Geochemical modeling of systems affected by irrigation: The case of Lerma basin (Spain, 2004-2020)

Geologically "saline" zones with scarce pluviometry, which are already susceptible to the salinization of natural drainage, can experience the acceleration of the salinization of the receiving water systems with the implementation of irrigation. The main objective of this paper is to analyze the geochemical processes that control the variations of the hydrosaline balance due to the implementation of irrigation of the Lerma basin (Spain) from the beginning of its transformation into irrigation land (2004) until the consolidation of irrigation (2020). The results of this study evidence the dissolution of some mineral phases, such as halite, gypsum, and dolomite, and the precipitation of others, such as calcite. Additionally, the final composition of the irrigation return flows cannot be explained without consideration of the NaCa exchange. Part of the dissolved Ca2+ is deposited in the soil, which, in turn, contributes with Na+ to the solution. These natural processes are accelerated with irrigation but progressively slow down as the soil salts are washed with time. Although less evident, there is an additional negative agroenvironmental effect associated with the precipitation of calcite and the possible formation of petrocalcic horizons in the soil. The results obtained herein indicate that studies focusing on the salinity of irrigated zones should go a step further and include the geochemical processes in quantifying the global mass of exported salts.

Hydrosaline balance evolution of an irrigated zone: The case of Lerma basin (Spain, 2004-2020)

Geologically saline zones with scarce pluviometry are areas susceptible to salinization of their natural drainage. However, the salinization of the receiving water systems can be accelerated with the implementation of irrigation. This work aims to analyze the effects of irrigation on some zones transformed into irrigation land, from the beginning of the process until its complete consolidation. To this end, salt balances are evaluated as a whole and for each significant chemical element. The study zone is the irrigable area of the Lerma basin (Spain), where hydrosaline balances have been carried out since the hydrological year 2004 (before the implementation of irrigation) until 2020 (after the consolidation of irrigation). The implementation of irrigation in the area has doubled the mass of exported salts up to an average of 3177 kg/ha irrigable·year, for the entire study period. 55 % of that amount results from a global mineral dissolution, although this process seems to decrease with time as these minerals are being flushed from the soil. Before irrigation was implemented, the general global dissolution pattern produced more concentration of most ions (SO42-, Cl-, Mg2+, Na+, and K+) in the water outputs than in the water inputs. After the implementation of irrigation, there were more water inputs than outputs in the balance and that was shown by the decrease in the dissolved HCO3- and Ca2+.These results indicate that the consolidation of irrigation progressively decreases the induced salinization in the water systems that receive the irrigation return flows. Further studies are required to expand the general understanding of the process and its effects, quantify the different geochemical processes involved, and identify possible additional environmental issues induced by irrigation.

Interventional Radiology and Spanish Medical Students: A Survey of Knowledge and Interests in Preclinical and Clinical Courses

INTRODUCTION

Interventional Radiology (IR) is a medical activity that has experienced an extraordinary growth in the medical field in Spain in recent years. However, there is a lack of visibility in the Spanish Health Administration and the University community, especially among medical students.

PURPOSE

The purpose of this study is to determine IR knowledge among medical students, preclinical and clinical, in a single University in Spain.

MATERIAL AND METHODS

An electronic survey was uploaded (November-December 2017) to an online learning platform (Moodle) and sent to 414 students from second (183 PCs) and fourth (231 Cs) year of medical school. A total of 313 students of 414 (75.6%) answered the survey 142/45.4% PCs and 171/54.6% Cs.

RESULTS

Students quantified their knowledge between adequate (41% PCs/80.7% Cs) and poor levels (50.7% PCs/14% Cs). Most of the students suggested that interventional radiologists (IRs) should have a mixed training, surgical and radiological (95% PCs/88.8% Cs). Majority of students indicated that the professionals in charge of carrying out angioplasty were the IRs (95% PCs/83.6% Cs) and only 20.4% PCs/12.8% Cs (P = 0.165) of students chose cardiologists. Almost all of the medical students in both groups said they wanted to know more about IR (99.3% PCs/100.0% Cs), and the majority of students (100.0% PCs/98.8% Cs) said they agree or strongly agree that IR should be taught as an undergraduate medical subject.

CONCLUSION

This study demonstrates that medical students in our University have poor knowledge of IR; however, they are overwhelmingly positive in their desire to have this subject taught as distinct curriculum in medical school.

Geochemical processes controlling water salinization in an irrigated basin in Spain: identification of natural and anthropogenic influence

Salinization of water bodies represents a significant risk in water systems. The salinization of waters in a small irrigated hydrological basin is studied herein through an integrated hydrogeochemical study including multivariate statistical analyses and geochemical modeling. The study zone has two well differentiated geologic materials: (i) Quaternary sediments of low salinity and high permeability and (ii) Tertiary sediments of high salinity and very low permeability. In this work, soil samples were collected and leaching experiments conducted on them in the laboratory. In addition, water samples were collected from precipitation, irrigation, groundwater, spring and surface waters. The waters show an increase in salinity from precipitation and irrigation water to ground- and, finally, surface water. The enrichment in salinity is related to the dissolution of soluble mineral present mainly in the Tertiary materials. Cation exchange, precipitation of calcite and, probably, incongruent dissolution of dolomite, have been inferred from the hydrochemical data set. Multivariate statistical analysis provided information about the structure of the data, differentiating the group of surface waters from the groundwaters and the salinization from the nitrate pollution processes. The available information was included in geochemical models in which hypothesis of consistency and thermodynamic feasibility were checked. The assessment of the collected information pointed to a natural control on salinization processes in the Lerma Basin with minimal influence of anthropogenic factors.

