Laser treatment of synovial inflammatory process in experimentally induced microcrystalline arthritis in Wistar rats.

The presence of intra-articular crystals is detected in different articular pathologies of acute or chronic nature. The aim of this work was to analyze the action of the indium gallium aluminum and phosphorus (InGaAlP) (λ = 670 nm) laser on the synovial membrane present in the knee joint in experimentally induced microcrystalline arthritis in male adult Wistar rats. The animals were divided into three experimental groups (n = 24): control (A), experimentally induced arthritis (B), experimentally induced arthritis+InGaAlP laser therapy (C). The laser treatment was made daily in the patellar region of the right knee after 48 h of the experimental induction. After 7, 14, and 21 days of therapy, the rats were euthanized and the right knees were removed and processed for histomorphometric, immunohistochemical, ultrastructural, and biochemical investigation of the synovium. The number of granulocytes on the 14th and 21st days was higher in B and lower in C and, lastly, in A. The number of fibroblasts on the 14th and 21st days was similar between A and C and below B. The number of blood vessels on the 21st day was higher in B than in the other groups. The positive number of cells for the TUNEL test was higher on the 14th and 21st days in B compared to the others. The percentage of tissue area occupied by birefringent collagen fibers was higher in B on the 21st day than in the others. The ultrastructure of cells showed fibroblast-like morphology in all groups and periods evaluated. The quantification of glycosaminoglycans did not present significant differences between the groups in all the experimental periods. The amount of hydroxyproline was higher in B compared to the other groups on the 14th and 21st days. The content of non-collagen proteins was higher in B on the 21st day in relation to the other groups. Quantification of TNF-α on the 21st day was higher in A and B than in C. For TGF-ß on the 21st day, groups B and C presented similar and higher values than A. For MMP-13, groups A and B presented data similar to and above C. In relation to ADAMT-S4, on the 21st day, groups B and C presented data similar to and lower than A. InGaAlP-670 nm therapy reduced the inflammatory process and tissue injuries of the synovial membrane in comparison to the untreated group, indicating its potential utilization in clinical studies aiming in the recovery of acute arthritis in patients.

Vascular Effects of Photodynamic Therapy with Curcumin in a Chorioallantoic Membrane Model.

Photodynamic Therapy (PDT) is a treatment that requires light, a photosensitizing agent, and molecular oxygen. The photosensitizer is activated by light and it interacts with the oxygen that is present in the cellular microenvironment. The molecular oxygen is transformed into singlet oxygen, which is highly reactive and responsible for the cell death. Therefore, PS is an important element for the therapy happens, including its concentration. Curcumin is a natural photosensitizer and it has demonstrated its anti-inflammatory and anti-oxidant effects that inhibit several signal transduction pathways. PDT vascular effects of curcumin at concentrations varying from 0.1 to 10 mM/cm² and topical administration were investigated in a chick Chorioallantoic Membrane (CAM) model. The irradiation was performed at 450 nm, irradiance of 50 mW/cm² during 10 min, delivering a total fluence of 30 J/cm². The vascular effect was followed after the application of curcumin, with images being obtained each 30 min in the first 3 h, 12 h, and 24 h. Those images were qualitatively and quantitatively analyzed with a MatLAB®. Curcumin was expected to exhibit a vascular effect due to its angio-inhibitory effect. Using curcumin as photosensitizer, PDT induced a higher and faster vascular effect when compared to the use of this compound alone.

Clinical and pathological features and treatment of AIDS-related cutaneous Kaposi's sarcoma in Chinese Han patients.

