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INTRODUCTION: The temporary prosthetic sphincterotomy is a possible treatment for neurologic detrusor sphincter dyssynergia (DSD). The purpose of the study was to verify the feasibility and effectiveness of the urethral stent (US) Temporary ALLIUM BUS "BULBAR URETHRAL STENT". PATIENTS AND METHODS: A prospective, non-comparative, single-center starting in 2015 was conducted. Were included patients over 18 years, with a neurologic DSD proved urodynamically for which medical treatment was not indicated or failed. The primary endpoint was the percentage of patients who had a voiding method considered as improved or much improved at 1 month and the feasibility of the procedure. RESULTS: From January to June 2015, 7 patients, (mean age 47.9 years [24-76 years]) were prospectively enrolled. One patient was lost to sight at one month and therefore excluded. The median follow-up was 8.1 months (1-10 months). All procedures were technically successful. At 1 month, there were 57% of grade 2 complications (Clavien-Dindo), 1 of 6 patients had a migration of the US. At one month, quality of life and the urologic situation was considered good in 3 patients, unchanged in 2 patients and decreased in 1 patient. The study was stopped after the inclusion of seven patients. At the date of the latest news, 5 of 6 patients had a migrated or an explanted US. CONCLUSION: The temporary urethral stent ALLIUM BUS does not seem to be a possible surgical alternative for the treatment of detrusor sphincter dyssynergia. LEVEL OF EVIDENCE: 4.
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Stents , Vejiga Urinaria Neurogénica/cirugía , Adulto , Anciano , Estudios de Factibilidad , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Calidad de VidaRESUMEN
OBJECTIVE: To evaluate oncologic and functional outcomes after percutaneous cryoablation (PCA) for renal masses based on our single center experience. PATIENTS AND METHODS: We retrospectively identified 26 patients who underwent PCA for 28 tumors between November 2006 and June 2011. Patient's demographics and baseline clinical characteristics, tumor features, perioperative information, and postoperative outcomes we rerecorded. A biopsy was performed systematically before each procedure. Control imaging was obtained at 1, 3, 6 and 12 months, and yearly thereafter. Oncological outcomes were determined by radiographic evidence of tumor recurrence, which was defined by contrast enhancement at the cryoablation site on control imaging at M3. RESULTS: Patients had mean age of 70.1 years, mean Charlson comorbidity index (CCI) and body mass index) were 6 and 29 kg/m(2) respectively. There were 11 kidney transplants, including 4 solitary. Mean tumor size was 29.5mm and was represented mainly by clear cell renal cell carcinomas (16/28), endophytic (17/28) and midkidney (14/28) (±9.8). Twenty-five cryoablations were performed percutaneously by two lumbotomy. Mean clearance preoperative MDRD was 66,1 mL/min. Mean length of stay was 3.3 days (±2.2). Intraoperative complications consisted of 2 pneumothorax and 6 minor complications postoperative (Clavien≤2). There were no major complications. Mean follow-up was 27.5 months (±15.7), MDRD clearance distance was 61.9 mL/min. Overall survival and disease-specific survival was 100%, while the recurrence-free survival was 78.6% (5 recurrences and 1 failure treatment). CONCLUSION: The percutaneous cryoablation provides a safe and oncologically to extirpative surgery for renal masses in patients with significant medical comorbidities. LEVEL OF EVIDENCE: 5.
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Carcinoma de Células Renales/cirugía , Criocirugía , Neoplasias Renales/cirugía , Laparoscopía , Recurrencia Local de Neoplasia/cirugía , Anciano , Índice de Masa Corporal , Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Renales/mortalidad , Carcinoma de Células Renales/patología , Criocirugía/métodos , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/mortalidad , Neoplasias Renales/patología , Laparoscopía/métodos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/mortalidad , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The increase in the incidence of neurodegenerative diseases linked to aging or injury needs to be addressed in research into neuroprotective or neuroregenerative therapies, and requires the development of specific biological models. To achieve this goal we propose (1) the use of the mouse olfactory epithelium as a biological support which specifically exhibits a regenerative or a self-renewing capacity and during the lifetime necessitates the presence of neural stem cells, and (2) the use of an intraperitoneal injection of 2,6-dichlorobenzonitrile (diclobenil) as a chemical inducer of neurodegeneration in olfactory epithelium by selectively killing mature cells. We developed a biological model to follow the processes of neurodegeneration (chemically induced) and neuroregeneration (self-renewal of olfactory epithelium). The purpose of this study was to develop a method to monitor quickly neurodegeneration/neuroregeneration processes in order to further screen protective and regenerative therapies. For this purpose, we used the sedimentation field flow fractionation elution of olfactory epithelium. We obtained specific elution profiles and retention parameters allowing the monitoring of the induction and kinetics of biological processes. The use of insulin-like growth factor 1α as a neuroprotective agent in an innovative nebulization protocol showed sedimentation field flow fractionation to be a simple, fast and low-cost method to monitor such a biological event on the scale of an entire organism.