Inhibition of the intimal hyperplasia in an arterial autograft model by blockade of the N-terminal of the integrin beta3 subunit by monoclonal antibody P37

Myointima formation or intimal hyperplasia is a major undesirable problem at the anastomotic ends of narrow bore arterial autografts and in other arterial wall injuries, which often leads to late restenosis and thrombosis and whose pathogenesis is still not understood. Platelets are suspected to intervene at some stages of its development, together with endothelial and muscle cells, the extracellular matrix and, most probably, adhesion receptors. To ascertain whether and at what stage beta3 integrins are involved, a rat arterial autograft model was used, together with monoclonal antibody P37, which is directed to the sequence 101-109 of the beta3 subunit of the human platelet fibrinogen receptor (integrin alphaIIbbeta3) and inhibits platelet aggregation in vitro and acute thrombosis in vivo. Three groups of animals were used: group I underwent an arterial autograft of a 5-mm segment of the right common iliac artery; group II received, intravenously, a single dose (0.8 mg/kg) of P37 at 15 min before the graft implantation; and group III was treated as group II but a similar dose of antibody was additionally given on day 14 after the operation. Animals in each group were sacrificed on days 7, 14, 21, 30 and 50 after the operation, and the grafts were removed for light and electron microscopy observation and further time-dependent morphometric analysis. By day 14, group I autografts already showed intimal hyperplasia and secretory smooth muscle cells, while group II and II autografts presented only some degenerative changes in the medial layer, with no signs of hyperplasia. Intimal hyperplasia was observed on day 21 in group II and on day 30 in group III, although less pronounced than in the corresponding controls. However, by day 50, the three groups had the same thickness of myointima. The immunohistochemical determination of metalloproteases suggests no role for these enzymes in the immunoinhibition of myointima formation. We conclude that P37 inhibits the onset of the intimal hyperplasia in the arterial autografts and that this onset in treated animals seems to be related to the decay of the circulating antibody. Further work is required to decide whether a higher or longer presence of circulating P37 can definitively prevent the development of intimal hyperplasia, as well as to ascertain which cells and which beta3 integrin receptors intervene.

[Diffuse pulmonary calcification in a patient with renal insufficiency]

We report the case of a 37-year-old man with chronic renal insufficiency, on hemodialysis, with no respiratory symptoms but whose chest radiograph showed parenchymal consolidation in the middle and upper lung fields. High resolution computed tomography showed a high-attenuating diffuse alveolar pattern that indicated calcium deposits. Bronchoscopy revealed metastatic calcification on the interalveolar septa and bronchiolar and arteriolar. The present report, based on radiologic and bronchoscopic findings, describes the pathogenesis and anatomical distribution of the patient's diffuse pulmonary calcification.

Cell Therapy: A Therapeutic Alternative to Treat Focal Cartilage Lesions

BACKGROUND

Human mesenchymal stem cells (MSCs) are present in most of the tissue matrix, taking part in their regeneration when injury or damage occurs. The aim of this study was to investigate the presence of cells with pluripotential characteristics in synovial membranes from osteoarthritic (OA) patients and the capacity of these cells to differentiate to chondrocytes.

METHODS

Synovial membranes (n = 8) from OA patients were digested with collagenase. Isolated cells were cultured with DMEM, 20% FBS, and FGFb10 ng/mL. Cells from second subculture were used to carry out phenotypic characterization experiments (flow cytometry analysis with 11 monoclonal antibodies) and chondrogenic differentiation experiments(micropellet cultured in chondrogenic medium). Chondrogenic differentiation of cells was assessment by quantification of cartilage extracellular matrix components by following techniques: Safranin O, Toluidine Blue, and Alcian Blue stains to detect proteoglycans and immunohistochemistry to detect type I and II collagen.

RESULTS

Flow cytometry analyses showed that in our population more than 90% of cells were positive for MSC markers: CD29 (95%), CD44 (90%), CD73 (95%), CD90 (98%). Cells were negative for hematopoietic markers (CD11b, CD34, and CD45). Furthermore, cells showed positive stain to multipotent markers such as CD117 (c-kit) (98%), CD166 (74%), and STRO-1 (88%) and to quiescent satellite cells like PAX-7 (35%). The micropellet analyses showed that the culture of these cells with TGFbeta-3 for 2 and 3 weeks stimulates proteoglycan and collagen type II synthesis. Both molecules are characteristic of hyaline articular cartilage.

CONCLUSION

In this work, we demonstrate the presence of a cellular population with MSC characteristics in synovial tissue from OA patients. As MSC takes part in reparative processes of adult tissues, these cells could play an important role in OA pathogenesis and treatment.