This retrospective study aimed to observe the clinicopathological features and immunological phenotypes, and explore effective treatment and prognosis for 12 Chinese Han patients with acquired immunodeficiency syndrome-related cutaneous Kaposi's sarcoma. All 12 patients were human immunodeficiency virus-positive, and underwent the standard highly active antiretroviral therapy (HAART). Skin lesions mainly presented as purple, or rufous papules, or plaques; skin biopsy showed diffuse or flaky infiltration of spindle cells, active proliferation of slit-like vasculature, erythrocyte exudation, hemosiderin deposition, and inflammatory cell infiltration. Immunohistochemical analysis showed the expression of Ubiquitin C-terminal hydrolase L1 (+), and CD31 (+) in T-cells; factor VIII (+) and HHF-35 (+) in the proliferating vascular endothelial cells; vimentin (+) and S-100 protein (-) in the vessel wall; and CD34 (+++) in the spindle cells of 6 cases, with 1 case of negative CD34 expression. Four patients with confined lesions underwent surgery and microwave therapy, and received a favorable prognosis. Two patients with limited lesions underwent microwave therapy, and the lesions subsided. Of six patients with widely distributed sarcomas, five underwent microwave therapy and one received combined chemotherapy; five attained significant efficacy, and one died. There were no significant differences in the clinicopathological features and immunological phenotypes between the Chinese Han patients and those from other populations. Along with basal HAART, patients in early stages, with sarcomas <2 cm in diameter should undergo surgery and microwave therapy, while patients with sarcomas >2 cm in diameter should undergo chemotherapy and microwave therapy.

Time-dependent effects of low-level laser therapy on the morphology and oxidative response in the skin wound healing in rats.

This study aims to investigate the effect of different energy densities provided by low-level laser therapy (LLLT) on the morphology of scar tissue and the oxidative response in the healing of secondary intention skin wounds in rats. Twenty-four male adult Wistar rats were used. Skin wounds were made on the backs of the animals, which were randomized into three groups of eight animals each as follows, 0.9% saline (control); laser GaAsAl 30 J/cm(2) (L30); laser GaAsAl 90 J/cm(2) (L90). The experiment lasted 21 days. Every 7 days, the wound contraction index (WCI) was calculated and tissue from different wounds was removed to assess the proportion of cells and blood vessels, collagen maturation index (CMI), thiobarbituric acid reactive substance (TBARS) levels and catalase activity (CAT). On the 7th and 14th days, the WCI and the proportion of cells were significantly higher in groups L30 and L90 compared to the control (p < 0.05). At all the time points analyzed, there was a greater proportion of blood vessels and a higher CMI in group L90 compared to the other groups (p < 0.05). On the 7th and 14th days, lower TBARS levels and increased CAT activity were found in the L90 group compared to the control (p < 0.05). On the 7th day, a moderately negative correlation was found between TBARS levels and WCI, CMI and CAT in all the groups. LLLT may modulate the oxidative status of wounded tissue, constituting a possible mechanism through which the LLLT exerts its effects in the initial phases of tissue repair.

Nutritional supplementation with L-arginine prevents pelvic radiation-induced changes in morphology, density, and regulating factors of blood vessels in the wall of rat bladder.

PURPOSE: To determine whether L-arginine has protective effects against radiation-induced alterations in the morphology and regulatory factors of vesical blood vessels in rats. METHODS: Male rats aged 3-4 months were divided into groups of 10 animals each: (a) controls, consisting of non-treated animals; (b) radiated-only rats; and (c) radiated rats receiving L-arginine supplementation. Radiation was in one session of 10 Gy and was aimed at the pelvic-abdominal region. L-arginine was administered once a day (0.65 g/kg body weight), starting 7 days before radiation and continuing until killing on the 16th day after radiation. The density, relative area, and wall thickness of blood vessels were measured in the vesical lamina propria using histological methods, and the expression of vascular endothelial growth factor (VEGF) and fibroblast growth factors (FGF) in the bladder wall was assessed by RT-PCR. RESULTS: Compared with controls, radiation alone decreased the density and relative area of blood vessels by 32 % (p < 0.01) and 25 % (p < 0.05), respectively, and reduced the arterial wall thickness by 42 % (p < 0.004). VEGF and FGF mRNA levels after radiation were diminished by 67 % (p < 0.002) and 56 % (p < 0.04), respectively. The radiated animals supplemented with L-arginine were not significantly different from controls. CONCLUSIONS: Pelvic radiation leads to significant vesical modifications, as in the morphology of blood vessels and in VEGF and FGF expression. All these changes, however, were prevented by L-arginine treatment. These results emphasize, therefore, the potential use of this amino acid as a radioprotective drug.

