An assessment of Norplant removal in Indonesia

The use of inhaled nitric oxide as a selective pulmonary vasodilator has expanded to include patients with congenital heart disease and pulmonary hypertension. The therapeutic and diagnostic roles of inhaled nitric oxide offer additional alternatives and benefits to these patients with pulmonary hypertension, particularly in the postoperative setting. This article reviews the background, mechanism of action, toxicities, and current clinical applications of inhaled nitric oxide in the child with congenital heart disease and pulmonary hypertension.     

Regulation of liver carbohydrate and lipid metabolism by cell volume

Intraoperative assessment of graft patency and completeness of revascularization can increase the success of coronary artery bypass grafting. A 56-year-old man underwent a quadruple bypass operation. Flow in the graft to the anterior descending artery was verified after completion of the distal anastomosis using a Doppler flow detector. Visualization of the native artery by thermal coronary angiography demonstrated that the flow passed into the second diagonal branch and not into the distal anterior descending artery, which had an unsuspected obstruction just distal to the anastomosis. The obstruction was dilated. Patency was verified with cold solution, and flow of warm blood to the entire artery was accomplished. This case demonstrates how the early (intraoperative) recognition of an unsuspected coronary obstruction using an infrared imaging system can improve the results of myocardial revascularization and avoid potential postoperative complications.     

Evaluation of selected lipid metabolism parameters in premature infants with infections

In 49 prematures (25 infected and 24 healthy) serum cholesterol and triglycerides concentrations, value of alpha, pre-beta and beta serum lipoproteins (by electrophoresis) and activity of AspAt, AlAt and GGTP were estimated. It was stated, that the mean serum cholesterol concentration at the beginning of infection was significantly lower than in healthy babies, but in 2-3 week of disease the mean value of this parameter was significantly higher than in first week of life. Mean value of alpha lipoprotein was significantly lower, mean value of pre-beta and beta lipoproteins were higher in sick prematures than in control. In septic prematures positive correlation between the high serum cholesterol concentration and activity of GGTP and AspAt was found. In 30% of all septic neonates hepatitis and in 65% of dead infected prematures structural damage of liver were noted.     

The temporal interaction of corticosterone and prolactin in affecting liver lipid metabolism of the chick

Experiments were conducted to determine if Brown Leghorn chickens (Gallus domesticus) showed a daily differential responsiveness to the phased injections of corticosterone and prolactin. In experiment 1, 28 day old chicks, maintained on continuous lighting and a standard diet, were treated daily for 6 days with corticosterone (300 mug. in 0.2 cc. saline) and with prolactin (150 mug. in 0.2 cc. saline) for 4 days. The prolactin injections began 2 days after the first corticosterone injection. The interval between daily corticosterone injections at 1800 hours followed by prolactin injections 6, 12 or 18 hours later resulted in a significant increase in the liver lipidcontent in the chicks. However, when corticosterone and prolactin were given at the same time (1800 hours), no increase in liver lipid content was observed. Corticosterone admininstered at 6oo hours and followed by prolactin injections had no effect on liver lipid content regardless of the time of prolactin prolactin injections. Experiment 2 was designed to test the effect of the administration of corticosterone or prolactin alone at either 600 hours or 1800 hours on liver lipid metabolism. Two groups of Brown Leghorn chicks received prolactin alone (for 2 days) at either 600 hours or 1800 hours. None of these treatment groups were significantly different from the uninjected controls. It is concluded that the chick has a diurnal sensitivity to the effects of coritcosterone and that once the liver is affected by corticosterone, a temporal interaction between this steroid and prolactin can affect the liver lipid content of the Brown Leghorn chick.     

Evaluation of early graft function by hepatic venous hemoglobin oxygen saturation following orthotopic liver transplantation in the rat

This study was designed to evaluate the use of hepatic venous oxygen saturation (Shvo2) as a predictor of early graft function after liver transplantation. We examined the levels of Shvo2 and serum ALT after transplantation using the isogeneic rat orthotopic liver transplant model. Shvo2 levels 2 hr after reperfusion in the 6-hr cold ischemia (nonviable allograft) group were significantly lower than those in the 1-hr and 3-hr cold ischemia (viable allograft) groups. However, there was no significant difference in ALT levels among these groups. These results suggest that decreased hepatic blood flow due to microcirculatory disturbances may occur in the nonviable allograft even in the early phase of reperfusion and may be responsible for ischemic damage to parenchymal cells. Therefore, Shvo2 could provide a simple index of the initial graft status and be useful for a rapid etiological diagnosis of early postoperative graft dysfunction and for estimating the graft outcome after liver transplantation.     

