RESUMO
BACKGROUND: In some patients with peritoneal carcinomatosis, we could perform the cytoreductive surgery and the HIPEC procedure by a complete laparoscopic approach to avoid morbidity. We consider that using laparoscopic approach for performing peritoneal carcinomatosis cytoreductive surgery and HIPEC with closed CO2 recirculation technique is possible and safe, with equal efficacy to conventional methods and hemodynamic complications. OBJECTIVE: Monitoring the effectiveness of the drug distribution in a laparoscopic ctoreductive and HIPEC surgery group with CO2 recirculation respect to a closed and open HIPEC group METHODS: Porcine model that included fifteen mini-pigs. Five pigs were operated with laparoscopic approach performing a pelvic and retroperitoneal lymphadenectomy. They later received a total laparoscopic closed HIPEC with CO2 recirculation (G1). Group 2 (G2): five pigs operated by an open cytoreductive surgery and closed HIPEC technique. Group 3 (G3): five animals in which an open cytoreductive surgery and an open HIPEC technique was performed. Blood and peritoneal determinations were realized after recirculation of the drug, at 60 min using chromatographic analysis. RESULTS: G1-G2: phrenic right peritoneum, p: 0.46. Phrenic left peritoneum, p: 0.46. Pelvic peritoneum, p: 0.17. Serum paclitaxel: p: 0.01. G1-G3: phrenic right peritoneum, p: 0.34. Phrenic left peritoneum, p: 0.34. Pelvic peritoneum, p: 0.17. Serum paclitaxel G1-G3, p: 0.02. CONCLUSIONS: A total laparoscopic approach for ctoreductive surgery and closed HIPEC with CO2 recirculation may be safe and feasible. In our experimental model there was no significant difference in tissue drug distribution respect the conventional techniques and there was a less toxicity because the serum drug concentration was significantly lower with laparoscopic approach respect the other groups.
Assuntos
Quimioterapia do Câncer por Perfusão Regional , Procedimentos Cirúrgicos de Citorredução/métodos , Hipertermia Induzida , Laparoscopia/métodos , Paclitaxel/administração & dosagem , Neoplasias Peritoneais/metabolismo , Neoplasias Peritoneais/terapia , Animais , Antineoplásicos Fitogênicos/administração & dosagem , Antineoplásicos Fitogênicos/farmacocinética , Terapia Combinada , Feminino , Excisão de Linfonodo/métodos , Paclitaxel/farmacocinética , Neoplasias Pélvicas/metabolismo , Neoplasias Pélvicas/patologia , Neoplasias Pélvicas/terapia , Neoplasias Peritoneais/patologia , Suínos , Distribuição TecidualRESUMO
BACKGROUND: Previously we demonstrated that monocyte phagolysosomal fusion is impaired in chronic HIV infection in adult patients. METHODS: We studied the phagolysosomal fusion of peripheral blood monocytes from 45 children vertically infected with HIV, 38 noninfected infants born to HIV-positive mothers and 14 children born to HIV-seronegative women, by a cytomorphologic method in which acridine orange is used as a fusion marker. RESULTS: The mean percentages of phagolysosomal fusion +/-SD were 42 +/- 16.1 for HIV-positive children, 55.3 +/- 15.5 for HIV-negative infants born to HIV-infected mothers and 58.2 +/- 12.7 for normal controls. Monocyte phagolysosomal fusion of HIV-infected children was significantly decreased in comparison to noninfected and normal infants (P < 0.001), while there was no difference between the two latter groups. Phagolysosomal fusion impairment in HIV-infected infants inversely correlated with age (r = -0.4527; P < 0.002) and directly correlated with CD4+ T cell counts (r = 0.393; P = 0.03). Moreover, phagolysosomal fusion strongly correlated with clinical manifestations; this function was significantly impaired in moderately and severely symptomatic HIV-infected children with respect to those who remained asymptomatic or mildly symptomatic (P < 0.05). CONCLUSIONS: Our results suggest that monocyte function in HIV-infected children progressively deteriorates, closely related to the severity of the clinical symptoms.
Assuntos
Infecções por HIV/sangue , Transmissão Vertical de Doenças Infecciosas , Fagossomos/fisiologia , Contagem de Linfócito CD4 , Criança , Pré-Escolar , Progressão da Doença , Infecções por HIV/congênito , Infecções por HIV/fisiopatologia , Infecções por HIV/transmissão , Humanos , Lactente , Recém-Nascido , FagocitoseRESUMO
Primary cultures of hypothalamic cells maintained in the presence of serum were either kept with homologous conditioned medium (CM) (i.e. only half of the medium was removed at each medium change) or without (total medium change). In cultures with homologous CM, TRH levels were increased. The effects of CMs from various intervals of the primary culture were tested. The strongest increases of TRH levels were obtained with CM from cultures enriched with hypothalamic glia.
