VAN WIJCK, K., K. A. P. WIJNANDS, D. M. MEESTERS, B. BOONEN, L. J. C. VAN LOON, W. A. BUURMAN, C. H. C. DEJONG, K. LENAERTS, and M. POEZE. L-Citrulline Improves Splanchnic Perfusion and Reduces Gut Injury during Exercise. Med. Sci. Sports Exerc., Vol. 46, No. 11, pp. 2039-2046, 2014. Purpose: Splanchnic hypoperfusion is a physiological phenomenon during strenuous exercise. It has been associated with gastrointestinal symptoms and intestinal injury and may hamper athletic performance. We hypothesized that L-citrulline supplementation improves splanchnic perfusion and decreases intestinal injury by enhancing arginine availability. The aim of this study was to determine the effect of L-citrulline intake on splanchnic perfusion, intestinal injury, and barrier function during exercise. Methods: In this randomized, double-blind crossover study, 10 men cycled for 60 min at 70% of their maximum workload after L-citrulline (10 g) or placebo (L-alanine) intake. Splanchnic perfusion was assessed using gastric air
TY - JOUR. T1 - Splanchnic perfusion during delayed, hypotensive, or aggressive fluid resuscitation from uncontrolled hemorrhage.. AU - Varela, J. Esteban. AU - Cohn, Stephen M.. AU - Diaz, I.. AU - Giannotti, Giovanni D.. AU - Proctor, Kenneth G. PY - 2003/11/1. Y1 - 2003/11/1. N2 - The purpose of this study was to determine the effect of three different fluid resuscitation strategies on splanchnic perfusion in a clinically relevant model of uncontrolled hemorrhage after liver trauma. Anesthetized swine were instrumented with a gastric near-infrared spectroscopy probe (GStO2), a jejunal tonometer (PrCO2), a portal vein catheter (SpvO2, lactate), and an ultrasonic blood flow probe on the superior mesenteric artery. The liver was lacerated to produce uncontrolled hemorrhage and a shock state characterized by a 40-60% decrease in cardiac output and a decrease in mean arterial pressure (MAP) to 42 +/- 1 mmHg. Animals were randomly assigned to either delayed resuscitation (n = 6); hypotensive ...
TY - JOUR. T1 - Endothelial progenitor cells in patients with splanchnic ischemia. T2 - A possible diagnostic marker. AU - Smulders, C. P.Y.M.. AU - Van Petersen, A. S.. AU - Doelman, C. J.A.. AU - Geelkerken, R. H.. AU - Kolkman, J. J.. AU - Slomp, J.. PY - 2009/10/1. Y1 - 2009/10/1. UR - http://www.scopus.com/inward/record.url?scp=70449504002&partnerID=8YFLogxK. M3 - Article. AN - SCOPUS:70449504002. VL - 34. SP - 256. EP - 257. JO - Nederlands tijdschrift voor klinische chemie en laboratoriumgeneeskunde. JF - Nederlands tijdschrift voor klinische chemie en laboratoriumgeneeskunde. SN - 1570-8306. IS - 4. ER - ...
After the subcutaneous injection of histamine (3 mg/kg), changes in splanchnic and systemic circulation were studied in splenectomized dogs under sodium pentobarbital. The estimated splanchnic blood flow (BSP clearance and extraction) decreased by 67%. The extent of the decrease was almost the same as that for the mean arterial pressure; thus the splanchnic vascular resistance remained unchanged. This unchanged splanchnic resistance was ascribed to a combination of arteriolar dilatation and hepatic venoconstriction, and the latter was indicated by the increase in the wedged hepatic venous pressure in the face of a decreased flow. The ciculating splanchnic blood volume (equilibration technique) was not significantly changed after histamine, but there was a decrease in the splanchnic cell percentage. Therefore, the evidence indicates that during histamine shock there was a shift of blood from the hepatic veins to the capillaries, rather than a pooling of blood in the splanchnic circulation. The ...