Effect of dietary fats and sesamin on the lipid metabolism and immune function of Sprague-Dawley rats

We examined the effect of three dietary fats, safflower oil (SAF) rich in linoleic acid, borage oil (BOR) rich in gamma-linolenic acid, and perilla oil (PER) rich in alpha-linolenic acid, on the lipid metabolism, and chemical mediator and immunoglobulin levels in Sprague-Dawley rats, as well as the dietary effect of sesame-derived antioxidative sesamin. The serum cholesterol, phospholipid, triglyceride, prostaglandin E2 level and splenic leukotriene B4 level were lower in the rats fed on BOR or PER than in those fed on SAF. SES feeding suppressed the expression of the lipid-decreasing effect of BOR, but not in the rats fed on PER. In respect of the fatty acid composition of the liver and spleen, PER feeding gave a lower arachidonic acid level, and higher eicosapentaenoic and docosahexaenoic acid levels than SAF feeding did, while the effect of BOR feeding was marginal. The effect of SES feeding on fatty acid composition was much smaller than that of dietary fats. In respect of immunoglobulin production, PER + SES feeding gave the lowest IgE productivity in the mesenteric lymph node lymphocytes. These results suggest that PER feeding regulated lipid metabolism and exerted an anti-allergic effect by a different mechanism from that with BOR feeding.     

Adrenal cortical function in rats with traumatic shock following removal and deafferentation of the hypothalamus

The 11-oxycorticosteroid (11-OCS) content was studied in the blood plasma of sham-operated rats, rats with intact, ablated and deafferentated medial-basal hypothalamus (MBH) in traumatic shock. There were no reliable differences in the 11-OCS basal level in various groups of rats. MBH ablation led to the reduction in the weight of adrenal and pituitary glands and MBH deafferentation -- to increase in the weight of the former. The 11-OCS level was reliably higher in traumatic shock of rats with complete MBH deafferentation than in sham-operated animals.     

Antithromin activity following blockade of the reticuloendothelial system, splenectomy and partial removal of the liver

The level of antithrombins II, III and IV decreased in proportion to the extent of intervention in destruction or removal of a part of the liver in rats. Destruction of the spleen led to depression, and removal--to activation of antithrombin IV. Back of the reticuloendothelial system caused a lesser fall of the antithrombin level than partial hepatectomy. The spleen is supposed to produce antithrombin IV inhibitor.     

Short term effects of diets with high levels of dithiocarbamates on carbohydrate and lipid metabolism of rat liver

The purpose of the work was to establish the eventual "metabolic toxicity" of pesticide-contaminated diets in the Rat. The liver metabolic response to various stimuli was compared in dithiocarbamate-fed animals and in non-contaminated ones. 112 weanling male Wistar CF rats were fed, during 15 days, with a demi-synthetic control diet. They were then divided into 4 lots:--the control group C, which went on to receive the same diet,--the nabame group N, the diet of which was supplemented with 275 ppm of the dithiocarbamate;--the thirame groupe R, receiving the control diet + 600 ppm thirame;--the zineb groupe Z, given the control diet + 3 600 ppm Zineb. The animals were fed with these diets during 14 days, their dithiocarbamate intake thus averaging 1/20 th of the per os LD 50/rat/day. At the end of this 2-week period, each of the 4 groups was divided into 4 sub-groups, all the animals were fasted overnight, then sacrified:--after no other treatment (sub-groups T);--30 minutes after an i.p. injection of 2.6 g/kg glucose (G);--after having been forced to walk in a restraint wheel for 50 minutes/hr during the 18 hrs of the night fast (sub-groups W);--after a 90 minutes exposure in a cold room (F). The weights of the animals, of their liver, heart, kidneys, adrenals and epididymal pads were recorded. In their liver, the following compounds were determined: water, proteins, total lipids, triglycerides, long-chain acyl-CoA, non-esterified fatty acids, total cholesterol, glycogen, glucose, alpha-glycerophosphate. The thirame rats had a lower food intake than the others and the smallest body weight, but their relative liver and kidneys weights were the highest. The nabame animals did not differ from the control ones but the zineb rats had the lightest epididymal fat pads. The primary effects of the dithiocarbamate diets on liver metabolism were apparently not the same in the 3 groups compared to the control ones: nabame and thirame increased glycogen, thirame increased the lipid compounds: long-chain actyl-CoA and triglycerides, where as zineb feeding resulted in an increase of glucose concentration and in a decrease of triglycerides and total lipids. Muscular exercise, or cold exposure, had the following effects compared to those they had in the control group: a greater glucose utilization in the nabame and thirame rats, a smaller glycogen and glucose utilization, associated with an increase of alpha-glycerophosphate, in the zineb animals. These results were considered altogether with those obtained in a previous paper by the same authors, which concerned liver ketone bodies and adenine nucleotides changes after the same experimental conditions, and it was concluded that the 3 dithiocarbamates actually had a common effect on rat metabolism: they all impaired glucose utilization by the liver. Also, fat mobilization from peripheral depots was shown to occur in the 3 experimental groups, resulting in liver fatty acid oxidation in the nabame and zineb rats, and in liver steatosis for the thirame ones...     