[Producing intravenous medications in a pharmacy]

The authors explain the different intravenous mixtures and the types of preloaded syringes elaborated in a centralized unit, analysing their profitability and evaluating their repercussion on the daily work nurses have to perform. This study was carried out in the Hospital de Poniente in Almeria, a county hospital which has 165 beds. The hospital authorities defined those medications which were chosen to be prepared in a centralized unit in the Pharmacy Service of the hospital and they drew up a list/guide of their corresponding conservation conditions. The authorities determined the time which nursing personnel in the various hospital units would employ in the elaboration of these medications and compared that with the time employed in the Pharmacy Service.

Modulatory role of IL10 in endothelial cell damage and platelet adhesion

This study explores the possibility of a regulatory role for cytokine IL-10 in platelet aggregation as an active vascular repair mechanism. Endothelial cells from human umbilical cord vein were cultured in the presence of different IL-10 concentrations (0-100 ng/ml). Platelet-rich plasma was then added to these cultures and allowed to act for 30 minutes. To rule out blood plasma involvement, washed platelets were also incubated with IL-10 (0-100 ng/ml). Changes in endothelial cell morphology were observed depending on the IL-10 concentration used; apoptotic cells appearing at the highest IL-10 concentration. Greatest platelet adhesion was noted at the highest IL-10 concentration. It was concluded that, in this in vitro model, low IL-10 levels do not affect cell viability or the pattern of platelet adhesion, but at high doses, this cytokine induces cell death and enhances platelet deposition.

A novel controlled drug-delivery system for growth hormone applied to healing skin wounds in diabetic rats

Controlled release systems for drugs, hormones and growth factors can be particularly useful in tissue repair processes. These systems act as a biodegradable support containing the substance to be delivered, allowing their gradual release. In the past years, the local application of growth factors has acquired special relevance as a therapeutic option for use in subjects who show deficient tissue scarring, the hormone dose being the limiting factor for its success. In this study, the in vitro biocompatibility of a copolymer formed by vinylpyrrolidone and 2-hydroxyethyl methacrylate, used as an administration vehicle for hGH, was evaluated. The system was then tested in vivo in terms of its capacity for healing incisional wounds in healthy and diabetic rats. For the in vitro studies, polymer and hormone degradation rates were determined, and polymer biocompatibility was evaluated in fibroblast cultures. In the in vivo experiments, an incision was made in the back of the animals, and polymers discs with/without hGH, were introduced in the aperture. Morphological, immunohistochemical and morphometric evaluations were performed on wound tissue specimens 3-10 days after surgery. In vitro, the polymer was found to be biodegradable and showed no toxic effects on fibroblasts, the hormone being slowly released to the culture medium. In untreated diabetic rats, a delayed skin scarring and cell response were observed, compared to that noted in healthy animals. Skin closure, keratinisation and fibrosis occurred earlier in the presence of the polymer-hGH system. The use of this co-polymer as an administration vehicle for hGH improves the wound scarring process in the pathological setting of diabetes.

Polymer controlled drug delivery system for growth hormone

The use of biomaterials as vehicles for pharmacological agents, hormones, and growth factors is at times the best treatment for controlled local administration. Our study was designed to evaluate the in vitro biocompatibility and potential clinical use of a new polymer, hydroxyethyl methacrylate-vinyl pirrolidone. Human fibroblasts were incubated in the presence of the polymer and/or growth hormone, and evaluation was made of both the rate of polymer and hormone degradation and the proliferative effect on the fibroblast population. Results indicate that this polymer is biodegradable and lacks toxicity toward these cells. The hormone was slowly released, as suggested by enhanced cell proliferation.

Mechanical and enzymatic thrombolysis for massive pulmonary embolism

PURPOSE

To assess the efficacy and safety of mechanical fragmentation combined with intrapulmonary thrombolysis in massive pulmonary thromboembolism (PTE) with hemodynamic impairment.

MATERIALS AND METHODS

Fifty-nine patients diagnosed with massive PTE with hemodynamic impact were treated. The initial clinical symptoms were shock in 23 patients (38.9%), syncope in eight (13.5%), and dyspnea at rest in 28 (47.4%). Mean O2 saturation was 67.8%. Mean pulmonary artery pressure (PAP) was 42.1 mm Hg. During fragmentation, thrombolysis was administered in the form of a urokinase bolus of 200,000-500,000 U in 57 patients and 20 mg of recombinant tissue plasminogen activator (rt-PA) in two patients. The mean urokinase dose used was 2,500,000 IU, whereas the total dose of rt-PA was 100 mg. Heparin sodium infusion was performed to reach activated partial thromboplastin time ratios of 2. The follow-up consisted of clinical assessment, pulmonary scintigraphy, and echocardiography. The patients received treatment with dicoumarin for 6 months after the procedure.

RESULTS

Clinical improvement was seen in 56 patients (94%). Three patients died. The mean PAP after the treatment was 21.8 mm Hg. The mean posttreatment Miller index was 0.35. Technical success was achieved in all cases and clinical symptoms improved in all cases except those in which the patients died. Pulmonary scintigraphy showed improved perfusion in all cases. Echocardiography was performed after 3-6 months, showing a mean pressure of 22.8 mm Hg (corrected values). There were no signs of recurrent PTE or arterial hypertension in the follow-up.

