RESUMO
BACKGROUND: Islet cell transplantation is a promising method to restore insulin independence to patients with type 1 diabetes mellitus. A main problem in clinical islet transplantation is the fact that only a small percentage of allogeneic islet-transplanted type 1 diabetic patients can completely omit insulin injections after transplantation. One reason for the impaired survival of islet grafts is aberration of the function of islets due to toxic agents, including oxygen radicals and nitric oxide, which arise during warm or cold ischemic time. Therefore, in clinical islet transplantation, islets have been preserved with a mixture of antioxidants to reduce free radical-mediated damage of transplanted beta cells. Our aim was to examine hepatic tissue after metabolic normalization following intraportal islet transplantation after application of sulforaphane. MATERIALS AND METHODS: Islets were isolated from pancreata of WAG rats. Sulforaphane (24 mg/kg) was administered 24 hours before isolated islets were transplanted into the liver through the portal vein (1200 +/- 100 per rat). At 9 months after transplantation the animals were killed and liver tissue removed for morphological examination. RESULTS: This report indicated that the intrahepatic portal vein site was indeed an excellent locus for implantation of free pancreatic islets. The islet grafts developed rich vascularization derived from both venous and arterial sources. The islet cells maintained their structural and functional integrity after implantation. CONCLUSION: Our results showed that sulforaphane improved islet function in vivo, indicating that combination of a free radical scavenger and an antioxidant (sulforaphane) may be used to increase the effectiveness of islet transplantation.
Assuntos
Anticarcinógenos/uso terapêutico , Diabetes Mellitus Experimental/cirurgia , Transplante das Ilhotas Pancreáticas/métodos , Tiocianatos/uso terapêutico , Animais , Modelos Animais de Doenças , Glucagon/análise , Imuno-Histoquímica , Insulina/análise , Ilhotas Pancreáticas/citologia , Isotiocianatos , Fígado/citologia , Masculino , Veia Porta/cirurgia , Ratos , Ratos Endogâmicos , SulfóxidosRESUMO
Lamotrigine (Lamictal, Glaxo Wellcome) is a drug which is used as add-on therapy in patients with refractory epilepsy. Several previous studies have demonstrated the efficacy of lamotrigine monotherapy, but only few have been done in pediatric patients. The aim of our study was the assessment of efficacy and tolerability of lamotrigine monotherapy in children with newly diagnosed partial epilepsy. Lamictal was used in 19 children (11 boys and 8 girls), aged 3-16 years. 17 patients demonstrated complex partial seizures (with or without secondarily generalisation), 2 children had simplex partial seizures. Symptomatic epilepsy was diagnosed in 10 patients and cryptogenic epilepsy in 9 cases. The drug was administered at the dose of 3.87 +/- 1.02 mg/kg/day during 24 weeks. Three children withdrew from the study because of adverse events: one patient developed rash, two ones seizure exacerbation. Lamictal produced of at least 50% reduction in seizure frequency in 12 (63.15%) children, included 10 seizure-free patients. One third patients experienced EEG improvement. The most common adverse effects were gastrointestinal and sleep disturbances, infections, dizziness, all of them were mild and transient and observed more often in children under 12 years of age. Lamotrigine monotherapy is effective and safe for treatment of newly diagnosed cryptogenic and symptomatic epilepsy with partial seizures but further studies are necessary specially in young children.
Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsias Parciais/tratamento farmacológico , Triazinas/uso terapêutico , Adolescente , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Eletroencefalografia , Epilepsias Parciais/diagnóstico , Feminino , Humanos , Lamotrigina , Masculino , Índice de Gravidade de DoençaRESUMO
The paper presents the results of experimental studies and clinical trials associated with mechanism underlying nervous system damage and pharmacological interventions to be employed in such processes. Abnormal lipid peroxidation was demonstrated in experimental seizures, epilepsy and cerebral stroke. The authors presented the mechanism of calcium channel blockers activity in epilepsy and their experience in employing such agents in epileptic patients. Results of studies on S-100 protein determinations as a marker of the blood-brain barrier damage in epilepsy and hydrocephalus were discussed, along with the employment of evoked potentials in diagnostic management of headaches and the effects of complex treatment of epilepsy in children using Nootropil. Selected data on experimental valproate encephalopathy were also presented. The authors believe that these studies contribute to the understanding of mechanism that are responsible for nervous system dysfunction, as well as to the evaluation and treatment of their effects.
