RESUMO
ABSTRACT This study aims to describe a challenging clinical case of a patient with a neurotrophic and exposure corneal ulcer. A 75-year-old male patient, with history of right eye (RE) limbic stem-cell insuficiency due to complications of recurrent herpetic keratitis, underwent successful limbic stem-cell transplantation in 2008. In 2010, an uneventful penetrating keratoplasty was performed. After a cataract phacoemulsification surgery with intraocular lens implantation done in 2011, best corrected visual acuity was 20/20, and remained stable until 2015. In July 2015, the patient developed right facial nerve palsy and two months later, presented with an extensive central corneal ulcer, with a significant thinning of central stroma, without infection signs, but with an imminent risk of perforation. Treatment with topical ofloxacin and intensive ocular lubrification was started in association with permanent ocular oclusion. Due to lack of any clinical improvement, treatment with RGTA [Poli (carboximetilglucose) sulfate, dextrano T40] (Cacicol®, Thea) was started. After two weeks of treatment, a complete reepithelization and partial stromal filling was observed. Continued monitoring and treatment with artificial tears was maintained, with no recurrence observed. There is an unmet need for a medical therapy that could help corneal neurotrophic ulcers to heal. The presented clinical case shows that the approach of targeting extracellular matrix can be effective in the reepithelialization of neurotrophic and exposure corneal ulcer that do not respond to conventional treatments.
RESUMO Este trabalho relata um caso clínico desafiante de doente com uma úlcera de córnea neurotrófica e de exposição. Doente do sexo masculino, de 75 anos, com antecedentes de queratites herpéticas de repetição no olho direito (OD), complicadas com o desenvolvimento de uma insuficiência límbica, foi submetido com sucesso a transplante de células límbicas em 2008. Em 2010 foi submetido a queratoplastia penetrante e em 2011, após realização de cirurgia de catarata, apresentava uma melhor acuidade visual corrigida (MAVC) de 20/20. A MAVC manteve-se estável até Julho de 2015, altura em que desenvolveu paresia facial periférica à direita. Dois meses depois, o doente desenvolveu uma úlcera de córnea central extensa, com adelgaçamento significativo do estroma central, sem sinais de infeção, mas com risco iminente de perfuração. Foi iniciado tratamento tópico com ofloxacina, lubrificação intensiva e oclusão ocular contínua. Por ausência de melhoria clínica, foi iniciado tratamento tópico com um RGTA [Poli (carboximetilglucose) sulfato, dextrano T40] (Cacicol®, Thea). Após duas semanas de tratamento, observou-se uma reepitelização completa e regeneração parcial do estroma. Foi mantida monitorização regular e tratamento com lágrimas artificiais, sem recidiva do quadro clínico. Há uma grande necessidade de tratamentos médicos que possam ajudar na regeneração de úlceras de córnea neurotróficas e de exposição. O caso clínico apresentado sugere que os fármacos que têm por alvo a matrix extracelular poderão ser eficazes na reepitelização de úlceras de córnea neurotróficas e de exposição que não respondem ao tratamento convencional.
Assuntos
Humanos , Masculino , Idoso , Regeneração/efeitos dos fármacos , Úlcera da Córnea/tratamento farmacológico , Glicosaminoglicanos/administração & dosagem , Soluções Oftálmicas/administração & dosagem , Estimulação Química , Cicatrização , Administração Tópica , Dextranos/administração & dosagem , Hipestesia , Anti-Infecciosos/administração & dosagemRESUMO
ABSTRACT Objective: To identify how many endoscopic injection (EI) procedures, STING method, must be performed before reaching an ideal success rate when simulation training has not been received. Materials and Methods: The EI procedures performed by two pediatric urology fellows were investigated. The study excluded patients without primary VUR and those with previous EI or ureteroneocystostomy, lower urinary tract dysfunction, and/or duplicate ureters. The EIs used dextranomer hyaluronate and the STING method, as described by O'Donnell and Puri. Groups number was determined by multiple statistical trials. Statistically significance differences were achieved with one combination that had 35 EI procedures each and with 3 different combination of patients, having 12, 24, and 36 patients, respectively. Therefore, groups were established 12 patients. The first fellow performed 54 EIs, and the second performed 51. Therefore, each of the first fellow's three groups contained 18 EI procedures, and each of the second fellow's 17. Results: The study included 72 patients and 105 ureter units. When the data from both fellows were combined, each of the three groups contained 35 procedures. For the first fellow, the success rates in the first, second, and third groups were 38.3%, 66.6%, and 83.3% (p = 0.02), respectively, and for the second fellow, the success rates were 41.2%, 64.7%, and 82.3% (p = 0.045), respectively. The increased success rates for both fellows were very similar. Conclusions: An acceptable rate of success for EI may be reached after about 20 procedures and a high success rate after about 35-40 procedures.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Refluxo Vesicoureteral/terapia , Curva de Aprendizado , Ácido Hialurônico/administração & dosagem , Estudos Retrospectivos , Dextranos/administração & dosagem , Resultado do Tratamento , Competência Clínica , CistoscopiaRESUMO
ABSTRACT Introduction: Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-institutional data showed that the amount of injection material has increased over time with the purpose of improving success rates, which also resulted in costs. We noticed an opposite trend in our center since we started using a new bulking agent. The aim of this study was to evaluate evolution of our practice with different bulking agents. Patients and Methods: Records of VUR patients who underwent subureteric injection with polyacrylate polyalcohol copolymer (PPC) and dextronomere hyaluronic acide (DxHA) between 2005 and 2014 were reviewed. Variation of different parameters throughout the study period was evaluated along with the success rate. Success was defined as complete resolution of reflux. Results: A total of 260 patients with 384 refluxing units were included. The success rate was higher in PPC group compared to DxHA group. There was no statistically significant difference between years regarding distribution of VUR grade, body weight, patient height, and age in PPC group. Despite significant reduction in injection volume, success rate did not decrease through the years with PPC. Conclusion: Different bulking agents may require different injection volumes to achieve the same success rate in endoscopic treatment of vesicoureteral reflux. Habits gained with previous experience using other materials should be revised while using a new agent.
