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1.
Tech Coloproctol ; 20(4): 249-54, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26902368

RESUMO

Rectal atresia and anal stenosis are rare forms of anorectal malformations. The aim of the definitive surgical repair in such cases is to preserve the anal canal, the dentate line, and the sphincter complex. We present a case of rectal atresia and anal stenosis to demonstrate the differences in the operative repair. The techniques described leave the anterior wall of the very distal anal canal untouched in both rectal stenosis and anal atresia; however, the dissection of the rectum differs. The atretic rectum in rectal atresia is mobilized and sutured to the anal canal circumferentially. In anal stenosis, the posterior rectum is mobilized in the form of rectal advancement, and the posterior 180° is anastomosed directly to the skin (as in a standard PSARP) with preservation of the anal canal as the anterior 180° of the final anoplasty. These patients have an excellent prognosis for bowel control and fecal continence, and therefore, complete mobilization and resection of the anal canal must be avoided.


Assuntos
Malformações Anorretais/cirurgia , Anus Imperfurado/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Canal Anal/cirurgia , Feminino , Humanos , Lactente , Reto/cirurgia
2.
Front Neurosci ; 18: 1324669, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38362021

RESUMO

The capuchin monkey (Sapajus apella), a New World monkey species, exhibits prominent characteristics that make it an ideal model for neuroscience research. These characteristics include its phylogenetic traits, telencephalization coefficient, anatomical structures and pathways, genetic profile, immune responses, cognitive abilities, and complex behavioral repertoires. Traditionally, methodologies for stereotactic neurosurgery in research models have relied on the use of brain atlases. However, this approach can lead to errors due to the considerable variation in brain size and shape among individual monkeys. To address this issue, we developed a protocol for deriving individual coordinates for each monkey using a straightforward and relatively inexpensive method involving MRI imaging. Our protocol utilizes a specially designed, 3D-printed stereotactic head-holder that is safe to use with an MR magnet, non-invasive placement of fiducial markers, and post-processing with open-source software. This approach enhances MRI data visualization, improves anatomical targeting, and refines the design of neurosurgical experiments. Our technique could also prove beneficial in other areas of neuroscience research that require accurate calculation of stereotaxic coordinates. Furthermore, it could be useful for other nonhuman primate species for which brain atlases are typically unavailable.

3.
Bioconjug Chem ; 21(2): 296-301, 2010 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-20078099

RESUMO

In a nonviral gene delivery system, localization of a plasmid DNA in the nucleus is a prerequisite for expression of a desired therapeutic protein encoded in the plasmid DNA. In this study, a reducible polymer-based gene delivery system for improved intracellular trafficking and nuclear translocation of plasmid DNA is introduced. The system is consisted of two components, a plasmid DNA having repeated binding sequence for a karyophilic protein, NFkappaB, and a reducible polymer. A reducible poly(amido ethylenimine), poly(TETA-CBA), was synthesized by a Michael-type addition polymerization between cystamine bisacrylamide and triethyl tetramine. The polymer forming tight complexes with plasmid DNA could be degraded in the reductive cytosol to release the plasmid DNA. The triggered release mechanism in the cytosol could facilitate the interaction between cytosolic NFkappaB and the plasmid DNA having repeated NFkappaB biding motif. Upon activation of NFkappaB by interleukin-1beta (IL-1beta), most of the plasmid distributed in the cytoplasm was localized within the nucleus, resulting in significantly higher gene transfection efficiency than controls with nondegradable PEI. The current study suggests an alternative way of improving transfection efficiency by taking advantage of endogenous transport machinery for intracellular trafficking and nuclear translocation of a plasmid DNA.


Assuntos
Resinas Acrílicas/química , Núcleo Celular/metabolismo , DNA/metabolismo , Plasmídeos/genética , Transfecção/métodos , Transporte Ativo do Núcleo Celular , Animais , Sequência de Bases , Butionina Sulfoximina/química , Carbocianinas/metabolismo , DNA/genética , Camundongos , Células NIH 3T3 , Oxirredução
4.
Am J Vet Res ; 79(1): 107-114, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29287162