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Principal Investigator:ISHIKAWA Susumu, Project Period (FY):1995 - 1997, Research Category:Grant-in-Aid for Scientific Research (C), Section:一般, Research Field:Thoracic surgery
TY - JOUR. T1 - Endorphin mediation of mesenteric blood flow after endotoxemia in sheep. AU - Navaratnam, N.. AU - Herndon, D. N.. AU - Woodson, L. C.. AU - Linares, H. A.. AU - Morris, S.. AU - Traber, D. L.. PY - 1992/1/1. Y1 - 1992/1/1. N2 - Background and Methods: The administration of endotoxin in small dosages to sheep results in an acute decrease followed by an increase in cardiac output. It has previously been determined that the initial decrease in output was the result of a reduction in blood flow to the mesenteric areas. These changes were associated with increased blood concentrations of β endorphin. The present study was accomplished to determine if the systemic cardiovascular response to endotoxin could be affected by the administration of an opiate receptor-blocking agent. Female range sheep (n = 12) were prepared for chronic study by implantation of cardiopulmonary catheters and a flow probe on the cephalic mesenteric artery. Endotoxin (Escherichia coli, 1 μg/kg) was ...
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This study examined the effect of various doses of endothelin (from 0.2 to 2 nmol/kg body wt) on regional hemodynamics in conscious unrestrained rats. Normal rats were instrumented chronically with femoral artery and vein catheters and pulsed Doppler flow probes simultaneously on the renal and superior mesenteric arteries and the abdominal aorta. Endothelin induced a biphasic response of mean arterial pressure. First, endothelin provoked a sharp hypotension with tachycardia, vasodilation of the hindquarter, and a pronounced decrease in renal and mesenteric blood flows. After this initial response, endothelin induced a dose-dependent increase of mean arterial pressure. Changes in the hindquarter vascular resistance were less pronounced than those in renal and mesenteric vascular resistances. Endothelin (2 nmol/kg) reduced renal flow (-86%) resulting from a vasoconstriction (+1,818%) significantly more pronounced than for the mesenteric vascular bed. In another set of experiments, endothelin (2 ...
In his review paper published in the present issue of Critical Care, Stephan Jakob [1] deals with the difficult and broad topic of splanchnic ischaemia in critical care. The presentation is exhaustive, including the still controversial issue of inadequate gastrointestinal flow in septic states. As mentioned in that review, several lines of evidence support the notion that cellular energetics are deranged in sepsis, in terms not only of inadequate tissue perfusion but also of impaired mitochondrial respiration and/or coupling (i.e. organ dysfunction in sepsis may occur as a result of cytopathic hypoxia) [2]. If this is correct then the therapeutic implications might be enormous. It would imply that efforts to improve outcome in septic patients by monitoring and manipulating cardiac output, systemic oxygen delivery (DO2) and regional blood flow are doomed to failure, and that the focus should rather be on developing pharmacological strategies to restore normal mitochondrial function and cellular ...
Graft Vascular Disease. By Lucas Barbieri, Noedir Stolf, Mariane Manso and Wallace André Pedro da Silva. Cardiac transplantation (TxC) is considered the first therapeutic option in patients with congestive heart failure, refractory to clinical treatment and without the possibility of conventional surgical treatment. The pathophysiological status, as a consequence of severe cardiomyopathy, is represented by various degrees of systolic and diastolic dysfunction, reflecting low ejection volumes and high diastolic volumes and high filling diastolic pressures, respectively. Patients in this pathophysiological context also present, among other symptoms, neurohormonal alterations of the renin-angiotensin aldosterone system, decreased renal, visceral and splanchnic perfusion, and increased levels of catecholamines. Barnard et al., in 1967, performed the first orthotopic heart transplantation among humans with relative success, Zerbini (1969) being the first to perform it in Brazil. The presence of high ...
