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1.
J Surg Res ; 225: 181-188, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29605030

RESUMO

BACKGROUND: Hemorrhagic shock-induced lung edema and inflammation are two of the main reasons for the rejection of lungs donated for transplantation. Hypertonic saline (HS) induces intravascular volume expansion and has considerable immunomodulating effects that might minimize edema. Our hypothesis is based on the use of a hypertonic solution for treatment of donors who are in shock in an attempt to increase the supply of lungs for transplantation. METHODS: A total of 80 rats were allocated to four groups: one group was given an infusion of normal saline (NS; n = 20), one group received HS; n = 20, a sham group (n = 20), and a Shock group (n = 20). Half of the lungs from each group were evaluated in an ex vivo perfusion system, and the other half was used for measurements of cytokine levels and neutrophil counts. RESULTS: In the ex vivo perfusion assessment, the pulmonary artery pressures of the animals in the NS and HS groups did not exhibit significant differences compared with those in the sham group (P > 0.05) but were lower than those in the Shock group (P < 0.01). Furthermore, the tumor necrosis factor-α levels and neutrophil counts were lower in the HS group than those in the Shock group (P < 0.01) and did not exhibit significant differences compared with those in either the NS and Sham groups (P > 0.05). CONCLUSIONS: We showed that HS was equivalent to isotonic saline and contributed to the treatment of lungs subjected to hemorrhagic shock.

2.
ESC Heart Fail ; 5(3): 355-364, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29465824

RESUMO

AIMS: Some authors have hypothesized that left ventricular chamber dilatation in ischaemic and idiopathic cardiomyopathies results in spherical transformation. Aiming to characterize how this transformation occurs, a study was performed by comparing normal and dilated specimens regarding sphericity and proportionality in left heart chambers. It is important to provide data for the development of therapeutic strategies in these diseases. METHODS AND RESULTS: An anatomical study was performed by comparing normal (n = 10), ischaemic (n = 15), and idiopathic (n = 18) dilated human cardiomyopathic specimens regarding left ventricular chambers and their segmental proportionality to normal hearts. It was performed by capturing and processing images with proper software in three different levels of left ventricular chamber (basal, equatorial, and apical). These obtained data were analysed based on sphericity and proportionality by two dedicated indexes. Spherical shape: Calculated segmental indexes showed that dilated specimens were not spherical because they were smaller than as expected for a spherical shape (all values were <70% of a perfect sphere). Proportionality: There was no difference between basal index perimeters among groups, but apical index was lower in dilated specimens than in normal hearts, and so dilatation was not proportional to normal hearts. CONCLUSIONS: Left ventricular chambers of anatomical specimens with dilated cardiomyopathies did not display a spherical shape and were not proportional to normal hearts.

3.
Environ Sci Pollut Res Int ; 23(10): 9862-70, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26856867

RESUMO

Diesel exhaust particles (DEPs) from diesel engines produce adverse alterations in cells of the airways by activating intracellular signaling pathways and apoptotic gene overexpression, and also by influencing metabolism and cytoskeleton changes. This study used human bronchial epithelium cells (BEAS-2B) in culture and evaluates their exposure to DEPs (15ug/mL for 1 and 2 h) in order to determine changes to cell rheology (viscoelasticity) and gene expression of the enzymes involved in oxidative stress, apoptosis, and cytotoxicity. BEAS-2B cells exposed to DEPs were found to have a significant loss in stiffness, membrane stability, and mitochondrial activity. The genes involved in apoptosis [B cell lymphoma 2 (BCL-2 and caspase-3)] presented inversely proportional expressions (p = 0.05, p = 0.01, respectively), low expression of the genes involved in antioxidant responses [SOD1 (superoxide dismutase 1); SOD2 (superoxide dismutase 2), and GPx (glutathione peroxidase) (p = 0.01)], along with an increase in cytochrome P450, family 1, subfamily A, polypeptide 1 (CYP1A1) (p = 0.01). These results suggest that alterations in cell rheology and cytotoxicity could be associated with oxidative stress and imbalance between pro- and anti-apoptotic genes.


Assuntos
Antioxidantes/metabolismo , Apoptose/efeitos dos fármacos , Brônquios/efeitos dos fármacos , Células Epiteliais/efeitos dos fármacos , Expressão Gênica/efeitos dos fármacos , Material Particulado/toxicidade , Emissões de Veículos/toxicidade , Apoptose/genética , Brônquios/metabolismo , Brônquios/patologia , Caspase 3/genética , Caspase 3/metabolismo , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Citocromo P-450 CYP1A1/genética , Citocromo P-450 CYP1A1/metabolismo , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Glutationa Peroxidase/genética , Glutationa Peroxidase/metabolismo , Humanos , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/genética , Tamanho da Partícula , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Reologia
4.
Acta Cir Bras ; 30(5): 359-65, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26016936

RESUMO

PURPOSE: To evaluate a new perfusate solution to be used for ex vivo lung perfusion. METHODS: Randomized experimental study using lungs from rejected brain-dead donors harvested and submitted to 1 hour of ex vivo lung perfusion (EVLP) using mainstream solution or the alternative. RESULTS: From 16 lungs blocs tested, we found no difference on weight after EVLP: Steen group (SG) = 1,097±526g; Alternative Perfusion Solution (APS) = 743±248g, p=0.163. Edema formation, assessed by Wet/dry weigh ratio, was statistically higher on the Alternative Perfusion Solution group (APS = 3.63 ± 1.26; SG = 2.06 ± 0.28; p = 0.009). No difference on PaO2 after EVLP (SG = 498±37.53mmHg; APS = 521±55.43mmHg, p=0.348, nor on histological analyses: pulmonary injury score: SG = 4.38±1.51; APS = 4.50±1.77, p=0.881; apoptotic cells count after perfusion: SG = 2.4 ± 2.0 cells/mm2; APS = 4.8 ± 6.9 cells/mm2; p = 0.361). CONCLUSION: The ex vivo lung perfusion using the alternative perfusion solution showed no functional or histological differences, except for a higher edema formation, from the EVLP using Steen Solution(r) on lungs from rejected brain-dead donors.


