Beneficial effects of phosphatidylcholine during hindlimb reperfusion.

BACKGROUND: Microcirculatory dysfunctions and mast cell (MC) reactions play important roles in hypoxic tissue injuries. The aims of this study were to characterize the effects of hindlimb ischemia-reperfusion (I-R) on the periosteal microcirculation and to define the consequences of systemic phosphatidylcholine (PC) therapy during this condition. MATERIALS AND METHODS: Microcirculatory changes were visualized by means of fluorescence intravital videomicroscopy in anesthetized Wistar rats. There was 60 min of complete hindlimb ischemia followed by a 180-min reperfusion in the presence of PC treatment (50 mg/kg i.v.; in the second 10 min of reperfusion) or vehicle. Further two groups served as vehicle- or PC-treated sham-operated controls. The proportion of degranulated MCs and the leukocyte accumulation (myeloperoxidase, MPO assay) were determined in muscle biopsies. RESULTS: I-R significantly increased the muscle MPO activity (from 14.94 to 63.45 mU/mg) and the proportion of degranulated MCs (to 82.5%). The periosteal capillary RBC velocity (RBCV) and the functional capillary density (FCD) had decreased, while the primary and secondary leukocyte-endothelial cell interactions had increased by the end of reperfusion (rolling from 20.8 to 40.0%, and firm adherence from 254 to 872 mm(-2)). PC treatment decreased the leukocyte rolling and sticking, preserved the FCD and improved the RBCV. The MC degranulation and MPO activity diminished significantly in the muscle layer. CONCLUSIONS: PC administration improves I-R-induced periosteal microcirculatory dysfunctions and ameliorates secondary inflammatory reactions. Systemic PC treatment could offer a potential treatment modality during hypoperfusion or inflammatory conditions of the bones.

[Effects of phosphatidylcholine therapy after hindlimb ischemia and reperfusion]. / A foszfatidilkolin kezelés hatása kísérletes vegtag iszkémiát követoen.

BACKGROUND: Microcirculatory dysfunctions and mast cell reactions play important roles in hypoxic tissue injuries. The aims of this study were to characterize the effects of hindlimb ischemia-reperfusion on the periosteal microcirculation and to define the consequences of systemic phosphatidylcholine therapy during this condition. MATERIALS AND METHODS: Microcirculatory changes were visualized by means of fluorescence intravital videomicroscopy in anesthetized Wistar rats. 60 min of complete hindlimb ischemia was followed by a 180-min reperfusion in the presence of phosphatidylcholine treatment (50 mg/kg iv; in the second 10 min of reperfusion) or vehicle. Further two groups served as vehicle- or PC-treated sham-operated controls. The proportion of degranulated mast cells and the leukocyte accumulation (myeloperoxidase, MPO assay) were determined in muscle biopsies. RESULTS: Ischemia-reperfusion significantly increased the muscle MPO activity (from 14.94 to 63.45 mU/mg) and the proportion of degranulated mast cells (to 82.5%). The periosteal capillary red blood cell velocity (RBCV) and the functional capillary density (FCD) had decreased, while the primary and secondary leukocyte-endothelial cell interactions had increased by the end of reperfusion (rolling from 20.8 to 40.0%, and firm adherence from 254 to 872 mm-2). Phosphatidylcholine treatment decreased the leukocyte rolling and sticking, preserved the FCD and improved the RBCV The mast cell degranulation and MPO activity diminished significantly in the muscle layer. CONCLUSIONS: Mast cell degranulation accompanies ischemia-reperfusion-induced periosteal microcirculatory derangement. Systemic phosphatidylcholine treatment affords protection through ameliorating secondary inflammatory reactions.

[Early clinical experience with postoperative monitoring of a patient after laparoscopic splenectomy combined with spleen autotransplantation. A case report]. / Minimálisan invazív módszerrel végzett, lép autotranszplantált beteg posztoperatív követésére alkalmazott képalkotó eljárásokkal nyert kezdeti tapasztalataink. Esetismertetés.

We performed splenectomy combined with spleen autotransplantation after blunt abdominal trauma by minimally invasive technique at the County Teaching Hospital in Kecskemét. In case of advanced post traumatic spleen injury, spleen autotransplantation (Furka's spleen chips) is a well-known method to try to avoid postsplenectomy syndrome. During the operation, when in situ preservation of the spleen is not possible, chips of spleen tissue are transplanted into the omentum. Function of the transplanted spleen tissue was monitored by scintigraphy. We describe two different types of spleen scintigraphy to check the viability of spleen chips.

Endothelin-a receptor antagonist treatment improves the periosteal microcirculation after hindlimb ischemia and reperfusion in the rat.

OBJECTIVES: To examine the microcirculatory changes in the rat tibial periosteum after hindlimb ischemia and reperfusion and to evaluate the effects of endothelin-A (ET-A) receptor antagonist therapy in this condition. The healing and functioning of vascularized bone autografts depend mainly on the patency of the microcirculation, and the activation of ET-A receptors may be an important component of the tissue response that occurs during ischemia-reoxygenation injuries. METHODS: Wistar rats were subjected to 1 hour of hindlimb ischemia and 3 hours of reperfusion. The periosteal microcirculation was visualized by intravital fluorescence microscopy. The leukocyte rolling and adherence in the postcapillary venules and the functional capillary density of the periosteum were determined. Two separate groups were treated with the selective ET-A receptor antagonist BQ 610 or the novel ET-A receptor antagonist ETR-p1/fl peptide at the onset of reperfusion. RESULTS: Reperfusion was accompanied by a significant decrease in functional capillary density and by an increase in the primary and secondary leukocyte-endothelial cell interactions. ET-A receptor inhibition reduced the leukocyte rolling and firm adherence and attenuated the decrease in functional capillary density in both treated groups. CONCLUSIONS: ET-1 plays a major role in microvascular dysfunction in the periosteum during reperfusion. The ET-1-ET-A receptor system might be an important target for tissue salvage therapy in transplantation surgery.