109 research outputs found
The effect of U-74389G on experimental pancreas ischemia reperfusion injury, encompassing ischemic preconditioning in a swine model: biochemical, hemodynamic and histopathologic study
No full textObjective: A pivotal role of lazaroid U-74389G, as specific antioxidant factor oftissue damage in various organs, has recently been suggested. In addition,preconditioning by brief exposure to ischemia protects tissues against damage evokedby subsequent severe ischemia.The objective of this study was to elucidate the effect of U-74389G and thephenomenon of ischemic preconditioning, in an experimental Ischemia Reperfusioninduced pancreatiitis and to determine the oxidative stress.Design: Prospective randomized controlled studySetting: 1st Department of Propaedeutic Surgery, Hippokratio Hospital, University ofAthens, 114 Vas Sofias Avenue, Athens 116 27, Greece and Experimental–ResearchCenter, Elpen Pharmaceuticals, Athens, GreeceSubjects: Twenty four (male and female) pigs, weighting 28–35 kg.Background. Oxidative stress is a crucial factor in the pathophysiology of acutepancreatitis and its systemic complications. Lazaroids are a novel class of antioxidantsthat potently protect pancreatic acinar cells against oxidant attack. The aim of ourstudy was to evaluate the therapeutic potential of 21-aminosteroid U-74389G inpancreatic injury after ischemia and reperfusion of the organ, in a swine model.Materials and methods. Twelve pigs (28–35 kg), were randomized into the followingtwo experimental groups: Group A (control group, n=6): Ischemia of pancreas (30min) followed by reperfusion for 120 min and Group B (n=6): Ischemia of pancreas(30 min), U-74389G intravenous injection (10 mg/kg) in the inferior vena cava, andreperfusion for 120 min. Tissue and blood sampling was conducted at 0, 30, 60, 90and 120 min after reperfusion. Repeated-measures ANOVA was performed for theevaluation of differences between the two groups.Results. Histopathological evaluation did not reveal a statistically significantdifference concerning hemorrhage (p=0.193), leukocyte infiltration (p=0.838), acinarnecrosis (p=0.183) and vacuolization (p=0.185) in the pancreatic tissue between thetwo groups; nevertheless, edema seemed more pronounced in the U-74389G group(p=0.020). Serum metabolic data in the control and therapy groups were notsignificantly different; accordingly, tissue malondialdehyde levels (p=0.705) andtumor necrosis factor-α values (p=0.863) did not differ between the two groups.Conclusion. Based on the histological data and the absence of reduction in themalondialdehyde and tumor necrosis factor-α levels, it is concluded that theadministration of U-74389G does not seem to exert a sizable therapeutic effect inattenuating pancreatic damage from ischemia-reperfusion injury.BACKGROUND/PURPOSE: The potential of lazaroid U-74389G in attenuatinginjury after ischemia and reperfusion has been reported in the context of variousorgans. The present study focuses specifically on the pancreas and aims to examineany effects of U-74389G in a swine model of pancreatic ischemia and reperfusion,encompassing ischemic preconditioning.METHODS: Twelve pigs, weighing 28–35 kg, were randomized into twoexperimental groups: Group A (control group, n=6): Two periods of ischemicpreconditioning (5 min each) separated by a 5- min rest interval; then ischemia time30 min and reperfusion for 120 min. Group B (n=6): the same as above, with U-74389G intravenous injection in the inferior vena cava immediately prior to theinitiation of reperfusion. Blood sampling and pancreatic biopsies were conducted at 0,30, 60, 90 and 120 min after reperfusion. Repeated-measures ANOVA wasundertaken to evaluate differences between the two study groups.RESULTS: No statistically significant differences were noted concerning thehistopathological parameters in the control and therapy groups (p=0.563 for edema,p=0.241 for hemorrhage, p=0.256 for leukocyte infiltration, p=0.231 for acinarnecrosis and p=0.438 for vacuolization). In accordance with the above, serummetabolic data (glucose, creatinine, urea, total and direct bilirubin, total calcium,amylase, lipase, SGOT/AST, SGPT/ALT, ALP, γGT, LDH, CRP, insulin) were notsignificantly different between the two groups; similarly, tumor necrosis factor-αvalues (p=0.705) and tissue malondialdehyde levels (p=0.628) did not differ betweenthe control and therapy groups.CONCLUSIONS: This swine model of pancreatic ischemia and reperfusion,encompassing preconditioning, indicates that U-74389G lazaroid does not seem toexert protective effects from pancreatic damage.