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Objective To evaluate the role of intercellular gap junction in lung injury induced by hemorrhagic shock and resuscitation in rabbits. Methods Twenty-four healthy rabbits of both sexes weighing 1.5-2.2 kg were used in this study. The animals were anesthetized with iv 3% pentobarbital 30 mg/kg,tracheostomized and mechanically ventilated. Femoral artery was cannulated for MAP monitoring, blood-letting.Right external jugular vein was cannulated for fluid infusion. Hemorrhagic shock was induced according to the method described by Wiggers. MAP was maintained at 35-40 mm Hg for 60 min. The animals were then randomly divided into 2 groups (n = 12 each):traditional treatment group (group A) and octanol group (group B). Both groups received rapid iv infusion of lactated Ringer's solution (LR solution) 1.5 ml·kg-1 ·min-1 for 30 min (T3 ).In group B 99.5% octanol (a specific gap junction inhibitor) 5 mmol/kg was injected intraperitoneally (IP) in addition to iv LR solution infusion. Thirty minutes later the animals were resuscitated with infusion of the blood withdrawn and LR solution (the volume was equal to the volume of blood loss). Then LR solution was infused iv at 2.5 ml· kg-1 · h-1 for 150 min ( T4 ). Left ventricular systolic pressure (LVSP) and HR were recorded before blood letting (T1), immediately after successful establishment of the model (T2), and at T3 and T4. The mortality during resuscitation was calculated. The animals were killed at T4. Blood samples were taken from femoral artery for determination of the serum protein concentration. The lungs were removed. The left lower lobe was lavnged. The protein concentration in broncho-alveolar lavage fluid (BALF) was measured. Lung permeability index (LPI) was calculated (LPI = protein concentration in BALF protein concentration in serum). Na+-K+-ATPase and Ca2+-ATPase activities and W/D lung weight ratio were determined and microscopic examination was performed. Results HR was significantly lower at T3 and T4 and LVSP higher at T4 in group B than in group A. The pulmonary permeability index, W/D lung weight ratio and mortality were significantly lower and the activities of Ns+-K+-ATPase and Ca2+ -ATPase were significantly higher in group B than in group A. The lung tissue danage was significantly ameliorated in group B. Conclusion Intercellular gap junction is involved in the development of lung injury induced by hemorrhagic shock and resuscitation in rabbits.

9.Clinical character and surgical interventions of chordomas in the cervical spine

Junming MA ; Jianru XIAO ; Dong CAO

Chinese Journal of Orthopaedics 1998;0(12):-

Objective To retrospectively study the character, surgical interventions of chordomas in the cervical spine. Methods All the clinical data of 8 cases of chordoma arising in the cervical spine which under went surgical treatment in our department from 1989 to 2006 were retrospectively reviewed, which including 5 males and 3 females. The patients ranged from 34 to 72 years at diagnosis, with an average age of 53.8 years. Surgical interventions were defined according to WBB criteria. 3 patients underwent subtotal centrum or total centrum resection, 2 patients underwent sagital resection and 2 patients received subtotal or total spondylectomy. Extracapsular excision was performed in a intradural invasion case. Autogenic iliac blocks were used as bone graft in 5 cases and titanium mesh with bone cement filling-in for anterior pedestal in 2 cases for reconstructing the stability of spine. Radiation therapy was given as an adjuvant treatment after surgery. Results Symptom of nerve root irritation disappeared or relieved prominently and the patients suffering spinal cord compression symptom got well recovery with at least 1 or 2 levels after operation. The typical “Physaliphorous cell” could be found in the oncologic examination in all those cases. Follow-up average 43.5 months, ranged from 3 to 120 months. All the internal fixation got well fusion and the rate of fusion for the bone graft was 100%. There were 4 cases in which the postoperative local recurrence of the tumor can be seen, with one patient dead of complications of high paralysis, but no local recurrence was observed in the cases which received total spondylectomy. No evidence of distant metastasis was observed in 7 cases for our series except the special intradural case which had the operation history for “sacral chordoma” before. So we consider it as a intradural metastasis case of the primary sacral chordoma. Conclusion Chordomas are rarely seen in the cervical spine and the typical clinical manifestation is rare in pristine cases. So we should think highly of the CT and MR examination for diagnosis. Total spondylectomy with postoperative radiation therapy could lower the rate of local recurrence.