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Kris-Etherton PM, Hecker KD, Bonanome A, Coval SM, Binkoski AE, Hilpert KF, Griel AE, Etherton TD. Bioactive compounds in foods: their role in the prevention of cardiovascular disease and cancer. Am J Med 2002; 113 Suppl 9B:71S-88S. [PMID: 12566142 DOI: 10.1016/s0002-9343(01)00995-0] [Citation(s) in RCA: 1201] [Impact Index Per Article: 52.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
"Bioactive compounds" are extranutritional constituents that typically occur in small quantities in foods. They are being intensively studied to evaluate their effects on health. The impetus sparking this scientific inquiry was the result of many epidemiologic studies that have shown protective effects of plant-based diets on cardiovascular disease (CVD) and cancer. Many bioactive compounds have been discovered. These compounds vary widely in chemical structure and function and are grouped accordingly. Phenolic compounds, including their subcategory, flavonoids, are present in all plants and have been studied extensively in cereals, legumes, nuts, olive oil, vegetables, fruits, tea, and red wine. Many phenolic compounds have antioxidant properties, and some studies have demonstrated favorable effects on thrombosis and tumorogenesis and promotion. Although some epidemiologic studies have reported protective associations between flavonoids or other phenolics and CVD and cancer, other studies have not found these associations. Various phytoestrogens are present in soy, but also in flaxseed oil, whole grains, fruits, and vegetables. They have antioxidant properties, and some studies demonstrated favorable effects on other CVD risk factors, and in animal and cell culture models of cancer. However, because phytoestrogens act both as partial estrogen agonists and antagonists, their effects on cancer are likely complex. Hydroxytyrosol, one of many phenolics in olives and olive oil, is a potent antioxidant. Resveratrol, found in nuts and red wine, has antioxidant, antithrombotic, and anti-inflammatory properties, and inhibits carcinogenesis. Lycopene, a potent antioxidant carotenoid in tomatoes and other fruits, is thought to protect against prostate and other cancers, and inhibits tumor cell growth in animals. Organosulfur compounds in garlic and onions, isothiocyanates in cruciferous vegetables, and monoterpenes in citrus fruits, cherries, and herbs have anticarcinogenic actions in experimental models, as well as cardioprotective effects. In summary, numerous bioactive compounds appear to have beneficial health effects. Much scientific research needs to be conducted before we can begin to make science-based dietary recommendations. Despite this, there is sufficient evidence to recommend consuming food sources rich in bioactive compounds. From a practical perspective, this translates to recommending a diet rich in a variety of fruits, vegetables, whole grains, legumes, oils, and nuts.
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Review |
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1201 |
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Abstract
Epidemiologic studies have shown a beneficial association between polyunsaturated fatty acid (PUFA), specifically linoleic acid (C18:2, n-6), intake and cardiovascular disease morbidity and mortality. Clinical studies have shown that n-6 PUFAs have the most potent cholesterol-lowering effects of the individual fatty acid classes, and emerging evidence suggests that PUFAs have favorable effects on postprandial lipemia. However, some studies suggest that high intakes of linoleic acid may have adverse effects on proinflammatory cytokines and adhesion molecules. Research is needed to establish the optimal level of dietary PUFAs that maximally affects the greatest number of health risk factors.
