1
|
Age-Related Progression of Microvascular Dysfunction in Cystic Fibrosis: New Detection Ways and Clinical Outcomes. Physiol Res 2021. [DOI: 10.33549//physiolres.934743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
There are concerns about altered vascular functions that could play an important role in the pathogenesis and influence the severity of chronic disease, however, increased cardiovascular risk in paediatric cystic fibrosis (CF) has not been yet fully understood. Aim was to analyse vascular disease risk and investigate changes over times in CF and controls. We prospectively enrolled 22 CF subjects (a median age of 16.07 years), and 22 healthy demographically matched controls (a median age of 17.28 years) and determined endothelial function. We utilised a combined diagnostic approach by measuring the plethysmographic Reactive Hyperemia Index (RHI) as the post-to preocclusive endothelium-dependent changes of vascular tone, and biomarkers that are known to be related to endothelial dysfunction (ED): asymmetric dimethyl arginine (ADMA), high-sensitive CRP (hsCRP), VCAM-1 and E-selectin. RHI values were significantly lower in CF young adults (p<0.005). HsCRP (p<0.005), E-selectin (p<0.001) and VCAM-1 (p<0.001) were significantly increased in CF patients since childhood. The findings have provided a detailed account of the ongoing process of microvascular dysfunction with gradual progression with the age of CF patients, making them further at risk of advanced vascular disease. Elevations of biomarkers in CF children with not yet demonstrated RHI changes but with significantly reduced RHI in adulthood and lipid profile changes indicate the possible occurrence of ED with CF-related specific risk factors over time and will enable us to provide the best possible support.
Collapse
|
2
|
Age-Related Progression of Microvascular Dysfunction in Cystic Fibrosis: New Detection Ways and Clinical Outcomes. Physiol Res 2021; 70:893-903. [PMID: 34717066 DOI: 10.33549/physiolres.934743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
There are concerns about altered vascular functions that could play an important role in the pathogenesis and influence the severity of chronic disease, however, increased cardiovascular risk in paediatric cystic fibrosis (CF) has not been yet fully understood. Aim was to analyse vascular disease risk and investigate changes over times in CF and controls. We prospectively enrolled 22 CF subjects (a median age of 16.07 years), and 22 healthy demographically matched controls (a median age of 17.28 years) and determined endothelial function. We utilised a combined diagnostic approach by measuring the plethysmographic Reactive Hyperemia Index (RHI) as the post-to preocclusive endothelium-dependent changes of vascular tone, and biomarkers that are known to be related to endothelial dysfunction (ED): asymmetric dimethyl arginine (ADMA), high-sensitive CRP (hsCRP), VCAM-1 and E-selectin. RHI values were significantly lower in CF young adults (p<0.005). HsCRP (p<0.005), E-selectin (p<0.001) and VCAM-1 (p<0.001) were significantly increased in CF patients since childhood. The findings have provided a detailed account of the ongoing process of microvascular dysfunction with gradual progression with the age of CF patients, making them further at risk of advanced vascular disease. Elevations of biomarkers in CF children with not yet demonstrated RHI changes but with significantly reduced RHI in adulthood and lipid profile changes indicate the possible occurrence of ED with CF-related specific risk factors over time and will enable us to provide the best possible support.
Collapse
|
3
|
Reduction of renal function during mechanical ventilation of healthy lungs in an animal biomodel. ACTA ACUST UNITED AC 2015; 116:25-9. [PMID: 25666958 DOI: 10.4149/bll_2015_005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To identify factors involved in reno-pulmonary interactions during mechanical ventilation. MATERIALS AND METHODS The study included a total of 25 domestic piglets. The animals were divided into three groups based on different strategies of ventilation. Group A; spontaneously breathing piglets; group B animals ventilated with tidal volume of 6 ml.kg-1 and group C with animals ventilated with tidal volume 10 ml.kg-1. Clinical monitoring and laboratory tests were performed for all groups at baseline and then at 1 hour and 12 hours for groups B and C. Ventilation indices, hemodynamics, urine output, creatinine clearance, glomerular filtration index, fractional excretion of sodium, free water clearance and tissue samples were recorded. The data obtained were statistically analysed. RESULTS Lower creatinine clearance and renal indices were seen in group B (p < 0.05) and in group C (p < 0.001) at 1 hour, and a difference in urine output for group C (p < 0.01) compared to group A was observed. At 12 hours, there was a further reduction in creatinine clearance and renal indices for group B (p < 0.05) and group C (p < 0.01). The lung mechanics and hemodynamics were not significantly influenced. CONCLUSIONS The study showed a causal relationship between renal dysfunction and positive pressure mechanical ventilation with respect to tidal volume and time (Tab. 4, Fig. 2, Ref. 17).
