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1.
Neuroscience ; 167(3): 678-90, 2010 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-20211700

RESUMO

Dopamine/cAMP signaling has been reported to mediate behavioral responses related to drug addiction. It also modulates the plasticity and firing properties of medium spiny neurons (MSNs) in the nucleus accumbens (NAc), although the effects of cAMP signaling on the resting membrane potential (RMP) of MSNs has not been specifically defined. In this study, activation of dopamine D1-like receptors (D1Rs) by SKF-38393 elicited membrane depolarization and inward currents in MSNs from the NAc core of 14-17 day-old mice. Similar results were obtained following stimulation of adenylyl cyclase (AC) activity with forskolin or application of exogenous cAMP. Forskolin occluded SKF-38393's effects, thus indicating that D1R action is mediated by AC/cAMP signaling. Accordingly, AC blockade by SQ22536 significantly inhibited the responses to SKF-38393. Effects elicited by D1R stimulation or increased cAMP levels were unaffected by protein kinase A (PKA) or protein kinase C (PKC) blockade and were not mimicked by the Epac agonist, 8CPT-2Me-cAMP. Responses to forskolin were also not significantly modified by cyclic nucleotide-gated (CNG) channel blockade. Forskolin-induced membrane depolarization was associated with increased membrane input resistance. Voltage-clamp experiments revealed that forskolin and SKF-38393 effects were due to inhibition of resting K(+) currents exhibiting inward rectification at hyperpolarized potentials and a reversal potential (around -90 mV) that shifted with the extracellular K(+) concentration. Forskolin and D1R agonist effects were abolished by the inward rectifier K(+) (Kir)-channel blocker, BaCl(2). Collectively, these data suggest that stimulation of postsynaptic D1Rs in MSNs of the NAc core causes membrane depolarization by inhibiting Kir currents. This effect is mediated by AC/cAMP signaling but it is independent on PKA, PKC, Epac and CNG channel activation, suggesting that it may stem from cAMP's direct interaction with Kir channels. D1R/cAMP-mediated excitatory effects may influence the generation of output signals from MSNs by facilitating their transition from the quiescent down-state to the functionally active up-state.


Assuntos
AMP Cíclico/metabolismo , Neurônios/metabolismo , Núcleo Accumbens/metabolismo , Canais de Potássio Corretores do Fluxo de Internalização/metabolismo , Receptores de Dopamina D1/metabolismo , Transdução de Sinais/fisiologia , 2,3,4,5-Tetra-Hidro-7,8-Di-Hidroxi-1-Fenil-1H-3-Benzazepina/farmacologia , Adenina/análogos & derivados , Adenina/farmacologia , Adenilil Ciclases/efeitos dos fármacos , Adenilil Ciclases/metabolismo , Animais , Colforsina/farmacologia , Proteínas Quinases Dependentes de AMP Cíclico/efeitos dos fármacos , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Dopamina/metabolismo , Agonistas de Dopamina/farmacologia , Inibidores Enzimáticos/farmacologia , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Neurônios/citologia , Neurônios/efeitos dos fármacos , Núcleo Accumbens/citologia , Núcleo Accumbens/efeitos dos fármacos , Técnicas de Cultura de Órgãos , Técnicas de Patch-Clamp , Canais de Potássio Corretores do Fluxo de Internalização/efeitos dos fármacos , Receptores de Dopamina D1/agonistas , Transdução de Sinais/efeitos dos fármacos , Transmissão Sináptica/efeitos dos fármacos , Transmissão Sináptica/fisiologia
3.
Minerva Chir ; 61(1): 51-6, 2006 Feb.
Artigo em Inglês, Italiano | MEDLINE | ID: mdl-16568023

RESUMO

Primary hyperparathyroidism is a clinical condition related to an excessive and abnormally regulated secretion of parathyroid hormone (PTH) from the parathyroid glands which is responsible for an alteration of the calcium and phosphorus metabolism. Parathyroid adenomas are the most important cause of primary hyperparathyroidism (80-85%). A case of parathyroid adenoma observed in a patient aged 47, admitted to the Emergency Medicine Department of our Hospital with a diagnosis of hypertensive crisis, cephalea, vomiting, and a clinical history of recurrent episodes of severe abdominal and renal pain, is presented. Lab data showed severe hypercalcemia and a progressive worsening of the renal function. A severe neurological involvement with stupor, derangement of mind, the arising of acute respiratory depression, lethargy compelled the colleagues to transfer him to the Intensive Care Unit; a neck ultrasonography showed a poor-echogenous area under the right thyroid inferior pole, with signs of vascularization. The suspect of a primary hyperparathyroidism related to a single adenoma of the parathyroid gland suggested a surgical treatment. A ''concise parathyroidectomy'' was performed. Our surgical approach was confirmed by the comparison of the preintervention and the post-intervention iPTH values: 2080 pg/mL (normal range: 12-65 pg/mL) before excision vs 101 pg/mL after the removal. The histologycal exam reported a parathyroid adenoma with large areas with haemorrage. Three days after surgery the patient was in good general conditions. Patients affected by primary hyperparathyroidism are often misdiagnosed because their clinical conditions can create differential diagnosis problems with other diseases. However the surgical option remains the gold standard treatment.