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West SG, Hecker KD, Mustad VA, Nicholson S, Schoemer SL, Wagner P, Hinderliter AL, Ulbrecht J, Ruey P, Kris-Etherton PM. Acute effects of monounsaturated fatty acids with and without omega-3 fatty acids on vascular reactivity in individuals with type 2 diabetes. Diabetologia 2005; 48:113-22. [PMID: 15624100 DOI: 10.1007/s00125-004-1600-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2004] [Accepted: 07/31/2004] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS We examined the acute postprandial effects of meals containing unsaturated fatty acids on flow-mediated dilation (FMD) of the brachial artery and triacylglycerols in individuals with type 2 diabetes. We hypothesised that consumption of omega-3 fatty acids would enhance vascular function. Saturated fat reduces FMD for several hours, but there is inconsistent evidence about whether foods containing unsaturated fats impair FMD acutely. Little is known about the acute effects of omega-3 fatty acids on vascular reactivity. METHODS We measured FMD before and 4 h after 3 test meals (50 g fat, 2,615 kJ) in 18 healthy adults with type 2 diabetes. The monounsaturated fatty acids (MUFA) meal contained 50 g fat from high oleic safflower and canola oils. Two additional meals were prepared by replacing 7% to 8% of MUFA with docosahexaenoic acid and eicosapentaenoic acid from sardine oil or alpha-linolenic acid from canola oil. RESULTS In the sample as a whole, FMD was increased 17% at 4 h vs. the fasting baseline. After the MUFA meal, subjects with the largest increases in triacylglycerols had the largest FMD decreases. The opposite pattern was observed after meals containing docosahexaenoic acid and eicosapentaenoic acid or alpha-linolenic acid. In subjects with high fasting triacylglycerols, meals containing 3 to 5 g of omega-3 fatty acids increased FMD by 50% to 80% and MUFA alone had no significant effects on FMD. CONCLUSIONS/INTERPRETATION Endothelium-dependent vasodilation was not impaired 4 h after meals containing predominantly unsaturated fatty acids. The fatty acid composition of the meal and the metabolic status of the individual determine the vascular effects of a high-fat meal.
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Comparative Study |
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Coburn M, Kunitz O, Baumert JH, Hecker K, Haaf S, Zühlsdorff A, Beeker T, Rossaint R. Randomized controlled trial of the haemodynamic and recovery effects of xenon or propofol anaesthesia. Br J Anaesth 2005; 94:198-202. [PMID: 15531620 DOI: 10.1093/bja/aei023] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is limited clinical experience with xenon in a large number of patients. We present intra- and postoperative haemodynamic and recovery data comparing xenon and total intravenous anaesthesia with propofol. METHODS A total of 160 patients aged 18-60 years (ASA I and II) undergoing elective surgery took part in this prospective non-blinded randomized controlled trial. After local ethics committee approval and written informed consent, patients were allocated randomly to either the xenon or the propofol group. Anaesthesia was induced with propofol and remifentanil and was maintained with xenon at 60% (minimal alveolar concentration 0.95) or with propofol 0.1-0.12 mg kg(-1) min(-1). Remifentanil was titrated to clinical need in both groups. RESULTS The two study groups were comparable with respect to age, weight, height, gender and ASA classification. Baseline in heart rate and systolic arterial pressure (SAP) were comparable in both groups. Following induction, SAP initially decreased but returned to baseline values over 15 min in the xenon group and differed significantly from the propofol group. Heart rate decreased significantly only in the xenon group and remained at stable values. Occurrence and duration of hypertension, hypotension and bradycardia showed no significant difference between groups. Patient recovery time in the post-anaesthetic care unit and recovery from anaesthesia was similar in the two groups. CONCLUSIONS After induction the xenon/opioid regimen maintains systolic blood pressure at baseline levels and a low heart rate. No differences between groups were found in haemodynamic stability during anaesthesia. Recovery from xenon anaesthesia was similar to that observed in the propofol group.
