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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Oxygen free radical injury during reperfusion of ischemically stored heart transplants may further impair the ability of the transplanted heart to reuse substrate for recovery. We compared the effects of oxygen free radical scavengers, superoxide dismutase and catalase, either alone or combined with glucose-insulin-potassium, in an improved model of the heterotopically transplanted rat heart. Group 1 hearts (n = 8) received no preservation before transplantation and were transplanted immediately. Hearts in four other groups (n = 8 for each group) underwent cold storage (4 degrees to 6 degrees C) for 3 1/2 hours before transplantation. Five minutes before reperfusion of the transplanted hearts, recipient rats received one of the following intravenous treatments: saline (group 2), glucose-insulin-potassium (group 3), superoxide dismutase/catalase (group 4), and superoxide dismutase/catalase plus glucose-insulin-potassium (group 5). Left ventricular end-diastolic pressure, rate of rise of left ventricular pressure, myocardial blood flow, coronary resistance, and tissue adenosine triphosphate content of the heart transplants were assessed during or at the end of 2 hours of reperfusion. Hearts treated with superoxide dismutase/catalase alone showed improvement of end-diastolic pressure and myocardial blood flow. The use of glucose-insulin-potassium alone did not facilitate the recovery of transplanted hearts. In contrast, the combined use of superoxide dismutase/catalase plus glucose-insulin-potassium resulted in a superior recovery of all functional and hemodynamic parameters. These results indicate that free radical scavengers in the presence of glucose-insulin-potassium significantly improve functional recovery in the setting of heart transplantation.
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PMID:Improved recovery of heart transplants by combined use of oxygen-derived free radical scavengers and energy enhancement. 151 71

We have recently demonstrated that calcium channel blockers can protect the ischemic myocardium at concentrations which do not decrease myocardial workload or metabolic demand before ischemia. In this study, we extended these observations by determining what effect the calcium channel blocker, diltiazem, has on overall myocardial energy substrate metabolism in aerobic, ischemic and reperfused ischemic hearts. Isolated working rat hearts were perfused at a 11.5-mm Hg preload, 80-mm Hg afterload, with Krebs-Henseleit buffer containing 11 mM glucose, 1.2 mM palmitate and 500 microU/ml insulin. Glycolysis and glucose oxidation rates were determined in aerobic and reperfused ischemic hearts perfused with [3H]/[14C]glucose, whereas fatty acid oxidation rates were determined under similar conditions in hearts perfused with [14C]palmitate. Addition of diltiazem (0.8 microM) before subjecting hearts to a 30-min period of global no-flow ischemia resulted in a significant improvement in recovery of mechanical function (heart rate x developed pressure during reperfusion recovered to 28 and 53% of preischemic levels, in control and diltiazem-treated hearts, respectively). If diltiazem was added at reperfusion, no improvement of functional recovery was seen. Addition of diltiazem before or after ischemia had no effect on palmitate or glucose oxidation during reperfusion, but did significantly decrease rates of glycolysis during reperfusion. In hearts subjected to low-flow ischemia (coronary flow = 0.5 ml/min), diltiazem significantly decreased glycolytic rates during ischemia (glycolytic rates were 2.09 +/- 0.25 and 1.58 +/- 0.28 mumol/min.g dry wt. in control and diltiazem-treated hearts, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of diltiazem on glycolysis and oxidative metabolism in the ischemic and ischemic/reperfused heart. 154 89

Triglyceride turnover in reperfused/ischemic rat hearts was investigated. Hearts were initially perfused under aerobic conditions for a 1-h "pulse" perfusion with 1.2 mM [1-14C]palmitate to label the endogenous lipid pools, followed by a 30-min period of no-flow ischemia or a 10-min period of retrograde perfusion (control). Hearts were then reperfused under aerobic conditions with buffer containing 1.2 mM [9,10-3H]palmitate. All buffers contained 11 mM glucose and 500 microunits/ml insulin. Rates of endogenous triglyceride lipolysis and synthesis were measured during reperfusion, whereas rates of exogenous palmitate oxidation were measured both prior to ischemia and during reperfusion following ischemia. During reperfusion of ischemic hearts, a 20% increase in exogenous fatty acid oxidation rates was seen compared with pre-ischemic rates. Despite an initial burst of endogenous fatty acid oxidation, no acceleration of steady state endogenous triglyceride lipolysis was seen compared with their nonischemic hearts. In contrast, a significant increase in triglyceride synthesis was observed. Triglyceride turnover was also measured in a series of hearts reperfused following ischemia in the absence of exogenous fatty acids. A significant enhancement of functional recovery was seen compared with hearts reperfused with 1.2 mM palmitate. In addition, a significant increase in fatty acid oxidation from endogenous triglyceride lipolysis was observed. We conclude that the heart quickly recovers its ability to oxidize exogenous fatty acids during reperfusion and that although triglyceride lipolysis is not accelerated during reperfusion of ischemic hearts in the presence of 1.2 mM palmitate, a significant increase in triglyceride synthesis does occur.
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PMID:Myocardial triglyceride turnover during reperfusion of isolated rat hearts subjected to a transient period of global ischemia. 174 Apr 30