Assuntos
Humanos , Pré-Escolar , Criança , Polímeros/administração & dosagem , Refluxo Vesicoureteral/terapia , Materiais Biocompatíveis/administração & dosagem , Resinas Acrílicas/administração & dosagem , Dextranos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Seguimentos , Resultado do Tratamento , UreteroscopiaRESUMO
OBJECTIVE: To identify how many endoscopic injection (EI) procedures, STING method, must be performed before reaching an ideal success rate when simulation training has not been received. MATERIALS AND METHODS: The EI procedures performed by two pediatric urology fellows were investigated. The study excluded patients without primary VUR and those with previous EI or ureteroneocystostomy, lower urinary tract dysfunction, and/or duplicate ureters. The EIs used dextranomer hyaluronate and the STING method, as described by O'Donnell and Puri. Groups number was determined by multiple statistical trials. Statistically significance differences were achieved with one combination that had 35 EI procedures each and with 3 different combination of patients, having 12, 24, and 36 patients, respectively. Therefore, groups were established 12 patients. The first fellow performed 54 EIs, and the second performed 51. Therefore, each of the first fellow's three groups contained 18 EI procedures, and each of the second fellow's 17. RESULTS: The study included 72 patients and 105 ureter units. When the data from both fellows were combined, each of the three groups contained 35 procedures. For the first fellow, the success rates in the first, second, and third groups were 38.3%, 66.6%, and 83.3% (p = 0.02), respectively, and for the second fellow, the success rates were 41.2%, 64.7%, and 82.3% (p = 0.045), respectively. The increased success rates for both fellows were very similar. CONCLUSIONS: An acceptable rate of success for EI may be reached after about 20 procedures and a high success rate after about 35-40 procedures.
Assuntos
Dextranos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Curva de Aprendizado , Refluxo Vesicoureteral/terapia , Adolescente , Criança , Pré-Escolar , Competência Clínica , Cistoscopia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
INTRODUCTION: Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-institutional data showed that the amount of injection material has increased over time with the purpose of improving success rates, which also resulted in costs. We noticed an opposite trend in our center since we started using a new bulking agent. The aim of this study was to evaluate evolution of our practice with different bulking agents. PATIENTS AND METHODS: Records of VUR patients who underwent subureteric injection with polyacrylate polyalcohol copolymer (PPC) and dextronomere hyaluronic acide (DxHA) between 2005 and 2014 were reviewed. Variation of different parameters throughout the study period was evaluated along with the success rate. Success was defined as complete resolution of reflux. RESULTS: A total of 260 patients with 384 refluxing units were included. The success rate was higher in PPC group compared to DxHA group. There was no statistically significant difference between years regarding distribution of VUR grade, body weight, patient height, and age in PPC group. Despite significant reduction in injection volume, success rate did not decrease through the years with PPC. CONCLUSION: Different bulking agents may require different injection volumes to achieve the same success rate in endoscopic treatment of vesicoureteral reflux. Habits gained with previous experience using other materials should be revised while using a new agent.
