The influence of the low-energy defibrillating impulse on the endothelin-1 concentration in the left heart ventricle and blood serum of the healthy rabbits.

The influence of low-energy defibrillation on changes in the ET-1 levels in the myocardium and on disruptions in coronary blood flow and microcirculation being their consequence still remains unclear. Myocardial microcirculatory dysfunction is considered as a significant cause underlying myocardial dysfunction in post-cardiac arrest syndrome. This study is aimed at evaluating time-dependent changes in ET-1 levels in serum and the heart of a healthy rabbit following the application of a low-energy two-phase shock impulse. The research was conducted in 35 healthy rabbits at the age of 36 - 42 weeks and with body mass from 3200 to 4150 grams. The animals were divided in a randomized way into four groups depending on the dose of the electrical energy planned for the application during the experiment. The life parameters of the animals were monitored with the application of BeneView T5 patient monitor. The concentration of endothelin-1 in the groups was measured before, 15 and 360 minutes after the application of the low-energy double-phase straight-lined electrical impulse. A transthoracic low-energy defibrillation shock impulse causes a long-term increase in the endothelin-1 levels in the heart muscle and blood serum in a healthy rabbit. The increase in ET-1 levels results from the effect of electrical energy, independently of consequences of the ischemia/reperfusion injury. The increase in the endothelin-1 levels may lead to capillary blood flow abnormalities in the heart, contributing to the development of its dysfunction in the course of postresuscitation disease.

Impact of low-energy shock impulse on nitric oxide serum levels in healthy rabbits.

Nitric oxide (NO) has emerged as a potent effector molecule for a post-resuscitation disease as a result of the low-energy defibrillation. In this article, the authors anlysed the changes of endogenous nitric oxide levels in serum of 35 healthy rabbits after the transthoracic application of low-energy two-phase shock impulse. The animals were randomised into four groups according to the electrical energy dose to be applied during the experiment. Life parameters of the animals were monitored using the BeneViev T5 patient monitor. The nitric oxide concentration in the groups was measured before, 15 and 360 minutes after applying the low-energy two-phase linear electrical impulse. From 15 to 360 minutes the decrease in nitric oxide concentration was observed. The effect was dependent on single impulse and accumulated energy volumes. The highest decrease of NO concentration was observed in 15 minutes following the application of two electrical impulses of accumulated energy of 8 J/kg/bm. After 360 minutes following the application, a significant increase in nitric oxide levels was recorded. The changes in the nitric oxide levels in the blood serum 15 minutes after the defibrillation may initiate the vasomotor disorders as a result of the low-energy influence of the shock impulse.

The influence of fatty acids on theophylline binding to human serum albumin. Comparative fluorescence study.

Theophylline, popular diuretic, is used to treat asthma and bronchospasm. In blood it forms complexes with albumin, which is also the main transporter of fatty acids. The aim of the present study was to describe the influence of fatty acids (FA) on binding of theophylline (Th) to human serum albumin (HSA) in the high affinity binding sites. Binding parameters have been obtained on the basis of the fluorescence analysis. The data obtained for the complex of Th and natural human serum albumin (nHSA) obtained from blood of obese patients qualified for surgical removal of stomach was compared with our previous studies on the influence of FA on the complex of Th and commercially available defatted human serum albumin (dHSA).

Gastroduodenoscopy: a routine examination of 2,800 patients before laparoscopic cholecystectomy.

BACKGROUND: Unrecognized gastric and duodenal peptic ulcer is a common cause of epigastric pains for patients with cholelithiasis qualified for laparoscopic cholecystectomy. Undiagnosed gastric or duodenal ulcer may be the cause of persistent pains after cholecystectomy. The purpose of the study was to assess the value of a routine preoperative panendoscopy for qualifying patients to undergo laparoscopic cholecystectomy. METHODS: The study enrolled 2,800 patients treated for cholelithiasis from May 1993 to December 2002. Endoscopic examination was performed for all treated patients 1 to 4 days before their operations. RESULTS: Preoperative endoscopy showed pathologic changes in the stomach or duodenum in 1,187 (42%) of 2,800 patients qualified for laparoscopic cholecystectomy. Gastric ulcer was found in 179 patients (6.4%) duodenal ulcer in 127 patients (4.5%), gastritis in 735 patients (26.3%), polyps in 143 patients (5.1%), and cancer in 3 patients (0.1%). The surgery was postponed for patients with ulcer, and antiulcer treatment was started. In 16 patients, the symptoms associated with cholelithiasis subsided after healing of the ulcer. Cholelithiasis in these patients was asymptomatic, and a cholecystectomy was not performed. CONCLUSIONS: Panendoscopy should be a routine examination performed for each patient qualified to undergo laparoscopic cholecystectomy. For some patients with asymptomatic cholelithiasis, pain in fact is caused by peptic ulcer.

[Laparoscopic excision of huge spleen in a 5-year-old boy with hypersplenism]. / Laparoskopowe usuniecie olbrzymiej sledziony u 5-letniego chlopca z powodu hipersplenizmu.

Minimally invasive surgery has been recently gaining acceptance as an alternative to "open" surgery. The benefits of video-surgery consist of minor surgical trauma of tissues, shorter hospital stay, quicker return to full activity and better cosmetic effect compared to traditional splenectomy. Less peritoneal adhesions after laparoscopic splenectomy decreases also the risk of strangulation ileus in the future. Authors present laparoscopic splenectomy in 5 year-old boy with hypersplenism. Technical details, intraoperative difficulties, immediate and late outcome were described. The early results, advantages and disadvantages were also discussed.

[Palliative procedures in advanced stomach cancer]. / Zabiegi paliatywne w zaawansowanym raku zoladka.

Gastric carcinoma still occurs in the advanced form, despite easier availability of endoscopic examinations. Symptoms, location and the degree of progression of gastric carcinoma in 186 patients treated between 1980-1997 were presented in the paper. Curative partial gastrectomy was carried out in 69 patients. The palliative procedure of partial gastrectomy, gastroenterostomy shunt and trophic fistula was carried out 117 patients. Attention was paid to the most recent methods of treatment which, hopefully, improve the results of the treatment of advanced gastric carcinoma.