Σκοπός: Σκοπός της παρούσης πειραματικής μελέτης είναι η δοκιμή τουαντιοξειδωτικού U-74389G σε ζωικό πρότυπο χοίρου και συγκεκριμένα σεπρωτόκολλο βραχείας διάρκειας ισχαιμίας / ισχαιμίας / επαναιμάτωσης παγκρέατος.Θα μελετηθεί βιοχημικά, αιμοδυναμικά και ιστοπαθολογικά η ευεγερτική ή μη δράσητου συγκεκριμένου μορίου. Έμφαση θα δοθεί στην επίδραση της βραχείας διάρκειαςισχαιμίας (ischemic preconditioning).Σχεδιασμός: Προοπτική τυχαιοποιημένη ελεγχόμενη μελέτηΤοποθεσία: Πειραματικό Χειρουργείο Ερευνητικού-Πειραματικού Κέντρου ELPENΑ.ΕΠειραματόζωα: 24 Χοίροι (αρσενικοί ή θηλυκοί) βάρους 28-35 kgΠείραμα: Τα πειραματόζώα κατανεμήθηκαν τυχαιοποιημένα σε 4 πειραματικέςομάδες (6 ζώα σε κάθε ομάδα) και υπεβλήθησαν σε 30 min ισχαιμία και ακολούθωςσε 120 min επαναιμάτωσης παγκρέατος, σύμφωνα με το κατατεθέν ερευνητικόπρωτόκολλο.Η δόση του αντιοξειδωτικού μορίου είναι 10 mg/kg βάρους σώματος του ζώου.Επειδή το μόριο είναι πρωτότυπο δικαιούμαστε σε αυτήν τη φάση να μην τοσυγκρίνουμε με άλλο μόριο που θα χρησιμεύσει ως θετικός μάρτυρας (γνωστήευεργετική ή έστω απλά θετική δράση).Μετρήσεις και Κύρια ΑποτελέσματαΒιοχημική μελέτη:-Γενικός βιοχημικός κύκλος (ηπατικός κύκλος, γλυκόζη, αμυλάση, λιπάση,κρεατινίνη, CRP)-Αιματολογικός έλεγχος-Έλεγχος πηκτικότητας (APTT, D-dimers)-ΤΝF-α. Ο ΤΝF-α διαδραματίζει κεντρικό ρόλο στην παθογένεση της οξείαςπαγκρεατίδας και συσχετίζεται με συνακόλουθες επιπλοκές.-MDA (malondialdehyde). Η MDA ιστού είναι δείκτης οξειδωτικού stress και ως εκτούτου μπορεί να προσδιορίσει την αποτελεσματικότητα του αντιοξειδωτικού.Η επιλογή των προαναφερθέντων βιοχημικών παραγόντων βασίστηκε σε συγκερασμόπειραματικών και κλινικών μελετών. Παρατέθηκε ποικιλία μορίων, προκειμένου ναεπιλεγούν τα περισσότερο ενδιαφέροντα και αξιόπιστα.Αιμοδυναμική Μελέτη:Έλεγχος καρδιακής λειτουργίας, αρτηριακής και φλεβικής πίεσης, οξυμετρίας,αερίων αίματος.Ιστοπαθολογική Μελέτη:Αναλυτική ιστοπαθολογική μελέτη (παθολογοανατομική) και βαθμολόγηση τωνευρημάτων με score. Στο τέλος του πειράματος, εκτός από το πάγκρεας, θα ληφθούντεμάχια ήπατος, νεφρού, καρδιάς και πνευμόνων ( βιοψίες ).Συμπεράσματα: Βασιζόμενοι στα ιστοπαθολογικά αποτελέσματα και στην απουσίαελλάτωσης των MDA TNF-α, συμπεραίνεται ότι η χορήγηση του λαζαροειδούς U-74389G σε πειραματικό μοντέλο ισχαιμίας επαναιμάτωσης παγκρέατος χοίρου, δενφαίνεται να δείχνει αξιοσημείωτη θεραπευτική επίδραση ή να μετριάζει τις βλάβεςτων ελευθέρων ριζών από ισχαιμία και συνακόλουθη επαναιμάτωση.Επιπροσθέτως, σύμφωνα με την ανάλυση των αποτελεσμάτων της παρούσης ερεύνης,προκύπτει ότι το υπό μελέτη αντιοξειδωτικό μόριο επιδείνωσε την εμφάνισηπαγκρεατικού οιδήματος, τόσο ενδοπαρεγχυματικά όσο και στο διάμεσο χώρο τουοργάνου και μάλιστα με στατιστική σημαντικότητα της τάξεως, p=0.020. Ωστόσο, ηπροσθήκη στο πειραματικό μοντέλο του χειρισμού της ισχαιμικής προπόνησης(ischemic preconditioning), οδήγησε σε εξουδετέρωση αυτής της ανεπιθυμήτουδράσεως
The postoperative redox status of patients with diabetes mellitus: a mini review
Get PDFThe human organism is exposed to variable endogenous and exogenous factors that result in the induction of free radicals. Surgeries are associated with increased inflammation and production of free radicals through various mechanisms, including ischemia, hemolysis, or endogenous antioxidant depletion. Importantly, a more oxidized redox status could lead to the condition known as “oxidative stress,” which is related to alterations in insulin signaling and may lead to insulin resistance and diabetes mellitus. Therefore, patients with diabetes who undergo surgery could be more vulnerable compared with healthy individuals. Thus, this review focuses on the currently available literature regarding the link between the redox status and diabetes complications after surgery and the methods used to assess the redox status of patients, which is the first step to designing an appropriate treatment strategy. To this end, we queried PubMed for novel works published up to May 2020
