Penile intracorporeal infusion--possible access to the systemic circulation. Pressure flow studies in dogs and humans.

OBJECTIVE: To assess penile intracorporeal infusion as a simple alternative method of intravenous access during the initial phase of fluid resuscitation in male patients. DESIGN: Laboratory pressure flow studies in dogs and in humans. SUBJECTS: 5 male mongrel dogs, and 10 male patients who were being investigated for psychogenic impotence (n = 5) or organic impotence (n = 5). INTERVENTIONS: Dogs- two 19G needles were inserted into the canine corpora cavernosa, one for fluid infusion, and the other for cavernosal pressure monitoring. Ringer's lactate solution was infused into the corpora cavernosa, through an infusion pump. The dogs were then bled until systolic blood pressure reached 60 mmHg, and resuscitated by transfusion of autologous blood into the corpora cavernosa. HUMANS: Ringer's lactate solution was infused into a corpus cavernosum through a 19G scalp vein needle. Pressure monitoring was done through another 19 G needle. MAIN OUTCOME MEASURE: Fluid flow rates and in humans time taken to insert an intracorporeal needle. RESULTS: Mean (SD) infusion rate through the canine corpora was 110 (22) ml/minute for Ringer's lactate solution and 109 (18) ml/minute for autologous blood. Mean infusion rate into the human corpora was 89.7 (12) ml/minute in the psychogenic impotent patients, and 88.2 (9) ml/minute in the organic impotent patients. Mean time taken to insert the needle was 15 (7) sec. CONCLUSIONS: An intracorporeal infusion line can be established in a short period of time and adequate quantities of fluids can be infused through the human and canine corpora cavernosa.

The effect of minocin on the pericardium.

The purpose of this study was to evaluate in a dog model whether intrapericardial instillation of tetracycline is superior to the effect of drainage alone in causing pericardial adhesions and cavity obliteration. Twelve mongrel dogs were randomly divided into two experimental groups. All dogs received a pericardial drain through a sterile thoracotomy. Group A dogs (n = 6) received minocycline hydrochloride, 20 mg/kg, group B received normal saline. All dogs were sacrificed 1 month later. Echocardiograms performed 1 week postsurgery were normal in all dogs. Macroscopic evaluation disclosed that all group A dogs had over 25% cavity obliteration whereas group B dogs had no adhesions or had obliteration of less than 25% of the cavity area. Microscopic evaluation showed that group A dogs had severe pericardial fibrosis and thickening with slight focal lymphoplasmocytic infiltration. Myocardial damage was not seen. Our results support the clinical use of injecting tetracycline into the pericardium (in addition to drainage) to cause cavity obliteration in patients with persistent pericardial effusion.

Removal of excess inorganic phosphate by haemoperfusion with composite beads.

New composite beads, made by encapsulating hydrous zirconium oxide powder in agarose, are evaluated in vitro and in vivo for the removal of inorganic phosphate from the blood. Phosphate adsorption is rather good and calcium removal can be controlled. Thus, a 250 to 300 ml column is capable of reducing phosphate plasma level by some 5 mg per cent, thus making it attractive for the treatment of acute renal failure. Biocompatibility tests showed that supplementing the standard heparinization procedure by adding some citrate, as ACD, to the extracorporeal circuit greatly improves platelet and leucocyte count. No adverse haemodynamic effects were noted in repeated haemoperfusions of five dogs.

Role of peritoneal absorption in ascites.

The movement of water, electrolytes and protein across the peritoneum was studied experimentally and clinically in ascites. In the experimental and clinically in ascites. In the experimental studies, large amounts of solutions of various osmolar and colloid osmolar concentrations were infused rapidly into the peritoneal cavities of 32 dogs. In 26 of these dogs, the ureters were ligated before the experiment was begun; the other six dogs served as controls. The clinical studies were done in five patients with ascites. Tritium, 35S and RISA dilution techniques were used to study the kinetics of the different components of peritoneal fluid. Osmolarity changes were measured in plasma and peritoneal fluid by the freezing point depression method. Volume changes of peritoneal fluid were measured serially up to 24 hours for the assessment of the peritoneal absorption rate. The rate of fluid movement across the peritoneal membrane seems to be influenced, among others, by the composition of the intraperitoneal fluid, as well as by the properties of the membrane itself. An asymmetric pattern of peritoneal absorption rate of the different compositional elements of ascitic fluid was observed in this study which seems to interrelate with dynamic equilibrium which develops between ascites and the physiologic body fluid compartments. No cessation of peritoneal fluid absorption or a maximal reabsorption rate was observed in this study; nevertheless, variations in the rate of peritoneal absorption due to miscellaneous influences are possible.