Assuntos
Adenoma/complicações , Hiperparatireoidismo Primário/etiologia , Neoplasias das Paratireoides/complicações , Adenoma/cirurgia , Erros de Diagnóstico , Humanos , Hiperparatireoidismo Primário/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/cirurgia
4.
J Vasc Access ; 6(4): 171-6, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16552697

RESUMO

BACKGROUND/AIMS: The goal of the therapeutic management of patients affected by end-stage renal disease (ESRD) is to maintain the vascular access (VA) as long as possible. Myointimal hyperplasia development in the vascular walls of arteriovenous fistulas (AVFs) is considered one of the most important factors responsible for procedure failure. These alterations could be linked to hemodynamic changes in the anastomosis and to the presence of the surgical suture itself. We report our preliminary experience, discussing the use and the possible benefits of an absorbable suture in polyglycolide trimethylene carbonate (PTC) in AVF creation. METHODS: Seventy-four AVFs were created as primary access for hemodialysis (HD), using PTC, over 4 years. Age, gender, ESRD etiology, artery and vein preoperative diameters, AVF survival outcome, and the number of AVFs created per year were recorded. The Kaplan-Meier method was used to analyze AVF survival rates. RESULTS: No dehiscences, pseudoaneurysms, or failures in the 'critical' period related to PTC absorption were recorded. Kaplan-Meier analysis was used to evaluate AVF survival; 12-month primary AVF survival (74.33%) and AVF failure (25.67%) rates, 9 'early' (8.22%) and 10 'late' failures (13.51%), and a 360-day mean survival were found. CONCLUSIONS: Our data indicate that PTC, a well known and widely used material for sutures in vascular surgery, is safe and effective in AVF creation. Potential advantages of PTC sutures are represented by a reduced myointimal hyperplasia formation in the AVF vascular walls, prolonging the AVF lifespan and avoiding re-interventions.

5.
Acta Otolaryngol Suppl ; (552): 42-5, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15219046

RESUMO

A number of studies have shown that cisplatin and gentamicin ototoxic effects may result from free radical-mediated damage due to the reduction of antioxidant substances and an increased lipid peroxidation. The authors summarize the results obtained evaluating the auditory and vestibular functions and the inner ear hair cell morphology and survival after administration of antioxidant agents against cisplatin and gentamicin. In the first experiment, albino guinea pigs were treated with gentamicin (100 mg/kg per day, i.m.) alone or gentamicin (100 mg/kg per day, i.m.) plus alpha-tocopherol (100 mg/kg per day, i.m.) for 2 weeks. In a second experiment, albino guinea pigs were injected with cisplatin (2.5 mg/kg per day) or cisplatin (2.5 mg/kg per day) plus tiopronin (300 mg/kg) for 6 days. Electrocochleographic recordings were made from an implanted round window electrode. In all experiments compound action potentials (CAPs) were measured at 2-16 kHz. Changes in cochlear function were characterized as CAP threshold shifts. To evaluate vestibular function, the animals underwent sinusoidal oscillations in the dark about their vertical and longitudinal axes to evoke horizontal and vertical vestibulo-ocular reflexes (VOR). Frequency stimulation parameters ranged from 0.02 to 0.4 Hz and peak-to-peak amplitude was 20 degrees. Morphological changes were analysed by light microscopy and scanning electron microscopy. Both hearing loss and vestibular dysfunction induced by gentamicin were significantly attenuated by alpha-tocopherol. However, tiopronin co-therapy slowed the progression of hearing loss in cisplatin-treated animals and significantly attenuated the final threshold shifts. Cisplatin had little effect on the hair cells of cristae ampullares and maculae. Vestibular function was completely preserved in tiopronin co-treated animals. In conclusion, antioxidants such as alpha-tocopherol or tiopronin interfere with gentamicin and cisplatin damage and this suggests that they may be useful in preventing oto-vestibulotoxicity. Therefore, it is important to develop protective strategies that permit the avoidance of the toxic side effects of these drugs without interfering with their therapeutic effects.


