Download Clinical Aspects of Microdialysis by O. Elekes, K. Venema, F. Postema, R. Dringen, B. Hamprecht, PDF

By O. Elekes, K. Venema, F. Postema, R. Dringen, B. Hamprecht, J. Korf M.D. (auth.), Dr. Aminadav Mendelowitsch, Dr. Helen Langemann, Dr. Beat Alessandri, Dr. Hans Landolt, Professor Dr. Otmar Gratzl (eds.)

Microdialysis is a minimally invasive technique which allows non-stop tracking of parameters within the extracellular house of assorted tissues. it's been investigated in animal types for over a decade, and plenty of guides have supplied perception into its benefits and downsides. in spite of the fact that, inspite of its huge, immense strength for revealing metabolic techniques in general and pathological tissue, microdialysis in people remains to be in its infancy. medical neurointensive medication these days calls for even more than traditional tracking tools. As already proven through jugular bulb measurements of oxygen and lactate, sooner or later clinicians should want to have entry to non-stop neurochemical details from the sufferer. this data might be used to avoid these enigmatic secondary lesions which play any such unfavorable position in neurointensive medication, or at the very least allow therapy of them at an early level. The huge info now on hand from the laboratory might support with the translation of scientific analogues. within the collage health center of Neurosurgery in Basel we now have been curious about the sector of micro dialytic tracking for a number of years and feature recognized the issues, either technical and moral, that are concerned about taking the tough step from animal experiments to scientific program. In 1994 we suggestion that examine on scientific microdialysis had reached the degree which might let scientists and clinicians to have many fruitful discussions.

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The parameters used must reflect pathological changes at an early stage, and the analysis should be available on-line or immediately after sample collection. The effects offactors such as tube length and flow rate on the behaviour of the chosen parameters (in our case on-line pH, radical scavengers and uric acid) in the MD set-up must be investigated in vitro and in animal models before use in the clinic. The range of non-pathological values of parameters of interest in human brain should be known.

The results for Asc, VA and GSH are shown in Fig. 4. 005 flM at 2h. Baseline levels were already reached after 1 hour. Levels of Asc and GSH, compounds occurring mainly intracellularly, were higher in the first sample after probe insertion, as also found for other parameters in rat models [5]. Results for patient 2 (with a severe head injury) are shown in Table 1. : 15 iii ::::J.. 5 hours after probe insertion ~ CD c 3 40 ~ 2 30 "El E :::I Fig. 4. 5 0 60 ___ IlM in dialysate 20 0 10 o 5 20 10 15 outer concentration (IlM) 25 Fig.

Globus MYT, Dietrich WD (1992) The role of neurotransmitters in brain injury. 1st Ed. Plenum, New York: p 378. 6. Benveniste H (1991) The excitotoxin hypothesis in relation to cerebral ischemia. Cerebrovasc Brain Metab Rev 3(3): 213-245 7. Hamberger A, Jacobson I, Nystrom B, Sandberg M (1991) Microdialysis sampling of the neuronal environment in basic and clinical research. J Intern Med 230(4): 375-380 8. Hillered L, Persson L, Ponten U, Ungerstedt U (1990) Neurometabolic monitoring of the ischaemic human brain using microdialysis.

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