Assuntos
Resinas Acrílicas/administração & dosagem , Materiais Biocompatíveis/administração & dosagem , Dextranos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Polímeros/administração & dosagem , Refluxo Vesicoureteral/terapia , Criança , Pré-Escolar , Seguimentos , Humanos , Resultado do Tratamento , UreteroscopiaRESUMO
Superparamagnetic iron oxide nanoparticles (SPIONs) are of great interest in nanomedicine due to their capability to act simultaneously as a contrast agent and as a targeted drug delivery system. At present, one of the biggest concerns about the use of SPIONs remains around its toxicity and, for this reason, it is important to establish the safe upper limit for each use. In the present study, SPION coated with cross-linked aminated dextran (CLIO-NH2) were synthesized and their toxicity to zebrafish brain was investigated. We have evaluated the effect of different CLIO-NH2 doses (20, 50, 100, 140 and 200 mg/kg) as a function of time after exposure (one, 16, 24 and 48 h) on AChE activity and ache expression in zebrafish brain. The animals exposed to 200 mg/kg and tested 24 h after administration of the nanoparticles have shown decreased AChE activity, reduction in the exploratory performance, significantly higher level of ferric iron in the brains and induction of casp8, casp 9 and jun genes. Taken together, these findings suggest acute brain toxicity by the inhibition of acetylcholinesterase and induction of apoptosis.
Assuntos
Acetilcolinesterase/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/enzimologia , Dextranos/farmacologia , Animais , Comportamento Animal/efeitos dos fármacos , Dextranos/administração & dosagem , Relação Dose-Resposta a Droga , Injeções Intraperitoneais , Ferro/análise , Ferro/metabolismo , Nanopartículas de Magnetita/administração & dosagem , Nanopartículas , Tamanho da Partícula , Peixe-ZebraRESUMO
In this research work, DEXTRAN- and polyethylene glycol (PEG)-coated iron-oxide superparamagnetic nanoparticles were synthetized and their cytotoxicity and biodistribution assessed. Well-crystalline hydrophobic Fe3 O4 SPIONs were formed by a thermal decomposition process with d = 18 nm and σ = 2 nm; finally, the character of SPIONs was changed to hydrophilic by a post-synthesis procedure with the functionalization of the SPIONs with PEG or DEXTRAN. The nanoparticles present high saturation magnetization and superparamagnetic behavior at room temperature, and the hydrodynamic diameters of DEXTRAN- and PEG-coated SPIONs were measured as 170 and 120 nm, respectively. PEG- and DEXTRAN-coated SPIONs have a Specific Power Absorption SPA of 320 and 400 W/g, respectively, in an ac magnetic field with amplitude of 13 kA/m and frequency of 256 kHz. In vitro studies using VERO and MDCK cell lineages were performed to study the cytotoxicity and cell uptake of the SPIONs. For both cell lineages, PEG- and DEXTRAN-coated nanoparticles presented high cell viability for concentrations as high as 200 µg/mL. In vivo studies were conducted using BALB/c mice inoculating the SPIONs intravenously and exposing them to the presence of an external magnet located over the tumour. It was observed that the amount of PEG-coated SPIONs in the tumor increased by up to 160% when using the external permanent magnetic as opposed to those animals that were not exposed to the external magnetic field.
Assuntos
Dextranos/farmacocinética , Compostos Férricos/farmacocinética , Campos Magnéticos , Nanopartículas , Animais , Chlorocebus aethiops , Dextranos/administração & dosagem , Dextranos/toxicidade , Cães , Portadores de Fármacos , Avaliação Pré-Clínica de Medicamentos , Feminino , Compostos Férricos/administração & dosagem , Compostos Férricos/toxicidade , Técnicas In Vitro , Injeções Intravenosas , Fígado/metabolismo , Pulmão/metabolismo , Células Madin Darby de Rim Canino , Nanopartículas de Magnetita/administração & dosagem , Nanopartículas de Magnetita/toxicidade , Neoplasias Mamárias Experimentais/metabolismo , Teste de Materiais , Camundongos , Camundongos Endogâmicos BALB C , Nanopartículas/administração & dosagem , Nanopartículas/toxicidade , Polietilenoglicóis , Pele/metabolismo , Espectroscopia de Infravermelho com Transformada de Fourier , Distribuição Tecidual , Células VeroRESUMO
INTRODUCTION: The aim of this work was to quantify the effects of injection volume at different technetium-99m specific radiotracer doses on its lymphatic movement in animal model. PROCEDURES: Effects of injection volume (50, 100 µl) at different doses (0.05, 0.135, 0.22 nmol) on popliteal node (PN) detection were studied in rats. The radiotracer under study was (99m)Technetium-cysteine-mannose-dextran conjugate (30 kDa). RESULTS: At 0.05 nmol dose, higher PN uptake was observed at 50 µl injection volume (2.6 fold increase). Conversely, at 0.135 nmol dose, an increase of radiotracer retention in PN was achieved at 100 µl volume, 78% higher than 50 µl. However, at 0.22 nmol dose, the injection volume changes did not influence on the PN uptake. Considering as suitable radiotracer performance: high PN uptake and extraction, better combinations were 0.05 nmol/50 µl, 0.135 nmol/100 µl, 0.22/50 µl. CONCLUSION: Suitable performances could be reached by proper combinations of dose, injection volume and concentration for a specific radiotracer used in sentinel lymph node detection.
