Chapter 176 173. Angels and Devils

As an important organ in the abdominal cavity, the adrenal glands will also have various diseases, just like other organs.

When organic lesions appear and may further worsen or even cancer, or the lesions themselves have affected the body's hormone levels and the effect of internal medicine treatment is limited, modern surgery will intervene. The most common and direct way is to remove the already lesions of the adrenal glands.

【1】

However, the adrenal glands are responsible for maintaining the balance of body fluid electrolytes and maintaining normal blood pressure and heart rate. Resection, especially bilateral simultaneous resection, will bring many side effects.

Therefore, bilateral adrenalectomy has extremely strict indications. [2]

Once you have undergone bilateral total adrenal resection, you need to take hormones for life after the operation. However, the substitute treatment of taking medication alone is to mechanize the hormone levels and cannot be compared with the regulatory capacity of normal gland secretion.

The most obvious thing is the pituitary gland that regulates systemic hormones. The lack of adrenal glands makes it difficult to suppress the adrenocorticotropin (ACTH) secreted by the pituitary gland. Long-term stimulation will cause the pituitary gland to undergo lesions. [3]

At this time, it is very important to maintain adrenal levels.

To deal with missing organs, surgical methods are generally to choose transplantation. However, the voles are too small, so it is impossible to perform adrenal vascular anastomosis. Moreover, Kawei made a temporary decision and did not retain enough blood vessels when removing the adrenal glands.

Therefore, we can only do simple "planting" here, rather than transplanting in the traditional sense.

However, compared to implants used to hedge complications after double adrenalectomy, Kawei does not need to deal with the lesion tissue on the adrenal gland. He can directly skip the preparation stage and do it directly. [4]

For patients with some of the adrenal tissues that are still available, surgeons have found a way to autologously implant after resection.

"There is still some time for anesthesia, let him lie down for a while." Kavey took a piece of wet gauze dipped in warm saline and covered Torre's abdomen incision, and said, "Let's peel off the fat around the adrenal glands first.

Then."

At this time, Matik and Koch seemed to have walked into the experimental building.

The two should have had some different opinions on some content in the chemistry class. Before the door was opened, the extremely poor sound insulation brought their conversation into the ears of Kavey and Savalin.

"I admit that Germany's chemical ability is much better than Austria, but that only stays at the level of dye research and development," said Matic. "But now that Austria has methylene blue, it has improved in dye research and development."

Koch didn't seem to care: "I've been to that dye factory, and unfortunately the chemist who developed methylene blue was a British, a German student. The German was Augster

William von Hoffmann, now a professor of chemistry at the University of Berlin”

"I know, next you will say that Hoffmann's teacher is also a German, named Eustus von Libich. He is a big shot who proposed the theory of organic groups and textbooks. I must know him." [5

】

The two pushed open the laboratory door side by side, and Matic's rebuttal continued: "But this has nothing to do with methylene blue having Austrian chemical patents."

"It's just one of the dyes, not"

The topic ended here because the two found out that Kavi was in the lab.

"Mr. Kavi!" Koch was excited, "Why are you here?"

"It's just here to do an experiment." Kawei glanced at the two of them and quickly withdrew his gaze. "Since you are here, let's take a look together. You don't need to do the surgery, but you need to understand the purpose and content of the experiment.

”

Due to information blockade, the newly completed Countess surgery was not discussed among ordinary people and its status was not as high as that of cesarean section. However, within the medical community, this surgery mobilized three of the most famous surgeons in Austria today to do it.

Several innovations have been made, and the shock is unprecedented.

Koch is just a doctoral student in Germany who has not graduated yet. His experience, skills and nationality are not enough to make him on this stage, but Kawei still helped him. With such experience during his study tour, he can also return to China for the future.

Pave the way for work.

So Koch used the honorary title here.

Kavi didn't think so much, because when Ignaz was already in charge, it would be embarrassing to find other pathology experts. And among young doctors, Ignaz can keep up with Ignaz

There are not many people with pathological experiment capabilities.

Everyone has similar levels, so naturally interpersonal relationships are more important, so Kavi chose Begt and Koch.

Facts have also proved that the two have the ability to go on stage to do experiments.

"What I want to study this time is the adrenal glands." Kawei straight to the point, "Anatomically, the location of the adrenal glands has been clear, including surrounding tissues and blood vessels. What I want to study now is its function, that is, it exists in humans and animals.

The meaning in the body.”

"What a big topic"

"The method is to observe the daily life of the voles after removing the glands. These two are the adrenal glands of the voles." Kawei said with a beaker.

"What a small adrenal gland."

The two of them had a rough understanding of the next experimental project, but questions also arose: "Since the adrenal glands have been cut off, why is the incision still open?"