Fracture of the Second Rib: An Indirect Sign of Serious Trauma Like Fracture of the First Rib?
No full textBackground: The first 3 ribs are anatomically well-protected, shielded by the large thoracic muscles, the shoulder girdle, and the arm. A significant force is required to fracture these ribs; thus, such fractures suggest a high-energy trauma and are associated with injuries to vital organs of the thorax, such as the aorta, the heart, the lungs and the great vessels. Methods: A retrospective analysis was conducted over a 10-year period at a single hospital. The study assessed patients with fractures of the second rib, including their concurrent injuries and the overall severity of their trauma. Results: Among the 76 patients included in the study, the average age was 47.35 years, 81.5% were men, and 19.5% were women. Thirteen patients (17.1%) survived their injuries. The most common causes of injury were road traffic accidents (63%) and pedestrian injuries (22%). The patients who did not survive sustained injuries to an average of 5 additional organs, while survivors had injuries to an average of 2.07 additional organs. Left rib fractures were the most frequently observed (46%). The most serious concurrent injuries reported were to the aorta (5.26%), heart (10.52%), lung (52.36%), head (57.89%), liver (30.2%), spleen (26.31%), and kidney (17.1%). Conclusion: As indicators of serious injury to vital endothoracic organs, isolated fractures of the second rib should be considered equal to first rib fractures in clinical importance. © 2023, The Korean Society for Thoracic and Cardiovascular Surger
Left Coronary Artery Circumflex Branch Arising From Main Stem of Pulmonary Artery: An Uncommon Anatomical Variation
No full textThe left circumflex coronary artery anatomy is considered highly variable. Herein, we present a case of a 9-year-old male child with a remarkable medical history of a spontaneously closed interventricular septal defect, without residual regurgitation, who was referred for cardiological evaluation in view of orthopedic surgery. During the preoperative examination, echocardiography was performed, which showed multiple flows in the interventricular septum as well as a diastolic flow at the level of the pulmonary valve. Due to these findings, it was decided to perform a cardiac catheterization. On cardiac catheterization, it was diagnosed an anatomical variation of the circumflex branch of the left coronary artery arising from the main stem of the pulmonary artery. Significant stenosis was remarkable, as well as collateral circulation of both the circumflex and the left anterior descending artery with the right coronary artery. The child finally at the age of 11 underwent cardiothoracic surgery. To conclude, during asymptomatic cardiological evaluation, we should always think about the possibility of anatomic variations of the coronary arteries. Missing these types of anomalies may predispose to inadvertent life-threatening complications or sudden death
Botulinum Toxin in the Surgical Treatment of Complex Abdominal Hernias: A Surgical Anatomy Approach, Current Evidence and Outcomes
No full textThe Coexistence of an Incomplete Superficial Palmar Arch and a BerrettinAnastomosis: A Case Report
No full textObjective. The aim of this study is to present a relatively rare case of the coexistence of an incomplete superficial palmar arch and a Berrettini anastomosis, identified in a cadaveric specimen, and further discuss the potential clinical implications of such anatomical variations. Case Report. The variation was found in the left hand of a formalin-fixed male cadaver of Greek origin, that was dissected under an operating microscope (×4, ×10 magnification) in our Anatomy Department. In the specimen, we found an incomplete superficial palmar arch, formed only by the superficial branch of the ulnar artery, and a Type 1 Berrettini Anastomosis, originating from the ulnar nerve and joining a branch of the median nerve. Conclusion. To avoid iatrogenic damage and permanent loss of sensation, hand surgeons and microsurgeons should be aware of the presence of a BA, and the potential coexistence of this variation with vascular abnormalities in the hand that may complicate surgical procedures. © 2023 Antonopoulos et al