CONCLUSION

The data provided confirm the efficacy and safety of mechanical fragmentation and pharmacologic thrombolysis in the treatment of massive PTE with hemodynamic impairment, showing improvement of symptoms and a decrease in PAP.

Animal experience in the Günther Tulip retrievable inferior vena cava filter

PURPOSE

To assess the retrievability of the Günther Tulip temporary inferior vena cava filter from a technical viewpoint, and consider the histopathologic changes that occur at the anchoring site of the filter prongs to the vein endothelium in Landrace pigs.

METHODS

Twenty-two Günther Tulip retrievable filters were inserted in 22 experimental Landrace pigs via the jugular vein. Device implantation time was 0, 3, 7, 12, 14, 15, 16, 20, 30, 35 and 56 days. Study subjects were divided into two groups. In one group the filter was retrieved percutaneously via the jugular vein whereas in the other group it was removed surgically. The specimens obtained (vena cava and filter) were histopathologically examined. Prior to filter retrieval, a venacavography was obtained in all cases. Degree of retrieval difficulty was rated as follows: no difficulty (N), slight (S), mild (M), high (H) and unretrievable (U).

RESULTS

Of the 22 implanted filters, 11 should have been removed percutaneously but this was impossible in three cases (U). In four cases the device was retrieved with no difficulty (N); in two cases the degree of difficulty was mild (M) and in other two it was high (H) and slight (S) respectively. Retrieval difficulties were observed after 16 days. Starting from day 20, there was evidence of fibrosis with thick intimal proliferation and total filter prong involvement, which accounts for the difficulty in retrieving the device.

CONCLUSIONS

It is advisable not to exceed a filter retrieval time of 16 days in view of the fibrotic changes reported. It might be necessary to perform a larger study with more animals and with retrieval times between 14 and 20 days.

[Ocular changes associated with connective tissue disorders: role of the elastic and collagen components]

Every day, the emerging fields of genomics and proteomics provide new information about both normal and pathological processes, among which, the extracellular matrix appears to play a significant role. Over the past decade, the classic fibrillar components of the matrix, collagen and elastin, have been the subject of extensive research leading to a wealth of information which is far form being fully interpreted. Although the basic composition and structure of the matrix components has been well established, today more than twenty five different varieties of collagen have been described, and elastic fibers are currently described as polymeric complexes, composed of at least 19 different proteins in their microfibrillar and amorphic portions. Mutations in three of the genes coding for some of the most abundant proteins in the elastic fibers give rise to a wide range of elastic tissue phenotypes, from skeletal or dermal anomalies to vascular or ocular defects. In this review, our aim was to gain insight into the fibrillar component of the extracellular matrix in an attempt to improve our understanding of certain ocular disorders.

Potential role of a new anti-beta3 integrin antibody in the development of intimal hyperplasia after vascular surgery: an in vitro smooth muscle cell model

The occurrence of intimal hyperplasia after vascular surgery is an ongoing concern in current clinical practice. Among the many factors involved in the development of this pathology, platelet adhesion and myointimal proliferation play a major role. Both these processes are mediated by integrins (mainly alphavbeta3 integrins). Over the past years, several substances have been designed to delay or inhibit the cell proliferation that leads to hyperplasia and mainly include monoclonal antibodies directed against integrins. The aim of the present study was to evaluate the effects of an antibody denoted P37 (anti beta3 integrin) on human smooth muscle cells (SMC) and its role in blocking the B3 subunit. To this end, SMC from human umbilical artery were cultured in the presence or absence of the cell substrate vitronectin (VN) and incubated with P37. After 4 days of treatment, determination was made of cell proliferation and migration. Smooth muscle cells grown on VN showed increased proliferation and migration compared to control VN-free cultures. However, the presence of P37 in the culture medium inhibited proliferation and reduced migration. Combined treatment with VN and P37 led to improved proliferation but VN was unable to reverse the effects on migration observed in the former cultures. Results suggest that in vitro, P37 is capable of blocking human SMC beta3 integrins and thus impedes cell proliferation and migration These findings may have clinical implications related to modulation of the development of hyperplasia.

Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression

OBJECTIVE

To determine the expression pattern of certain metalloproteinases (MMPs) known to be involved in the degradation of the extracellular matrix in cultured fibroblasts from the transversalis fascia (TF) of patients with inguinal hernia.

SUMMARY BACKGROUND DATA

Inguinal hernia is a common pathology, the cause of which remains unknown. It is, however, clear that the TF is one of the anatomical structures that may impede the formation of hernias, and particularly the direct type of hernia. In previous studies the authors found enhanced MMP-2 expression in TF specimens in vivo. The persistence of increased expression in cultured fibroblasts might support the idea of a genetic defect as the cause for this pathology.

METHODS

Fibroblasts from the TF of patients with direct and indirect inguinal hernia were cultured and compared with those obtained from control TF in terms of MMP (MMP-2 and MMP-9) expression.

RESULTS

Significant active MMP-2 expression was shown by TF fibroblasts from young patients with direct hernias. These findings were confirmed by immunosorbent assay, immunoblotting, and zymography of the fibroblast culture media. No MMP-9 expression was detected.

CONCLUSION

These results indicate that MMP-2 may be involved in the TF matrix degradative process in patients with direct hernia. The persistence of changes in MMP-2 levels in the cell cultures appears to suggest a genetic defect or irreversible change as the origin of this pathology rather than environmental factors, which may later participate in the development of the hernial process.

