bile trypsin AP in the dog causes significant decreases in QT and QCAP without altering QAVS. The decrease in O2CP in association with a constant QAVS suggests a metabolic block to oxygen uptake at the cellular level. Continuous infusion of LMW dextran at a dose of 1.5 ml/kg/hr in the dog does not reverse these abnormalities.
Ex vivo recirculation perfusion preparations of the canine pancreas are useful for the study of pancreatic physiology and exocrine secretory function. Vagaries of isolated ex vivo organ perfusion, however, require a thorough familiarity with available circulation media and component technology. Electrolyte and acid-base homeostasis can be facilitated by incorporating a dialysis unit into the perfusion circuit. Viability of the preparation is best assessed by constancy of vascular resistance and oxygen extraction during the period of perfusion. Limitations imposed by this closed method of organ perfusion on studies of pancreatic endocrine function and on duodenopancreatic hormonal interactions (enteroinsular axis) must be recognized.
A significant number of saphenous vein femoral-popliteal bypass graft failures have been attributed to flow abnormalities caused by venous valves. Seventy-seven greater saphenous vein valves were observed and photographed through a 0-degree choledochoscope during pulsatile and nonpulsatile flow. No valve was seen to lie flat against the vein wall. With pulsatile flow the valves were noted to close during diastole. Stasis was noted within the valve cusps. Twenty-three valves produced photographs of sufficient quality to allow measurement of the luminal obstruction caused by the valves. This valvular obstruction represented 61% +/- 12% of the total vein lumen. Fifty venous valves were lysed by five different techniques: the microscissors, the Connolly vein stripper, the Mills valvulotome, the venotomy valvulectomy of Hall, and eversion valvulectomy. The first three methods created valvular incompetence, but flaps of valve cusps were observed to disturb flow and place potentially thrombogenic surfaces within the vein lumen. Valvulectomy, whether by venotomy or eversion, removed the valve cusps satisfactorily.
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