Effect of cold atmospheric plasma/NO gas application with different exposure times on healing in wounds with tissue loss in diabetic rats.

Applications of cold atmospheric plasma/nitric oxide (CAP/NO) gas have recently garnered popularity when treating impaired wound healing in patients with diabetes. In this study, we aimed to investigate the effects of NO gas application for 60 and 120 s on wound healing in diabetic rats. A dorsal excision 3 cm in diameter was performed in 15 diabetic rats; these rats were categorized into the following 3 groups: DC (untreated diabetic control); DNO/60 (exposure to 200 ppm NO gas for 60 s/day); and DNO/120 (exposure to 200 ppm NO gas for 120 s/day). Wound contraction on days 0, 3, 7, 11, and 14 and wound contraction rate between days 0 and 14 were evaluated. On day 14, tissue samples were collected for histopathologic assessment of inflammation, epithelial regeneration, angiogenesis congestion, and collagen fiber organization. Normality of distribution was assessed using the Shapiro-Wilk test, and intergroup comparisons were performed using the Mann-Whitney U test (NPar Test) and the Kruskal-Wallis test (non-parametric ANOVA). Wound contraction during treatment days 7-14 was significantly greater in the NO-treatment groups than in the DC group (p<0.05). The NO60 s and NO120 s groups showed a significantly higher wound contraction rate than the DC group (p=0.033, p=0.049, respectively). Significant differences were noted between the control and NO groups in terms of inflammation (p<0.05) and between the control group and DNO/60 and DNO/120 groups in terms of collagen organization (p<0.05, p<0.01, respectively). Evaluation of epithelialization revealed significant intergroup differences between the control and NO treatment groups (p<0.01). In this study, the application of NO once a day for 60 seconds and 120 seconds in diabetic wounds contributed equally to wound healing.

Investigation of the protective effect of anzer propolis in cerebral ischemia-reperfusion injury.

OBJECTIVE: Globally, stroke is the leading cause of disability and death. With the use of thrombolytic therapy, reperfusion injury, and its consequences came to the fore. We aimed to find out how anzer propolis, which can only be obtained in Turkey's Eastern Black Sea region, affected ischemia-reperfusion injury using biochemical and histological techniques. MATERIALS AND METHODS: 32 female Wistar albino rats were divided into 4 groups, including a control group. Three of the groups underwent 30 minutes of induced ischemia via clamping of the common carotid artery, followed by ischemia-reperfusion injury through the release of the clamp. One group received no treatment, another received oral administration of 100 mg/kg of anzer propolis one hour before surgery, and the third group received oral administration of 40 mg/kg of acetylsalicylic acid just before surgery. Histopathological examination assessed apoptosis and tissue necrosis, while serum and brain tissue were evaluated for levels of nerve growth factor (NGF), Interlokin 1ß (IL-1ß), Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), total antioxidant capacity (TAS), and total oxidant capacity (TOS). RESULTS: Anzer propolis and acetylsalicylic acid significantly reduced hyperemia in vessels, vacuolization in neurons, glial cell infiltration, and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) positivity. The anzer propolis group had the highest NGF levels. The anzer propolis and acetylsalicylic acid groups had lower levels of TNF-a and IL-6 in the brain tissue than the ischemia-reperfusion group, while TAS levels were higher. CONCLUSIONS: The findings obtained in this study suggest that anzer propolis has a neuroprotective effect against ischemia-reperfusion injury and will have beneficial effects on neurodegeneration. We believe our findings will contribute to the clinical treatment of ischemia-reperfusion injury.

Evaluation of preemptive dexketoprofen trometamol effect on blood chemistry, vital signs and postoperative pain in dogs undergoing ovariohysterectomy.

