RESUMO
The protective effect of the calcium channel blocker nimodipine on liver ischemia and reperfusion was studied in the rat. The homeostasis of intracellular calcium ions seems to be a determinant factor in the cell injury that appears after ischemia and reperfusion. Nimodipine was used to downregulate the calcium levels in the cytosol of the ischemic cell, the hypothetical role of Ca2+ in the pathogenesis of ischemia and reperfusion injury. The experimental procedure consisted of the temporary interruption of blood flow to the left lateral and medial lobes of the rat liver and subsequent reperfusion after a period of 45 min of ischemia. Nimodipine (10 micrograms/kg body wt) was administered either before or after the onset of ischemia. The postischemic liver blood flow and liver oxyhemoglobin saturation were recorded using a He-Ne laser Doppler flowmeter and photometer, which showed, in the pretreated group, a recovery of reperfusion blood flow (58.1%) and liver reflectance (85.5%) significantly better (P < 0.01 and P < 0.001) than those in the respective untreated controls of flow (32.8%) and reflectance (70.5%). In the group that received nimodipine after ischemia, the recovery of the blood flow and the postreperfusion liver reflectance were not significantly better than those in the untreated control group. ALT levels (P < 0.05), galactose elimination capacity (P < 0.001), and histological studies also showed a protective effect of calcium antagonist nimodipine when administered before ischemia.
Assuntos
Bloqueadores dos Canais de Cálcio/farmacologia , Isquemia/fisiopatologia , Circulação Hepática/efeitos dos fármacos , Nimodipina/farmacologia , Traumatismo por Reperfusão/fisiopatologia , Animais , Hemoglobinas/metabolismo , Isquemia/sangue , Isquemia/patologia , Fígado/irrigação sanguínea , Fígado/patologia , Fígado/fisiopatologia , Masculino , Microcirculação/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/sangue , Traumatismo por Reperfusão/patologiaAssuntos
Antígenos CD59/biossíntese , Ativação do Complemento , Endotélio Vascular/fisiopatologia , Isquemia/fisiopatologia , Circulação Hepática , Fígado/irrigação sanguínea , Reperfusão , Animais , Antígenos CD59/análise , Endotélio Vascular/metabolismo , Galactose/metabolismo , Expressão Gênica , Hemoglobinas/metabolismo , Homeostase , Isquemia/sangue , Fluxometria por Laser-Doppler , Masculino , Ratos , Ratos Sprague-Dawley , Fluxo Sanguíneo RegionalRESUMO
A study in 64 patients with a high risk of wound dehiscence or eviscerated wounds or in whom repeat laparotomies for peritoneal lavages due to sepsis were planned was accomplished using adjustable nylon ties for the closure of the abdominal wall, either as retention sutures or as one-layer sutures. The adjustable nylon ties are described, as well as the technique for placing and adjusting them. It is concluded that the adjustable nylon ties can substitute advantageously for the conventional retention sutures since the former are wider, easy to place, and can be readjusted to the point that they can be opened completely if it is necessary and then closed again. This is especially useful when repeat laparotomies for peritoneal lavages are required in patients with intra-abdominal sepsis.