Sample records for temporary intestinal ischemia

  1. Intestinal Ischemia (United States)

    ... weight loss Intestinal ischemia Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  2. Intestinal ischemia and infarction (United States)

    ... ency/article/001151.htm Small intestinal ischemia and infarction To use the sharing features on this page, please enable JavaScript. Intestinal ischemia and infarction occurs when there is a narrowing or blockage ...

  3. Intestinal Ischemia: US-CT findings correlations (United States)


    Background Intestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies. Methods Basing on experience of our institutions, over 200 cases of mesenteric ischemia/infarction investigated with both US and CT were evaluated considering, in particular, the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen). Results To make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial,venous) and nonocclusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text. Conclusion At present, the reference diagnostic modality for intestinal ischaemia is contrast-enhanced CT. However, there are some disadvantages associated with these techniques, such as radiation exposure, potential nephrotoxicity and the risk of an allergic reaction to the contrast agents. Thus, not all patients with suspected bowel ischaemia can be subjected to these examinations. Despite its limitations, US could constitutes a good imaging method as first examination in acute settings of suspected mesenteric ischemia. PMID:23902826

  4. Urticarial Vasculitis-Associated Intestinal Ischemia

    Directory of Open Access Journals (Sweden)

    Uni Wong


    Full Text Available Urticarial vasculitis (UV is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a case of urticarial vasculitis-associated intestinal ischemia.

  5. Urticarial Vasculitis-Associated Intestinal Ischemia (United States)

    Wong, Uni; Yfantis, Harris; Xie, Guofeng


    Urticarial vasculitis (UV) is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a case of urticarial vasculitis-associated intestinal ischemia. PMID:27190661

  6. Farnesoid X Receptor Activation Attenuates Intestinal Ischemia Reperfusion Injury in Rats.

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    Laurens J Ceulemans

    Full Text Available The farnesoid X receptor (FXR is abundantly expressed in the ileum, where it exerts an enteroprotective role as a key regulator of intestinal innate immunity and homeostasis, as shown in pre-clinical models of inflammatory bowel disease. Since intestinal ischemia reperfusion injury (IRI is characterized by hyperpermeability, bacterial translocation and inflammation, we aimed to investigate, for the first time, if the FXR-agonist obeticholic acid (OCA could attenuate intestinal ischemia reperfusion injury.In a validated rat model of intestinal IRI (laparotomy + temporary mesenteric artery clamping, 3 conditions were tested (n = 16/group: laparotomy only (sham group; ischemia 60min+ reperfusion 60min + vehicle pretreatment (IR group; ischemia 60min + reperfusion 60min + OCA pretreatment (IR+OCA group. Vehicle or OCA (INT-747, 2*30mg/kg was administered by gavage 24h and 4h prior to IRI. The following end-points were analyzed: 7-day survival; biomarkers of enterocyte viability (L-lactate, I-FABP; histology (morphologic injury to villi/crypts and villus length; intestinal permeability (Ussing chamber; endotoxin translocation (Lipopolysaccharide assay; cytokines (IL-6, IL-1-β, TNFα, IFN-γ IL-10, IL-13; apoptosis (cleaved caspase-3; and autophagy (LC3, p62.It was found that intestinal IRI was associated with high mortality (90%; loss of intestinal integrity (structurally and functionally; increased endotoxin translocation and pro-inflammatory cytokine production; and inhibition of autophagy. Conversely, OCA-pretreatment improved 7-day survival up to 50% which was associated with prevention of epithelial injury, preserved intestinal architecture and permeability. Additionally, FXR-agonism led to decreased pro-inflammatory cytokine release and alleviated autophagy inhibition.Pretreatment with OCA, an FXR-agonist, improves survival in a rodent model of intestinal IRI, preserves the gut barrier function and suppresses inflammation. These results turn

  7. The treatment of chronic intestinal ischemia. (United States)

    Illuminati, G; Caliò, F G; D'Urso, A; Papaspyropoulos, V; Mancini, P; Ceccanei, G; Vietri, F


    Due to the rarity of the condition, large and prospective series defining the optimal method of digestive arteries revascularization, for the treatment of chronic intestinal ischemia, are lacking. The aim of this consecutive sample clinical study was to test the hypothesis that flexible application of different revascularization methods, according to individual cases, will yield the best results in the management of chronic intestinal ischemia. Eleven patients, of a mean age of 57 years, underwent revascularization of 11 digestive arteries for symptomatic chronic mesenteric occlusive disease. Eleven superior mesenteric arteries and one celiac axis were revascularized. The revascularization techniques included retrograde bypass grafting in 7 cases, antegrade bypass grafting in 2, percutaneous arterial angioplasty in 1, and arterial reimplantation in one case. The donor axis for either reimplantation or bypass grafting was the infrarenal aorta in 4 cases, an infrarenal Dacron graft in 4, and the celiac aorta in one case. Grafting materials included 5 polytetrafluoroethylene (PTFE) and 3 Dacron grafts. Concomitant procedures included 3 aorto-ilio-femoral grafts and one renal artery revascularization. Mean follow-up length was 31 months. There was no operative mortality. Cumulative survival rate was 88.9% at 36 months (SE 12.1%). Primary patency rate was 90% at 36 months (SE 11.6%). The symptom free rate was 90% at 36 months (SE 11.6%). Direct reimplantation, antegrade and retrograde bypass grafting, all allow good mid-term results: the choice of the optimal method depends on the anatomic and general patients status. Associated infrarenal and renal arterial lesions can be safely treated in the same time of digestive revascularization. Angioplasty alone yields poor results and should be limited to patients at poor risk for surgery.

  8. SM22 a Plasma Biomarker for Human Transmural Intestinal Ischemia

    NARCIS (Netherlands)

    Schellekens, Dirk H. S. M.; Reisinger, Kostan W.; Lenaerts, Kaatje; Hadfoune, M.'hamed; Olde Damink, Steven W.; Buurman, Wim A.; Dejong, Cornelis H. C.; Derikx, Joep P. M.


    To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia. Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is

  9. Effect Of Ischemia-Reperfusion On Healing In Intestinal Anastomosis ...

    African Journals Online (AJOL)

    The effect of reperfusion injury on the healing of intestinal anastomotic wound directly subjected to ischemia-reperfusion stress was investigated in dogs. Three groups of dogs were utilized for the study. In group A (Control) cranial mesenteric artery and collateral blood supply were isolated but not occluded. In groups B and ...

  10. Gastrin attenuates ischemia-reperfusion-induced intestinal injury in rats. (United States)

    Liu, Zhihao; Luo, Yongli; Cheng, Yunjiu; Zou, Dezhi; Zeng, Aihong; Yang, Chunhua; Xu, Jia; Zhan, Hong


    Intestinal ischemia-reperfusion (I/R) injury is a devastating complication when the blood supply is reflowed in ischemic organs. Gastrin has critical function in regulating acid secretion, proliferation, and differentiation in the gastric mucosa. We aimed to determine whether gastrin has an effect on intestinal I/R damage. Intestinal I/R injury was induced by 60-min occlusion of the superior mesenteric artery followed by 60-min reperfusion, and the rats were induced to be hypergastrinemic by pretreated with omeprazole or directly injected with gastrin. Some hypergastrinemic rats were injected with cholecystokinin-2 (CCK-2) receptor antagonist prior to I/R operation. After the animal surgery, the intestine was collected for histological analysis. Isolated intestinal epithelial cells or crypts were harvested for RNA and protein analysis. CCK-2 receptor expression, intestinal mucosal damage, cell apoptosis, and apoptotic protein caspase-3 activity were measured. We found that high gastrin in serum significantly reduced intestinal hemorrhage, alleviated extensive epithelial disruption, decreased disintegration of lamina propria, downregulated myeloperoxidase activity, tumor necrosis factor-α, and caspase-3 activity, and lead to low mortality in response to I/R injury. On the contrary, CCK-2 receptor antagonist L365260 could markedly impair intestinal protection by gastrin on intestinal I/R. Severe edema of mucosal villi with severe intestinal crypt injury and numerous intestinal villi disintegrated were observed again in the hypergastrinemic rats with L365260. The survival in the hypergastrinemic rats after intestinal I/R injury was shortened by L365260. Finally, gastrin could remarkably upregulated intestinal CCK-2 receptor expression. Our data suggest that gastrin by omeprazole remarkably attenuated I/R induced intestinal injury by enhancing CCK-2 receptor expression and gastrin could be a potential mitigator for intestinal I/R damage in the clinical setting.

  11. Verification of chronic intestinal ischemia by angiography

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    Stolze, T.; Sandmann, W.


    With chronical occlusion of an intestianal artery (coeliac artery, superior and inferior mesenteric artery) functionally acting and organ-supplying collateral circulations may develop. When this collateral circulation provides a sufficient blood supply, uncharacteristic (10) and absent or minor clinical symptomatology (21) result and therefore in many cases such vascular occlusions are not detected in older people. Consequently, the possible existence of an intestinal ischaemia should be taken into consideration when indefinite complaints occur in older patients, particularly in those cases, where arterial occlusions exist in the lower extremities. With chronical intestinal (arteriosclerotic) ischaemia an acute thrombo-embolism has always to be regarded as a possible complication.

  12. Therapeutic hypothermia reduces intestinal ischemia/reperfusion ...

    African Journals Online (AJOL)

    To investigate the effects of therapeutic hypothermia (TH) on the morphology and function of intestine after cardiac arrest and resuscitation, 45 male rats were randomly assigned into three groups: (1) normothermia group, animals underwent ventricular fibrillation (VF) and cardiopulmonary resuscitation (CPR) with the rectal ...

  13. Urticarial Vasculitis-Associated Intestinal Ischemia


    Uni Wong; Harris Yfantis; Guofeng Xie


    Urticarial vasculitis (UV) is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a ca...

  14. Isolated Superior Mesenteric Artery Dissection with Small Intestine Ischemia

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    Masahito Aimi


    Full Text Available Superior mesenteric artery (SMA dissection without aortic dissection is a rare condition, and its diagnosis is considered to be difficult. Intestinal infarction is a severe complication of the disease, which may require resection of the intestine. We present a case of isolated SMA dissection. A 53-year-old man experienced sudden pain in the abdomen while playing Japanese pinball and was admitted to our hospital due to acute abdominal symptoms of uncertain cause. Enhanced CT revealed a defect of the root of the SMA, while angiography and intravascular ultrasound findings showed dissection of the SMA wall. Conservative treatment was chosen at the time, while a part of the small intestine was eventually resected because of progressive ischemia. Although SMA dissection is a rare occurrence in cases with acute abdominal symptoms, awareness of the condition is important for differential diagnosis.

  15. Midgut neuroendocrine tumor presenting with acute intestinal ischemia. (United States)

    Mantzoros, Ioannis; Savvala, Natalia Antigoni; Ioannidis, Orestis; Parpoudi, Styliani; Loutzidou, Lydia; Kyriakidou, Despoina; Cheva, Angeliki; Intzos, Vasileios; Tsalis, Konstantinos


    Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors, commonly called carcinoids, account for about 2/3 of all neuroendocrine tumors, they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms, which usually leads to a delayed diagnosis. Imaging modalities can aid diagnosis and surgery remains the mainstay of treatment. We present a case of a jejunal neuroendocrine tumor that caused nonspecific symptoms for about 1 year before manifesting with acute mesenteric ischemia. Abdominal X-rays revealed pneumatosis intestinalis and an abdominal ultrasound and computed tomography confirmed the diagnosis. The patient was submitted to segmental enterectomy. Histopathological study demonstrated a neuroendocrine tumor with perineural and arterial infiltration and lymph node metastasis. The postoperative course was uneventful and the patient denied any adjuvant treatment.

  16. Mechanism underlying methyl eugenol attenuation of intestinal ischemia/reperfusion injury

    National Research Council Canada - National Science Library

    El-Shorbagy, Haidan M; Saleh, Hanan


    .... We aimed to determine whether a pure methyl eugenol (ME) given before intestinal ischemia, protects against intestinal I/R injury and the possible mechanism involved in this protection. Rat received ME (100 mg/kg...

  17. Intestinal ischemia/reperfusion induces bronchial hyperreactivity and increases serum TNF-alpha in rats

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    Arruda Marcio Jose Cristiano de


    Full Text Available INTRODUCTION: Intestinal or hepatic ischemia/reperfusion induces acute lung injury in animal models of multiple organ failure. Tumor necrosis factor (TNF- alpha is involved in the underlying inflammatory mechanism of acute respiratory distress syndrome. Although the inflammatory cascade leading to acute respiratory distress syndrome has been extensively investigated, the mechanical components of acute respiratory distress syndrome are not fully understood. Our hypothesis is that splanchnic ischemia/reperfusion increases airway reactivity and serum TNF-alpha levels. OBJECTIVE: To assess bronchial smooth muscle reactivity under methacholine stimulation, and to measure serum TNF-alpha levels following intestinal and/or hepatic ischemia/reperfusion in rats. METHOD: Rats were subjected to 45 minutes of intestinal ischemia, or 20 minutes of hepatic ischemia, or to both (double ischemia, or sham procedures (control, followed by 120 minutes of reperfusion. The animals were then sacrificed, and the bronchial response to increasing methacholine molar concentrations (10-7 to 3 x 10-4 was evaluated in an ex-vivo bronchial muscle preparation. Serum TNF-alpha was determined by the L929-cell bioassay. RESULTS: Bronchial response (g/100 mg tissue showed increased reactivity to increasing methacholine concentrations in the intestinal ischemia and double ischemia groups, but not in the hepatic ischemia group. Similarly, serum TNF-alpha (pg/mL concentration was increased in the intestinal ischemia and double ischemia groups, but not in the hepatic ischemia group. CONCLUSION: Intestinal ischemia, either isolated or associated with hepatic ischemia, increased bronchial smooth muscle reactivity, suggesting a possible role for bronchial constriction in respiratory dysfunction following splanchnic ischemia/reperfusion. This increase occurred in concomitance with serum TNF-alpha increase, but whether the increase in TNF-alpha caused this bronchial contractility remains

  18. L- and D-lactate as biomarkers of arterial-induced intestinal ischemia

    DEFF Research Database (Denmark)

    Nielsen, Casper; Mortensen, Frank V; Erlandsen, Erland J


    Intestinal ischemia is difficult to diagnose, and search for new biomarkers has led to interest in D-lactate, which arises from bacterial fermentation in the gastrointestinal tract.......Intestinal ischemia is difficult to diagnose, and search for new biomarkers has led to interest in D-lactate, which arises from bacterial fermentation in the gastrointestinal tract....

  19. Early Diagnosis of Intestinal Ischemia Using Urinary and Plasma Fatty Acid Binding Proteins

    NARCIS (Netherlands)

    Thuijls, Geertje; van Wijck, Kim; Grootjans, Joep; Derikx, Joep P. M.; van Bijnen, Annemarie A.; Heineman, Erik; Dejong, Cornelis H. C.; Buurman, Wim A.; Poeze, Martijn

    Objective: This study aims at improving diagnosis of intestinal ischemia, by measuring plasma and urinary fatty acid binding protein (FABP) levels. Methods: Fifty consecutive patients suspected of intestinal ischemia were included and blood and urine were sampled at time of suspicion. Plasma and

  20. Prophylactic Ozone Administration Reduces Intestinal Mucosa Injury Induced by Intestinal Ischemia-Reperfusion in the Rat (United States)

    Onal, Ozkan; Yetisir, Fahri; Sarer, A. Ebru Salman; Zeybek, N. Dilara; Onal, C. Oztug; Yurekli, Banu; Celik, H. Tugrul; Sirma, Ayse; Kılıc, Mehmet


    Objectives. Intestinal ischemia-reperfusion injury is associated with mucosal damage and has a high rate of mortality. Various beneficial effects of ozone have been shown. The aim of the present study was to show the effects of ozone in ischemia reperfusion model in intestine. Material and Method. Twenty eight Wistar rats were randomized into four groups with seven rats in each group. Control group was administered serum physiologic (SF) intraperitoneally (ip) for five days. Ozone group was administered 1 mg/kg ozone ip for five days. Ischemia Reperfusion (IR) group underwent superior mesenteric artery occlusion for one hour and then reperfusion for two hours. Ozone + IR group was administered 1 mg/kg ozone ip for five days and at sixth day IR model was applied. Rats were anesthetized with ketamine∖xyzlazine and their intracardiac blood was drawn completely and they were sacrificed. Intestinal tissue samples were examined under light microscope. Levels of superoxide dismutase (SOD), catalase (CAT), glutathioneperoxidase (GSH-Px), malondyaldehide (MDA), and protein carbonyl (PCO) were analyzed in tissue samples. Total oxidant status (TOS), and total antioxidant capacity (TAC) were analyzed in blood samples. Data were evaluated statistically by Kruskal Wallis test. Results. In the ozone administered group, degree of intestinal injury was not different from the control group. IR caused an increase in intestinal injury score. The intestinal epithelium maintained its integrity and decrease in intestinal injury score was detected in Ozone + IR group. SOD, GSH-Px, and CAT values were high in ozone group and low in IR. TOS parameter was highest in the IR group and the TAC parameter was highest in the ozone group and lowest in the IR group. Conclusion. In the present study, IR model caused an increase in intestinal injury.In the present study, ozone administration had an effect improving IR associated tissue injury. In the present study, ozone therapy prevented

  1. Prophylactic Ozone Administration Reduces Intestinal Mucosa Injury Induced by Intestinal Ischemia-Reperfusion in the Rat

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    Ozkan Onal


    Full Text Available Objectives. Intestinal ischemia-reperfusion injury is associated with mucosal damage and has a high rate of mortality. Various beneficial effects of ozone have been shown. The aim of the present study was to show the effects of ozone in ischemia reperfusion model in intestine. Material and Method. Twenty eight Wistar rats were randomized into four groups with seven rats in each group. Control group was administered serum physiologic (SF intraperitoneally (ip for five days. Ozone group was administered 1 mg/kg ozone ip for five days. Ischemia Reperfusion (IR group underwent superior mesenteric artery occlusion for one hour and then reperfusion for two hours. Ozone + IR group was administered 1 mg/kg ozone ip for five days and at sixth day IR model was applied. Rats were anesthetized with ketamine∖xyzlazine and their intracardiac blood was drawn completely and they were sacrificed. Intestinal tissue samples were examined under light microscope. Levels of superoxide dismutase (SOD, catalase (CAT, glutathioneperoxidase (GSH-Px, malondyaldehide (MDA, and protein carbonyl (PCO were analyzed in tissue samples. Total oxidant status (TOS, and total antioxidant capacity (TAC were analyzed in blood samples. Data were evaluated statistically by Kruskal Wallis test. Results. In the ozone administered group, degree of intestinal injury was not different from the control group. IR caused an increase in intestinal injury score. The intestinal epithelium maintained its integrity and decrease in intestinal injury score was detected in Ozone + IR group. SOD, GSH-Px, and CAT values were high in ozone group and low in IR. TOS parameter was highest in the IR group and the TAC parameter was highest in the ozone group and lowest in the IR group. Conclusion. In the present study, IR model caused an increase in intestinal injury.In the present study, ozone administration had an effect improving IR associated tissue injury. In the present study, ozone therapy

  2. The protective effects of curcumin on intestine and remote organs against mesenteric ischemia/reperfusion injury. (United States)

    Onder, Akın; Kapan, Murat; Gümüş, Metehan; Yüksel, Hatice; Böyük, Abdullah; Alp, Harun; Başarili, Mustafa Kemal; Firat, Uğur


    Mesenteric ischemia/reperfusion injury induces a systemic response and releases harmful substances that may affect distant organs such as the lung, liver and kidney. We designed this study to determine if curcumin has protective effects against mesenteric ischemia/reperfusion injury and mesenteric ischemia/reperfusion-induced intestinal and distant organ injury. Forty Wistar-Albino rats were divided into four groups as: sham, control, ischemia/reperfusion, and ischemia/reperfusion+curcumin. The ischemia/reperfusion and ischemia/reperfusion+curcumin groups were subjected to mesenteric arterial ischemia for 30 minutes and reperfusion for 1 hour. The control and ischemia/reperfusion+curcumin groups were administered curcumin (200 mg/kg, single dose) via oral gavage 15 min before the injury insult. Blood and pulmonary, hepatic and kidney tissue specimens were obtained to measure serum malondialdehyde and total antioxidant capacity, tissue levels of total antioxidant capacity, total oxidative status, and oxidative stress index. In addition, intestine, pulmonary, hepatic, and kidney tissue specimens were obtained for the evaluation of histopathological changes. The histopathological injury scores of the intestine and distant organs were significantly higher in the ischemia/reperfusion group; these injuries were prevented by curcumin in the ischemia/reperfusion+curcumin group. In the ischemia/reperfusion group, a significant increase in serum malondialdehyde levels was determined, which was prevented with curcumin pretreatment in the ischemia/reperfusion+curcumin group. Total antioxidant capacity levels were significantly supported by curcumin pretreatment in the control and ischemia/reperfusion+curcumin groups. This study demonstrated that curcumin ameliorates histopathological damage in the intestine and distant organs against mesenteric ischemia/reperfusion injury.

  3. A cause of porto-mesenteric pneumatosis not secondary to intestinal ischemia. (United States)

    Soto Montesinos, Cristina; Farré Font, Roser; Güell Farré, Merce


    The finding of portal pneumatosis may be related to multiple etiologies such as intestinal inflammatory diseases, intestinal infectious diseases, chemotherapy and radiotherapy treatments or advanced stages of intestinal ischemia. The gold standard for diagnosis is computed tomography, and once the findings are observed, proper differential diagnosis must be asserted to prevent unnecessary laparotomies.

  4. Ischemia and prolonged reperfusion before anastomotic construction do not reduce wound strength in the rat intestine.

    NARCIS (Netherlands)

    Posma, L.A.; Bleichrodt, R.P.; Goor, H. van; Hendriks, T.


    BACKGROUND: Under certain conditions, transient intestinal ischemia can reduce anastomotic strength. Preliminary findings suggest that prolonged reperfusion time, before anastomotic construction, results in reduced wound strength. The purpose of this study is to determine if wound strength indeed

  5. A prolonged interval between deep intestinal ischemia and anastomotic construction does not impair wound strength in the rat.