OBJECTIVE: To investigate the postoperative analgesic effects of preemptive dexketoprofen trometamol in dogs subjected to ovariohysterectomy (OHE). MATERIAL AND METHODS: Seventeen adult bitches of various breeds were used in this study. The dogs were randomly allocated into of two groups. Subjects in the dexketoprofen trometamol (DEX) group (n=10), received intravenous (i.v.) dexketoprofen trometamol, 1 mg/kg, 15 minutes before premedication, while those assigned to the control (C) group (n=7) were given no analgesics prior to premedication. Pain level was assessed by two researchers before the administration of anaesthesia (15 minutes before start) and 0, 1, 2, 4 and 6 hours after surgery. A modified University of Melbourne Pain Scale (UMPS) was used to evaluate pain in both groups. RESULTS: Serum cortisol level changed from 0 to 1 h and from 0 to 1 to 4 h were compared between the groups; the increase in the C group was statistically significant. The modified UMPS was applied to both groups at baseline and postoperative 1, 2, 4 and 6 h. According to this test, the values for DEX were significantly lower than controls at 4 and 6 h (p<0.001). CONCLUSION: Stable vital signs with unchanged biochemical parameters on dexketoprofen administration are a promising finding. The clinical advantage shown by the pain scale difference and the low serum cortisol levels should qualify dexketoprofen for preemptive pain management in dogs (Tab. 5, Fig. 2, Ref. 30).

The effect of gabapentin and pregabalin on intestinal incision wound healing in rabbits.

AIM: To evaluate the macroscopic and histologic effects of pregabalin (PG) gabapentin (GB) on longitudinal intestinal wound healing in New Zealand rabbits. MATERIALS AND METHODS: The animals were divided into three groups randomly; the control group (n=6), PG group (n=6) and GB group (n=6). All animals were premedicated with xylazine HCI, 5 mg/kg i.m. and general anaesthesia was performed by ketamine HCI 50 mg/kg i.m injection. A 4 cm incision in the caecum through median laparotomy was achieved under aseptic surgery. Intestinal wound was closed with double-sutured. All animals were received parenteral antibiotic treatment for 5 days. PG and GB groups were treated by PG (30 mg/kg, oral, daily) and GB (30 mg/kg, oral, daily) for 10 days respectively. Control group did not receive any treatment. The animals were euthanized on day 10 and the caecum was examined by laparotomy. Adhesion formation was observed, and tissue samples were taken from suture lines for histologic examination. Cellular infiltration (polymorphonuclear white blood cells and mononuclear cells), accumulation of connective tissue, vascularization and extent of necrosis were evaluated and scored separately for each of mucosal, submucosal, muscular and serosal layers of caecum. RESULTS: Adhesions were more severe in the GB group compared to other groups. No statistically significant differences were detected among the three groups about the wound healing. CONCLUSION: It was suggested that the use of gabapentinoids had no significant effect on wound healing in patients undergoing gastrointestinal surgery and further studies with treatment periods longer than 10 days are needed.

Comparison of flunixin meglumine and meloxicam influence on postoperative and oxidative stress in ovariohysterectomized bitches.

The aim of this study was to compare the effect of flunixin meglumine (FM) and meloxicam (M) on postoperative and oxidative stress in ovariohysterectomized bitches. Twenty four bitches were divided into three groups (n = 8 in each) and treated during premedication as follows: FM (2.2 mg/kg, iv, Fluvil, Vilsan, Turkey), M (0.2 mg/kg, sc, Maxicam, Sanovel, Turkey) or 0.9% saline (1 ml, iv, IE, Turkey)--control (C) group. The concentrations of serum cortisol, nitric oxide (NO), malondialdehyde (MDA), antioxidant potential (AOP) and glutation (GSH) were measured in blood samples collected during incision (0 h), closure of incision line (0.5 h) and 1, 2.5, 12 and 24 hours after incision. It was observed that cortisol level was higher at 0.5, 1 and 2.5 h in group C (p < 0.05), 0.5 h in group FM (p < 0.001), and 1 and 2.5 h in group M (p < 0.01), as compared to that determine at 0 h. Group C showed higher cortisol level during 0.5 h (p < 0.05) than that found in the other groups. Group FM displayed lower levels during 1 h (p < 0.01) and 2.5 h (p < 0.05) as compared to those observed in other groups. Concentrations of MDA, AOP and GSH between all the groups did not show any significant differences. MDA level was higher at 0.5 and 1 h in group M (p < 0.05) than that found in group C and it was the lowest at 2.5 h in group C (p < 0.05). AOP was higher at 2.5 h in group FM and M (p < 0.05) than that observed in group C, and at 12 and 24 h in group M than that found in group C and FM. GSH did not show any significant differences between the groups. NO level in group FM after 12 h was higher (p < 0.05) than that at 0.5, 1 and 24 h. Moreover, NO level was lower at 0.5 (p < 0.01), 1 (p < 0.05) and 24 h (p < 0.05) in group FM than that observed in group C and M. In conclusion, flunixin meglumine decreases cortisol and NO levels more efficiently than meloxicam. Therefore, it is suggested that postoperative stress following ovariohysterectomy may be prevented by flunixin meglumine in bitches.