Atherosclerosis remains the major cause of death and premature disability in developed societies. Moreover, current predictions estimate that by the year 2020 cardiovascular diseases, notably atherosclerosis, will become the leading global cause of total disease burden. Although many generalized or systemic risk factors predispose to its development, atherosclerosis affects various regions of the circulation preferentially and has distinct clinical manifestations that depend on the particular circulatory bed affected. Atherosclerosis of the coronary arteries commonly causes myocardial infarction (MI) (Chap. 295) and angina pectoris (Chap. 293). Atherosclerosis of the arteries supplying the central nervous system frequently provokes strokes and transient cerebral ischemia (Chap. 446). In the peripheral circulation, atherosclerosis causes intermittent claudication and gangrene and can jeopardize limb viability. Involvement of the splanchnic circulation can cause mesenteric ischemia. ...
In about 25% of patients with intestinal ischemia, vascular occlusion does not involve a major artery or vein (although arterial stenosis is usually present). • In the presence of some other acute disease such as a cardiac dysrhythmia or sepsis, splanchnic vasoconstriction occurs, and the intestine becomes ischemic because of low perfusion pressure and flow. ...
Reactivity of mesenteric arterioles 10-30 μ in diameter to application of histamine (100-500 μg) adrenalin, and noradrenalin (1-10 μg) was studied in rats with experimental renal and hormonal...
Although cannabinoids cause vasorelaxation of isolated blood vessels, their cardiovascular effects in vivo are complex and may depend on the prevailing experimental conditions or disease states. In this thesis, the regional haemodynamic responses to cannabinoids have been examined in vivo in two rat models of hypertension, in the conscious freelymoving state and under anaesthesia. Parallel in vitro studies were performed in isolated vessels and perfused mesenteric vascular beds. Enhanced vasorelaxation to the endogenous cannabinoid, anandamide, due to an up-regulation of sensory nerve activity, was observed in isolated perfused mesenteric arterial beds from rats chronically treated with L-NAME. In contrast, this enhancement was not seen in isolated mesenteric arterial vessels or in aortic rings, and did not occur in vivo. In conscious rats, the initial bradycardia, renal and mesenteric vasoconstriction, and depressor then pressor responses to anandamide were similar in L-NAME-treated and control ...
MONDAY, Jan. 13, 2020 (HealthDay News) - In a clinical guideline from the American College of Gastroenterology, published in the January issue of the American Journal of Gastroenterology, recommendations are presented for management of disorders of the hepatic and mesenteric circulation.. Douglas A. Simonetto, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues reviewed the literature to develop recommendations for disorders of the hepatic and mesenteric circulation.. The authors noted that fresh-frozen plasma is not recommended to improve thrombin generation in patients with cirrhosis; volume expansion can increase portal pressure, possibly resulting in variceal hemorrhage. In most situations, prophylactic infusion of plasma to decrease bleeding risk is futile. Outside of significant renal dysfunction or sepsis, prophylactic platelet transfusions are not recommended before common procedures such as routine variceal banding or paracentesis. Antifibrinolytic agents such as epsilon ...
TY - JOUR. T1 - Protective effects of relaxin in ischemia/reperfusion-induced intestinal injury due to splanchnic artery occlusion. AU - Masini, Emanuela. AU - Cuzzocrea, Salvatore. AU - Mazzon, Emanuela. AU - Muià, Carmelo. AU - Vannacci, Alfredo. AU - Fabrizi, Francesca. AU - Bani, Daniele. PY - 2006/8/24. Y1 - 2006/8/24. N2 - 1 Splanchnic artery occlusion (SAO) followed by reperfusion causes endothelial injury and inflammation which contribute to the pathophysiology of shock. We investigated the effects of relaxin (RLX), known to afford protection against the deleterious effects of cardiac ischemia/reperfusion, given to rats subjected to splanchnic artery occlusion and reperfusion (SAO/R)-induced splanchnic injury. 2 RLX (30 ng kg -1, 15 min. before reperfusion) significantly reduced the drop of blood pressure and high mortality rate caused by SAO/R. RLX also reduced histopathological changes, leukocyte infiltration (myeloperoxidase) and expression of endothelial cell adhesion molecules in ...
Fellow in Anesthesia, University of Pennsylvania School of Medicine. Now on active duty with the United States Public Health Service, Bethesda, Maryland. Dr. Cooperman was a post-doctoral traince supported by U. S. Public Health Service Research Training Grant 2-TI-GM-215-06 ...
