IL-6 secreted during an aseptic inflammatory state, such as sustaining head trauma with SIADH, is quantitatively correlated to AVP, indicating that this cytokine is directly and/or indirectly involved in the pathogenesis of SIADH.

E Van Der Voort (Rotterdam, The Netherlands)

In vivo 31P magnetic resonance spectroscopy(MRS) was used to evaluate the effect of nimodipine on changes of pH and the ratio of PCr/Pi in cats subjected to an incomplete global cerebral ischemia-reperfusion under the pretreated condition of hyperglycemia. DESIGN:Prospective,controlled animal study. SUBJECTS:Animals were subjected to a transient (18 minutes) incomplete global ischemia : the systemic arterial hypotension was induced, and immediately followed by the bilateral carotid artery ligation. METHODS:Twenty cats were divided into 3 groups: for group 1(control), 7 cats were employed for a control group; for group 2(hyperglycemia), 7 cats were a hyperglycemia group with infusion of 50% glucose prior to ischemia; for group 3 (nimodipine), 6 cats were infused with 50% glucose prior to ischemia, and nimodipine after ischemia. The time course of changes in pH and PCr/Pi was monitored before, during and after ischemia. RESULTS AND STATISTICAL ANALYSES:The pH decreased immediately after ischemia in all three groups. After the reperfusion was made, the values of the pH did not return to the baseline for the group 2 and 3, in contrary to the group 1. The ratio of PCr/Pi was dropped to 20% of the baseline value after ischemia in all three groups. The value was recovered progressively during reperfusion period for group 1, whereas for group 2 and group 3 the values were remained depressed. For statistical analyses unpaired t-test and Wilcoxon signed rank test were used. CONCLUSION:The results suggest that the condition of hyperglycemia induced by the infusion of 50% glucose prior to the incomplete global cerebral ischemia-reperfusion, may deteriorate the cerebral ischemia and infusion of nimodipine during ischemia-reperfusion has no beneficial effects to improve the cerebral acidosis and the metabolic recovery.

The purpose of this work is to study the influence of different hemodynamic situations on ANF release, as well as other hormones involved in the regulation of hydrosaline metabolism in patients with congenital heart diseases. Methods: 65 children diagnosed of congenital heart diseases were studied prospectively before and after cardiac surgery. Patients were distributed into two groups depending on the results of the hemodynamic evaluation through diagnostic catheterism before surgery. Group I: With normal pulmonary blood flow or pulmonary ischemia(NPF/Isch) (Qp/Qs<2; PASP<40 mmHg, PASP/SAP<0.75) and group II, with high pulmonar blood flow or pulmonary hypertension (HPF/PHT) (Qp/QS>2.5; PASP>71 mmHg; PASP/SAP>0.73). ANF, ADH, renin, aldosterone, ACTH and cortisol were determined three times: 24h before cardiac surgery, 24h and 45h after cardiac surgery. Systemic pressures, CVP, MLAP and diuresis were recorded as Well. TISS (Therapeutic Intervention Scoring System) was calculated as global evaluating tool of the clinical situation in each patient. Results: We found significative correlation (p<0.001) between CVP and plasma levels of ANF, ADH, aldosterone, ACTH and cortisol, in group II (HPF/PHT), 24h before and 24h after surgery. At 48h of postoperative period, only persisted correlation between CVP and ADH, renin, aldosterone and ACTH (p<0.05). Group I (NPF/Isch.) shows negative lineal correlation (p<0.05) among atrial pressures and plasma levels of ANF and aldosterone 24h after cardiac surgery. Moreover, positive correlation between TISS score and plasma levels of ANF, 24h (p