RESUMO

OBJECTIVE To compare the pharmacokinetics of 2 commercial florfenicol formulations following IM and SC administration to sheep. ANIMALS 16 healthy adult mixed-breed sheep. PROCEDURES In a crossover study, sheep were randomly assigned to receive florfenicol formulation A or B at a single dose of 20 mg/kg, IM, or 40 mg/kg, SC. After a 2-week washout period, each sheep was administered the opposite formulation at the same dose and administration route as the initial formulation. Blood samples were collected immediately before and at predetermined times for 24 hours after each florfenicol administration. Plasma florfenicol concentrations were determined by high-performance liquid chromatography. Pharmacokinetic parameters were estimated by noncompartmental methods and compared between the 2 formulations at each dose and route of administration. RESULTS Median maximum plasma concentration, elimination half-life, and area under the concentration-time curve from time 0 to the last quantifiable measurement for florfenicol were 3.76 µg/mL, 13.44 hours, and 24.88 µg•h/mL, respectively, for formulation A and 7.72 µg/mL, 5.98 hours, and 41.53 µg•h/mL, respectively, for formulation B following administration of 20 mg of florfenicol/kg, IM, and 2.63 µg/mL, 12.48 hours, and 31.63 µg•h/mL, respectively, for formulation A and 4.70 µg/mL, 16.60 hours, and 48.32 µg•h/mL, respectively, for formulation B following administration of 40 mg of florfenicol/kg, SC. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that both formulations achieved plasma florfenicol concentrations expected to be therapeutic for respiratory tract disease caused by Mannheimia haemolytica or Pasteurella spp at both doses and administration routes evaluated.


Assuntos
Antibacterianos/farmacocinética , Ovinos/metabolismo , Tianfenicol/análogos & derivados , Animais , Área Sob a Curva , Cromatografia Líquida de Alta Pressão/veterinária , Estudos Cross-Over , Composição de Medicamentos/veterinária , Meia-Vida , Injeções Intramusculares/veterinária , Injeções Subcutâneas/veterinária , Masculino , Tianfenicol/administração & dosagem , Tianfenicol/farmacocinética
5.
Biomaterials ; 28(10): 1912-7, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17218006

RESUMO

Designing synthetic macromolecular vehicles with high transfection efficiency and low cytotoxicity has been a major interest in the development of non-viral gene carriers. A reducible poly(amido ethylenimine) (SS-PAEI) synthesized by addition copolymerization of triethylenetetramine and cystamine bis-acrylamide (poly(TETA/CBA)) was used as a carrier for small interference RNA (siRNA). Poly(TETA/CBA) could efficiently condense siRNA to form stable complexes under physiological conditions and perform complete release of siRNA in a reductive environment. When formulated with VEGF-directed siRNA, poly(TETA/CBA) demonstrated significantly higher suppression of VEGF than linear-polyethylenimine (PEI) (L-PEI, 25kDa) in human prostate cancer cells (PC-3). After 5h of transfection, substantial dissociation and intracellular distribution of siRNA was observed in the poly(TETA/CBA) formulation, but not in the L-PEI formulation. The triggered release of siRNA by reductive degradation of poly(TETA/CBA) in the cytoplasm may affect the RNAi activity by increasing cytoplasmic availability of siRNA. These results suggest that the rational design of non-viral carriers should involve considerations for intracellular dissociation and trafficking of a nucleic acid drug to maximize its effect, in conjunction with formation of stable complexes under physiological conditions.


Assuntos
Aziridinas/química , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Interferência de RNA , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/farmacocinética , Transfecção/métodos , Linhagem Celular Tumoral , Portadores de Fármacos/química , Humanos , Masculino , Teste de Materiais , RNA Interferente Pequeno/administração & dosagem , RNA Interferente Pequeno/química
6.
J Control Release ; 118(2): 254-61, 2007 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-17276536

RESUMO

Delivery of the hypoxia-inducible vascular endothelial growth factor (RTP-VEGF) plasmid using a novel reducible disulfide poly(amido ethylenediamine) (SS-PAED) polymer carrier was studied in vitro and in vivo. In vitro transfection of primary rat cardiomyoblasts (H9C2) showed SS-PAED at a weighted ratio of 12:1 (polymer/DNA) mediates 16 fold higher expression of luciferase compared to an optimized bPEI control. FACS analysis revealed up to 57+/-2% GFP positive H9C2s. The efficiency of plasmid delivery to H9C2 using SS-PAED was found to depend upon glutathione (GSH) levels inside the cell. SS-PAED mediated delivery of RTP-VEGF plasmid produced significantly higher levels of VEGF expression (up to 76 fold) under hypoxic conditions compared to normoxic conditions in both H9C2 and rat aortic smooth muscle cells (A7R5). Using SS-PAED, delivery of RTP-VEGF was investigated in a rabbit myocardial infarct model using 100 mug RTP-VEGF. Results showed up to 4 fold increase in VEGF protein expression in the region of the infarct compared to injections of SS-PAED/RTP-Luc. In conclusion, SS-PAED mediated therapeutic delivery improves the efficacy of ischemia-inducible VEGF gene therapy both in vitro and in vivo and therefore, has potential for the promotion of neo-vascular formation and improvement of tissue function in ischemic myocardium.