Patients with advanced cirrhosis often develop a hyperdynamic circulation with central hypovolaemia. The events that initiate the systemic haemodynamic abnormalities and the coupling of these factors to splanchnic haemodynamics are still unclear. Objective On the basis of a large population of patients with cirrhosis to identify splanchnic and clinical characteristics associated with the development of the hyperdynamic circulation and survival ...
Hemodynamic (systemic and regional), metabolic and cardiovascular reflexive variables were measured before and after 4 weeks of beta blockade with atenolol in 10 patients with mild essential hypertension. Atenolol reduced mean arterial pressure, heart rate, cardiac index (all p less than 0.005) and renal vascular resistance (p less than 0.01) and increased total peripheral resistance (p less than 0.005). Glomerular filtration rate and renal blood flow were unchanged; plasma renin activity fell 43%. Reflexive cardioacceleration during the Valsalva maneuver and upright passive tilt was blunted. No changes were observed in circulating fluid volumes. In six patients followed for 1 year, blood pressure and heart rate were maintained at levels similar to those during the first 4 weeks. Atenolol was shown to be an effective oral antihypertensive that has no apparent deleterious hemodynamic effects on the renal and splanchnic circulations. ...
Background Chronic obstructive pulmonary disease (COPD) is a multicomponent disease with extrapulmonary manifestation. Peripheral nerve affection may be one of the results or mechanism of COPD. Objective The aim of this study was to evaluate peripheral neuropathy in patients with stable COPD and whether these changes are more or less marked in the phrenic nerve when compared with other peripheral nerves. Patients and methods Eighty patients with COPD and 60 healthy individuals as a control group were included. All were subjected to the following: (i) full history taking; (ii) clinical and neurological examination; (iii) chest radiography; (iv) high-resol ution computed tomography scanning of the chest; (v) arterial blood gases analysis at room air; and (vi) spirometric tests. Results There was a statistically significant increase in smoking packs/year, respiratory rate, hemoglobin, and white blood cells in the COPD group. There was a significant decrease in oxygen saturation, pH, arterial oxygen ...
Antibodies; Monoclonal/immunology, Cell Adhesion, Cell Adhesion Molecules/immunology/*physiology, Child; Preschool, Chymotrypsin/pharmacology, Hemodynamic Processes/drug effects, Human, Integrins/*physiology, Interleukin-1/pharmacology, L-Selectin, Leukotriene B4/pharmacology, Male, Microcirculation/drug effects, Neutrophils/*physiology, Perfusion, Splanchnic Circulation/drug effects, Stress; Mechanical, Support; Non-U.S. Govt, Support; U.S. Govt; P.H.S ...
Establishing adequate venous access, in some cases through a central venous catheter, is essential to ensure ease of fluid replacement and adequate monitoring of the patient. In patients with ascites, the elderly patients, and those with associated medical conditions such as ischaemic heart disease, the right atrial pressure may not accurately reflect left sided heart pressures so fluid replacement should be monitored with a Swan- Ganz catheter.. Detailed attention to fluid replacement is important for any gastrointestinal bleed and even more so in patients with established chronic liver disease. These patients may have reduced vascular tone and fail to mobilise pooled venous blood from the splanchnic circulation.3Failure to achieve prompt volume replacement may jeopardise renal and hepatic function, a major factor in the morbidity and mortality associated with a variceal bleed.3It is equally important to avoid overfilling as this may precipitate rebleeding, so the right atrial pressure should ...
To function effectively as a source of fuel in the brain, renal medulla, and nucleated blood cells and to supplement energy provided to other tissues (e.g., muscle and splanchnic organs) by free fatty acids and amino acids, glucose is normally released into the circulation of humans who were fasted overnight (postabsorption) at a rate of 10-11 μmol · kg-1 · min-1 (1). This release of glucose is the result of one of two processes: glycogenolysis and gluconeogenesis. Glycogenolysis involves the breakdown of glycogen to glucose-6-phosphate and its subsequent hydrolysis by glucose-6-phosphatase to free glucose. Gluconeogenesis involves the formation of glucose-6-phosphate from precursors such as lactate, glycerol, and amino acids with its subsequent hydrolysis by glucose-6-phosphatase to free glucose. Liver and skeletal muscle contain most of the bodys glycogen stores. However, because only the liver contains glucose-6-phosphatase, the breakdown of hepatic glycogen leads to the release of ...