Collapse
|
4
|
Focal histopathological progression of porcine experimental abdominal aortic aneurysm is mitigated by atorvastatin. INT ANGIOL 2013; 32:291-306. [PMID: 23711681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM Observational studies in human patients and animal experiments suggested that statins have a potential in slowing the growth of small abdominal aortic aneurysms (AAA). Our aim was to quantify histological postoperative changes of AAA in porcine experimental model of AAA with and without administration of atorvastatin. METHODS The AAA was induced by intraaortic infusion of porcine pancreatic elastase and subrenal application of plastic cuff. The AAA statin group (N.=14) received atorvastatin 1 mg/kg daily for 28 days, the other AAA group (N.=13) did not. The aortic diameter was measured by ultrasonography. Aortic samples were described using eleven quantitative histological parameters and compared with healthy aortae. RESULTS There was no difference in aortic diameter between the AAA with statin when compared to AAA without statin. Administration of atorvastatin led to a better postoperative histological condition of the aortic elastin network, preservation of contractile phenotype of vascular smooth muscle, a higher density of vasa vasorum, it prevented thickening of intima and media. The increase in wall thickness in AAA without atorvastatin has not been accompanied by a proportional increase in number of vasa vasorum. CONCLUSION The effects of atorvastatin seem to prevent the histopathological progression of AAA.
Collapse
|
5
|
[Pharmacological influencing of abdominal aortic aneurysm model - animal experimental study, primary results]. ROZHLEDY V CHIRURGII : MESICNIK CESKOSLOVENSKE CHIRURGICKE SPOLECNOSTI 2012; 91:475-480. [PMID: 23152990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The aim of our work was to influence growth and histological changes in the wall of an experimentally induced aneurysm of the abdominal aorta in a large laboratory animal (domestic pig) by administering atorvastatin (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor). MATERIAL AND METHODS Within the scope of the above mentioned experimental work, we compared the growth rate of the aneurysm between the group influenced by statin administration (n=14) and the group without any pharmacological treatment (n=13). We also compared histological changes in the structure of the aortic wall in both groups with aneurysm and the wall of the aorta without aneurysm (n=6). RESULTS During the 4-week follow-up, we did not prove a statistically significant difference in the growth rate of aneurysms between the above mentioned groups. The histological structure of the aneurysm walls, however, differed between the two groups. The structure of the wall in the group of animals influenced by statin administration resembled the structure of the aortic wall without aneurysm. CONCLUSION The results presented demonstrate that statins do influence the composition of the aortic wall. In our opinion, the administration of statins could lead to changes resulting in a more stable aneurysmatic wall. We believe that patients with smaller aneurysms who are not indicated for surgery or endovascular treatment could be treated with statins. Stabilization of the aneurysmal wall could slow down the growth of the aneurysm and prevent its rupture.