Assuntos
Antibacterianos/efeitos adversos , Antineoplásicos/efeitos adversos , Antioxidantes/farmacologia , Cisplatino/efeitos adversos , Gentamicinas/efeitos adversos , Perda Auditiva/prevenção & controle , alfa-Tocoferol/farmacologia , Potenciais de Ação , Animais , Antibacterianos/administração & dosagem , Antineoplásicos/administração & dosagem , Audiometria de Resposta Evocada , Cisplatino/administração & dosagem , Cóclea/efeitos dos fármacos , Cóclea/patologia , Feminino , Gentamicinas/administração & dosagem , Cobaias , Perda Auditiva/induzido quimicamente , Microscopia , Reflexo Vestíbulo-Ocular/efeitos dos fármacos , Tiopronina/farmacologia , Vestíbulo do Labirinto/efeitos dos fármacos , Vestíbulo do Labirinto/patologia
6.
Acta Otolaryngol ; 124 Suppl 552: 42-5, 2004 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26942826

RESUMO

A number of studies have shown that cisplatin and gentamicin ototoxic effects may result from free radical-mediated damage due to the reduction of antioxidant substances and an increased lipid peroxidation. The authors summarize the results obtained evaluating the auditory and vestibular functions and the inner ear hair cell morphology and survival after administration of antioxidant agents against cisplatin and gentamicin. In the first experiment, albino guinea pigs were treated with gentamicin (100 mg/kg per day, i.m.) alone or gentamicin (100 mg/kg per day, i.m.) plus α-tocopherol (100 mg/kg per day, i.m.) for 2 weeks. In a second experiment, albino guinea pigs were injected with cisplatin (2.5 mg/kg per day) or cisplatin (2.5 mg/kg per day) plus tiopronin (300 mg/kg) for 6 days. Electrocochleographic recordings were made from an implanted round window electrode. In all experiments compound action potentials (CAPs) were measured at 2-16 kHz. Changes in cochlear function were characterized as CAP threshold shifts. To evaluate vestibular function, the animals underwent sinusoidal oscillations in the dark about their vertical and longitudinal axes to evoke horizontal and vertical vestibulo-ocular reflexes (VOR). Frequency stimulation parameters ranged from 0.02 to 0.4 Hz and peak-to-peak amplitude was 20°. Morphological changes were analysed by light microscopy and scanning electron microscopy. Both hearing loss and vestibular dysfunction induced by gentamicin were significantly attenuated by α-tocopherol. However, tiopronin co-therapy slowed the progression of hearing loss in cisplatin-treated animals and significantly attenuated the final threshold shifts. Cisplatin had little effect on the hair cells of cristae ampullares and maculae. Vestibular function was completely preserved in tiopronin co-treated animals. In conclusion, antioxidants such as α-tocopherol or tiopronin interfere with gentamicin and cisplatin damage and this suggests that they may be useful in preventing oto-vestibulotoxicity. Therefore, it is important to develop protective strategies that permit the avoidance of the toxic side effects of these drugs without interfering with their therapeutic effects.

7.
Minerva Chir ; 58(3): 313-20, 2003 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-12955049

RESUMO

The occurrence of pulmonary gas embolism in patients undergoing laparoscopic cholecystectomy is reported in the medical literature. Severe intraoperative complications or the patient's death were correlated to gas embolism during laparoscopic procedures. However, the careful retrospective study or the autoptic exam of such casualties have always showed an erroneus direct puncture of vessels or the straight insertion of the Veress needle into a parenchymal organ. It is obvious that the direct gas injection into a vein or into parenchymal organs is a primary cause of gas embolism, as well as the high flow insufflation of gas into the peritoneal cavity in concomitance with the lesion of major abdominal vessel's wall. Gas embolism may occur each time the vein internal pressure is lower than the external pressure and not only during a laparoscopic procedure when carbon dioxyde is inflated into the peritoneal cavity, but also during open surgery such as major liver resections, neurosurgery, vascular or cardiac surgery. The review of large series of laparoscopic cholecystectomies reported in the international literature, as well as our own clinical experience in this field, together with the results of laboratory animal studies based on the experimental insufflation or injection of carbon dioxyde, show that gas embolism must not be considered as a complication of laparoscopic surgery. Due to the above mentioned risks with the use of the Veress needle, the surgeon should revalue alternative means in creating the pneumoperitoneum.