Comparison of the effects of lidocaine and fentanyl in epidural anesthesia in dogs.

The study included 12 clinically healthy, adult male dogs of various breeds, admitted to our clinic for castration. After general anesthesia with sevoflurane, we administered epidural fentanyl (1 mcg/kg) to fentanyl group, while lidocaine group was given Lidocaine (3 mg/kg) through epidural administration. When hemodynamic parameters were stabilized, first measurements were recorded at minutes 0, 15, 30, 60 in both groups, which included Heart Rate (HR), body temperature, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), sodium (Na+), potassium (K+), glucose (GLC), and hemoglobin (HB) measurements. In addition, serum samples were obtained from arterial blood at the same measurement times, and pH, pO2, pCO2, HCO3, %O2 Saturation, BE levels were measured. For hematological analysis, WBC, RBC, HCT, THR counts were performed. For serum biochemical analysis, venous blood samples were collected at minutes 0 and 60 and CK, TP, UREA, ALT, AST, ALB, GGT, CRE, CK-MB parameters were assessed using auto-analyzer. Moreover, cortisol levels were measured in the samples collected at minutes 0, 30, and 60.Mean arterial blood pressure values measured at minutes 15, 30 and 60 were found significantly lower in the fentanyl group (p<0.01). In conclusion, we suggest that epidural anesthesia with lidocaine and fentanyl can provide an effective and safe option in high-risk groups (Tab. 5, Fig. 1, Ref. 24).

[Healing of osteochondral defects in canine knee with avocado/soybean unsaponifiables: a morphometric comparative analysis]. / Avokado/soya fasülyesinin sabunlasmayan ekstresi verilen köpeklerin dizlerinde osteokondral defekt iyilesmesi: Bir karsilastirmali morfometrik analiz.

OBJECTIVES: This study aims to determine the effects of avocado/soybean unsaponifiables (ASU) on healing in a canine osteochondral defect model. MATERIALS AND METHODS: Fourteen dogs were included in the study and randomly divided into two groups. Two osteochondral defects were produced in the lateral aspect of the trochlear groove of the knee joint. The treatment group (group 1; n=7) was given 300 mg ASU capsules every three days whereas the control group (group 2; n=7) was given a normal diet. Animals were then allowed to ambulate normally until euthanasia at 15 weeks. The knees were dissected and the trochlear grooves with defects were removed for pathological examination. The amount of regenerated tissue was determined quantitatively using image analysis and the tissue content was evaluated semi-quantitatively using Safranin-O and Masson trichrome histochemical stains. Transforming growth factor beta (TGF-beta) increase was evaluated semi-quantitatively with immunohistochemical staining methods. RESULTS: Morphometric analysis revealed a significantly more immature repair tissue in group 1 (p<0.002). Both collagen and chondral tissue content of the regenerated tissue were significantly increased in group 1 (p<0.002). Compared to that in group 2, cartilage tissue in group 1 showed a much more marked immunostaining reaction of TGF-beta. CONCLUSION: Avocado/soybean unsaponifiables treatment stimulates the healing of the osteochondral defects in canine knee possibly by increasing TGF-beta in the tissues.

Treatment with unsaponifiable extracts of avocado and soybean increases TGF-beta1 and TGF-beta2 levels in canine joint fluid.