Assuntos
Hipóxia Celular , Dissulfetos/metabolismo , Terapia Genética/métodos , Plasmídeos/metabolismo , Poliaminas/metabolismo , Transfecção/métodos , Fator A de Crescimento do Endotélio Vascular/biossíntese , Animais , Separação Celular , Células Cultivadas , Modelos Animais de Doenças , Dissulfetos/química , Citometria de Fluxo , Genes Reporter , Glutationa/metabolismo , Proteínas de Fluorescência Verde , Luciferases , Músculo Liso Vascular/metabolismo , Infarto do Miocárdio/genética , Infarto do Miocárdio/metabolismo , Isquemia Miocárdica/genética , Isquemia Miocárdica/metabolismo , Miócitos Cardíacos/metabolismo , Oxirredução , Plasmídeos/química , Poliaminas/química , Polietilenoimina/química , Coelhos , Ratos , Fator A de Crescimento do Endotélio Vascular/genética
7.
J Control Release ; 118(2): 245-53, 2007 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-17270304

RESUMO

Naked plasmid DNA (pDNA)-based gene therapy has low delivery efficiency, and consequently, low therapeutic effect. We present a biodegradable nonionic triblock copolymer, PEG(13)-PLGA(10)-PEG(13), to enhance gene delivery efficiency in skeletal muscle. Effects of PEG(13)-PLGA(10)-PEG(13) on physicochemical properties of pDNA were evaluated by atomic force microscopy (AFM) imaging, gel electrophoresis and zeta-potential analysis. AFM imaging suggested a slightly compacted structure of pDNA when it was mixed with the polymer, while zeta-potential measurement indicated an increased surface potential of negatively charged pDNA. PEG(13)-PLGA(10)-PEG(13) showed a relatively lower toxicity compared to Pluronic P85 in a skeletal muscle cell line. The luciferase expression of pDNA delivered in 0.25% polymer solution was up to three orders of magnitude more than branched polyethylenimine (bPEI(25 k))/pDNA and three times more than that of naked pDNA five days after intramuscular administration. This in vivo gene delivery enhancement was also observed displaying a two-fold higher expression of human vascular endothelial growth factor (VEGF). Based on fluorescence labeled pDNA distribution, it is speculated that the greater diffusivity of PEG(13)-PLGA(10)-PEG(13)/pDNA compared to bPEI(25 k)/pDNA accounts for better transfection efficiency in vivo. To summarize, combining PEG(13)-PLGA(10)-PEG(13) with pDNA possesses the potential to improve gene delivery efficiency in skeletal muscle.


Assuntos
Músculo Esquelético/metabolismo , Plasmídeos/metabolismo , Polietilenoglicóis/química , Poliglactina 910/química , Transfecção/métodos , Animais , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Eletroforese em Gel de Ágar , Genes Reporter , Humanos , Luciferases , Masculino , Camundongos , Microscopia de Força Atômica , Músculo Esquelético/efeitos dos fármacos , Conformação de Ácido Nucleico , Plasmídeos/química , Poloxaleno/toxicidade , Polietilenoglicóis/toxicidade , Polietilenoimina/química , Poliglactina 910/toxicidade , Ratos , Ratos Sprague-Dawley , Propriedades de Superfície , Fatores de Tempo , Fator A de Crescimento do Endotélio Vascular/biossíntese , Fator A de Crescimento do Endotélio Vascular/genética
8.
Reprod Fertil Dev ; 19(5): 617-25, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17601409