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West SG, Wagner P, Schoemer SL, Hecker KD, Hurston KL, Likos Krick A, Boseska L, Ulbrecht J, Hinderliter AL. Biological correlates of day-to-day variation in flow-mediated dilation in individuals with Type 2 diabetes: a study of test-retest reliability. Diabetologia 2004; 47:1625-31. [PMID: 15365618 DOI: 10.1007/s00125-004-1502-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2004] [Accepted: 05/04/2004] [Indexed: 11/25/2022]
Abstract
AIMS/HYPOTHESIS Dysfunction of the vascular endothelium is commonly observed in Type 2 diabetes, and endothelial function may be an important outcome for clinical trials in diabetic samples. However, the most commonly used non-invasive test of endothelial function (flow-mediated dilation [FMD]) is technically challenging to perform, and no previous studies have carefully examined the reproducibility of FMD measurements in individuals with Type 2 diabetes. In this study, we tested the hypothesis that larger day-to-day changes in insulin and glucose are associated with larger fluctuations in FMD. METHODS Ultrasound was used to measure the FMD (% change from baseline diameter) of the brachial artery in 18 healthy adults with Type 2 diabetes on three separate occasions, in the absence of changes to diet, activity level or medications. The CV and mean deviations between pairs of FMD scores in the same individual were used as the primary outcome variables. RESULTS The CV for FMD (29.7%) was higher than the level traditionally accepted for biochemical assays. However, this CV estimate is within the low range of published values for FMD in healthy individuals. FMD scores were not significantly correlated with glucose or insulin levels. However, subjects with the largest variability in FMD also showed the largest fluctuations in glucose ( r=0.52), insulin ( r=0.47) and heart rate ( r=0.48) ( p</=0.05). CONCLUSIONS/INTERPRETATION FMD can be reliably measured in individuals with Type 2 diabetes, and population-specific data on reliability is critical for the design of adequately powered studies of endothelial function.
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Hilpert KF, West SG, Kris-Etherton PM, Hecker KD, Simpson NM, Alaupovic P. Postprandial effect of n-3 polyunsaturated fatty acids on apolipoprotein B-containing lipoproteins and vascular reactivity in type 2 diabetes. Am J Clin Nutr 2007; 85:369-76. [PMID: 17284731 DOI: 10.1093/ajcn/85.2.369] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Plasma lipoproteins may be classified by their apolipoprotein composition. The lipoprotein subclass containing apolipoproteins B and C (LpB:C) is considered the most atherogenic. OBJECTIVE We evaluated the acute effects of individual fatty acids on apolipoprotein B (apo B)-containing lipoproteins in adults with type 2 diabetes (n = 15). DESIGN We administered 3 meals in a randomized, double-blind, crossover design. Treatments contained skim milk and 50 g fat from high-oleic acid safflower and canola oils (monounsaturated fatty acid; MUFA), MUFA + 3.5 g alpha-linolenic acid (ALA; MUFA + ALA) from high-ALA canola oil, or MUFA + 4.0 g both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA; MUFA + EPA/DHA) from sardine oil. Apo B, LpB, LpB:C, LpB:E + LpB:C:E, and LpA-II:B:C:D:E were measured at baseline and 2 and 4 h after the meal. Flow-mediated dilation was measured at baseline and 4 h after the meal. RESULTS The treatments significantly increased apo B and LpB postprandially (P < 0.03 for both), but the magnitude of the changes did not differ significantly between the treatments. The postprandial change in LpB:C was 23% lower after MUFA + EPA/DHA than after MUFA (treatment x time interaction, P < 0.0001). MUFA + ALA attenuated the increase in LpA-II:B:C:D:E in those with high triacylglycerols (>/=1.69 mmol/L) but was the only treatment to significantly increase this particle in those with low triacylglycerols (treatment x group interaction, P < 0.0001). Examination of change scores did not reveal the source of the interaction of treatment and time (P < 0.007) for LpB:E + LpB:C:E. Furthermore, the subjects with the largest increases in LpB:C exhibited the largest impairment in endothelial function. CONCLUSIONS The results suggest that unsaturated fatty acids differentially affect concentrations of apo B-containing lipoprotein subclasses. A rise in LpB:C adversely affects endothelial function. Meals containing MUFA + EPA/DHA attenuated the postprandial rise in LpB:C and the impairment of endothelial function.