Avocado and soya unsaponifiables (ASU) are plant extracts used as a slow-acting antiarthritic agent. ASU stimulate the synthesis of matrix components by chondrocytes, probably by increasing the production of transforming growth factor-beta (TGF-beta). TGF-beta is expressed by chondrocytes and osteoblasts and is present in cartilage matrix. This study investigates the effect of ASU treatment on the levels of two isoforms of TGFbeta, TGF-beta1 and TGF-beta2, in the knee joint fluid using a canine model. Twenty-four outbred dogs were divided into three groups. The control animals were given a normal diet, while the treated animals were given 300 mg ASU every three days or every day. Joint fluid samples were obtained prior to treatment, and at the end of every month (up to three months). TGF-beta1 and TGF-beta2 levels were measured using a quantitative sandwich enzyme immunoassay technique. ASU treatment caused an increase in TGF-beta1 and TGF-beta2 levels in the joint fluid when compared to controls. The different doses did not cause a significant difference in joint fluid TGF levels. TGF-beta1 levels in the treated animals reached maximum values at the end of the second month and then decreased after the third month, while TGF-beta2 levels showed a marginal increase during the first two months, followed by a marked increase at the end of the third month. In conclusion, ASU increased both TGF-beta1 and TGF-beta2 levels in knee joint fluid.

Implantation of novel small-diameter polyurethane vascular prostheses interposed in canine femoral and carotid arteries.

OBJECTIVES: The performance of small-diameter (3-5-mm) vascular grafts still poses a challenge in the field of vascular surgery. We present here our preliminary experience with implanting unique small-sized polycarbonate urethane vascular grafts in 7 dogs. MATERIAL AND METHODS: Each animal was implanted with 4 interposition grafts, 2 femoral and 2 carotid. No anti-thrombotic medication was administered. Doppler sonography was performed at 3-month intervals to examine for patency and flow characteristics. Animals were sacrificed electively at 3, 6 and 12 months. RESULTS: At 3 months, all grafts were patent. After 6 months, 3 grafts occluded and at 1 year a further 6 grafts occluded. Hence 9 of 28 grafts occluded (67.9% patency). During the study, no correlation could be established between flow velocity or resistance index and occlusion. Histopathology showed intimal hyperplasia to be the cause of occlusion. CONCLUSIONS: Compared to literature data on small-diameter grafts in the same position, ADIAM's Biomechanical grafts performed clearly better. Compliance data suggest a correlation between elastic compliance and patency.

Mg++SO4 treatment improves the hemodynamics following the acute myocardial ischemia and reperfusion.

BACKGROUND: The effect of Mg++SO4 on myocardial hemodynamics was investigated in this study. METHODS: Twelve dogs were entered in this research. Six dogs received Mg++SO4 and the remaining dogs were considered as controls. The amount of Mg++SO4 that was administered to the animals was 0.15 mmol/kg/hr each. The left anterior descending artery was occluded for a period of 1 hour and the drug was administered during reperfusion. RESULTS: Two hours after reperfusion, cardiac output was 1275+/-50 ml/min in the control group and 1475+/-25 ml/min in the Mg++SO4 group (p<0.05), pulmonary capillary wedge pressure was 18+/-3 mmHg in the control group and 12+/-2 mmHg in the Mg++SO4 group. CONCLUSIONS: In this study it was shown that Mg++SO4 usage after 1 hour arterial occlusion and 2 hours reperfusion protects the heart from the adverse effects of ischemia/reperfusion and had a better central hemodynamics.

ATP-MgCl2 treatment after experimental acute myocardial ischemia and reperfusion.

BACKGROUND: The effect of ATP-MgCl2 on myocardial metabolism and hemodynamics was investigated in this study. METHODS: Twelve dogs were entered in this research. Six dogs received ATP-MgCl2 and the remaining dogs were considered as controls. The amount of ATP and MgCl2 concentration of this solution is 100 mumol/ml each. The volume administered to the animals during the aortic occlusion is 0.25 ml/kg/hour; in the solution are 100 mumol/ml dose each. The volume administered to the animals during reperfusion is 0.25 ml/kg/hour. The left anterior descending artery was occluded for a period of one hour and the drug was administered during reperfusion. RESULTS: Three hours after reperfusion, cardiac output was 1524 +/- 26 ml/min in the control group and 1638 +/- 47 ml/min in the ATP-MgCl2 group (p < 0.05), pulmonary capillary wedge pressure was 14 +/- 3 in the control group and 8 +/- 2 in the ATP-MgCl2 group. At the same time interval tissue ATP and lactate level was 7 +/- 3, 1.3 +/- 0.4 in the control group and 14 +/- 2, 0.0 +/- 0.2 in the ATP-MgCl2 group respectively (p < 0.05). CONCLUSIONS: In this study we demonstrated that ATP-MgCl2 usage after one hour of arterial occlusion protects the heart from the adverse effects of ischemia/reperfusion.