Function of inflammatory cells and neoral cyclosporin-A in heart transplant-associated coronary vasculopathy

The role of Sandimmun Neoral (S-n) and the immune response in transplant-associated coronary vasculopathy (TACV) was evaluated in a Lewis (Lew)-to-Fischer-344 (F344) rat abdominal heterotopic heart transplant model. Some of the transplant recipients were treated with S-n (5mg/kg/day) for 14 days post-transplant, or until sacrifice. Grafts were subjected to immunohistochemical (ED1, CD4, CD8 and alpha-actin+ cells) analysis from day 7 to 100 post-transplant. Singenic controls did not develop TACV, irrespective of whether they had received the drug or not. TACV was detected in Lew-F344 transplants regardless of S-n administration with participation of ED1+, CD8+ and alpha-actin+ cells, although its incidence was lower in animals receiving prolonged S-n treatment. In this model, accelerated arteriosclerosis of the graft appeared to be related more to the rejection effect than to the action of the immunosuppressive agent.

Rapid thawing increases the fragility of the cryopreserved arterial wall

OBJECTIVE

To extend present knowledge of the biomechanical and structural changes which occur in the cryopreserved, rapidly thawed arterial wall.

MATERIALS AND METHODS

Minipig iliac arterial segments were cryopreserved at -196 degrees C in either minimum essential medium or Wisconsin solution. Fresh segments served as the control group. After 1 month, the specimens were rapidly thawed (37 degrees C) and processed for biomechanical, ultrastructural, morphological and immunohistochemical (MMP-1, MMP-2, MMP-3 and MMP-9) analysis. Visualisation of apoptotic cells was performed by TUNEL method. For the mechanical distension analysis, an in vitro circuit was designed.

RESULTS

The cryopreserved segments showed a 42% incidence of spontaneous fracture and the appearance of microfractures which affected the endoluminal third of the vessel. An accumulation of liquid in the subelastica was observed. An increased expression of wall-degradative enzymes (mainly MMP-2) was also observed following cryopreservation. No significant differences were detected in the proportional elasticity module or tensile strength of the specimen groups. No differences in mechanical distension were observed between groups after the vessel segments were subjected to the pulsatile circuit flow for 72 h. Cell damage was most intense in the specimens cryopreserved in Wisconsin solution.

CONCLUSIONS

Cryopreservation in both the solutions employed, followed by rapid thawing, induce changes in the permeability which increase the fragility of the cryopreserved arterial wall. Both increased expression of wall-degradative enzymes and accumulation of liquid may contribute to graft failure after implantation.

Evaluation of the smooth muscle cell component and apoptosis in the varicose vein wall

This study was designed to evaluate the role of the smooth muscle cell and the apoptosis in the pathogenesis of the varicose vein. Segments of saphenous vein were obtained from healthy subjects and from those with varicose veins. The vein specimens were subdivided according to subject age (younger or older than 50 years) and according to the varicose vein source (distal or proximal). Morphological, ultrastructural, cell proliferation (anti-PCNA method) and cell death (TUNEL method) analysis were performed. The walls of healthy, control vein specimens acquired a more collagenous and papillomatous appearance with age. A slight increase in the number of TUNEL-positive cells was also observed in specimens from older subjects. The proportion of apoptotic cells was much greater in the varicose veins than in control specimens. Most cellular alterations were seen in proximal varicose segments obtained from young subjects. These specimens showed hypertrophic areas with a high degree of cellularity (both in the media and in the thickened intima). The highest proportion of apoptotic cells and collagenisation were also observed in these areas. The enhanced number of apoptotic cells in varicose veins observed mainly in proximal/young vein specimens could be responsible, at least in part, for the acceleration of the final fibrosclerotic process characteristic of the varicose vein wall.

Role of macrophages in myocardial apoptosis following cardiac transplant. Influence of immunosuppressive treatment

Cytotoxic T cells may induce myocardial apoptosis by histiocyte activation during rejection following allogenic heart transplant. The aim of the present investigation was to evaluate the macrophage response and its relationship to the programmed death of cardiomyocytes in rejection and during cyclosporin-A (CsA) treatment. An abdominal, heterotopic heart transplant rat model was used establishing two groups: singenic (ST) and allogenic (AL) transplant. 5 mg/kg/day (s.c.) CsA (Sandimun) was administered to half of the animals in each group. Morphological and structural analysis was performed 7, 14, 21, 30, 50 and 100 days post-transplant. Macrophages were detected using the monoclonal antibody (ED1). The TUNEL method was used to visualise apoptotic cells. Two weeks after ST in animals without immuno-suppressive treatment, the transplanted myocardium had been extensively infiltrated by inflammatory cells, many of which were ED1-positive. At 21 days follow-up, the number of labelled cells had fallen. In animals treated with CsA the amount of ED1-positive cells was lower than that seen in the anterior group. Only a few isolated cells of the infiltrate were TUNEL-positive. In the AT group, rejection took place between 9-15 days in the untreated animals. The myocardium was highly infiltrated by mononuclear cells. Some were ED1-positive. Small groups of apoptotic cells were visible in the infiltrate and in some vessel lumens. Rejection was resolved in animals treated with CsA. The macrophage response diminished during follow-up in a similar way to that occurring in the ST. Few cells showed TUNEL positivity. It may be concluded that: a) CsA treatment diminishes the amount of infiltrated macrophages; b) animals receiving ST or AT, show a low level of apoptosis; c) in the present model, the apoptosis of cardiomyocytes does not appear to be induced by macrophages; and d) in this model it is not possible to relate apoptosis and rejection.