RESUMO

The present 2-year study investigated the feasibility of using porcine zona pellucidae (pZP) as antigen for immunocontraception in American black bears. Sows, 3-6 years of age, were administered either two doses of 250 microg pZP with Freund's adjuvant (n = 10) or adjuvant alone (n = 5), one in April and one in May, and were kept away from the boars until June. Serum samples were collected before injections and before denning (November). The presence of sows with cubs at side was observed during premature emergence from denning. First-year results indicated that anti-pZP antibody titres in vaccinated sows were 2.5-9.0-fold (range) higher compared with non-vaccinated sows and that the vaccinated sows were threefold less likely to become pregnant (P = 0.167). Control and vaccinated bears produced 1.6 and 0.2 cubs per sow, respectively (P = 0.06). The second-year study investigated the feasibility of using pZP sequestered in a controlled-release pellet and a water-soluble adjuvant (QS-21) to avoid regulatory problems associated with Freund's adjuvant. Sows in the treatment group (n = 22) were administered a single dose of an emulsion of 250 microg pZP and 150 microg QS-21 plus a pellet containing 70-90 microg pZP for delayed release as booster dose. Control sows (n = 5) received the QS-21 adjuvant in pellet alone. Serum samples were collected before inoculations (April) and before denning (November). Seven cubs were born to the five control sows, but none was born to the 22 vaccinated sows (P < 0.001). Anti-pZP antibody mean absorbance ratios in control sows remained at background levels, whereas vaccinated sows had ratios fourfold higher than controls. Two-dimensional polyacrylamide gel electrophoresis and immunohistochemical localisation confirmed immunoreactivity of sera from inoculated bears. We conclude that cub production in the American black bear can be effectively limited with either two injections of 250 microg pZP or a single inoculation of partially purified pZP sequestered in controlled-release pellets.


Assuntos
Anticoncepção Imunológica/veterinária , Ursidae/fisiologia , Vacinas Anticoncepcionais/imunologia , Zona Pelúcida/imunologia , Adjuvantes Imunológicos/administração & dosagem , Animais , Animais Recém-Nascidos , Antígenos/administração & dosagem , Antígenos/imunologia , Preparações de Ação Retardada , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Glicolatos/administração & dosagem , Imunoglobulina G/sangue , Imuno-Histoquímica/veterinária , Ácido Láctico , Masculino , Ovário/fisiologia , Ácido Poliglicólico , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Progesterona/sangue , Suínos , Ursidae/sangue , Ursidae/imunologia , Vacinas Anticoncepcionais/administração & dosagem
9.
Theriogenology ; 68(6): 853-60, 2007 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-17681370

RESUMO

The sensitivity (Se) and specificity (Sp) of different testing schemes were estimated for detecting Tritrichomonas foetus (T. foetus) in smegma samples from experimentally infected bulls. Culture and polymerase chain reaction (PCR) on smegma samples were evaluated alone and in parallel testing. Mature dairy bulls (n=79) were intrapreputially inoculated with T. foetus (n=19); Campylobacter (C.) fetus venerealis (n=13); both T. foetus and C. fetus venerealis (n=11); Tetratrichomonas spp. (n=9); C. fetus fetus (n=8); or were not inoculated (n=19). For each bull, smegma samples were collected for 6 week post-inoculation and tested for T. foetus by In Pouch TF culture and PCR. Most T. foetus-inoculated bulls became infected, according to culture (86.7%), PCR (90.0%), and both tests together (93.3%). In T. foetus-inoculated bulls, both tests combined in parallel on a single sample had a Se (78.3%) and Sp (98.5%) similar to two cultures (Se 76.0%, Sp 98.5%) or two PCR (Se 78.0%, Sp 96.7%) sampled on consecutive weeks. The PCR on three consecutive weekly samples (Se 85.0%, Sp 95.4%) and both tests applied in parallel on three consecutive weekly samples (Se 87.5%, Sp 95.6%) were similar to the current gold-standard of six weekly cultures (Se 86.7% and Sp 97.5%). Both tests used in parallel six times had the highest Se (93.3%), with similar Sp (92.5%). Tetratrichomonas spp. were only sporadically detected by culture or PCR. In conclusion, we have proposed alternative strategies for T. foetus diagnostics (for the AI industry), including a combination of tests and repeat testing strategies that may reduce time and cost for bull surveillance.


Assuntos
Reação em Cadeia da Polimerase/métodos , Infecções Protozoárias em Animais , Infecções por Protozoários/diagnóstico , Esmegma/parasitologia , Tritrichomonas foetus/isolamento & purificação , Animais , Bovinos , Técnicas de Cultura de Células , Masculino , Modelos Animais , Preservação Biológica , Sensibilidade e Especificidade , Tritrichomonas foetus/genética
10.
Neurogastroenterol Motil ; 29(10): 1-9, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28524640