    NARCIS (Netherlands)

    Posma, L.A.; Bleichrodt, R.P.; Goor, H. van; Hendriks, T.


    INTRODUCTION: Transient intestinal ischemia can reduce anastomotic strength, which poses an increased risk of complications. The objective of this study is to establish if a prolonged interval between profound ischemia and construction of an anastomosis affects anastomotic strength. METHODS: Male

  6. Mucosal injury induced by ischemia and reperfusion in the piglet intestine: Influences of age and feeding

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    Crissinger, K.D.; Granger, D.N. (Louisiana State Univ. Medical Center, Shreveport (USA))


    The pathogenesis of neonatal necrotizing enterocolitis is unknown, but enteral alimentation, infectious agents, and mesenteric ischemia have been frequently invoked as primary initiators of the disease. To define the vulnerability of the intestinal mucosa to ischemia and reperfusion in the developing piglet, we evaluated changes in mucosal permeability using plasma-to-lumen clearance of chromium 51-labeled ethylenediaminetetraacetic acid in the ileum of anesthetized 1-day-, 3-day-, 2-wk-, and 1-mo-old piglets as a function of (a) duration of intestinal ischemia (20, 40, or 60 min of total superior mesenteric artery occlusion), (b) feeding status (fasted or nursed), and (c) composition of luminal perfusate (balanced salt solution vs. predigested cow milk-based formula). Baseline chromium 51-labeled ethylenediaminetetraacetic acid clearance was not significantly altered by ischemia, irrespective of duration, or feeding in all age groups. However, clearances were significantly elevated during reperfusion after 1 h of total intestinal ischemia in all age groups, whether fasted or fed. Reperfusion-induced increases in clearance did not differ among age groups when the bowel lumen was perfused with a balanced salt solution. However, luminal perfusion with formula resulted in higher clearances in 1-day-old piglets compared with all older animals. Thus, the neonatal intestine appears to be more vulnerable to mucosal injury induced by ischemia and reperfusion in the presence of formula than the intestine of older animals.

  7. Early anastomotic repair in the rat intestine is affected by transient preoperative mesenteric ischemia.

    NARCIS (Netherlands)

    Posma, A.E.; Bleichrodt, R.P.; Lomme, R.M.L.M.; Man, B.M. de; Goor, H. van; Hendriks, T.


    INTRODUCTION: During bowel surgery, perioperative blood loss and hypotension can lead to transient intestinal ischemia. Recent preclinical studies reveal that the strength of intestinal anastomoses can be compromised after reperfusion. So far, this phenomenon has not been investigated in the very

  8. The effect of serum, intestinal and peritoneal visfatin levels on early diagnosis of acute mesenteric ischemia. (United States)

    Ucak, Alper; Temizkan, Veysel; Sen, Huseyin; Bulut, Erman C; Can, Murat F; Ugur, Murat; Selcuk, Arif; Kucukodaci, Zafer; Ozcan, Ömer


    Acute mesenteric ischemia (AMI) is a rapidly progressive disease where early diagnosis is life-saving. As a new cytokine, levels of thevisfatin might be affected during the ischema and reperfusion. In our study, we obtained changes of visfatin levels in the serum, peritoneal and intestinal lavage samples in rats, to investigate the effectiveness of these changes in the early diagnosis of AMI. In group 1 (Sham group) the intestine was exteriorated after the laparotomy was performed and allowed to stand for 3 hours without ischemia. In group 2 (acute mesenteric ischemia-reperfusion group) the mesenteric artery was ligated and, mesenteric blood flow was restored after 60-minute ischemia. To compare with intestinal injury, in group 3 (acute pancreatitis group) the ductus pancreaticus was ligated, and the abdomen was closed for 3 days in expectation of the formation of pancreatitis. In all of the groups, the intestinal lavage, peritoneal lavage and blood samples were analyzed to evaluate the levels of visfatin, TNF-alpha, IL-6 and IL-8. Samples were taken before the procedure in all groups; additionally 60 minutes after ischemia and 120 minutes after reperfusion in group 2; and after the development of the pancreatitis in group 3. Serum, intestinal and peritoneal lavage visfatin levels were found to be increased in group 2 and group 3 (Pischemia and reperfusion; in intestinal lavage sample the increase was only in the ischemic phase (Pischemia in serum (P=0.03) and after reperfusion in intestinal lavage (P=0.004) samples. Serum, intestinal and peritoneal visfatin levels were increased not only in the case of mesenteric ischemia, but also in acute pancreatitis. In these two clinical pathologies, the visfatin levels of the intestinal and peritoneal cavitiesmay increase parallel to the serum visfatin levels.

  9. Disruption of the Mucosal Barrier during Gut Ischemia Allows Entry of Digestive Enzymes into the Intestinal Wall


    Chang, Marisol; Kistler, Erik B.; Schmid-Schönbein, Geert W


    Intestinal ischemia is associated with high morbidity and mortality but the underlying mechanisms are uncertain. We hypothesize that during ischemia the intestinal mucosal barrier becomes disrupted, allowing digestive enzymes access into the intestinal wall initiating autodigestion. We used a rat model of splanchnic ischemia by occlusion of the superior mesenteric and celiac arteries up to 30 min with and without luminal injection of tranexamic acid as a trypsin inhibitor. We determined the l...

  10. Chronic intestinal ischemia and splanchnic blood-flow: Reference values and correlation with body-composition

    DEFF Research Database (Denmark)

    Zacho, Helle; Henriksen, Jens Henrik Sahl; Abrahamsen, Jan


    chronic intestinal ischemia (15 women), age 40-85 years, prior to and after a standard meal. The method is based on the Fick principle using the continuous infusion of an indicator (99mTechnetium-labelled mebrofenin) and catheterization of an artery and the hepatic vein. An angiography of the intestinal...... related to lean body mass. Age and sex exerted no impact on SO₂U. CONCLUSION: A direct correlation between body weight and the postprandial increase in SBF was observed. The effect of body weight should be considered in the diagnosis of chronic intestinal ischemia....

  11. Intestinal ischemic preconditioning after ischemia/reperfusion injury in rat intestine: profiling global gene expression patterns. (United States)

    Moore-Olufemi, Stacey D; Olufemi, Shodimu-Emmanuel; Lott, Steve; Sato, Norio; Kozar, Rosemary A; Moore, Frederick A; Radhakrishnan, Ravi S; Shah, Shinil; Jimenez, Fernando; Kone, Bruce C; Cox, Charles S


    Intestinal ischemia/reperfusion (IR) injury involves activation of inflammatory mediators, mucosal necrosis, ileus, and alteration in a variety of gene products. Ischemic preconditioning (IPC) reduced all the effects of intestinal injury seen in IR. In an effort to investigate the molecular mechanisms responsible for the protective effects afforded by IPC, we sought to characterize the global gene expression pattern in rats subjected to IPC in the setting of IR injury. Rats were randomized into five groups: (1) Sham, (2) IPC only (3) IR, (4) Early IPC + IR (IPC --> IR), and (5) Late IPC + IR (IPC --> 24 h --> IR). At 6 h after reperfusion, ileum was harvested for total RNA isolation, pooled, and analyzed on complementary DNA (cDNA) microarrays with validation using real-time polymerase chain reaction (PCR). Significance Analysis of Microarray (SAM) software was used to determine statistically significant changes in gene expression. Early IPC + IR had 5,167 induced and 4 repressed genes compared with the other groups. SAM analysis revealed 474 out of 10,000 genes differentially expressed among the groups. Early and Late IPC + IR had more genes involved in redox hemostasis, the immune/inflammatory response, and apoptosis than either the IPC only or IR alone groups. The transcriptional profile suggests that IPC exerts its protective effects by regulating the gene response to injury in the intestine.

  12. Defining the nonreturn time for intestinal ischemia reperfusion injury in mice. (United States)

    Stringa, P; Lausada, N; Romanin, D; Machuca, M; Cabanne, A; Rumbo, M; Gondolesi, G


    Among the abdominal organs, the intestine is probably the most sensitive to ischemia reperfusion injury (IRI), a phenomenon that occurs in many intestinal disorders. Few studies have reported in detail the impact of intestinal ischemia time in mice. We evaluated the effect of various warm intestinal ischemia times in an intestinal IRI model in mice. Adult male Balb/c mice were divided into 4 groups that differed in intestinal ischemia time: G1, 30; minutes; G2, 35 minutes; G3, 40 minutes; and G4, 45 minutes. Histological evaluation showed average Park scores as follows: G1 0.6 ± 0.55; G2 1.8 ± 0.45; G3 4.8 ± 2.25; and G4 5 ± 1.79. All animals from G1 survived 30 hours. G2 animals showed intermediate behavior with all succumbing between 18 and 30 hours postprocedure. G3 and G4 displayed similar survival results with animals succumbing before 6 hours after intestinal reperfusion. These data showed that Park index scores of 3 or higher were related to early death. We concluded that the 5 minutes between 35 and 40 minutes is the critical limit, after which all mice die after reperfusion. This result may represent a valuable tool for future research in mice. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Life and death at the mucosal-luminal interface: New perspectives on human intestinal ischemia-reperfusion

    NARCIS (Netherlands)

    Grootjans, Joep; Lenaerts, Kaatje; Buurman, Wim A.; Dejong, Cornelis H. C.; Derikx, Joep P. M.


    Intestinal ischemia is a frequently observed phenomenon. Morbidity and mortality rates are extraordinarily high and did not improve over the past decades. This is in part attributable to limited knowledge on the pathophysiology of intestinal ischemia-reperfusion (IR) in man, the paucity in

  14. The role of ischemic preconditioning and pentoxifylline in intestinal ischemia/reperfusion injury of rats. (United States)

    Oliveira, Teresinha Regina Ribeiro de; Oliveira, Geraldo Ferreira de; Simões, Ricardo Santos; Tikazawa, Eduardo Hiroshi; Monteiro, Hugo Pequeno; Fagundes, Djalma José; Taha, Murched Omar


    To investigate the role of ischemic preconditioning (IPC) and pentoxifylline (PTX) in intestinal mucosa ischemia/reperfusion injury (IR). Thirty rats were assigned to 5 groups (N=6): (CG): no clamping of the superior mesenteric artery (90 min.); (IR-SS): saline + ischemia (30 min.) + reperfusion (60 min.); (IR-PTX): PTX + ischemia (30min.) + reperfusion (60 min.); (IPC-IR-SS): 5 min. of ischemia + 5 minutes of reperfusion (IPC) + saline + ischemia (30 min.) + reperfusion (60 min.); (IPC-IR-PTX ): 5 min. of ischemia + 5 min. of reperfusion (IPC) + PTX + 30 min. of I + 60 minutes of R. The IR-PTX, IPC-IR-SS and IPC-IR-PTX groups had significantly lower scores of mucosa damage than the IR-SS group. IR-PTX group showed higher scores than the IPC-IR-PTX group, in accordance with the hypothesis of a favorable effect of IPC alone or in association with PTX. Additionally, IPC-IR-SS had a higher damage score than the IPC-IR-PTX. The villi height and crypt depth were similar in all groups. The villi height in the IR-SS was significantly lower. Ischemic preconditioning or pentoxifylline alone protect the intestinal mucosa from ischemia/reperfusion injury. However, they do not have a synergistic effect when applied together.

  15. The effects of Peroxiredoxin VI on the preservation of the small intestine in rats after ischemia/reperfusion damage

    Directory of Open Access Journals (Sweden)

    A. E. Gordeeva


    Full Text Available The intestine is an extremely sensitive organ with regard to ischemia/reperfusion damage (I/R because of its high oxygen reguirement. The aim of this study is to investigate the effects of Peroxiredoxin VI (Prx VI on preservation of the small intestine after the intestinal ischemia/reperfusion injury in strangulation ileum model. Intestinal ischemia/ reperfusion injury in strangulation model was produced by occlusion of the distal ileum loop and mesentery with its blood vessels for 60 min followed by a 120-min reperfusion period. A group of animals received intravenous injections of 10 mg/kg Prx VI 15 min prior to the intestinal ischemia/reperfusion in the strangulation model. After surgery, part of the intestine was collected for histological analysis. In I/R group a breakdown in the integrity of villi and crypts was revealed, as well as infiltration of lymphocytes, oxidative damage with serious mucosal loss. Prx VI pretreatment to rats with ischemia/reperfusion injury protected the intestine from ischemia/reperfusion injury by reducing oxidative damage and preserving intestinal mucosal composition. These results demonstrated that Prx VI possessed advantageous antioxidant effects as well as effectively attenuated ischemia-reperfusion trauma of the strangulated intestine segment. 

  16. Bacterial translocation and mortality on rat model of intestinal ischemia and obstruction. (United States)

    Costa, Rafael Izar Domingues da; Rasslan, Roberto; Koike, Marcia Kiyomi; Utiyama, Edivaldo Massazo; Montero, Edna Frasson de Souza


    To develop an experimental model of intestinal ischemia and obstruction followed by surgical resection of the damaged segment and reestablishment of intestinal transit, looking at bacterial translocation and survival. After anesthesia, Wistar rats was subject to laparotomy, intestinal ischemia and obstruction through an ileal ligature 1.5cm of ileum cecal valve; and the mesenteric vessels that irrigate upstream of the obstruction site to approximately 7 to 10 cm were ligated. Abdominal wall was closed. Three, six or twenty-four hours after, rats were subject to enterectomy followed by an end to end anastomosis. After 24h, mesenteric lymph nodes, liver, spleen and lung tissues were surgically removed. It was studied survival rate and bacterial translocation. GraphPadPrism statistical program was used. Animals with intestinal ischemia and obstruction for 3 hours survived 24 hours after enterectomy; 6hx24h: survival was 70% at 24 hours; 24hx24h: survival was 70% and 40%, before and after enterectomy, respectively. Culture of tissues showed positivity on the 6hx24h and negativity on the 3hx24h. The model that best approached the clinic was the one of 6x24h of ischemia and intestinal obstruction, in which it was observed bacterial translocation and low mortality rate.

  17. The protective role of montelukast against intestinal ischemia-reperfusion injury in rats. (United States)

    Wu, Shenbao; Zhu, Xuxing; Jin, Zhonghai; Tong, Xiuping; Zhu, Liqin; Hong, Xiaofei; Zhu, Xianfei; Liu, Pengfei; Shen, Weidong


    Several drugs are effective in attenuating intestinal ischemia-reperfusion injury (IRI); however little is known about the effect of montelukast. Fifty rats were randomly assigned to 3 groups: model group (operation with clamping), sham group (operation without clamping), and study group (operation with clamping and 0.2, 2 and 20 mg/kg montelukast pretreatment). Intestinal ischemia-reperfusion was performed by occlusion (clamping) of the arteria mesenterica anterior for 45 min, followed by 24 h reperfusion. Intestinal IRI in the model group led to severe damage of the intestinal mucosa, liver and kidney. The Chiu scores of the intestines from the study group (2 and 20 mg/kg) were lower than that of the model group. Intestinal IRI induced a marked increase in CysLTR1, Caspase-8 and -9 expression in intestine, liver and kidney, which were markedly reduced by preconditioning with 2 mg/kg montelukast. Preconditioning with 2 g/kg montelukast significantly attenuated hepatic tissue injury and kidney damage, and decreased plasma interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels in plasma after intestinal IRI. In conclusion, preconditioning with montelukast could attenuate intestinal IRI and the subsequent systemic inflammatory response in rats.

  18. Ischemic preconditioning and tacrolimus pretreatment as strategies to attenuate intestinal ischemia-reperfusion injury in mice. (United States)

    Stringa, P; Romanin, D; Lausada, N; Machuca, M; Raimondi, J C; Cabanne, A; Rumbo, M; Gondolesi, G


    The intestine is highly sensitive to ischemia-reperfusion injury (IRI), a phenomenon occurring in different intestinal diseases. Several strategies to mitigate IRI are in experimental stages; unfortunately, no consensus has been reached about the most appropriate one. We report a protocol to study ischemic preconditioning (IPC) evaluation in mice and to combine IPC and tacrolimus (TAC) pretreatment in a warm ischemia model. Mice were divided into treated (IPC, TAC, and IPC + TAC) and untreated groups before intestinal ischemia. IPC, TAC, and IPC + TAC groups were able to decrease postreperfusion nitrites levels (P < .05). IPC-containing groups had a major beneficial effect by preserving the integrity of the intestinal histology (P < .05) and improving animal survival (P < .002) compared with TAC alone or the untreated group. The IPC + TAC group was the only one that showed significant improvement in lung histological analysis (P < .05). The TAC and IPC + TAC groups down-regulated intestinal expression of interleukin (II)-6 and IL1b more than 10-fold compared with the control group. Although IPC and TAC alone reduced intestinal IRI, the used of a combined therapy produced the most significant results in all the local and distant evaluated parameters. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Intestinal Injury Currents Associated with Mesenteric Ischemia and Reperfusion (United States)

    Cordova, T.; Bradshaw, L. A.; O'Mahony, G. P.; Gallucci, M. R.; Berch, B.; Richards, W. O.


    A non-invasive method of detecting mesenteric ischemia is presented. The aim of this study was to evaluate the effect of arterial reperfusion on these injury currents. The small bowel of New Zealand white rabbits was exteriorized and the mesenteric blood flow interrupted. Experiments were conducted in three groups, control (n = 3), ischemia (n = 6) and reperfusion following ischemia (n = 5). The subject's position was modulated in and out of the biological field detection range of a SQUID magnetometer. The changes in magnetic field amplitude for the experimental groups were 9.3% and 31.0% for the control and the ischemia groups respectively. The reperfusion group first exhibited a decrease of 17.4% from pre-ischemic to the ischemic period followed by an increase of 13.9% of the ischemic value after re-establishing perfusion. It is concluded that injury currents in GI smooth muscle that appear during ischemia are reduced to pre-ischemic levels during reperfusion.

  20. D-lactate is a valid biomarker of intestinal ischemia induced by abdominal compartment syndrome

    DEFF Research Database (Denmark)

    Nielsen, Casper; Kirkegård, Jakob; Erlandsen, Erland J


    BACKGROUND: Intra-abdominal hypertension (IAH) often leads to abdominal compartment syndrome, which is followed by intestinal ischemia and associated with a high mortality. The diagnosis of abdominal compartment syndrome is difficult, and no valid biochemical markers are available. We conducted...

  1. Temporal relationship of serum markers and tissue damage during acute intestinal ischemia/reperfusion

    Directory of Open Access Journals (Sweden)

    Francisco Javier Guzmán-de la Garza


    Full Text Available OBJECTIVE: It is essential to identify a serological marker of injury in order to study the pathophysiology of intestinal ischemia reperfusion. In this work, we studied the evolution of several serological markers after intestinal ischemia reperfusion injury in rats. The markers of non-specific cell damage were aspartate aminotransferase, alanine aminotransaminase, and lactic dehydrogenase, the markers of inflammation were tumor necrosis factor alpha, interleukin-6, and interleukin-1 beta, and the markers of intestinal mucosal damage were intestinal fatty acid binding protein and D-lactate. We used Chiús classification to grade the histopathological damage. METHODS: We studied 35 Wistar rats divided into groups according to reperfusion time. The superior mesenteric artery was clamped for 30 minutes, and blood and biopsies were collected at 1, 3, 6, 12, 24, and 48 hours after reperfusion. We plotted the mean ± standard deviation and compared the baseline and maximum values for each marker using Student’s t-test. RESULTS: The maximum values of interleukin-1 beta and lactic dehydrogenase were present before the maximal histopathological damage. The maximum tumor necrosis factor alpha and D-lactate expressions coincided with histopathological damage. Alanine aminotransaminase and aspartate aminotransferase had a maximum expression level that increased following the histopathological damage. The maximum expressions of interluken-6 and intestinal fatty acid binding protein were not significantly different from the Sham treated group. CONCLUSION: For the evaluation of injury secondary to acute intestinal ischemia reperfusion with a 30 minute ischemia period, we recommend performing histopathological grading, quantification of D-lactate, which is synthesized by intestinal bacteria and is considered an indicator of mucosal injury, and quantification of tumor necrosis factor alpha as indicators of acute inflammation three hours after reperfusion.

  2. Evaluation of the effects of ischemic preconditioning on the hematological parameters of rats subjected to intestinal ischemia and reperfusion. (United States)

    Tahir, Muhammad; Arshid, Samina; Heimbecker, Ana Maria C; Castro, Mariana S; Souza Montero, Edna Frasson de; Fontes, Belchor; Fontes, Wagner


    Intestinal ischemia/reperfusion often leads to acute lung injury and multiple organ failure. Ischemic preconditioning is protective in nature and reduces tissue injuries in animal and human models. Although hematimetric parameters are widely used as diagnostic tools, there is no report of the influence of intestinal ischemia/reperfusion and ischemic preconditioning on such parameters. We evaluated the hematological changes during ischemia/reperfusion and preconditioning in rats. Forty healthy rats were divided into four groups: control, laparotomy, intestinal ischemia/reperfusion and ischemic preconditioning. The intestinal ischemia/reperfusion group received 45 min of superior mesenteric artery occlusion, while the ischemic preconditioning group received 10 min of short ischemia and reperfusion before 45 min of prolonged occlusion. A cell counter was used to analyze blood obtained from rats before and after the surgical procedures and the hematological results were compared among the groups. The results showed significant differences in hematimetric parameters among the groups. The parameters that showed significant differences included lymphocyte, white blood cells and granulocyte counts; hematocrit; mean corpuscular hemoglobin concentration; red cell deviation width; platelet count; mean platelet volume; plateletcrit and platelet distribution width. The most remarkable parameters were those related to leukocytes and platelets. Some of the data, including the lymphocyte and granulocytes counts, suggest that ischemic preconditioning attenuates the effect of intestinal ischemia/reperfusion on circulating blood cells. Our work contributes to a better understanding of the hematological responses after intestinal ischemia/reperfusion and IPC, and the present findings may also be used as predictive values.