Assuntos
Cisteína/análogos & derivados , Dextranos/farmacocinética , Linfonodos/metabolismo , Manose/farmacocinética , Compostos de Organotecnécio/farmacocinética , Compostos Radiofarmacêuticos/farmacocinética , Animais , Cisteína/administração & dosagem , Cisteína/farmacocinética , Dextranos/administração & dosagem , Feminino , Linfonodos/diagnóstico por imagem , Manose/administração & dosagem , Compostos de Organotecnécio/administração & dosagem , Cintilografia , Compostos Radiofarmacêuticos/administração & dosagem , Ratos , Ratos Wistar , Biópsia de Linfonodo Sentinela/métodos , Distribuição TecidualRESUMO
INTRODUCTION: Lung transplantation, a consolidated treatment for end-stage lung disease, utilizes preservation solutions, such as low potassium dextran (LPD), to mitigate ischemia-reperfusion injury. We sought the local development of LPD solutions in an attempt to facilitate access and enhance usage. We also sought to evaluate the effectiveness of a locally manufactured LPD solution in a rat model of ex vivo lung perfusion. METHODS: We randomized the following groups \?\adult of male Wistar rats (n = 25 each): Perfadex (LPD; Vitrolife, Sweden); locally manufactured LPD-glucose (LPDnac) (Farmoterapica, Brazil), and normal saline solution (SAL) with 3 ischemic times (6, 12, and 24 hours). The harvested heart-lung blocks were flushed with solution at 4°C. After storage, the blocks were connected to an IL-2 Isolated Perfused Rat or Guinea Pig Lung System (Harvard Apparatus) and reperfused with homologous blood for 60 minutes. Respiratory mechanics, pulmonary artery pressure, perfusate blood gas analysis, and lung weight were measured at 10-minute intervals. Comparisons between groups and among ischemic times were performed using analysis of variance with a 5% level of significance. RESULTS: Lungs preserved for 24 hours were nonviable and therefore excluded from the analysis. Those preserved for 6 hours showed better ventilatory mechanics when compared with 12 hours. The oxygenation capacity was not different between lungs flushed with LPD or LPDnac, regardless of the ischemic time. SAL lungs showed higher PCO(2) values than the other solutions. Lung weight increased over time during perfusion; however, there were no significant differences among the tested solutions (LPD, P = .23; LPDnac, P = .41; SAL, P = .26). We concluded that the LPDnac solution results in gas exchange were comparable to the original LPD (Perfadex); however ventilatory mechanics and edema formation were better with LPD, particularly among lungs undergoing 6 hours of cold ischemia.
Assuntos
Citratos/administração & dosagem , Dextranos/administração & dosagem , Pulmão , Potássio/química , Animais , Masculino , Modelos Teóricos , Ratos , Ratos WistarRESUMO
OBJETIVO: avaliar a eficácia da injeção intraoperatória para identificação do LS em câncer de mama com o uso do Dextran 500-99m-tecnécio (Tc) e analisar o tempo para marcação do linfonodo sentinela (LS) axilar. MÉTODOS: estudo prospectivo realizado entre abril de 2008 e junho de 2009 que incluiu 74 biópsias de LS em pacientes com câncer de mama em estádios T1N0 e T2N0. Após a indução anestésica, injetou-se de 0,5 a 1,5 mCi (18 a 55 MBq) de Dextran 500-99m-Tc filtrado 0,22 µm num volume de 5 mL de acordo com a técnica de injeção subareolar para a biópsia do LS. Após a marcação com o radiofármaco injetou-se 2 mL de azul patente. O tempo entre a injeção e a marcação na região axilar, a contagem com o probe do LS in vivo, ex vivo, background e o número de LS identificados foram documentados. Os dados foram analisados por meio da estatística descritiva pelo programa SPSS, versão 18. RESULTADOS: identificamos o LS em 100 por cento dos casos. A taxa de identificação com o probe foi de 98 por cento (73/74 casos). Um caso (1,35 por cento) estava marcado apenas com o azul. A dose média do radiofármaco aplicada foi 0,97 mCi±0,22. O tempo para marcação na região axilar, após a injeção subareolar, foi de 10,7 minutos (±5,7 min. ). Foram identificados, em média, 1,66 linfonodos marcados com o radioisotopo. CONCLUSÃO: o procedimento para identificação do LS com injeção intraoperatória do radiofármaco é oncologicamente seguro, apresentando conforto ao paciente e agilidade à equipe cirúrgica.