RESUMO

BACKGROUND: Colonic dilation is common in children with intractable functional constipation (FC). Our aim was to describe the association between segmental colonic dilation and colonic dysmotility in children with FC. METHODS: We performed a retrospective study on 30 children with intractable FC (according to the Rome III criteria) who had undergone colonic manometry and contrast enema within a 12-month time period. Colonic diameter was measured at 5 cm intervals from the anal verge up to the splenic flexure. Moreover, the distance between the lateral margins of the pedicles of vertebra L2 was measured to provide a ratio (colonic diameter or length/distance between the lateral margins; "standardized colon size" [SCS]). All manometry recordings were visually inspected for the presence of high-amplitude propagating contractions (HAPCs); a parameter for colonic motility integrity. The intracolonic location of the manometry catheter sensors was assessed using an abdominal X-ray. KEY RESULTS: Colonic segments with HAPCs had a significantly smaller median diameter than colonic segments without HAPCs (4.08 cm vs 5.48 cm, P<.001; SCS 1.14 vs 1.66, P=.001). Children with prematurely terminating HAPCs had significantly larger SCS ratios for colonic diameter than children with fully propagating HAPCs (P=.008). SCS ratios for the length of the rectosigmoid and the descending colon and the SCS ratio for sigmoid colon diameter were significantly larger in children with FC compared to a previously described normative population (P<.0001, P<.0001 and P=.0007 respectively). CONCLUSIONS & INFERENCES: Segmental colonic dilation was associated with prematurely terminating HAPCs and may be a useful indicator of colonic dysmotility.


Assuntos
Colo/patologia , Constipação Intestinal/patologia , Motilidade Gastrointestinal/fisiologia , Contração Muscular/fisiologia , Adolescente , Criança , Colo/fisiopatologia , Constipação Intestinal/fisiopatologia , Dilatação Patológica/patologia , Dilatação Patológica/fisiopatologia , Feminino , Humanos , Masculino , Manometria , Músculo Liso/fisiopatologia , Estudos Retrospectivos
11.
J Control Release ; 114(3): 381-8, 2006 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-16884805

RESUMO

Vascular endothelial growth factor (VEGF) is an endogenous mediator of tumor angiogenesis. Blocking associations of the VEGF with its corresponding receptors (Flt-1, KDR/flk-1) have become critical for anti-tumor angiogenesis therapy. Previously, we synthesized PEI-g-PEG-RGD conjugate and evaluated as an angiogenic endothelial polymeric gene carrier. In this study, PEI-g-PEG-RGD/pCMV-sFlt-1 complexes are evaluated in terms of tumor growth inhibition in vivo. Complexes were repeatedly injected systemically via tail vein into subcutaneous tumor-bearing mice. As a result, tumor growth was inhibited in the PEI-g-PEG-RGD/pCMV-sFlt-1 injected group. However, this effect was not identified in PEI-g-PEG/pCMV-sFlt-1 or PEI-g-PEG-RGD/pCMV-GFP control groups. Moreover, the survival rate increased in the PEI-g-PEG-RGD/pCMV-sFlt-1 group compared with the controls group. These results suggest that delivery of pCMV-sFlt-1 using PEG-g-PEG-RGD may be effective for anti-angiogenic gene therapy.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Técnicas de Transferência de Genes , Terapia Genética/métodos , Neoplasias Experimentais/tratamento farmacológico , Peptídeos Cíclicos/administração & dosagem , Polietilenoglicóis/administração & dosagem , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/genética , Animais , Linhagem Celular Tumoral , Citomegalovirus/genética , Portadores de Fármacos , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Neoplasias Experimentais/irrigação sanguínea , Distribuição Tecidual
12.
J Am Vet Med Assoc ; 229(4): 557-61, 2006 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-16910856

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of a single injection of tulathromycin, compared with saline (0.9% NaCl) solution-treated control calves, for treatment of induced infectious bovine keratoconjunctivitis in calves. DESIGN: Clinical trial. ANIMALS: 30 Holstein bull calves ranging from 5 to 6 months old and 75 to 200 kg (165 to 440 lb) with no history of Moraxella bovis infections, no history of M bovis vaccination, and negative results for M bovis on 3 consecutive ocular bacterial cultures. PROCEDURES: Both eyes of each calf were infected with 1 X 10(10) colony-forming units of piliated M bovis for 3 consecutive days prior to the trial. On day 0, ocular lesion scores were determined for each calf and the calves were weighed and assigned to a treatment (2.5 mg/kg [1.14 mg/lb] of body weight, SC) or control group according to a stratified random allocation based on weight and lesion score. Eyes were stained with fluorescein and photographed daily to record healing. Eyes were evaluated bacteriologically for M bovis on days 0 to 6 and at 3-day intervals thereafter. RESULTS: Median time to ulcer resolution in calves treated with tulathromycin was 9.1 days. More than 50% of control calves still had ulcers at the end of the trial (21 days). Moraxella sp was isolated less often from the eyes of treated calves than from the control calves. By day 10, the treated calves had lower ocular lesion scores than control calves. CONCLUSIONS AND CLINICAL RELEVANCE: A single dose of tulathromycin (SC) was an effective treatment of calves with experimentally induced infectious bovine keratoconjunctivitis. The long serum half-life of tulathromycin, along with the results of this trial, suggests that tulathromycin may be a rational choice as a single-injection treatment for infectious bovine keratoconjunctivitis.