Assuntos
Dióxido de Carbono , Colecistectomia Laparoscópica/efeitos adversos , Embolia Aérea/etiologia , Animais , Embolia Aérea/epidemiologia , Humanos
8.
Int J Artif Organs ; 25(10): 985-93, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12456040

RESUMO

Hepatic support is indicated in acute liver failure (ALF) patients to foster liver regeneration, or until a liver becomes available for orthotopic liver transplantation (OLT), in primary non function of the transplanted liver, and hopefully in chronic liver disease patients affected by ALF episodes, in whom OLT is not a therapeutic option. The concept of bioartificial liver (BAL) is based on the assumption that only the hepatocytes can perform the whole spectrum of biotransformation functions, which are needed to prevent hepatic encephalopathy, coma and cerebral edema. Among others, two important issues are related to BAL development: 1) the choice of the cellular component; 2) the cell mass needed to perform an adequate BAL treatment. Primary hepatocytes, of human or animal origin, should be considered the first choice because they express highly differentiated functions. Accordingly, a minimal cell mass corresponding to 10% of a human adult liver, i.e. 150 grams of freshly isolated, > or = 90% viable hepatocytes should be used. When 4 degrees C cold-stored or cryopreserved hepatocytes are used, the cellular mass should be increased because of a drop in cell viability and function. In case of hepatoma-derived cells, cultured cell lines or engineered cells, an adequate functional cell mass should be used, expressing metabolic and biotransformation activities comparable to those of primary hepatocytes. Finally, the use of porcine hepatocytes or other animal cells in BAL devices should be presently directed only to ALF patients as a bridge treatment to OLT, because of potential transmission of animal retrovirus and prions which may potentially cause major pandemics.


Assuntos
Hepatócitos , Fígado Artificial , Animais , Contagem de Células , Linhagem Celular , Sobrevivência Celular , Células Cultivadas , Hepatócitos/metabolismo , Humanos , Falência Hepática Aguda/terapia , Consumo de Oxigênio , Suínos , Preservação de Tecido
9.
Int J Artif Organs ; 25(3): 192-202, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11999191

RESUMO

Orthotopic liver transplantation (OLT) is the only effective therapeutic modality in severe acute hepatic failure (AHF). The scarcity of organs for transplantation leads to an urgent necessity for temporary liver support treatments in AHF patients. A hepatocyte-based bioartificial liver (BAL) is under investigation with the main purpose to serve as bridging treatment until a liver becomes available for OLT, or to promote spontaneous liver regeneration. We developed a novel radial-flow bioreactor (RFB) for three-dimensional, high-density hepatocyte culture and an integrated pumping apparatus in which, after plasmapheresis, the patient's plasma is recirculated through the hepatocyte-filled RFB. Two hundred thirty grams of freshly isolated porcine hepatocytes were loaded into the RFB for clinical liver support treatment. The BAL system was used 8 times in supporting 7 AHF patients in grade III-IV coma, all waiting for an urgent OLT Three patients with no history of previous liver diseases were affected by fulminant hepatic failure (FHF) due to hepatitis B virus, 3 by primary non-function (PNF) of the transplanted liver, and one by AHF due to previous abdominal trauma and liver surgery. Six out of 7 patients underwent OLT following BAL treatment(s), which lasted 6-24 hours. All patients tolerated the procedures well, as shown by an improvement in the level of encephalopathy, a decrease in serum ammonia, transaminases and an amelioration of the prothrombin time, with full neurological recovery after OLT Our initial clinical experience confirms the safety of this BAL configuration and suggests its clinical efficacy as a temporary liver support system in AHF patients.


Assuntos
Falência Hepática Aguda/terapia , Fígado Artificial , Adolescente , Adulto , Animais , Sobrevivência Celular , Células Cultivadas , Circulação Extracorpórea , Feminino , Hepatócitos/metabolismo , Humanos , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Suínos
10.
Neurosci Lett ; 311(2): 101-4, 2001 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-11567788

RESUMO

A possible functional role of inducible isoform of nitric oxide synthase (iNOS) was explored in vitro on the motility of mouse distal colon. Using an isotonic - non-isovolumic technique, peristaltic activity and video images of the external wall of colonic segments were recorded before and after addition to the medium of Aminoguanidine (AG) and N-(3-(aminomethyl)benzyl) acetamidine (W1400) [10(-7) M-10(-4) M], two iNOS inhibitors. AG and W1400 induced an hyperexcitability of visceral smooth muscle characterised by an increase of basal tone and spontaneous phasic activity. As a consequence of these effects, the peristaltic activity declined and disappeared at the highest concentrations. These findings indicated a removal of inhibitory action performed by NO synthesised by iNOS in the colonic segment. The implications of results are discussed in term of tonic relaxation of intestinal smooth muscle to allow intraluminal content accommodation.