Assuntos
Transplante de Pulmão/métodos , Pulmão/irrigação sanguínea , Soluções para Preservação de Órgãos , Preservação de Órgãos/métodos , Perfusão/métodos , Adolescente , Adulto , Idoso , Circulação Extracorpórea/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismo por Reperfusão , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo , Doadores de Tecidos , Coleta de Tecidos e Órgãos/métodos , Adulto Jovem
5.
Acta cir. bras ; 30(5): 359-365, 05/2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-747026

RESUMO

PURPOSE: To evaluate a new perfusate solution to be used for ex vivo lung perfusion. METHODS: Randomized experimental study using lungs from rejected brain-dead donors harvested and submitted to 1 hour of ex vivo lung perfusion (EVLP) using mainstream solution or the alternative. RESULTS: From 16 lungs blocs tested, we found no difference on weight after EVLP: Steen group (SG) = 1,097±526g; Alternative Perfusion Solution (APS) = 743±248g, p=0.163. Edema formation, assessed by Wet/dry weigh ratio, was statistically higher on the Alternative Perfusion Solution group (APS = 3.63 ± 1.26; SG = 2.06 ± 0.28; p = 0.009). No difference on PaO2 after EVLP (SG = 498±37.53mmHg; APS = 521±55.43mmHg, p=0.348, nor on histological analyses: pulmonary injury score: SG = 4.38±1.51; APS = 4.50±1.77, p=0.881; apoptotic cells count after perfusion: SG = 2.4 ± 2.0 cells/mm2; APS = 4.8 ± 6.9 cells/mm2; p = 0.361). CONCLUSION: The ex vivo lung perfusion using the alternative perfusion solution showed no functional or histological differences, except for a higher edema formation, from the EVLP using Steen Solution(r) on lungs from rejected brain-dead donors. .


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Transplante de Pulmão/métodos , Pulmão/irrigação sanguínea , Soluções para Preservação de Órgãos , Preservação de Órgãos/métodos , Perfusão/métodos , Circulação Extracorpórea/métodos , Traumatismo por Reperfusão , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo , Doadores de Tecidos , Coleta de Tecidos e Órgãos/métodos
6.
Rev. bras. cir. cardiovasc ; 29(4): 478-486, Oct-Dec/2014. tab
Artigo em Português | LILACS | ID: lil-741724

RESUMO

Introdução: A cardiomiopatia dilatada idiopática (CMDId) é causadora de grande impacto, porém aspectos de sua fisiopatologia são desconhecidos. Objetivo: Avaliar aspectos anatomo-histológicos de corações com CMDId comparando-os a corações normais, com medidas perimetrais dos anéis atrioventriculares direito (AVD) e esquerdo (AVE) e dos ventrículos direito (VD) e esquerdo (VE) e a porcentagem de fibras colágenas e elásticas dos anéis. Métodos: Foram avaliados 13 corações de cadáveres portadores de CMDId e 13 corações normais, que foram dissecados mantendo-se os anéis atrioventriculares e a massa ventricular, com laminação em segmentos correspondentes a 20%, 50% e 80% da distância entre o sulco atrioventricular e o ápice ventricular. Os cortes foram submetidos à digitalização fotográfica, sendo comparadas as medidas. Os anéis foram dissecados, medidos e enviados ao laboratório de anatomia patológica, sendo realizadas colorações por meio de hematoxilina-eosina, picrossírius e resorcina fuccina oxidada. Resultados: Com relação aos ventrículos, no grupo CMDId ocorre dilatação nos segmentos apical, equatorial e basal. A medida do AVD foi maior no grupo CMDId, não havendo diferença no AVE entre os grupos. Com relação ao percentual de fibras colágenas, há diminuição no grupo CMDId em relação ao grupo normal. Com relação às fibras elásticas, não houve diferença entre os grupos. Conclusão: Ocorre alteração da geometria ventricular com dilatação no grupo CMDId. Na CMDId observou-se aumento no perímetro do AVD. Não se observou aumento do perímetro do AVE. Houve diminuição percentual na área total de colágeno tanto no AVD quanto no AVE em corações com CMDId. .


Introduction: Idiopathic dilated cardiomyopathy causes great impact but many aspects of its pathophysiology remain unknown. Objective: To evaluate anatomical and histological aspects of hearts with idiopathic dilated cardiomyopathy and compare them to a control group, evaluating the behavior of the perimeters of the atrioventricular rings and ventricles and to compare the percentage of collagen and elastic fibers of the atrioventricular rings. Methods: Thirteen hearts with cardiomyopathy and 13 normal hearts were analysed. They were dissected keeping the ventricular mass and atrioventricular rings, with lamination of segments 20%, 50% and 80% of the distance between the atrioventricular groove and the ventricular apex. The sections were subjected to photo scanning, with measurement of perimeters. The atrioventricular rings were dissected and measured digitally to evaluate their perimeters, later being sent to the pathology laboratory, and stained by hematoxylin-eosin, picrosirius and oxidized resorcin fuccin. Results: Regarding to ventricles, dilation occurs in all segments in the pathological group, and the right atrioventricular ring measurement was higher in idiopathic dilated cardiomyopathy group, with no difference in the left side. With respect to collagen, both sides had lower percentage of fibers in the pathological group. With respect to the elastic fibers, there was no difference between the groups. Conclusion: There is a change in ventricular geometry in cardiomyopathy group. The left atrioventricular ring does not dilate, in spite of the fact that in both ventricles there is lowering of collagen. .