Assuntos
Antibacterianos/uso terapêutico , Doenças dos Bovinos/tratamento farmacológico , Dissacarídeos/uso terapêutico , Compostos Heterocíclicos/uso terapêutico , Ceratoconjuntivite Infecciosa/tratamento farmacológico , Infecções por Moraxellaceae/veterinária , Animais , Bovinos , Doenças dos Bovinos/patologia , Ceratoconjuntivite Infecciosa/patologia , Masculino , Moraxella bovis/efeitos dos fármacos , Infecções por Moraxellaceae/tratamento farmacológico , Infecções por Moraxellaceae/patologia , Fatores de Tempo , Resultado do Tratamento
13.
J Pediatr Urol ; 11(3): 120.e1-5, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26048706

RESUMO

INTRODUCTION: This retrospective review was undertaken to identify the postoperative outcomes of children undergoing 'mini' percutaneous nephrolithotomy (MPCNL) at a single institution. OBJECTIVE: Outcomes measured included: percentage of stone clearance, postoperative analgesia requirements, the need for intraoperative or postoperative blood transfusion, length of stay and morbidity. STUDY DESIGN: A total of 46 patients were reviewed over a two-and-a-half-year period; the mean age was 7.3 years (range: 1-16 years). The MPCNL was performed with a radiological-guided peripheral puncture, followed by dilatation of the nephrostomy tract to a maximum Amplatz sheath size of 16-French; an 11-French nephroscope was used. Stone disintegration was achieved either with pneumatic or laser lithotripsy. RESULTS: Complete stone clearance was achieved in 35/46 children (76%). The remaining 11 children had a stone clearance rate of over 80%. No patients required intraoperative/postoperative blood transfusion. A total of 39% of patients were managed on simple/non-opiate based analgesia, with 54% requiring opioid analgesia postoperatively for less than 24 h. There were no procedure-related complications and no mortalities. The mean length of stay was 2.24 days. DISCUSSION: The management of urolithiasis can be challenging in children. The use of percutaneous nephrolithotomy, is becoming increasingly popular in the treatment of paediatric urolithiasis. The stone clearance rate in children undergoing standard PCNL, has been reported to be 50-98% in the literature [1,2,3,4]. Samad et al. [2] in 2006, reported their experience in 188 consecutive PCNLs, using a 17Fr or 26Fr nephroscope. Their largest sub group included children aged >5-16 yrs. Within this group, 57% were treated with a 17Fr nephroscope and 43% with the 26Fr nephroscope, achieving stone clearance of only 47% with PCNL monotherapy. In this group the transfusion rate was 3% [2]. Badawy et al., reported their experience of 60 children in 1999, using a 26 or 28Fr Amplatz sheath. They reported an 83.3% stone clearance with single session PCNL, with only one procedure being abandoned due to intraoperative bleeding requiring blood transfusion [3]. In 2007, Bilen et al. reported their experience and compared the use of 26Fr, 20Fr and 14Fr (mini) PCNL. Stone size, previous surgery and the mean haemoglobin drop postoperatively did not change between the groups, however the blood transfusion rate was higher in the 26Fr and 20Fr Amplatz sheath groups. The stone clearance was highest in the 'mini PCNL' group at 90%, compared to 69.5% in the 26Fr and 80% in the 20Fr group [4]. MPCNL has become increasingly popular over recent years, with stone clearance reported as 80-85% [5-7] following a single session of MPCNL as monotherapy. In 2012, Yan et al. reported 85.2% stone clearance with mini PCNL monotherapy (tract size 14-16Fr), with no children requiring blood transfusion [6]. Zeng et al. reported their experience of 331 renal units in children, with stone clearance rates reaching 80.4% and a blood transfusion rate of 3.1% [8]. In our centre, we do not perform postoperative haemoglobin levels as a matter of routine and any investigations are performed on an intention to treat principle. Bilen et al. reported no blood transfusions being required in their cohort of patients undergoing MPCNL [4] and this is supported by Yan et al. [6]. CONCLUSION: Mini PCNL is an effective and safe procedure for the treatment of paediatric renal stones. In the present series, all children achieved greater than 80% stone clearance, none received a blood transfusion (intra/postoperatively) and there were no mortalities. Postoperative pain was managed with simple analgesia in 39%; however, the majority required opiate analgesia for less than 24 hours.