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Randomized Controlled Trial |
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Kris-Etherton PM, Kris-Etherton PM, Binkoski AE, Zhao G, Coval SM, Clemmer KF, Hecker KD, Jacques H, Etherton TD. Dietary fat: assessing the evidence in support of a moderate-fat diet; the benchmark based on lipoprotein metabolism. Proc Nutr Soc 2002; 61:287-98. [PMID: 12133212 DOI: 10.1079/pns2002157] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There is a growing database that has evaluated the effects of varying amounts of total fat on risk factors for cardiovascular disease, diabetes and overweight and obesity. The evidence clearly suggests that extremes in dietary fat should be avoided, and instead a diet moderate in total fat (25-35 % energy) is preferable for the majority of individuals. Moreover, we now appreciate the importance of individualizing dietary fat recommendations within this range of total fat. With respect to cardiovascular disease, a diet higher in total fat (30-35 % energy) affects the lipid and lipoprotein risk profile more favourably than a lower-fat diet; this is also the case for individuals with diabetes, with the added benefit of better glycaemic control. Dietary fibre (> or = 25 g/d) attenuates and even prevents the potentially adverse lipid and lipoprotein effects of a lower-fat diet. With respect to weight control, a moderate-fat diet can be as, or even more, effective than a lower-fat diet, because of advantages with long-term adherence and potentially favourable effects on lipids and lipoproteins. Thus, there is now a convincing scientific basis to advocate a diet moderate in total fat for the majority of individuals. Implicit to this position is that unsaturated fat has numerous beneficial health effects. However, because fat is energy dense, moderation in fat intake is essential for weight control. Consequently, a simple message to convey is to avoid diets that are very low and very high in fat. Moreover, within the range of a moderate-fat diet it is still important to individualize the total fat prescription. Nonetheless, the guiding principle is that moderation in total fat is the defining benchmark for a contemporary diet that reduces risk of chronic disease.
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Review |
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Baumert JH, Reyle-Hahn M, Hecker K, Tenbrinck R, Kuhlen R, Rossaint R. Increased airway resistance during xenon anaesthesia in pigs is attributed to physical properties of the gas. Br J Anaesth 2002; 88:540-5. [PMID: 12066731 DOI: 10.1093/bja/88.4.540] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In this study we investigated the effects of the physical properties of xenon on respiratory mechanisms in pigs. METHODS With institutional approval, 10 female pigs (mean 25.2 (SD 2.5) kg) were anaesthetized with thiopental, remifentanil, and pancuronium. Gas flow and pressure were recorded continuously at the proximal end of the tracheal tube during constant flow ventilation for control, with 100% oxygen (control), followed by 1.5% isoflurane in 70/30% nitrogen/oxygen, 1.0% isoflurane in 70/30% nitrous oxide/oxygen, and 70/30% xenon/oxygen in random order. Compliance (C) and resistance (R) were calculated using a single compartment model. Resistance was corrected for gas viscosities eta and also for densities pho and viscosities eta as (pho*eta)(1/2) to compare assumptions of laminar and mixed flow in the airways. RESULTS With constant flow ventilation, xenon increases inspiratory pressure compared with other gas mixtures. There were no significant differences in resistance, corrected for laminar or mixed flow, between the gas mixtures. Xenon anaesthesia did not affect compliance. CONCLUSIONS The increase in airway pressure observed with xenon anaesthesia is attributed completely to its higher density and viscosity. Therefore, determination of airway resistance must take into account the physical properties of the gas. Xenon does not exert any major effect on airway diameter.
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Ciechanski P, Cheng A, Damji O, Lopushinsky S, Hecker K, Jadavji Z, Kirton A. Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition. BJS Open 2018; 2:70-78. [PMID: 29951631 PMCID: PMC5989997 DOI: 10.1002/bjs5.43] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 12/13/2017] [Indexed: 02/05/2023] Open
Abstract
Background Changes in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct-current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effects of tDCS on simulation-based laparoscopic surgical skill acquisition. Methods In this double-blind, sham-controlled randomized trial, participants were randomized to receive 20 min of anodal tDCS or sham stimulation over the dominant primary motor cortex, concurrent with Fundamentals of Laparoscopic Surgery simulation-based training. Primary outcomes of laparoscopic pattern-cutting and peg transfer tasks were scored at baseline, during repeated performance over 1 h, and again at 6 weeks. Intent-to-treat analysis examined the effects of treatment group on skill acquisition and retention. Results Of 40 participants, those receiving tDCS achieved higher mean(s.d.) final pattern-cutting scores than participants in the sham group (207·6(30·0) versus 186·0(32·7) respectively; P = 0·022). Scores were unchanged at 6 weeks. Effects on peg transfer scores were not significantly different (210·2(23·5) in the tDCS group versus 201·7(18·1) in the sham group; P = 0·111); the proportion achieving predetermined proficiency levels was higher for tDCS than for sham stimulation. Procedures were well tolerated with no serious adverse events and no decreases in motor measures. Conclusion The addition of tDCS to laparoscopic surgical training may enhance skill acquisition. Trials of additional skills and translation to non-simulated performance are required to determine the potential value in medical education and impact on patient outcomes. Registration number: NCT02756052 (https://clinicaltrials.gov/).
