Animals ; Animals, Newborn ; Brain Edema ; prevention & control ; Hypoxia-Ischemia, Brain ; prevention & control ; Progesterone ; therapeutic use ; Rats ; Rats, Wistar

Following short-term intubation for general anesthesia, respiratory difficulty may result from laryngeal or subglottic edema after extubation. We have hypothesized that this problem could be pretreated by administering a high-dose of dexamethasone intravenously before extubation. After glottic injuries were made under direct laryngoscopic view, intubation was performed and maintained for 1 hour in 33 rabbits. The rabbits were divided into 3 groups; dexamethasone (1 mg/kg) was administered to group 1(n=12) immediately after intubation and group 2(n=10) just before extubation; group 3(n=11) received normal saline, just before extubation. After extubation, subglottic excursion pressure was measured for 4 hours. 15 injured rabbit larynges and 3 normal ones were extracted for histologic section. 2 of 12 rabbits in group 1; 3 of 10 in group 2; and 5 of 11 in group 3, showed mild stridor after extubation(p>0.05). All rabbits developed maximum increase in subglottic pressure within 2 hours after extubation. Group 1 and 2 showed less increase in pressure compared to group 3(p<0.05), but here was no statistical difference between group 1 and 2(p>0.05). Histologic sections of the larynges showed less submucosal edema, including other changes in group 1 and 2, than in group 3(p<0.05). In conclusion, administering a high-dose of dexamethasone before extubation, is effective in prophylaxis and treatment of laryngeal injuries following short-term intubation in rabbits. This is especially true in edema.
Animal ; Dexamethasone/administration & dosage/*therapeutic use ; Intubation, Intratracheal/*adverse effects ; Laryngeal Edema/etiology/*prevention & control ; Rabbits

To explore the causes of the postoperative complications of the penile elongation and the measures to prevent them in order to raise the success rate of the penile elongation. 1,000 patients who had received the penile elongation were reviewed and analyzed for the causes of postoperative complications, and the measures of prevention and treatment were discussed. Our results showed that, of the 1,000 cases, 64 had the postoperative complications, including 20 cases of edema of prepuce, 15 cases of flap necrosis, 12 hematoma, 9 infections, and 8 cases of fat and clumsy penis. It is concluded that correct operative manipulation, strict aseptic measures and necessary postoperative care and management could avoid or reduce the postoperative complications. When complications happened, a satisfactory result can be achieved with timely and correct treatment in the majority of the patients.
Adolescent ; Adult ; Aged ; Edema ; etiology ; prevention & control ; Hematoma ; prevention & control ; Humans ; Male ; Middle Aged ; Penis ; abnormalities ; injuries ; surgery ; Postoperative Complications ; prevention & control ; therapy ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Surgical Wound Infection ; etiology ; prevention & control ; Urologic Surgical Procedures, Male ; methods

PURPOSE: Recently, conjunctivochalasis repair surgery using electrocauterization has been gaining popularity. However, patients with electrocauterized conjunctivoplasty tend to complain of more postoperative pain than patients undergoing simple excision with suturing. Therefore, we investigated the effects of electrocauterization on inflammation of the conjunctiva using an experimental animal model and compared these with the effects of simple excision with suturing. METHODS: Ten New Zealand white rabbits underwent cauterization in the right eyes and excision and suturing in the left eyes. For each eye, we excised or electrocauterized the inferior bulbar conjunctiva, 1 mm in width and 6 mm in length, 2 mm from the limbus. A fine-needle electrode was inserted subconjunctivally, and electrocauterization was performed. In the contralateral eye, the corresponding area was excised and re-approximated with 10-0 nylon sutures. Sutures were removed after 14 days. Tissue samples were obtained at 21 days post-procedure, and inflammatory cells were counted in five randomly selected fields (x200) on hematoxylin-eosin stained slides. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta concentrations in tears were measured using enzyme linked immunosorbent assays. RESULTS: All cauterized eyes demonstrated smooth surface healing without scarring after 5 days, whereas sutured eyes presented with mild edema with some scarring until the suture was removed. The number of inflammatory cells was significantly greater in sutured eyes compared with cauterized eyes (p = 0.035, Mann-Whitney U-test) at 21 days post-procedure. Tear TNF-alpha and IL-1beta concentrations at 21 days were similar in both groups. CONCLUSIONS: Electrocauterization for conjunctivoplasty seems to be advantageous in terms of inflammation compared with simple suturing and excision.
Animals ; Conjunctiva/pathology ; Conjunctivitis/*pathology/*surgery ; Disease Models, Animal ; Edema/pathology/prevention & control ; Electrocoagulation/*methods ; Humans ; Male ; Pain, Postoperative/pathology/*prevention & control ; Rabbits ; *Suture Techniques ; Treatment Outcome

OBJECTIVETo explore the effects of ultrafiltration technique in preventing and relieving pulmonary injury in children undergoing open heart surgery and cardiopulmonary bypass (CPB).

