ABSTRACT
Objective To summarize the experience of operation on gastric carcinoma combined with severe pulmonary dysfunction and reduce the incidence of postoperative fatality and complications.Methods According to FVC,MVV,FEV1 from high to low grouping,and interfere with ambroxol hydrochloride,doxofylline,budesonide,terbutaline,ipratropium bromide,tiotropium bromide to 20 patients who suffered gastric carcinoma combined with severe pulmonary dysfunction before and after operation,and interfere with different anesthesia methods.Results Postoperative complications occurred in 20 patients within one month,Hydrothorax in 2 cases,pulmonary infection in 2 cases,respiratory failure in 2 cases,acute pulmonary edema in 1 cases,acute pulmonary embolism in 1 case.After active treatment,19 patients cured,1 case died due to acute pulmonary edema.Conclusion The complications rate and risks are high in the gastric carcinoma patients combined with severe pulmonary dysfunction,and strict preoperative and postoperative managements are key to the operation.
ABSTRACT
Leptopspirosis is a syndrome with different clinical manifestations including the most severe and often fatal forms of pulmonary disease of unknown etiology. Pulmonary injury during the inflammatory process has been associated with the excessive number of alveolar macrophages (AMs) and polymorphonuclear leukocytes stimulated in the lungs and with the production of reactive oxygen and nitrogen intermediates and other inflammatory mediators. The aim of the present work was to evaluate the cellular immune response of AMs or inflammatory cells of hamsters during leptospirosis. The activity of AMs was determined by measuring nitric oxide (NO) and protein production as well as inflammatory cell infiltration in bronchoalveolar lavage (BAL) fluid. Pulmonary activity during infection was monitored by measuring pH, pressure of oxygen (PaO2), and pressure of carbon dioxide (PaCO2) in blood samples. Cellular immune response and its role in the genesis of leptospirosis have been incriminated as the main causes of tissue and pulmonary injuries, which consequently lead to the pulmonary dysfunction in severe cases of leptospirosis. The present results show a low production of NO in both supernatant of alveolar macrophage culture and BAL. In the latter, protein production was high and constant, especially during acute infection. Total and differential cell count values were 2.5X10(6) on day 4; 7.3X10(6) on day 21; and 2.3X10(6) on day 28 after infection, with lymphocytes (84.04 percent) predominating over neutrophils (11.88 percent) and monocytes (4.07 percent). Arterial blood gas analysis showed pulmonary compromising along with the infectious process, as observed in parameter values (mean±SD) evidenced in the infected versus control group: PaO2 (60.47mmHg±8.7 vs. 90.09mmHg±9.18), PaCO2 (57.01mmHg±7.87 vs. 47.39mmHg±4.5) and pH (7.39±0.03 vs. 6.8±1.3). Results indicated that Leptospira infection in hamsters is a good experimental model to study leptospirosis. However, some of the immune parameters showed variations which might be associated with the animal species.
Subject(s)
Animals , Male , Leptospirosis/complications , Macrophages, Alveolar , Lung/physiopathology , MesocricetusABSTRACT
Ovbective To evaluate whether the deleterious effect of cardiopulmonary bypass (CPB) mediated by oxygen free radicals could be prevented by controlling PaO 2 in cyanotic children. Methods Cyanotic pediatric patients undergoing cardiac surgery (n=38) were randomly allocated into 2 groups. The groups matched in respect to sex,age,body surface area and preoperative ventricular function. Group H (n=18) had CPB initiated at a FiO 2 of 0.8,group L (n=18) had CPB initiated at a FiO 2 of 0.4. SOD and MDA were determined in arterial blood sample before CPB,30 minutes after initiation of CPB and 30 minutes post CPB. Various pulmonary parameters were determined 10 minutes after intubation,30 minutes after CPB,the 2nd hours and the 6th hours in the intensive care units. Results At the 6th hours in ICU,the mean postoperative increase in peak airway pressure and P(A-a)O 2/PaO 2 in group H was significant higher than that in group L(P