Assuntos
Humanos , Cardiomiopatia Dilatada/patologia , Valvas Cardíacas/patologia , Ventrículos do Coração/patologia , Remodelação Ventricular , Análise de Variância , Colágeno/análise , Tecido Elástico/anatomia & histologia , Tecido Elástico/patologia , Valvas Cardíacas/anatomia & histologia , Ventrículos do Coração/anatomia & histologia , Valores de Referência , Estatísticas não Paramétricas
7.
Rev Bras Cir Cardiovasc ; 29(3): 338-43, 2014 Jul-Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25372906

RESUMO

INTRODUCTION: A feature of dilated cardiomyopathy is the deformation of ventricular cavity, which contributes to systolic dysfunction. Few studies have evaluated this deformation bearing in mind ventricular regions and segments of the ventricle, which could reveal important details of the remodeling process, supporting a better understanding of its role in functional impairment and the development of new therapeutic strategies. OBJECTIVE: To evaluate if, in basal, equatorial and apical regions, increased internal transverse perimeter of left ventricle in idiopathic dilated cardiomyopathy occurs proportionally between the septal and non-septal segment. METHODS: We performed an anatomical study with 28 adult hearts from human cadavers. One group consisted of 18 hearts with idiopathic dilated cardiomyopathy and another group with 10 normal hearts. After lamination and left ventricle digital image capture, in three different regions (base, equator and apex), the transversal internal perimeter of left ventricle was divided into two segments: septal and not septal. These segments were measured by proper software. It was established an index of proportionality between these segments, called septal and non-septal segment index. Then we determined whether this index was the same in both groups. RESULTS: Among patients with normal hearts and idiopathic dilated cardiomyopathy, the index of proportionality between the two segments (septal and non-septal) showed no significant difference in the three regions analyzed. The comparison results of the indices NSS/SS among normal and enlarged hearts were respectively: in base 1.99 versus 1.86 (P=0.46), in equator 2.22 versus 2.18 (P=0.79) and in apex 2.96 versus 3.56 (P=0.11). CONCLUSION: In the idiopathic dilated cardiomyopathy, the transversal dilatation of left ventricular internal perimeter occurs proportionally between the segments corresponding to the septum and free wall at the basal, equatorial and apical regions of this chamber.


Assuntos
Cardiomiopatia Dilatada/patologia , Septos Cardíacos/patologia , Ventrículos do Coração/patologia , Processamento de Imagem Assistida por Computador/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Ilustração Médica , Pessoa de Meia-Idade , Valores de Referência , Estatísticas não Paramétricas , Remodelação Ventricular , Adulto Jovem
8.
Rev. bras. cir. cardiovasc ; 29(3): 338-343, Jul-Sep/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-727172

RESUMO

Introduction: A feature of dilated cardiomyopathy is the deformation of ventricular cavity, which contributes to systolic dysfunction. Few studies have evaluated this deformation bearing in mind ventricular regions and segments of the ventricle, which could reveal important details of the remodeling process, supporting a better understanding of its role in functional impairment and the development of new therapeutic strategies. Objective: To evaluate if, in basal, equatorial and apical regions, increased internal transverse perimeter of left ventricle in idiopathic dilated cardiomyopathy occurs proportionally between the septal and non-septal segment. Methods: We performed an anatomical study with 28 adult hearts from human cadavers. One group consisted of 18 hearts with idiopathic dilated cardiomyopathy and another group with 10 normal hearts. After lamination and left ventricle digital image capture, in three different regions (base, equator and apex), the transversal internal perimeter of left ventricle was divided into two segments: septal and not septal. These segments were measured by proper software. It was established an index of proportionality between these segments, called septal and non-septal segment index. Then we determined whether this index was the same in both groups. Results: Among patients with normal hearts and idiopathic dilated cardiomyopathy, the index of proportionality between the two segments (septal and non-septal) showed no significant difference in the three regions analyzed. The comparison results of the indices NSS/SS among normal and enlarged hearts were respectively: in base 1.99 versus 1.86 (P=0.46), in equator 2.22 versus 2.18 (P=0.79) and in apex 2.96 versus 3.56 (P=0.11). Conclusion: In the idiopathic dilated cardiomyopathy, the transversal dilatation of left ventricular internal perimeter occurs proportionally between the segments corresponding to the septum and free wall at the ...


Introdução: Uma das características da cardiomiopatia dilatada idiopática é a deformação da cavidade ventricular, a qual contribui para a disfunção sistólica. Poucos trabalhos julgam importante a avaliação dessa deformação ventricular levando em consideração regiões e segmentos do ventrículo, o que pode revelar detalhes importantes do processo de remodelamento, dando suporte a um melhor entendimento do seu papel no comprometimento funcional e ao surgimento de novas estratégias terapêuticas. Objetivo: Verificar se, em regiões diferentes, o aumento do perímetro transversal da câmara ventricular esquerda na cardiomiopatia dilatada idiopática ocorre de maneira proporcional entre o segmento septal e o não septal (parede livre). Métodos: Foi realizado um estudo anatômico com 28 corações adultos. Um grupo foi constituído por 18 corações com cardiomiopatia dilatada idiopática e outro grupo com 10 corações normais. Em três regiões diferentes (base, equador e ápice), o perímetro interno transversal do ventrículo esquerdo foi dividido em dois segmentos: septal e não septal. Foi criado um índice de proporcionalidade entre esses segmentos. Em seguida verificou-se se esse índice era o mesmo entre os grupos. Resultados: Entre corações normais e portadores de cardiomiopatia dilatada idiopática, o índice de proporcionalidade entre os dois segmentos (septal e não septal) não apresentou diferença significativa nas três regiões analisadas. Conclusão: Na cardiomiopatia dilatada idiopática, a dilatação transversal do septo é proporcional à dilatação da parede livre nas regiões basal, equatorial e apical da câmara ventricular esquerda. .