Assuntos
Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/tratamento farmacológico , Adulto , Animais , Biomarcadores/análise , Bloqueadores dos Canais de Cálcio/uso terapêutico , Criança , Epilepsia/diagnóstico , Epilepsia/tratamento farmacológico , Potenciais Evocados , Humanos , Peroxidação de Lipídeos , Piracetam/uso terapêutico , Proteínas S100/análise , Ácido Valproico/uso terapêuticoRESUMO
PURPOSE: The aim was to compare quantitative EEG analysis of REM sleep in children with Down syndrome (DS) and normal age-matched controls. MATERIAL AND METHODS: Twenty-one channel EEG of 21 patients with Down syndrome and 21 normal children, with ages ranging from 1 to 8 years, were submitted to quantitative analysis EEG of discharge-free epochs. The signals were recorded using a set of 17 (F3, F4, F7, F8, Fz, C3, C4, Cz, P3, P4, Pz, O1, O2, T3, T4, T5, T6) scalp electrodes. For each child, 20 artifact-free EEG epochs, each of 2 s without epileptiform discharges were selected for spectral analysis to calculate spectral power. Delta, theta, alpha and beta frequency ranges were compared between groups for all electrode positions. RESULTS: Quantitative analysis of the REM sleep from DS group disclosed reduction of the power mainly in the alpha when comparing the healthy group. Beta, theta and delta bands did not differ significantly between the groups. CONCLUSIONS: Our findings agree with recent evidences that these children may differ from children normal development.
Assuntos
Síndrome de Down/fisiopatologia , Eletroencefalografia , Sono REM/fisiologia , Criança , Pré-Escolar , Humanos , LactenteRESUMO
The mechanisms of brain plasticity include: a change in the balance of excitation and inhibition; a long-term potentiation or long-term depression; a change in neuronal membrane excitability; the anatomical changes-formation of new axon terminals and new synapses. There are few tools for brain plasticity investigations. The utility of the neurophysiologic in the determination of brain reorganization and repair in patients with cerebral palsy (CP) are described. The authors discuss also their results of quantitative EEG, visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs) in children with CP. They showed the existence of brain reorganization and repair in children with CP.
Assuntos
Encéfalo/fisiopatologia , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/fisiopatologia , Criança , Técnicas de Diagnóstico Neurológico , Eletroencefalografia , Potenciais Somatossensoriais Evocados , Potenciais Evocados Visuais , HumanosRESUMO
PURPOSE: Studies of the visual evoked potentials (VEP) in migraine have yielded contradictory results. Several investigators suggested that VEP may be helpful test in diagnosis of a child with headache. The aim of our study was to compare interictal pattern-reversal visual evoked potentials (PR-VEP) in children and adolescents with migraine and tension-type headaches and to evaluate VEP parameters in migraine with and without aura. MATERIAL AND METHODS: The study was carried out in 93 children and adolescents aged 7-18 years with attack headaches. RESULTS: 51 children had diagnosed migraine. In this group 30 children (59%) had migraine without aura (MO), 12 children (23.5%) migraine with aura (MA) and 9 (17.5%) patients other variants of migraine (MV): hemiplegic, ophthalmoplegic, basilar. In control group 42 children were classified as tension-type headaches. All children had PR-VEP performed in headache-free period, without prophylactic treatment. The P100 mean latency was significantly longer in migraine than in tension-type headache. Amplitudes N1-P100 and P100-N2 were significantly larger in migraneurs compared with tension-type headache. The mean amplitudes of N1-P100 and P100-N2 were significantly lower in MA compared with group MO. There were no statistically significant differences of other PR-VEP parameters between MA, MO, MV. If we compare individual results of each patient with migraine with mean value +/- 2 standard deviations (SD) of tension-type headaches group, only 25% have VEP abnormalities of latency or amplitude above 2SD value in tension-type headache group. CONCLUSIONS: The diagnosis of migraine in children actually remains predominantly based on medical history, due to low sensitivity and specificity of electrodiagnostic tests in headaches. However PR-VEP may support the diagnosis of migraine in some cases. VEP could be also helpful method in studying the pathogenesis of different forms of migraine. VEP abnormalities in migraine can be related to a cortical spreading depression and a central neurotransmitter alterations.