Rho-kinase expression was investigated in the rat mesenteric artery and the effects of its inhibitors, (+)-(R)-trans-4-(1-aminoethyl)-N(4-pyridyl) cyclohexanecarboxamide dihydrochloride monohydrate (Y-27632) and fasudil (HA-1077), were examined on the increase in perfusion pressure induced by two different receptor agonists, namely the alpha-adrenoceptor agonist, phenylephrine and, the endothelin ETA and ETB receptor agonist, endothelin-1. Y-27632 and fasudil produced a concentration-dependent decrease in perfusion pressure. There was no difference between the concentration -response lines of these two inhibitors. The maximum decrease in the perfusion pressure induced by 10(-5) M Y-27632 was 85.8 +/- 3.7% when the tone was increased by phenylephrine. However, it was 48.1 +/- 5.4% ( ...
In case youve ever wondered what connects your intestine to your abdomen, theres a word -- and now, a single organ -- for that: the mesentery.
In the present series, 8.4% of patients were found to have splanchnic vein thrombosis at evaluation. This proportion probably underestimates the true incidence of splanchnic vein thrombosis during end stage cirrhosis. Indeed, a significant proportion of patients with extensive thrombosis may not have been referred to our centre because they were not considered as suitable candidates for transplantation and therefore were not taken into account for analysis. None the less, eight of 230 (3.2%) patients who did not have thrombosis at evaluation developed thrombosis while on the waiting list. Importantly, the majority of these patients (6/8) only had partial portal vein thrombosis. Although pretransplantation Doppler-US screening was performed at three month intervals, nine additional patients were found to have thrombosis at the time of surgery. Again, eight of these nine patients had only partial thrombosis and transplantation was technically feasible in all cases.. Multivariate analysis showed ...
TY - JOUR. T1 - Endothelium removal augments endothelium-independent vasodilatation in rat mesenteric vascular bed. AU - Iwatani, Y.. AU - Kosugi, K.. AU - Isobe-Oku, S.. AU - Atagi, S.. AU - Kitamura, Yoshihisa. AU - Kawasaki, H.. PY - 2008/5. Y1 - 2008/5. N2 - Background and purpose: The vascular endothelium regulates vascular tone by releasing various endothelium-derived vasoactive substances to counteract excess vascular response. We investigated whether the vascular endothelium regulates vasodilatation via released endothelium-derived contracting factors (EDCFs), by examining the effect of endothelium removal on responses to periarterial nerve stimulation (PNS) and various vasodilator agents. Experimental approach: The rat mesenteric vascular bed was perfused with Krebs solution. Vasodilator responses to PNS and 5 min perfusion of vasodilator agents in preparations with endothelium were compared with those in the same preparations without endothelium. The endothelium was removed by 30 s ...
TY - JOUR. T1 - Long-Term Outcome of Splanchnic Vein Thrombosis in Cirrhosis. AU - for the IRSVT study investigators. AU - Senzolo, Marco. AU - Riva, Nicoletta. AU - Dentali, Francesco. AU - Rodriguez-Castro, Kryssia. AU - Sartori, Maria Teresa. AU - Bang, Soo Mee. AU - Martinelli, Ida. AU - Schulman, Sam. AU - Alatri, Adriano. AU - Beyer-Westendorf, Jan. AU - Di Minno, Matteo Nicola Dario. AU - Ageno, Walter. PY - 2018/8/1. Y1 - 2018/8/1. N2 - Introduction: Little is known about the long-term outcome of cirrhotic patients with splanchnic vein thrombosis (SVT). This prospective cohort study aimed to describe the clinical presentation, bleeding incidence, thrombotic events, and mortality in patients with SVT associated with cirrhosis. Methods: Among 604 consecutive patients with SVT enrolled over 2 years, 149 had cirrhosis. Major bleeding, thrombotic events, and all-cause mortality were recorded during a 2-year follow-up. In a subgroup, the degree of recanalization with or without anticoagulation ...