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Cardiomiopatia Dilatada/patologia , Septos Cardíacos/patologia , Ventrículos do Coração/patologia , Processamento de Imagem Assistida por Computador/métodos , Ilustração Médica , Valores de Referência , Estatísticas não Paramétricas , Remodelação Ventricular
9.
J Surg Res ; 192(2): 635-41, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25151469

RESUMO

BACKGROUND: Ischemia-reperfusion injury (IRI) is one of the principal obstacles for the lung transplantation (LTx) success. Several strategies have been adopted to minimize the effects of IRI in lungs, including ex vivo conditioning of the grafts and the use of antioxidant drugs, such as methylene blue (MB). We hypothesized that MB could minimize the effects of IRI in a LTx rodent model. METHODS: Forty rats were divided into four groups (n = 10) according to treatment (saline solution or MB) and graft cold ischemic time (3 or 6 h). All animals underwent unilateral LTx. Recipients received 2 mL of saline or MB intraperitoneally before transplantation. After 2 h of reperfusion, arterial blood and exhaled nitric oxide samples were collected and bronchoalveolar lavage performed. Then animals were euthanized, and histopathology analysis as well as cell counts and cytokine levels measurements in bronchoalveolar lavage fluid were performed. RESULTS: There was a significant decrease in exhaled nitric oxide, neutrophils, interleukin-6, and tumor necrosis factor-α in MB-treated animals. PaO2 and uric acid levels were higher in MB group. CONCLUSIONS: MB was able in attenuating IRI in this LTx model.


Assuntos
Antioxidantes/farmacologia , Transplante de Pulmão/métodos , Azul de Metileno/farmacologia , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/cirurgia , Animais , Líquido da Lavagem Broncoalveolar , Isquemia Fria , Citocinas/metabolismo , Modelos Animais de Doenças , Inibidores Enzimáticos/farmacologia , Feminino , Hemorragia/tratamento farmacológico , Hemorragia/metabolismo , Hemorragia/cirurgia , Óxido Nítrico/metabolismo , Oxigênio/sangue , Pressão Parcial , Edema Pulmonar/tratamento farmacológico , Edema Pulmonar/metabolismo , Edema Pulmonar/cirurgia , Ratos Sprague-Dawley , Traumatismo por Reperfusão/metabolismo , Cloreto de Sódio , Ácido Úrico/sangue
10.
Rev Bras Cir Cardiovasc ; 29(4): 478-86, 2014 Oct-Dec.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25714199

RESUMO

INTRODUCTION: Idiopathic dilated cardiomyopathy causes great impact but many aspects of its pathophysiology remain unknown. OBJECTIVE: To evaluate anatomical and histological aspects of hearts with idiopathic dilated cardiomyopathy and compare them to a control group, evaluating the behavior of the perimeters of the atrioventricular rings and ventricles and to compare the percentage of collagen and elastic fibers of the atrioventricular rings. METHODS: Thirteen hearts with cardiomyopathy and 13 normal hearts were analysed. They were dissected keeping the ventricular mass and atrioventricular rings, with lamination of segments 20%, 50% and 80% of the distance between the atrioventricular groove and the ventricular apex. The sections were subjected to photo scanning, with measurement of perimeters. The atrioventricular rings were dissected and measured digitally to evaluate their perimeters, later being sent to the pathology laboratory, and stained by hematoxylin-eosin, picrosirius and oxidized resorcin fuccin. RESULTS: Regarding to ventricles, dilation occurs in all segments in the pathological group, and the right atrioventricular ring measurement was higher in idiopathic dilated cardiomyopathy group, with no difference in the left side. With respect to collagen, both sides had lower percentage of fibers in the pathological group. With respect to the elastic fibers, there was no difference between the groups. CONCLUSION: There is a change in ventricular geometry in cardiomyopathy group. The left atrioventricular ring does not dilate, in spite of the fact that in both ventricles there is lowering of collagen.


Assuntos
Cardiomiopatia Dilatada/patologia , Valvas Cardíacas/patologia , Ventrículos do Coração/patologia , Remodelação Ventricular , Análise de Variância , Colágeno/análise , Tecido Elástico/anatomia & histologia , Tecido Elástico/patologia , Valvas Cardíacas/anatomia & histologia , Ventrículos do Coração/anatomia & histologia , Humanos , Valores de Referência , Estatísticas não Paramétricas
11.
Acta Cir Bras ; 28(1): 10-8, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23338108

