ABSTRACT
OBJECTIVE: Hemorrhagic cystitis (HC) is a generally self-limited complication of hematopoietic stem cell transplantation (HSCT). It may occur in the early or late posttransplant period and can promote sometimes severe morbidity. We analyzed our data regarding HC in allogeneic HSCT patients in order to establish the efficacy of hyperbaric oxygen (HBO) therapy in severe HC and to document the main problems during its use. METHODS: Between March 1993 and August 2006, 161 patients received allogeneic HSCT. Mesna, hyperhydration and forced diuresis were used as early HC prophylaxis of cyclophosphamide-induced HC. However, HC was diagnosed in 49 of the 161 recipients and 17 of them were considered as severe HC. We analyzed their data retrospectively. RESULTS: Forced diuresis with hyperhydration (up to 8 L/day) and transfusion support to maintain a platelet count above 30x109/L were sufficient in 10 of the 17 patients with severe HC. Alternative therapies used included intravesical irrigation with formalin and prostaglandin (PG)F2 alpha and HBO, and HBO appeared to be the most useful among them. CONCLUSION: We conclude that HBO offers a noninvasive therapeutic alternative in the management of intractable HC in the HSCT setting.
ABSTRACT
PURPOSE: To detect the neuroprotective role of nimodipine and dantrolene in N-methyl- d-aspartate (NMDA)-induced retinal injury. METHODS: In this study we used two calcium antagonists which have two different modes of action, nimodipine and dantrolene, to prevent NMDA-induced retinal ischemia in guinea pigs. In 40 animals we injected nimodipine (n=10), dantrolene (n=10), a combination of both (n=10) or sterile 0.9% NaCl solution as a placebo (n=10) before intravitreal injection of NMDA. We enucleated one eye of each animal after 48 hours and performed histopathologic examination. We also measured malondialdehyde (MDA) levels in retinal homogenates as a marker of ischemic injury. RESULTS: Our results indicate that ganglion cells of the retina were preserved mostly by nimodipine, followed by combined nimodipine-dantrolene, and dantrolene respectively. The ganglion cell count was statistically significantly higher in cases where we used calcium antagonists than in the control group (p<0.05). We also found that MDA was significantly reduced by calcium antagonists compared to the control group (p<0.05). CONCLUSION: Our data show that nimodipine and dantrolene both have potential neuroprotective effects; nimodipine preserved retinal ganglion cells to a greater extent than dantrolene from NMDA-induced retinal injury.