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Fraccionamiento de Campo-Flujo/métodos , Enfermedades Neurodegenerativas/inducido químicamente , Enfermedades Neurodegenerativas/patología , Nitrilos , Mucosa Olfatoria/inervación , Mucosa Olfatoria/patología , Animales , Apoptosis , Modelos Animales de Enfermedad , Factor I del Crecimiento Similar a la Insulina/uso terapéutico , Cinética , Masculino , Ratones , Regeneración Nerviosa/efectos de los fármacos , Enfermedades Neurodegenerativas/tratamiento farmacológico , Fármacos Neuroprotectores/uso terapéutico , Mucosa Olfatoria/efectos de los fármacosRESUMEN
OBJECTIVES: Identification of factors associated with disease activity and B and T cell activation is a challenge in primary Sjogren's syndrome (pSS). Neurotrophins (NTs), recently reported as B cell antiapoptotic, and T-cell activation factors seem to be implicated in autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). METHODS: Samples from 18 pSS patients and 12 control subjects were studied to determine serum levels of nerve-growth factor (NGF) and brain-derived neurotrophic factor (BDNF), and their relationships with T- and B-cell activation and disease activity. Peripheral blood mononuclear cells (PBMCs) from patients with pSS and controls were examined by flow cytometry for HLA-DR expression by activated T cells. B cell activation was evaluated by B cell activating factor (BAFF) serum levels measured by enzyme-linked immunosorbent assay (ELISA) and immunoglobulin (Ig) and free light chain (FLC) levels. RESULTS: Mean serum levels of BDNF in pSS patients were significantly higher than in healthy controls and correlated directly with disease activity. NGF levels were associated with the subgroup of patients with hypergammaglobulinaemia. The pSS group was characterized by peripheral CD4+ and CD8+ T cell activation that correlated positively with BDNF and NGF levels, respectively. CONCLUSION: NT levels are potential biomarkers for lymphocyte activation in pSS patients.
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Factor Neurotrófico Derivado del Encéfalo/sangre , Factor de Crecimiento Nervioso/sangre , Síndrome de Sjögren/sangre , Síndrome de Sjögren/patología , Linfocitos T/patología , Adulto , Anciano , Anciano de 80 o más Años , Factor Activador de Células B/sangre , Biomarcadores/sangre , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/patología , Linfocitos T CD8-positivos/inmunología , Linfocitos T CD8-positivos/patología , Estudios de Casos y Controles , Femenino , Antígenos HLA-DR/metabolismo , Humanos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Síndrome de Sjögren/inmunología , Linfocitos T/inmunologíaRESUMEN
The aim of the present study was to isolate neural stem cells from a complex tissue: the avian olfactory epithelium; by using sedimentation field flow fractionation (SdFFF). By using "Hyperlayer" elution mode, fraction collection and cell characterization methods, results shows that SdFFF could be a useful cell sorter to isolate an enriched, viable and sterile immature neural cell fraction from which the reconstitution of a complete epithelium was possible. In culture, SdFFF eluted cells first led to a "pseudoplacodal" epithelioid cell type from which derived "floating cells". These cells were then able to generate neurosphere-like structures which were composed of cell having many features of immature cells: undifferentiated, self-renewable and multipotentiality. Such a population might be used as a model to improve our understanding of the mechanisms of olfactory neoneurogenesis.