  3. Disruption of the mucosal barrier during gut ischemia allows entry of digestive enzymes into the intestinal wall. (United States)

    Chang, Marisol; Kistler, Erik B; Schmid-Schönbein, Geert W


    Intestinal ischemia is associated with high morbidity and mortality, but the underlying mechanisms are uncertain. We hypothesize that during ischemia the intestinal mucosal barrier becomes disrupted, allowing digestive enzymes access into the intestinal wall initiating autodigestion. We used a rat model of splanchnic ischemia by occlusion of the superior mesenteric and celiac arteries up to 30 min with and without luminal injection of tranexamic acid as a trypsin inhibitor. We determined the location and activity of digestive proteases on intestinal sections with in situ zymography, and we examined the disruption of two components of the mucosal barrier: mucin isoforms and the extracellular and intracellular domains of E cadherin with immunohistochemistry and Western blot techniques. The results indicate that nonischemic intestine has low levels of protease activity in its wall. After 15-min ischemia, protease activity was visible at the tip of the villi, and after 30 min, enhanced activity was seen across the full thickness of the intestinal wall. This activity was accompanied by disruption of the mucin layer and loss of both intracellular and extracellular domains of E cadherin. Digestive protease inhibition in the intestinal lumen with tranexamic acid reduced morphological damage and entry of digestive enzymes into the intestinal wall. This study demonstrates that disruption of the mucosal epithelial barrier within minutes of intestinal ischemia allows entry of fully activated pancreatic digestive proteases across the intestinal barrier triggering autodigestion.

  4. [Management of mesenteric ischemia in the era of intestinal stroke centers: The gut and lifesaving strategy]. (United States)

    Nuzzo, A; Corcos, O


    Mesenteric ischemia is a gut and life-threatening, medical and surgical, digestive and vascular emergency. Mesenteric ischemia is the result of an arterial or venous occlusion, a vasospasm secondary to low-flow states in intensive care patients, aortic clamping during vascular surgery or intestinal transplantation. Progression towards mesenteric infarction and its complications is unpredictable and correlates with high rates of mortality or a high risk of short bowel syndrome in case of survival. Thus, mesenteric ischemia should be diagnosed and treated at an early stage, when gut injury is still reversible. Diagnostic workup lacks sensitive and specific clinical and biological marker. Consequently, diagnosis and effective therapy can be achieved by a high clinical suspicion and a specific multimodal management: the gut and lifesaving strategy. Based on the model of ischemic stroke centers, the need for a multidisciplinary and expert 24/24 emergency care has led, in 2016, to the inauguration of the first Intestinal Stroke Center (Structure d'urgences vasculaires intestinales [SURVI]) in France. This review highlights the pathophysiological features of chronic and acute mesenteric ischemia, as well as the diagnosis workup and the therapeutic management developed in this Intestinal Stroke Center. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  5. Lipid-rich enteral nutrition controls intestinal inflammation, improves intestinal motility and mucosal barrier damage in a rat model of intestinal ischemia/reperfusion injury. (United States)

    Lin, Zhi-Liang; Tan, Shan-Jun; Cheng, Min-Hua; Zhao, Chen-Yan; Yu, Wen-Kui; He, Yu-Long; Li, Jieshou; Li, Ning


    It has been reported that lipid-rich enteral nutrition (EN) could ameliorate inflammation in various diseases. In this study, we investigated whether lipid-rich EN could control intestinal inflammation, improve intestinal motility and mucosal barrier injury after intestinal ischemia/reperfusion (I/R) injury. Male adult rats received saline, conventional EN, or lipid-rich EN via gavage before and after intestinal I/R injury. The superior mesenteric artery was occluded for 60 min. The sham group underwent laparotomy without superior mesenteric artery occlusion and was administrated saline. Intestinal motility was measured 4 h after intestinal I/R injury by fluorescein isothiocyanate-dextran transit assay; the intestinal and systemic inflammation were assessed by analyzing intestinal and serum concentrations of tumor necrosis factor α, interleukin (IL)- 6, and IL-10, separately. The intestinal mucosal barrier injury was assessed by analyzing the serum levels of intestinal fatty acid-binding protein (I-FABP) and intestinal mucosal tight junction (TJ) proteins. The intestinal I/R injury decreased intestinal motility and intestinal mucosal TJs expression significantly when compared with the sham group (P < 0.05). The intestinal and systemic inflammatory parameters and the serum I-FABP were also significantly higher in the I/R groups than those in the sham group (P < 0.05). Both conventional and lipid-rich EN increased the intestinal motility and the intestinal mucosal TJs expression and decreased the intestinal and systemic inflammatory parameter and serum I-FABP levels to different degrees when compared with the I/R group (P < 0.05). However, lipid-rich EN significantly improved the negative alterations in these biochemical parameters when compared with the conventional EN (P < 0.05). These results suggest that lipid-rich EN might be able to control intestinal inflammation, improve intestinal motility and mucosal barrier injury after intestinal I/R injury

  6. The jagged-2/notch-1/hes-1 pathway is involved in intestinal epithelium regeneration after intestinal ischemia-reperfusion injury.

    Directory of Open Access Journals (Sweden)

    Guoqing Chen

    Full Text Available Notch signaling plays a critical role in the maintenance of intestinal crypt epithelial cell proliferation. The aim of this study was to investigate the role of Notch signaling in the proliferation and regeneration of intestinal epithelium after intestinal ischemia reperfusion (I/R injury.Male Sprague-Dawley rats were subjected to sham operation or I/R by occlusion of the superior mesenteric artery (SMA for 20 min. Intestinal tissue samples were collected at 0, 1, 2, 4, and 6 h after reperfusion. Proliferation of the intestinal epithelium was evaluated by immunohistochemical staining of proliferating nuclear antigen (PCNA. The mRNA and protein expression levels of Notch signaling components were examined using Real-time PCR and Western blot analyses. Immunofluorescence was also performed to detect the expression and location of Jagged-2, cleaved Notch-1, and Hes-1 in the intestine. Finally, the γ-secretase inhibitor DAPT and the siRNA for Jagged-2 and Hes-1 were applied to investigate the functional role of Notch signaling in the proliferation of intestinal epithelial cells in an in vitro IEC-6 culture system.I/R injury caused increased intestinal crypt epithelial cell proliferation and increased mRNA and protein expression of Jagged-2, Notch-1, and Hes-1. The immunofluorescence results further confirmed increased protein expression of Jagged-2, cleaved Notch-1, and Hes-1 in the intestinal crypts. The inhibition of Notch signaling with DAPT and the suppression of Jagged-2 and Hes-1 expression using siRNA both significantly inhibited the proliferation of IEC-6 cells.The Jagged-2/Notch-1/Hes-1 signaling pathway is involved in intestinal epithelium regeneration early after I/R injury by increasing crypt epithelial cell proliferation.

  7. Ischemic post-conditioning attenuates the intestinal injury induced by limb ischemia/reperfusion in rats

    Directory of Open Access Journals (Sweden)

    Y.F. Leng


    Full Text Available The purpose of this study was to investigate the protective effects of ischemic post-conditioning on damage to the barrier function of the small intestine caused by limb ischemia-reperfusion injury. Male Wistar rats were randomly divided into 3 groups (N = 36 each: sham operated (group S, lower limb ischemia-reperfusion (group LIR, and post-conditioning (group PC. Each group was divided into subgroups (N = 6 according to reperfusion time: immediate (0 h; T1, 1 h (T2, 3 h (T3, 6 h (T4, 12 h (T5, and 24 h (T6. In the PC group, 3 cycles of reperfusion followed by ischemia (each lasting 30 s were applied immediately. At all reperfusion times (T1-T6, diamine oxidase (DAO, superoxide dismutase (SOD, and myeloperoxidase (MPO activity, malondialdehyde (MDA intestinal tissue concentrations, plasma endotoxin concentrations, and serum DAO, tumor necrosis factor-α (TNF-α, and interleukin-10 (IL-10 concentrations were measured in sacrificed rats. Chiu’s pathology scores for small intestinal mucosa were determined under a light microscope and showed that damage to the small intestinal mucosa was lower in group PC than in group LIR. In group PC, tissue DAO and SOD concentrations at T2 to T6, and IL-10 concentrations at T2 to T5 were higher than in group LIR (P < 0.05; however, tissue MPO and MDA concentrations, and serum DAO and plasma endotoxin concentrations at T2 to T6, as well as TNF-α at T2 and T4 decreased significantly (P < 0.05. These results show that ischemic post-conditioning attenuated the permeability of the small intestines after limb ischemia-reperfusion injury. The protective mechanism of ischemic post-conditioning may be related to inhibition of oxygen free radicals and inflammatory cytokines that cause organ damage.

  8. Ischemic Preconditioning-Induced SOCS-1 Protects Rat Intestinal Ischemia Reperfusion Injury via Degradation of TRAF6. (United States)

    Liu, Sheng-Zhi; He, Xue-Mei; Zhang, Xu; Zeng, Fan-Cai; Wang, Fang; Zhou, Xiang-Yu


    The inflammatory immune response plays an important role in mesenteric ischemia and ischemia-reperfusion injury. Toll-like receptor 4 (TLR4) is a critical receptor in transduction of the inflammatory response and plays an important role in intestinal homeostasis. Tumor necrosis factor receptor-associated factor 6 (TRAF6), known as a key adaptor protein downstream of TLR4, is involved in the inflammatory response by activating multiple apoptotic signaling pathways. However, mechanisms of the suppressor of cytokine signaling-1 (SOCS-1) in regulating cell inflammation and apoptosis are still obscure. To investigate the TLR4-TRAF6 signaling pathway in intestinal ischemia and reperfusion injury, as well as SOCS-1 expression after ischemic preconditioning in the rat intestine. The small bowel ischemia, ischemia-reperfusion, and preconditioning models were induced using ligation of the superior mesenteric artery in male Sprague-Dawley rats; then, the mRNA and protein levels of TLR4, TRAF6, and SOCS-1 were analyzed using real-time PCR, Western blot, and immunohistochemistry, respectively. The expression of TLR4 and TRAF6 was gradually increased with increasing intestinal ischemia duration, but increased substantially after ischemia-reperfusion injury. After ischemic preconditioning, TLR4 and TRAF6 expressions decreased; however, expression of SOCS-1 and the TLR4-TRAF6 pathway inhibitor was increased. These data show that ischemic preconditioning may induce the activation of SOCS-1 to inhibit the TLR4-TRAF6 signaling pathway, thereby playing a protective role in ischemia-reperfusion injury.

  9. Protective effect of salvianolic acid B against intestinal ischemia ...

    African Journals Online (AJOL)

    Methods: Forty-eight healthy male rats were randomly choosen and divided into 4 groups of 12 rats each. Control group rats underwent ... In addition, pretreatment with SAB reverted intestinal (ileum) histopathological changes to almost normal architecture with significant reduction in Chiu score. Conclusion: The results of ...

  10. Protective effect of salvianolic acid B against intestinal ischemia ...

    African Journals Online (AJOL)

    Tong MS. Protective effect of melatonin‐supported adipose derived mesenchymal stem cells against small bowel ischemia‐reperfusion injury in rat. J pineal Res. 2015; 59(2): 206-220. 15. Chiu CJ, McArdle AH, Brown R, Scott HJ, Gurd FN. Intestinal mucosal lesion in low-flow states: I. A morphological, hemodynamic, and.

  11. Translocation of {sup 99m}Tc labelled bacteria after intestinal ischemia and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Joao, Samir Assi; Alencar, Suelene Suassuna Silvestre de [Rio Grande do Norte Univ., Natal, RN (Brazil). Faculdade de Medicina. Dept. de Cirurgia; Medeiros, Aldo da Cunha [Rio Grande do Norte Univ., Natal, RN (Brazil). Faculdade de Medicina. Nucleo de Cirurgia Experimental]. E-mail:; Diniz, Simone Otilia Fernandes; Cardoso, Valbert Nascimento [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Faculdade de Farmacia. Lab. de Radioisotopo; Brandt, Carlos Teixeira [Pernambuco Univ., Recife, PE (Brazil). Faculdade de Medicina. Dept. de Cirurgia


    Ischemia and reperfusion of the small intestine disrupts gut barrier, causes bacterial translocation and activates inflammatory responses. An experimental study was planned to evaluate if {sup 99m}Tc labelled Escherichia coli translocates to mesenteric lymph nodes, liver, spleen, lung and serum of rats submitted to mesenteric ischemia/reperfusion. Additionally, it was observed if the time of reperfusion influences the level of translocation. Forty male Wistar rats underwent 45 minutes of gut ischemia by occlusion of the superior mesenteric artery. The translocation of labelled bacteria to different organs and portal serum was determined in rats reperfused for 30 minutes, 24 hours, sham(S) and controls(C), using radioactivity count and colony forming units/g (CFU). All the organs from rats observed for 24 hours after reperfusion had higher levels of radioactivity and positive cultures (CFU) than did the organs of rats reperfused for 30 minutes, C and S, except in the spleen (p<0,01). The results of this study indicated that intestinal ischemia/reperfusion led to bacterial translocation, mostly after 24 hours of reperfusion. (author)


    Du, Lei; Zhang, Rongjia; Luo, Tianhang; Nie, Mingming; Bi, Jianwei


    Intestinal ischemia-reperfusion (I/R) injury can occur in clinical settings such as organ transplantation, cardiopulmonary bypass and trauma. The noble gas helium attenuates I/R injury in a number of animal organs and thus may offer a strategy for reducing I/R-induced intestinal injury in clinical settings. In the present study, we used four different helium preconditioning (HPC) profiles to investigate the potential beneficial effect of HPC on I/R-induced intestinal injury. Male Sprague-Dawley rats were pretreated with three cycles of air breathing for 5 min combined with three cycles of breathing a 70% helium:30% oxygen mixture for either 2, 5, 10, or 15 min, after which they were subjected to 60-min intestinal ischemia and 60-min reperfusion. Sixty minutes after reperfusion, the intestinal tissues of the variously treated rats were analyzed using histology, immunohistochemistry, terminal dUTP nick-end labeling staining, myeloperoxidase activity assay, Western blotting, and enzyme-linked immunosorbent assay for tumor necrosis factor α and macrophage inflammatory protein 1α. Intestinal permeability was assayed by measuring fluorescein isothiocyanate-dextran release in blood samples. The results showed that the HPC profile consisting of three cycles of 10 or 15 min of helium breathing and three cycles of 5 min of air breathing reduced I/R-induced intestinal injury, cell apoptosis, and the inflammatory response. However, the 2- or 5-min helium breathing did not confer any protective effects. It seems that longer helium episodes should be used in HPC profiles designed to attenuate intestinal I/R injury.

  13. Iloprost Use in Patients with Persistent Intestinal Ischemia Unsuitable for Revascularization. (United States)

    Nuzzo, Alexandre; Soudan, Damien; Billiauws, Lore; Bataille, Julie; Maggiori, Léon; Ronot, Maxime; Stocco, Jeanick; Bouhnik, Yoram; Castier, Yves; Corcos, Olivier


    Persistent or chronic intestinal ischemic injury (i3) can lead to severe malnutrition and acute mesenteric ischemia. Although recommended, revascularization of splanchnic arteries is sometimes unrealizable. We report a case series of iloprost use in consecutive stable patients with persistent i3 unsuitable for revascularization followed in a tertiary care center. The feasibility of revascularization was discussed and ruled out by a multidisciplinary team, and informed consent was obtained prior to consideration of a vasoactive therapy. Therapeutic response was defined at 6 months by a decrease in the use of analgesic and parenteral nutrition, and no need for intestinal resection. Between 2006 and 2015, 6 patients (mean age: 51) were included. Splanchnic vascular insufficiency was due to superior mesenteric artery (SMA) thrombosis (n = 4), dissection of the celiac trunk and SMA (n = 1), or repeated vasospasm resulting in chronic nonocclusive mesenteric ischemia (n = 1). Iloprost was delivered via continuous intravenous perfusion at a maximum dosage of 2 ng/kg/min for 6 hours/day on 4 consecutive days, without severe adverse events. Therapeutic response was observed in 4 patients, 3 of which completely stopped parenteral nutrition and analgesic with no need for intestinal resection. Our results are consistent with findings of a favorable effect of iloprost in patients with persistent splanchnic ischemia that should be confirmed in prospective trials. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Inhibition of ERK1/2 worsens intestinal ischemia/reperfusion injury.

    Directory of Open Access Journals (Sweden)

    Kechen Ban

    Full Text Available BACKGROUND: The role of extracellular signal-regulated protein kinase (ERK in intestinal ischemia/reperfusion (I/R injury has not been well investigated. The aim of the current study was to examine the effect of inhibition of the ERK pathway in an in vitro and in vivo model of intestinal I/R injury. METHODS: ERK1/2 activity was inhibited using the specific inhibitor, U0126, in intestinal epithelial cells under hypoxia/reoxygenation conditions and in mice subjected to 1 hour of intestinal ischemia followed by 6 hours reperfusion. In vitro, cell proliferation was assessed by MTT (3-(4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide assay, apoptosis by DNA fragmentation, and migration using an in vitro model of intestinal wound healing. Cells were also transfected with a p70S6K plasmid and the effects of overexpression similarly analyzed. In vivo, the effects of U0126 on intestinal cell proliferation and apoptosis, intestinal permeability, lung and intestinal neutrophil infiltration and injury, and plasma cytokine levels were measured. Survival was also assessed after U0126. Activity of p70S6 kinase (p70S6K was measured by Western blot. RESULTS: In vitro, inhibition of ERK1/2 by U0126 significantly decreased cell proliferation and migration but enhanced cell apoptosis. Overexpression of p70S6K promoted cell proliferation and decreased cell apoptosis. In vivo, U0126 significantly increased cell apoptosis and decreased cell proliferation in the intestine, increased intestinal permeability, intestinal and lung neutrophil infiltration, and injury, as well as systemic pro-inflammatory cytokines, TNF-α, IL-6 and IL-1β. Mortality was also significantly increased by U0126. Inhibition of ERK1/2 by U0126 also abolished activity of p70S6K both in vitro and in vivo models. CONCLUSION: Pharmacologic inhibition of ERK1/2 by U0126 worsens intestinal IR injury. The detrimental effects are mediated, at least in part, by inhibition of p70S6K, the major

  15. Gene expression related to oxidative stress in the heart of mice after intestinal ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Somaio Neto, Frederico; Ikejiri, Adauto Tsutomu; Bertoletto, Paulo Roberto; Chaves, José Carlos Bertoletto [Universidade Federal da Grande Dourados - UFGD, Dourados, MS (Brazil); Teruya, Roberto [Universidade Federal do Mato Grosso do Sul - UFMS, Campo Grande, MS (Brazil); Fagundes, Djalma José, E-mail:; Taha, Murched Omar [Universidade Federal de São Paulo - UNIFESP, São Paulo, SP (Brazil)


    Intestinal ischemia-reperfusion is a frequent clinical event associated to injury in distant organs, especially the heart. To investigate the gene expression of oxidative stress and antioxidant defense in the heart of inbred mice subjected to intestinal ischemia and reperfusion (IR). Twelve mice (C57BL / 6) were assigned to: IR Group (GIR) with 60 minutes of superior mesenteric artery occlusion followed by 60 minutes of reperfusion; Control Group (CG) which underwent anesthesia and laparotomy without IR procedure and was observed for 120 minutes. Intestine and heart samples were processed using the RT-qPCR / Reverse transcriptase-quantitative Polymerase Chain Reaction method for the gene expression of 84 genes related to oxidative stress and oxidative defense (Student's 't' test, p < 0.05). The intestinal tissue (GIR) was noted to have an up-regulation of 65 genes (74.71%) in comparison to normal tissue (CG), and 37 genes (44.04%) were hyper-expressed (greater than three times the threshold allowed by the algorithm). Regarding the remote effects of intestinal I/R in cardiac tissue an up-regulation of 28 genes (33.33%) was seen, but only eight genes (9.52%) were hyper-expressed three times above threshold. Four (7.14%) of these eight genes were expressed in both intestinal and cardiac tissues. Cardiomyocytes with smaller and pyknotic nuclei, rich in heterochromatin with rare nucleoli, indicating cardiac distress, were observed in the GIR. Intestinal I/R caused a statistically significant over expression of 8 genes associated with oxidative stress in remote myocardial tissue.

  16. The effect of nicorandil on small intestinal ischemia-reperfusion injury in a canine model. (United States)

    Suto, Yujin; Oshima, Kiyohiro; Arakawa, Kazuhisa; Sato, Hiroaki; Yamazaki, Hodaka; Matsumoto, Koshi; Takeyoshi, Izumi


    It has been shown that nicorandil, which has both ATP-sensitive K+ (KATP) channel opener-like and nitrate-like properties, has an organ-protective effect in ischemia-reperfusion injury in several experimental animal models. We evaluate the effectiveness of nicorandil on warm ischemia-reperfusion injury of the small intestine in a canine model. Eighteen beagle dogs were divided into three groups: the control group (n=6); the nicorandil group (n=6), to which nicorandil was injected intravenously before the ischemia; and the glibenclamide group (n=6), to which glibenclamide, which closes the KATP channel and does not suppress the nitrate effect of nicorandil, was orally administered, and then nicorandil was injected in the same manner as in the nicorandil group. Both the superior mesenteric artery and vein were clamped for 2 h. Superior mesenteric artery blood flow, small intestinal mucosal tissue blood flow, intramucosal pH, and histopathological analyses were compared among the three groups. Superior mesenteric artery blood flow, mucosal tissue blood flow and pHi after reperfusion were significantly maintained in the nicorandil in comparison with the control and the glibenclamide groups. The histopathological findings showed less severe mucosal damage after reperfusion in the nicorandil group compared with the other two groups. Between the control group and the glibenclamide group, no significant differences were observed in all those parameters. This study suggests that nicorandil has a protective effect on small intestinal IR injury, and activation of KATP channels plays an important role in inhibiting small intestinal IR injury.

