Kinin metabolism in the perfused ventilated rat lung. II: Influence of ventilation, perfusion, and perfusate composition variation on bradykinin metabolism in uninjured lung.

Bradykinin metabolism by peptidases of the pulmonary endothelium has been investigated in the previously uninjured, ventilated, and asanguinously perfused rat lung. The influence of short-duration (up to 20 min) abnormal ventilation and perfusion conditions on bradykinin metabolism was assessed. Neither variation of the oxygen concentration (0 to 45%) nor omission of carbon dioxide in the ventilatory gas altered bradykinin metabolism significantly.

Coagulation parameter instability as an early predictor of intracranial hemorrhage during extracorporeal membrane oxygenation.

Extracorporeal membrane oxygenation (ECMO) has been used to treat over 2,000 neonates with severe respiratory distress due to a number of different diagnoses. Its application has been expanded into the pediatric population as well. Despite both technical advances and refinement of management techniques, intracranial hemorrhage remains a major cause of both morbidity and mortality during ECMO.

Quality control of hemoglobin solutions. I. The purity of hemoglobin before modification.

It is not yet clear whether the toxicity of hemoglobin solutions is due to hemoglobin per se, contaminants, or both. To elucidate the problem, it is first necessary to prepare "pure hemoglobin," i.e.

Kinin metabolism in the perfused ventilated rat lung. I: Bradykinin metabolism in a system modeling the normal, uninjured lung.

Bradykinin (BK) in an asanguinous salt solution was perfused through intact rat lung. BK concentration varied from 0.0015 to 89 microM.

Management of massive hemorrhage associated with abdominal trauma.

Control of massive hemorrhage from intra-abdominal organs and major vascular structures may tax the ingenuity of the trauma surgeon. It is emphasized, however, that total blood loss and the amount of transfused blood are far less critical than the duration and severity of shock.

Biocompatibility of hemoglobin solutions. II. The inflammatory reaction of human monocytes and mouse peritoneal macrophages.

This study explored the inflammatory mechanism of toxicity of hemoglobin solutions (Hb-S). Human monocytes and mouse activated peritoneal macrophages were incubated with seven different solutions. The first four consisted of non-cross-linked bovine Hb.

Generation of free oxygen radicals and the toxicity of hemoglobin solutions.

The observed toxicity of hemoglobin solutions (HbS) might depend, at least in part, on the tendency of Hb to autoxidation with generation of oxygen free-radicals. Aims of this study were: (1) to quantitate plasma elevations of H2O2 and lipid peroxides after replacement of 1/3 of calculated blood volume in various groups of rabbits with different Hb solutions; (2) to correlate these elevations with parameters of brain, heart, lung, liver and kidney injury or dysfunction; and (3) investigate the protective effect of mannitol as a radical scavenger. One Hb solution contaminated with stromal phospholipids raised H2O2 from 31.

Nephrotoxicity of hemoglobin solutions.

Nephrotoxicity is a problem of hemoglobin solutions (HbS) that still awaits full elucidation and correction. Therefore, a study was conducted using five HbS with different characteristics to replace 1/3 of blood volume in five groups of rabbits. All HbS contained bovine Hb, 6.

Toxic factors in the red blood cell membrane.

The toxic effects of hemolysed RBCs have been studied for more than 100 years, but the specific factors involved have not been identified. This study focused on phosphatidylethanolamine (PE) and phosphatidylserine (PS), two aminophospholipids that normally reside on the cytoplasmic side of the red cell membrane. An in vitro experiment with murine peritoneal exudate macrophages showed that PE and PS: a) stimulated the production of H2O2, complement factor C3a, prostacyclin, and thromboxane at a dose of 5 micrograms/ml; b) produced cell injury, evidenced by release of lipid peroxides, LDH, and by morphologic changes on phase-contrast and electron microscopy at a dose of 50 micrograms/ml; and c) caused cell death in 50-66% of cells at a dose of 100 micrograms/ml.

Biocompatibility of hemoglobin solutions. I. Reactions of vascular endothelial cells to pure and impure hemoglobins.

Hemoglobin (Hb) solutions can cause vasoconstriction and activation of intravascular coagulation. Because the endothelium plays a major role in the regulation of vascular tone and hemostasis, a study was conducted of human umbilical vein endothelial cells (EC) incubated with various Hbs. Cell injury was evaluated by electron microscopy and the release of lactic dehydrogenase, H2O2, and procoagulant "tissue factor.

Human lung membrane-bound neutral metallo-endopeptidase-catalyzed hydrolysis of bradykinin.

Human lung membrane-bound neutral metallo-endopeptidase (NME; EC 3.4.24.

Complement activation and the toxicity of stroma-free hemoglobin solutions in primates.