METHODSThirty cases with congenital heart defects were divided into a control group and an experimental group. In the control group, conventional cardiopulmonary bypass was used without ultrafiltration; while in the experimental group, cardiopulmonary bypass with balanced ultrafiltration and modified ultrafiltration were used. Pulmonary static compliance (Cstat), airway resistance (Raw), alveolar-arterial oxygen difference (A-a DO2), hematocrit (HCT), serum albumin (Alb), interleukin-6 (IL-6), endothelia-1 (ET-1) and thromboxane (TXB2) were measured.

RESULTSThe pulmonary function was improved, HCT and serum albumin concentrations were increased, and some harmful medium-size solutes were decreased in the experimental groups compared with the control group.

CONCLUSIONSCombination of balanced ultrafiltration with modified ultrafiltration can effectively concentrate blood, exclude harmful inflammatory mediators, and attenuate lung edema and inflammatory responsive pulmonary injury.

Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; methods ; Child, Preschool ; Heart Defects, Congenital ; surgery ; Humans ; Lung Diseases ; prevention & control ; Pulmonary Edema ; prevention & control ; Ultrafiltration ; methods

INTRODUCTIONReperfusion of acutely ischaemic tissue may, paradoxically, lead to systemic complications. This phenomenon is believed to be initiated by humoral factors that have accumulated in the ischaemic tissue. The ancient art of venesection may reduce the load of these mediators at the point of reperfusion. The aim of this study is to test if selective venesection, by removing the initial venous return from the ischaemic tissue, can attenuate the systemic effects of the ischaemic-reperfusion injury using a porcine model of acute limb ischaemia.

MATERIALS AND METHODSThe right femoral arteries of anaesthetised female pigs were clamped. Twelve pigs were divided into 2 groups (n = 6 per group). In the treatment group, 5% of blood volume was venesected from the ipsilateral femoral vein upon reperfusion; the other arm served as control. The animals were sacrifi ced after 4 days for histological examination. A pathologist, blinded to the experimental groups, graded the degree of microscopic injury.

RESULTSFor the control group, the kidneys showed glomeruli and tubular damage. The livers demonstrated architectural distortion with cellular oedema. There was pulmonary oedema as well as extensive capillary congestion and neutrophil infiltration. Such findings were absent or reduced in the venesected animals. Consequently, the injury scores for the kidney, lung, liver and heart were significantly less for the venesected animals.

CONCLUSIONSelective venesection reduces the remote organ injuries of the ischaemic-reperfusion phenomenon.

Animals ; Disease Models, Animal ; Female ; Hindlimb ; injuries ; Multiple Organ Failure ; etiology ; pathology ; prevention & control ; Phlebotomy ; Pulmonary Edema ; etiology ; pathology ; prevention & control ; Reperfusion Injury ; complications ; therapy ; Sus scrofa

Animals ; Brain Edema ; prevention & control ; therapy ; Cerebrovascular Circulation ; Dipeptides ; therapeutic use ; Hepatic Encephalopathy ; pathology ; prevention & control ; therapy ; Humans ; Naloxone ; therapeutic use

OBJECTIVETo investigate the preventive effects of Salvia miltiorrhiza (SM) on multiple organ edema in the rats which suffered from hind limb ischemia/reperfusion( LI/R).

METHODSTwenty four Wistar rats were randomly divided into 3 groups (n = 8): control group (C group), ischemia/reperfusion group (I/R group ), Salvia miltiorrhiza group (SM group). Referring to Tourniquet method, the model rats which underwent 4 hours ischemia and 4 hours reperfusion of hind limbs were made. Thirty minutes before reperfusion, SM was given to the rats in SM group by tail vein injection at the dose of 5 mL/kg. Accurately weighed one gram of heart, liver, kidney, lung, brain, intestine and skeletal muscle from every animals, weigh these specimens after baking (60 degrees C, 55 hours), calculated the ratio of wet and dry (Wet/Dry,W/D). The levels of interleukin-1 (IL-1) ,interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) in plasma and the contents of Superoxide dismutase (SOD) and malonaldehyde (MDA) were measured. The morphologic changes of skeletal muscle were observed with microscope.

