Acute, bilateral pneumothorax (PT) was produced in 14 newborn piglets. The clinical status of the operated and 14 control animals was monitored by measuring the arterial blood gases, acid-base balance and mean arterial blood pressure. Different brain regions were processed for electron microscopy and albumin immunohistochemistry; water and electrolyte contents were also determined at the end stage of experimental intervention. Electron microscopy showed more intense pinocytotic activity in the endothelium of brain capillaries from PT animals evaluated by morphometry. Statistically significant (p < 0.01) differences were found in the distribution of pinocytotic vesicles in different brain areas of PT animals. The blood-brain barrier seemed to be impermeable to albumin in all brain regions both in the controls and in the PT group. Parallel with the changes observed in pinocytosis, the water and sodium contents were also increased in the PT group in the parietal cortex (water content 85.18 ± SD 0.81% vs. 84.10 ± SD 0.52%, p < 0.01; sodium content in wet brain tissue 70.94 ± SD 8.44 mmol/kg vs. 65.09 ± SD 4.43 mmol/kg, p < 0.05, in dry brain tissue 481.70 ± 75.70 mmol/kg vs. 410.15 ± SD 35.45 mmol/kg, p < 0.05) and in the cerebellum (water content 83.95 ± SD 1.08% vs. 83.02 ± SD 0.89%, p < 0.05; sodium content in wet brain tissue 60.67 ± SD 3.16 mmol/kg vs. 55.90 ± 6.26 mmol/kg, p < 0.01). However, in other brain regions – especially in the water-shed area – there was no correlation between the changes of pinocytosis and water-electrolyte contents of the tissues. It is suggested that the type of edema developing in this severe cardiovascular/hypoxic collapse is cytotoxic of origin and this fact should be more seriously taken into account in the treatment of the disease.
A randomized prospective study of the effectiveness of allopurinol (Ap), a potent and specific inhibitor of the enzyme xanthine oxidase, was performed in premature infants endangered by hypoxia. The drug was given at a dose of 20 mg/kg/day orally for 3 days. In the Ap-treated group the expected decrease in the serum concentration and urinary excretion of uric acid was accompanied by a decrease in the mortality rate of infants with idiopathic respiratory distress syndrome. In these patients a concomitant improvement in renal function, as indicated by an increased urinary flow rate and creatinine output, was also obvious. It is suggested that the observed beneficial effect is due to the specific inhibition of xanthine oxidase associated with Ap therapy leading to reduced generation of superoxide radicals and decreased urinary loss of purine
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