RESUMO

PURPOSE: To investigate the compatibility of a new model of self-expandable tracheal stent in rats. METHODS: A new device of polyurethane covered and non - covered stent was placed in the trachea of Wistar rats. Animals were distributed in two groups: the polyurethane covered and non-covered group. Macroscopic parameters included position within the tracheal lumen, adherence to the mucosa, degree of dilatation, permeability and internal diameter. Microscopic findings evaluated were: incorporation, inflammatory activity, granulation tissue and epithelial revetment injuries. The observation follow-up was six weeks. All parameters were quantified based on determined score values. Incorporation of the stents was evaluated based on the observation if the stent was fixed into the trachea or if it could be removed. Degree of dilatation was performed by external diameter measurements. Granulation tissue was evaluated by measurements of height of the tissue growing into the tracheal lumen. RESULTS: 100% of non-covered stents had total attachment to mucosa and 100% of polyurethane covered type had adherence only. Regarding dilatation, granulation tissue, inflammatory activity and internal diameter measurements, there were no significant differences between the groups. Pathological tracheal wall injuries were present in both groups. CONCLUSION: Both models of stent demonstrated biocompatibility with the trachea. Rats are suitable for an experimental model of tracheal stent study.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Stents , Traqueia/cirurgia , Ligas/uso terapêutico , Animais , Feminino , Masculino , Teste de Materiais , Modelos Animais , Poliuretanos/uso terapêutico , Ratos , Ratos Wistar , Reprodutibilidade dos Testes , Traqueia/patologia
12.
Acta cir. bras ; 28(1): 10-18, jan. 2013. ilus, tab
Artigo em Inglês | LILACS | ID: lil-662342

RESUMO

PURPOSE: To investigate the compatibility of a new model of self-expandable tracheal stent in rats. METHODS: A new device of polyurethane covered and non - covered stent was placed in the trachea of Wistar rats. Animals were distributed in two groups: the polyurethane covered and non-covered group. Macroscopic parameters included position within the tracheal lumen, adherence to the mucosa, degree of dilatation, permeability and internal diameter. Microscopic findings evaluated were: incorporation, inflammatory activity, granulation tissue and epithelial revetment injuries. The observation follow-up was six weeks. All parameters were quantified based on determined score values. Incorporation of the stents was evaluated based on the observation if the stent was fixed into the trachea or if it could be removed. Degree of dilatation was performed by external diameter measurements. Granulation tissue was evaluated by measurements of height of the tissue growing into the tracheal lumen. RESULTS: 100% of non-covered stents had total attachment to mucosa and 100% of polyurethane covered type had adherence only. Regarding dilatation, granulation tissue, inflammatory activity and internal diameter measurements, there were no significant differences between the groups. Pathological tracheal wall injuries were present in both groups. CONCLUSION: Both models of stent demonstrated biocompatibility with the trachea. Rats are suitable for an experimental model of tracheal stent study.


Assuntos
Animais , Feminino , Masculino , Ratos , Materiais Biocompatíveis/uso terapêutico , Stents , Traqueia/cirurgia , Ligas/uso terapêutico , Teste de Materiais , Modelos Animais , Poliuretanos/uso terapêutico , Ratos Wistar , Reprodutibilidade dos Testes , Traqueia/patologia
13.
Clinics (Sao Paulo) ; 67(11): 1309-14, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23184209

RESUMO

OBJECTIVE: This study evaluated the performance of lungs that were preserved with different solutions (Celsior, Perfadex or saline) in an ex vivo rat lung perfusion system. METHODS: Sixty Wistar rats were anesthetized, anticoagulated and randomized into three groups (n = 20). The rats were subjected to antegrade perfusion via the pulmonary artery with Perfadex, Celsior, or saline, followed by 6 or 12 hours of ischemia (4ºC, n = 10 in each group). Respiratory mechanics, gas exchange and hemodynamics were measured at 10-minute intervals during the reperfusion of heart-lung blocks in an ex vivo system (IL2-Isolated Perfused Rat or Guinea Pig Lung System, Harvard Apparatus, Holliston, Massachusetts, USA; Hugo Sachs Elektronik, Germany) for 60 minutes. The lungs were prepared for histopathology and evaluated for edema following reperfusion. Group comparisons were performed using ANOVA and the Kruskal-Wallis test with a 5% level of significance. RESULTS: Gas exchange was not significantly different between lungs perfused with either Perfadex or Celsior at the same ischemic times, but it was very low in lungs that were preserved with saline. Airway resistance was greater in the lungs that were preserved for 12 hours. Celsior lungs that were preserved for 6 and 12 hours exhibited lower airway resistance (p = 0.01) compared to Perfadex lungs. Pulmonary artery pressure was not different between the groups, and no significant differences in histopathology and apoptosis were observed between the groups. CONCLUSIONS: Lungs that were preserved with Celsior or Perfadex exhibited similar gas exchange and histopathological findings. Airway resistance was slightly lower in the Celsior-preserved lungs compared with the Perfadex-preserved lungs.


Assuntos
Citratos , Isquemia , Pulmão , Soluções para Preservação de Órgãos , Preservação de Órgãos/métodos , Animais , Dissacarídeos , Eletrólitos , Glutamatos , Glutationa , Histidina , Pulmão/irrigação sanguínea , Pulmão/patologia , Transplante de Pulmão , Masculino , Manitol , Perfusão/métodos , Troca Gasosa Pulmonar/fisiologia , Ratos , Ratos Wistar , Cloreto de Sódio , Fatores de Tempo
14.
Clinics ; 67(11): 1309-1314, Nov. 2012. ilus, graf
Artigo em Inglês | LILACS | ID: lil-656723