Assuntos
Colo/enzimologia , Motilidade Gastrointestinal/fisiologia , Músculo Liso/enzimologia , Óxido Nítrico Sintase/metabolismo , Amidinas/farmacologia , Animais , Benzilaminas/farmacologia , Inibidores Enzimáticos/farmacologia , Guanidinas/farmacologia , Camundongos , Camundongos Endogâmicos C57BL , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase/antagonistas & inibidores , Óxido Nítrico Sintase Tipo II
11.
Neuroreport ; 12(9): 1847-50, 2001 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-11435910

RESUMO

The slow compensatory phases of the vestibulo-ocular reflex (VOR) in the rabbit tend to drift and the drift reverses the direction. This periodic alternating drift (PAD) has two peculiar characteristics: (1) it is induced by sinusoidal vestibular stimulation in naive animals, being evoked immediately after stimulus onset and persisting after the end of stimulation; (2) the peak velocity and period of the drift are dependent on stimulus amplitude. PAD of the rabbit has strong similarities with PAN, a periodic alternating nystagmus observed in humans with cerbellar disorders and in monkeys after nodulo-uvulectomy, although its peak velocity is smaller. It is hypothesized that PAD is due to a slight instability, caused by vestibular stimulation in darkness, of the cerebellar adaptive loop, which exerts a variable gain control on the time constant of the velocity storage integrator.


Assuntos
Movimentos Oculares/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Vestíbulo do Labirinto/fisiologia , Animais , Relógios Biológicos/fisiologia , Cerebelo/fisiologia , Vias Neurais/fisiologia , Nistagmo Patológico/fisiopatologia , Estimulação Física , Coelhos , Núcleos Vestibulares/fisiologia
12.
Life Sci ; 69(1): 101-11, 2001 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-11411800

RESUMO

The effects of the cannabinoid receptor agonist Win 55,212-2 and of the competitive cannabinoid receptor antagonist SR 141716A on the electrically-evoked peristalsis of isolated distal colon of mouse were studied. Intraluminal pressure, longitudinal displacement, ejected fluid volume and changes in morphology of external intestinal wall were simultaneously recorded in the pre-drug period and in presence of Win 55,212-2 alone or in combination with SR 141716A. In the pre-drug period (control), peristaltic activity was characterised by regular, monophasic waves and the intraluminal content propelled towards anterograde (oro-aboral) direction with a propulsion velocity of 1.25 +/- 0.1 mm x s(-1). Pressure and shortening waves showed a peak amplitude of 2.44 +/- 0.32 kPa and 1.8 +/- 0.72 mm, respectively. The mean amount of fluid volume ejected during each contraction was 80 +/- 12.6 microl. The addition of Win 55,212-2 [10(-7)-10(-4) M] to the organ bath determined a dose-related attenuation of peristaltic activity consequent to the decrease of circular and longitudinal muscle strength. The decrease of contractile activity was followed by dose-dependent decrease of the amount of fluid ejected during peristalsis. The effects of Win 55,212-2 [10(-7)-10(-5) M] were prevented by SR 141716A, indicating the presence of cannabinoid CB1 receptors in the mouse distal colon. SR 141716A alone enhanced both tonic and phasic motor activities in the colonic longitudinal smooth muscle, suggesting that CB1 receptor antagonists could act either through antagonising the effect of endogenous CB1 receptor agonist or by an agonist effect on these receptors. The present results further support the hypothesis that cannabinoids perform a neuromodulatory role in various tracts of gastrointestinal system and first demonstrate their action also in the distal colon of rodents.