Collapse
|
6
|
Different cardiac loading conditions and haemodynamic monitoring in animal models. BRATISL MED J 2012; 113:131-4. [PMID: 22428759 DOI: 10.4149/bll_2012_032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To develop models of various cardiac loading conditions in an experimental study. MATERIALS AND METHODS A total of 78 piglets, average weight 24 kg were divided into 4 groups under different cardiac loading conditions: Group A were spontaneously breathing pigs without haemodynamic changes, Group B were ventilated animals with increased left ventricular afterload, Group C ventilated with increased right ventricular preload and Group D ventilated with increased afterload of both heart ventricles. Haemodynamic parameters were invasively measured at 60 and 120 minutes. RESULTS Groups B, C and D demonstrated higher preload of both ventricles, compared with Group A. Group C demonstrated higher preload and afterload of both ventricles in comparison with Groups B and D. CONCLUSION Haemodynamic measured data confirmed the expected changes in cardiac loading and corresponded to human clinical situations. These models may be used for future experimental haemodynamic studies (Tab. 1, Fig. 3, Ref. 8).
Collapse
|
7
|
Abstract
The aims of our study were to evaluate plasma levels of gut hormones in children with Type 1 diabetes mellitus (T1DM) in comparison with healthy controls and to correlate plasma concentrations of gut hormones with blood biochemistry, markers of metabolic control and with anthropometric parameters. We measured postprandial levels of specific gut peptide hormones in T1DM children. Amylin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1), ghrelin, leptin, pancreatic polypeptide (PP), and polypeptide YY (PYY) were assessed in 19 T1DM children and 21 healthy reference controls. Multiplex assay kit (LINCOplex(®)) was used for determination of the defined plasma hormone levels. T1DM subjects had significantly reduced amylin (p<0.001) and ghrelin (p<0.05) levels, whereas GIP (p<0.05) was elevated when compared with healthy controls. Plasma levels of other measured hormones did not differ statistically between the studied groups. Further analysis of T1DM patients demonstrated an association between body mass index and GLP-1 (r=0.4642; p<0.05), leptin (r=0.5151; p<0.05), and amylin (r=0.5193; p<0.05). Ghrelin levels positively correlated with serum HDL cholesterol (r=0.4760; p<0.05). An inverse correlation was demonstrated with triglycerides (TG) (r= -0.5674; p<0.01), insulin dosage (r= -0.5366; p<0.05), and HbA1c% (r= -0.6864; p<0.01). Leptin was inversely correlated with TG (r= -0.6351; p<0.01). Stepwise regression analysis was performed to enlighten the predictive variables. Our study demonstrated an altered secretion pattern of gut peptide hormones in T1DM children. A close correlation was revealed between these peptides as well as with blood biochemistry, markers of metabolic control and with anthropometric parameters. Further studies are essential to explore this issue in T1DM children.
Collapse
|
8
|
Signaling molecules for early detection of adverse interactions during mechanical ventilation in animal models. In Vivo 2011; 25:209-217. [PMID: 21471537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The early identification of adverse interactions during mechanical ventilation, investigated by multiplexed immunoanalysis. MATERIALS AND METHODS Twenty piglets (average age 7 weeks, weight 23 kg) were intubated and divided into groups: A, spontaneously breathing; B, protectively ventilated; C, ventilated with injurious strategy; D, ventilated with lung disability. At the 1st hour (time-1) and 12th hour (time-2) of the study, brain natriuretic peptide (BNP), intercellular cell adhesion molecules (ICAM-1), vascular cell adhesion molecules (VCAM-1), tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (Il-6) were analyzed in the blood. RESULTS The injurious ventilated group C exhibited an increase in both cell adhesion molecules (p<0.01), TNF-alpha and BNP (p<0.05) at time-1, and at time-2 further increases (p<0.05). In group D, an increase in ICAM-1 and BNP (p<0.05) at time-1, and increases in Il-6 and ICAM-1 (p<0.05) at time-2, with notable decreases in urine output were observed. Overall, the lung damage correlated with TNF-alpha (r=0.904), Il-6 (r=0.740), and ICAM-1 (r=0.756) levels. CONCLUSION All five monitored molecules quickly and reliably signaled adverse interactions.