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Journal Article |
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St-Onge MP, Aban I, Bosarge A, Gower B, Hecker KD, Allison DB. Snack chips fried in corn oil alleviate cardiovascular disease risk factors when substituted for low-fat or high-fat snacks. Am J Clin Nutr 2007; 85:1503-10. [PMID: 17556685 PMCID: PMC3666855 DOI: 10.1093/ajcn/85.6.1503] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The perception that all high-fat snacks are unhealthy may be wrong. OBJECTIVE We aimed to assess whether replacing low-fat and high-fat snacks with snacks rich in polyunsaturated fatty acids (PUFAs) and low in saturated and trans fatty acids would improve cardiovascular health. DESIGN Thirty-three adults participated in a randomized crossover trial of 3 controlled feeding phases of 25 d each in which a different type of snack was provided: low-fat (30.8% of energy from fat, 5.2% of energy from PUFAs), high-PUFA (36.3% of energy from fat, 9.7% of energy from PUFAs), or high-fat (37.9% of energy from fat, 5.8% of energy from PUFAs) snack. RESULTS Each diet reduced LDL- and total cholesterol concentrations, but reductions were greater with the low-fat and the high-PUFA diets than with the high-fat diet: LDL cholesterol (11.8% and 12.5% compared with 8.8%, respectively; P = 0.03 and 0.01), total cholesterol (10.5% and 10.7% compared with 7.9%, respectively; P = 0.03 and 0.02). The high-PUFA diet tended to reduce triacylglycerol concentrations (9.4%; P = 0.06), and this change was greater than that with the low-fat (P = 0.028) and high-fat (P = 0.0008) diets. CONCLUSIONS These data show that snack type affects cardiovascular health. Consuming snack chips rich in PUFA and low in saturated or trans fatty acids instead of high-saturated fatty acid and trans fatty acid or low-fat snacks leads to improvements in lipid profiles concordant with reductions in cardiovascular disease risk.
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Randomized Controlled Trial |
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Hecker KD. Effects of dietary animal and soy protein on cardiovascular disease risk factors. Curr Atheroscler Rep 2001; 3:471-8. [PMID: 11602067 DOI: 10.1007/s11883-001-0037-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A growing body of research offers insight into the influence of dietary protein on cardiovascular disease (CVD) risk. Early studies in rabbits indicated that animal protein was atherogenic; however, this has not been demonstrated in other animals species (pig, primate) or humans. More recent studies have found that low-fat animal protein can effectively improve some CVD risk factors. Soy protein has received much attention in recent years due to its seemingly marked effect on plasma cholesterol levels. However, further research has shown the hypocholesterolemic effect of soy protein to be most pronounced in cases of moderate to severe elevations in plasma lipids. Still, animal and soy protein sources contain a variety of bioactive components that may offer protection above and beyond cholesterol reduction. This review provides evidence that as part of a low-saturated fat diet, animal and/or soy protein intake at or above the recommended intake level of 15% of total calories lowers plasma cholesterol levels, reduces blood pressure, and potentially facilitates healthy weight management.