PURPOSE: to determine the efficacy of intraoperative injection of Dextran-500-99m-technetium (Tc) for the identification of the sentinel lymph node (SLN) in breast cancer and analyze time to label the SLN in the axillary region. METHODS: a prospective study between April 2008 and June 2009, which included 74 sentinel lymph node biopsies (SLNB) in patients with breast cancer in stages T1N0 and T2N0. After induction of anesthesia, 0.5 to 1.5 mCi of Dextran-500-99m-Tc filtered 0.22 µm in a volume of 5 mL was injected intraoperative using the subareolar technique for SLNB. After labeling with the radioisotope, 2 mL of patent blue was injected. The time elapsed between injection and the axillary hot spot, the in vivo and ex vivo counts of the hottest nodes, the background count, and the number of SLN identified were documented. Data were analyzed using descriptive statistics with SPSS program, version 18. RESULTS: we identified the SLN in 100 percent of cases. The rate of SLN identification with the probe was 98 percent (73/74 cases). In one case (1.35 percent) the SLN was labeled only with the blue dye. The mean dose of radioisotope injected was 0.97±0.22 mCi. The average time to label the SLN was 10.7 minutes (±5.7 min). We identified on average of 1.66 SLN labeled with the radioisotope. CONCLUSION: the procedure for SLN identification with an intraoperative injection of the radioisotope is oncologically safe and comfortable for the patient, providing agility to the surgical team.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias da Mama/patologia , Neoplasias da Mama , Dextranos/administração & dosagem , Cuidados Intraoperatórios , Compostos de Organotecnécio/administração & dosagem , Compostos Radiofarmacêuticos/administração & dosagem , Biópsia de Linfonodo Sentinela/métodos , Injeções , Estudos ProspectivosRESUMO
PURPOSE: to determine the efficacy of intraoperative injection of Dextran-500-99m-technetium (Tc) for the identification of the sentinel lymph node (SLN) in breast cancer and analyze time to label the SLN in the axillary region. METHODS: a prospective study between April 2008 and June 2009, which included 74 sentinel lymph node biopsies (SLNB) in patients with breast cancer in stages T1N0 and T2N0. After induction of anesthesia, 0.5 to 1.5 mCi of Dextran-500-99m-Tc filtered 0.22 µm in a volume of 5 mL was injected intraoperative using the subareolar technique for SLNB. After labeling with the radioisotope, 2 mL of patent blue was injected. The time elapsed between injection and the axillary hot spot, the in vivo and ex vivo counts of the hottest nodes, the background count, and the number of SLN identified were documented. Data were analyzed using descriptive statistics with SPSS program, version 18. RESULTS: we identified the SLN in 100% of cases. The rate of SLN identification with the probe was 98% (73/74 cases). In one case (1.35%) the SLN was labeled only with the blue dye. The mean dose of radioisotope injected was 0.97 ± 0.22 mCi. The average time to label the SLN was 10.7 minutes (± 5.7 min). We identified on average of 1.66 SLN labeled with the radioisotope. CONCLUSION: the procedure for SLN identification with an intraoperative injection of the radioisotope is oncologically safe and comfortable for the patient, providing agility to the surgical team.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Dextranos/administração & dosagem , Cuidados Intraoperatórios , Compostos de Organotecnécio/administração & dosagem , Compostos Radiofarmacêuticos/administração & dosagem , Biópsia de Linfonodo Sentinela/métodos , Feminino , Humanos , Injeções , Pessoa de Meia-Idade , Estudos Prospectivos , CintilografiaRESUMO
OBJECTIVES: Sentinel lymph node biopsy (SLNB) has been performed for purposes of disease staging. SLN is usually located in the axillary region and internal mammary chain (IMC). Metastasis in internal mammary nodes can be an important prognostic factor and an indication for systemic treatment in patients with small carcinomas. The SLNB technique continues to evolve and the proper radiopharmaceutical injection route remains under discussion. This study evaluated the success rate of deep injection to identify axillary and extra-axillary SLNs and compared the results with superficial injection technique. METHODS: Forty-six patients diagnosed with breast cancer (stages I and II) were submitted to radiopharmaceutical injection. Deep injection of technetium-99m-dextran 500 was carried out in 20 patients (group A) and periareolar injection of technetium-99m-phytate was carried out in 26 patients (group B). All SLNs were studied by imprint cytology and hematoxylin and eosin staining. RESULTS: SLN identification rate was 76.1% (35 of 46). The SLN identification rate was 75% (15 of 20) for group A and 76.9% (20 of 26) for group B. Axillary SLNs were identified in 65% (13 of 20) of group A and 76.9% (20 of 26) of group B, with no statistical difference (P = 0.75). Extra-axillary SLNs were only identified in group A, and IMC was the principal extra-axillary location. CONCLUSION: Deep injection of radiopharmaceutical achieved a good SLN identification rate in axillary and extra-axillary locations and it is an important method for detecting IMC sentinel nodes.
Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Injeções/métodos , Linfonodos/patologia , Compostos Radiofarmacêuticos/administração & dosagem , Biópsia de Linfonodo Sentinela , Adulto , Idoso , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Dextranos/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Organotecnécio/administração & dosagem , Gravidez , CintilografiaRESUMO
OBJECTIVE AND DESIGN: To investigate the effect of experimental tumor bearing on acute inflammation models in rats. METHODS: Four and 7 days after Walker tumor implantation in the right armpit, carrageenan or dextran- induced edema in the contralateral paw, carrageenan induced neutrophil migration into peritoneal cavities, cutaneous vascular permeability induced by bradykinin, histamine, serotonin, substance P, capsaicin or compound 48/80, and mesenteric mast cell degranulation induced by compound 48/80 were evaluated. The control group did not receive tumor implantation. Statistical analysis was performed using one way analysis of variance (ANOVA) followed by the Bonferroni test. RESULTS: On the 7(th) day after tumor inoculation, there were significant decreases in both carrageenan and dextran- induced paw edema. Tumor bearing did not change the neutrophil infiltration induced by carrageenan. There were decreases in cutaneous vascular permeability induced by compound 48/80, serotonin or bradykinin, but not that induced by histamine, substance P. A significant inhibition of mesenteric mast cell degranulation induced by compound 48/80 was observed, on the 4(th) and 7(th) days after tumor inoculation. CONCLUSION: Tumor bearing can limit mast cell function and vascular events in acute systemic inflammation in rats, without changes in neutrophil migration.
Assuntos
Degranulação Celular/imunologia , Inflamação/imunologia , Mastócitos/imunologia , Neoplasias/metabolismo , Animais , Bradicinina/farmacologia , Permeabilidade Capilar/efeitos dos fármacos , Capsaicina/farmacologia , Carragenina/administração & dosagem , Carragenina/imunologia , Dextranos/administração & dosagem , Dextranos/imunologia , Edema/induzido quimicamente , Histamina/farmacologia , Inflamação/induzido quimicamente , Mastócitos/citologia , Transplante de Neoplasias , Neoplasias/patologia , Ativação de Neutrófilo , Infiltração de Neutrófilos , Ratos , Ratos Wistar , Serotonina/farmacologia , Substância P/farmacologia , p-Metoxi-N-metilfenetilamina/farmacologiaRESUMO
Systemic administration of the low-potassium dextran solution on the peripheral oxidative stress was evaluated in an animal model of lung ischemia-reperfusion in rats. In one experiment, male Wistar rats were divided into two groups (n=5): one received intravenous saline, whereas in the other the animals were given intravenous low potassium dextran solution. In another experiment, male Wistar rats were divided into four groups (n=5): control, ischemia, saline and low potassium dextran. Except for the control animals, all groups were submitted to left hilar clamping for 30 min, followed by reperfusion for 30 min. Saline or low potassium dextran was administered intravenously immediately before clamp removal. In the first experiment there were no significant differences in lipid peroxidation. Total radical trapping potential measurements showed a significant increase in animals receiving low potassium dextran; in the second experiment, there was an increase in lipid peroxidation in both saline and ischemia groups compared to controls, and low potassium dextran. Low potassium dextran group showed an increase in total radical trapping potential measurements compared to all other groups. Ischemia-reperfusion injury mediated by reactive oxygen species was attenuated by the systemic use of low potassium dextran in this animal model of ischemia-reperfusion of the lung.
Assuntos
Sequestradores de Radicais Livres/administração & dosagem , Isquemia/tratamento farmacológico , Pulmão/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Traumatismo por Reperfusão/prevenção & controle , Animais , Dextranos/administração & dosagem , Modelos Animais de Doenças , Glucose/administração & dosagem , Injeções Intravenosas , Isquemia/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Pulmão/irrigação sanguínea , Pulmão/metabolismo , Masculino , Ratos , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , Traumatismo por Reperfusão/metabolismo , Fatores de TempoRESUMO
Hyperosmotic-hyperoncotic solutions have been widely used during prehospital care of trauma patients and have shown positive hemodynamic effects. Recently, there has been a growing interest in intra-operative use of hypertonic solutions. We reviewed 30 clinical studies on the use of hypertonic saline solutions during surgeries, with the majority being cardiac surgeries. Reduced positive fluid balance, increased cardiac index, and decreased systemic vascular resistance were the main beneficial effects of using hypertonic solutions in this population. Well-designed clinical trials are highly needed, particularly in aortic aneurysm repair surgeries, where hypertonic solutions have shown many beneficial effects. Examining the immunomodulatory effects of hypertonic solutions should also be a priority in future studies.