Collapse
|
9
|
Induced therapeutic hypothermia following cardiac arrest in children. BRATISL MED J 2011; 112:92-96. [PMID: 21456509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Evidence-based medicine currently dictates that in children, the controlled hypothermia may be applied only to the first degree and only in cases of neonatal encephalopathy and acute brain injury. Current recommendations are limited in terms of indication as well as by their very low degree of relevance (47.1%). DATA SOURCE The conclusions of published clinical and experimental studies, and ultimately the ongoing study of our clinical work. In our study, we monitored the core body temperature, brain bioelectrical potentials and infarction, heart rate, systemic venous and arterial pressure, cardiac output, hourly diuresis, and haemostasis parameters. STUDY SELECTION Distinct designs of clinical and experimental studies make it difficult to compare their outputs. DATA SYNTHESIS The aim of this article is to expand our current knowledge of resuscitation care in children as well as that of the use of therapeutic hypothermia. The introduction of this method into routine pediatric clinical practice is hindered by lack of an explicitly defined therapeutic protocol. CONCLUSION The method of therapeutic hypothermia is not a predictor of survival but its proper implementation can be the key to the recovery of functions of body organs and systems after successful cardiopulmonary resuscitation. Unfortunately, this method is associated with adverse effects, namely with myocardial depression during the induction phase, and life-threatening complications after bringing the core of body to normal temperature. To increase the patient safety we have developed a safe strategy. Our protocol provides a relatively rapid induction, short interval of active cooling and passive rewarming over a long period of time (Tab. 3, Fig. 1, Ref. 34). Full Text in free PDF www.bmj.sk.
Collapse
|
10
|
P8.05 REACTIVE HYPEREMIA INDEX AND DETECTION OF ENDOTHELIAL DYSFUNCTION IN PAEDIATRIC HEMATO/ONCOLOGY PATIENTS. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
11
|
Diffuse alveolar damage due to inappropriate strategy of mechanical ventilation in an experimental porcine model. In Vivo 2010; 24:699-704. [PMID: 20952736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The aim of the study was to determine how tidal volumes may affect the lung and haemodynamics during mechanical ventilation. MATERIALS AND METHODS With the approval of the Ethics Committee, the study included a total of 24 healthy piglets, average weight 30 kg (range 28-33 kg). The animals were ventilated for 90 minutes under general anaesthesia with two different tidal volume strategies and allocated into three groups. Group A, animals were healthy controls, Group B, animals comprised 8 piglets with an abdominal aortic aneurysm and ventilated with a low tidal volume strategy (VT(exp) 7 ml/kg). Group C comprised 8 animals seven days after kidney transplantation, ventilated with a high tidal volume strategy (VT(exp) 12 ml/kg). Changes in lung mechanics and hemodynamics were assessed at 30th and 90th minutes. Lung tissue samples were examined histologically. RESULTS Protective ventilation in Group A and B did not confer any haemodynamic and lung mechanic differences. Significant differences were only found in Group C at 90 minutes for increased preload of both heart ventricles (CVP; t-test 4.07, p<0.01 and PAoP; t-test 8.43, p<0.01), pulmonary vascular resistance (t-test 3.11, p<0.05), and decreased expiratory tidal volume (t-test 6.07, p<0.01), dynamic lung compliance (t-test 3.83, p<0.01) and cardiac output (t-test 2.07, p<0.01). Diffuse alveolar damage was detected histologically. CONCLUSION Mechanical ventilation at high tidal volumes reaching 12 ml/kg caused functional changes in the lungs, diffuse alveolar damage and reduction of cardiac output within 90 minutes.