Modulation of PECAM-1 (CD31) expression in human endothelial cells: effect of IFNgamma and IL-10

Intercellular contacts formed between endothelial cells (EC) permit the formation of a confluent monolayer and play a major role in the recruitment and the migration of leukocytes in the inflammatory response. It is currently accepted that cytokines are responsible for the signals involved in the induction of such endothelial alterations. The platelet EC adhesion molecule (PECAM-1), a specific component of EC junctions, is one of many molecules which participate in the regulation of EC interaction with blood components. Given that the regulatory mechanisms which affect the expression of this adhesion molecule are only partially understood, the aim of the present study was to compare the effects of two antagonistic inflammatory cytokines, interferon (IFN)-gamma and interleukin (IL)-10, on the expression of PECAM-1. Human umbilical vein EC grown to subconfluence were stimulated with IL-10 (10 ng/ml) and/or IFNgamma (100 U/ml) for 24 h. PECAM-1 expression was determined by FACScan and immunofluorescence. Morphological analysis of the cell cultures was performed by optical and scanning electron microscopy. In the presence of IL-10, no changes in cell growth and morphology or in the intensity of PECAM-1 expression were observed. However, when the cultures were treated with IFNgamma, the EC acquired a fibroblast-like appearance, growth was disorganized and PECAM-1 disappeared from cell junctions. The mean intensity expression and the percentage of EC expression of this antigen were analyzed by flow cytometry and significantly decreased after culture in the presence of IFNgamma. The simultaneous addition of IFNgamma and IL-10 to the EC cultures induced modifications similar to those observed in the presence of IFNgamma alone. Regulation of the expression of PECAM-1 with the subsequent functional implications seems to be dependent upon the IFNgamma signal and it is unaffected by IL-10. The different effects shown by IL-10 and IFNgamma on the expression of PECAM-1 in EC could reflect opposite regulatory actions of the inflammatory response induced by these cytokines.

Arterial damage induced by cryopreservation is irreversible following organ culture

OBJECTIVES

The aim of the present study was to investigate the changes which occur to the arterial wall following cryopreservation and thawing and to determine whether these changes are reversible after a week of culture in an organ bath.

MATERIALS AND METHODS

Rat iliac arterial segments were cryopreserved. Once thawed, the arterial segments were cultured for a period of 0, 1, 2, 4 or 7 days. Freshly isolated rat iliac vessels cultured for 7 days served as the control group. Evaluation was made of ultrastructural changes, the expression of metalloproteinase activity (MMP-1, MMP-3 and MMP-9) and the apoptotic state of cells.

RESULTS

The freezing-thawing process induced damage to the arterial segments compared to fresh control vessels. After 1 week of culture, arteries showed a high degree of tissue degeneration. Only a few individual endothelial cells remained on the luminal surface. There was a gradual increase in the proportion of apoptotic cells. The sequential expression of MMP-1 during the first 2 days and subsequent expression of MMP-3 and MMP-9 were of most significance.

CONCLUSIONS

Cryopreservation induced damage to the vessels which could not be reversed by organ culture. The changes observed in the expression of metalloproteinases may be indicative of the degenerative process which occurs in the extracellular matrix.

Coating PTFE vascular prostheses with a fibroblastic matrix improves cell retention when subjected to blood flow

An investigation was made into the effect of blood flow on endothelial cells (EC) and mesothelial cells (MC) seeded on a vascular expanded polytetrafluoroethylene (ePTFE) prosthesis coated with a fibroblastic matrix. Endothelial cells were obtained from the external jugular vein and MC from the omentum. To test the performance of prostheses, a custom designed, femoral "ex vivo" circuit was developed in mongrel dogs. Four study groups were established: a control group, A1, where prostheses were uncoated and seeded with EC; a second control group, A2, where prostheses were uncoated and seeded with MC; group B1 where prostheses were coated with a fibroblastic matrix and seeded with EC; and group B2 where coated prostheses were seeded with MC. All cells were labeled with 111Indium oxine (10 microCi/mL) before seeding. After the seeded cells had formed a monolayer on the ePTFE prostheses (which took approximately 24 h) the prostheses were placed in the "ex vivo" circuit. The rates of blood flow to which prostheses were exposed were measured at the point of inflow (117.5 +/- 12.50 mL/min, mean +/- SD) and outflow (72.6 +/- 14.3 mL/min). MC showed a greater baseline radionuclide uptake than did EC. The cells of groups B1 and B2 adhered sufficiently to the fibroblastic matrix and covered enough of the prosthetic surface to be positioned in the "ex vivo" circuit (76.90 +/- 8.24% surface covered in EC-seeded prostheses and 71.65 +/- 6.23% in MC-seeded prostheses). After exposure to blood flow the quantity of radionuclide-labeled cells and the prosthetic surface covered by them were greatly reduced though the fibroblast-coated prostheses showed greater cell retention.