Viabilidade anátomo-clínica da utilização dos vasos perfurantes do músculo peitoral maior como pedículo receptor na reconstrução mamária imediata e tardia com microcirurgia / Viability of utilizing the pectoralis major perforator muscular vessels as a recipient pedicle in immediate and late breast reconstruction with microsurgery

Na reconstrução mamária com microcirurgia, a qualidade dos vasos, a proximidade com a região torácica e a anatomia constante são fatores relevantes na escolha do pedículo receptor. Apesar da grande aplicação clínica, os vasos toracodorsais e torácicos internos apresentam restrições como a imprevisibilidade da qualidade nas reconstruções tardias, as alterações do contorno do tórax e a inviabilidade de uma eventual revascularização futura do miocárdio. Com o desenvolvimento dos retalhos vascularizados por vasos perfurantes e o maior treinamento dos cirurgiões, novas alternativas de pedículos foram desenvolvidas. A preservação da cartilagem costal e dos vasos torácicos internos, bem como a maior exposição do campo operatório são mencionados como vantagens do emprego dos vasos perfurantes do músculo peitoral maior como receptor. Apesar da anatomia dos vasos perfurantes ter sido previamente estudada, são imprecisas as informações sobre sua origem e distribuição no tórax. Ademais, são escassos os dados relacionados à sua incidência e utilização nas reconstruções imediatas e tardias. Na presente investigação foram incluídos dois estudos: anatômico e clínico. No estudo anatômico avaliou-se a origem, distribuição e dimensões dos vasos perfurantes em 24 cadáveres frescos (48 regiões torácicas), por técnica de coloração e posterior dissecção. No estudo clínico analisou-se, 69 pacientes (77 reconstruções mamárias), sendo 46 imediatas e 31 tardias. Constatou-se no estudo anatômico 2,7 vasos perfurantes por região torácica, destes, 93% apresentaram pequeno e médio calibre e concentração preferencial no segundo espaço intercostal. Os vasos e o pedículo perfurante revelaram comprimento médio de 2,4 cm (1,0 a 3,2 cm) e 3,6 cm (2,1 a 4,5 cm), respectivamente. No estudo clínico, não foram observadas diferenças entre as pacientes submetidas à reconstrução imediata e tardia, quanto a idade (p=0,599), IMC (p=0,498), lateralidade da mama (p=0,671), hipertensão arterial...

In breast reconstruction with microsurgery, the proper selection of the recipient pedicle is a significant factor for success. The compatibility of caliber and the uniform anatomy are the chief relevant factors in the choice of recipient vessels. Regardless of their broad clinical application, the thoracodorsal and internal thoracic vessels demonstrate limitations such as the unpredictable quality of late reconstructions, the changes in thoracic contour and the impairment for future coronary bypass. The progress of microsurgical technique and the development of perforator flaps has led to new recipient pedicle alternatives. Thus, sparing of the costal cartilages and the internal thoracic vessels as well as the wide surgical exposure are the main advantages of using the pectoralis major perforator vessels as recipient pedicles. Although the anatomy of the perforator vessels has been previously studied, the data about their origin and distribution is inexact. In addition, the data concerning their incidence and quality of immediate and late reconstructions are not available. In the present investigation, an anatomical and clinical study were performed. In the anatomical study, the origin, distribution and size of perforator vessels were evaluated in 24 fresh cadavers (48 thoracic regions) by staining technique and posterior dissection. The clinical study analyzed 69 patients (77 reconstructions), 46 immediate and 31 late reconstructions. The anatomic study observed 2.7 perforator vessels per thoracic region, with 93% presenting small and medium caliber and major concentration in the second intercostal space. The vessels and the perforator pedicles demonstrated an average length of 2.4 cm (1.0 to 3.2 cm) and 3.6 cm (2.1 to 4.5 cm) respectively. In the clinical study, no differences were observed between the immediate and late reconstructions regarding age (p=0.599), BMI (p=0.498), breast side (p=0.671), hypertension (p=0.732), diabetes (p>0.999) and smoking...