Collapse
|
12
|
P5.05 REACTIVE HYPEREMIA INDEX AND DETECTION OF ENDOTHELIAL DYSFUNCTION IN CHILDREN. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
13
|
Total body response to mechanical ventilation of healthy lungs: an experimental study in piglets. Physiol Res 2009; 59:545-552. [PMID: 19929141 DOI: 10.33549/physiolres.931752] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The objective of our study was to assess the influence of mechanical ventilation on healthy body organs. Fifteen piglets (aged 6 weeks, 19-27 kg) were anesthetized, instrumented, and divided into three groups: Group A - spontaneously breathing, group B - mechanically ventilated with tidal volume 6 ml/kg, and group C - ventilated with tidal volume 10 ml/kg for 12 hours. The parameters of lung, heart, liver and kidney functions neurohumoral regulation and systemic inflammatory reaction were recorded initially (time-1) and after 12 hours (time-12) of mechanical ventilation. At the onset of experiment (time-1) the levels of soluble adhesive molecules were higher (CAM; P<0.01), glomerular filtration index and free water clearance were lower (P<0.05) in both ventilated groups than in group A. Right ventricle myocardial performance index was higher (RIMP; P<0.05) in group C when compared with group A. Levels of CAM (P<0.05) and creatinine clearance (P<0.01) were higher, free water clearance was lower (P<0.05) in group C when compared to group B. At time-12 the RIMP (P<0.05) and levels of CAM were increased (P<0.01), creatinine clearance was decreased (P<0.05) in both ventilated groups compared to the same parameter at time-1. Ventilation index was higher (P<0.05), and hypoxemic index was lower (P<0.01) in group C when compared to group B. In conclusion, this study showed that mechanical ventilation induced changes compatible with early inflammatory response in healthy animals. Higher tidal volumes had detrimental effect on ventilatory parameters, reduced myocardial performance and potentiated adverse reaction of other organs.
Collapse
|
14
|
[Ischemia-reperfusion injury in kidney transplantation from non-heart beating donor--do antioxidants or antiinflammatory drugs play any role?]. ROZHLEDY V CHIRURGII : MESICNIK CESKOSLOVENSKE CHIRURGICKE SPOLECNOSTI 2009; 88:65-68. [PMID: 19413262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Ischemia reperfusion injury (IRI) represents a serious problem of transplanted kidneys from a non-heart-beating donor (NHBD). It is probably the main cause of primary a function or delayed graft function. The aim of the experimental study was to demonstrate on an experimental model the possibilities of reduction of IRI by intravenous application of antioxidants or immunosuppressives to the recipient before the kidney transplantation. METHOD Piglets weighing between 20-25 kg were used (N = 45) for the experiment. Intravenous application of multivitamins (GI) and a combination of immunosuppressives (GII) was tested one hour before the kidney transplantation from the NHBD. As a control a group (GIII) with simple NHBD modelling was used. At intervals of 0, 20, 60 and 120 minutes after the kidney transplantation, plasma levels of malondiadehyde (MDA) and reduced glutathione (GSH) were assessed. Before and 120 minutes after transplantation tissue concentrations of both factors were assessed in the transplanted kidney. RESULTS A permanent increase in MDA plasma concentrations occurred in GIII. In GI and GII, after a temporary increase of MDA plasma levels in the first 20 minutes after reperfusion, there was their permanent decrease then. (p < 0.05, resp. p < 0.01). The differences in the MDA plasma levels of GI and GII groups did not reach statistical significance. The both groups differed from GIII (p < 0.001). GSH plasma levels and also tissue concentrations of MDA and GSH were not statistically significant in any group in the course of the experiment. CONCLUSION Intravenous application of multivitamins or immunosuppressives before kidney transplantation could have a significant influence on the immediate function of transplanted kidneys from a NHBD.
Collapse
|
15
|
Ischemia-reperfusion injury in kidney transplantation from non-heart-beating donor--do antioxidants or antiinflammatory drugs play any role? BRATISL MED J 2009; 110:133-136. [PMID: 19507631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Ischemia reperfusion injury (IRI) is a serious problem of transplanted kidneys from a non-heart-beating donor (NHBD). IRI is probably the main cause of primary disfunction or delayed graft function. The aim of this study was to demonstrate the reduction of IRI by intravenous application of antioxidants or immunosuppressives to the recipient before the kidney transplantation in an experimental model. METHOD Piglets weighing between 20-25 kg were used (n=45) for the experiment. Intravenous application of multivitamins (GI) and a combination of immunosuppressives (GII) was tested one hour before the kidney transplantation from the NHBD. In control group (GIII) simple NHBD modelling was used. Plasma levels of malondiadehyde (MDA) and reduced glutathione (GSH) were assessed at intervals of 0, 20, 60 and 120 minutes after the kidney transplantation. Concentrations of both MDA and GSH were also assessed in the transplanted kidney before and 120 minutes after transplantation. RESULTS A permanent increase in MDA plasma concentrations occurred in GIII. In GI and GII, after a transient increase in MDA plasma levels within the first 20 minutes after reperfusion, it decreased permanently (p<0.05, p<0.01). MDA plasma levels were not significantly different between GI and GII groups, but both groups differed from GIII (p<0.001). GSH plasma levels and tissue concentrations of MDA and GSH were not statistically significant in any group in the course of the experiment. CONCLUSION Intravenous application of multivitamins or immunosuppressives before kidney transplantation could have a significant influence on the immediate function of transplanted kidneys from a NHBD (Tab. 3, Fig. 1, Ref. 13). Full Text (Free, PDF) www.bmj.sk.