Assuntos
Dextranos/administração & dosagem , Hemodinâmica/efeitos dos fármacos , Derivados de Hidroxietil Amido/administração & dosagem , Substitutos do Plasma/administração & dosagem , Solução Salina Hipertônica/administração & dosagem , Procedimentos Cirúrgicos Operatórios , Quimioterapia Combinada , Humanos , Assistência Perioperatória , Equilíbrio HidroeletrolíticoRESUMO
We reported the physical chemical characterization of a new series of native dextran (B110-1-2). The chemical structure of the polymer was characterized by IR, (1)H and (13)C NMR spectroscopy and compared with that of a commercial native dextran B512-F obtained from Sigma Company. Molecular weights of the product and different commercial dextran fractions of Leuconostoc mesenteroides from 43000 to 170000 average molecular weight (M(w)) were established by the analysis of intrinsic viscosity in aqueous solutions and compared with those obtained by gel permeation chromatography (GPC). The critical overlap concentration around 9g/L was obtained. No interactions of powder mixtures with different commercial excipients (lactose, cetyl alcohol, HPMC) and drugs (propranolol hydrochloride, acetyl salicyclic acid, isosorbide dinitrate, lobenzarit disodium, and nifedipine) were demonstrated by differential scanning calorimetry (DSC) analysis. Tablets obtained by direct compression showed good physical-mechanical and technological properties. Dextran B110-1-2 has similar physical chemical properties as commercial Sigma B512-F. Water uptake, erosion and dissolution profile studies for dextran tablets established that glucose polymer with molecular weight M(w) > or = 2x10(6) is suitable for the development of controlled release solid dosage forms (soluble drugs). Fraction of dextran (M(w) 40000-170000) could be more useful for immediate release tablets.
Assuntos
Dextranos/administração & dosagem , Excipientes , Preparações Farmacêuticas , Saccharum/química , Comprimidos , Espectroscopia de Ressonância Magnética , Espectrofotometria Infravermelho , ViscosidadeRESUMO
Hyperosmotic-hyperoncotic solutions have been widely used during prehospital care of trauma patients and have shown positive hemodynamic effects. Recently, there has been a growing interest in intra-operative use of hypertonic solutions. We reviewed 30 clinical studies on the use of hypertonic saline solutions during surgeries, with the majority being cardiac surgeries. Reduced positive fluid balance, increased cardiac index, and decreased systemic vascular resistance were the main beneficial effects of using hypertonic solutions in this population. Well-designed clinical trials are highly needed, particularly in aortic aneurysm repair surgeries, where hypertonic solutions have shown many beneficial effects. Examining the immunomodulatory effects of hypertonic solutions should also be a priority in future studies.
Assuntos
Humanos , Dextranos/administração & dosagem , Hemodinâmica/efeitos dos fármacos , Derivados de Hidroxietil Amido/administração & dosagem , Substitutos do Plasma/administração & dosagem , Procedimentos Cirúrgicos Operatórios , Solução Salina Hipertônica/administração & dosagem , Quimioterapia Combinada , Assistência Perioperatória , Equilíbrio HidroeletrolíticoRESUMO
The objective of the present investigation was to compare the effect of isovolemic hemodilution with 3% albumin, dextran-40, and enoxaparin on the prevention of thrombosis in femoral vein microanastomosis using an experimental model in rats. Forty male Wistar rats were allocated into four groups: group 1, control, thrombogenic model without previous treatment; group 2, hemodiluted, thrombogenic model with previous hemodilution; group 3, dextran-40, thrombogenic model with dextran infusion (10 ml/kg), and group 4, enoxaparin, thrombogenic model with administration of enoxaparin (0.5 mg/kg/day). Hemostatic parameters, hematologic examinations, patency of anastomosis, and histopathological examination were evaluated. The hemostatic parameters were similar in the four groups studied. Group hemodiluted, dextran-40, and enoxaparin showed significantly reduced number of red blood cells and platelets as compared with the control group. The hemodilution significantly increased the patency rates of the vein at 20 min and 48 h. Dextran-40 and enoxaparin improved the patency of the vein only at 20 min, but failed to show a significant increase in the final patency at 48 h. After 48 h, the rate of venous thrombosis, as evaluated microscopically, was significantly decreased in hemodiluted animals (1/8) as compared with controls (10/10); in rats treated with dextran-40 (7/10) and enoxaparin (5/10) the rate of venous thrombosis was significantly higher as compared with rats of the group hemodiluted. Based on these observations, it can be concluded that hemodilution with albumin 3% was a safe and more adequate procedure than the use of the schemes of administration of dextran-40 and enoxaparin used in this study to prevent thrombus formation at femoral vein microanastomosis in rats. Since hemodilution promotes reduction in blood viscosity and in erythrocyte and platelet aggregation as well as dilution of the coagulation factors themselves, its use could provide better microcirculatory blood perfusion, decreasing the risk of thrombosis, and making possible safer microsurgical procedures.