Myocardial preservation in acute coronary artery occlusion with coronary sinus retroperfusion and carnitine.

BACKGROUND: Effectiveness of retrograde coronary sinus perfusion with the use of carnitine supplementation over the severity of ischemia/reperfusion injury, in acute coronary occlusion. METHODS: Eighteen mongrel dogs, divided equally into control, retrograde perfusion (retroperfusion) and carnitine retroperfusion (retrocarnitine) groups. After taking the basal values, the left anterior descending artery was occluded. At the fifteenth minute, without ending the occlusion, retrograde coronary sinus cardioplegia in the retroinfusion group and in the carnitine group, 0.15 mmol/kg of L-carnitine retroperfusion was performed. Then, hemodynamic and biochemical measurements were taken till the end of 120 minutes. The control group had no retroperfusion or medical therapy. RESULTS: Between the three groups, there was a statistically significant difference in cardiac index, mean arterial pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, right atrial pressure as hemodynamic parameters and myocardial oxygen extraction, myocardial Lactate extraction, protein thiols and Malonyl dialdehyde (MBA) as biochemical parameters, at different time intervals (p<0.05). CONCLUSION: Coronary sinus retroperfusion with carnitine is found to be very effective in reducing oxygen free radical release and however this advantage did not switch to the hemodynamic function between the retrograde coronary sinus infusion group and retroinfusion carnitine group. In our opinion retrograde coronary sinus perfusion with the use of carnitine supplementation reduces the severity of ischemia/reperfusion injury.

Experimental inhibition of protamine cardiotoxicity by prostacyclin.

Twelve animals (26+/-5 kg) were subjected to the study. In this experimental study, the authors used prostacyclin to inhibit the toxic metabolite release during protamine administration. Animals were divided into two equal groups. Six animals received prostacyclin (the prostacyclin group), and the other six animals did not receive any additional treatment (the control group). All cardiac output and biochemical measurements were evaluated at baseline; before cardiopulmonary bypass; and at 5, 30, and 60 minutes after protamine administration. The measured cardiac index showed that the hearts treated with prostacyclin had satisfactory preservation of left ventricular function. Metabolic and biochemical data showed that the tumor necrosis factor level was raised significantly in the control group (20.75+/-2.2 in the control group and 13.75+/-2.5 pg/mL in the prostacyclin group). Also, E and P selectin levels were elevated in the control group, but this change was less marked in the prostacyclin group. In addition, the intracellular adhesion molecule-1 (ICAM-1) level was significantly higher in the control group than in the prostacyclin group (9.26+/-2.13 in the control group and 5.13+/-1.66 ng/mL in the prostacyclin group). The authors observed that prostacyclin inhibited the toxic mediator release during heparin reversal with protamine. This inhibition is one way of protecting the myocardium reserves from protamine cardiotoxicity.

Experimental evaluation of retrograde cerebral perfusion by single photon emission computed tomography technique (SPECT).

BACKGROUND: Protection of the brain is of vital importance during aortic arch aneurysms. In this study efficiency of retrograde cerebral perfusion was evaluated with the use of single photon emission computed tomography technique (SPECT) by using 99mTc hexamethylpropylene amine oxime (HMPAO). METHODS: Four animals were used. The internal maxillary vein was the site of retrograde cerebral perfusion. The animals were studied after the heart rate and respiration were stopped with the use of the high dose drug administration and the brain was perfused with cold Ringer's lactated solution. After this procedure, 99mTc HMPAO-SPECT study was performed. RESULTS: In one animal we did not get any cerebral image because of the competent venous valve in the internal maxillary vein. In the remaining animals, normal brain perfusion was achieved. CONCLUSIONS: 99mTc HMPAO-SPECT study documented that blood flow via the retrograde way meets the metabolic demand of the brain. Retrograde delivery of 99mTc HMPAO did not conclude any poorly perfused area in the brain when in given both sides and all parts of the brain can be effectively perfused by cerebral venous system in hypothermic conditions.