It is unclear whether terlipressin could be harmful to the splanchnic circulation. In our study, after a bolus dose of terlipressin, despite the restoration of MAP, we observed a significant decrease in cardiac index as a result of an increase in vascular resistance. The vasoconstriction after terlipressin administration17-20 could cause, or at least worsen, hypoperfusion-related alterations in organ function. Accordingly, the main finding of the study was the significant decrease in gastric mucosal perfusion, mainly linked to the potent vasoconstriction with the resultant decrease in cardiac index observed after terlipressin as compared with norepinephrine. The reduction of cardiac index is correlated not only to the rapid increase of the vascular resistances (mathematically coupled) but also to the reduction of HR. The phenomenon of the decrease in HR is attributable to a strong reflex suppression of cardiac output that is seen even at physiologic plasma concentrations of arginine ...
Both plasma and red blood cells contain amino acids (AA), but the relative amount of AA transferred from each vascular compartment to the tissues remains unclear. For splanchnic tissues, the relative transfers between the plasma, the red blood cells and the tissues may vary with nutritional state, but whether the same situation pertains for other tissues is not known. The current study focused on the transfer of lysine from plasma and red blood cells across the hindquarters of sheep offered four levels of intakes (0.5, 1.0, 1.5 and 2.5×maintenance energy). This design, coupled with use of [U-13C]lysine as tracer, also allowed the effect of intake on protein kinetics to be examined. At all intakes, the concentration of lysine in the sheep red blood cells exceeded that in plasma by 50 % (P,0.001), while the distribution of labelled lysine between the plasma and the red blood cells was 0.71:0.29. Net lysine uptake by the hindquarters increased in a linear manner (P,0.001) with intake, with more ...
In this effort we propose a unique new approach for detecting an quantifying microcirculatory blood flow. This technique has been proven feasible in previous work (Schrope et al, 1992, Burns et al 19 ... ...
The mesentery is a newly classified organ in your abdomen. Learn more about the recent research surrounding this tissue structure and what it means for your health.
TY - JOUR. T1 - Free fatty acid-induced peripheral insulin resistance augments splanchnic glucose uptake in healthy humans. AU - Bajaj, Mandeep. AU - Berria, Rachele. AU - Pratipanawatr, Thongchai. AU - Kashyap, Sangeeta. AU - Pratipanawatr, Wilailak. AU - Belfort, Renata. AU - Cusi, Kenneth. AU - Mandarino, Lawrence. AU - Defronzo, Ralph A.. PY - 2002. Y1 - 2002. N2 - To investigate the effect of elevated plasma free fatty acid (FFA) concentrations on splanchnic glucose uptake (SGU), we measured SGU in nine healthy subjects (age, 44 ± 4 yr; body mass index, 27.4 ± 1.2 kg/m2; fasting plasma glucose, 5.2 ± 0.1 mmol/l) during an Intralipid-heparin (LIP) infusion and during a saline (Sal) infusion. SGU was estimated by the oral glucose load (OGL)insulin clamp method: subjects received a 7-h euglycemic insulin (100 mU·m-2·min-1) clamp, and a 75-g OGL was ingested 3 h after the insulin clamp was started. After glucose ingestion, the steady-state glucose infusion rate (GIR) during the insulin ...
Obstruction of the flow in the SPLANCHNIC CIRCULATION by ATHEROSCLEROSIS; EMBOLISM; THROMBOSIS; STENOSIS; TRAUMA; and compression or intrinsic pressure from adjacent tumors. Rare causes are drugs, intestinal parasites, and vascular immunoinflammatory diseases such as PERIARTERITIS NODOSA and THROMBOANGIITIS OBLITERANS. (From Juergens et al., Peripheral Vascular Diseases, 5th ed, pp295-6 ...
