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Leukocyte-endothelial cell interactions play an important role in mediating organ dysfunctions observed after hemorrhagic shock. P-selectin is the first endothelial cell adhesion molecule to be upregulated after an ischemic insult. The objective of this study was to define kinetics of P-selectin expression in different regional vascular beds of mice exposed to hemorrhagic shock. In-vivo P-selectin expressions were determined using dual radiolabeled monoclonal antibody technique in lungs, heart, liver, kidneys, intestinal mesentery, stomach, small bowel, and colon 0.5, 1, 2, 5, 10, and 24 h after resuscitation of 40 mmHg hemorrhagic shock. In another group, P-selectin expression was determined in same organs 5 h after resuscitation of 30 mmHg hemorrhagic shock. Hemorrhagic shock of 40 mmHg caused significant upregulation of P-selectin in lungs and liver at 30 min after resuscitation (P < 0.001). There was a second and more pronounced upregulation of P-selectin in lungs and liver at 5 h after resuscitation (P < 0.001). In heart, intestinal mesentery, stomach, small bowel, and colon, P-selectin was not upregulated until 5 h after resuscitation from 40 mmHg hemorrhagic shock (P < 0.001). While hemorrhagic shock of 40 mmHg did not cause P-selectin upregulation in kidneys, hemorrhage to 30 mmHg did elicit a significant increase at 5 h after resuscitation (P < 0.001). We conclude that P-selectin is upregulated after resuscitation of hemorrhagic shock in lungs, liver, heart, stomach, and intestines. P-selectin upregulation in kidneys only takes place after more severe hemorrhagic shock.

Background: Intestinal thickening in gastroschisis results from prolonged exposure to amniotic fluid (AF). Experimental AF exchange has been shown to prevent intestinal thickening in gastroschisis., Case: A 25-year-old primigravida was referred at 24 weeks' gestation with a prenatal diagnosis of gastroschisis. Transabdominal AF exchange was performed at 29 weeks. This pretreatment did not cause any complications and prevented intestinal thickening in our patient. Thus, we were able to perform primary fascial closure with an intra-abdominal pressure less than 5 mmHg. We began feeding the infant on the 5th day and discharged her on the 8th day., Conclusion: Evidence obtained from this initial case seems promising for the further application of the AF exchange for prevention of intestinal thickening in gastroschisis.