Coronary sinus retroperfusion during acute experimental coronary artery occlusion.

BACKGROUND: This study was planned to show the effect of retroperfusion and cardiopulmonary bypass on myocardial hemodynamic recovery. METHODS: Eighteen dogs entered this study. After, left anterior descending artery (LAD) was dissected and occluded, the animals were divided into three equal groups; Group I: retrograde coronary sinus perfusion, group II: cardiopulmonary bypass and retrograde coronary sinus perfusion, Group III: control group, left anterior descending artery occlusion only. RESULTS: In Group III, deterioration of the hemodynamic values progressed parallel with the degree of ischemic damage but in Group I, hemodynamic parameters were better because of the retrograde coronary sinus perfusion and minimally affected by the reperfusion. In Group II, at the end of the cardiopulmonary bypass minimal myocardial damage was observed. CONCLUSIONS: There is no statistical difference between Group I and II if we examine the data that was taken after reperfusion although myocardial performance was better in Group II.

Effects of ATP-MgCl2 administration in hypovolemic dogs.

BACKGROUND: The aim of the study was to evaluate the efficacy of ATP-MgCl2 on myocardial insufficiency associated with hypovolemic shock in dogs. We designed the study as a controlled randomized study. METHODS: Six mixed-breed dogs weighing 22 +/- 3 kg were included in the control group and 20 +/- 3 kg in the ATP-MgCl2 group. After the animals were anesthetized 40 ml/kg of blood was withdrawn in 15 minutes. Animals were observed for 45 minutes after removal of blood. Six animals received 45 ml/kg of lactated Ringer's solution and the other animals were treated with 45 ml/kg of lactated Ringer's solution and ATP-MgCl2. All measurements were made before removal of blood, 45 min after exsanguination and at 1 hour intervals for 3 hours. The following parameters were measured; systemic and pulmonary arterial pressures, pulmonary capillary wedge pressure, central venous pressure, cardiac output, rectal temperature, arterial pH, PCO2 and PO2 and mixed venous hemoglobin oxygen saturation. In addition blood samples were collected for the analysis of lactate and tumor necrosis factor (TNF) concentrations. RESULTS: After hemorrhage, cardiac index (CI) decreased significantly from 122 +/- 9 to 52 +/- 9 ml/kg/min in the control group (p < 0.0001) and from 124 +/- 11 ml/kg/min to 50 +/- 6 ml/kg/min in the ATP-MgCl2 group, respectively (p < 0.0001). After volume replacement, Cl was 93 +/- 6 ml/kg/min in the control group and 111 +/- 4 ml/kg/min in the ATP-MgCl2 group 3 hours after the onset of reinfusion, respectively (p < 0.05). TNF was 36 +/- 5 pg/ml in the control group and 21 +/- 3 pg/ml in the ATP-MgCl2 group (p < 0.05). Three hours after the onset of hemorrhagic shock, oxygen consumption and delivery were 126 +/- 14 and 206 +/- 19 ml/min in the control group and 198 +/- 16 and 305 +/- 27 ml/min in the ATP-MgCl2 group, respectively. At the same time point the oxygen extraction ratio was 0.49 +/- 0.04 in the control group and 0.61 +/- 0.03 in the ATP-MgCl2 group (p < 0.01). CONCLUSIONS: Hemorrhagic shock causes TNF release which may cause multiple organ failure. Organ dysfunction still persists even after the appropriate treatment. ATP-MgCl2 attenuates the release of TNF which may improve the adverse effects of hemorrhagic shock.

Preservation of myocardial metabolism in acute coronary artery occlusions with retrograde coronary sinus perfusion and iloprost.

