allopurinol and Pulmonary-Embolism

Topics: Adenosine; Allopurinol; Animals; Carbon Dioxide; Cold Temperature; Dogs; Glutathione; Hypothermia; Insulin; Lung; Lung Transplantation; Organ Preservation; Organ Preservation Solutions; Oxygen; Postoperative Complications; Potassium; Pulmonary Embolism; Raffinose; Reperfusion; Sodium Oxybate

Protection of the failing right ventricle (RV) in the surgical treatment of massive pulmonary embolism is a keystone for myocardial recovery. This study evaluated whether cardioplegia should be used or avoided. In a modified Langendorff rat heart model pulmonary embolism was simulated by afterload elevation (20 cm H2O) for 30 min. Hearts were arrested with cardioplegic solutions [St. Thomas Hospital (ST); University of Wisconsin (UW); oxygenated Krebs-Henseleit-Potassium (KHP)] and stored for 10 min or were allowed to beat empty (NoCP) for 15 min. After reestablishing of baseline conditions groups were measured for 60 min. Cardiac index (CI) decreased in all groups to 20% during afterload elevation. Group NoCP showed 68 and Group ST 65% recovery after 10 min and deteriorated after 30 min. After 60 min CI was 37 (ST) and 39% (NoCP). UW and KHP showed a significantly better recovery (KHP 100%; UW 88%). At 60 min CI decreased to 60 (KHP) and 64% (UW), but was still significantly higher than corresponding values of NoCP and ST. Following increased pulmonary afterload cardioplegia with UW or KHP solution is beneficial for RV recovery. The composition of the cardioplegia is obviously important and needs further study.

Topics: Acute Disease; Adenosine; Allopurinol; Animals; Cardioplegic Solutions; Disease Models, Animal; Embolectomy; Evaluation Studies as Topic; Extracorporeal Circulation; Glucose; Glutathione; Heart Arrest, Induced; Heart Failure; Hypertension, Pulmonary; Insulin; Male; Myocardial Reperfusion Injury; Organ Preservation Solutions; Pulmonary Embolism; Raffinose; Rats; Rats, Inbred Lew; Tromethamine; Ventricular Function, Right

In the present investigation alterations in the free radical generating and scavenging enzymes in platelets, neutrophils (PMNLs), heart and lung homogenates following rat pulmonary thromboembolism have been studied. Thrombosis was induced by intravenous infusion of collagen and adrenaline. Levels of malonaldehyde (MDA) were elevated in the PMNLs after thrombosis. Activities of superoxide dismutase (SOD) and catalase (CAT) were found to increase in platelets and PMNLs respectively. However, there was no significant alteration in the lactate dehydrogenase (LDH), lysozyme (LYS), ratio of xanthine oxidase to dehydrogenase (XO/XH) and PMNLs O2- generation before and after thrombosis. Migration of PMNLs following thrombosis was indicated by increased activity of myeloperoxidase (MPO) in the heart. In addition, pretreatment with allopurinol, a xanthine oxidase inhibitor and indomethacin, a cyclooxygenase inhibitor offered protection against thromboembolism induced death/paralysis. Results suggest the involvement of free radicals in thrombosis.

Topics: Allopurinol; Animals; Blood Platelets; Catalase; Free Radical Scavengers; Indomethacin; Lung; Male; Malondialdehyde; Neutrophils; Pulmonary Embolism; Rats; Rats, Sprague-Dawley; Superoxide Dismutase

Involvement of free radicals and their scavenging enzymes in mice pulmonary thromboembolism, induced by intravenous infusion of collagen and adrenaline, has been studied. Malonaldehyde (MDA) and activities of xanthine oxidase (XO), catalase (CAT) and superoxide dismutase (SOD) were estimated in platelets, heart and lung homogenates. MDA increased in all the tissues sharply, while animals showed 70-80% thrombocytopenia. Xanthine oxidase activity in these animals increase significantly in heart. However, increased SOD activity and decreased catalase activity was observed in platelets. Intravenous administration of superoxide dismutase (5 mg/kg), catalase (5 mg/kg) and mannitol (200 mg/kg) protected the mice against pulmonary thromboembolism. The importance of free radicals in mice pulmonary thromboembolism has been demonstrated.

Topics: Animals; Blood Platelets; Catalase; Collagen; Epinephrine; Free Radicals; Lung; Male; Malondialdehyde; Mannitol; Mice; Myocardium; Oxygen; Pulmonary Embolism; Superoxide Dismutase; Thrombocytopenia; Xanthine Oxidase

Antithrombotic activity of ten pyrazolo pyrimidine derivatives was tested in mouse pulmonary thromboembolism model. Out of these compounds, Thiopurinol (C5H4N4S) showed dose-dependent protection in mice from death/paralysis induced by collagen + adrenaline. It also caused dose-dependent inhibition of thrombus formation in the cat. Thiopurinol inhibited aggregation of platelets induced by ADP and arachidonic acid but did not inhibit superoxide generation. It had no antiinflammatory activity nor any effect on cardiovascular system. The results indicate that the antithrombotic activity of the compound is mediated via inhibition of platelet aggregation.

Topics: Allopurinol; Animals; Blood Pressure; Cats; Extracorporeal Circulation; Free Radicals; Heart Rate; Indomethacin; Male; Mice; Mice, Inbred Strains; Platelet Aggregation Inhibitors; Pulmonary Embolism; Respiration; Superoxides; Uricosuric Agents

Topics: Allopurinol; Animals; Blood Platelets; Cats; Cyclic AMP; Cyclooxygenase Inhibitors; Epoprostenol; Fibrinolytic Agents; Male; Mice; Platelet Aggregation; Pulmonary Embolism; Thrombosis; Xanthine Oxidase

Using two case-histories it is shown that atypical radiological findings caused the delay in diagnosis of pulmonary embolism depsite clinical signs (such as fever and intermittent dyspnoea; cyanosis, haemoptoe and cough reflex were absent). The exact diagnosis was finally established after having excluded all diseases, which were of greater probability on the grounds of the x-ray findings.

Topics: Adult; Allopurinol; Diagnosis, Differential; Digitalis Glycosides; Female; Heparin; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Pulmonary Embolism; Radiography; Radionuclide Imaging; Spironolactone