RESUMO

OBJECTIVE: This study evaluated the performance of lungs that were preserved with different solutions (Celsior, Perfadex or saline) in an ex vivo rat lung perfusion system. METHODS: Sixty Wistar rats were anesthetized, anticoagulated and randomized into three groups (n = 20). The rats were subjected to antegrade perfusion via the pulmonary artery with Perfadex, Celsior, or saline, followed by 6 or 12 hours of ischemia (4ºC, n = 10 in each group). Respiratory mechanics, gas exchange and hemodynamics were measured at 10-minute intervals during the reperfusion of heart-lung blocks in an ex vivo system (IL2-Isolated Perfused Rat or Guinea Pig Lung System, Harvard Apparatus, Holliston, Massachusetts, USA; Hugo Sachs Elektronik, Germany) for 60 minutes. The lungs were prepared for histopathology and evaluated for edema following reperfusion. Group comparisons were performed using ANOVA and the Kruskal-Wallis test with a 5% level of significance. RESULTS: Gas exchange was not significantly different between lungs perfused with either Perfadex or Celsior at the same ischemic times, but it was very low in lungs that were preserved with saline. Airway resistance was greater in the lungs that were preserved for 12 hours. Celsior lungs that were preserved for 6 and 12 hours exhibited lower airway resistance (p = 0.01) compared to Perfadex lungs. Pulmonary artery pressure was not different between the groups, and no significant differences in histopathology and apoptosis were observed between the groups. CONCLUSIONS: Lungs that were preserved with Celsior or Perfadex exhibited similar gas exchange and histopathological findings. Airway resistance was slightly lower in the Celsior-preserved lungs compared with the Perfadex-preserved lungs.


Assuntos
Animais , Masculino , Ratos , Citratos , Isquemia , Pulmão , Soluções para Preservação de Órgãos , Preservação de Órgãos/métodos , Dissacarídeos , Eletrólitos , Glutamatos , Glutationa , Histidina , Transplante de Pulmão , Pulmão/irrigação sanguínea , Pulmão/patologia , Manitol , Perfusão/métodos , Troca Gasosa Pulmonar/fisiologia , Ratos Wistar , Cloreto de Sódio , Fatores de Tempo
15.
Clinics (Sao Paulo) ; 67(6): 647-52, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22760905

RESUMO

OBJECTIVE: Infections have been and remain the major cause of morbidity and mortality after lung transplantation. Because mucociliary clearance plays an important role in human defense mechanisms, the influence of drugs on the mucociliary epithelium of patients undergoing lung transplantation must be examined. Prednisone is the most important corticosteroid used after lung transplantation. The aim of this study was to evaluate the effects of bronchial transection and prednisone therapy on mucociliary clearance. METHODS: A total of 120 rats were assigned to 4 groups according to surgical procedure or drug therapy: prednisone therapy (1.25 mg/kg/day); bronchial section and anastomosis + prednisone therapy (1.25 mg/kg/day); bronchial section + saline solution (2 ml/day); and saline solution (2 ml/day). After 7, 15, or 30 days, the animals were sacrificed, and the lungs were removed from the thoracic cavity. The in situ mucociliary transport velocity, ciliary beat frequency and in vitro mucus transportability were evaluated. RESULTS: Animals undergoing bronchial section surgery and anastomosis had a significant decrease in the ciliary beat frequency and mucociliary transport velocity 7 and 15 days after surgery (p<0.001). These parameters were normalized 30 days after the surgical procedure. Prednisone improved mucous transportability in the animals undergoing bronchial section and anastomosis at 15 and 30 days (p<0.05). CONCLUSION: Bronchial section and anastomosis decrease mucociliary clearance in the early postoperative period. Prednisone therapy improves mucus transportability in animals undergoing bronchial section and anastomosis.


Assuntos
Brônquios/cirurgia , Glucocorticoides/uso terapêutico , Transplante de Pulmão , Depuração Mucociliar/efeitos dos fármacos , Prednisona/uso terapêutico , Anastomose Cirúrgica/efeitos adversos , Animais , Masculino , Modelos Animais , Depuração Mucociliar/fisiologia , Período Pós-Operatório , Ratos , Ratos Wistar , Fatores de Tempo
16.
Clinics ; 67(6): 647-652, 2012.
Artigo em Inglês | LILACS | ID: lil-640216

RESUMO

OBJECTIVE: Infections have been and remain the major cause of morbidity and mortality after lung transplantation. Because mucociliary clearance plays an important role in human defense mechanisms, the influence of drugs on the mucociliary epithelium of patients undergoing lung transplantation must be examined. Prednisone is the most important corticosteroid used after lung transplantation. The aim of this study was to evaluate the effects of bronchial transection and prednisone therapy on mucociliary clearance. METHODS: A total of 120 rats were assigned to 4 groups according to surgical procedure or drug therapy: prednisone therapy (1.25 mg/kg/day); bronchial section and anastomosis + prednisone therapy (1.25 mg/kg/day); bronchial section + saline solution (2 ml/day); and saline solution (2 ml/day). After 7, 15, or 30 days, the animals were sacrificed, and the lungs were removed from the thoracic cavity. The in situ mucociliary transport velocity, ciliary beat frequency and in vitro mucus transportability were evaluated. RESULTS: Animals undergoing bronchial section surgery and anastomosis had a significant decrease in the ciliary beat frequency and mucociliary transport velocity 7 and 15 days after surgery (p<0.001). These parameters were normalized 30 days after the surgical procedure. Prednisone improved mucous transportability in the animals undergoing bronchial section and anastomosis at 15 and 30 days (p<0.05). CONCLUSION: Bronchial section and anastomosis decrease mucociliary clearance in the early postoperative period. Prednisone therapy improves mucus transportability in animals undergoing bronchial section and anastomosis.


