RESUMEN
OBJECTIVES: to compare the inflammatory response following endovascular and conventional AAA repair. DESIGN: prospective study. PATIENTS AND METHODS: ten patients were selected for open surgery (OPEN) and ten for endovascular (ENDO) AAA repair. Leukocytes, platelets, myeloperoxidase, lactoferrin, beta-thromboglobulin, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-alpha) and complement activation products were measured before, during and after surgery. RESULTS: in the OPEN group the median hospital stay was longer (6 vs. 12 days, p=0.001) and more patients required transfusion (p=0.02). IL-6 and CRP increased postoperatively, most in OPEN (p<0.01). Platelet counts decreased after the first angiography in ENDO (p<0.01) and before aortic cross-clamping in OPEN (p<0.05). The decrease was larger in OPEN (p=0.02). Leukocyte counts decreased after the first angiography in ENDO, and thereafter increased (p=0.001). An equivalent increase was observed in OPEN after declamping (p=0.001). Leukocyte and platelet degranulation products increased after the first angiography in ENDO and after declamping in OPEN. Changes in complement activation products were small. TNF-alpha did not change significantly. CONCLUSION: endovascular AAA repair caused significant leukocyte and platelet activation. Based on the timing of activation this could be caused by radiographic contrast media.
Asunto(s)
Reacción de Fase Aguda/etiología , Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/efectos adversos , Laparotomía/efectos adversos , Reacción de Fase Aguda/sangre , Reacción de Fase Aguda/patología , Anciano , Biomarcadores/sangre , Enzimas Activadoras de Complemento/sangre , Femenino , Fibrinógeno/metabolismo , Hemoglobinas/metabolismo , Humanos , Interleucina-6/sangre , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/patología , Pronóstico , Estudios Prospectivos , Receptores del Factor de Necrosis Tumoral/sangre , Factor de Necrosis Tumoral alfa/metabolismo , Cicatrización de HeridasRESUMEN
A description is given of the natural variation in nitrogen-fixing Rhizobium and Frankia spp. strains and the ability to form root nodules on compatible host plants. Arguments are given for the hypothesis that co-evolution has taken place through mutual interaction of host plants and indigenous Rhizobium and Frankia populations in the soil leading to most efficient symbiotic associations. The significance of root nodules as selective enrichment cultures of particular strains in natural and cultivated soils is exemplified by Rhizobium leguminosarum on various ecotypes of Pisum sativum and with Frankia sp. on various actinorhizal plants, in particular Alnus spp., in different geographic regions. The importance of a host-dependent distribution of Rhizobium and Frankia spp. for agriculture and forestry is discussed.
Asunto(s)
Actinomycetales/metabolismo , Fijación del Nitrógeno , Plantas/microbiología , Rhizobium/metabolismo , Microbiología del Suelo , Simbiosis , Actinomycetales/genética , Actinomycetales/crecimiento & desarrollo , Fabaceae/genética , Fabaceae/microbiología , Variación Genética , Plantas Medicinales , Rhizobium/genética , Rhizobium/crecimiento & desarrollo , Especificidad de la EspecieRESUMEN
Nodulation of Pisum sativum cv. Afghanistan by Rhizobium leguminosarum strain Tom can be blocked by the nonnodulating R. leguminosarum strain PF2. This system was used to study the dynamics of rhizobial binding to seedling root surfaces. Appreciable numbers of 35S-labeled rhizobia bound to the root surface within 2h after inoculation. PF2 colonized the root surfaces earlier and in greater numbers that did Tom. Radioactive extracellular polysaccharides and lipopolysaccharides from either organism failed to bind to the seedling roots in measurable quantities.