A total of 12 healthy mongrel dogs were subjected to the study. The left anterior descending artery was occluded. The occlusion was done for 15 min. At the end of this period, without removing the occlusion, the heart was retroperfused for 3 h. Then, occlusion was removed and reperfusion was supplied. Animals were divided into two equal groups. Six animals received iloprost and the other six control did not receive any additional treatment. In the iloprost group, the drug was administered into the coronary sinus. After 15 min following occlusion, iloprost was infused at a rate of 50 microg/min continuously. Cardiac output (CO), mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), heart rate (HR), pulmonary capillary wedge pressure (PCWP), right atrium pressure (RAP), myocardial oxygen extraction (MOE) and myocardial lactate extraction (MLE) parameters were examined in the two groups, before and during retroperfusion and during the reperfusion (1-4 h). Iloprost retroperfusion (50 microg/min) was started at the fifteenth minute of occlusion and continued till the end of the observation period (3 h). The measured hemodynamic data showed that the hearts treated with iloprost had satisfactory preservation of cardiac function. At the end of the reperfusion period cardiac output was 1.5 +/- 0.06 L/min in the control and 1.7 +/- 0.04 L/min in the iloprost group (P < 0.05). At the end of the reperfusion period, tumor necrosis factor level was raised significantly in the control group (P < 0.05). Myocardial lactate release was also high in the control group (P < 0.05). CPK-MB release was low in the iloprost group (P < 0.05). We conclude that retrogradely administered iloprost reduced the risk of myocardial injury and it is probable that this drug effectively distributes to the area of myocardium at risk.

Iloprost added to the cardioplegic solutions improves myocardial performance.

A total of 12 mongrel dogs were divided into two equal groups. Six animals received IIoprost and the other 6 animals did not receive any additional treatment. In the Iloprost group, Iloprost was added to the cardioplegic solution (25 ng). Also, Iloprost was used (10 ng/kg/min.) 5 min. before and after cross-clamping. All cardiac output and biochemical measurements were evaluated before cross-clamp and 15 min., 1 h, and 4 h after cross-clamp. The measured dp/dt shows that the hearts treated with Iloprost preserved left ventricular function. Comparison of contractility indices between the groups revealed that contractile recovery was 59% in the control group and 71% in the Iloprost group (p < 0.05). Tumor necrosis factor (TNF) alpha level was significantly elevated in the control group (p < 0.001). Its level was 22.2 +/- 2.2 pg/mL in the control group and 13.8 +/- 1.0 pg/mL in the Iloprost group. E- and P-selectin levels were elevated in the control group (p < 0.001). ICAM-1 level was also elevated in the control group. ICAM-1 level was 17.7 +/- 1.8 ng/mL in the control group and 8.5 +/- 1.8 ng/mL in the Iloprost group. The Iloprost that was added to the cardioplegic solution and low dose administration during the pre- and post-ischemic period inhibits the toxic mediator release from endothelium-leukocyte interaction and reduces the severity of ischemia-reperfusion injury.

Cardiovascular effects of enoximone and epinephrine on heparin reversal with protamine in conscious dogs.

OBJECTIVE: To compare enoximone with epinephrine as treatments for the cardiotoxic effects of protamine sulfate. STUDY DESIGN: Prospective randomized study. ANIMAL POPULATION: 12 healthy cross-bred dogs weighing 23 +/- 4 kg. METHODS: The dogs were anesthetized with xylazine and ketamine to allow instrumentation. Femoral arterial and venous catheters were inserted for pressure monitoring and to allow drug infusion. A thermodilution catheter mounted with a fast response thermistor was inserted into the pulmonary artery via the jugular vein to measure cardiac output and right ventricular volumes. Heparin 300 units/kg followed by protamine 4.5 mg/kg were administered 45 minutes after the xylazine/ketamine. Four animals were not treated (controls), four received enoximone, and four were given epinephrine. Cardiopulmonary parameters were monitored for a period of 30 minutes. RESULTS: Cardiac index was 104 +/- 15 mL/kg/min in the enoximone group, 72 +/- 13 mL/kg/min in the epinephrine group, and 63 +/- 10 mL/kg/min in the control group (P < .05 enoximone versus control and epinephrine). Right ventricular end systolic volume was 18 +/- 3, 27 +/- 4, and 29 +/- 6 mL in the enoximone, epinephrine, and control groups (P < .05 enoximone versus control and epinephrine). There were no differences in mean arterial pressure or pulmonary and systemic vascular resistance between the groups. CONCLUSION AND CLINICAL RELEVANCE: In this study, enoximone was more effective than epinephrine at reversing the hemodynamic changes associated with protamine sulfate administration.