  17. Dynamic alteration of the colonic microbiota in intestinal ischemia-reperfusion injury.

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    Fan Wang

    Full Text Available BACKGROUND: Intestinal ischemia-reperfusion (I/R plays an important role in critical illnesses. Gut flora participate in the pathogenesis of the injury. This study is aimed at unraveling colonic microbiota alteration pattern and identifying specific bacterial species that differ significantly as well as observing colonic epithelium change in the same injury model during the reperfusion time course. METHODOLOGY/PRINCIPAL FINDINGS: Denaturing gradient gel electrophoresis (DGGE was used to monitor the colonic microbiota of control rats and experimental rats that underwent 0.5 hour ischemia and 1, 3, 6, 12, 24, and 72 hours following reperfusion respectively. The microbiota similarity, bacterial diversity and species that characterized the dysbiosis were estimated based on the DGGE profiles using a combination of statistical approaches. The interested bacterial species in the gel were cut and sequenced and were subsequently quantified and confirmed with real-time PCR. Meanwhile, the epithelial barrier was checked by microscopy and D-lactate analysis. Colonic flora changed early and differed significantly at 6 hours after reperfusion and then started to recover. The shifts were characterized by the increase of Escherichia coli and Prevotella oralis, and Lactobacilli proliferation together with epithelia healing. CONCLUSION/SIGNIFICANCE: This study shows for the first time that intestinal ischemia-reperfusion results in colonic flora dysbiosis that follows epithelia damage, and identifies the bacterial species that contribute most.

  18. Plasma intestinal fatty acid binding protein (I-FABP) concentrations increase following intestinal ischemia in pigs

    NARCIS (Netherlands)

    Niewold, T.A.; Meinen, M.; Meulen, van der J.


    Intestinal fatty acid binding protein (I-FABP) is an intracellular epithelial protein in the intestinal mucosa of many animals. IFABP appears in the circulation following epithelial damage, and in humans, is proven to be a parameter for damage to the mucosa. In this paper, an ELISA test designed for

  19. Ischemic preconditioning attenuates remote pulmonary inflammatory infiltration of diabetic rats with an intestinal and hepatic ischemia-reperfusion injury

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    Farid José Thomaz Neto


    Full Text Available PURPOSE: To assess ischemic preconditioning (IPC effects in pulmonary lesion in intestinal and hepatic ischemia-reperfusion (IR injury models using diabetic rats. METHODS: Diabetes (DM was induced in 28 male Wistar rats by alloxan (42 mg/kg, IV. After 28 days, severe DM rats were submitted to intestinal or hepatic IR injury with or without IPC. Intestinal IR (30 min of mesenteric artery occlusion and 30 min of reperfusion; n=6 and IPC groups (10 min ischemia, 10 min reperfusion, followed by intestinal IR; n=6, and Hepatic IR (30 min of hepatic pedicle occlusion and 30 min of reperfusion; n=5 and IPC groups (10 min ischemia, 10 min reperfusion, followed by hepatic IR; n=5, were compared to DM rats group (n=6. Plasmatic lactate, glycemia were measured before and after IR injury. Histomorphology of lung was performed counting inflammatory cells. Data was expressed in mean± SE. P<0.05. RESULTS: Glycemia and lactate were similar among groups. IPC did not interfere in these parameters. On histological evaluation, IR increased inflammatory cells infiltration in pulmonary parenchyma compared to control in both IR injury models. IPC attenuated inflammatory infiltration in lungs. CONCLUSION: Ischemic preconditioning protects against remote ischemia-reperfusion injury in lung on intestinal or hepatic ischemia-reperfusion model with acute diabetes.

  20. Proanthocyanidin protects intestine and remote organs against mesenteric ischemia/reperfusion injury. (United States)

    Sizlan, Ali; Guven, Ahmet; Uysal, Bulent; Yanarates, Omer; Atim, Abdulkadir; Oztas, Emin; Cosar, Ahmet; Korkmaz, Ahmet


    Intestinal ischemia/reperfusion (IR) induces a systemic inflammatory response and releases harmful substances that may affect the function and integrity of distant organs such as lung, liver, and kidney. We conducted this study to find out if proanthocyanidins (PA) has protective effects against mesenteric IR injury and mesenteric IR-induced intestinal and distant organ injury. Thirty-two Sprague-Dawley rats were divided into four groups: control, control + PA, IR, IR + PA. The IR and IR + PA groups were subjected to mesenteric arterial ischemia for 60 min and reperfusion for 6 h. The Control + PA and IR + PA groups were administered PA (100 mg/kg/day via oral gavage) for 7 days prior to injury insult. We collected ileal and distant organ tissues, such as pulmonary, hepatic, and kidney specimens to measure tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx), and nitrite plus nitrate (NO(x)), and we then evaluated histological changes. In the IR group, significant increases in MDA and NO(x) levels and significant increases in SOD and GPx activities of intestine, liver, kidney, and lung were observed. The MDA and NO(x) levels were significantly lower, as were the SOD and GPx activities in the IR + PA group than that in the IR group. Although the intestine and distant organs damage scores were significantly higher in the IR group, these injuries were prevented by PA in the IR + PA group. This study demonstrates that PA has a significant effect in the protection of the intestine and the remote organs against mesenteric IR injury.

  1. Mannitol infusion immediately after reperfusion suppresses the development of focal cortical infarction after temporary cerebral ischemia in gerbils. (United States)

    Ito, Umeo; Hakamata, Yoji; Watabe, Kazuhiko; Oyanagi, Kiyomitsu


    Previously we found that, after temporary cerebral ischemia, microvasculogenic secondary focal cerebral cortical ischemia occurred, caused by microvascular obstruction due to compression by swollen astrocytic end-feet, resulting in focal infarction. Herein, we examined whether mannitol infusion immediately after restoration of blood flow could protect the cerebral cortex against the development of such an infarction. If so, the infusion of mannitol might improve the results of vascular reperfusion therapy. We selected stroke-positive animals during the first 10 min after left carotid occlusion performed twice with a 5-h interval, and allocated them into four groups: sham-operated control, no-treatment, mannitol-infusion, and saline-infusion groups. Light- and electron-microscopic studies were performed on cerebral cortices of coronal sections prepared at the chiasmatic level, where the focal infarction develops abruptly in the area where disseminated selective neuronal necrosis is maturing. Measurements were performed to determine the following: (A) infarct size in HE-stained specimens from all groups at 72 and 120 h after return of blood flow; (B) number of carbon-black-suspension-perfused microvessels in the control and at 0.5, 3, 5, 8, 12 and 24 h in the no-treatment and mannitol-infusion groups; (C) area of astrocytic end-feet; and (D) number of mitochondria in the astrocytic end-feet in electron microscopic pictures taken at 5 h. The average decimal fraction area ratio of infarct size in the mannitol group was significantly reduced at 72 and 120 h, associated with an increased decimal fraction number ratio of carbon-black-suspension-perfused microvessels at 3, 5 and 8 h, and a marked reduction in the size of the end-feet at 5 h. Mannitol infusion performed immediately after restitution of blood flow following temporary cerebral ischemia remarkably reduced the size of the cerebral cortical focal infarction by decreasing the swelling of the end

  2. Protective effects of dietary EPA and DHA on ischemia-reperfusion-induced intestinal stress. (United States)

    Brahmbhatt, Viral; Oliveira, Manuel; Briand, Muriel; Perrisseau, Geneviève; Bastic Schmid, Viktoria; Destaillats, Frédéric; Pace-Asciak, Cecil; Benyacoub, Jalil; Bosco, Nabil


    The immunoregulatory effects of dietary omega-3 fatty acids are still not fully characterized. The aim of this study was to determine whether dietary eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake limits intestinal ischemia-reperfusion (IR) injury. To test this, rats were fed either control or EPA/DHA supplemented diet for 3 weeks following which they underwent either a sham or an IR surgical protocol. A significant reduction in mucosal damage was observed after EPA/DHA supplemented diet as reflected by maintenance of total protein content. To address the underlying mechanisms of protection, we measured parameters of oxidative stress, intestinal and serological cytokines and intestinal eicosanoids. Interestingly, EPA/DHA fed animals displayed a higher activity of oxidative stress enzyme machinery, i.e., superoxide dismutase and catalase in addition to a reduction in total nitrate/nitrite content. While no changes in cytokines were observed, eicosanoid analyses of intestinal tissue revealed an increase in metabolites of the 12-lipoxygenase pathway following IR. Further, IR in EPA/DHA fed animals was accompanied by a significant increase of 17,18-epoxyeicosatetraenoic acid, 8-Iso prostaglandin F(3α) and thromboxane B(3), by more than 12-, 6-, 3-fold, respectively. Thus, the data indicate that EPA/DHA supplementation may be able to reduce early intestinal IR injury by anti-oxidative and anti-inflammatory mechanisms. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Rapid reversal of human intestinal ischemia-reperfusion induced damage by shedding of injured enterocytes and reepithelialisation.

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    Joep P M Derikx

    Full Text Available BACKGROUND: Intestinal ischemia-reperfusion (IR is a phenomenon related to physiological conditions (e.g. exercise, stress and to pathophysiological events (e.g. acute mesenteric ischemia, aortic surgery. Although intestinal IR has been studied extensively in animals, results remain inconclusive and data on human intestinal IR are scarce. Therefore, an experimental harmless model for human intestinal IR was developed, enabling us to clarify the sequelae of human intestinal IR for the first time. METHODS AND FINDINGS: In 30 patients undergoing pancreatico-duodenectomy we took advantage of the fact that in this procedure a variable length of jejunum is removed. Isolated jejunum (5 cm was subjected to 30 minutes ischemia followed by reperfusion. Intestinal Fatty Acid Binding Protein (I-FABP arteriovenous concentration differences across the bowel segment were measured before and after ischemia to assess epithelial cell damage. Tissue sections were collected after ischemia and at 25, 60 and 120 minutes reperfusion and stained with H&E, and for I-FABP and the apoptosis marker M30. Bonferroni's test was used to compare I-FABP differences. Mean (SEM arteriovenous concentration gradients of I-FABP across the jejunum revealed rapidly developing epithelial cell damage. I-FABP release significantly increased from 290 (46 pg/ml before ischemia towards 3,997 (554 pg/ml immediately after ischemia (p<0.001 and declined gradually to 1,143 (237 pg/ml within 1 hour reperfusion (p<0.001. Directly after ischemia the intestinal epithelial lining was microscopically normal, while subepithelial spaces appeared at the villus tip. However, after 25 minutes reperfusion, enterocyte M30 immunostaining was observed at the villus tip accompanied by shedding of mature enterocytes into the lumen and loss of I-FABP staining. Interestingly, within 60 minutes reperfusion the epithelial barrier resealed, while debris of apoptotic, shedded epithelial cells was observed in the lumen

  4. Semaphorin 3A expression following intestinal ischemia/reperfusion injury in Sox10-Venus mice. (United States)

    Takeda, Masahiro; Miyahara, Katsumi; Okawada, Manabu; Akazawa, Chihiro; Lane, Geoffrey J; Yamataka, Atsuyuki


    Semaphorin 3A (Sema3A) is a protein secreted during development of the nervous system that plays an important role in neuronal pathophysiology. However, there is no known correlation between Sema3A and intestinal ischemia/reperfusion (I/R) injury. We assessed Sema3A expression and distribution in relation to enteric nervous system (ENS) damage seen after intestinal I/R injury in Sox10-Venus mice. Intestinal I/R injury was induced by vascular occlusion for 3 h. Ileal specimens were harvested 0, 3, 12, 24, 48, and 96 h after reperfusion. Stereoscopic microscopy and fluorescence microscopy were used to assess sox10-Venus+ cells and PGP9.5+ cells. By 3 h after reperfusion, Sema3A expression had increased to a maximum and Sox10-Venus+ cells had faded to a minimum in harvested ileal segments. Both differences were statistically significant. By 96 h after reperfusion, both Sema3A and Sox10-Venus+ cell fluorescence had reverted to original levels. Hematoxylin and eosin staining identified histologic damage mimicking Sema3A expression, while PGP9.5+ cell response was minimal. We are the first to demonstrate a correlation between Sema3A expression and ENS damage following intestinal I/R in Sox10-Venus mice.

  5. Use of a Temporary Shunt as a Salvage Technique for Distal Extremity Amputations Requiring Repair by Vessel Grafting during Critical Ischemia

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    Bilsev Ince


    Full Text Available BackgroundAlthough the use of temporary shunts in proximal extremity amputations has been reported, no study has described the use of temporary shunts in distal extremity amputations that require vein grafting. Moreover, the total volume of blood loss when temporary shunts are used has not been reported. The aim of this study was to investigate the applicability of a temporary shunt for distal extremity amputations requiring repair by vessel grafting with an ischemia time of >6 hours. This study also aimed to determine the total volume of blood loss when temporary shunts were used.MethodsPatients who underwent distal major extremity replantation and/or revascularization with a vessel graft and who experienced ischemia for 6–8 hours between 2013 and 2014 were included in the study. A 6-Fr suction catheter was cut to 5 cm in length after the infusion of heparin, and secured with a 5-0 silk suture between the distal and the proximal ends of the artery. While bleeding continued, the bones were shortened and fixed. After the complete restoration of circulation, the arterial shunt created using the catheter was also repaired with a vein graft.ResultsSix patients were included in this study. The mean duration of ischemia was 7.25 hours. The mean duration of suction catheter use during limb revascularization was 7 minutes. The mean transfusion volume was 7.5 units. No losses of the extremity were observed.ConclusionsThis procedure should be considered in distal extremity amputations requiring repair by vessel grafting during critical ischemia.

  6. The alteration in intestinal secretory immunoglobulin A and its secreting cells during ischemia/reperfusion injury

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    Li-qun SUN


    Full Text Available Objective To investigate the change in intestinal secretion immunoglobulin A (sIgA level and IgA-secreting cells during ischemia/reperfusion (I/R injury. Methods Forty-eight BALB/c mice were randomly divided into 6 experimental groups in accordance with different reperfusion times (R2h, R6h, R12h, R24h, and R72h group, and one sham group (n=8. Bacterial translocation to distant organs (lung, spleen, and mesenteric lymph nodes was observed. The sIgA level of the intestinal tract was measured by enzyme-linked immunosorbent assay (ELISA. The B cell subgroup in the lymphocytes related to the intestinal tract was measured by flow cytometry. Results The bacterial translocation occurred during I/R injury, and the intestinal sIgA level decreased, and they showed an obvious negative correlation (r2=0.729. With the increase in intestinal I/R injury, the ratio of IgM+B220+ cells in the gut-associated lymphoid tissue increased, whereas the proportion of IgA+B220+ cells decreased. The most significant change was found in R12h group (P < 0.01. Conclusions The proportion of IgM+ B cells in the gut-associated lymphoid tissue increased, whereas that of IgA+ B cells reduced during I/R injury. These phenomena may cause sIgA level to reduce and bacterial translocation of the distant organs to occur.

  7. L-Arginine Modulates Intestinal Inflammation in Rats Submitted to Mesenteric Ischemia-Reperfusion Injury. (United States)

    Taha, M O; de Oliveira, J V; Dias Borges, M; de Lucca Melo, F; Gualtieri, F G; E Silva Aidar, A L; Pacheco, R L; de Melo Alexandre E Silva, T; Klajner, R K; Iuamoto, L R; Munhoz Torres, L; Morais Mendes de Paula, B J; de Campos, K; Oliveira-Junior, I S; Fagundes, D J


    The goal of this study was to investigate whether exogenous offer of L-arginine (LARG) modulates the gene expression of intestinal dysfunction caused by ischemia and reperfusion. Eighteen Wistar-EPM1 male rats (250-300 g) were anesthetized and subjected to laparotomy. The superior mesenteric vessels were exposed, and the rats were randomized into 3 groups (n = 6): the control group (CG), with no superior mesenteric artery interruption; the ischemia/reperfusion group (IRG), with 60 minutes of ischemia and 120 minutes of reperfusion and saline injections; and the L-arginine group (IRG + LARG), with L-arginine injected in the femoral vein 5 minutes before ischemia, 5 minutes after reperfusion, and after 55 minutes of reperfusion. The total RNA was extracted and purified from samples of the small intestine. The concentration of each total RNA sample was determined by using spectrophotometry. The first-strand complementary DNA (cDNA) was synthesized in equal amounts of cDNA and the Master Mix SYBR Green qPCR Mastermix (SABiosciences, a Qiagen Company, Frederick, Md). Amounts of cDNA and Master Mix SYBR Green qPCR Mastermix were distributed to each well of the polymerase chain reaction microarray plate containing the predispensed gene-specific primer sets for Bax and Bcl2. Each sample was evaluated in triplicate, and the Student t test was applied to validate the homogeneity of each gene expression reaction (P < .05). The gene expression of Bax in IRG (+1.48) was significantly higher than in IRG-LARG (+9.69); the expression of Bcl2L1 in IRG (+1.01) was significantly higher than IRG-LARG (+22.89). The apoptotic cell pathway of 2 protagonists showed that LARG improves the gene expression of anti-apoptotic Bcl2l1 (Bcl2-like 1) more than the pro-apoptotic Bax (Bcl2-associated X protein). Copyright © 2016. Published by Elsevier Inc.

  8. Fatal Small Intestinal Ischemia Due to Methamphetamine Intoxication: Report of a Case With Autopsy Results

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    Hamid Attaran


    Full Text Available Methamphetamine is one of the most common abused drugs, so its various effects on different body organs should be familiar to all physicians. Regarding its gastrointestinal sequels, there are few reports of ischemic colitis induced by its vasoconstrictive effects. This is the first report of isolated small intestinal infarction resulting in death following methamphetamine toxicity. A 40-year-old woman with a past history of medical treatment for obesity referred to hospital with severe chest and back pain, perspiration, nausea, agitation, high blood pressure, bradycardia and subsequent lethargy and vasomotor instability. Cardiac evaluations were normal, and a toxicologic urinalysis revealed methamphetamine. Later, abdominal pain predominated, and ultrasonography revealed signs of bowel infarction. She did not consent to surgery and succumbed afterward. At autopsy gangrene and perforation of distal ileum were found. The cause of death was determined as intestinal gangrene following methamphetamine toxicity. Methamphetamine has anorectic effects and so is used in some "diet pills"; Consumers may not even know they are using methamphetamine. Hence in cases of either known MA abuse or those using unknown weight reduction drugs presenting with gastrointestinal complaints or abdominal pain, intestinal ischemia should be kept in mind and if plausible, intervened promptly.

  9. Feasibility of real-time intestinal bloodstream evaluation using probe-based confocal laser endomicroscopy in a porcine intestinal ischemia model. (United States)

    Takahashi, Tsuyoshi; Nakatsuka, Rie; Hara, Hisashi; Higashi, Shigeyoshi; Tanaka, Kouji; Miyazaki, Yasuhiro; Makino, Tomoki; Kurokawa, Yukinori; Yamasaki, Makoto; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro; Nakajima, Kiyokazu


    Intestinal ischemia can lead to fatal complications if left unrecognized during surgery. The current techniques of intraoperative microvascular assessment remain subjective. Probe-based confocal laser endomicroscopy (pCLE) has the potential to objectively evaluate microvascular blood flow in real-time setting. The present study evaluated the technical feasibility of real-time intestinal bloodstream evaluation using pCLE in a porcine intestinal ischemia model. Seven pigs were used. The intestinal ischemia model was prepared by sequentially dividing the mesenteric blood vessels. The intestinal bloodstream was evaluated on its serosal surface using pCLE (Cellvizio 488 probe, Ultra Mini O) at every 1-cm segment from a vessel-preservation border (i.e., the cut end of the vessel). Images of the blood vessels and flow of red blood cells (RBCs) in each visualized vessel were semi-qualitatively assessed using a 3-scale scoring system. In addition, 25 surgeons blindly assessed the 10 movies recorded at 0, 1, 2, 3, and 5 cm from a vessel-preservation border using a 4-scale scoring system to confirm the consistency of the evaluation of the pCLE system. Images of the blood vessels were successfully obtained from the cut end of the vessel to the segment 4 cm away. Good unidirectional flow of RBCs was observed from the cut end to the 2-cm segment, whereas the flow became bidirectional between 2 and 3 cm segments. Beyond 4 cm, no flow images were obtained. The specimen obtained from the segment beyond 4 cm showed remarkable mucosal color change, which was confirmed as a necrotic change histologically. The evaluations from the cut end of the vessel to the segment 1 cm away by surgeons were excellent or good and it was almost consistent. Real-time bloodstream evaluation using pCLE is feasible and potentially effective for predicting intestinal ischemia during surgery.

  10. The surgical treatment of chronic intestinal ischemia: results of a recent series. (United States)

    Illuminati, G; Caliò, F G; D'Urso, A; Papaspiropoulos, V; Mancini, P; Ceccanei, G


    Due to the rarity of the condition, large and prospective series defining the optimal method of digestive arteries revascularization, for the treatment of chronic intestinal ischemia, are lacking. The aim of this consecutive sample clinical study was to test the hypothesis that flexible application of different revascularization methods, according to individual cases, will yield the best results in the management of chronic intestinal ischemia. Eleven patients, of a mean age of 56 years, underwent revascularization of 11 digestive arteries for symptomatic chronic mesenteric occlusive disease. Eleven superior mesenteric arteries and one celiac axis were revascularized. The revascularization techniques included retrograde bypass grafting in 7 cases, antegrade bypass grafting in 2, percutaneous arterial angioplasty in 1, and arterial reimplantation in one case. The donor axis for either reimplantation or bypass grafting was the infrarenal aorta in 4 cases, an infrarenal Dacron graft in 4, and the celiac aorta in one case. Grafting materials included 5 polytetrafluoroethylene (PTFE) and 3 Dacron grafts. Concomitant procedures included 3 aorto-ilio-femoral grafts and one renal artery revascularization. Mean follow-up duration was 31 months. There was no operative mortality. Cumulative survival rate was 88.9% at 36 months (SE 12.1%). Primary patency rate was 90% at 36 months (SE 11.6%). The symptom free rate was 90% at 36 months (SE 11.6%). Direct reimplantation, antegrade and retrograde bypass grafting, all allow good mid-term results: the choice of the optimal method depends on the anatomic and general patient's status. Associated infrarenal and renal arterial lesions can be safely treated in the same time of digestive revascularization. Angioplasty alone yields poor results and should be limited to patients at poor risk for surgery.

