147 resultados para lower esophagus sphincter
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The watersheds at Bear Creek, Oak Ridge, TN, have similar soil–landscape relationships. The lower reaches of many of these watersheds consist of headwater riparian wetlands situated between sloping non-wetland upland zones. The objectives of this study are to examine the effects of (i) slope and geomorphic processes, (ii) human impacts, and (iii) particular characteristics of soils and saprolite that may effect drainage and water movement in the wetlands and adjacent landscapes in one of these watersheds. A transect was run from west to east in a hydrological monitored area at the lower reaches of a watershed on Bear Creek. This transect extended from a steep side slope position across a floodplain, a terrace, and a shoulder slope. On the upland positions of the Nolichucky Shale, mass wasting, overland flow and soil creep currently inhibit soil formation on the steep side slope position where a Typic Dystrudept is present, while soil stability on the shoulder slope has resulted in the formation of a well-developed Typic Hapludult. In these soils, argillic horizons occur above C horizons on less sloping gradients in comparison to steeper slopes, which have Bw horizons over Cr (saprolite) material. A riparian wetland area occupies the floodplain section, where a Typic Endoaquept is characterized by poorly drained conditions that led to the development of redoximorphic features (mottling), gleying, organic matter accumulation, and minimal development of subsurface horizons. A thin colluvial deposit overlies a thick well developed Aquic Hapludalf that formed in alluvial sediments on the terrace position. The colluvial deposit from the adjacent shoulder slope is thought to result from soil creep and anthropogenic erosion caused by past cultivation practices. Runoff from the adjacent sloping landscape and groundwater from the adjacent wetland area perhaps contribute to the somewhat poorly drained conditions of this profile. Perched watertables occur in upland positions due to dense saprolite and clay plugging in the shallow zones of the saprolite. However, no redoximorphic features are observed in the soil on the side slope due to high runoff. Remnants of the underlying shale saprolite, which occur as small discolored zones resembling mottles, are also present. The soils in the study have a CEC of
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Objective: Prolonged limb ischemia followed by reperfusion (I/R) is associated with a systemic inflammatory response syndrome and remote acute lung injury. Ischemic preconditioning (IPC), achieved with repeated brief periods of I/R before the prolonged ischemic period, has been shown to protect skeletal muscle against ischemic injury. The aim of this study was to ascertain whether IPC of the limb before I/R injury also attenuates systemic inflammation and acute lung injury in a fully resuscitated porcine model of hind limb I/R. Methods: This prospective, randomized, controlled, experimental animal study was performed in a university-based animal research facility with 18 male Landrace pigs that weighed from 30 to 35 kg. Anesthetized ventilated swine were randomized (n = 6 per group) to three groups: sham-operated control group, I/R group (2 hours of bilateral hind limb ischemia and 2.5 hours of reperfusion), and IPC group (three cycles of 5 minutes of ischemia/5 minutes of reperfusion immediately preceding I/R). Plasma was separated and stored at -70° C for later determination of plasma tumor necrosis factor-a and interleukin-6 with bioassay as markers of systemic inflammation. Circulating phagocytic cell priming was assessed with a whole blood chemiluminescence assay. Lung tissue wet-to-dry weight ratio and myeloperoxidase concentration were markers of edema and neutrophil sequestration, respectively. The alveolar-arterial oxygen gradient and pulmonary artery pressure were indices of lung function. Results: In a porcine model, bilateral hind limb (I/R) injury significantly increased plasma interleukin-6 concentrations, circulating phagocytic cell priming, and pulmonary leukosequestration, edema, and impaired gas exchange. Conversely, pigs treated with IPC before the onset of the ischemic period had significantly reduced interleukin-6 levels, circulating phagocytic cell priming, and experienced significantly less pulmonary edema, leukosequestration, and respiratory failure. Conclusion: Lower limb IPC protects against systemic inflammation and acute lung injury in lower limb I/R injury.
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OBJECTIVE: To investigate the role of recombinant bactericidal/permeability-increasing protein (rBPI21) in the attenuation of the sepsis syndrome and acute lung injury associated with lower limb ischemia-reperfusion (I/R) injury. SUMMARY BACKGROUND DATA: Gut-derived endotoxin has been implicated in the conversion of the sterile inflammatory response to a lethal sepsis syndrome after lower torso I/R injury. rBPI21 is a novel antiendotoxin therapy with proven benefit in sepsis. METHODS: Anesthetized ventilated swine underwent midline laparotomy and bilateral external iliac artery occlusion for 2 hours followed by 2.5 hours of reperfusion. Two groups (n = 6 per group) were randomized to receive, by intravenous infusion over 30 minutes, at the start of reperfusion, either thaumatin, a control-protein preparation, at 2 mg/kg body weight, or rBPI21 at 2 mg/kg body weight. A control group (n = 6) underwent laparotomy without further treatment and was administered thaumatin at 2 mg/kg body weight after 2 hours of anesthesia. Blood from a carotid artery cannula was taken every half-hour for arterial blood gas analysis. Plasma was separated and stored at -70 degrees C for later determination of plasma tumor necrosis factor (TNF)-alpha, interleukin (IL)-6 by bioassay, and IL-8 by enzyme-linked immunosorbent assay (ELISA), as a markers of systemic inflammation. Plasma endotoxin concentration was measured using ELISA. Lung tissue wet-to-dry weight ratio and myeloperoxidase concentration were used as markers of edema and neutrophil sequestration, respectively. Bronchoalveolar lavage protein concentration was measured by the bicinclinoic acid method as a measure of capillary-alveolar protein leak. The alveolar-arterial gradient was measured; a large gradient indicated impaired oxygen transport and hence lung injury. RESULTS: Bilateral hind limb I/R injury increased significantly intestinal mucosal acidosis, intestinal permeability, portal endotoxemia, plasma IL-6 concentrations, circulating phagocytic cell priming and pulmonary leukosequestration, edema, capillary-alveolar protein leak, and impaired gas exchange. Conversely, pigs treated with rBPI21 2 mg/kg at the onset of reperfusion had significantly reduced intestinal mucosal acidosis, portal endotoxin concentrations, and circulating phagocytic cell priming and had significantly less pulmonary edema, leukosequestration, and respiratory failure. CONCLUSIONS: Endotoxin transmigration across a hyperpermeable gut barrier, phagocytic cell priming, and cytokinemia are key events of I/R injury, sepsis, and pulmonary dysfunction. This study shows that rBPI21 ameliorates these adverse effects and may provide a novel therapeutic approach for prevention of I/R-associated sepsis syndrome.
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%0 per cent of antibiotic use in the community is for respiratory infection. this editorial considers wwh 8 out of 10 consultations for cough in general practice result inantibiotic prescribing