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Review |
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15 |
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Hecker KD, Kris-Etherton PM, Zhao G, Coval S. Impact of body weight and weight loss on cardiovascular risk factors. Curr Atheroscler Rep 1999; 1:236-42. [PMID: 11122716 DOI: 10.1007/s11883-999-0038-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Overwieght and obesity are classified as a major risk for cardiovascular disease (CVD). An increase in the body mass index is associated with adverse changes in the plasma lipid and lipoprotein profile resulting in elevated total cholesterol, low-density lipoprotein-cholesterol, and triglyceride levels and a decrease in high-density lipoprotein levels. An android pattern of obesity is associated with a more deleterious plasma lipoprotein profile as well as hypertension and insulin resistance, resulting in an even greater increase in CVD risk. Weight loss through caloric restriction improves the plasma lipoprotein profile. A Step-1 diet plus exercise confer even greater benefits.
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Review |
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Koblinger K, Hecker K, Nicol J, Wasko A, Fernandez N, Léguillette R. Bronchial collapse during bronchoalveolar lavage in horses is an indicator of lung inflammation. Equine Vet J 2013; 46:50-5. [PMID: 23662631 DOI: 10.1111/evj.12096] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 04/07/2013] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING STUDY The bronchoalveolar lavage (BAL) procedure can return variable volumes of fluid, possibly depending on the presence of bronchial collapse during fluid aspiration and on the severity of lung inflammation. OBJECTIVES We tested the hypothesis that horses with bronchial collapse during BAL are at higher risk of having severe lung inflammation. STUDY DESIGN Prospective field study. METHODS Bronchial collapse was graded using a new simple scoring method (0, 1 or 2) during a standardised BAL procedure in the field on 131 horses with normal, mild/moderate or severe lower airway inflammation on cytology of BAL fluid. RESULTS Of the 131 horses, 37 (28%), 55 (42%) and 39 (30%) horses had bronchial collapse scores of 0, 1 and 2, respectively. There was a difference in collapse scores between all the BAL inflammation categories (P<0.001). Severe collapse had a positive predictive value of 0.95 for both mild/moderate and severe BAL inflammation, with a prevalence of 63% and 20%, respectively. The BAL fluid return volume in the horses with severe collapse scores was lower than volumes in the partial (score 1/2) and no collapse (score 0/2) groups (P<0.001). The BAL fluid volume was negatively correlated with BAL neutrophil percentage (P<0.001). CONCLUSIONS Airway collapse during BAL is associated with airway inflammation and neutrophilia. POTENTIAL RELEVANCE During a standardised BAL procedure, clinicians can expect lung inflammation in horses that have bronchial collapse and bronchial collapse in horses with lung inflammation. Lung inflammation may be a contributing factor in the mechanism of bronchial collapse during BAL in horses.
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Research Support, Non-U.S. Gov't |
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Vagts DA, Hecker K, Iber T, Roesner JP, Spee A, Otto B, Rossaint R, Nöldge-Schomburg GFE. Effects of xenon anaesthesia on intestinal oxygenation in acutely instrumented pigs. Br J Anaesth 2004; 93:833-41. [PMID: 15465844 DOI: 10.1093/bja/aeh271] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Xenon is a narcotic gas that might be able to replace volatile anaesthetics or nitrous oxide due to its favourable pharmacological properties, such as providing haemodynamic stability. Intestinal oxygenation is affected by most volatile anaesthetics as a result of cardiodepressive effects. Reducing oxygenation of the gut might be a factor leading to perioperative organ dysfunction. This animal study was designed to assess the effects of xenon on intestinal oxygenation. METHODS After ethical approval, 24 anaesthetized, acutely instrumented pigs were randomly assigned to three groups: nine animals received xenon anaesthesia with inspiratory concentrations of 0, 20, 50 and 65% in addition to their basic i.v. anaesthesia, nine animals served as a study control group, and five animals were used to assess model stability. Measurement of systemic and regional haemodynamic and oxygenation parameters was made 30 min after changing the xenon concentration. RESULTS Xenon elicited dose-dependent systemic haemodynamic changes: heart rate and cardiac output decreased by 30%, while mean arterial pressure was stable. Superior mesenteric artery blood flow was lower in the xenon group. Vascular resistance of the superior mesenteric artery increased. The small intestinal oxygen supply decreased with increasing xenon concentration; the mucosal tissue oxygen partial pressure decreased but did not reach hypoxic (<5 mm Hg) values. Serosal tissue oxygen partial pressure was maintained. CONCLUSIONS Xenon, in addition to basic i.v. anaesthesia, elicited a decrease in cardiac output and maintained mean arterial pressure. Intestinal oxygenation was maintained, although regional macrohaemodynamic perfusion decreased. Xenon does not impair intestinal oxygenation under physiological conditions.