Assuntos
Cálculos Renais/terapia , Litotripsia , Nefrostomia Percutânea , Adolescente , Analgésicos/uso terapêutico , Transfusão de Sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Tempo de Internação , Masculino , Estudos Retrospectivos , Resultado do Tratamento
14.
Hum Immunol ; 30(3): 208-14, 1991 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-2055785

RESUMO

In most individuals, natural killer (NK) activity is abolished after lymphocyte irradiation with 3,000 cGy, while lymphocytes from a minority of males retain 100% NK activity and lymphocytes from some females retain 50% NK activity after this dose. Radiation sensitivity of NK activity is controlled by X-linked codominant genes. The frequency of the allele that imparts resistance is 7%. We studied a unique family in which both parents have the resistant allele such that the father is completely resistant and the mother is partially resistant. The three offspring of this couple were one sensitive male, one partially resistant female, and one completely resistant female. The radiation sensitivity of nonspecific cytotoxic functions mediated by various types of effector cells from all five family members were evaluated in order to determine whether other cytotoxic functions were controlled by the same set of genes. The cytotoxic functions investigated were: NK and lymphokine-activated killing, anomalous killing and lectin-dependent cellular cytotoxicity, and antibody-dependent cell-mediated cytotoxicity. Our data indicate that the radiation sensitivity of all types of nonspecific cytotoxic cells is under the same genetic control.


Assuntos
Citotoxicidade Imunológica/genética , Cromossomo X , Adulto , Citotoxicidade Celular Dependente de Anticorpos/genética , Citotoxicidade Celular Dependente de Anticorpos/efeitos da radiação , Citotoxicidade Imunológica/efeitos da radiação , Feminino , Genes Dominantes , Ligação Genética , Humanos , Células Matadoras Ativadas por Linfocina/imunologia , Células Matadoras Ativadas por Linfocina/efeitos da radiação , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/efeitos da radiação , Masculino , Pessoa de Meia-Idade , Linhagem , Tolerância a Radiação/genética
15.
Urology ; 11(5): 474-7, 1978 May.
Artigo em Inglês | MEDLINE | ID: mdl-675901

RESUMO

A prospective study to assess the effects of triethylene glycol diglyceridyl ether (Epodyl) in the management of superficial noninvasive vesical neoplasm (T1) is presented. Apart from a few local side effects, the response of the tumor to Epodyl was very good as assessed up to three years. Further long-term studies are being done.


Assuntos
Éteres/uso terapêutico , Etoglucida/uso terapêutico , Neoplasias da Bexiga Urinária/tratamento farmacológico , Diatermia , Etoglucida/administração & dosagem , Etoglucida/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Recidiva Local de Neoplasia , Neoplasias da Bexiga Urinária/terapia
16.
Urology ; 20(4): 382-4, 1982 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7147506

RESUMO

Tuberculous stricture of the ureter is not uncommon in centers which treat large numbers of patients with urinary tuberculosis. Ninety-seven such strictures were seen in 92 patients over a twenty-five-year period. All patients were treated with appropriate antituberculous chemotherapy. Transurethral dilatation of the ureteral stricture was done on 80 ureters. Dilatation was successful in 51 ureters (64%) and failed to relieve the strictures in 29. Technical difficulties prevented dilatation of 17 ureters. We believe that transurethral dilatation should be attempted on all tuberculous ureteral strictures and that other procedures should be employed only if dilatation fails.


Assuntos
Tuberculose Renal/complicações , Obstrução Ureteral/etiologia , Adolescente , Adulto , Idoso , Antituberculosos/uso terapêutico , Criança , Dilatação/métodos , Endoscopia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nefrectomia , Tuberculose Renal/tratamento farmacológico , Ureter/cirurgia , Obstrução Ureteral/terapia , Bexiga Urinária/cirurgia , Cateterismo Urinário/métodos
17.
J Autism Dev Disord ; 14(4): 423-7, 1984 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-6097576

RESUMO

This case study presents the history of a child diagnosed with severe tuberous sclerosis (TS) with an original prognosis of severe to profound mental retardation. Infantile spasms and seizures were eventually controlled, and with educational and therapeutic intervention, this child progressed until she was functioning within normal limits by age 4. This paper presents the position that early diagnosis, early seizure control, and early multidisciplinary intervention are crucial in reducing the poor prognosis in such cases.