Assuntos
Hipotálamo/efeitos dos fármacos , Fatores de Crescimento Neural/biossíntese , Neurônios/efeitos dos fármacos , Hormônio Liberador de Tireotropina/biossíntese , Sequência de Aminoácidos , Animais , Contagem de Células/efeitos dos fármacos , Células Cultivadas , Meios de Cultivo Condicionados , Citarabina/farmacologia , Hipotálamo/citologia , Hipotálamo/metabolismo , Camundongos , Dados de Sequência Molecular , Neurônios/metabolismoRESUMO
Durante el período junio 1990-junio 1993, como parte de un proyecto multidisciplinario y prospectivo de seguimiento de niños HIV+, se realizó la evaluación neurológica y el estudio tomográfico cerebral de 85 pacientes, con edades comprendidas entre 4 meses y 8 años (X: 2 años). Nos propusimos correlacionar los signos neurológicos (SN) con los hallazgos tomográficos y establecer el valor predictivo de dichos parámetros. En 70 niños sintomáticos (Grupo A), 55 tomografías computadas cerebrales (TCC) resultaron patológicas (78,6 por ciento); 28 de estos pacientes eran menores de 1 año y 14 de ellos menores de 6 meses. Todos presentaban SN de encefalopatía progresiva (EP) o estática (EE) moderada. Los hallazgos tomográficos fueron: 1) atrofia cortical y/o central (AAC) en 30 pacientes; 2) AAC + calcificaciones de los ganglios basales (CGB) en 5 pacientes; 3) hipodensidad de la sustancia blanca (HSB) en 6 pacientes; 4) accidente cerebro-vascular (ACV) en 1 paciente; 5) hidrocefalia congénita + calcificaciones en 4 pacientes; 6) lesiones secundarias a maltrato en 2 pacientes; 7) colección subdural (CS) en 1 paciente; 8) infecciones oportunistas (IO) en 6 pacientes. Quince de estos niños fallecieron durante el estudio por diferentes causas (27,3 por ciento)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , HIV , Manifestações NeurológicasRESUMO
Durante el período junio 1990-junio 1993, como parte de un proyecto multidisciplinario y prospectivo de seguimiento de niños HIV+, se realizó la evaluación neurológica y el estudio tomográfico cerebral de 85 pacientes, con edades comprendidas entre 4 meses y 8 años (X: 2 años). Nos propusimos correlacionar los signos neurológicos (SN) con los hallazgos tomográficos y establecer el valor predictivo de dichos parámetros. En 70 niños sintomáticos (Grupo A), 55 tomografías computadas cerebrales (TCC) resultaron patológicas (78,6 por ciento); 28 de estos pacientes eran menores de 1 año y 14 de ellos menores de 6 meses. Todos presentaban SN de encefalopatía progresiva (EP) o estática (EE) moderada. Los hallazgos tomográficos fueron: 1) atrofia cortical y/o central (AAC) en 30 pacientes; 2) AAC + calcificaciones de los ganglios basales (CGB) en 5 pacientes; 3) hipodensidad de la sustancia blanca (HSB) en 6 pacientes; 4) accidente cerebro-vascular (ACV) en 1 paciente; 5) hidrocefalia congénita + calcificaciones en 4 pacientes; 6) lesiones secundarias a maltrato en 2 pacientes; 7) colección subdural (CS) en 1 paciente; 8) infecciones oportunistas (IO) en 6 pacientes. Quince de estos niños fallecieron durante el estudio por diferentes causas (27,3 por ciento)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , HIV , Manifestações NeurológicasAssuntos
Humanos , Lactente , Pré-Escolar , Criança , Tomografia , Tomografia Computadorizada de Emissão , ArgentinaAssuntos
Humanos , Lactente , Pré-Escolar , Criança , Tomografia , Tomografia Computadorizada de Emissão , ArgentinaAssuntos
Sistema Hipotálamo-Hipofisário/fisiologia , Hormônios Liberadores de Hormônios Hipofisários/metabolismo , Animais , Retroalimentação , Peixes , Regulação da Expressão Gênica , Hipotálamo/metabolismo , Camundongos , Neurônios/metabolismo , Peptídeos/metabolismo , Hormônios Liberadores de Hormônios Hipofisários/genética , Hormônios Liberadores de Hormônios Hipofisários/fisiologia , Precursores de Proteínas/metabolismo , RatosRESUMO
We studied several parameters of the jugular flebogram in 70 patients who had undergone cardiac surgery. Fifty six of them were on sinusal rithm and 14 in auricular fibrillation. We found among them 39 who had undergone commissurotomy and 16 who had got valvular prothesis. The results of these studies were analyzed and compared with those of 94 normal subjects, taking in consideration the type of surgical intervention and the time elapsed since the operation was performed--the latter in the more numerous group. It is interesting to observe that the sinus grows deeper after the intervention so making the relation xv/yv lower than the unit in 33% of the patients maintaining sinusal rithm. This alteration remained stationary during some years in some of the cases, the results suggesting a greater frequency during the first months of the post-operatory period. We didn't find any relation of this morphologic alteration with the presence of a pericardial construction, pulmonary hypertension, valvular injuries with repercussion on the right heart or modifications on the nenous pressure which we think due to functional changes following the pericardiotomy. It is interesting to observe these mechanographic signs in relation with the post-operatory period of cardiac surgery, but we must avoid hypervaluation of those cases suspicious of pericardial constriction.