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Query: HUMANGGP:034761 (insulin)
 211,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to investigate the possible relationship between a glucose-containing pump prime and changes in plasma potassium during extracorporeal circulation, determinations were made of blood glucose and plasma insulin, potassium, and magnesium in 18 subjects undergoing open-heart surgery. In 6 of the patients, the same parameters had been measured during a pre-operative glucose tolerance test. It was found that the elimination of glucose was considerably impaired during extracorporeal circulation, in spite of high insulin levels. During the first minutes of extracorporeal circulation, plasma potassium fell more than during the glucose tolerance test, in spite of comparable insulin levels. It is concluded that changes in plasma potassium during extracorporeal circulation do not reflect insulin activity to any noticeable extent.
Scand J Thorac Cardiovasc Surg 1975
PMID:Plasma potassium and insulin during extracorporeal circulation using a glucose-containing pump prime. 0 53

We have previously shown that acute coronary occlusion in the dog is often accompanied by increased adrenaline release into the blood. In the present study the consequences of this humoral reaction were studied in anaesthetised healthy mongrel dogs subjected to adrenaline infusion administered at a rate relevant to spontaneous release of this amine in coronary occlusion. Adrenaline was infused in a dose of 1.2 microgram.kg-1.min-1 for 4 h. Dogs receiving saline served as the control. Adrenaline administration led to the decrease in insulin/glucose ratio, to a significant fall in serum triiodothyronine and in blood pH. Free fatty acid levels doubled. Histochemically, a diminution in succinic dehydrogenase and ATPase activity in adrenaline-treated hearts was found. A significant fall in the activity of mitochondrial hexokinase in these hearts was detected spectrophotometrically. Electron microscopic study revealed alterations in the mitochondrial structure. These findings indicate that an excess of adrenaline in ammounts similar to that seen in experimental infarction leads to profound metabolic and hormonal disturbances and exerts a detrimental effect upon myocardium.
Cardiovasc Res 1978 Mar
PMID:Evidence for the detrimental effect of adrenaline infused to healthy dogs in doses imitating spontaneous secretion after coronary occlusion. 2 14

Antiarrhythmic concentrations of disopyramide in canine plasma and myocardium were determined by gas chromatography. Ventricular tachycardia was incuded in anesthetized dogs by the intravenous administration of ouabain. Disopyramide phosphate was then administered by a two-stage continuous infusion method. A rapid infusion of disopyramide (9.08 mg/kg/hr) was administered for 30 min, followed by a slow infusion (2.18 mg/kg/hr) to maintain steady-state plasma levels of 1.98-2.21, mean +/- SEM = 2.1 +/- 0.02 microgram/ml at the end of 2 hr. Myocardial tissue levels of disopyramide at steady-state plasma levels were four times those of plasma (atrial tissue, 8.91 +/- 0.10; right ventricular free wall, 8.93 +/- 0.13; left ventricular free wall, 9.11 +/- 0.16 microgram/gm wet tissue). The intravenous administration of 80 units crystalline zinc insulin produced both hypokalemia (3.78 +/- 0.22 reduced to 2.36 +/- 0.18 mEq potassium/liter plasma) and a reappearance of ventricular tachycardia despite no change in plasma and myocardial tissue concentrations of disopyramide from those which had been effective in establishing and maintaining sinus rhythm. The observations demonstrate a relationship between plasma and myocardial disopyramide concentrations such that the former can be used in assessing patient therapy. In addition, this study suggests the important of plasma potassium in determining the therapeutic effectiveness of disopyramide.
J Cardiovasc Pharmacol
PMID:Disopyramide plasma and myocardial tissue concentrations as they relate to antiarrhythmic activity. 9 10

Cyclic AMP is a common second messenger for a variety of hormones such as catecholamine, glucagon, and growth hormone, which are affected by cardiac surgery. Changes in plasma cyclic AMP level may thus reflect an altered hormonal milieu. The effects of open-heart surgery on plasma cyclic AMP and its relation with serum insulin were studied in 33 adult patients who underwent cardiac surgery with cardiopulmonary bypass. Plasma cyclic AMP levels were markedly elevated during cardiopulmonary bypass and returned toward normal within several days after the operation. The serum insulin concentration remained low, and no positive correlation was found with plasma cyclic AMP level. The responses were similar in patients who had aorta-coronary bypass grafts and those who had valve replacements.
J Thorac Cardiovasc Surg 1978 Feb
PMID:Levels of plasma cyclic AMP and insulin in cardiac surgery. 20 75

The conducting system was studied in an in situ perfused swine heart preparation with reduced coronary flow (ischemia) using perfusate containing high and low levels of glucose (26.6 versus 8.6mM) with and without insulin. Coronary flow was maintained at normal levels for 60 minutes in control hearts. In ischemic hearts flow was reduced to about 50 percent of control levels for 30 minutes. Ultrastructural studies documented only subtle modifications of Purkinje fibers in ischemic hearts. Glycogen depletion and disruption of cell junctions were observed in some fibers. One consistent finding was the activation of the lysosomal system. The outer membranes of primary lysosomes appeared herniated and in some cases disrupted, and small vesicles containing hydrolytic enzymes were seen in association with the Golgi apparatus and larger primary lysosomes. Specimens prepared for the demonstration of acid phosphatase indicated a redistribution of hydrolytic enzymes in Purkinje fibers with a depostion of acid hydrolases in smaller lysosomal vesicles, the transverse and side-to-side junctions between cells, and occasionally in the sarcoplasmic reticulum. Enriched perfusate containing high levels of glucose with insulin appeared to have no therapeutic effects in terms of the structure of the Purkinje fibers. The results suggest that alterations in the lysosomal system may be one of the earliest structural changes which occur in oxygen-deficient hearts.
J Thorac Cardiovasc Surg 1979 May
PMID:Ischemic injury to the conducting system of the heart. Involvement of myocardial lysosomes. 43 Oct 98