Reports differ as to the efficacy of glucose and insulin as cardioplegic additives. Although deliberate oxygenation of crystalloid cardioplegic solutions improves myocardial protection, little is known about the protection afforded by glucose and insulin in such oxygenated solutions. In the isolated working rat heart, we studied the addition of oxygen, glucose, and insulin, separately and together, to a cardioplegic solution. The solution was equilibrated with O2 or N2, with glucose added as a substrate or sucrose as a nonmetabolizable osmotic control, with or without insulin. Hearts were arrested for 2 hours at 8 degrees C by multidose infusions. Oxygenation decreased lactate production and improved high-energy phosphate and glycogen preservation during arrest, prevented ischemic contracture, and improved functional recovery. The addition of glucose to the oxygenated solution increased the level of adenosine triphosphate at end-arrest from 10.5 +/- 0.5 to 13.9 +/- 0.6 nmol/mg dry weight and glycogen stores from 18.7 +/- 2.5 to 35.7 +/- 5.5 nmol/mg dry weight. The further addition of insulin did not better preserve these metabolites. Improvements in functional recovery due to glucose or insulin in the oxygenated solution attained statistical significance when both additives were included. Glucose increased lactate production significantly only when the solution was nitrogenated. Insulin added to the nitrogenated glucose-containing solution increased adenosine triphosphate and glycogen levels after 1 hour of arrest; and, although insulin did not prevent ischemic contracture from developing during the latter part of arrest with profound depletion of these metabolites, functional recovery was improved. The mechanism of improved functional recovery by insulin is not clear.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Oxygenated cardioplegia: the metabolic and functional effects of glucose and insulin. 201 22

A 47 year old male insulin-dependent diabetic developed two synchronous life-threatening Clostridium perfringens infections under unusual circumstances. Numerous sterile abscesses were also present, being the result of regular pentazocine intramuscular injections. Extensive surgical debridement and parenteral antibiotic therapy proved effective in treating the septicaemia and the large soft tissue abscesses in the buttock and thigh. The patient made an excellent functional recovery. The pathogenesis of gas gangrene after injection is discussed with particular reference to the diabetic patient.
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PMID:Gas gangrene in a diabetic after intramuscular injection. 290 51

To clarify the functional recovery of the liver after partial hepatectomy, serum c-AMP responses to glucagon were investigated after hepatectomy in rats. Serum glucagon, insulin and weight of the regenerating liver were simultaneously measured. Wistar strain male rats, weighing 120-130 g, were divided into three groups; I 30% hepatectomy, II 70% hepatectomy and III sham operation. On the first postoperative day, cyclic AMP response to glucagon was remarkably decreased in I and II groups. In group I, c-AMP response returned to the normal level 2 weeks after operation. In group II the response returned to normal at the sixth postoperative week. The liver weights were almost normal after two weeks in the both groups. Levels of serum glucagon sharply increased 24 hours after operation and returned to the normal level after 7 days. However the levels of serum insulin showed no remarkable changes. In conclusion, the complete functional recovery of the liver after hepatectomy needed 6 weeks in cyclic AMP response to glucagon and was delayed 4 weeks to that of the liver weight after 70% hepatectomy. Insulin seems to have no direct effect of the liver regeneration.
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PMID:[Cyclic AMP response to glucagon after partial hepatectomy]. 299 Oct 97

Cryopreservation of islets of Langerhans offers a number of important benefits for attempts to cure diabetes by transplantation. In the published literature, a variety of cooling rates, ranging from 0.25 to 75 degrees C/min, in conjunction with warming rates of 4-200 degrees C/min have been proposed to give optimal preservation of islets. In view of the general importance of rates of temperature change in determining survival and because of the possibility of modulating tissue immunogenicity by freezing and thawing, we have studied the interaction of cooling rate and warming rate for isolated rat islets that had been either fully or partially equilibrated with 2 M dimethyl sulfoxide (DMSO). Batches of islets were stored at -196 degrees C after cooling at 0.3, 3.0, 10, 30, 60, 150, or greater than 1000 degrees C/min and then warmed at either 10 or 50 degrees C/min. Survival was assessed by measuring the secretion of insulin during static incubation in alternating nonstimulatory and stimulatory media. Cooling rates extending over three orders of magnitude proved not to be a major determinant of survival when the islets were equilibrated with 2 M DMSO: greater than 50% survival was achieved at all cooling rates studied when the warming rate was at 50 degrees C/min. Peak survival (83%) was attained at a cooling rate of 0.3 degrees C/min, but only slightly lower recoveries were obtained at 60 and greater than 1000 degrees C/min. However, in islets only partially equilibrated with cryoprotectants, functional recovery was highly dependent on the cooling and warming rates, with peak survivals after slow cooling and rapid warming. Full permeation of the tissue with cryoprotectant offered maximal recovery of function.
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PMID:Interaction of cooling rate, warming rate, and extent of permeation of cryoprotectant in determining survival of isolated rat islets of Langerhans during cryopreservation. 309 10