Assuntos
Anticonvulsivantes/uso terapêutico , Desenvolvimento Infantil , Educação Inclusiva , Espasmos Infantis/terapia , Esclerose Tuberosa/terapia , Hormônio Adrenocorticotrópico/uso terapêutico , Terapia Comportamental/métodos , Criança , Desenvolvimento Infantil/efeitos dos fármacos , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Inteligência/efeitos dos fármacos
18.
Am Surg ; 58(7): 391-4, 1992 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1616182

RESUMO

A 2-year retrospective analysis of portable ultrasound examinations in the intensive care unit was conducted to evaluate the indications and efficacy of portable sonography. A total of 86 examinations were performed on 79 patients. Of these, 22 per cent of the examinations supported the suspected diagnosis and contributed to treatment. Seventy per cent of the examinations excluded the suspected diagnosis. There was a 9 per cent incidence that yielded unsuspected information that contributed to treatment. Only 8 per cent of the examinations were misleading or proven false. The authors found that with an overall sensitivity of 79 per cent and specificity of 97 per cent, portable ultrasonography is a valuable, relatively inexpensive test in the critical care setting.


Assuntos
Cuidados Críticos , Unidades de Terapia Intensiva , Ultrassonografia/estatística & dados numéricos , Abscesso/diagnóstico por imagem , Abscesso/epidemiologia , Ascite/diagnóstico por imagem , Ascite/epidemiologia , Estudos de Avaliação como Assunto , Doenças da Vesícula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/epidemiologia , Humanos , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia/instrumentação
19.
J Vet Intern Med ; 8(2): 105-11, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-8046672

RESUMO

Two 2-year-old Salers cattle from different herds raised on pasture were evaluated for retarded growth and diarrhea. Increase of liver enzyme activities and prolonged sulfobromophothalein (BSP) half life (T1/2) indicated liver disease with impaired liver function. Histopathologic examination of liver biopsies revealed a micronodular cirrhosis with marked deposition of hemosiderin in hepatocytes, Kupffer cells, and arterioles. Transferrin saturation (TS) and liver iron content were markedly increased, consistent with a diagnosis of hemochromatosis. Both animals were euthanatized due to deterioration in their condition. Necropsy findings included hepatomegaly and hemosiderin accumulation in the liver, lymph nodes, pancreas, spleen, thyroid, kidney, brain and other glandular tissue. Continued surveillance of the second herd (serum iron, total iron binding capacity [TIBC], unsaturated iron binding capacity [UIBC], and TS), identified a heifer as a hemochromatosis suspect in a subsequent generation. Liver biopsies from that animal revealed the same histopathologic changes as the previous 2 animals, and similar increases in liver iron content (8,700 ppm, normal range 45 to 300 ppm). The 3 affected cattle were all products of line breeding programs and shared a common ancestor. The absence of dietary iron loading in conjunction with the histopathologic and metabolic findings were consistent with a diagnosis of primary hemochromatosis. The reported disease is similar to idiopathic hemochromatosis in human beings in which there is a hereditary defect in iron metabolism.


Assuntos
Doenças dos Bovinos/diagnóstico , Hemocromatose/veterinária , Animais , Bovinos , Doenças dos Bovinos/genética , Feminino , Hemocromatose/diagnóstico , Hemossiderina/metabolismo , Ferro/sangue , Cirrose Hepática/patologia , Masculino , Linhagem , Transferrina/metabolismo
20.
Am J Vet Res ; 46(1): 160-2, 1985 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3970421

RESUMO

The range for postmortem vitreous humor Mg2+ concentration in 97 healthy cattle was 1.8 mg/dl to 2.72 mg/dl at 23 C for a 48-hour postmortem interval. The postmortem vitreous Mg2+ concentration closely paralleled the antemortem serum Mg2+ concentration at 23 C. Low environmental temperature (4 C) had no effect on postmortem vitreous concentration. However, high environmental temperatures (30 C) significantly (P less than 0.05) reduced postmortem vitreous Mg2+ concentration at the 36-hour postmortem interval. It was concluded that postmortem vitreous humor Mg2+ determination could be a useful diagnostic aid in cattle for detecting Mg2+ imbalances for at least 48 hours after death, provided the postmortem environmental temperature did not exceed 23 C after 24 hours.


Assuntos
Bovinos/metabolismo , Magnésio/análise , Corpo Vítreo/análise , Matadouros , Animais , Doenças dos Bovinos/diagnóstico , Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/veterinária , Masculino , Temperatura , Fatores de Tempo
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