Collapse
|
16
|
Cytokines and liver regeneration after partial portal vein ligation in porcine experimental model. BRATISL MED J 2009; 110:447-453. [PMID: 19750979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
THE AIM OF STUDY The limits of liver surgery are restricted today by the functional reserves of remnant parenchyma. The aim of this article was to acquaint the general surgical and medical public with the results of experimental liver regeneration stimulated by cytokines and thus to enhance their effort to carry on with implementing the research results in clinical practice. METHODS Authors present their experimental model of liver regeneration after ligation of portal branches for caudate and right lateral, and right medial liver lobes. The regeneration was induced by application of TNF-alpha and IL-6 into the non-occluded portal branches, and compared with the results of other experimental teams. RESULTS AND CONCLUSION The absolute volume of hypertrophic lobes increases after application of TNF-alpha more rapidly, whereas in the control group, practically no changes were recorded in hypertrophic liver lobes volumes in first three days. The achieved acceleration of growth of hypertrophic liver lobes after application of TNF-alpha and IL-6 confirmed the key role of studied pleiotropic cytokines in the priming of liver parenchyma regeneration after portal vein ligation (Fig. 3, Ref. 26).
Collapse
|
17
|
Adverse effects of the high tidal volume during mechanical ventilation of normal lung in pigs. BRATISL MED J 2008; 109:45-51. [PMID: 18457308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The "open lung concept" theory of mechanical ventilation is correct, but an unsuitable setting of the machine is not appropriate in children. TYPE OF STUDY This experimental study is a comparative, closed, randomized, double-blind study. The aim of the study was to verify the hypothesis that even a short-term high tidal volume during the course of mechanical ventilation damages the lung parenchyma as well as extra-pulmonary organs. MATERIAL AND METHODS The inappropriate strategy of mechanical lung ventilation was simulated on an animal model. The study was performed on 30 healthy white domestic piglets (25 kg). Using a random selection, the piglets with healthy lungs were ventilated for 120 minutes under general anaesthesia with two different strategies of mechanical ventilation, i.e. 15 animals achieving alveolar hyperinflation with a high tidal volume (14 ml.kg(-1)), and 15 animals according to the "lung protective strategy" principle. Lung tissue samples were examined morphologically using the blind test method, and the proinflammatory cytokines levels were assessed in the piglets' serum. RESULTS The study demonstrated that a high tidal volume during mechanical lung ventilation with permanent positive pressure after 120 minutes induced very important morphological and functional lung changes that unfavourably influenced blood circulation, reduced cardiac output and induced a systemic inflammatory reaction (Fig. 9, Ref. 11).
