RESUMO
This prospective study was designed to evaluate changes in upper extremity lymphatic drainage after ALND in comparison to the preoperative status using lymphoscintigraphy. The study enrolled 44 women (mean age: 57.95; range: 35-80) with a new diagnosis of unilateral invasive breast carcinoma who had been scheduled to undergo ALND. This was a substudy of the physiotherapeutic project, in which subjects after ALND were randomized into 4 groups treated with: 1) rehabilitation exercises; 2) manual lymphatic drainage; 3) pneumatic compression pump; and 4) education only. Clinical evaluation which included arm measurements and lymphoscintigraphy was performed in every subject before surgery and 3 times after surgery (1-6 weeks, 1 and 2 years after ALND). Follow-up was completed in 44 subjects at 1 year and in 32 subjects at 2 years. Lymphedema diagnosis was made in 4 subjects 1 year after ALND (9%) and in 8 subjects 2 years after ALND (25%). Among them, respectively, only 50% and 62% noticed and reported lymphedema. Quantitative analysis of lymphoscintigrams and photoplethysmography results did not reveal upper extremities lymphatic transport and/or venous function impairment after the ALND procedure. Qualitative analysis of lymphoscintigrams revealed most commonly disappearance of previously functional lymph nodes and appearance of dermal backflow in subjects who developed lymphedema. Conversely, appearance of functional lymph nodes in different locations after ALND may indicate protection from development of upper extremity lymphedema.
Assuntos
Axila/cirurgia , Linfedema Relacionado a Câncer de Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Carcinoma/cirurgia , Excisão de Linfonodo , Linfocintigrafia , Adulto , Idoso , Idoso de 80 Anos ou mais , Axila/diagnóstico por imagem , Linfedema Relacionado a Câncer de Mama/prevenção & controle , Terapia por Exercício , Feminino , Humanos , Dispositivos de Compressão Pneumática Intermitente , Drenagem Linfática Manual , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Período Pré-Operatório , Prognóstico , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
The appetitive properties of MK801 were investigated using the conditioned place preference paradigm. Male Sprague-Dawley rats received conditioned place preference training for a four-day period. The conditioning box consisted of three chambers with distinctive visual and tactile cues, separated by removable doors. On alternating days rats received MK801 (0.05, 0.1, 0.25, 0.5 and 0.75 mg/kg) paired with one side of the chamber and saline paired with the other side. On the fifth day, rats were placed in the center chamber and the time spent in each chamber, as well as entries into each chamber were recorded by a trained observer. MK801 produced a conditioned place preference for side paired with drug for the four highest doses. Contrary to previous findings, these results indicate that MK801 is appetitive at doses higher than has previously been assumed.