Assuntos
Canabinoides/farmacologia , Colo/fisiologia , Morfolinas/farmacologia , Naftalenos/farmacologia , Peristaltismo/efeitos dos fármacos , Piperidinas/farmacologia , Pirazóis/farmacologia , Animais , Benzoxazinas , Canabinoides/antagonistas & inibidores , Colo/citologia , Colo/efeitos dos fármacos , Interações Medicamentosas , Estimulação Elétrica , Potenciais Evocados/efeitos dos fármacos , Potenciais Evocados/fisiologia , Técnicas In Vitro , Masculino , Camundongos , Camundongos Endogâmicos ICR , Músculo Liso/citologia , Músculo Liso/efeitos dos fármacos , Músculo Liso/fisiologia , Rimonabanto
13.
Acta Otolaryngol ; 121(2): 229-33, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11349785

RESUMO

The present research analysed on chronic animals the functional recovery of eye motility after impairment of the proprioceptive input at the level of the semilunar ganglion. The horizontal vestibulo-ocular reflex (HVOR) was recorded in normal pigmented rabbits before and after a partial electrolytic lesion of the semilunar ganglion. The recordings were repeated daily for 8-10 days to evaluate the recovery. Immediately after the lesion, as previously observed, HVOR slow phases were unaffected, while quick phases (QPs) showed a reduction in peak velocity and a deviation of trajectories from the horizontal plane. QP peak velocity was almost completely restored within 3-5 days, while trajectory deviation was not corrected during the observation period. Furthermore, in some animals, the variability of trajectories showed, starting from days 3-5, a progressive increase that led to a greater spatial disorganization. A process of lesion-induced plasticity takes place. but only the velocity of QPs can be recovered rapidly, while the QP trajectory impairment does not appear to be compensated substantially, which underlines a determinant role in the control of QP spatial orientation exerted by EOM proprioceptive signals.


Assuntos
Vias Aferentes/fisiologia , Músculos Oculomotores/inervação , Propriocepção/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Gânglio Trigeminal/fisiologia , Animais , Plasticidade Neuronal/fisiologia , Nervo Oftálmico/fisiologia , Coelhos
14.
Ann Ital Chir ; 71(3): 281-3, 2000.
Artigo em Italiano | MEDLINE | ID: mdl-11014006

RESUMO

Acute liver failure is a life-threatening condition since conventional medical treatments have little effect on survival. Artificial liver support systems based on blood detoxification alone have proven to be ineffective. A liver support system should carry out essential functions such as the phase I reaction in which lipid-soluble toxic substance are rendered water-soluble by the enzyme system of the cytochrome P450 and NADPH-cytochrome reductase, and are therefore conjugated by the phase II reaction, before excretion. Liver support systems should be capable of sustaining patients until an organ is available for liver transplantation (bridging treatment), or improving the survival in patients for whom liver transplantation is not a therapeutic option. Recent advances in cell biology and tissue culture techniques have led the way for potential clinical use of isolated hepatocytes so that they are now an important element of bioartificial liver (BAL) support devices. Some of these BAL are currently under clinical investigation in the USA and Europe, and the results of the prospective controlled trials will be soon available.


Assuntos
Falência Hepática Aguda/cirurgia , Fígado Artificial , Previsões , Humanos
15.
Ann Ital Chir ; 71(3): 337-45, 2000.
Artigo em Italiano | MEDLINE | ID: mdl-11014013

RESUMO

Hepatocyte based artificial liver support systems are under investigation to support acute liver failure patients. The main purpose of such systems is to serve as a bridge to liver transplantation, or to promote spontaneous liver recovery. Limitation in mass-transfer capacity makes hollow-fiber bioreactors unsuited for long-term functioning of hybrid devices. We developed a novel radial-flow bioreactor in which the fluid perfuses the module from the center to the periphery, after having diffused through a space occupied by a three-dimensional structure filled with the hepatocytes. Five grams of freshly isolated porcine hepatocytes were seeded into uncoated, woven-non woven, hydrophilic polyester fabric, overlaid by two polyethersulfone membranes. Liver cells were perfused with 37 degrees C-warm, oxygenated, serum-free tissue culture medium, in which NH4Cl and Lidocaine were added at the final concentration of 1 mM and 60 micrograms/ml, respectively. Ammonium chloride removal, urea synthesis, monoethylglycinexylide (MEGX), pO2, pCO2, and pH were measured throughout the 14 day duration of the study. In a separate set of experiments, a scaled-up version of the radial flow bioreactor containing 150 grams of cells was perfused for 7 h with recirculating human plasma and MEGX production was monitored. During the 2 weeks of the study, an increasing production of urea was paralleled by constant ammonium removal. MEGX concentration after Lidocaine addition increased throughout the 14 days of perfusion with tissue culture medium, as well as after 7 hour perfusion with human plasma. Under transmission and scanning electron microscopy cells appeared attached to the polyester and one to each other, displaying ultrastructural features typical of functioning hepatocytes. Our study showed that liver cells were metabolically active when perfused into the radial-flow bioreactor. This configuration allowed close contact between media, or plasma, and cells at a physiological flow rate, by equalizing the concentration of the perfusing components, including O2, throughout the module. Our results suggest a potential use of this system for temporary extracorporeal liver support in acute hepatic failure patients.


