腺病毒介导的Bcl-XL shRNA对结肠癌细胞的体外抗肿瘤性

目的研究腺病毒介导的Bcl—XL shRNA对结肠癌细胞株的体外抗肿瘤性。方法将已有的Bcl-XL腺病毒进行扩增纯化．并通过反转录反应分析该腺病毒在mRNA水平对Bcl-XL的表达调控。通过MTT检测及克隆形成实验,了解该腺病毒对结直肠癌细胞株（Lovo细胞株）的体外杀伤作用。结果Ad／Bcl．XLshRNA作用于Lovo细胞株导致Bcl—XL mRNA表达水平下降。与对照腺病毒Ad／GFP相比,Ad／Bcl-XL shRNA显著抑制Lovo细胞的增长（P〈0．05）,且该抑制效应呈剂量和时间依赖性;显著抑制Lovo细胞的克隆形成（P〈0．05）,且该抑制效应呈剂量依赖性。而Ad／Bcl—XL shRNA对正常人成纤维细胞（NHFB）无明显杀伤作用。结论腺病毒介导的Bcl-XL shRNA对Lovo细胞株具有杀伤作用,可能存在潜在的结肠癌治疗价值。     

人端粒酶反转录酶启动子调控NK4基因靶向治疗结肠癌的实验研究

目的 构建人端粒酶反转录酶（HTERT）启动子调控的NK4基因重组腺病毒表达系统,探讨NK4基因对结肠癌生长、侵袭转移的抑制作用.方法 以Ad HTERTp-NK4重组腺病毒载体感染结肠癌细胞HTC116,分别以RT-PCR方法和Western blot检测细胞内NK4基因mRNA及蛋白表达量：MTT和体外侵袭实验观察NK4对结肠癌细胞增殖及侵袭转移能力的抑制作用.建立结肠癌裸鼠皮下移植瘤模型,观察重组腺病毒Ad HTERTp-NK4对裸鼠结肠癌移植瘤生长的影响.结果 Ad HTERTp-NK4重组腺病毒载体感染HCT116细胞后,HCT116细胞内NK4 mRNA及蛋白表达水平明显增高：Ad HTERTp-NK4重组腺病毒感染后,HCT116细胞生长抑制率和侵袭抑制率分别为47.14%和40.63%,与Ad HTERTp-GFP（空载体）组（2.75%和2.31%）比较,差异均有统计学意义（均P＜0.05）.局部注射Ad HTERTp-NK4重组腺病毒载体后,结肠癌裸鼠皮下移植瘤模型肿瘤生长受抑,抑瘤率为47.3%,与空载体组（4.6%）比较,差异有统计学意义（P＜0.05）.结论 HTERT启动子调控NK4基因靶向治疗系统可有效抑制结肠癌的增殖及侵袭转移,在结肠癌的基因治疗具有较好的应用前景.     

反苯环丙胺对结肠癌细胞迁移和侵袭的影响

目的 探讨抑制赖氨酸特异性脱甲基酶1(lysine specific demet hylase 1,LSDl)活性对人结肠癌细胞迁移的影响.方法 本研究应用反苯环丙胺抑制LSD1酶的活性,通过划痕试验和Transwall实验在体外观察人结肠癌Lovo细胞迁移和侵袭的变化.用RT-PCR和Western blot法检测LSD1的表达和H3K4me2甲基化水平. 结果 经过不同剂量反苯环丙胺(40、60和80 μmol/L)处理后,细胞增殖实验结果显示对人结肠癌Lovo细胞增殖无影响(P＞0.05);60μmol/L反苯环丙胺干预后,划痕试验结果发现Lovo细胞迁移明显受抑制.TranswaⅡ实验发现穿过小室的细胞数:60 μmol/L反苯环丙胺组为(69.7±2.5),而对照组为(222.7±11.0),两者比较差异有统计学意义(P＜0.05).RT-PCR检测显示Lovo细胞中的LSDl mRNA和蛋白水平的表达无改变,但H3 K4me2甲基化水平升高.结论 60μmol/L反苯环丙胺能抑制结肠癌Lovo细胞的LSD1酶活性,降低细胞的迁移和侵袭能力.     