Fifty-two diabetic patients who underwent pulmonary surgery for coccidioiodmycosis were evaluated by a retrospective study which included classification by stage of disease, status of insulin dependency, and reaction to coccidioidin skin test. The insulin-dependent diabetic patient had a fourfold increase in the incidence of more severe (progressive) disease. Perioperative therapy with amphotericin B may be of value in the adult surgical candidate with progressive disease but is not necessary or desirable in the juvenile diabetic patient. Coccidioidomycosis is a disease of relative immunocompromise, and a negative skin test should herald such compromise and support a decision for surgery. Such surgery in the progressive stages should be totally extirpative. The presence of inadequately resected disease may adversely affect subsequent immunologic resistance of the host.
J Thorac Cardiovasc Surg 1978 May
PMID:Surgery for coccidioidomycosis in 52 diabetic patients with special reference to related immunologic factors. 64 60

Cardioplegic protective infusates are designed to induce rapid diastolic arrest and also to reduce or delay the onset of ischemic damage. As this study shows, the use of such infusates can greatly improve postischemic recovery of cardiac function. A number of investigators include glucose, insulin, or mannitol in their infusates in an attempt to increase the amount of protection afforded to the ischemic myocardium. Using an isolated, working rat heart model of cardiopulmonary bypass and ischemic cardiac arrest, we have shown that under certain conditions these additives can be deterimental to tissue protection. The deleterious effects of glucose and mannitol are dose dependent and can be modified by the inclusion of insulin in the infusate. The damaging effects of glucose appear to be both osmotic and metabolic in origin and those of mannitol, purely osmotic. The effects of insulin are complex and may affect a number of cellular processes.
J Thorac Cardiovasc Surg 1978 Jul
PMID:Myocardial protection during ischemic cardiac arrest. Possible deleterious effects of glucose and mannitol in coronary infusates. 66 62

To evaluate the importance of time, temperature, and cardioplegia on the ability of the canine myocardium to maintain functional and ultrastructural integrity following induced arrest, we studied 220 dogs by varying myocardial temperature (34 degrees, 24 degrees, and 11 degrees C.), arrest time (0 to 120 minutes), and cardioplegic agents. Change in left ventricular function (LVF) was defined as the arithmetic difference in the center of mass between prearrest and postarrest LVF curves and was expressed as percent recovery of left ventricular stroke work. Left ventricular biopsies were obtained for semiquantitative electron microscopic analysis. After 90 minutes of cross-clamping, only hearts protected with combined hypothermia (H) and potassium-induced cardioplegia (K) significantly recovered prearrest function (24 degrees C.--80 percent, 11 degrees C.--99 percent). Hypothermia (H) alone for 90 minutes was less protective (24 degrees C.--49 percent, 11 degrees C.--59 percent). H preserved 84 percent of function after 60 minutes and 91 percent after 45 minutes. Normothermic arrest resulted in only 39 percent return of function at 45 minutes but could be extended with potassium-induced cardioplegia(K) to 78 percent at 60 minutes and 54 percent at 90 minutes. The addition of procaine plus HK improved protection over HK alone (95 percent versus 80 percent) but by itself was not effective. Neither hydrocortisone nor pretreatment with glucose-insulin-potassium, branched chain amino acids, or propranolol increased the protective effect of HK plus procaine. Inadequately protected groups (normothermia or H without K) showed more myocytic and capillary endothelial damage than the HK groups. No technique of myocardial protection studied completely preserved LVF, but the combination of HK plus procaine resulted in maximal recovery of LVF following cross-clamping for up to 120 minutes.
J Thorac Cardiovasc Surg 1978 Nov
PMID:Effect of cross-clamp time, temperature, and cardioplegic agents on myocardial function after induced arrest. 70 64

The effect of glucose-insulin-potassium (GIK) infusions was studied in 45 dogs after left anterior descending coronary artery ligation. GIK caused a modest increase in lactate concentration in small veins draining the infarct but did not affect glucose uptake. No effect on creatine kinase activity in the infarct was seen from GIK, although there was a slight increase in blood flow to the centre of the infarct. We concluded that GIK did not reduce infarct size in this experimental model.
Cardiovasc Res 1978 Jul
PMID:The effect of glucose-insulin-potassium on experimental myocardial infarction in the dog. 71 56

Glucose and fatty acid substrates had different effects on the cardiac output, heart work and rates of release of lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) from isolated perfused working rat hearts with coronary artery ligation. Release of LDH or CPK was increased in hearts perfused with free fatty acids (FFA) instead of glucose. The addition of insulin decreased palmitate-induced release of LDH but did not increase cardiac output, while the addition of glucose to hearts perfused with fatty acid both increased cardiac output and depressed LDH release. In FFA-perfused hearts addition of both glucose and insulin gave lowest rates of enzyme release and increased cardiac output, heart rate and heart work. It is proposed that glucose and/or insulin protected the hearts from the deleterious effects of FFA.
Cardiovasc Res 1978 Oct
PMID:Effect of substrates and of coronary artery ligation on mechanical performance and on release of lactate dehydrogenase and creatine phosphokinase in isolated working rat hearts. 74 93


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