  11. Surgical revascularization of the celiac artery for persistent intestinal ischemia in short bowel syndrome. (United States)

    Roussel, Arnaud; Nuzzo, Alexandre; Pellenc, Quentin; Castier, Yves; De Blic, Romain; Cerceau, Pierre; Boulitrop, Célia; Coblence, Mathieu; Aguir, Sonia; Mordant, Pierre; Maggiori, Léon; Huguet, Audrey; Sibert, Annie; Joly, Francisca; Corcos, Olivier


    Without prompt superior mesenteric artery (SMA) revascularization, acute mesenteric ischemia (AMI) frequently leads to death or short bowel syndrome (SBS). In SBS patients, persistent or chronic intestinal ischemia (PII) of the remnant bowel can lead to recurrences of AMI. Since SMA revascularization is sometimes unfeasible, celiac artery (CA) revascularization may improve blood supply to the remnant bowel. The aim of this study was to describe and to assess our experience of the CA revascularization in case of SMA occlusion unsuitable for revascularization in the setting of PII in SBS patients. All consecutive patients with i) SBS consecutive to AMI, ii) persistent intestinal ischemia (PII), iii) irreversible SMA occlusion, i.e unsuitable for radiological or surgical revascularization and iv) occlusion or severe stenosis of the CA were included. Thirteen patients (7 males/6 females, mean age = 47.2 ± 12.1 years) were included. The mean length of remnant small bowel was 47 ± 39 cm and 77% of patients had a stoma. The types of revascularization included anterograde aorto-hepatic bypass n = 11 (84%), ilio-hepatic bypass n = 1 (8%) and endarterectomy n = 1 (8%). Major adverse events were observed in 5 cases: bypass graft infection (n = 2), hemorrhagic pericarditis (n = 2), hemorrhagic shock (n = 2) and aortic false aneurysm (n = 1). After a mean follow-up of 27.0 ± 25.2 months, symptoms of PII relieved in 12 cases (92%) allowing for digestive surgical rehabilitation with continuity restoration in 7 patients (54%). PN was weaned for 2 patients. One-year and 3-year survival rates were 73.8% and 73.8% respectively. No recurrence of AMI or further need for bowel resection was noticed. For patients with SBS suffering from PII with CA occlusion or stenosis without possibility of SMA revascularization, the surgical revascularization of the CA allowed digestive rehabilitation with acceptable morbidity and mortality rates

  12. Does calcium dobesilate protect against intestinal ischemia-reperfusion injury induced in rats? (United States)

    Seker, A; Bardakci, O; Eryilmaz, S; Kocarslan, S; Incebiyik, A; Yucel, Y; Taskin, A; Soyalp, M; Gokalp, O; Uzunkoy, A


    In this study, we investigated whether the administration of calcium dobesilate (CD) affects oxidative stress markers and histopathological outcomes in a rat model of intestinal ischemia-reperfusion (IR) injury. This study was conducted with 30 male Wistar rats. The rats were randomly assigned to three groups as follows: a sham group (n = 10), an IR group (n = 10), and an IR + CD group (n = 10). In the sham group, superior mesenteric artery (SMA) dissection alone was performed during laparotomy. In the IR group, the procedure included SMA occlusion for 60 min, followed by reperfusion for 60 min. In the IR + CD group, CD (100 mg/kg/day) was additionally given for two days before laparotomy by intragastric lavage. In all the rats, 2 ml of blood were drawn, and an ileal segment (approximately 2 cm in size) was removed to evaluate oxidative stress markers. The ileal segment removed was divided into two pieces, and one piece was reserved for histopathological evaluation. Compared to the other groups, both serum and tissue oxidative stress indices were lower in the IR + CD group. The decrease was due to CD increasing the total antioxidant capacity. Moreover, the histological analysis showed that CD reduced tissue injury. CD may exert a protective effect against intestinal IR injury by increasing antioxidant capacity.

  13. Comparative Effects of Triflusal, S-Adenosylmethionine, and Dextromethorphan over Intestinal Ischemia/Reperfusion Injury

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    Carlos R. Cámara-Lemarroy


    Full Text Available Ischemia/reperfusion (I/R is a condition that stimulates an intense inflammatory response. No ideal treatment exists. Triflusal is an antiplatelet salicylate derivative with anti-inflammatory effects. S-adenosylmethionine is a metabolic precursor for glutathione, an endogenous antioxidant. Dextromethorphan is a low-affinity N-methyl-D-aspartate receptor inhibitor. There is evidence that these agents modulate some of the pathways involved in I/R physiopathology. Intestinal I/R was induced in rats by clamping the superior mesenteric artery for 60 minutes, followed by 60 minutes of reperfusion. Rats either received saline or the drugs studied. At the end of the procedure, serum concentrations of tumor necrosis factor-alpha (TNF-alpha, malonaldehyde (MDA, and total antioxidant capacity (TAC were determined and intestinal morphology analyzed. I/R resulted in tissue damage, serum TNF-alpha and MDA elevations, and depletion of TAC. All drugs showed tissue protection. Only triflusal reduced TNF-alpha levels. All drugs lowered MDA levels, but only triflusal and S-adenosylmethionine maintained the serum TAC.

  14. Noninvasive monitoring of small intestinal oxygen in a rat model of chronic mesenteric ischemia (United States)

    Fisher, Elaine M.; Khan, Mahmood; Salisbury, Ronald; Kuppusamy, Periannan


    We noninvasively monitored the partial pressure of oxygen (pO2) in rat small intestine using a model of chronic mesenteric ischemia by electron paramagnetic resonance oximetry (EPR) over a 7-day period. The particulate probe lithium octa-n-butoxynaphthalocyanine (LiNc-BuO) was embedded into the oxygen permeable material polydimethyl siloxane (PDMS) by cast-molding and polymerization (Oxy-Chip). A one-time surgical procedure was performed to place the Oxy-Chip on the outer wall of the small intestine (SI). The superior mesenteric artery (SMA) was banded to approximately 30% blood flow for experimental rats. Noninvasive measurement of pO2 was performed at baseline for control rats or immediate post-banding and on days 1, 3, and 7. The SI pO2 for control rats remained stable over the 7-day period. The pO2 on day 7 was 54.5 ± 0.9 mmHg (mean ± SE). SMA banded rats were significantly different from controls with a noted reduction in pO2 post banding with a progressive decline to a final pO2 of 20.9 ± 4.5 mmHg (mean ± SE; p = 0.02). All SMA-banded rats developed adhesions around the Oxy-Chip yet remained asymptomatic. The hypoxia marker Hypoxyprobe™ was used to validate low tissue pO2. Brown cytoplasmic staining was consistent with hypoxia. Mild brown staining was noted predominantly on the villus tips in control animals. SMA-banded rats had an extended region of hypoxic involvement in the villus with a higher intensity of cytoplasmic staining. Deep brown staining of the enteric nervous system neurons and connective tissue both within layers and in the mesentery were noted. SMA banded rats with lower pO2 values had a higher intensity of staining. Thus, monitoring SI pO2 using the probe Oxy-Chip provides a valid measure of tissue oxygenation. Tracking pO2 in conditions that produce chronic mesenteric ischemia will contribute to our understanding of intestinal tissue oxygenation and how changes impact symptom evolution and the trajectory of chronic disease. PMID

  15. Effect of Pretreatment With Extract of Origanum vulgare Leaves on Experimental Intestinal Ischemia-Reperfusion Injury in Rats

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    Omid Azari


    Full Text Available Background Origanum vulgare is used in traditional medicine for antimicrobial, anti-inflammatory and antioxidant activities. Objectives The present study was designed to investigate the protective effects of O. vulgare leaves extract on experimentally induced intestinal ischemia/reperfusion (I/R injury in rats. Materials and Methods In this experimental study, 24 male Wistar albino rats randomly divided into four groups. Group I/R underwent ischemia-reperfusion of the intestine (45 minutes of ischemia followed by 1 hour of reperfusion. Treatment groups I and II were given O. vulgare extract (200 and 400 ppm via oral gavages for 1 week before inducing I/R. Group sham was given normal saline orally without inducing I/R. After the experiments, the jejunum was removed and the tissues were processed for histomorphometric examination of mucosa. Results The treatment with O. vulgare extract significantly decreased mucosal damages in the treatment groups compared to group I/R, while severe mucosal damages were observed in the group I/R. Also, there was significant difference between treatment groups I and II (P = 0.054. Group sham observed normal intestinal mucosa. Conclusions According to the results of current study, administration of O. vulgare extract protects the intestinal mucosa from I/R injuries.

  16. Critical Limb Ischemia (CLI) (United States)

    ... and; in the intestines it is known as mesenteric ischemia and can cause severe abdominal pain. What are ... you may be sent for coronary angiography. For mesenteric ischemia, imaging of the three vessels supplying the intestines ...

  17. Nitric oxide regulates homeoprotein OTX1 and OTX2 expression in the rat myenteric plexus after intestinal ischemia-reperfusion injury. (United States)

    Filpa, Viviana; Carpanese, Elisa; Marchet, Silvia; Pirrone, Cristina; Conti, Andrea; Rainero, Alessia; Moro, Elisabetta; Chiaravalli, Anna Maria; Zucchi, Ileana; Moriondo, Andrea; Negrini, Daniela; Crema, Francesca; Frigo, Gianmario; Giaroni, Cristina; Porta, Giovanni


    Neuronal and inducible nitric oxide synthase (nNOS and iNOS) play a protective and damaging role, respectively, on the intestinal neuromuscular function after ischemia-reperfusion (I/R) injury. To uncover the molecular pathways underlying this dichotomy we investigated their possible correlation with the orthodenticle homeobox proteins OTX1 and OTX2 in the rat small intestine myenteric plexus after in vivo I/R. Homeobox genes are fundamental for the regulation of the gut wall homeostasis both during development and in pathological conditions (inflammation, cancer). I/R injury was induced by temporary clamping the superior mesenteric artery under anesthesia, followed by 24 and 48 h of reperfusion. At 48 h after I/R intestinal transit decreased and was further reduced by Nω-propyl-l-arginine hydrochloride (NPLA), a nNOS-selective inhibitor. By contrast this parameter was restored to control values by 1400W, an iNOS-selective inhibitor. In longitudinal muscle myenteric plexus (LMMP) preparations, iNOS, OTX1, and OTX2 mRNA and protein levels increased at 24 and 48 h after I/R. At both time periods, the number of iNOS- and OTX-immunopositive myenteric neurons increased. nNOS mRNA, protein levels, and neurons were unchanged. In LMMPs, OTX1 and OTX2 mRNA and protein upregulation was reduced by 1400W and NPLA, respectively. In myenteric ganglia, OTX1 and OTX2 staining was superimposed with that of iNOS and nNOS, respectively. Thus in myenteric ganglia iNOS- and nNOS-derived NO may promote OTX1 and OTX2 upregulation, respectively. We hypothesize that the neurodamaging and neuroprotective roles of iNOS and nNOS during I/R injury in the gut may involve corresponding activation of molecular pathways downstream of OTX1 and OTX2.NEW & NOTEWORTHY Intestinal ischemia-reperfusion (I/R) injury induces relevant alterations in myenteric neurons leading to dismotility. Nitrergic neurons seem to be selectively involved. In the present study the inference that both neuronal and

  18. Simvastatin nanoparticles attenuated intestinal ischemia/reperfusion injury by downregulating BMP4/COX-2 pathway in rats. (United States)

    Tong, Fei; Dong, Bo; Chai, Rongkui; Tong, Ke; Wang, Yini; Chen, Shipiao; Zhou, Xinmei; Liu, Daojun


    The purpose of the research was to explore the therapeutic action of simvastatin-loaded poly(ethylene glycol)-b-poly(gamma-benzyl l-glutamate) (PEG-b-PBLG50) on intestinal ischemia/reperfusion injury (II/RI) through downregulating bone morphogenetic protein 4 (BMP4)/cyclooxygenase-2 (COX-2) pathway as compared to free simvastatin (Sim). Sprague Dawley rats were preconditioned with 20 mg/kg Sim or simvastatin/PEG-b-PBLG50 (Sim/P) compounds, and then subjected to 45 min of ischemia and 1 h of reperfusion. The blood and small intestines were collected, serum levels of interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α, and nitric oxide (NO) were checked, and the dry/wet intestine ratios, superoxide dismutase activity, myeloperoxidase content, reactive oxygen species, endothelial nitric oxide synthase, protein 47 kDa phagocyte oxidase (p47phox), BMP4, COX-2, and p38 mitogen-activated protein kinase (p38MAPK) expressions were measured in intestinal tissues. Both Sim and Sim/P pretreatment reduced intestinal oxidative damnification, restricted inflammatory harm, and downregulated the BMP4 and COX-2 expressions as compared to II/RI groups, while Sim/P remarkably improved this effect.

  19. The Protective Effect of Curcumin versus Sodium Nitroprusside on Intestinal Ischemia/Reperfusion Injury

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    Dalia M Saleh


    Full Text Available Objective: Intestinal ischemia/reperfusion (I/R injury is a signi and #64257;cant complication in abdominal vascular surgery. Various treatment modalities have been applied, however, the role of nitric oxide (NO in this type of injury is still controversial. Aim of the work: To compare the protective effect of curcumin vs sodium nitroprusside (SNP, NO donor on intestine and remote organs following intestinal I/R injury. Methods: Rats were divided into 4 groups (sham-control, I/R, curcumin+I/R, SNP+I/R. I/R was induced by 30 min clamping the superior mesenteric artery (SMA then 60 min reperfusion. Rats were pretreated with either curcumin (80 mg/kg/day with food for one week or SNP (5 mg/kg, i.p prior to I/R. Intestinal levels of malondialdehyde (MDA, Nitrite/nitrate, superoxide dismutase (SOD and reduced glutathione (GSH were measured. The sections from jejunum, lungs and liver were stained with hematoxylin and eosin (H and E for histopathological examination. Immunohistochemical stains for eNOS expression in the jejunum and cleaved caspase-3 for apoptosis in the lungs and liver were done. Results: I/R resulted in both local and remote organs in and #64258;ammation associated with signi and #64257;cant increase in MDA and nitrate/nitrite and significant decrease in SOD and GSH levels. These histological and biochemical changes were improved by pretreatment with curcumin and to less extent by SNP. Immunohistochemical examination showed significant decrease in eNOS activity in the I/R group which was improved by curcumin pretreatment not by SNP. Liver apoptosis was improved by curcumin while lung apoptosis was improved by SNP. Conclusion: Curcumin ameliorates I/R-induced local and remote organs damage through its anti-inflammatory and antiapoptotic effect. SNP may be beneficial in I/R injury but not as significant as curcumin. [J Interdiscipl Histopathol 2014; 2(2.000: 74-87

  20. Alcohol dehydrogenase: A potential new marker for diagnosis of intestinal ischemia using rat as a model (United States)

    Gumaste, Upendra R; Joshi, Mukund M; Mourya, Devendra T; Barde, Pradip V; Shrivastav, Ghanshyam K; Ghole, Vikram S


    AIM: Intestinal ischemia (Ii) is an abdominal emergency due to blockade of the superior mesenteric artery resulting in 60-100% mortality if diagnosed late. Changes in several biochemical parameters such as D (-)-lactate, Creatinine kinase isoenzymes and lactate dehydrogenase suggested for early diagnosis, lack specificity and sensitivity. Therefore a biochemical parameter with greater sensitivity needs to be identified. METHODS: Wistar male rats were randomly assigned into two groups; control sham operated (n = 24) and ischemic test (n = 24) group. Superior mesenteric arterial occlusion was performed in the ischemic test group for 1 h. Alcohol dehydrogenase (ADH) was estimated in blood from portal vein, right ventricle of heart, dorsal aorta (DA) and inferior vena cava (IVC). The Serum glutamic acid pyruvate transaminase (SGPT) was also estimated in blood from portal vein and right ventricle of heart. RESULTS: A significant increase (P<0.001) in the levels of ADH in both portal blood as well as heart blood of the test group (232.72±99.45 EU and 250.85±95.14 EU, respectively) as compared to the control group (46.39±21.69 EU and 65.38±30.55 EU, respectively) were observed. Similarly, increased levels of ADH were observed in blood samples withdrawn from DA and IVC in test animals (319.52±80.14 EU and 363.90±120.68 EU, respectively) as compared to the control group (67.68±63.22 EU and 72.50±58.45 EU, respectively). However, in test animals there was significant increase in SGPT in portal blood (P = 0.054) without much increase in heart blood. CONCLUSION: Significant increase in the levels of ADH in portal and heart blood within 1 h of SMA occlusion without increase in SGPT in heart blood, suggests that the origin of ADH is from ischemic intestine and not from liver. Similarly, raised ADH levels were found in DA and IVC as well. IVC blood does represent peripheral blood sample. A raised level of ADH in test animals confirms it to be a potential marker in the

  1. Intraperitoneal xenon for the detection of early intestinal ischemia: effect of ascites, adhesions, and misdirected injections

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    Gharagozloo, F.; Bulkley, G.B.; LaFrance, N.; Zuidema, G.D.


    Significant delay in the washout of intraperitoneal xenon (/sup 133/Xe) in rats and dogs with decreased splanchnic blood flow (bowel strangulation, superior mesenteric artery and vein occlusion) has been previously demonstrated as the basis for radionuclide imaging to detect early (prenecrotic) intestinal ischemia. In this study, the effect of ascites, adhesions, and misdirected injections on the validity of this technique is evaluated. Xenon-133 (0.6 mCi) in 3 ml saline was injected into the peritoneal cavity of anesthetized rats and the washout of gamma activity monitored externally for 90 min. Gamma camera images were obtained at 30-min intervals. After 60 min, only 12 +/- 2% of injected activity remained in the controls. Sham option (13 +/- 1%) and simple obstruction (12 +/- 2) had been previously shown not to significantly slow washout, but segmental strangulation had done so dramatically (32 +/- 2%, P less than 0.0001). In these experiments, ascitic fluid (Ringer's lactate) in volumes of 10 ml (13 +/- 1%), 20 ml (13 +/- 1%), and 40 ml (13 +/- 1%), did not significantly slow washout in nonischemic rats. Sixty and eighty milliliters produced very tense ascites and slight but significant delay in washout (14 +/- 1%, 17 +/- 1%, respectively, P less than 0.05). Moderate (11 +/- 1%) and severe (11 +/- 1%) adhesions produced by serosal scarification did not delay washout nor affect imaging. Injections of isotope intentionally misdirected into the abdominal wall (32 +/- 2%), bowel wall (18 +/- 1%), and bowel lumen (19 +/- 2%), each significantly (P less than 0.001) slowed washout. However, such misdirected injections were easily recognizable as such on the 1-min gamma camera images and could thereby be excluded as artifactual. It is concluded that the intraperitoneal xenon technique is not invalidated by mild to moderate ascites nor by moderate to severe adhesions.

  2. How to differentiate spontaneous intramural intestinal hemorrhage from acute mesenteric ischemia. (United States)

    Tseng, Chia-Ying; Chiu, Yu-Hui; Chuang, Jui-Ling; Chen, Jen-Dar; Huang, Hsien-Hao; How, Chorng-Kuang; Yen, David Hung-Tsang; Huang, Mu-Shun


    The purpose of our study was to assess the diagnostic values of laboratory tests to differentiate spontaneous intramural intestinal hemorrhage (SIIH) from acute mesenteric ischemia (AMI) after abdominal computed tomography (CT) survey in the emergency department (ED). We retrospectively included 76 patients diagnosed SIIH or AMI after abdominal CT. The mean ages of 28 SIIH patients and 48 AMI patients were 75.9 ± 13.7 years and 75.8 ± 11.6 years, respectively. Patients with SIIH had significantly higher rate of Coumadin use (P < .001) and localized tenderness (P < .05). In laboratory findings, SIIH patients had prolonged prothrombin time (PT) (83.6 ± 30.0 vs. 13.4 ± 3.2, P < .001), lower blood urea nitrogen (P < .05), lower creatinine (P < .05), and lower creatine kinase (P < .05). Prolonged PT showed good discriminative value to differentiate acute abdomen patients with SIIH from AMI after abdominal CT, with an area under the receiver operating characteristic curve of 0.980 (95% confidence interval, 0.918-0.998; P < .0001). Prolonged PT cut-off value of ≧22.5 seconds had a sensitivity of 92.9% and a specificity of 100%. Logistic regression analysis identified prolonged PT as an independent predictor of SIIH (odds ratio, OR, 22.2; P = .007). Abdominal pain patients with either SIIH or AMI are rare in the ED, but abdominal CT sometimes cannot help to differentiate them due to similar CT findings. Prolonged PT might help emergency physicians and surgeons differentiate SIIH from AMI in such cases. © 2013.

  3. Targeting Complement in Treatment of Intestinal Ischemia/Reperfusion-Induced Injury

    National Research Council Canada - National Science Library

    Fleming, Sherry D; Kiang, Juliann G; Tsokos, George C


    .... Understanding the role of complement and its natural regulatory molecules will enable the development of therapeutic interventions to prevent excessive damage during mesenteric ischemia/reperfusion (IR...

  4. Successful intestinal ischemia treatment by percutaneus transluminal angioplasty of visceral arteries in a patient with abdominal angina

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    Nenezić Dragoslav


    Full Text Available Introduction. Abdominal angina, also known as chronic mesenteric ischemia or intestinal angina, is a rare disease caused by intestinal flow reduction due to stenosis or occlusion of mesenteric arteries. A case of successful treatment of a patient with abdominal angina by percutaneous transuliminal angioplasty of high-grade superior mesenteric artery and coeliac trunk stenosis was presented. Case Outline. A 77-year-old male patient was admitted at our Clinic for severe postprandial abdominal pains followed by frequent diarrhoeas. Extensive gastrointestinal investigations were performed and all results were normal. Multislice computerized (MSCT arteriography was indicated which revealed ostial celiac trunk and superior mesenteric artery subocclusion. Percutaneous transluminal angioplasty of the superior mesenteric artery and coeliac trunk was done with two stents implantation. Just a few hours following the intervention, after food ingestion, there were no abdominal pains. Six months later, the patient described a significant feeling of relief after food ingestion and no arduousness at all. Conclusion. High-grade visceral arteries stenoses in patients with intestinal ischemia symptoms can be treated by either surgical procedures or percutaneus transluminal angioplasty. In cases when a low operative risk is anticipated, surgical treatment is recommended due to a better anatomical outcome, while percutaneus angioplasty is advised to elderly patients in whom increased operative risks can be expected.