Assuntos
Dextranos/uso terapêutico , Enoxaparina/uso terapêutico , Veia Femoral/cirurgia , Hemodiluição/métodos , Complicações Pós-Operatórias/prevenção & controle , Soroalbumina Bovina/uso terapêutico , Trombose Venosa/prevenção & controle , Anastomose Cirúrgica/efeitos adversos , Animais , Dextranos/administração & dosagem , Modelos Animais de Doenças , Quimioterapia Combinada , Enoxaparina/administração & dosagem , Fibrinolíticos/administração & dosagem , Fibrinolíticos/uso terapêutico , Infusões Intravenosas , Masculino , Microcirurgia/efeitos adversos , Microcirurgia/métodos , Substitutos do Plasma/administração & dosagem , Substitutos do Plasma/uso terapêutico , Ratos , Ratos Wistar , Soroalbumina Bovina/administração & dosagem , Resultado do Tratamento , Trombose Venosa/etiologiaRESUMO
1. The lateral hypothalamus (LH) and the dorsal periaqueductal gray area (dPAG) are two important brain structures involved in central cardiovascular control. 2. In the present study, we searched for possible rostrocaudal somatotopy in the neural connections from the three subdivisions of the LH (anterior-LHa; tuberal-LHt and posterior-LHp) to the different rostrocaudal portions of the dPAG. 3. The bidirectional neuronal tracer biotinylated-dextran-amine (BDA) was microinjected into different rostrocaudal coordinates of the dPAG (AP 3.4-2.7 mm) of male Wistar rats. One week later, animals were sacrificed and brain slices were processed and analyzed to detect neuronal efferent projections from the LH to the dPAG. 4. Neuronal cell body staining was observed along all the rostrocaudal axis of the LH when BDA was microinjected in more rostral dPAG coordinates. When the BDA was microinjected into more caudal dPAG regions, labeled neurons were observed only in the caudal portion of the LH. 5. Efferent projections from the LHa were directed only to the rostral portion of the dPAG. Projections from the rostral and medial portions of the LHt were also directed to the rostral dPAG, whereas both rostral and caudal dPAG received projections from the caudal portion of the LHt. Efferent projections from the anterior portion of the LHp were directed to both rostral and caudal dPAG, whereas projections from the caudal LHp were only directed to the rostral portion of the dPAG.6. The results suggest a somatotopic correlation in LH projections to the dPAG with main connections to the rostral dPAG, which are efferent from the three divisions of the LH. More caudal regions of the dPAG received afferents only from posterior sites in the LH. 7. Moreover, the results point out to extensive and complex neural somatotopic projections from all LH subdivisions to different rostrocaudal portions of the dPAG, reinforcing the idea of significant functional interactions between the brain structures.
Assuntos
Mapeamento Encefálico , Hipotálamo/anatomia & histologia , Substância Cinzenta Periaquedutal/anatomia & histologia , Vias Aferentes/anatomia & histologia , Animais , Biotina/administração & dosagem , Biotina/análogos & derivados , Dextranos/administração & dosagem , Vias Eferentes/anatomia & histologia , Masculino , Microinjeções , Modelos Biológicos , Vias Neurais/anatomia & histologia , Ratos , Ratos WistarRESUMO
PURPOSE: To study which of the two most used radiopharmaceutical drugs for the sentinel lymph node (SLN) biopsy procedure (dextran 500 99mTc and phytate 99mTc) best defines the SLN and migrates less to other lymph nodes. MATERIAL AND METHODS: Thirty-two rats, separated into two groups, underwent lymphoscintigraphy examination with either dextran or phytate followed by sentinel (popliteal), lumbar, and inguinal lymph node biopsy. Radiation was detected with a gamma probe. RESULTS: The statistical study indicated count rates significantly higher in the SLN than in the other basins for both the dextran (P<0.01) and phytate groups (P<0.001). There was no statistically significant difference concerning SLN absorption in either group (P=0.2981). In the dextran group, migration occurred to 1.5 lymphatic basins with counting higher than 10% of that found in the SLN versus 0.8 in the phytate group (P=0.0023). Migration was thus higher in the dextran group (P=0.0207). CONCLUSION: There was no statistically significant difference between dextran and phytate in the SLN identification, but the phytate migrated to fewer lymphatic basins beyond the SLN and with less intensity.