Assuntos
Animais , Masculino , Ratos , Brônquios/cirurgia , Glucocorticoides/uso terapêutico , Transplante de Pulmão , Depuração Mucociliar/efeitos dos fármacos , Prednisona/uso terapêutico , Anastomose Cirúrgica/efeitos adversos , Modelos Animais , Depuração Mucociliar/fisiologia , Período Pós-Operatório , Ratos Wistar , Fatores de Tempo
17.
J Bras Pneumol ; 37(5): 589-97, 2011 Sep-Oct.
Artigo em Inglês, Português | MEDLINE | ID: mdl-22042390

RESUMO

OBJECTIVE: To present a model of prostaglandin I2 (PGI2) administration (inhaled vs. parenteral) and to assess the functional performance of the lungs in an ex vivo lung perfusion system. METHODS: Forty Wistar rats were anesthetized and placed on mechanical ventilation followed by median sterno-laparotomy and anticoagulation. The main pulmonary artery was cannulated. All animals were maintained on mechanical ventilation and were randomized into four groups (10 rats/group): inhaled saline (IS); parenteral saline (PS); inhaled PGI2 (IPGI2); and parenteral PGI2 (PPGI2). The dose of PGI2 used in the IPGI2 and PPGI2 groups was 20 and 10 µg/kg, respectively. The heart-lung blocks were submitted to antegrade perfusion with a low potassium and dextran solution via the pulmonary artery, followed by en bloc extraction and storage at 4ºC for 6 h. The heart-lung blocks were then ventilated and perfused in an ex vivo lung perfusion system for 50 min. Respiratory mechanics, hemodynamics, and gas exchange were assessed. RESULTS: Mean pulmonary artery pressure following nebulization decreased in all groups (p < 0.001), with no significant differences among the groups. During the ex vivo perfusion, respiratory mechanics did not differ among the groups, although relative oxygenation capacity decreased significantly in the IS and PS groups (p = 0.04), whereas mean pulmonary artery pressure increased significantly in the IS group. CONCLUSIONS: The experimental model of inhaled PGI2 administration during lung extraction is feasible and reliable. During reperfusion, hemodynamics and gas exchange trended toward better performance with the use of PGI2 than that with the use of saline.


Assuntos
Anti-Hipertensivos/administração & dosagem , Epoprostenol/administração & dosagem , Transplante de Pulmão/fisiologia , Relação Ventilação-Perfusão/efeitos dos fármacos , Administração por Inalação , Animais , Pressão Sanguínea/fisiologia , Rejeição de Enxerto/prevenção & controle , Infusões Parenterais/métodos , Infusões Parenterais/normas , Masculino , Modelos Animais , Artéria Pulmonar/fisiologia , Troca Gasosa Pulmonar/fisiologia , Distribuição Aleatória , Ratos , Ratos Wistar , Mecânica Respiratória/fisiologia , Relação Ventilação-Perfusão/fisiologia
18.
J. bras. pneumol ; 37(5): 589-597, set.-out. 2011. ilus, tab
Artigo em Português | LILACS | ID: lil-604385

RESUMO

OBJETIVO: Apresentar um modelo experimental de administração de prostaglandina I2 (PGI2) por via inalatória vs. parenteral e avaliar o desempenho funcional dos pulmões em um sistema de perfusão pulmonar ex vivo. MÉTODOS: Quarenta ratos Wistar foram anestesiados, ventilados, submetidos a laparotomia com ressecção do esterno e anticoagulados. O tronco da artéria pulmonar foi canulado. Todos os animais foram submetidos a ventilação mecânica. Os animais foram randomizados em quatro grupos (10 ratos/grupo): salina nebulizada (SN); salina parenteral (SP); PGI2 nebulizada (PGI2N); e PGI2 parenteral (PGI2P). A dose de PGI2 nos grupos PGI2N e PGI2P foi de 20 e 10 µg/kg, respectivamente. Os blocos cardiopulmonares foram submetidos in situ a perfusão anterógrada com solução de baixo potássio e dextrana a 4ºC via artéria pulmonar, extraídos em bloco e armazenados a 4ºC por 6 h. Os blocos foram ventilados e perfundidos em um sistema ex vivo por 50 min, sendo obtidas medidas de mecânica ventilatória, hemodinâmica e trocas gasosas. RESULTADOS: Houve redução da pressão arterial pulmonar média após a nebulização em todos os grupos (p < 0,001), sem diferença entre os grupos. Na perfusão ex vivo, a mecânica ventilatória não diferiu entre os grupos. Houve redução da capacidade relativa de oxigenação ao longo da perfusão nos grupos SN e SP (p = 0,04), e houve aumento significativo da pressão arterial pulmonar no grupo SN. CONCLUSÕES: O modelo experimental de administração de PGI2 na extração pulmonar é exequível e confiável. Na reperfusão, os resultados de hemodinâmica e de trocas gasosas demonstraram tendência a um melhor desempenho com o uso de PGI2 do que com solução salina.