Embryonic regulation of integrins beta 3, alpha 4, and alpha 1 in human endometrial epithelial cells in vitro

In the present study, we examined the embryonic regulation of beta 3 integrin in human endometrial epithelial cells (EEC) at the protein level and analyzed putative embryonic factors responsible for this regulation. The model employed is based on a clinical in vitro fertilization program in which single human embryos were cocultured with EEC until blastocyst stage and then transferred back to the uterus. After embryo transfer, EEC wells were divided according to the embryonic status reached: EEC with embryos that achieved the blastocyst stage, EEC with arrested embryos, and EEC without embryos. Immunostaining for beta 3 was positive in plasma membrane of EEC. Flow cytometry showed a mean percentage of beta 3-stained cells of 24.1 +/- 5.7 in EEC cocultured with embryos that achieved the blastocyst stage (n = 13) vs. 9.5 +/- 1.6 (P < 0.05) in those EEC cultured with arrested embryos (n = 12). Immunostaining for alpha 1 and alpha 4 integrins was negative in EEC monolayers studied, regardless of the presence or absence of embryos, and these findings were confirmed by flow cytometry. The possibility that the embryonic IL-1 system and leukemia inhibitory factor were involved in the endometrial beta 3 up-regulation was investigated by neutralizing experiments demonstrating a significant inhibition of beta 3-stained cells when EEC monolayers were cultured in the presence of EEC/blastocyst-conditioned media with (n = 4) vs. without (n = 8) antihuman interleukin (IL)-1 alpha + IL-1 beta (1.65% vs. 14.6%; P < 0.05). Dose-response experiments further demonstrated an up-regulation of beta 3 positive cells when IL-1 alpha + IL-1 beta were added to the medium at a concentration of 10 pg/mL compared with control medium without added cytokines (40% vs. 20%, n = 4). The functional relevance of the EEC beta 3 up-regulation was tested using a mouse blastocyst adhesion assay. More mouse blastocysts attached to EEC previously in contact with human blastocyst (72.7%) compared with those EEC previously in contact with arrested embryos (40%). Our results demonstrate the selective effect of a developing human embryo on EEC expression of beta 3, which is maximal when a human blastocyst instead of an arrested embryo is considered. Furthermore, the embryonic IL-1 system seems to be involved in the EEC beta 3 up-regulation, reinforcing the concept of precise paracrine cross-talk between blastocyst and endometrial epithelium during embryonic implantation.

Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes

The aim of this study was to examine the fascia transversalis (FT) from patients with direct and indirect hernia in an attempt to identify possible differences between each type of hernia. FT samples were obtained from 36 patients presenting inguinal hernia (23 indirect hernia and 13 direct hernia) who underwent surgery. We have analysed the ultrastructure of the fascia surrounding the hernial lesions, the proline and lysine hydroxylation in the tissue, the type I-type III collagen ratio and the presence of metalloproteinases. We have not detected ultrastructural differences in the collagen fibrils from FT in direct and indirect hernias. However, the interfibrillar matrix was more abundant in direct hernias, showing abundant electron-dense particles. No differences in proline hydroxylation were observed between each type of hernia. A small decrease in lysine hydroxylation was detected in patients with direct hernia. Enzyme-linked immunosorbent assays (ELISAs) showed no statistically significant differences in the type I-type III collagen absorbance ratios. Immunohistochemistry revealed no differences in the expression of matrix metalloproteinase-1. FT from patients presenting direct hernia showed a very strong staining vs. metalloproteinase-2 when compared with that observed in indirect hernia.

Mesothelial versus endothelial cell seeding: evaluation of cell adherence to a fibroblastic matrix using 111In oxine

OBJECTIVES

The aim of this study was to compare the behaviour of mesothelial cells (MC) to that of endothelial cells (EC) when seeded onto a PTFE, prosthesis coated with a fibroblastic matrix.

DESIGN, MATERIAL AND METHODS

Three study groups were examined: a control group (Control) of PTFE prostheses with a fibroblast matrix (n = 8); Group EC, PTFE prostheses seeded with EC on a fibroblastic matrix (n = 8); and Group MC, PTFE, prostheses seeded with MC on a fibroblastic matrix (n = 8). All cell types were labelled with 111In (100 microCi/ml) 24 h after seeding, when the cells had formed a monolayer on the prosthetic surface. Radioactive levels were measured at 2, 4, 6, and 24 h.

RESULTS

Both EC and MC showed optimal adherence. The MC had a better radioactive uptake and retention than the EC. The number of EC and MC cells that remained adherent to the matrix was large enough to ensure complete covering of the prosthetic surface.

CONCLUSION

The use of MC is therefore feasible as an optimal alternative for achieving a natural covering on vascular prostheses prepared with a fibroblastic matrix.

The interleukin-1 system and human implantation

PROBLEM

Cytokines and growth factors are increasingly implicated in embryonic implantation. In the present study, we focus on the interleukin-1 system as an example of local regulator in human implantation.