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Journal Article |
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Tenbrinck R, Hahn MR, Gültuna I, Hofland J, van Dijk G, Baumert J, Hecker K, Erdmann W. The first clinical experiences with xenon. Int Anesthesiol Clin 2001; 39:29-42. [PMID: 11507376 DOI: 10.1097/00004311-200104000-00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Clinical Trial |
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16
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Hegger H, Huckestein B, Hecker K, Janssen M, Freimuth A, Reckziegel G, Tuzinski R. Fractal Conductance Fluctuations in Gold Nanowires. PHYSICAL REVIEW LETTERS 1996; 77:3885-3888. [PMID: 10062333 DOI: 10.1103/physrevlett.77.3885] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Coburn M, Kunitz O, Baumert JH, Hecker K, Rossaint R. Patients' self-evaluation after 4-12 weeks following xenon or propofol anaesthesia. Eur J Anaesthesiol 2005; 22:870-4. [PMID: 16225724 DOI: 10.1017/s026502150500147x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to assess postoperative patients' self-evaluation after xenon anaesthesia compared to total intravenous anaesthesia with propofol. METHODS 160 patients aged 18-60 yr, ASA I-II undergoing elective surgery took part in this randomised-controlled trial. After approval by the local Ethics Committee and as soon as the patients had given their written informed consent, they were randomly allocated to either the xenon (n = 80) or propofol (n = 80) group. In both groups remifentanil was used as opioid. The postoperative patients' self-evaluation was assessed with a double-blind telephone poll. Early spatial orientation, patients' self-evaluation of anaesthesia, choice of the same anaesthesia for future operations and recall of uncomfortable feelings after anaesthesia were determined. RESULTS 116 Patients were analysed, 63 in the xenon and 53 in the propofol group. The two study groups were comparable with respect to age, weight, height, gender and ASA classification. The two groups indicated similar values in the early spatial orientation at the onset of recovery and thereafter. Patients' self-evaluation of anaesthesia with main emphasis at high marks and repetition of the same anaesthesia if necessary were similar in both groups. Recalls of uncomfortable feelings were comparable but not for postoperative pain and appetite/thirst which appeared with a significantly higher incidence in the xenon group. CONCLUSIONS Patients' self-evaluation and memory of early spatial orientation following xenon anaesthesia are comparable to propofol.
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Schäfer R, Hecker K, Hegger H, Langheinrich W. Experimental study of mesoscopic fluctuations in nonlinear conductance and magnetoconductance. PHYSICAL REVIEW. B, CONDENSED MATTER 1996; 53:15964-15970. [PMID: 9983435 DOI: 10.1103/physrevb.53.15964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Hecker K, Hegger H, Schäfer R, Murek U, Braden C, Langheinrich W. Length dependence of conductance fluctuations in metallic nanobridges. PHYSICAL REVIEW. B, CONDENSED MATTER 1994; 50:18601-18606. [PMID: 9976297 DOI: 10.1103/physrevb.50.18601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Hecker K, Groll J, Müller-Lissner S. [Acute renal failure, jaundice and thrombocytopenia in a 48-year-old patient]. Internist (Berl) 1997; 38:470-3. [PMID: 9264985 DOI: 10.1007/s001080050060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Case Reports |
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Hecker K, Rossaint R. [Xenon and other volatile anesthetic agents- mode of action]. Anasthesiol Intensivmed Notfallmed Schmerzther 2001; 36:644-6. [PMID: 11592027 DOI: 10.1055/s-2001-17678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Review |