腺病毒介导的RNA干扰对大肠癌HCT116细胞株β-连环蛋白表达的抑制作用

目的 构建针对人β-连环蛋白(catenin)的腺病毒载体pAdHl-shβ-catenin-GFP,应用RNA干扰(RNAi)的方法,观察其在体内和体外对人大肠癌细胞株HCT116生长的抑制作用.方法 设计合成针对β-catenin的shRNA,并克隆至腺病毒表达载体AdH1-GFP上,制备针对β-catenin的腺病毒载体AdH1-GFP-shβ-catenin-GFP,与腺病毒骨架载体共转染293A细胞包装病毒,采用空斑法测定病毒滴度为5×109pfu/ml,感染HCT116细胞.应用Western bolt和报告基因检测HCT116细胞β-cmemn表达水平和转录活性,噻唑蓝(MTT)比色法测定活细胞数并绘制细胞生长曲线,建立软琼脂克隆形成实验观察肿瘤体外成瘤能力,同时建立裸鼠HCT116细胞移植瘤模型,观察肿瘤生长情况.结果 成功构建针对β-catenin基因的RNAi腺病毒表达载体,与AdH1-GFP组比较AdH1-shβ-catenin-GFP组在感染24 h和48 h HCT116细胞β-catenin表达水平和转录活性显著降低,细胞的增殖和克隆形成能力则下降50%(P<0.01).体内实验表明重组腺病毒载体介导的β-catenin shRNA明显抑制肿瘤生长(P<0.01).结论 腺病毒介导的RNAi技术可有效降低β-catenin在大肠癌细胞中的表达水平,抑制肿瘤细胞在体内外的增殖活性.     

吉非替尼对结肠癌细胞的生长抑制作用与PTEN表达的关系

目的 观察表皮生长因子受体酪氨酸激酶抑制剂吉非替尼对人结肠癌细胞的生长抑制作用,探讨这种作用与结肠癌细胞PTEN表达的关系.方法 应用体外药物敏感实验检测吉非替尼对6种人结肠癌细胞系的生长抑制作用;应用RT-PCR检测不同结肠癌细胞中PTEN mRNA水平;应用Western blot 检测结肠癌细胞中PTEN蛋白表达水平.结果 吉非替尼在体外对6种结肠癌细胞系的生长抑制作用差异很大(F=325.51,P＜0.05).吉非替尼作用浓度为1 μmol/L时,Lovo细胞系抑制率达34%,对吉非替尼最为敏感,其半量抑制浓度(IC50)＜10 μmol/L;HT29和SW480为中度敏感(10μmol/L＜IC50＜100 μmol/L);而HCT116、LS174T和SW620不敏感,其IC50＞100 μmol/L.各个细胞系中PTEN mRNA和PTEN蛋白均有表达.结论 吉非替尼对结肠癌细胞的生长抑制作用与PTEN mRNA和PTEN蛋白表达水平无明显相关,即PTEN表达状态还不能作为预测结肠癌对吉非替尼敏感性的可靠生物学指标.     

Celebrex对雄激素非依赖性前列腺癌细胞的抑制作用

目的 探讨选择性环氧化酶-2(COX-2)抑制剂Cetebrex对雄激素非依赖性前列腺癌PC3细胞株的抑制作用及机制. 方法 体外培养人雄激素非依赖性前列腺癌细胞PC3,应用MTT法、RT-PCR和ELISA法检测Celebrex对PC3细胞生长的作用及对COX-2 mRNA、前列腺素E2(PGE2)和IL-6表达的影响. 结果 Celebrex在一定时间和剂量范围内可明显抑制PC3细胞的生长,Celebrex无论在时间-效应或剂量-效应关系上均不影响PC3细胞COX-2 mRNA的表达,但能明显减少PGE2和IL-6的表达. 结论 炎症因子的分泌增多可能是雄激素非依赖性前列腺癌细胞生长的动力,Celebrex对COX-2 mRNA的表达无明显影响,主要是通过抑制COX-2及其下游炎症因子PGE2和IL-6等的表达而对雄激素非依赖性前列腺癌发挥抑制效应.     

腺病毒载体介导反义Src基因治疗胶质瘤

目的 探讨腺病毒载体介导的反义Src基因对胶质瘤生长的作用及其机制.方法 应用携带反义Src基因的重组腺病毒体外感染C6胶质瘤细胞,观察其对细胞形态、生长曲线和克隆形成率的影响.建立大鼠胶质瘤动物模型,原位注射重组腺病毒.观察其治疗作用,Western blot检测肿瘤组织Src、Ras、MAPK蛋白的表达,实时逆转录-聚合酶链反应(Real-time RT-PCR)检测肿瘤组织Caspase-3、Caspase-8 mRNA的表达.结果 体外研究表明感染反义Src基因的C6胶质瘤细胞生长受到显著抑制.体内研究表明应用携带反义Src基因的腺病毒原位注射治疗大鼠胶质瘤能够抑制肿瘤生长,减少Src、Ras、MAPK蛋白的表达,增加Caspase-3、Caspase-8 mRNA的表达.结论 腺病毒载体介导的反义Src基因能够抑制大鼠胶质瘤细胞的生长.Src-Ras-MAPK信号通路参与胶质瘤的生长,抑制该信号通路可以增加凋亡通路关键蛋白Caspase-3、Caspase-8的表达.     