  5. Pretreatment with remifentanil protects against the reduced-intestinal contractility related to the ischemia and reperfusion injury in rat

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    Hale Sayan-Ozacmak


    Full Text Available BACKGROUND AND OBJECTIVES: Serious functional and structural alterations of gastrointestinal tract are observed in failure of blood supply, leading to gastrointestinal dismotility. Activation of opioid receptors provides cardioprotective effect against ischemia-reperfusion (I/R injury. The aim of the present study was to determine whether or not remifentanil could reduce I/R injury of small intestine. METHODS: Male Wistar Albino rats were subjected to mesenteric ischemia (30 min followed by reperfusion (3 h. Four groups were designed: sham control; remifentanil alone; I/R control; and remifentanil + I/R. Animals in remifentanil + I/R group were subjected to infusion of remifentanil (2 ug kg-1 min-1 for 60 min, half of which started before inducing ischemia. Collecting the ileum tissues, evaluation of damage was based on contractile responses to carbachol, levels of lipid peroxidation and neutrophil infiltration, and observation of histopathological features in intestinal tissue. RESULTS: Following reperfusion, a significant decrease in carbachol-induced contractile response, a remarkable increase in both lipid peroxidation and neutrophil infiltration, and a significant injury in mucosa were observed. An average contractile response of remifentanil + I/R group was significantly different from that of the I/R group. Lipid peroxidation and neutrophil infiltration were also significantly suppressed by the treatment. The tissue samples of the I/R group were grade 4 in histopathological evaluation. In remifentanil + I/R group, on the other hand, the mucosal damage was moderate, staging as grade 1. CONCLUSIONS: The pretreatment with remifentanil can attenuate the intestinal I/R injury at a remarkable degree possibly by lowering lipid peroxidation and leukocyte infiltration.

  6. Mesenteric ischemia. (United States)

    Bobadilla, Joseph L


    This article reviews the presentation, diagnosis, evaluation, and treatment of the various forms of mesenteric ischemia, including acute and chronic ischemia. In addition, nonocclusive mesenteric ischemia and median arcuate ligament compressive syndrome are covered. The goals are to provide a structured and evidence-based framework for the evaluation and management of patients with these intestinal ischemia syndromes. Special attention is given to avoiding typical pitfalls in the diagnostic and treatment pathways. Operative techniques are also briefly discussed, including an evidence-based review of newer endovascular techniques. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Effect of lidocaine on inflammation in equine jejunum subjected to manipulation only and remote to intestinal segments subjected to ischemia. (United States)

    Bauck, Anje G; Grosche, Astrid; Morton, Alison J; Graham, A Sarah; Vickroy, Thomas W; Freeman, David E


    OBJECTIVE To examine effects of continuous rate infusion of lidocaine on transmural neutrophil infiltration in equine intestine subjected to manipulation only and remote to ischemic intestine. ANIMALS 14 healthy horses. PROCEDURES Ventral midline celiotomy was performed (time 0). Mild ischemia was induced in segments of jejunum and large colon. A 1-m segment of jejunum was manipulated by massaging the jejunal wall 10 times. Horses received lidocaine (n = 7) or saline (0.9% NaCl) solution (7) throughout anesthesia. Biopsy specimens were collected and used to assess tissue injury, neutrophil influx, cyclooxygenase expression, and hypoxia-inducible factor 1α (HIF-1α) expression at 0, 1, and 4 hours after manipulation and ischemia. Transepithelial resistance (TER) and mannitol flux were measured by use of Ussing chambers. RESULTS Lidocaine did not consistently decrease neutrophil infiltration in ischemic, manipulated, or control tissues at 4 hours. Lidocaine significantly reduced circular muscle and overall scores for cyclooxygenase-2 expression in manipulated tissues. Manipulated tissues had significantly less HIF-1α expression at 4 hours than did control tissues. Mucosa from manipulated and control segments obtained at 4 hours had lower TER and greater mannitol flux than did control tissues at 0 hours. Lidocaine did not significantly decrease calprotectin expression. Severity of neutrophil infiltration was similar in control, ischemic, and manipulated tissues at 4 hours. CONCLUSIONS AND CLINICAL RELEVANCE Manipulated jejunum did not have a significantly greater increase in neutrophil infiltration, compared with 4-hour control (nonmanipulated) jejunum remote to sites of manipulation, ischemia, and reperfusion. Lidocaine did not consistently reduce neutrophil infiltration in jejunum.

  8. Acute Mesenteric Ischemia (United States)

    ... of Celiac Disease Additional Content Medical News Acute Mesenteric Ischemia By Parswa Ansari, MD, Assistant Professor and Program ... Abdominal Abscesses Abdominal Wall Hernias Inguinal Hernia Acute Mesenteric Ischemia Appendicitis Ileus Intestinal Obstruction Ischemic Colitis Perforation of ...

  9. Liver injury following small intestinal ischemia reperfusion in rats is attenuated by Pistacia lentiscus oil: antioxidant and anti-inflammatory effects. (United States)

    Saidi, Saber Abdelkader; Ncir, Marwa; Chaaben, Rim; Jamoussi, Kamel; van Pelt, Jos; Elfeki, Abdelfattah


    Intestinal ischemia-reperfusion (IIR) not only leads to severe intestine damage but also induced subsequent destruction of remote organs. We investigated the protective effect of Pistascia lentiscus L. (Anacardiaceae) oil on IIR. Wistar rats were divided into three groups: sham, intestinal IR and P. lentiscus pretreatment (n = 18 each). In the pretreatment group, oil was administered 1 h before induction of warm ischemia. IIR led to severe liver damage manifested as a significant (p oil decreased the visible intestinal damage, as well as a significant decrease in serum AST and ALT levels. In addition, Pistacia lentiscus reduce liver injury, as evidenced by the decrease in liver tissue myeloperoxidase activity and lipoperoxidation (MDA) level. Pistascia lentiscus attenuates liver injury induced by IIR, attributable to the antioxidant and anti-inflammatory effect.

  10. [Effects of lymphatic drainage and omega-3 polyunsaturated fatty acids on intestinal ischemia-reperfusion injury in rats]. (United States)

    Zhou, Kai-Guo; He, Gui-Zhen; Zhang, Rui; Chen, Xue-Feng


    To investigate the effects of lymphatic drainage and omega-3 polyunsaturated fatty acid (omega-3PUFA) on high mobility group box 1 (HMGB1), inflammatory cytokines and endotoxin in rats with intestinal ischemia-reperfusion (I/R) injury. A total of 72 SD rats were randomly divided into drainage-alone group, I/R group, ischemia-reperfusion plus drainage (I/R + D) group (n = 8 each) and 3 groups with 16 rats undergoing gastrostomy in each group: normal diet (N) group, enteral nutrition (EN) group and enteral nutrition & omega-3PUFA (PUFA) group. And they were further divided into 2 subgroups (n = 8). The rats in I/R and I/R + D groups were subjected to a 60-min ischemia follow by 120-min reperfusion injury of superior mesenteric artery. When the rats suffered I/R injury, intestinal lymph was drained for 180 min in the I/R + D group. The rats in the drainage-alone group received 180-min lymph drainage without I/R injury. After 5 days with different nutrition regimes, the models were established similarly. The rats in the I/R + D sub-groups were treated with intestinal lymph drainage for 180 min. The serum and lymph samples were collected post-operatively. Endotoxin was detected by a Limulus kit. The inflammatory cytokines and high mobility group box 1 (HMGB1) were analyzed by enzyme-linked immunosorbent assay (ELISA). Endotoxin, inflammatory cytokines and lymphatic HMGB1 of lymphatic in the I/R + D group were higher than those in the drainage-alone group [all P lymphatic levels of TNF-alpha (tumor necrosis factor-alpha) and HMGB1 in the N and EN groups were higher than those in the PUFA group[ TNF-alpha: (46 +/- 17) pg/ml, (54 +/- 16) pg/ml vs (28 +/- 9) pg/ml, HMGB1: (4.8 +/- 1.6) ng/ml, (5.3 +/- 1.8) ng/ml, (3.0 +/- 1.0) ng/ml, all P Lymphatic drainage may reduce the levels of endotoxin, inflammatory cytokines and HMGB1 so as to alleviate the intestinal I/R injury. The intervention of omega-3PUFA has some protective effect through relieving inflammation.

  11. C-reactive protein and natural IgM antibodies are activators of complement in a rat model of intestinal ischemia and reperfusion

    NARCIS (Netherlands)

    Padilla, Niubel Diaz; van Vliet, Arlene K.; Schoots, Ivo G.; Seron, Mercedes Valls; Maas, M. Adrie; Peltenburg, Esther E. Posno; de Vries, Annebeth; Niessen, Hans W. M.; Hack, C. Erik; van Gulik, Thomas M.


    Background. The role of C-reactive protein (CRP), natural immunoglobulin M (IgM), and natural IgM against phosphorylcholine (anti-Pc IgM) was investigated in relation with complement activation in a rat model of intestinal ischemia and reperfusion (II/R). The effect of Cl-esterase inhibitor (C1-Inh)

  12. Transient blood-brain barrier permeability following profound temporary global ischemia: an experimental study using /sup 14/C-AIB

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    Dobbin, J.; Crockard, H.A.; Ross-Russell, R.


    The influence of reperfusion after profound incomplete forebrain ischemia on blood-brain barrier (BBB) permeability to a small protein tracer was studied in male Sprague-Dawley rats. The mean cortical blood to brain transfer constant (Ki) for /sup 14/C-amino isobutyric acid (AIB) was significantly greater at 3 and 6 h of reperfusion, 2.5 times the mean values of controls (p less than 0.05) (2.5 microliter g-1 min-1 and 1.0 microliters g-1 min-1 respectively), but had returned to control values after reperfusion for 24 h. Analysis of distribution of Ki values showed that following 15 min and 30 min of profound ischemia, there was a significant increase in transfer of AIB across the blood-brain barrier (BBB) after recirculation for up to 6 h, though there was no evidence of protein extravasation as assessed by Evans Blue (EB) dye. After 24 h of reperfusion, the BBB to AIB was restored, and Ki values had returned to control values. It is concluded that following transient global ischemia, the BBB may recover rapidly.

  13. Transient profound mesenteric ischemia strongly affects the strength of intestinal anastomoses in the rat.

    NARCIS (Netherlands)

    Posma, L.A.; Bleichrodt, R.P.; Goor, H. van; Hendriks, T.


    PURPOSE: Experimental data suggest that transient preoperative ischemia and reperfusion may compromise anastomotic strength. However, data on this subject are equivocal, in particular as to the onset and duration of this effect. This study was designed to comprehensively characterize the effects of

  14. Mesenteric Ischemia


    Toohey, Shannon


    Mesenteric ischemia is classified as either acute or chronic. The former is a life-threatening emergency in which a sudden reduction in intestinal blood flow may ultimately result in bowel infarction. The most common causes are arterial embolism, arterial thrombosis, nonocclusive mesenteric ischemia, and mesenteric venous thrombosis. A high index of suspicion, early diagnosis and rapid intervention are necessary so that normal mesenteric perfusion is restored before fatal bowel infarction can...

  15. Impaired Intestinal Mucosal Barrier upon Ischemia-Reperfusion: “Patching Holes in the Shield with a Simple Surgical Method”

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    Olivér Rosero


    Full Text Available Mesenteric ischemia-reperfusion (IR is associated with impairment of the gut barrier function and the initiation of a proinflammatory cascade with life-threatening results. Therefore methods directed to ameliorate IR injury are of great importance. We aimed at describing the effects of postconditioning (PC on the alterations of the intestinal mucosal function and the inflammatory response upon mesenteric IR. Methods. Male Wistar rats were gavaged with green fluorescent protein-expressing E. coli suspensions. Animals were randomized into three groups (n=15, sham-operated, IR-, and PC-groups, and underwent 60 minutes of superior mesenteric artery occlusion, followed by 6 hours of reperfusion. Postconditioning was performed at the onset of reperfusion. Blood and tissue samples were taken at the end of reperfusion, for histological, bacteriological, and plasma examinations. Results. The PC-group presented a more favorable claudin-2, claudin-3, claudin-4, and zonula occludens-1 membrane expression profile, and significantly lower rates of bacterial translocation to distant organs and plasma D-lactate levels compared to the IR-group. Histopathological lesions, plasma I-FABP, IL-6, and TNF-α levels were significantly lower in the PC-group compared to the IR-group. Conclusion. The use of postconditioning improved the integrity of the intestinal mucosal barrier upon mesenteric IR, and thus reduced the incidence of bacterial translocation and development of a systemic inflammatory response.

  16. Prophylactic and therapeutic effect of ginko biloba extract (Egb761 on mortality of intestinal deep ischemia-reperfusion model in rats

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    Mustafa Ateş


    Full Text Available Objectives: Ginkgo biloba extract (EGb761 is a standardized form of Ginkgo Biloba plant leaves which have been used by Chines nearly 5000 years and Its’ antioxidant activity is known. In this study we aimed to investigate effect use of EGb761 on mortality in Megison'un deep ischemia reperfusion model of rats.Materials and Methods: 138 male Spraque-Dawley rats were used in this study. The rats were divided into 4 groups: Group I (control group, Group II (deep ischemia-reperfusion group, Group III (Group of prophylaxis and treatment of deep ischemia-reperfusion with EGb 761, Group IV (group of treatment with EGb 761 during deep ischemia. Deep ischemia was applied 30 minutes. Rats were followed-up one week after laparotomy. Differences between numbers of mortality in groups during one week follow-up were compared.Results: Number of died rats in Group I, II, III, and IV during one week follow-up were 2 (7.7%, 22 (61.1%, 6 (13.6%, and 11 (34.3% respectively. Mortality rate decreased statistically significant with use of EGb761 with pro-phylactic and therapeutic purposes (p<0.001, p<0.028.Conclusion: EGb761's prophylactic and therapeutic benefit on intestinal ischemia reperfusion injury was observed. However, these results should be supported with further biochemical and histopathological studies.

  17. The Mechanism of Sevoflurane Preconditioning-Induced Protections against Small Intestinal Ischemia Reperfusion Injury Is Independent of Mast Cell in Rats

    Directory of Open Access Journals (Sweden)

    Xiaoliang Gan


    Full Text Available The study aimed to investigate whether sevoflurane preconditioning can protect against small intestinal ischemia reperfusion (IIR injury and to explore whether mast cell (MC is involved in the protections provided by sevoflurane preconditioning. Sprague-Dawley rats exposed to sevoflurane or treated with MC stabilizer cromolyn sodium (CS were subjected to 75-minute superior mesenteric artery occlusion followed by 2-hour reperfusion in the presence or absence of MC degranulator compound 48/80 (CP. Small intestinal ischemia reperfusion resulted in severe intestinal injury as demonstrated by significant elevations in intestinal injury scores and p47phox and gp91phox, ICAM-1 protein expressions and malondialdehyde and IL-6 contents, and MPO activities as well as significant reductions in SOD activities, accompanied with concomitant increases in mast cell degranulation evidenced by significant increases in MC counts, tryptase expression, and β-hexosaminidase concentrations, and those alterations were further upregulated in the presence of CP. Sevoflurane preconditioning dramatically attenuated the previous IIR-induced alterations except MC counts, tryptase, and β-hexosaminidase which were significantly reduced by CS treatment. Furthermore, CP exacerbated IIR injury was abrogated by CS but not by sevoflurane preconditioning. The data collectively indicate that sevoflurane preconditioning confers protections against IIR injury, and MC is not involved in the protective process.

  18. Effects of bilberry (Vaccinium myrtillus) in combination with lactic acid bacteria on intestinal oxidative stress induced by ischemia-reperfusion in mouse. (United States)

    Jakesevic, Maja; Xu, Jie; Aaby, Kjersti; Jeppsson, Bengt; Ahrné, Siv; Molin, Göran


    Intestinal ischemia-reperfusion (I/R) results in oxidative stress, inflammation, and tissue injuries. The present study investigates the antioxidative and anti-inflammatory effects of a dietary supplement of bilberry, either alone or in combination with Lactobacillus plantarum RESO56, L. plantarum HEAL19, or Pediococcus acidilactici JAM046, in an I/R-induced model for oxidative stress in mice. A bilberry diet without addition of bacteria significantly decreased both lipid peroxidation (p = 0.001) and mucosal injury in the ileum. Of 14 anthocyanins identified in bilberry, anthocyanin arabinosides were the most resistant to absorption and microbial degradation in the intestines. Cyanidin-3-glucoside and delphinidin-3-glucoside seemed to be mostly absorbed in the stomach and upper part of the small intestine, while malvidin-3-galactoside, peonidin-3-glucoside, peonidin-3-galactoside, and petunidin-3-galactoside seemed to be digested by the microbiota in the cecum. Bilberry strongly influenced the composition of the cecal microbiota. In conclusion, a food supplement of bilberry protected small intestine against oxidative stress and inflammation induced by ischemia-reperfusion.

  19. Influência do antibiótico nas lesões de isquemia e reperfusão intestinal: estudo experimental em ratos The influence of antibiotics on intestinal ischemia and reperfusion: experimental study in rats

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    Maria de Lourdes Pessole Biondo-Simões


    Full Text Available Muito se tem questionado sobre os efeitos da isquemia intestinal seguida de reperfusão (I/R, chamando a atenção para o papel dos leucócitos na patobiologia da I/R. A fisiopatogenia das lesões está intimamente ligada à geração de radicais de oxigênio durante o período em que se processa a reperfusão. A ruptura da barreira intestinal permitindo a translocação bacteriana agravaria ainda mais estas lesões. Este estudo tem por objetivo avaliar as lesões intestinais na vigência de isquemia e na reperfusão com e sem antibioticoterapia. Submeteram-se 42 ratos Wistar à anestesia e laparotomia mediana. Obteve-se isquemia intestinal por clampeamento das artérias mesentéricas cranial e caudal por 30 minutos. Após reperfundiu-se por igual tempo. Metade destes animais receberam 50 mg/kg de eritromicina por via oral nas 24 horas que antecederam o procedimento. Cada um destes grupos foi subdividido em outros 3, constituíndo os subgrupos de controle, isquemia e isquemia/reperfusão. Ao final, ressecaram-se segmentos do intestins delgado para processamento histológico. Avaliaram-se os resultados pela escala de CHIU e col. e submeteram-se os resultados à tratamento estatístico. Observou-se que a mucosa intestinal apresentava-se com padrão normal nos grupos de controle, tanto com antibioticoprofilaxia como sem. Os intestinos submetidos à isquemia com ou se antibioticoprofilaxia mostraram, lesões com descolamento e perda de vilosidades até infartamento transmucoso. Os intestinos reperfundidos apresentavam lesões semelhantes. Verificou-se que os intestinos reperfundidos que receberam antibioticoprofilaxia apresentavam lesões mais graves do que os que sofreram isquemia sem antibioticoprofilaxia (p=0,0303. Concluiu-se que o uso de antibióticos pré-isquemia não diminui a gravidade das lesões histopatológicas da mucosa intestinal, não protegendo das lesões após a reperfusão.The role of the white blood cells in the ischemia and

  20. 6-Gingerol protects intestinal barrier from ischemia/reperfusion-induced damage via inhibition of p38 MAPK to NF-κB signalling. (United States)

    Li, Yanli; Xu, Bin; Xu, Ming; Chen, Dapeng; Xiong, Yongjian; Lian, Mengqiao; Sun, Yuchao; Tang, Zeyao; Wang, Li; Jiang, Chunling; Lin, Yuan


    Intestinal ischemia reperfusion (I/R) injury caused by severe trauma, intestinal obstruction, and operation is one of the tough challenges in clinic. 6-Gingerol (6G), a main active ingredient of ginger, is found to have anti-microbial, anti-inflammatory, anti-oxidative, and anti-cancer activities. The present study was designed to characterize the potential protective effects of 6G on rat intestinal I/R injury and reveal the correlated mechanisms. Rat intestinal I/R model was established with clamping the superior mesenteric artery (SMA) and 6G was intragastrically administered for three consecutive days before I/R injury. Caco-2 and IEC-6 cells were incubated under hypoxia/reoxygenation (H/R) conditions to simulate I/R injury in vitro. The results showed that 6G significantly alleviated intestinal injury in I/R injured rats by reducing the generation of oxidative stress and inhibiting p38 MAPK signaling pathway. 6G significantly reduced MDA level and increased the levels of SOD, GSH, and GSH-Px in I/R injured intestinal tissues. 6G significantly decreased the production of proinflammatory cytokines including TNF-α, IL-1β, and IL-6, and inhibited the expression of inflammatory mediators iNOS/NO in I/R injured intestinal tissues. The impaired intestinal barrier function was restored by using 6G in I/R injured rats and in both Caco-2 and IEC-6 cells characterized by inhibiting p38 MAPK phosphorylation, nuclear translocation of NF-κB, and expression of myosin light chain kinase (MLCK) protein. 6G also reduced the generation of reactive oxygen species (ROS) in both Caco-2 and IEC-6 cells. In vitro transfection of p38 MAPK siRNA mitigated the impact of 6G on NF-κB and MLCK expression, and the results further corroborated the protective effects of 6G on intestinal I/R injury by repressing p38 MAPK signaling. In conclusion, the present study suggests that 6G exerts protective effects against I/R-induced intestinal mucosa injury by inhibiting the formation of ROS and p

  1. [Nonocclusive acute mesenteric ischemia]. (United States)

    Vasile, I; Meşină, C; Paşalega, M; Calotă, F; Vâlcea, I D


    The authors present one case of acute mesenteric ischemia appeared to the patient 70 years old, with HTA and coronary heart disease with heart arrhythmia treated with angiotensin-converting-enzyme inhibitor, anti arrhythmia agents and antithrombin therapy (trombostop). Acute mesenteric ischemia is not an isolated clinical entity, but a complex of diseases, including acute mesenteric arterial embolus and thrombus, mesenteric venous thrombus and nonocclusive mesenteric ischemia. These diseases have common clinical features caused by impaired blood perfusion of the intestine, bacterial translocation and systemic inflammatory response syndrome. Reperfusion injury is another important feature of nonocclusive mesenteric ischemia. We discuss about the nonocclusive mesenteric ischemia is the most lethal form of acute mesenteric ischemia because of the poor understanding of its pathophysiology and its nonspecific symptoms, which often delay its diagnosis. Although acute mesenteric ischemia is still lethal and in-hospital mortality rates have remained high over the last few decades, accumulated knowledge on this condition is expected to improve its prognosis.