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Separación Celular/métodos , Fraccionamiento de Campo-Flujo/métodos , Mucosa Olfatoria/embriología , Células Madre/citología , Animales , Células Cultivadas , Embrión de Pollo , Factor de Crecimiento Nervioso/farmacología , Mucosa Olfatoria/citología , Receptor trkA/biosíntesis , Células Madre/efectos de los fármacosRESUMEN
In the nervous system, apoptosis is a major process during embryonic and postnatal stages. In chick, experimental cell death can be obtained by axotomy. We have compared the responses of olfactory neurons to axotomy at embryonic stage E17 and postnatal stages.Forty-three chicken embryos and 32 young chickens less than 3 weeks old were used. We combined optic microscopy, electronic microscopy, terminal (TdT)-mediated dUTP-nick end labeling (TUNEL) method and gel electrophoresis of genomic DNA to analyze cell death. Cells in synthetic phase were labeled by bromodeoxyuridine injected i.p. and detected by immunohistochemistry. Apoptotic index and 5-bromo-2'-deoxyuridine (BrdU) labeling index were calculated for each stage. The Wilcoxon test was used for statistical analysis. A P value <0.05 was considered significant. Within 3 days following axotomy in E17 chicken embryos, there was no significant increase of apoptosis on the lesion side analyzed 3, 6, 12, 18, 24, 48 or 56 h later. A slight increase of bromodeoxyuridine incorporation appeared at 3 h, was weakly significant at 24 h (P=0.045) and the return to basal rate took place at 48 h. In postnatal stages, an apoptotic wave appeared 12 h after axotomy, reached a maximum at 24 h, and then decreased between 48 h and 72 h. A significant elevation of bromodeoxyuridine incorporation occurred on 48 h with a 24 h delay after the peak of apoptotic death. This differential response to axotomy in embryos and postnatal chickens might be due to a less complete maturation and higher plasticity of embryonic olfactory neurons corresponding to different requirement for survival and differentiation factors. Thus the embryonic or immature neurons would depend more on local epithelial environment and mature or postnatal neurons would require target-derived survival factors and die from apoptosis after their shortage resulting from axotomy.
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Apoptosis/fisiología , Diferenciación Celular/fisiología , División Celular/fisiología , Supervivencia Celular/fisiología , Plasticidad Neuronal/fisiología , Neuronas Receptoras Olfatorias/embriología , Neuronas Receptoras Olfatorias/fisiología , Envejecimiento/metabolismo , Animales , Axotomía , Bromodesoxiuridina , Embrión de Pollo , Pollos , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Microscopía Electrónica , Neuronas Receptoras Olfatorias/ultraestructuraRESUMEN
Insulin-like growth factor 1 (IGF1) receptor is expressed in avian olfactory neurons and IGF1 in the bulb. To explore the function of IGF1 in olfactory system in the chick, we infused IGF1 at the lesion site 0 and 12 h after olfactory axotomy. The animals were killed 1-3 days later. TdT mediated dUTP nick end labeling method and bromodeoxyuridine incorporation allowed the evaluation of programmed cell death and mitotic activity respectively in the olfactory epithelia of IGF1 treated or untreated lesioned animals and controls. IGF1 treatment suppressed the apoptotic wave, stimulated mitosis which peaked within 24 h (instead of 48 h), to return promptly to normal, and transiently maintained the number of calmodulin related kinase II expressing neurons at normal levels. It reveals a long lasting effect of IGF1 on the survival of lesioned olfactory neurons and transient effects on maintenance of differentiation and mitosis stimulation.
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Apoptosis/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Embrión de Pollo/crecimiento & desarrollo , Factor I del Crecimiento Similar a la Insulina/farmacología , Mitosis/efectos de los fármacos , Neuronas/efectos de los fármacos , Mucosa Olfatoria/efectos de los fármacos , Animales , Apoptosis/fisiología , Axotomía , Diferenciación Celular/efectos de los fármacos , Diferenciación Celular/fisiología , Supervivencia Celular/fisiología , Embrión de Pollo/citología , Embrión de Pollo/metabolismo , Inmunohistoquímica , Factor I del Crecimiento Similar a la Insulina/metabolismo , Mitosis/fisiología , Regeneración Nerviosa/efectos de los fármacos , Regeneración Nerviosa/fisiología , Neuronas/citología , Neuronas/metabolismo , Mucosa Olfatoria/citología , Mucosa Olfatoria/metabolismo , Degeneración Retrógrada/tratamiento farmacológico , Degeneración Retrógrada/metabolismo , Degeneración Retrógrada/prevención & control , Factores de TiempoRESUMEN
1. Cyclo-oxygenase 2 (COX-2) is implicated in multiple physiopathological processes. We have studied its physiological expression during chicken embryogenesis. 2. An original procedure was set to prepare a COX-2 probe from red blood cells. In situ hybridization, reverse transcription-polymerase chain reaction and northern blots, were performed on chick embryos from embryonic day (E) 3 to postnatal day 15. 3. In the mesonephros, the signal detected in mesonephric tubules presented a slow increase from E5 to E9, a plateau up to E12 and then a decrease, while the signal increased in the metanephros and then decreased after hatching. Transient expression of COX-2 mRNA in endothelial cells of the infundibulum of the aorta was also detected between E12 and E17. 4. This enzyme may have important roles in kidney morphogenesis during early embryonic stages and in tubular functions during development and in adult life. In the cardiovascular system, its vasodilatory effect could modulate the vasoconstrictor effect of the systolic pressure between E12 and E17 and contribute to a normal morphogenesis of the arterial tree and heart.