Previous studies from this laboratory demonstrated that the use of an oxygenated cardioplegic solution in the hypothermic arrested rat heart resulted in improved preservation of high-energy phosphate stores (adenosine triphosphate and creatine phosphate), mechanical recovery during reperfusion, and preservation of myocardial ultrastructure. In the current study the effect of cardioplegic solutions oxygenated with 30%, 60%, and 95% oxygen was evaluated in the isolated rat heart with reference to the maintenance of adenosine triphosphate, creatine phosphate, oxygen consumption, functional recovery, and mitochondrial oxidative phosphorylation in vitro. Results indicate that the hearts receiving cardioplegic solutions supplemented with 95% oxygen and 5% carbon dioxide maintained adenosine triphosphate and creatine phosphate at control values for at least 5 hours. The oxygen consumption during elective cardiac arrest, mechanical performance during reperfusion, and in vitro mitochondrial oxygen uptake and phosphorylation rate were highest in the hearts receiving cardioplegic solutions supplemented with 95% oxygen when compared to solutions with 30% and 60% oxygen. Addition of glucose and insulin to the cardioplegic solution (95% oxygen) increased the adenosine triphosphate levels but failed to improve function after reperfusion. Although myocardial adenosine triphosphate and creatine phosphate were well preserved by the oxygenated cardioplegic solution, there was a discrepancy between the adenosine triphosphate levels at the end of the arrest period, which represents the potential for mechanical function, and the actual function of the hearts after 5 hours.
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PMID:Oxygen requirements of the isolated rat heart during hypothermic cardioplegia. Effect of oxygenation on metabolic and functional recovery after five hours of arrest. 281 24

Thirty-six patients undergoing aortic valve replacement were investigated to ascertain whether the addition of glucose-insulin before and after ischaemic heart arrest could aid to the functional recovery of hearts following global ischaemia. One group of patients (n = 14) received glucose plus insulin from the onset of anaesthesia until crossclamping of the aorta (1 g + 1.5 U/kg bw X h). A second dose (0.5 g + 1.0 U/kg bw) was given at the end of ischaemia. 22 patients, serving as control received glucose in the same manner but without insulin. Needle biopsies from the left ventricular apex region were obtained: before starting cardiopulmonary bypass; at the end of ischaemia; and after 10 minutes of reperfusion and analyzed for its content of ATP, CP ADP and lactate. In both groups ATP and CP were significantly decreased after ischaemia and increased after reperfusion. ADP and lactate levels were elevated after ischaemia and decreased after reperfusion in the insulin-group but not in the control-group. During the total investigation period ATP- and CP-concentrations in the insulin-group were higher compared to the control-group, whereas ADP and lactate of the control-group were above the insulin-group.
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PMID:Enhancement of myocardial energy potentials in man by glucose-insulin treatment before and after ischaemic heart arrest. 388 27

Difficulty of some patients to maintain adequate cardiac output following the termination of cardiopulmonary bypass remains a significant problem in cardiac surgery. The patients with diabetes mellitus frequently fail to respond to therapy after the cardiopulmonary bypass. However, little is known about the relationship between the control of diabetes mellitus and myocardial performance. The purpose of the present study was to look at the effect of diabetes and insulin treatment upon ventricular function and myocardial microcirculation in isolated perfused rat heart. Experimental diabetes was induced by injecting streptozotocin and some of them were treated by insulin injection. Severe form of ischemia was induced in heart from acute form of diabetes and functional recovery was compared among the control, diabetic and insulin treated groups. In chronic form of diabetes, myocardial function and microcirculation which was measured by local H2 generation method were studied during aerobic perfusion and mild form of ischemic perfusion. The hearts from experimental diabetes were more susceptible to ischemia and insulin pretreatment protected the functional alterations. This beneficial effect of insulin was associated with improved glucose and fatty acid metabolism. Myocardial microcirculation in hearts from diabetes was significantly less than in control, however, this was not correctable by the insulin treatment.
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PMID:Insulin treatment and myocardial function in isolated, perfused heart from diabetic rat. 636 94


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