected to cardiac surgery and CPB.

Animals↗

PubMed1993

[The first successful lung resection].

In 1883 Krönlein resected a sarcoma of the ribs in an 18 year old female. Six months later he reoperated the patient for a local recurrency. At the second operation which necessitated a wide exposure of the thoracic cavity he deliberately removed a pulmonary metastasis about the size of a walnut. Two years later a new recurrence had to be resected. The three interventions led to a survival of 7 years. The patient succumbed to a further recurrence in 1890. Krönleins operation opened two new chapters in surgery, pulmonary interventions in general and in particular surgery of pulmonary metastasis. Surgery of lungs was not a topic of that era, particularly since some incisions for abscesses and resections of pulmonary parenchyma had not been successful. By limiting the indication to patients with sufficient pulmonary function and by following the successful pneumonectomy experiments in animals Krönlein favored pulmonary resection. The success of this intervention confirmed these considerations especially since it lasted for years. It was followed in 1885 by a pulmonary resection by G. Ruggi in Bologna. Surgery of the lung, however, came in general use only 50 years later.

Germany↗