OBJECTIVE:To present a model of prostaglandin I2 (PGI2) administration (inhaled vs. parenteral) and to assess the functional performance of the lungs in an ex vivo lung perfusion system. METHODS: Forty Wistar rats were anesthetized and placed on mechanical ventilation followed by median sterno-laparotomy and anticoagulation. The main pulmonary artery was cannulated. All animals were maintained on mechanical ventilation and were randomized into four groups (10 rats/group): inhaled saline (IS); parenteral saline (PS); inhaled PGI2 (IPGI2); and parenteral PGI2 (PPGI2). The dose of PGI2 used in the IPGI2 and PPGI2 groups was 20 and 10 µg/kg, respectively. The heart-lung blocks were submitted to antegrade perfusion with a low potassium and dextran solution via the pulmonary artery, followed by en bloc extraction and storage at 4ºC for 6 h. The heart-lung blocks were then ventilated and perfused in an ex vivo lung perfusion system for 50 min. Respiratory mechanics, hemodynamics, and gas exchange were assessed. RESULTS: Mean pulmonary artery pressure following nebulization decreased in all groups (p < 0.001), with no significant differences among the groups. During the ex vivo perfusion, respiratory mechanics did not differ among the groups, although relative oxygenation capacity decreased significantly in the IS and PS groups (p = 0.04), whereas mean pulmonary artery pressure increased significantly in the IS group. CONCLUSIONS: The experimental model of inhaled PGI2 administration during lung extraction is feasible and reliable. During reperfusion, hemodynamics and gas exchange trended toward better performance with the use of PGI2 than that with the use of saline.


Assuntos
Animais , Masculino , Ratos , Anti-Hipertensivos/administração & dosagem , Epoprostenol/administração & dosagem , Transplante de Pulmão/fisiologia , Relação Ventilação-Perfusão/efeitos dos fármacos , Administração por Inalação , Pressão Sanguínea/fisiologia , Rejeição de Enxerto/prevenção & controle , Infusões Parenterais/métodos , Infusões Parenterais/normas , Modelos Animais , Artéria Pulmonar/fisiologia , Troca Gasosa Pulmonar/fisiologia , Distribuição Aleatória , Ratos Wistar , Mecânica Respiratória/fisiologia , Relação Ventilação-Perfusão/fisiologia
19.
Clinics (Sao Paulo) ; 66(8): 1451-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21915499

RESUMO

OBJECTIVE: To study the effects of mycophenolate sodium on mucociliary clearance. INTRODUCTION: Mycophenolate is one of the most commonly used immunosuppressive drugs in lung transplantation. Although its pharmacokinetic properties are well defined, its side effects on mucociliary clearance have not yet been studied. METHODS: Sixty rats were subjected to left bronchial section and anastomosis. The right bronchus was used as a control. After surgery, the rats were assigned to two groups based on whether they received saline solution (n = 30) or mycophenolate sodium (n = 30). After 7, 15, or 30 days of treatment, 10 animals from each group were sacrificed, and in vitro mucus transportability, in situ mucociliary transport velocity and ciliary beat frequency were measured. RESULTS: The analysis of mucus transportability revealed that neither mycophenolate nor bronchial section altered any transportability related property for up to 30 days of treatment after surgery (p>0.05). With regard to ciliary beat frequency, the operated left bronchi from the mycophenolate group showed a significant decrease on post-surgical day 30 (p = 0.003). In addition, we found a significant reduction in the in situ mucociliary transport velocity in the mycophenolate-treated group (p = 0.0001). DISCUSSION: These data add important information regarding mucociliary clearance dysfunction following mycophenolate therapy and suggest that mycophenolate might contribute to the high incidence of respiratory tract infections in lung transplant patients. Further studies are needed to investigate the combined action of mycophenolate with other immunosuppressive drugs and to establish methods to protect and recover mucociliary clearance, an important airway defense mechanism.


Assuntos
Brônquios/cirurgia , Imunossupressores/farmacologia , Depuração Mucociliar/efeitos dos fármacos , Ácido Micofenólico/análogos & derivados , Anastomose Cirúrgica , Animais , Masculino , Ácido Micofenólico/farmacologia , Ratos , Ratos Wistar , Cloreto de Sódio/farmacologia , Fatores de Tempo
20.
Clinics ; 66(8): 1451-1456, 2011. ilus
Artigo em Inglês | LILACS | ID: lil-598403

RESUMO

OBJECTIVE: To study the effects of mycophenolate sodium on mucociliary clearance. INTRODUCTION: Mycophenolate is one of the most commonly used immunosuppressive drugs in lung transplantation. Although its pharmacokinetic properties are well defined, its side effects on mucociliary clearance have not yet been studied. METHODS: Sixty rats were subjected to left bronchial section and anastomosis. The right bronchus was used as a control. After surgery, the rats were assigned to two groups based on whether they received saline solution (n = 30) or mycophenolate sodium (n = 30). After 7, 15, or 30 days of treatment, 10 animals from each group were sacrificed, and in vitro mucus transportability, in situ mucociliary transport velocity and ciliary beat frequency were measured. RESULTS: The analysis of mucus transportability revealed that neither mycophenolate nor bronchial section altered any transportability related property for up to 30 days of treatment after surgery (p>0.05). With regard to ciliary beat frequency, the operated left bronchi from the mycophenolate group showed a significant decrease on post-surgical day 30 (p = 0.003). In addition, we found a significant reduction in the in situ mucociliary transport velocity in the mycophenolate-treated group (p = 0.0001). DISCUSSION: These data add important information regarding mucociliary clearance dysfunction following mycophenolate therapy and suggest that mycophenolate might contribute to the high incidence of respiratory tract infections in lung transplant patients. Further studies are needed to investigate the combined action of mycophenolate with other immunosuppressive drugs and to establish methods to protect and recover mucociliary clearance, an important airway defense mechanism.


Assuntos
Animais , Masculino , Ratos , Brônquios/cirurgia , Imunossupressores/farmacologia , Depuração Mucociliar/efeitos dos fármacos , Ácido Micofenólico/análogos & derivados , Anastomose Cirúrgica , Ácido Micofenólico/farmacologia , Ratos Wistar , Cloreto de Sódio/farmacologia , Fatores de Tempo
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