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Hecker K, Moritz K. Ärztemangel – Hamburg geht neue Wege ... DAS GESUNDHEITSWESEN 2018. [DOI: 10.1055/s-0038-1639224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rückert JC, Rückert RI, Gellert K, Hecker K, Müller JM. Surgery for carcinoma of the gallbladder. HEPATO-GASTROENTEROLOGY 1996; 43:527-33. [PMID: 8799389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND/AIMS Carcinoma of the gallbladder is one of the gastrointestinal malignancies with an extraordinarily poor prognosis. The 5-year survival rate amounts to less than 5 per cent in most series. Our aim was to analyze the experience of a single center with surgery for gallbladder carcinoma with special reference to liver wedge resection. MATERIALS AND METHODS A retrospective analysis examined all patients of the Clinic of Surgery of the Humboldt University Medical School (Charité) with diagnosed gallbladder carcinoma operated on between January 1981 and August 1993. The analysis was based on patient documentation. Cumulative survival rates were calculated according to the method of Kaplan/Meier. Statistical significances were calculated using logrank and Wilcoxon's tests. RESULTS Eighty one patients (61 female, 20 male) were included in the study. The preoperative diagnoses were confirmed in 33 patients (40.7%). The stage distribution according to the TNM-system revealed 6, 10, 12, and 53 patients at the stages I-IV, respectively. The curative resection rate was 22.2%. Stage-dependent surgical procedures resulted in cumulative survival rates of 33.3% for stages I and II, 8.3% for stage III and 1.9% for stage IV. The overall prognosis was significantly determined by metastatic spread to the lymph nodes. CONCLUSIONS Diagnostic efforts should focus on detecting the low stages I and II of gallbladder carcinoma. Our results suggest that aggressive surgical management with second intervention and wedge resection or more extended liver resection is the method of choice for stage T1b or more advanced stages of gallbladder carcinoma.
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Hecker KD. Web alert. Curr Atheroscler Rep 1999; 1:177-8. [PMID: 11409357 DOI: 10.1007/s11883-999-0028-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Iber T, Hecker K, Vagts DA, Roesner JP, Otto B, Steinicke A, Nöldge-Schomburg GFE, Rossaint R. Xenon anesthesia impairs hepatic oxygenation and perfusion in healthy pigs. Minerva Anestesiol 2008; 74:511-519. [PMID: 18854792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Over the last 15 years, there has been growing interest in the noble gas xenon as a new inhalational anesthetic. This is due to its favorable pharmacological properties such as short onset and offset, as well as its hemodynamic stability. However, most volatile anesthetics appear to play an important role in the multi-factorial etiology of perioperative liver injury by decreasing liver blood flow with a subsequent reduction of hepatic oxygen supply. However, the effects of the anesthetic gas xenon on hepatic perfusion and oxygenation have not been completely investigated. METHODS Following ethical approval, 18 anesthetized and acutely monitored pigs were randomly assigned to the two following groups: 9 animals received xenon anesthesia in increasing inspiratory concentrations of 0%, 20%, 50%, and 65% in addition to their basic intravenous anesthesia; 9 animals served as a control group. Measurement points for systemic and regional hemodynamic and oxygenation parameters were performed 30 min after changing the xenon concentration. RESULTS Xenon elicited dose-dependent systemic hemodynamic changes such that the mean arterial pressure did not change, while the heart rate and cardiac output decreased by about 30%, thereby indicating an increase in the systemic vascular resistance. Portal venous blood flow decreased, while hepatic arterial blood flow was unchanged. The oxygen supply of the liver was reduced, but not the rate of indocyanine plasma disappearance from the liver. Furthermore, the increase of liver surface pO2 to systemic hyperoxia was absent, and hepatic lactate uptake was reduced. CONCLUSION Xenon, in addition to basic intravenous anesthesia, elicited a decrease in heart rate and cardiac output and an increase in mean arterial pressure. Similar to volatile anesthetics, xenon does reduce portal venous flow and influences hepatic tissue oxygenation. In contrast, hepatic arterial blood flow remains stable in the presence of xenon, and no changes in the hepatic arterial buffer responses were evident. Xenon does affect hepatic perfusion and oxygenation.
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