Aesthetic outcome of breast implant removal in 85 consecutive patients

As we began to see increasing numbers of women concerned about their gel-filled breast implants, we became aware that we could not advise them with any degree of confidence what they might expect in terms of aesthetic result after implant removal. We decided to review the records and outcomes over a 2-year period of a number of patients who underwent implant removal. Eighty-five consecutive patients were reviewed, 69 of whom had undergone cosmetic augmentation and 16 of whom had breast reconstruction with silicone gel implant(s). Thirty-nine of the 69 cosmetic augmentation patients had removal of implants alone, and 27 had removal accompanied by mastopexy. Three had reaugmentation with saline-filled implants; one had replacement with saline-filled implants. Fifteen of the 16 reconstruction patients underwent autogenous tissue transfer. Preoperative and postoperative photographs of all patients were mixed randomly and rated by two independent raters in four aesthetic categories on a five-point scoring system. Repeatability was measured several weeks later, when each rater scored randomly selected photographs from this patient pool. The patients also performed their own outcome evaluations by means of questionnaire. We discovered that cosmetic augmentation patients who undergo implant removal only often suffer adverse aesthetic results. The postremoval appearance of many cosmetic augmentation patients actually will be improved over their preoperative appearance when mastopexy is performed in conjunction with implant removal. The study demonstrated that patients with certain body types could expect a particular outcome; i.e., women with asthenic builds and older patients with lax, striated breast skin generally had unsatisfactory aesthetic outcomes with implant removal only. Patients selected for autogenous breast reconstruction had favorable results, with extended latissimus dorsi and TRAM flaps yielding equally good outcomes. The study allows us to offer patients an optimistic view of postoperative results following breast implant removal. We have begun to advise selected patients that implant removal accompanied by mastopexy provides a more pleasing aesthetic outcome than implant removal alone.     

Altered hepatic hemodynamics and improved liver function following intrahepatic vascular infusion of prostaglandin E1

Prostaglandin E1 (PGE1) has cytoprotective effects in the liver. To find how PGE1 influenced hepatic hemodynamics, oxygen metabolism, and hepatic function, we carried out an experimental and a clinical study. PGE1 was continuously administered into the hepatic artery (n = 5) or portal vein (n = 5) at a rate of 0.01 micrograms/kg per min in healthy mongrel dogs. In the clinical study, in eight patients PGE1 was administered through the hepatic artery at a rate of 0.01 micrograms/kg per min after hepatic lobectomy. In the experimental study, hepatic hemodynamics and oxygen metabolism did not change during the administration of PGE1 into the portal vein. During administration of PGE1 into the hepatic artery, hepatic arterial flow increased 1.5-fold after administration compared to the rate before administration (P < 0.01). Hepatic arterial pressure, hepatic arterial resistance, and post-sinusoidal resistance significantly decreased after administration (P < 0.01, P < 0.01, and P < 0.05, respectively). Hepatic oxygen supply increased significantly (P < 0.01). In the patients, serum glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) levels remained low after surgery, and the recovery of protein synthesis was improved compared with that in eight hepatectomized patients without PGE1 administration (controls). The intrahepatic arterial infusion of PGE1 was considered useful for the recovery of liver function.     

Tea consumption, lipid metabolism, and atherosclerosis

The use of tea is derived from the Far East and was introduced into Europe, where in some countries tea soon became a favorite drink. Tea accounts for about 43% of all caffeine consumption. Total world caffeine consumption in 1981 was estimated to be approximately 120,000 tons, equivalent to 70 mg a day for each human. There is evidence from in vitro and animal studies, as well as from human investigations, that tea and its main constituents can prevent atherosclerosis to a certain extent. Supplementing tea as beverage instead of coffee might react beneficially with other antiatherosclerotic strategies. Investigations on the hypolipidemic and antiatherosclerotic action of tea, and therefore flavonoid intake, are still in their infancy and further fundamental data from controlled trials are needed to evaluate possible positive effects of tea consumption to prevent or treat atherosclerosis. Brief information on the biological potential of caffeine and flavonoids, as well as on their possible beneficial effects on the atherosclerotic process is documented in this review.