The toxicity of hemoglobin solutions was studied in the context of their ability to activate serum complement (C). Three bovine polymerized hemoglobin solutions (BPHSs) with different degrees of purity were used for experiments in vitro and in vivo. BPHS-1 contained bacterial endotoxins (E) (5 EU/ml) and stromal phospholipids (PLs) (1.

Toxicity of polymerized hemoglobin solutions.

Four solutions of bovine polymerized hemoglobin (BPHS) and rabbit plasma were used to replace one-third of the blood volume in five groups of rabbits. The first three solutions were "impure" because of the presence of stromal phosphatidyl-ethanolamine and phosphatidyl-serine in BPHS-1, environmental endotoxins in BPHS-2, and a large amount of higher molecular weight hemoglobin-glutaraldehyde polymers in BPHS-3. These solutions caused a 33 per cent mortality rate and significant morbidity which was characterized by hemodynamic instability, respiratory and renal insufficiency, elevation of hepatic enzyme levels, thrombocytopenia, leukopenia, disseminated intravascular coagulation (DIC) and activation of the alternate pathway of complement.

A multicatalytic high-molecular-weight neutral endopeptidase from human kidney.

A multicatalytic endopeptidase (ME) with three distinct activities, chymotrypsin-like, cucumisin-like, and trypsin-like, occurred in all rat tissues examined with highest activities in kidney, testes, liver, and spleen; they were assayed with benzyloxycarbonyl-Gly-Gly-Leu-p-nitroanilide (Z-Gly-Gly-Leu-pNA), benzyloxycarbonyl-Leu-Leu-Glu-2-naphthylamide (Z-Leu-Leu-Glu-2NA), and benzyloxycarbonyl-Gly-Gly-Arg-2-naphthylamide (Z-Gly-Gly-Arg-2NA), respectively. All three activities were recovered from a single protein band on a polyacrylamide gel after electrophoresis of purified human kidney ME. The native enzyme had a Mr of 650,000, and it consisted of about 5,135 amino acid residues.

A high-molecular-mass neutral endopeptidase-24.5 from human lung.

A high-Mr neutral endopeptidase-24.5 (NE) that cleaved bradykinin at the Phe5-Ser6 bond was purified to apparent homogeneity from human lung by (NH4)2SO4 fractionation, ion-exchange chromatography and gel filtration. The final enzyme preparation produced a single enzymically active protein band after electrophoresis on a 5% polyacrylamide gel.

One hundred and fourteen fistulas of the gastrointestinal tract treated with total parenteral nutrition.

During a period of five years, all patients with fistulas of the gastrointestinal tract who received total parenteral nutrition as a part of the therapy were evaluated retrospectively. One hundred and eight patients with 114 fistulas of the gastrointestinal tract were studied. There were 58 male and 50 female patients.

Gastrointestinal malignancies in infancy, childhood, and adolescence.

Gastrointestinal and hepatobiliary malignancies in the pediatric age group are rare tumors and are usually treated with frustratingly poor results because of late diagnosis. Current efforts to improve treatment are directed at earlier diagnosis of these tumors in combination with aggressive surgery and adjuvant therapy.

Human lung post-proline endopeptidase: purification and action on vasoactive peptides.

Post-proline endopeptidase (PPE, EC 3.4.21.

Small bowel obstruction in the elderly.

Hospital records were reviewed for all patients 70 years or older who were treated for small bowel obstruction (SBO) at The New York Hospital-Cornell Medical Center from January 1975 through December 1980. There were 87 patients treated surgically and 20 patients treated nonoperatively. When the clinical evidence of strangulation was evaluated for preoperative reliability, 35 per cent of the patients had none of the accepted criteria for strangulation.

Extracellular fluid deficit following operation and its correction with Ringer's lactate. A reassessment.

The changes in extracellular fluid volume (ECV) in two groups of surgical patients, one receiving Ringer's lactate solution intraoperatively and the other receiving only dextrose and water, were assessed. A deficit in the ECV, as measured by radioactive sulfate, of 1.9 +/- 0.

The reliability of the results of ultrasound detection of fluid collections in the early postceliotomy period.

The results of this prospective clinical study have demonstrated a low rate of false-positive abdominal sonographic findings in patients undergoing routine studies the seventh day after abdominal surgical procedures. It is concluded that any intraperitoneal fluid collection detected by ultrasound examination in a patient postoperatively demonstrating signs and symptoms of abdominal sepsis (fever, leukocytosis, pain, tenderness, persistent ileus, excessive drainage, wound changes and so on), should be considered as the source, as abdominal fluid collections do not persist as a "normal" part of the healing process one week after extensive biliary tract or colonic operations. Sonography is a highly specific procedure for the detection of abdominal abscesses after the seventh postoperative day.