RESUMEN
BACKGROUND/AIMS: The decreased synthesis of nitric oxide (NO) during ischaemia/reperfusion (I/R) has been implicated as the major underlying mechanism for the pathogenesis of acute ischaemic colitis (A.I.C.). The aim of this study was to investigate the prophylactic effect of L-arginine, a NO donor, on tissue injury during intestinal I/R, and compare its efficacy with that of exogenous vasodilators (molsidomine) and inert nitrogen-containing molecules (casein). MATERIAL AND METHODS: One hundred forty four Wistar rats underwent occlusion of the superior mesentery artery for 30, 60 and 90 min for induction of intestinal ischaemia, followed by 90 min of reperfusion. The rats were randomly assigned to receive L-arginine, molsidomine, or casein hydrolysate. In all groups, apart of the histological study, we determined the levels of serum malondialdehyde (MDA), a reliable marker indicating the degree of the tissue damage after intestinal I/R. RESULTS: Serum MDA levels were significantly lower in the L-arginine group compared to the untreated animals or those that had received molsidomine or casein, after a period of ischaemia of 90 minutes (p < 0.0005), as well as after a period of ischaemia of 60 or 90 minutes followed by a 90 minutes reperfusion (p = 0.011, and p < 0.0005, respectively). In addition, lesser histopathological damage was noted after the use of L-arginine compared to that caused by the administration of molsidomine and casein. CONCLUSION: These findings support a prophylactic effect of L-arginine in experimentally induced intestinal ischaemia. In short, L-arginine attenuates the degree of tissue damage in intestinal ischaemia and promotes healing of intestinal mucosa.
Asunto(s)
Arginina/farmacología , Colitis Isquémica/tratamiento farmacológico , Daño por Reperfusión/prevención & control , Vasodilatadores/farmacología , Enfermedad Aguda , Animales , Biomarcadores/sangre , Caseínas/farmacología , Colon/irrigación sanguínea , Colon/patología , Mucosa Intestinal/irrigación sanguínea , Mucosa Intestinal/patología , Masculino , Malondialdehído/sangre , Arteria Mesentérica Superior , Modelos Animales , Molsidomina/farmacología , Distribución Aleatoria , Ratas , Ratas Wistar , Factores de TiempoRESUMEN
We report a case of a 65-year-old man with microscopic polyangiitis who developed prostate cancer and gastric adenocarcinoma after prolonged oral use of cyclophosphamide. Acute hepatitis with jaundice and marked increase in aminotranferases occurred after 6 months of flutamide treatment for metastatic prostate carcinoma. It is suggested that patients with vasculitis or other autoimmune disorders should avoid prolonged use of cyclophosphamide and other cytotoxic drugs in order to minimize long-term adverse effects, of which the risk of cancer is by far the most important. In patients on flutamide treatment, careful monitoring of flutamide administration with repeated liver function tests should be undertaken, and the drug must be immediately discontinued in patients with abnormal results to avoid progression of liver injury.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Antineoplásicos Hormonales/efectos adversos , Flutamida/efectos adversos , Neoplasias de la Próstata/tratamiento farmacológico , Vasculitis/diagnóstico , Adenocarcinoma/secundario , Anciano , Humanos , Masculino , Neoplasias de la Próstata/patología , Neoplasias Gástricas/secundarioRESUMEN
Cholesterol embolism is an unusual but serious complication of intra-arterial procedure such as arterial catheterization, angiography, and angioplasty. In this short paper a case of fatal cholesterol embolisation after angiography is described. Histology examination revealed atheroembolic lesions in the kidneys, spleen and colon.