0.75

0.76

PLASMA INTERLEUKIN 1 RESPONSE TO ELECTIVE CHOLECYSTECTOMY. J Series, D Shapiro, I Cameron, W D Fraser, 0 J Garden, H J G Burns, A Shenkin , University Departments of Clinical Biochemistry and Surgery, Royal Infirmary, Glasgow, Scotland.

Interleukin 1 (IL-l) has been proposed to be a mediator of the acute phase protein response after surgical trauma. Assays of plasma IL-l have been limited by the presence of inhibitors and lack of sensitivity. A new sensitive and rapid method to measure plasma IL-1 has been developed and has been used to study patients undergoing elective cholecystectomy.

IL-l is extracted from plasma onto silica and inhibitors of the assay are washed off the silica in 1.4 M NaCl. IL-l is eluted with ethylene glycol, desalted and detected by a bioassay using the IL-l responsive LBRM TG6 and IL-2 dependent HT2A cell line&. Response is measured by 3H-thymidine incorporation. Plasma samples were collected in eight patients preoperatively and at frequent intervals till 72 hours post-operation.

An increase in serum C-reactive protein and fall in serum iron and zinc concentrations demonstrated similar acute phase reactions in all patients. Plasma IL-1 activity post- operation was variable but was detectable in only 6 patients. IL-l levels were extremely low at t5 pg/ml. Transient peaks of IL-l activity were seen either before (3 patients) or after (3 patients) the plasma CRP response.

These results are not consistent with the hypothesis that IL-l is acting systemically as the main mediator of the acute phase response to injury but do not exclude a local tissue action.

Acknowledgement We are grateful to Cetus Corporation, California for the gift of the LBRM TG6 and HT2A cell lines.

1. Larrick JW, Brindley C, iXyle MV. Journal of Immunological Methods 79 (1985) 3945.

AMINO ACID BALANCE ACROSS THE MYOCARDIUM AND THE LEG IMMEDIATELY AFTER

OPEN HEART SURGERY R.Svedjeholm,R.Ekroth,I.Milocco,F.Nilssdn,SE.Svensson,E.Vinnars,J.Wern- erman. Depts. of Cardiovasc SurR,Univ Hosp Uppsala and GothenburR, Dept.of Anesthesiology St.Gorans Hospital,Stockholm,Sweden.

Amino acid (AA) balance across the myocardium and the leg was studied in 6 male patients aged 42 - 65 years 1 hour after the end of aortocoro- nary bypass surgery.

Coronary sinus blood flow (thermodilution technique) was 94,7+14,1 ml/min and Leg blood flow (capacitance pletysmograhy)was 1,0 +0,2 ml/lOOR * min.There was a significant negative total AA AV-difference (plasma) across both the leg (-529,8+72,1 umol/l) and the myocardium (-47,1226,3 umol/l).Alanine and glutamine accounted for 50 % of the AA lost from the leg but there was a significant net release of 16 other AA.Alani.ne (- 33,5+6,9 umol/l) and glutamine (-21,1+6,7 umol/l) were the only AA sho- wing-a net release from the heart.GLtamate was extracted by both the heart (38,1+3,3 umol/l) and the leg (61,8+9,5 umol/l).Leucine and the BCAA as a coup constituted the principal difference between these tis- sues being extracted by the heart and released by the lea.

The negative total AA AV-difference across the leg was 11 times greater than-across the heart.Relating these results to blood flow with estimated tissue perfusion being approximately 50 times higher in the myocardium it is concluded that the AA loss per 100 S of tissue was considerably grea- ter from the heart.Net loss of AA from the leg was of a moderate degree due to low blood flow values.The pattern of AA exchanges suggest a com- mon mechanism rather than effects of local surgical- and/or ischemic trauma.

46