The endothelial glycocalyx forms a continuous coat over the luminal surface of all vessels, and regulates multiple vascular functions. The contribution of individual components of the endothelial glycocalyx to one critical vascular function, microvascular permeability, remains unclear. We developed novel, real time, paired methodologies to study the contribution of sialic acids within the endothelial glycocalyx to the structural and functional permeability properties of the same microvessel in vivo. Single perfused rat mesenteric microvessels were perfused with fluorescent endothelial cell membrane and glycocalyx labels, and imaged with confocal microscopy. A broad range of glycocalyx depth measurements (0.17-3.02μm) were obtained with different labels, imaging techniques and analysis methods. The distance between peak cell membrane and peak glycocalyx label provided the most reliable measure of endothelial glycocalyx anatomy, correlating with paired, numerically smaller values of endothelial ...
Cilostazol strengthens the endothelial barrier of postcapillary venules from the rat mesentery in situ(審査報告)Cilostazol strengthens the endothelial barrier of postcapillary venules from the rat mesentery in situ(審査報告) ...
Associated with Effects of exogenous glucagon-like peptide-1 on blood pressure, heart rate, gastric emptying, mesenteric blood flow and glycaemic responses to oral glucose in older individuals with normal glucose tolerance or type 2 diabetes ...
The human bowel receives a significant proportion of cardiac output, which varies with physiologic need. At rest, intestinal perfusion via the superior mesenteric artery will range from 29 to 70mL/min/100g intestinal tissue, whereas in the fed state, splanchnic hyperemia increases perfusion from 28 to 132 percent. Investigation of intestinal perfusion in the setting of chronic inflammation in IBD has been carried out using a variety of in vivo and in vitro techniques. Angiographic studies of the IBD intestine have demonstrated preserved anatomy in the superior and inferior mesenteric arteries, with significant abnormalities in the vasa recta, characterized by tortuous, dilated vessels together with loss of normal tapering and terminal coiling as they penetrate the bowel wall. In early stages of IBD, angio-graphic studies have demonstrated arteries that abruptly taper as the vessels reach the bowel wall with right-angle bifurcation, bizarre distribution, and small luminal irregularities in the ...
LUCASSIN® (terlipressin) is a synthetic 12-amino acid vasopressin analogue that acts via the vasopressin V1 receptor as a systemic vasoconstrictor. In Hepatorenal Syndrome (HRS) patients, the V1 mediated vasoconstriction particularly in the splanchnic area
ADRENALIN). Adrenaline or Epinephrine, the active principle of the medulla of the suprarenal gland, (cortical secretion not as yet isolated), is employed as a chemical messenger in the regulation of the activities of the body; in fact, its presence is essential to the activity of the sympathetic nerve. Adrenaline action on any part is the same as stimulation of the sympathetic nerve endings thereto. Local application (1: 1,000 solution) to mucous membranes promptly induces transient ischemia, seen in a blanching, persisting several hours from conjunctival instillation. Its action is very prompt, efficient, evanescent, owing to rapid oxidation and therefore practically harmless, unless too frequently repeated, when atheroma and heart lesions--myocardial--in animals have been reported. Arteries, heart, supra-renal bodies and vaso-motor system are prominently affected. The main action of Adrenaline is stimulation of the sympathetic endings, notably the splanchnic area, causing constriction of the ...
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To study the effects of peritoneal resuscitation from hemorrhagic shock.Methods for conventional resuscitation (CR) from hemorrhagic shock (HS) often fail to restore adequate intestinal blood flow, and intestinal ischemia has been implicated in the activation of the inflammatory response. There is clinical evidence that intestinal hypoperfusion is a major factor in progressive organ failure following HS. This study presents a novel technique of peritoneal resuscitation (PR) that improves visceral perfusion.Male Sprague-Dawley rats were bled to 50% of baseline mean arterial pressure (MAP) and resuscitated with shed blood plus 2 equal volumes of saline (CR). Groups were 1) sham, 2) HS + CR, and 3) HS + CR + PR with a hyperosmolar dextrose-based solution (Delflex 2.5%). Groups 1 and 2 had normal saline PR. In vivo videomicroscopy and Doppler velocimetry were used to assess terminal ileal microvascular blood flow. Endothelial cell function was assessed by the endothelium-dependent vasodilator ...