RESULTSIt was found that after suffering from ischemia/reperfusion, the W/D of every specimens increased in different degree (P < 0.05, P < 0.01). In plasma, the values of SOD decreased but MDA increased obviously (P < 0.05, P < 0.01). The levels of IL-1, IL-6 ,TNF-alpha-a in plasma increased (P < 0.05, P <0.01). After LI/R, infiltration of inflammatory cells, broaden interstitial around muscle fiber and disordered arrangement of muscle fibers could be seen under microscope. However, Compared with LI/R group, W/D and levels of serum inflammatory factors in SM group were all lower, the values of SOD in plasma increased but MDA in plasma failed down. Pathological changes in skeletal muscle were improved.

CONCLUSIONLimb ischemia/reperfusion can lead to multiple organ edema, Salvia miltiorrhiza can prevent the edema in some degree by anti-oxidation and anti-inflammation.

Animals ; Cytokines ; blood ; Edema ; pathology ; prevention & control ; Hindlimb ; blood supply ; Male ; Malondialdehyde ; blood ; Rats ; Rats, Wistar ; Reperfusion Injury ; pathology ; prevention & control ; Salvia miltiorrhiza ; Superoxide Dismutase ; blood

OBJECTIVETo investigate the influence of therapeutic bloodletting at Jing-well points and hypothermia on acute cerebral edema after traumatic brain injury (TBI) in rats.

METHODSSeventy-five SD rats were randomly divided into sham-operation group (Sham), TBI group (TBI), bloodletting group (BL), mild-induced hypothermia group (MIH), and bloodletting plus MIH group (BL + MIH) (n = 15). The model of TBI was established by electric controlled cortical impactor (eCCI). The rats of BL group were bloodletting at Jing-well points immediately after injury, twice daily. While the MIH group was settled on a hypothermia blanket promptly after TBI for 6 hours, so that the temperature dropped to 32 degrees. Each of measurement was performed after 48 hours. Magnetic resonance imaging (MRI) was used to evaluate the dynamic impairment of cerebral edema after TBI (n = 3). In addition, mNSS score, measurements of wet and dry brain weight, and Evans Blue assay were performed to investigate the neurologic deficit, cerebral water content (n = 8), and blood-brain barrier permeability (BBB), (n = 4), respectively.

RESULTSMRI analysis showed that the cerebral edema, hematoma and midline shifting of rats in TBI group was more serious than other treatment group. Meanwhile compared with TBI group, the mNSS scores of every treatment group were meaningfully lower (all P < 0.05). Furthermore, treatment with BL+ MIH group was superior to the separated BL and MIH group (all P < 0.01). In addition, brain water content of each intervention group reduced to varying degrees (all P < 0.05), especially that of MIH group and BL + MIH group (P <0.01). BBB permeability of each treatment group was also significantly improved (all P < 0.01), and the improvement in MIH group and BL + MIH group was much better than the BL alone group (P < 0.05, P < 0.01).

CONCLUSIONOur major finding is that bloodletting at Jing-well points and MIH can reduce cerebral edema and BBB dysfunction and exert neuroprotective effects after TBI. The results suggest that the combination of BL and MIH is more effective than other treatment being used alone.

Animals ; Blood-Brain Barrier ; Bloodletting ; Brain ; pathology ; Brain Edema ; prevention & control ; Brain Injuries ; therapy ; Hypothermia, Induced ; Rats ; Rats, Sprague-Dawley

Severe ischemic stroke carries a high rate of disability and death. The severity of stroke is often assessed by the degree of neurological deficits or the extent of brain infarct, defined as severe stroke and large infarction, respectively. Critically severe stroke is a life-threatening condition that requires neurocritical care or neurosurgical intervention, which includes stroke with malignant brain edema, a leading cause of death during the acute phase, and stroke with severe complications of other vital systems. Early prediction of high-risk patients with critically severe stroke would inform early prevention and treatment to interrupt the malignant course to fatal status. Selected patients with severe stroke could benefit from intravenous thrombolysis and endovascular treatment in improving functional outcome. There is insufficient evidence to inform dual antiplatelet therapy and the timing of anticoagulation initiation after severe stroke. Decompressive hemicraniectomy (DHC) <48 h improves survival in patients aged <60 years with large hemispheric infarction. Studies are ongoing to provide evidence to inform more precise prediction of malignant brain edema, optimal indications for acute reperfusion therapies and neurosurgery, and the individualized management of complications and secondary prevention. We present an evidence-based review for severe ischemic stroke, with the aims of proposing operational definitions, emphasizing the importance of early prediction and prevention of the evolution to critically severe status, summarizing specialized treatment for severe stroke, and proposing directions for future research.
Humans ; Ischemic Stroke/pathology* ; Brain Edema/surgery* ; Stroke/prevention & control* ; Brain/pathology* ; Brain Infarction/pathology* ; Treatment Outcome