[Experimental evaluation of mesenteric flowmetric changes induced by eating and digestion under normal conditions and after vagotomy and gastric resection]

Reference is made to recent data concerning the regulation of mesenteric haemodynamics by enteric hormones. Changes in mesenteric circulation in the course of altered intestinal hormonal secretion were examined. The results showed that a real connection exists between such secretion and the regulation of mesenteric haemodynamics, since flowmeter changes were noted after surgical operations performed on experimental animals.

A simple diagnostic sign in the superior mesenteric artery syndrome in a burned patient

In the superior mesenteric artery syndrome which may complicate extensive burns, a systolic murmur may be heard in the epigastrium when the patient is supine but not when he is prone. This sign combined with straight abdominal x-rays will clinch the diagnosis and thereby avoid an unnecessary barium meal or laparotomy.

Norepinephrine and isoprenaline induced changes of peripheral blood flow acceleration caused by changes of cardiac inotropy

In anesthetized dogs the norepinephrine (NE) and isoprenaline (ISO) (1--1024 ng/kg i.v.)--induced increase of maximum peripheral flow acceleration (celiac artery, cranial mesenteric artery, renal artery; and femoral artery) and the changes of the maximum first derivative of arterial pressure were compared with the increases of maximum ascending aortic flow acceleration and maximum first derivative of left ventricle pressure (LV dP/dt max). The maximum effect of each dose on maximum acceleration of flows (dF/dt max) and maximum first derivative of pressures (dP/dt max) occurred simultaneously for all v56--512 ng/kg) and for ISO (D50:128--256) ng/kg). We demonstrated that other varure) played only a minor role in the increases of LV dP/dt max in our studies. In contrast with the uniform response of dF/dt max and dP/dt max, the reaction of peripheral vascular resistance varied. In particular in the gastrointestinal tract the resistance could either be increased (NE, D50:115 ng/kg) or decreases (ISO, D50:15 ng/kg). Gastrointestinal resistance was a more sensitive variable for catecholamine stimulation than dF/dt max and dP/dt max. The data show that under the present experimental conditions induced by NE and ISO is due to increase of cardiac inotropy.

Left colon gangrene after acute inferior mesenteric artery occlusion

We report here an experience with five patients, aged 58 to 70, suffering gangrene of the left colon after spontaneous inferior mesenteric artery occlusion. All cases were the result of arteriosclerosis; in two, small aortic aneurysms were present and might have been responsible for emboli to the inferior mesenteric artery. The dead bowel was resected in all patients; three patients survived. No primary anastomoses were done and they are not recommended. Because ligation of the patent inferior mesenteric artery has been done so often without ill effects during aortic surgery, the collateral circulation to the left colon can be considered excellent. Gangrene is therefore rare and requires major interference with collateral circulation by emboli or arteriosclerotic occlusion. The clinical symptoms and signs may be confusing.

Cogan syndrome associated with mesenteric vascular insufficiency

Nonsyphilitic interstitial keratitis and deafness was first described as a distinct entity by Cogan in 1945. For years thereafter, it was believed to involve only the ocular and aural systems. It is gradually becoming apparent that the syndrome can also include other organ systems by affecting their blood supply. A patient with diagnosed Cogan syndrome subsequently developed mesenteric vascular insufficiency that was surgically corrected. This report lends more support to the belief that nonsyphilitic interstitial keratitis with deafness is only one manifestation of a more generalized vascular disease.

Persistent gastrointestinal bleeding due to angiodysplasia of the gut in von Willebrand's disease

Gastronintestinal vascular dysplasia as a cause of persistently recurring melaena is reported in two patients with von Willebrand's disease. Colonic wall vasculature was affected in one patient, the abnormality being demonstrated both radiologically and at operative hemicolectomy undertaken to control bleeding. Abnormalities in the vasculature of the duodenal and jejunal walls were found in the second patient at operation and necropsy, though not demonstrated by angiography.