  2. Intestinal intraluminal injection of glutamine increases trolox total equivalent antioxidant capacity (TEAC) in hepatic ischemia-reperfusion

    National Research Council Canada - National Science Library

    Alberto Bicudo Salomão; José Eduardo Aguilar-Nascimento; Sandro Percário; Victor Sano; Nicole Ribeiro Marques; Claudia Cristina Gomes de Oliveira Dias


    PURPOSE: To evaluate the effects of intraluminal injection of glutamine on the serum trolox equivalent antioxidant capacity in an experimental model of ischemia-reperfusion of the liver observing the...

  3. Radiological Evaluation of Bowel Ischemia (United States)

    Dhatt, Harpreet S.; Behr, Spencer C; Miracle, Aaron; Wang, Zhen Jane; Yeh, Benjamin M.


    Intestinal ischemia, which refers to insufficient blood flow to the bowel, is a potentially catastrophic entity that may require emergent intervention or surgery in the acute setting. Although the clinical signs and symptoms of intestinal ischemia are nonspecific, CT findings can be highly suggestive in the correct clinical setting. In this chapter we review the CT diagnosis of arterial, venous, and non-occlusive intestinal ischemia. We discuss the vascular anatomy, pathophysiology of intestinal ischemia, CT techniques for optimal imaging, key and ancillary radiological findings, and differential diagnosis. In the setting of an acute abdomen, rapid evaluation is necessary to identify intraabdominal processes that require emergent surgical intervention (1). While a wide-range of intraabdominal diseases may be present from trauma to inflammation, one of the most feared disorders is mesenteric ischemia, also known as intestinal ischemia, which refers to insufficient blood flow to the bowel (2). Initial imaging evaluation for intestinal ischemia is typically obtained with CT. Close attention to technique and search for key radiologic features with relation to the CT technique is required. Accurate diagnosis depends on understanding the vascular anatomy, epidemiology, and pathophysiology of various forms of mesenteric ischemia and their corresponding radiological findings on MDCT. At imaging, not only is inspection of the bowel itself important, but evaluation of the mesenteric fat, vasculature, and surrounding peritoneal cavity also helps improves accuracy in the diagnosis of bowel ischemia. PMID:26526436

  4. Protective effect of hesperidin against lung injury induced by intestinal ischemia/reperfusion in adult albino rats: histological, immunohistochemical and biochemical study. (United States)

    Bayomy, Naglaa A; Elshafhey, Saad H; ElBakary, Reda H; Abdelaziz, Eman Z


    Hesperidin is a naturally common flavonoid. It is an abundant and cheap by-product of citrus cultivation. It is reported to have antioxidative, anti-inflammatory and anticarcinogenic effects. This work was performed to investigate the possible protective role of hesperidin in ameliorating the effect of experimentally induced intestinal ischemia/reperfusion injury (I/R) on lung tissue, histologically, immunohistochemically and biochemically. Thirty male Wistar adult albino rats were randomized into three groups named: group I (control group); group II (I/R); and group III (I/R with hesperidin). Intestinal I/R was induced by occluding the superior mesenteric artery for 60 min, followed by 120 min of reperfusion period. Animals were given hesperidin orally 1h before the onset of ischemia. At the end of the reperfusion period the lung tissues were extracted for histopathological examination and immunohistochemical detection of the distribution of inducible nitric oxide synthase (iNOS). Pulmonary edema was evaluated by lung tissue wet/dry weight ratios. The levels of malondialdehyde (MDA, a biomarker of oxidative damage), myeloperoxidase (MPO, an index of the degree of neutrophil accumulation) and glutathione (GSH, a biomarker of protective oxidative injury) were also determined in all dissected tissues. Pretreatment with hesperidin (in group III) alleviated lung morphological changes noticed in I/R group and the levels of MDA and MPO were significantly decreased whereas those of GSH were significantly increased. Immunohistochemical study revealed a significant decrease in the iNOS. Hesperidin also significantly alleviated the formation of pulmonary edema as evidenced by the decreased organ wet/dry weight ratios. Hesperidin exerts a protective effect against lung damage induced by intestinal I/R injury in rats by reducing oxidative stress. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. The presence of oxidized low-density lipoprotein and inducible nitric oxide synthase expression in renal damage after intestinal ischemia reperfusion

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    Gamze Yurdakan


    Full Text Available Intestinal ischemia/reperfusion (I/R is a complex phenomenon that causes destruction of both local and remote tissues. The objective of this study was to investigate the possible participation of oxidized low-density lipoproteins (oxLDLs and inducible nitric oxide synthase (iNOS expression in renal tissue damage after intestinal I/R. The superior mesenteric artery was blocked for 30 minutes, followed by 24 hours of reperfusion. At the end of the reperfusion period, renal tissues were removed; the presence of oxLDL, superoxide dismutase enzyme activity, malondialdehyde levels, and iNOS expression were evaluated. I/R resulted in positive oxLDL staining in renal tissue. Compared with control rats, tissue from the I/R group showed significantly higher malondialdehyde levels and lower superoxide dismutase enzyme activity. Strong and diffuse iNOS expression was present in the I/R group. Our findings support the hypothesis that I/R of intestinal tissue results in oxidative and nitrosative stress and enhances lipid peroxidation in the end organ. These data show that oxLDL accumulates in rat renal tissue after intestinal I/R. Antioxidant strategies may provide organ protection in patients with reperfusion injury, at least by affecting interactions with free radicals, nitric oxide, and oxLDL. This study demonstrates for the first time that oxLDL may play a role in renal tissue damage after intestinal I/R. Antioxidant strategies may be beneficial for protection from reperfusion injury.

  6. Anti-inflammatory and antioxidant effects of flavonoid-rich fraction of bergamot juice (BJe in a mouse model of intestinal ischemia/reperfusion injury

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    Daniela Impellizzeri


    Full Text Available The flavonoid-rich fraction of bergamot juice (BJe has demonstrated anti-inflammatory and antioxidant activities. The aim of work was to test the beneficial effects of BJe on the modulation of the ileum inflammation caused by intestinal ischemia/reperfusion (I/R injury in mice. To understand the cellular mechanisms by which BJe may decrease the development of intestinal I/R injury, we have evaluated the activation of signaling transduction pathways that can be induced by reactive oxygen species (ROS production. Superior mesenteric artery and celiac trunk were occluded for 30 min and reperfused for 1 h. The animals were sacrificed after 1 h of reperfusion, for both histological and molecular examinations of the ileum tissue. The experimental results demonstrated that BJe was able to reduce histological damage, cytokines production, adhesion molecules expression, neutrophil infiltration and oxidative stress by a mechanism involved both NF-κB and MAP kinases pathways. This study indicates that BJe could represent a new treatment against inflammatory events of intestinal I/R injury.

  7. Do lesions of the enteric nervous system occur following intestinal ischemia/reperfusion? Ocorrem lesões do sistema nervoso entérico após isquemia/reperfusão intestinal?

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    Glauber Kazuo Linhares


    Full Text Available PURPOSE: To evaluate tissue lesions, especially those of the intestinal innervation, in an excluded jejunal loop subjected to ischemia and reperfusion in rats. METHODS: To evaluate the role of ischemia and reperfusion lesions in an excluded intestinal loop, four groups of 20 rats were set up: control group (GCEI7 and three experimental groups (GIREI7, GIREI14 and GIREI28. They were all subjected to exclusion of an intestinal segment of six centimeters in length, at a distance of 10 centimeters from the Treitz angle. The 60 animals in the three experimental groups were additionally subjected to ischemia of the vascular pedicle for 30 minutes. The control group and the experimental group GIREI7 were evaluated on the 7th day after the operation. The groups GIREI14 and GIREI28 (which also underwent ischemia were utilized to evaluate the evolution of the lesion over time, on the 14th and 28th days after the operation, respectively. From the intestinal excluded loop, we take one ring of 0,5 cm distal and proximal, that were fixed in formaline 10% solution in order to do histological (HE and immuno-hystochemial (PS-100 evaluation (enteric nervous system. The distal loop was exteriorized in stoma and the proximal part closed with polipropilene 6-0. RESULTS: It was observed a decrease in the number of ganglionic cells in the myenteric plexus in the group subjected to ischemia and reperfusion (GIREI7, in relation to the control group (GCEI7 at the 7th post-operative day (Mann-Whitney test: p = 0.0173 *. Comparing the numbers of ganglionic cells in the myenteric plexus before and after jejunal loop exclusion GCEI7 - (Wilcoxon test: p = 0.0577. GIREI7 - Comparing the numbers of ganglionic cells in the myenteric plexus before and after ischemia (*p = 0.0399. Comparing the percentage variations in ganglionic cells in the myenteric plexus on the 7th, 14th and 28th days after the procedure, in the groups GIREI7, GIREI14 and GIREI28, it was observed that there

  8. Effects of L-arginine and NG-nitro L-arginine methyl ester (L-NAME) on ischemia/reperfusion injury of skeletal muscle, small and large intestines. (United States)

    Krauss, Hanna; Sosnowski, Przemyslaw; Biczysko, Maciej; Biczysko, Wieslawa; Majewski, Przemyslaw; Jablecka, Anna; Miskowiak, Bogdan; Smolarek, Iwona; Konwerska, Aneta; Ignys, Iwona; Micker, Maciej


    This study analyzed the effects of L-arginine and non-specific nitric oxide (NO) synthase blocker (L-NAME) on structural and metabolic changes in experimental ischemia/reperfusion injury in the rat. Histopathological evaluation of rat tissues after reperfusion was also performed. The animals were divided into four groups: [1] nonischemic control, [2] ischemia 4 hrs/repefusion 30, 60, 120 min, [3] ischemia/reperfusion after L-arginine administration, [4] ischemia/reperfusion, after L-arginine, and L-NAME. L-arginine (500 mg/kg) and L-NAME (75 micromol/rat/day) were administrated orally for 5 days before experiment. Concentrations of free radicals, CD-62P, CD-54 and malonyl dialdehyde (MDA) in tissues, and MDA and NO levels in sera were determined. Free radical levels significantly increased in reperfused skeletal muscle, small and large intestines. In large bowel, reperfusion increased MDA levels and evoked a rise of endotoxin level while NO levels decreased. Histological studies showed an increase in the number of lymphocytes in both intestines. Administration of L-arginine reduced leukocyte adherence associated with ischemia-repefusion injury, decreased the levels of free radicals and MDA in the examined tissues, and inhibited the release of endotoxins into blood. L-arginine-treated animals showed higher serum NO levels and reduced leukocyte bowel infiltration. Concomitant L-NAME administration reduced serum NO and tissue free radical [corrected] levels, but did not affect intestinal leukocyte infiltration. L-arginine could ameliorate intestinal ischemia/reperfusion injury and constitute a possible protective mechanism by decreasing neutrophil-endothelial interactions, stimulating free radical scavenging and reducing lipid peroxidation.

  9. Lesão intestinal após isquemia-reperfusão: estudo comparativo usando sal tetrazólico (MTT e histologia Ischemia-reperfusion injury of intestine: comparative study using tetrazolium salt (MTT and histology

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    Marcus Vinicius Henriques Brito


    Full Text Available Vários métodos são utilizados para avaliar e estimar as lesões intestinais de isquemia e reperfusão (IR. Assim, o objetivo do presente trabalho é realizar o estudo comparativo dos aspectos colorimétrico e histológico da lesão intestinal após IR. Para tal, foram utilizados 30 ratos Wistar, machos, pesando entre 310 a 410g, distribuídos em 3 grupos: Grupo Controle (GC, Grupo Isquemia e Reperfusão-1 (GIR-1 e Grupo Isquemia e Reperfusão-3 (GIR-3, com 10 animais cada. Nos grupos GIR-1 e GIR-3 foi realizada isquemia intestinal, por meio de falsa ligadura da artéria mesentérica anterior, durante 30 minutos e após esta a perfusão sangüínea foi restaurada. Estes animais foram submetidos a eutanásia após 1 e 3 dias de reperfusão, respectivamente, sendo colhido material para realização dos estudos colorimétrico, usando o Methyl Thiazolyl Blue (MTT e histológico pela hematoxilina e eosina. Os resultados obtidos demonstraram uma menor proporção de células viáveis e um maior grau de lesão da túnica mucosa nos animais do grupo GIR-3 em relação ao controle (pMany methods are used to evaluate ischemia reperfusion injury, but the most employed one is the histological study. However, it only demonstrates on mucosal tunic, the index of lesion and morphologic preserved cells, but not the index of viable functional cells, present in the sample. With this purpose, a colorimetric method was used, employing Methyl Thiazolyl Blue (MTT. The experiment was conducted in 30 Wistar male rats, distributed in 3 groups: Group Control (GC, Group ischemia and reperfusion-1 (GIR-1 and Group ischemia and reperfusion-3 (GIR-3, with 10 animals each. The Groups GIR-1 and GIR-3 were submitted to intestinal ischemia for 30 minutes by a false ligature of superior mesenteric artery, and submitted to euthanasia after 1 and 3 days of reperfusion, when material was picked for absorbency and histological procedures. It was observed a smaller proportion of

  10. Mesenteric ischemia-reperfusion injury: clearly improved hemodynamics but only minor protection of the rat small intestine by (sub)therapeutic heparin sodium and enoxaparin doses. (United States)

    Walensi, Mikolaj; de Groot, Herbert; Schulz, Rainer; Hartmann, Matthias; Petrat, Frank


    Tissue protection against ischemia (I)/reperfusion (R) injury by heparins can be due to their anticoagulant and/or non-anticoagulant properties. Here we studied the protective potential of the anticoagulant and the non-anticoagulant features of heparin sodium (HepSo) and enoxaparin (Enox) against mesenteric I/R injury in a rat model. Mesenteric I/R was induced in rats (n = 6 per group) by superior mesenteric artery occlusion (SMAO; 90 min) and reopening (120 min). Therapeutic/clinical and subtherapeutic/non-anticoagulant doses of HepSo (0.25 mg/kg bolus + 0.25 mg/kg × h; 0.05 mg/kg bolus + 0.1 mg/kg × h) or Enox (0.5 mg/kg bolus + 0.5 mg/kg × h; 0.05 mg/kg bolus + 0.1 mg/kg × h) were administered intravenously starting 30 min before SMAO to the end of reperfusion. Systemic/vital and intestinal microcirculatory parameters were measured during the whole experimental procedure, those of small intestine injury at the end. During intestinal reperfusion, mean arterial blood pressure and heart rates were significantly increased by HepSo and, less effectively, by Enox, in a dose-dependent manner. Intestinal microcirculation was only affected by the therapeutic HepSo dose, which decreased the microvascular flow and S(O2) during reperfusion. The subtherapeutic Enox treatment, as opposed to any HepSo dose, most effectively diminished I/R-induced intestinal hemorrhages, myeloperoxidase activity (as a measure of neutrophil invasion), and histopathological changes. Therapeutic but, to a lesser extent, also the subtherapeutic doses of both HepSo and Enox clearly improve hemodynamics during mesenteric reperfusion, while intestinal protection is exclusively provided by Enox, especially at its subtherapeutic dose. Alterations in intestinal microcirculation are not responsible for these effects. Thus, non-anticoagulant Enox doses and, preferably, heparin(oid)s unable to affect coagulation, could diminish clinical risks of I/R-induced gastrointestinal complications. Copyright

  11. Time-dependent alterations in serum NO concentration after oral administration of L-arginine, L-NAME, and allopurinol in intestinal ischemia/reperfusion

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    Amalia E Yanni


    Full Text Available Amalia E Yanni1, Eleutherios Margaritis2, Nikolaos Liarakos2, Alkisti Pantopoulou2, Maria Poulakou2, Maria Kostakis2, Despoina Perrea2, Alkis Kostakis31Department of Science of Dietetics and Nutrition, Harokopio University of Athens, Athens, Greece, 2Laboratory of Experimental Surgery and Surgical Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, 32nd Department of Propedeutic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceObjective: To study the effect of oral administration of a nitric oxide (NO donor L-arginine (L-Arg, a NO synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME and an inhibitor of xanthine oxidase, allopurinol (Allo, on serum NO concentration and catalase activity after intestinal ischemia/reperfusion (I/R in rats.Methods: Male Wistar rats received per os L-Arg (800 mg/kg or L-NAME (50 mg/kg or Allo (100 mg/kg 24 hrs, 12 hrs and 1 hr before underwent 1 hr occlusion of superior mesenteric artery followed by 1 hr of reperfusion (L-Arg(IR1, L-NAME(IR1 and Allo(IR1 respectively or 1 hr occlusion followed by 8 hrs of reperfusion (L-Arg(IR8, L-NAME(IR8 and Allo(IR8 respectively. There was one group underwent 1 hr occlusion (I, a group underwent 1 hr occlusion followed by 1 hr reperfusion (IR1, a group subjected to 1 hr occlusion followed by 8 hrs of reperfusion (IR8 and a last group that served as control (C. Serum NO concentration and catalase activity were measured.Results: After 1 hr of reperfusion serum NO concentration was elevated in IR1 and L-Arg(IR1 groups compared with group C but not in L-NAME(IR1 and Allo(IR1 group. Catalase activity was enhanced in L-NAME(IR1 group. Interestingly, serum NO concentration was increased after 8 hrs of reperfusion in all groups (IR8, L-Arg(IR8, L-NAME(IR8 and Allo(IR8 compared with control while catalase activity did not show significant difference in any group.Conclusions: The results of the

  12. Translocation of 99mTc labelled bacteria after intestinal ischemia and reperfusion Translocação de bactérias marcadas com 99mTc após isquemia e reperfusão intestinal

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    Samir Assi João


    Full Text Available PURPOSE: Ischemia and reperfusion of the small intestine disrupts gut barrier, causes bacterial translocation and activates inflammatory responses. An experimental study was planned to evaluate if 99mTc labelled Escherichia coli translocates to mesenteric lymph nodes, liver, spleen, lung and serum of rats submitted to mesenteric ischemia/reperfusion. Additionally, it was observed if the time of reperfusion influences the level of translocation. METHODS: Forty male Wistar rats underwent 45 minutes of gut ischemia by occlusion of the superior mesenteric artery. The translocation of labelled bacteria to different organs and portal serum was determined in rats reperfused for 30 minutes, 24 hours, sham(S and controls(C, using radioactivity count and colony forming units/g (CFU. RESULTS: All the organs from rats observed for 24 hours after reperfusion had higher levels of radioactivity and positive cultures (CFU than did the organs of rats reperfused for 30 minutes, C and S, except in the spleen (pOBJETIVO: Isquemia e reperfusão do intestino delgado têm sido implicadas na quebra da barreira mucosa, na translocação bacteriana e na ativação de reações inflamatórias. Este estudo procurou avaliar se a Escherichia coli marcada com 99mTc transloca para linfonodos mesentéricos, fígado, baço, pulmão e soro de ratos submetidos a isquemia intestinal/reperfusão e se o tempo de reperfusão influencia o fenômeno. MÉTODOS: Quarenta ratos Wistar foram submetidos a 45 minutos de isquemia intestinal através da oclusão da artéria mesentérica superior. A translocação de bactérias marcadas para os diferentes órgãos e soro portal foi determinada em ratos após reperfusão mesentérica por 30 minutos, 24 horas, sham e controles, usando contagem de radioatividade e formação de unidades de colônias/grama de tecido (FUC/g. RESULTADOS: Todos os órgãos dos animais observados com 24 horas de reperfusão intestinal tiveram níveis maiores de

  13. Infrared imaging contribution for intestinal ischemia detection in wound healing Contribuição da imagem infravermelha para detecção da isquemia intestinal na cicatrização das feridas

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    Osvaldo Malafaia


    Full Text Available PURPOSE: To study thermal variations obtained through infrared image in rats, and to evaluate the relationship between intestinal ischemic time and histopathological findings. METHODS: Thirty Wistar rats were operated after distribution in 5 groups with different times of ischemia. Thermograms were obtained by using a infrared camera. The surgical technique has been standardized for all groups: abdominal cavity opening by a 5cm length incision in the midline, abdominal wall plans section and cavity exposure, and exteriorization of the intestine. In group I (control, it was proceeded only laparotomy without superior mesenteric artery ligature. After first thermogram done, incision was closed with continuing suture. In each rat in groups II, III, IV and V, the superior mesenteric artery was located at its origin on abdominal aorta, dissected and occluded with a vascular microclamp, subjecting the intestine to ischemia in variable times. RESULTS: Rats submitted to a 30 minutes ischemia presented reactive hyperemia, thermal differential of 1.8°C and normal pathological examination. The 1 hour ischemia produced reactive hyperemia with ischemic areas, thermal differential of 1.0°C and injuries at villosities' tips. However, the 90 minutes ischemia had not shown reactive hyperemia with large ischemic areas, thermal differential of -1.0°C and injury in the upper third of the villosities. The 2 hours ischemia demonstrated a severe ischemia, thermal differential of -2.0°C and injury throughout the all villosities' extension. CONCLUSION: It has been possible studying thermal variations through infrared image in rats, showing correlation between thermal response in thermograms, ischemic time and histopathological findings.OBJETIVO: Estudar as variações térmicas obtidas por meio da imagem infravermelha em ratos, e avaliar sua correlação com o tempo de isquemia intestinal e os achados histopatológicos. MÉTODOS: Trinta ratos Wistar foram operados ap

  14. An antioxidant Trolox restores decreased oral absorption of cyclosporine A after liver ischemia-reperfusion through distinct mechanisms between CYP3A and P-glycoprotein in the small intestine. (United States)

    Ikemura, Kenji; Inoue, Koichi; Mizutani, Hideki; Oka, Hisao; Iwamoto, Takuya; Okuda, Masahiro


    Oxidative stress is a critical mediator of various injuries following ischemia-reperfusion (I/R) associated with organ transplantation. Although oral bioavailability of cyclosporine A (CsA) was decreased by increased first-pass metabolism through CYP3A and P-glycoprotein (P-gp) specifically in the upper small intestine after liver I/R, the mechanism responsible for them remained to be clarified. In the present study, the effect of Trolox (an α-tocopherol analogue) on the decreased oral absorption of CsA through elevated intestinal CYP3A and P-gp after liver I/R and their regulations were investigated. Rats were subjected to 60 min of liver ischemia followed by 12h of reperfusion. Trolox was administered intravenously 5 min before reperfusion. Trolox diminished the increased malondialdehyde and total glutathione levels in plasma by liver I/R and concomitantly prevented the decreased area under the blood concentration-time curve of orally administered CsA as well as initial absorption rate of CsA from upper small intestine. The elevated CYP3A mRNA and activity in the upper small intestine as well as expression levels of P-gp in upper, middle, and lower small intestines after liver I/R were attenuated by Trolox administration. The elevations of CYP3A levels specifically in the upper small intestine of I/R rats were correlated with the lithocholic acid levels in the bile. These results demonstrate that Trolox ameliorates the decreased oral absorption of CsA through elevated intestinal CYP3A and P-gp by preventing oxidative stress, where the biliary lithocholic acid may be responsible for the elevated transcription of CYP3A specifically in the upper small intestine after liver I/R. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Anti-human tissue factor antibody ameliorated intestinal ischemia reperfusion-induced acute lung injury in human tissue factor knock-in mice.