Assuntos
Reatores Biológicos , Fígado/citologia , Animais , Desenho de Equipamento , Fígado Artificial , Suínos
17.
Pancreas ; 19(3): 304-9, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10505762

RESUMO

Early studies showed that compensatory liver growth after anterior portal branch ligation (aPBL) may restore normoglycemia in streptozotocin (STZ)-diabetic rats, in which a subtherapeutic islet mass was previously transplanted into the liver. We hypothesized that this effect could be related to islet regeneration at the graft site. This study was designed to characterize the proliferative response of the intraportally transplanted islets, shortly after aPBL. Male Wistar-Furth rats were used as syngeneic islet donors and/or recipients. STZ-diabetic rats were divided in four groups: groups 1 and 2 underwent selective 250-islet transplantation (Tx) into the posterior liver lobes, followed by aPBL 10 days later; rats were killed 24 h (n = 9) and 48 h (n = 10) after aPBL, respectively; groups 3 and 4 underwent selective 250-islet Tx into the posterior liver lobes, followed by sham aPBL 10 days later; rats were killed 24 h (n = 3) and 48 h (n = 3) after aPBL, respectively. Two hours before killing, all animals were injected with 5'-bromo-2'-deoxyuridine (BrdU; 50 mg/kg, i.v.). Liver sections were immunostained for insulin and BrdU, and both hepatocyte and islet cell labeling index (LI) were calculated. Islet cell LI was 2.30+/-1.18% in group 1, 2.23+/-1.00% in group 2, 0.43+/-0.29% in group 3, and 0.39+/-0.21% in group 4 (group 1 vs. group 3: p<0.02; group 2 vs. group 4: p<0.01). Hepatocyte LI was 2.50+/-2.14% in group 1, 15.0+/-7.6% in group 2, 0.12 +/-0.04 in group 3, and 0.11+/-0.03% in group 4, respectively (group 1 vs. group 2: p<0.02; group 1 vs. group 3: p<0.001; group 2 vs. group 4: p<0.001). Our study showed that intraportally transplanted islets undergo a concurrent proliferative response after aPBL, although with a lower extent and a different timing when compared with the liver-cell response.


Assuntos
Diabetes Mellitus Experimental/patologia , Transplante das Ilhotas Pancreáticas , Ilhotas Pancreáticas/citologia , Fígado/citologia , Pâncreas/citologia , Animais , Ductos Biliares/citologia , Glicemia , Bromodesoxiuridina , Divisão Celular , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/terapia , Ligadura , Regeneração Hepática , Masculino , Veia Porta , Ratos , Ratos Endogâmicos WF
18.
Exp Neurol ; 159(2): 520-7, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10506523

RESUMO

The contribution of the different Ca(2+)-channel subtypes to the K(+)-evoked [(3)H]noradrenaline release from rat cerebral cortex synaptosomes has been investigated. In the same experimental model, it was also verified whether the calcium-mediated neurotransmitter release is influenced by IgGs purified from sera of seven patients affected by sporadic amyotrophic lateral sclerosis. Synaptosome treatment with 3.0 microM nifedipine or 2.0 microM calciseptine, which block L-type channels, slightly decreased [(3)H]noradrenaline release, the reduction being 7 and 13% of the control values, respectively. The blockade of N-type Ca(2+)-channels with omega-conotoxin-GVIA (0.001-1.0 microM) induced a concentration-dependent reduction of the neurotransmitter release, with maximum effect of 34%. omega-Agatoxin-IVA failed to significantly affect the studied release, which was instead markedly reduced by omega-conotoxin-MVIIC. After the blockade of N-type channels with maximal concentrations of omega-conotoxin-GVIA, 3.0 microM omega-conotoxin-MVIIC reduced the release by 58%. Synaptosome treatment with amyotrophic lateral sclerosis IgGs enhanced the K(+)-evoked [(3)H]noradrenaline release, which was mostly mediated by P/Q- and N-type Ca(2+)-channels. The increase induced by pathologic IgGs (0.2 mg/ml) ranged from 11 to 62% for the different patients, and it was concentration-dependent. The basal release was instead unaffected by IgG treatment. The results of the present study suggest that the K(+)-evoked [(3)H]noradrenaline release from brain cortex synaptosomes is mainly mediated by activation of P/Q- and N-type Ca(2+)-channels. Autoantibodies present in the sera of patients affected by sporadic amyotrophic lateral sclerosis may interact with these channels by producing an increased calcium influx, with consequent enhancement of the neurotransmitter release. Preliminary results of the present study have been published in abstract form (Martire et al., 1997, Pharmacol. Res. 35:9).