Collapse
|
18
|
Does the administration of antioxidants as scavengers of reactive oxygen species in kidney transplantation really have sense? BRATISL MED J 2007; 108:385-387. [PMID: 18225474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND The aim of the study was to evaluate the degree of ischemia reperfusion syndrome (IRS) in serious ischemic insult of a kidney transplant and to try to mitigate the production of reactive oxygen substances (ROS) and inflammatory response. METHODS The study was performed on 14 white pigs (20 kg). The pigs were divided in couples using a negative cross-matching and the couples were divided into the two groups. Each animal from the compatible couple was a donor/recipient of a kidney to/from the counterpart. Group II (TxII) received the intravenous antioxidants. Group I (TxI) was a control group. L-ascorbic acid 125 mg, selenium 4.4 mg, tocoferol 50 mg and N-acetyl-cysteine 200 mg were used as the antioxidants. They were applied intravenously to the TxII animals for 20 minutes before reperfusion of a kidney transplant. A serious ischemic insult was created by the left kidney hilum's cross-clamping for 30 min before donation. After the kidneys' removal, the left ones were flushed with Histidine Tryptophan Ketoglutarate (HTK) preservation solution and transplanted after the 1.5 hour (in the meantime stored in melted ice). Venous blood samples were taken for the assessment of malondialdehyde (MDA), reduced glutathione (GSH), glutathioneperoxidase (GSHPx), antioxidative capacity of plasma (AOC), interleukin 6 (IL-6), and tumor-necrosis factor alfa (TNFalfa) prior to the nefrectomy, before application of ROS scavengers (TxII), and during the 120-minute period after the transplantation (TxL+TxII). RESULTS There wasn't a significant difference neither in production of MDA, nor in the levels of GSH, GSHPx, AOC, IL6 and TNFalfa between the TxI and TxII groups. CONCLUSIONS Based on our results, we cannot conclude that the intravenous application of ROS scavengers in given combination and amount, administered to the recipient in the period just before transplantation, is a useful protective mechanism against kidney damage during IRS (Fig. 3, Ref. 17). Full Text (Free, PDF) www.bmj.sk.
Collapse
|
19
|
Immunosuppresive agents have an influence on ischemia-reperfusion injury in kidneys procured from a non-heart-beating donor: experimental study. Transplant Proc 2005; 36:2931-4. [PMID: 15686663 DOI: 10.1016/j.transproceed.2004.10.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ischemic-reperfusion injury (IRI) has a considerable influence on the function of kidneys from non-heart-beating donors (NHBD) after transplantation. IRI is accompanied by a marked inflammatory reaction with the production of reactive oxygen species and of the proinflammatory cytokine tumor necrosis factor alpha. The effect on the development of ischemic-reperfusion injury of early treatment of the donor with mycophenolate mofetil and tacrolimus was monitored in an animal model of a NHBD. The study demonstrated that the combination of the two immunosuppressives reduced the production in the NHBD kidney of tumor necrosis factor alpha, an indicator of the degree of inflammatory reaction after reperfusion, to a considerable extent but not of malondialdehyde or reduced glutathione. Pre-treatment of marginal donors with these immunosuppressants may improve the immediate function of transplanted kidneys by reducing cytokine production.
Collapse
|
20
|
[Mechanical ventilation on paediatric intensive care units in Czech Republic]. Anasthesiol Intensivmed Notfallmed Schmerzther 2005; 40:173-8. [PMID: 15770561 DOI: 10.1055/s-2005-861039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate the incidence of mechanically ventilated children in participating units, to find out the demographic data of the patients, to evaluate ventilator settings and to assess the mortality of ventilated children. DESIGN Prospective observational multicenter study between 1. 2. 2002 and 30. 4. 2002. SETTING Seven paediatric intensive care units in tertiary hospitals in the Czech Republic. PATIENTS All children between 1 month and 18 years admitted to the participating paediatric intensive care units who required intubation and mechanical ventilation were enrolled. METHOD Following parameters were recorded in all patients: demographic data (age, weight, gender), the origin of the admitting diagnosis, severity of illness (Pediatric Risk of Mortality Score - PRISM, Multiorgan System Failure - MOSF, Lung Injury Score - LIS), the origin of respiratory failure, presence of chronic disease and immunosuppression, length of ventilation, length of stay, ventilator setting, the use of unconventional ventilation, outcome (mortality), blood gas analyses and indices (alveoloarterial oxygen difference - AaDO (2), oxygenation index - OI, hypoxemia score - PaO (2)/FiO (2) and ventilation index - VI), deadspace to tidal volume ratio-Vd/Vt and dynamic respiratory system compliance (Cdyn). RESULTS One hundred and forty four children (42 % girls) were enrolled in total which represent 23 % of all admitted children. The mean age of the patients was 70 months and mean weight was 23 kg. PRISM score and the length of stay were twofold against mean values (11.7 vs. 5.7 and 10.4 vs. 4.8 days respectively). The mean length of ventilation was 117 hours, 66 % of the patients had an extrapulmonary origin of respiratory failure, 19 % of the patients were chronically ill, and 0,7 % had the evidence of immunosuppression. Pressure regulated volume controlled and Biphasic positive airway pressure were the most frequently used ventilator settings. Unconventional ventilation in all was used in 13 % of the patients. Mortality was 3.5 %. CONCLUSION Children on mechanical ventilation create 23 % of all patients admitted to paediatric intensive care units. The severity of illness and length of stay were twofold against mean values. Mortality rate was 3.5 % and hypoxia was not a cause of death in any patient.