The Superficial Temporal Artery: Anatomy and Clinical Significance in the Era of Facial Surgery and Aesthetic Medicine
No full textFrom rural to urban settings: life on the margins in the short stories of Dimosthenis Voutiras
No full textThis thesis has been focused on the research of the literary characters in the short stories of Dimosthenis Voutiras, one of the pioneer literary writers of his generation. More specifically, the explanatory interest turned to the characters which have been socially marginalised. These characters are depicted in short stories that cover a chronological period from the beginning of the author’s writing presence and ends at the middle of the Interwar Era. This thesis has been developed methodologically by utilising textual and extratextual criteria, making use of hermeneutic tools from narratology as well as from the scientific field of sociology. More precisely, the theoretical compass of the thesis was a narrative approach which is based on the wider theoretical framework of Gerard Genette, but also the typology of Dorrit Cohn about a research regarding the conscience of the fictional characters throughout a more stylistic type of analysis. In addition to this, vital findings regarding the depiction of the characters were emerged from the use of Mikhail Bakhtin's theory about dialogism and his conclusions concerning elements of Carnival. Furthermore, the approach to the behaviour and the identity of the socially marginalised characters, as they are attributed by the author, was achieved through cultural studies, and more particularly through the theoretical studies of Pierre Bourdieu regarding the life models of the popular (lower) class. As far as the categorisation of the characters is concerned, the typology which was used throughout the thesis was mainly that of Shlomith Rimmon – Kenan. The conclusions regarding the attribution of the social imprint and the political and philosophical ideas of the characters, place those characters into the spectrum of verisimilitude. Η παρούσα διατριβή επικεντρώθηκε στη μελέτη των λογοτεχνικών χαρακτήρων στα διηγήματα του Δημοσθένη Βουτυρά. Πιο συγκεκριμένα, το ερμηνευτικό ενδιαφέρον στράφηκε στους χαρακτήρες του κοινωνικού περιθωρίου, όπως αυτοί αποτυπώνονται σε διηγήματα που καλύπτουν χρονικά μια περίοδο από την αρχή της συγγραφικής παρουσίας του λογοτέχνη ως τα μέσα της μεσοπολεμικής περιόδου. Μεθοδολογικά η διατριβή αναπτύχθηκε αξιοποιώντας κειμενικά και εξωκειμενικά κριτήρια, με ερμηνευτικά εργαλεία από την αφηγηματολογία αλλά και το επιστημονικό πεδίο της κοινωνιολογίας. Πιο ειδικά, θεωρητικές πυξίδες αποτέλεσαν, η αφηγηματολογική προσέγγιση βάσει του ευρύτερου θεωρητικού σχήματος του Gerard Genette και η τυπολογία της Dorrit Cohn για τη μελέτη της συνείδησης των μυθοπλαστικών προσώπων σε μια πιο υφολογικού τύπου ανάλυση, ενώ σημαντικά ευρήματα για την αποτύπωση των χαρακτήρων αναδύθηκαν από την αξιοποίηση της θεωρίας του Bakhtin για τη διαλογικότητα και των συμπερασμάτων του σχετικά με το καρναβαλικό στοιχείο. Επιπλέον, η προσέγγιση της συμπεριφοράς και της ταυτότητας των περιθωριακών χαρακτήρων όπως τους αποδίδει ο συγγραφέας έγινε μέσω των πολιτισμικών σπουδών και ειδικότερα των θεωρητικών μελετών του Pierre Bourdieu, αναφορικά με τα μοντέλα ζωής της λαϊκής τάξης. Για την κατηγοριοποίηση των χαρακτήρων χρησιμοποιήθηκε κυρίως το μοντέλο της Shlomith Rimmon – Kenan. Τα συμπεράσματα σχετικά με την απόδοση του κοινωνικού αποτυπώματος, των πολιτικών και φιλοσοφικών ιδεών, τοποθετούν τους χαρακτήρες του Βουτυρά στο φάσμα της ρεαλιστικής αφήγησης.
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