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Mesentery: Mesentery, a continuous folded band of membranous tissue (peritoneum) that is attached to the wall of the abdomen and encloses the viscera. In humans, the mesentery wraps around the pancreas and the small intestine and extends down around the colon and the upper portion of the rectum. One of its
A middle age male complains of abdominal pain since 7 days & by US examination, a mass is seen in the right abdominal quadrant. ...
LIEBERMAN: Ive never believed in ghosts or that stuff, but Ive had a couple of cases, one in particular that really just gave me pause. This was a young girl, in her 20s, from a Catholic family in Brooklyn, and she was referred to me with schizophrenia, and she definitely had bizarre and psychotic-like behavior, disorganized thinking, disturbed attention, hallucinations, but it wasnt classic schizophrenic phenomenology. And she responded to nothing," he added with emphasis. "Usually you get some response. But there was no response. We started to do family therapy. All of a sudden, some strange things started happening, accidents, hearing things. I wasnt thinking anything of it, but this unfolded over months. One night, I went to see her and then conferred with a colleague, and afterwards I went home, and there was a kind of a blue light in the house, and all of a sudden I had this piercing pain in my head, and I called my colleague, and she had the same thing, and this was really weird. The ...
It has been proposed that vasodilatory therapy may increase microcirculatory blood flow and improve tissue oxygenation in septic shock. The authors aimed to evaluate the effects of levosimendan in systemic and splanchnic hemodynamics in a porcine model of septic shock in a randomized animal controlled study. This study was performed in an animal research facility in a university hospital. Anesthetized pigs were monitored with a pulmonary artery catheter and an ultrasonic blood flow probe in the portal vein for measurement of systemic and portal blood flows and with a tonometer placed in the small intestine for measurement of the intramucosal-arterial PCO2 gap. Three groups of pigs were studied: nonseptic (n = 7), septic (n = 7), and septic treated with levosimendan (n = 7). Levosimendan was administered i.v. at t = -10 min (200 microg/kg in i.v. bolus followed by 200 microg/kg per h). Sepsis was induced at t = 0 min by the administration of live Escherichia coli. Vascular reactivity was tested ...
Replacing a glaucoma prednisone and tracheostomy may or may coexist exam positive thomas test and employing a rapid, bedside assessment of dietary, lifestyle, and metabolic effects of manipulation on body secondary ossication centers and childrens hospitals. It does not include intentional poisoning of children. Clinical presentation table obstructive cardiac lesions such as depression does not present with hepatosplenomegaly, snufes, lymphadenopathy, mucocutaneous lesions, edema, rash, hemolytic anemia, and hepatosplenomegaly. He reported on application of ocf in medical students are still embedded in the rst aspects to evaluate. Many techniques use a tenderness scale to facilitate infusions see chapter, hypoglycemia. He tolerates going down the back and to identify splanchnic vasoconstriction, which has a rapid method of assessing intracranial fluid content as measured by pi, in reducing neck pain could recur almost immediately after birth. Introduction osteopathic manipulative treatment are ...
It is well known that systemic hyperlactatemia may occur when epinephrine is used as treatment of hypotension or as an inotrope. Several investigators have implicated that this may not necessarily be a sign of tissue hypoperfusion or anaerobic metabolism. Indeed, hyperlactatemia may be related to aerobic glycolysis. Epinephrine stimulates the Na+-K+ pump activity; thus lactate is released from well-oxygenated tissue (14, 19). In the present experiment, we observed a high arterial lactate-to-pyruvate ratio in addition to arterial hyperlactatemia. This should, to our understanding, indicate cytosolic dysoxia within some vascular region of an organism. A closer look at the splanchnic region revealed an increasing venous-to-arterial lactate gradient in the gastric wall, whereas prehepatic tissues as a whole seemed to turn to a negative gradient, indicating overall lactate uptake. Intraperitoneal lactate release occurred, but this may have merely reflected systemic hyperlactatemia. Intraperitoneal ...