Collapse
|
21
|
Can ischemia-reperfusion syndrome in transplanted kidneys procured from non–heart-beating donors be influenced by adding selenium into the reperfusion solution? an experimental study. Transplant Proc 2003; 35:3125-7. [PMID: 14697994 DOI: 10.1016/j.transproceed.2003.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ischemia-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). An animal model of NHBD was used to monitor the influence of the exogenous addition of selenium in the perfusion solution (HTK, Custodiol) on the generation of free oxygen radicals between 0 and 120 minutes after transplantation of the NHBD organ. During this interval, the malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney, significantly decreased. The augmentation of the anti-oxidant capacity of the preservation solution might represent a possible improvement in the function of kidneys transplanted from NHBDs.
Collapse
|
22
|
Can the ischemia-reperfusion syndrome in transplanted kidneys procured from non-heart-beating donors be influenced by adding selenium into the reperfusion solution? An experimental study. Transplant Proc 2003; 35:1584-6. [PMID: 12826226 DOI: 10.1016/s0041-1345(03)00466-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The ischemic-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). The animal model of a NHBD was used to monitor the influence of exogenous addition of selenium into the reperfusion solution (HTK, Custodiol) with respect to the formation of free oxygen radicals at 0 to 120 minutes after the NHBD transplantation. This maneuvers produced a statistically significant decrease in malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney. The augmentation of the antioxidative capacity of the preservation solution might be a possible route to improve the function of kidneys transplanted from NHBDs.
Collapse
|
23
|
Plasma and tissue levels of free oxygen radicals in recipients of kidneys from non-heart-beating donors: does recipient pretreatment with antioxidant drugs make sense? An experimental study in pigs. Transplant Proc 2002; 34:3060-4. [PMID: 12493375 DOI: 10.1016/s0041-1345(02)03660-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
24
|
Importance of selenium for the influence of ischemia-reperfusion syndrome after kidney transplantation from a non-heart beating donor in a pig model. Transplant Proc 2002; 34:3057-9. [PMID: 12493374 DOI: 10.1016/s0041-1345(02)03694-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
25
|
[Autoimmune enteropathy with onset in early infancy: clinico-morphologic and immunologic manifestations]. CASOPIS LEKARU CESKYCH 2002; 141:646-50. [PMID: 12515041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
This paper describes a severely affected male infant with serious protracted diarrhoea caused by a rare autoimmune enteropathy. The disease began at 6 weeks of age of the child and it was associated with small bowel villous atrophy and the presence of circulating antienterocyte antibodies. The child was treated with steroids and with parenteral and special enteral nutrition. The patient showed clinical improvement as documented by decreased stool output and possibility to terminate the parenteral nutrition. The small biopsy samples showed a return to normal. Antienterocyte antibodies were negative after the treatment. The patient has been followed up for at least 18 months and was in a clinical remission. We recommend that autoantibodies tests should be performed in all infants with unexplained protracted diarrhoea. The use of potent immunosuppressive drugs and the increasing experience with parenteral and enteral nutrition can improve the perspective of these previously fatal disorders.
Collapse
|