METHOD

Three different approaches are considered. First, we present evidence demonstrating its presence, regulation, and relevance on the human endometrium. Second, we demonstrate the presence of IL-1 system in the human embryo and the selective IL-1 release only when embryos were co-cultured with human endometrial epithelial cells (EEC) or EEC-conditioned media, indicating an obligate role of the endometrium in the regulation of the embryonic IL-1 system. Finally, we show data regarding the presence, hormonal regulation, and endometrial origin of IL-1 alpha, IL-beta, and IL-1ra levels in the endometrial fluid inside the endometrial cavity. Specifically, we present the IL-1 intracavitary microenvironment surrounding the human embryo at the apposition phase.

RESULTS

This work suggests that the IL-1 system seems to be relevant for human endometrial and embryonic physiology. Furthermore, this family of molecules must be considered as a relevant paracrine language displayed by both partners that may be important to endometrial and embryonic crosstalk during embryonic implantation.

Hormonal regulation of serum and endometrial IL-1 alpha, IL-1 beta and IL-1ra: IL-1 endometrial microenvironment of the human embryo at the apposition phase under physiological and supraphysiological steroid level conditions

We have investigated serum and intracavitary levels of IL-1 alpha, IL-1 beta and IL-1ra from agonadal women undergoing mock cycles (n = 20) of oocyte donation as a clinical model of controlled hormonal stimulation. Further, we compared the intracavitary IL-1 alpha, IL-1 beta and IL-1ra levels in the microenvironment of the human embryo at the apposition phase, day 5 after progesterone (P) administration using two different clinical models: oocyte donation (n = 20) which provides physiological steroid levels and a higher implantation rate per embryo, and in vitro fertilization (n = 6) with supraphysiological hormonal levels and a lower implantation rate.

Inhibitor of angiotensin-converting enzyme modifies myointimal origin in an arterial autograft model

Pharmacologic modulation by an inhibitor of angiotensin-converting enzyme (IACE: cilazapril) of vascular proliferative response to a full-thickness arterial injury (autograft) was studied in rats. An arterial autograft 5 mm long was made in the right common iliac artery of 50 female Sprague-Dawley rats (weight 250-300 g) by microsurgical techniques. The animals were divided into two study groups: group I (controls), 20 animals that underwent arterial autograft but received no other treatment; and group II (cilazapril-treated), 20 rats that underwent arterial autograft and received cilazapril (Roche), 10 mg/day orally (p.o.) in an excipient of 2% arabic gum, for 4 days before operation. Animals were killed on postoperative days 7, 14, 21, 30, and 50, and grafts were studied by light microscopy, scanning and transmission electron microscopy, and morphometry. In the control group, the hyperplasic response had begun by postoperative day 14 and was established by postoperative day 50. In the medial layer, the muscle cells changed in phenotype from contractile to secretory cells. The adventitia had a highly proliferative appearance. In the cilazapril-treated group, fibrin deposits and platelets formed a layer on the internal elastic lamina. This layer appeared to evolve toward an intimal hyperplasia that became quantifiable by postoperative day 21. The medial layer was clearly thinned and showed intense accumulation of lipid microvacuoles, elastic degeneration, and vacuolized cells. Our results suggest that the use of an inhibitor of ACE modified the origin of the intimal hyperplasia in the arterial autograft model. Enhancement of the thrombogenicity of the luminal surface favors myointimal development by thrombus reorganization.

Cytokines-adhesion molecules-invasive proteinases. The missing paracrine/autocrine link in embryonic implantation?

How implantation is regulated and brought about remains an enigma. The objective of the present review is to propose a hypothetical model based on our actual knowledge of the role of cytokines, adhesion molecules and invasive proteinases in the adhesion and invasion phases of embryonic implantation. For the purpose of clarity we will describe first what is known about the presence of these molecules in the endometrium and embryo in animal models and their relevance in embryonic implantation. Secondly, since human implantation is unique the presence of these factors in the human endometrium and embryo and their possible clinical relevance is considered separately. Finally, the link between cytokines, adhesion molecules and invasive proteinases as well as their endocrine/paracrine/autocrine regulation is put forward as a possible model that could lead us to a better understanding of the implantation process in humans.

Studies on the renal excretion mechanisms of cefadroxil

The mechanisms of renal excretion of cefadroxil were investigated in conscious rats. The drug was intravenously infused at several infusion rates (0.27, 1.08, 5.40, 12.00, and 31.35 mg/hr), and the total and renal clearances were determined after the steady-state was reached. Renal clearance accounted for approximately 91% of total clearance. Renal clearance of cefadroxil increased from 2.51 +/- 0.39 to 3.57 +/- 0.43 ml/min as the steady-state cefadroxil plasma concentration increased from 1.7 +/- 0.3 to 24.4 +/- 3.8 micrograms/ml, and this has been attributed to a saturable renal tubular reabsorption of the antibiotic. The ratio of unbound cefadroxil renal clearance to glomerular filtration rate was larger than unity, which indicates that the antibiotic also undergoes active renal tubular secretion. When cefadroxil was administered together with cephalexin, an increase in the renal clearance of cefadroxil was observed, which has been attributed to a competitive inhibition of the tubular reabsorption of cefadroxil by cephalexin. A pharmacokinetic model for the renal excretion of cefadroxil was developed, and mathematical expressions showing the relationship between renal clearance and steady-state plasma concentration were deduced.