Assuntos
Canais de Cálcio Tipo N/fisiologia , Córtex Cerebral/metabolismo , Imunoglobulina G/farmacologia , Doença dos Neurônios Motores/imunologia , Norepinefrina/metabolismo , Potássio/farmacologia , Sinaptossomos/metabolismo , Animais , Cloreto de Cádmio/farmacologia , Bloqueadores dos Canais de Cálcio/farmacologia , Canais de Cálcio Tipo N/efeitos dos fármacos , Humanos , Imunoglobulina G/sangue , Cinética , Masculino , Nifedipino/farmacologia , Ratos , Ratos Wistar , Sinaptossomos/efeitos dos fármacos , Trítio , ômega-Agatoxina IVA/farmacologia , ômega-Conotoxina GVIA/farmacologia
19.
Exp Physiol ; 84(5): 929-40, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10502660

RESUMO

Mechanical properties of the vascular smooth muscle from normal and dystrophin-deficient (mdx) mice were examined. Changes in resting and developed tensions in response to stretch were recorded in isolated portal vein. The vascular segments were elongated in 5 % increments of the 'in situ' length (Lr) up to 1.30Lr. The resting length-tension curves in male mdxmice were similar to normal mice, while a marked decrease in the slope of the curve was noted in female mdx mice. These findings were not affected by atropine, phentolamine, tetrodotoxin or [Ca2+] in the surrounding media. At Lr, the tension of isolated portal vein was characterized by spontaneous synchronized uniform force waves in normal mouse. In contrast, in mdxmouse portal veins an irregular motor pattern characterized by desynchronized force waves with a decrease of amplitude and an increase in frequency was recorded. Extension of the length of the portal vein segment did not increase the spontaneous phasic activity developed in female mdx mice although this was noted with male mdx mice and normal mice. Experiments with chemical depolarizing agents indicated that spontaneous myogenic excitation activated the great majority of vascular smooth muscle cells in normal mouse portal vein, whereas in mdx mice only a reduced number of these cells were excited suggesting that in the mdx mouse the intercellular electronic coupling is altered. In conclusion this study provides the first description of the mechanical activities of portal vein longitudinal muscle and shows that in mdx mice the motor activity is severely disrupted.


Assuntos
Distrofina/deficiência , Músculo Liso Vascular/fisiopatologia , Veia Porta/fisiopatologia , Acetilcolina/farmacologia , Animais , Espaço Extracelular/metabolismo , Feminino , Técnicas In Vitro , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos mdx , Músculo Liso Vascular/efeitos dos fármacos , Norepinefrina/farmacologia , Estimulação Física , Veia Porta/efeitos dos fármacos , Cloreto de Potássio/metabolismo , Valores de Referência , Vasoconstritores/farmacologia , Vasodilatadores/farmacologia , Sistema Vasomotor/fisiopatologia
20.
Clin Neurophysiol ; 110(1): 62-70, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10348322

RESUMO

In order to investigate the mechanisms underlying the generation of steady-state responses (SSRs), auditory evoked potentials elicited by click trains presented at several stimulation rates (30, 40, 50, 60 Hz) were recorded in 7 awake rats by means of epidural electrodes placed over the temporal cortex. Mean amplitude-rate function calculated on the recorded responses appeared almost flat and showed the maximum value at 50 Hz, while mean phases showed a linear increase when increasing the stimulation rate. In each rat, predictions of the recorded responses at 30, 40, 50 and 60 Hz were synthesized by superimposing middle-latency auditory evoked potentials (MAEPs) at suitable time intervals at each rate. Mean amplitudes calculated on the predicted curves decreased linearly when increasing the stimulation rate and appeared higher in comparison to those obtained from the recorded SSRs. Predicted phases showed a linear increase when increasing the stimulation rate and were leading with respect to corresponding phase values calculated for recorded SSRs. Our findings indicate that the MAEP superimposition mechanism does not adequately predict the generation of temporal recorded SSRs in rats. This was explained by admitting that phenomena related to the recovery cycle and, to a lesser extent, to rate-dependent facilitating effects come into play.


Assuntos
Potenciais Evocados Auditivos/fisiologia , Lobo Temporal/fisiologia , Estimulação Acústica , Animais , Masculino , Ratos , Ratos Wistar , Tempo de Reação/fisiologia
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