The main reason for doing this must be Savalin, because the next experiment is not his own, so he has to calm the other party's emotions. If he still can't perform the surgery properly under this situation, then the next one

There will be no longer a place for him in the laboratory.

"Good question!"

"Because I don't have time to go ahead, the surgery has to be done by Savalin," Kavey explained. "In order to remove the uncertainties that may appear in the experiment, I have to put the cut adrenal glands back."

“Can this be put back???”

Koch and Matic were extremely surprised, just like Savalin standing beside him. The surgery proposed by Kavey sounded no big deal, but it completely exceeded the scope of the three people's understanding.

"It's no big deal." Kavey said, "To be precise, this is not about putting it back, but about 'seed' back."

After saying that, he lifted the wet gauze on Tore's abdomen and compared the length of the lower abdominal muscles in the incision: "Before planting, you have to use a blade to slice the adrenal glands."

"Cut open?"

“Why do you need to cut it open?”

“Can it still work after cutting it?”

As surgery has developed to this day, although many drugs and technologies are still missing, the concept of transplantation has long existed. Just like repairing a clock, replacing broken parts with new ones can restore normal operation.

On the contrary, the concept of plant cultivation, like planting, seems more primitive.

“There are some of the most basic surgical and physiological knowledge needed to be applied here.”

Kawei was like a teacher, patiently answering the confusion of the three people: "First of all, physiology, the tissues in the human body need to provide nutrients, just like we need to eat. In terms of anatomical structure, both adrenal glands have lost their blood vessels.

, and there is a envelope around the adrenal glands, which blocks nutrient intake. In this case, in order to keep it active, this layer of barrier must be removed."

After saying that, Kawei chose the smallest surgical cut from the instrument box: "Fortunately, Mr. Laslow's foundry is very powerful, otherwise such a small adrenal gland would be difficult to deal with."

According to the requirements of autologous adrenal implantation in the human body, the adrenal glands after ex vivo need to remove surrounding fat tissue, then remove lesion tissue in the adrenal glands, and then use a knife to cut the remaining available parts into 1-2mm thick slices.

Now Kawei's conditions are limited, and the adrenal glands of the voles are too small, so I can only deal with it alive.

With the support of the microscope, he barely cut the two adrenal glands into 7 thin slices with tweezers, scissors and scalpels, and then reopened the gauze on Torey's body: "Select the thickest part of the subcutaneous muscles and cut some with scissors to remove some

The muscles, then put them in one by one.”

The whole process was completed under the operation of Kawei's hands and tissue tweezers. Both the brain and the fineness of the operation had exceeded the imagination of the three.

"Can this really work?" Koch couldn't understand, "it looked like growing potatoes in a vegetable garden."

"Yes, dig up the soil and bury the seeds." Matic agreed with this statement, "Sewing the skin is like covering the soil on it."

"If you succeed, you have to observe slowly after the operation." Kawei quickly sutured the skin incision, and then chose to bandage the wound with a gauze. "Everyone knows the average heart rate of voles."

"400 jumps per minute."

“There are differences in individuals, but overall it is this number.”

Savalin quickly loosened Torre's limbs and found a clean cage to serve as a single ward to rest after the operation. Kave took off his gloves, washed his hands, and then prepared to write them a simple experimental process.

"If I'm right, cutting off both adrenal glands will gradually slow down their heart rate, so the direction of observation after the surgery is daily life and heart rate."

In fact, he still wants to count his blood pressure, but the design drawings of the man's blood pressure monitor have just been sent to Laslow's company. He has not made the finished product yet. He really dare not expect it. So under the premise that a set of data is missing

, Kawei hopes to add other observation items.

"The observation time is 7-14 days, and some kidney powder is mixed into the feed to increase nutrition." Kawei briefly said the key points that need to be paid attention to, "In terms of drinking water, some drink clean water, and some drink normal saline. Observe first and observe for six days

It's mainly about weight, eating, activity, and muscle strength of the limbs."

"What then?" the three of them made the record.

"The feed started to be cut off on the seventh day," Kavey said, "but the water still has to be given, otherwise he will die soon."

"What are you going to do?" Savalin was a little nervous.

"I guess there is no big difference in six days, so I want to put them in some difficult environments and observe the stress response ability." Kavey said, "The fasting time is about two days, which is the ninth.

Watch their mobile rest postures and daily activities in the day.”

The three nodded: "There should be a comparison between groups."

"It also needs to be compared with before fasting."

"knew."

Seeing that the three of them were ready to start construction, Kawei quickly stopped them: "Don't worry, the experimental project has only been halfway through, and it's not over yet."

"besides?"

"For some voles who are strong enough, just fasting cannot defeat them." Kawei glanced at the existing tools in the laboratory, and the stress environment that can be done is very limited. "Get the maximum at that time."

The metal basin is filled with ice water. Remember, it is ice water and the temperature should not exceed 5 degrees Celsius.
To be continued...