Physiological cortisol levels block the inhibition of vascular reactivity produced by prolactin

Cortisol in concentrations similar to the unbound levels of the hormone in human plasma can reverse the inhibition of vascular reactivity produced by prolactin. In the rat mesenteric vascular bed, cortisol alone in similar concentrations had no significant effect on the pressor responses to norepinephrine: the action of cortisol was seen only when prolactin was present. The relationships between the effects of different concentrations of prolactin and cortisol suggest that at some point there is a competitive interplay between the effects of the two hormones. There is indirect evidence that this interplay is at the level of prostaglandin synthesis or release. We suggest that cortisol has no effect on basal prostaglandin production but blocks the synthesis or release occurring in response to polypeptide hormone stimulation.

Arachidonic acid in splanchnic artery occlusion shock

Arachindonic acid infused into the mesenteric vascular bed of normal pentobarbital-anesthetized dogs at a concentrations of 150 mug/kg per min produced no significant changes in mean arterial blood pressure (MABP), portal vein pressure (PVP), screen filtration pressure (SFP), platelet count, circulating lysosomal enzyme or myocardial depressant factor (MCF) activities, nad only modestly increased superior mesenteric arter flow (SMAF)ans endogenous prostaglandin concentrations concentrations. It is concluded that arachidonic acid, at the infusion rate employed, dose not have any major effect on the circulatory status or on the lysosomal or platelet stability in normal dogs. In contrast, arachidonic acid administered to dogs in splanchnic artery occulusion (SAO) shock significantly exacerbated the decline in MABP seen after release of the occlusive clamps and also significantly reduced mesenteric blood flow. The hypothnsive of arachidonic acid appears to be partly due to the fatty acid itself and partly due to the metavolically formed prostaglandin endoct the platelet count or aggregability, lysosomal hydrolase activity, or MDF formation in the SAO shock dogs. These data suggest that increased endogenous prostaglandin concentrations in themselves are not a prime factor in the pathophysiology of circulatory shock, but that endogenous prostaglandin or related substances can significantly modulate the shock state.

[Albumin kinetics in superior mesenteric artery shock in rats]

1. After 1-hour-tourniquet of the arteria mesenterical superior of the rat the result is a loss of intravasal fluid into the small intestine. After 2-hour-tourniquet the loss of fluid into the samll intestine can be higher than the volume of plasma circulating at the start of the experiment. During therapy with plasma substitute on base of gelatine (Haemaccel) the volume of content of the small intestine increases further. 2. After 1-hour-tourniquet the content of intravasal albumin is diminished by 26%, after 2-hour-tourniquet by 46%. Under therapy with a plasma substitute the loss of intravasal albumin increases further. 3. After 1-hour-tourniquet a transient accumulation of albumin was found in the wall of the samll intestine which was reduced after 2-hour-tourniquet. 4. The intravasal albumin is excreted in the small and the large intestine. After 1-hour-tourniquet 46% of excreted albumin was found in the small intestine after 2-hour-tourniquet 61%. It can be demonstrated, that under replacement with plasma substitute the result is mainly an "albumin dilution effect". The wall of the small intestine becomes permeable to high-molecular weight substances with an average molecular weight below 60.000. An effective therapy with the plasma substitute of the AMS-shock should, therefore, contain carrier substances with a molecular weight higher than 60.000.

Influence of cyclic nucleotides on protein synthesis in vascular smooth muscle

The incorporation of leucine-14C into protein in bovine mesenteric arteries was augmented by cyclic GMP (10-3 M) and decreased by cyclic AMP (10-3 M). There was no effect of 5'AMP (10-3 M). The phosphodiesterase inhibiting drugs theophylline (10-3 M) and papaverine (5 x 10-5 g/ml) both decreased the leucine-14C incorporation.

[Incomplete chronic duodenal stenosis caused by compression by the aorta and mesenteric artery]

In the light of data from the literature, as well as on the personal observations made in 5 cases of chronic, imcomplete duodenal stenosis through aortic-mesenteric pincers that have been hospitalized and operated, the authors stress: the complexity of the syndrome, the difficulties encountered in the establishment of the diagnosis, the severe consequences of the evolution, the necessity to apply surgical treatment as soon as possible.