双自杀基因重组腺病毒对胰腺癌细胞特异性杀伤作用

目的 研究腺病毒介导的KDR启动子驱动CD/TK融合基因系统(Ad-KDR-CDTK)对胰腺癌细胞Capan-2特异性的杀伤作用.方法 重组腺病毒体外感染表达KDR的Capaw2细胞株,用不表达KDR的肝癌细胞HepG2做对照.观察其感染效率并以RT-PCR方法 检测转基因细胞CDTK的表达,然后给予不同浓度的前药更昔洛韦(ganciclovir,GCV)和5-氟胞嘧啶(5-fluorocy-tosine,5-FC),MTT法观察该体系对Capan-2和HepG2细胞生长增殖的影响及其旁观者效应;电镜观察细胞的病变;流式细胞仪检测细胞周期的变化和DNA含量的变化.建立Capan-2裸鼠皮下移植瘤模型,瘤内注射Ad-KDR-CD/TK,腹腔注射前药GCV(50 mg·kg-1·d-1)和5-FC(500 mg·kg-1·d-1)14 d,观察肿瘤生长抑制效应.结果 腺病毒对两种细胞株的感染率相似,其感染率随腺病毒滴度的增高而递增.RT-PCR方法 检测发现转染Ad-KDR-CDTK的Capan-2细胞有目的 基因表达.MTT法检测显示前药呈剂量依赖性抑制Capan-2生长,而不表达KDR的肝癌细胞HepG2对前药不敏感,且观察到该体系对Capan-2明显的旁观者效应.电镜下可见Capan-2有凋亡改变.用流式细胞仪测定用药组出现典型的凋亡峰;细胞周期分析显示治疗后细胞G0-G1期比率增多,G2-M及S期细胞减少.在Capan-2裸鼠移植瘤模型中,该双自杀基因系统能够显著抑制肿瘤的生长.结论 KDR启动子可调控双自杀基因体系选择性杀伤胰腺癌细胞Capan-2,诱导胰腺癌细胞凋亡,并可显著抑制人胰腺癌裸鼠移植瘤的生长.     

WTX 慢病毒载体及其稳转结肠癌细胞株Lovo/WTX-EGFP 的建立

目的：构建抑癌基因WTX慢病毒载体,建立稳定转导WTX的结肠癌Lovo/WTX-EGFP细胞株,为研究WTX在结肠癌中的作用机制提供有效工具。方法：通过Gateway技术构建WTX慢病毒载体pLV.Ex3d.null-EF1A>WTX>IRES/EGFP并通过菌落PCR筛选鉴定,将其与辅助质粒pLV/helper-SL3,PLV/helper-SL4,PLV/helper-SL5共转染293FT细胞包装慢病毒并在荧光显微镜下行滴度值测定。用WTX慢病毒载体转导结肠癌Lovo细胞株,并通过多次挑克隆培养建立稳定表达WTX的Lovo/WTX-EGFP细胞株。结果：Gateway技术构建的慢病毒载体pLV.Ex3d.null-EF1A>WTX>IRES/EGFP经鉴定完全正确;慢病毒包装48 h后视野下可见清晰绿色荧光表达,病毒滴度为5×107 TU/mL。慢病毒载体成功转导Lovo细胞,经qPCR及Western blot检测WTX表达水平明显升高;通过多次挑克隆培养成功建立了稳定转导WTX的Lovo/WTX-EGFP细胞株。结论：通过Gateway技术可成功构建WTX慢病毒载体并获稳定转导WTX的Lovo/WTX-EGFP细胞株,为研究WTX在结肠癌中的作用机制提供了实验基础。     

靶向RNA干扰Survivin对结肠癌细胞HT-29增殖凋亡的影响

目的探讨肿瘤增殖型腺病毒（Ad-delE1b55KD-shRNA／Survivin-EGFP）介导的以人Survivin为靶标的RNA干扰对结肠癌细胞株HT-29中Survivin mRNA和蛋白表达及对HT-29增殖凋亡的影响。方法用Ad-delE1b55KD-shRNA／Survivin-EGFP转染结肠癌细胞株HT-29（以携带相同shRNA的增殖缺陷型腺病毒和脂质体载体为对照），用逆转录-聚合酶链反应（RT-PCR）和Western blot分别检测转染后的HT-29细胞中Survivin mRNA和蛋白表达的变化，用噻唑蓝（MTT）法、吖啶橙／溴乙锭荧光染色法、Annexin V-PE／7-AAD联合染色法检测细胞死亡率及凋亡率。结果与复制缺陷型腺病毒载体和脂质体载体比较，转染Ad-delE1b55KD-shRNA／Survivin-EGFP后，HT-29细胞中Survivin mRNA拷贝数及蛋白表达显著降低，其细胞死亡率和凋亡率显著提高（P〈0．05）。结论Ad-deIE1b55KD-shRNA／Survivin-EGFP介导的RNA干扰较之增殖缺陷型腺病毒载体和脂质体载体具有更高的干扰效率，且能高效地诱导结肠癌细胞凋亡并抑制其增殖。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.