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    Xiaolin He

    Full Text Available BACKGROUND: Interaction between the coagulation and inflammation systems plays an important role in the development of acute respiratory distress syndrome (ARDS. Anti-coagulation is an attractive option for ARDS treatment, and this has promoted development of new antibodies. However, preclinical trials for these antibodies are often limited by the high cost and availability of non-human primates. In the present study, we developed a novel alternative method to test the role of a humanized anti-tissue factor mAb in acute lung injury with transgenic mice. METHODOLOGY/PRINCIPAL FINDINGS: Human tissue factor knock-in (hTF-KI transgenic mice and a novel humanized anti-human tissue factor mAb (anti-hTF mAb, CNTO859 were developed. The hTF-KI mice showed a normal and functional expression of hTF. The anti-hTF mAb specifically blocked the pro-coagulation activity of brain extracts from the hTF-KI mice and human, but not from wild type mice. An extrapulmonary ARDS model was used by intestinal ischemia-reperfusion. Significant lung tissue damage in hTF-KI mice was observed after 2 h reperfusion. Administration of CNTO859 (5 mg/kg, i.v. attenuated the severity of lung tissue injury, decreased the total cell counts and protein concentration in bronchoalveolar lavage fluid, and reduced Evans blue leakage. In addition, the treatment significantly reduced alveolar fibrin deposition, and decreased tissue factor and plasminogen activator inhibitor-1 activity in the serum. This treatment also down-regulated cytokine expression and reduced cell death in the lung. CONCLUSIONS: This novel anti-hTF antibody showed beneficial effects on intestinal ischemia-reperfusion induced acute lung injury, which merits further investigation for clinical usage. In addition, the use of knock-in transgenic mice to test the efficacy of antibodies against human-specific proteins is a novel strategy for preclinical studies.

  16. Oxidative Stress and Lipid Peroxidation in the Ischemic Small Intestine: Pathological and Biochemical Evaluation in a Rat model of Superior Mesenteric Ischemia. (United States)

    Dumlu, Ersin G; Bozkurt, Birkan; Tokaç, Mehmet; Kiyak, Gulten; Özkardeş, Alper B; Ergin, Merve; Yazgan, Aylin; Kılıç, Mehmet


    The purpose of our study was to evaluate the role of oxidative stress and lipid peroxidation in acute mesenteric ischemia. Thirty male Wistar albino rats weighing 240-260 g were randomized into control (no operation), sham (operation without ischemia), and ischemia groups. To induce ischemia, the superior mesenteric artery was sutured. Total antioxidant and oxidant capacity and lipid peroxidase activity were measured in blood samples collected at 0 min, 60 min, and 240 min, and the pathology of ileum segments resected at 240 min was evaluated. Total oxidant status did not differ among the groups. Total antioxidant status increased significantly with time in the ischemia group compared to the control and sham groups (P ischemia group than controls (P ischemia values were similar among the groups. Similarly, basal and stimulated paraoxonase activity in blood samples did not differ among the groups. In conclusion, oxidative stress and lipid peroxidation have no significant role in the pathophysiology of acute mesenteric ischemia.

  17. Inhibition of P38 MAPK Downregulates the Expression of IL-1β to Protect Lung from Acute Injury in Intestinal Ischemia Reperfusion Rats

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    De-Yi Zheng


    Full Text Available Acute lung injury (ALI induced by intestinal ischemia/reperfusion (II/R has high incidence and mortality, in which IL-1β was essential for the full development of ALI. However, the detailed regulating mechanism for this phenomenon remains to be unclear. The purpose of this study was to investigate whether inhibition of P38 MAPK could downregulate the expression of IL-1β to protect lung from acute injury in II/R rats. Here, we found that the level of pulmonary edema at 16 hours after operation (hpo was obviously enhanced compared to that in 8hpo and sham groups. Immunofluorescent staining demonstrated that IL-1β and P38 MAPK were detected in lung tissues. And rats with II/R have the highest translation level for IL-1β and phosphorylation of P38 MAPK in lung tissues at 16hpo compared with 8hpo and sham groups. Moreover, administration of SB239063, an inhibitor of P38 α and β, could effectively downregulate the expressions of IL-1β and protects lung tissues from injury in II/R rats. Our findings indicate that the inhibition of P38 α and β may downregulate the expression of IL-1β to protect lung from acute injury in II/R, which could be used as a potential target for reducing ALI induced by II/R in the future clinical trial.

  18. Antioxidative protection of dietary bilberry, chokeberry and Lactobacillus plantarum HEAL19 in mice subjected to intestinal oxidative stress by ischemia-reperfusion (United States)


    Background Ischemia-reperfusion (I/R) in the intestines is an inflammatory condition which activates leukocytes and reactive oxygen species (ROS) and leads to lipid peroxidation and DNA damage. Bilberry and chokeberry fruits are rich sources of polyphenols which may act as antioxidants and prevent lipid peroxidation. Lactic acid bacteria (LAB) may improve microbial status in the intestines and increase the metabolic activity towards polyphenolic degradation. The aim of the study was to clarify antioxidative effects of bilberry and chokeberry fruits alone and with addition of a LAB-strain, Lactobacillus plantarum HEAL19, in an I/R-model in mice. Methods Male BALB/cJ mice were fed the experimental diets for 10 days. Diets consisted of standard chow supplemented with either bilberry (Vaccinium myrtillus) or chokeberry (Aronia × prunifolia) powder alone or in combination with the LAB-strain Lactobacillus plantarum HEAL19. I/R-injury was induced by holding superior mesenteric artery clamped for 30 minutes followed by reperfusion for 240 minutes. Thereafter, colonic and caecal tissues and contents were collected. Malondialdehyde (MDA) was used as indicator of lipid peroxidation and was measured by a calorimetric assay, lactobacilli were cultured on Rogosa agar plates and Enterobacteriaceae on VRBG agar plates, anthocyanins and phenolic acids were analysed by HPLC-DAD-ESI-MSn. Results MDA was significantly decreased in the colon of groups fed bilberry alone (p = 0.030) and in combination with L. plantarum HEAL19 (p = 0.021) compared to the IR-control but not in chokeberry-fed groups. Supplementation with bilberry or chokeberry alone reduced the total number of lactobacilli on the mucosa. Higher concentrations of anthocyanins were found in the colon than in the caecum content of mice. A more varied composition of different anthocyanins was also observed in the colon content compared to the caecum of bilberry-fed mice. Phenolic acids formed by microbial degradation of the

  19. Antioxidative protection of dietary bilberry, chokeberry and Lactobacillus plantarum HEAL19 in mice subjected to intestinal oxidative stress by ischemia-reperfusion

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    Ahrné Siv


    Full Text Available Abstract Background Ischemia-reperfusion (I/R in the intestines is an inflammatory condition which activates leukocytes and reactive oxygen species (ROS and leads to lipid peroxidation and DNA damage. Bilberry and chokeberry fruits are rich sources of polyphenols which may act as antioxidants and prevent lipid peroxidation. Lactic acid bacteria (LAB may improve microbial status in the intestines and increase the metabolic activity towards polyphenolic degradation. The aim of the study was to clarify antioxidative effects of bilberry and chokeberry fruits alone and with addition of a LAB-strain, Lactobacillus plantarum HEAL19, in an I/R-model in mice. Methods Male BALB/cJ mice were fed the experimental diets for 10 days. Diets consisted of standard chow supplemented with either bilberry (Vaccinium myrtillus or chokeberry (Aronia × prunifolia powder alone or in combination with the LAB-strain Lactobacillus plantarum HEAL19. I/R-injury was induced by holding superior mesenteric artery clamped for 30 minutes followed by reperfusion for 240 minutes. Thereafter, colonic and caecal tissues and contents were collected. Malondialdehyde (MDA was used as indicator of lipid peroxidation and was measured by a calorimetric assay, lactobacilli were cultured on Rogosa agar plates and Enterobacteriaceae on VRBG agar plates, anthocyanins and phenolic acids were analysed by HPLC-DAD-ESI-MSn. Results MDA was significantly decreased in the colon of groups fed bilberry alone (p = 0.030 and in combination with L. plantarum HEAL19 (p = 0.021 compared to the IR-control but not in chokeberry-fed groups. Supplementation with bilberry or chokeberry alone reduced the total number of lactobacilli on the mucosa. Higher concentrations of anthocyanins were found in the colon than in the caecum content of mice. A more varied composition of different anthocyanins was also observed in the colon content compared to the caecum of bilberry-fed mice. Phenolic acids formed by

  20. Intestinal intraluminal injection of glutamine increases trolox total equivalent antioxidant capacity (TEAC) in hepatic ischemia-reperfusion. (United States)

    Salomão, Alberto Bicudo; Aguilar-Nascimento, José Eduardo; Percário, Sandro; Sano, Victor; Marques, Nicole Ribeiro; Dias, Claudia Cristina Gomes de Oliveira


    To evaluate the effects of intraluminal injection of glutamine on the serum trolox equivalent antioxidant capacity in an experimental model of ischemia-reperfusion of the liver observing the applicability of modifications on the original assay method. Thirty Wistar rats underwent laparotomy to perform a 20 cm blind sac of small bowel and occlusion of the hepatic hilo for 30 minutes and reperfusion for 5 minutes. Into the gut sac it was injected glutamine (glutamine group, n=10) or distilled water (control group, n=10). Ten other animals (sham group) underwent laparotomy without artery occlusion. Blood samples were collected for trolox equivalent antioxidant capacity assays in different temperature conditions, reagent quantities and time for spectrophotometer readings. Total antioxidant capacity was significantly greater in glutamine group than in both control group (1.60[1.55-1.77] vs 1.44[1.27-1.53]) and sham group (1.60[1.55-1.77] vs 1.48[1.45-1.59]). Glutamine enhanced serum antioxidant capacity. The assay technique consistently reflected the changes in the antioxidant defenses in this experimental model.

  1. Effect of short-term ornithine alpha-ketoglutarate pretreatment on intestinal ischemia-reperfusion in rats Efeitos do pré-tratamento em curto prazo com ornitina alfa-cetoglutarato na isquemia-reperfusão intestinal em ratos

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    Eduardo Silvio Gouveia Gonçalves


    Full Text Available PURPOSE: To investigate the effects of preventive enteral administration of ornithine alpha-ketoglutarate (OKG in an ischemia-reperfusion rat model. METHODS: Sixty rats were randomized into five groups (G1-G5, n = 12. Each group was divided into two subgroups (n = 6 and treated with calcium carbonate (CaCa or OKG by gavage. Thirty minutes later, the animals were anesthetized with xylazine 15mg + ketamine 1mg ip and subjected to laparotomy. G1-G3 rats served as controls. Rats in groups G4 and G5 were subjected to ischemia for 30 minutes. Ischemia was achieved by clamping the small intestine and its mesentery, delimiting a segment of bowel 5 cm long and 5 cm apart from the ileocecal valve. In addition, G5 rats underwent reperfusion for 30 minutes. Blood samples were collected at the end of the laparotomy (G1, after 30 minutes (G2, G4 and 60 minutes (G3, G5 to determine concentrations of metabolites (pyruvate, lactate, creatine phosphokinase (CPK, thiobarbituric acid reactive substances (TBARS and glutathione (GSH. RESULTS: There was a significant decrease in tissue pyruvate and lactate and plasma CPK levels in OKG-treated rats at the end of reperfusion period. GSH levels did not change significantly in ischemia and reperfusion groups. However, TBARS levels increased significantly (pOBJETIVO: Investigar os efeitos da administração enteral preventiva de ornitina alfa-cetoglutarato (OKG em modelo de isquemia-reperfusão no rato. MÉTODOS: Sessenta ratos foram randomizados em cinco grupos (G1-G5, n=12. Cada grupo foi redistribuído em dois subgrupos (n=6 e tratado com carbonato de cálcio (CaCa ou OKG por gavagem. Trinta minutos mais tarde, os animais foram anestesiados com xilazina 1mg+cetamina 15mg i.p. e submetidos à laparotomia. Os ratos dos grupos G4-G5 foram submetidos à isquemia por 30 minutos. A isquemia foi obtida por pinçamento do intestino delgado, delimitando um segmento com 5 cm de comprimento e distando 5 cm da válvula ileocecal. O

  2. Protective effects of ascorbic acid pretreatment in a rat model of intestinal ischemia-reperfusion injury: a histomorphometric study Efeito protetor do pré-tratamento com ácido ascóbico em modelo experimental de isquemia-reperfusão intestinal: um estudo histomorfométrico

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    Oscar Haruo Higa


    Full Text Available BACKGROUND: Ascorbic acid has shown promise in attenuation of intestinal ischemia-reperfusion (I/R injury. The aim of this study was to determine the protective effects of ascorbic acid on intestinal morphology during IR injury in rats. MATERIALS AND METHODS: We examined morphological changes in the small intestine of Wistar rats after (i 40 minutes of ischemia (I, (ii ischemia followed by 30 min of reperfusion (IR, (iii ischemia with ascorbic acid (IA, (iv ischemia followed by reperfusion and ascorbic acid (IRA and (v in a sham group (S. We used morphometry to evaluate the amount of villous architecture, crypts, necrosis, hemorrhagic infarcts and inflammatory cells at the mesenteric and antimesenteric borders of the small intestine. RESULTS: Ascorbic acid caused a significant reduction of antimesenteric villous hemorrhagic infarction (pINTRODUÇÃO: O ácido ascórbico tem se mostrado como um agente promissor na atenuação da lesão causada pela isquemia/reperfusão (IR. O objetivo deste estudo foi determinar os efeitos protetores do ácido ascórbico na morfologia intestinal durante a IR em ratos. MATERIAL E MÉTODOS: Examinamos alterações morfológicas no intestino delgado de ratos do tipo Wistar. Após 40 minutos de isquemia (I, isquemia seguida de reperfusão (IR, isquemia com tratamento com ácido ascórbico (IA, isquemia seguida por 30 minutos de reperfusão e tratamento com ácido ascórbico (IRA e do grupo sham (S. Utilizamos a morfometria para avaliar quantitativamente a arquitetura dos vilos da mucosa intestinal, criptas intestinais, necrose, hemorragia, células inflamatórias nas bordas mesentéricas e antimesentéricas do intestino delgado. RESULTADOS: O ácido ascórbico causou uma redução significativa (p<0,05 no infarto hemorrágico dos vilos intestinais da borda antimesentérica do intestino delgado após isquemia seguida por reperfusão, bem como redução da necrose dos vilos em ambas as bordas após a isquemia (p<0

  3. Estenosis de la arteria mesentérica superior como causa de isquemia intestinal crónica: Tratamiento con angioplastia e implante de stent Superior mesenteric artery stenosis as a cause of chronic intestinal ischemia: Treatment with angioplastia and stent implantation

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    Nabil Hamdan


    Full Text Available La isquemia intestinal crónica es un cuadro poco frecuente que se asocia con alta morbilidad y mortalidad, cuya causa más frecuente es la arterioesclerosis. Los pacientes sufren de dolor abdominal localizado en epigastrio o periumbilical, que aparece de 10 a 30 minutos luego de la ingestión de alimentos. Se presenta un caso de isquemia intestinal crónica por estenosis de la arteria mesentérica superior disgnosticado por angiografía, el cual se trató con angioplastia percutánea e implante de stent. Se comentan los hallazgos clínicos y radiológicos y el procedimiento terapéutico.Chronic intestinal ischemia is an infrequent clinical presentation associated with high morbidity and mortality; its main cause is arteriosclerosis. Patients suffer abdominal pain localized in the epigastrium or periumbilical region that appears 10 to 30 minutes after food ingestion. A case of chronic intestinal ischemia due to stenosis of the superior mesenteric artery diagnosed through angiography is presented. The treatment consisted of percutaneous angioplastia and Stent implantation. Clinical and radiological findings and therapeutic procedure are discussed.

  4. Myocardial Ischemia (United States)

    ... pectoris: Chest pain caused by myocardial ischemia. Accessed June 1, 2015. Deedwania PC. Silent myocardial ischemia: Epidemiology and pathogenesis. Accessed June 1, 2015. Mann DL, ...

  5. Intestinal atresia and ectopia in a bovine fetus. (United States)

    Lejeune, B; Miclard, J; Stoffel, M H; Meylan, M


    A 2-year-old Red Holstein cow was presented with uterine torsion at 235 days of pregnancy. The fetus extracted by cesarean section had weak vital signs and marked abdominal distention. An edematous pouch that contained tubular structures with peristaltic activity was associated with the umbilical cord. Because of poor prognosis, both dam and fetus were euthanized. At necropsy, the fetus had severe distention of the forestomachs, abomasum, and proximal small intestine; absence of distal small intestine, cecum, and proximal colon; atresia of the 2 blind ends of the intestine; and atrophy of distal colon and rectum. The tubular structures associated with the umbilical cord were identified as the segments of intestine that were absent in the fetus. Intestinal atresia combined with ectopia may be caused by local ischemia during temporary herniation and rotation of the fetal gut into the extraembryonic coelom. The close connection between ectopic intestine and amniotic sheath of the umbilical cord in this case may have facilitated vascularization and allowed development and viability of the ectopic intestine. © The Authors 2011

  6. The ischemic preconditioning and postconditioning effect on the intestinal mucosa of rats undergoing mesenteric ischemia/reperfusion procedure Efeito do pré e pós-condicionamento isquêmico sobre a mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica

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    Carlos Henrique Marques dos Santos


    Full Text Available PURPOSE: To evaluate the effect of the ischemic preconditioning and the ischemic postconditioning over the tissue injury in the intestinal mucosa of rats undergoing the procedure of mesenteric ischemia and reperfusion. METHODS: Thirty Wistar rats were studied, divided in three groups: group A, undergoing mesenteric ischemia (30 minutes and reperfusion (60 minutes; group B, mesenteric ischemia and reperfusion preceded by ischemic preconditioning; group C, mesenteric ischemia and reperfusion and, before the beginning of reperfusion, the ischemic postconditioning was performed. At the end, a segment of the small intestine was dissected for histological analysis. The results were evaluated using the CHIU et al.6 classification followed by the statistic treatment. RESULTS: The mean values of the tissue injury levels were: group A, 3.5; group B, 1.2; and group C, 1. The difference between the result of group A with the results of groups B and C was considered statistically significant (p OBJETIVO: Avaliar o efeito do pré e pós-condicionamento isquêmico sobre a lesão tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica. MÉTODOS: Foram estudados 30 ratos Wistar, distribuídos em três grupos: grupo A, em que se realizou isquemia (30 minutos e reperfusão (60 minutos mesentérica; grupo B, isquemia e reperfusão mesentérica precedidos pelo pré-condicionamento isquêmico; grupo C, isquemia e reperfusão mesentérica e, precedendo o início da reperfusão, foi realizado o pós-condicionamento isquêmico. Ao final, ressecou-se um segmento do intestino delgado para análise histológica. Avaliaram-se os resultados pela classificação de CHIU e col.6 e procedeu-se o tratamento estatístico. RESULTADOS: As médias dos graus de lesão tecidual foram: grupo A, 3,5; grupo B, 1,2; grupo C, 1. A diferença entre o resultado do grupo A com os resultados dos grupos B e C foi considerada estatisticamente

  7. Prophylactic and therapeutic effect of ginko biloba extract (Egb761) on mortality of intestinal deep ischemia-reperfusion model in rats


    Mustafa Ateş; M. Hakan Köksal; M. Fevzi Celayir; Adil Baykan


    Objectives: Ginkgo biloba extract (EGb761) is a standardized form of Ginkgo Biloba plant leaves which have been used by Chines nearly 5000 years and Its’ antioxidant activity is known. In this study we aimed to investigate effect use of EGb761 on mortality in Megison'un deep ischemia reperfusion model of rats.Materials and Methods: 138 male Spraque-Dawley rats were used in this study. The rats were divided into 4 groups: Group I (control group), Group II (deep ischemia-reperfusion group), Gro...


    To explore the potential of exhaled breath analysis by Column Chromatography-Mass Spectrometry (GC-MS) as a non invasive and sensitive approach to evaluate mesenteric ischemia in pigs. Domestic pigs (n=3) were anesthetized with Guaifenesin/ Fentanyl/ Ketamine/ Xylazine...

  9. The balance between the production of tumor necrosis factor-alpha and interleukin-10 determines tissue injury and lethality during intestinal ischemia and reperfusion

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    Danielle G Souza


    Full Text Available A major goal in the treatment of acute ischemia of a vascular territory is to restore blood flow to normal values, i.e. to "reperfuse" the ischemic vascular bed. However, reperfusion of ischemic tissues is associated with local and systemic leukocyte activation and trafficking, endothelial barrier dysfunction in postcapillary venules, enhanced production of inflammatory mediators and great lethality. This phenomenon has been referred to as "reperfusion injury" and several studies demonstrated that injury is dependent on neutrophil recruitment. Furthermore, ischemia and reperfusion injury is associated with the coordinated activation of a series of cytokines and adhesion molecules. Among the mediators of the inflammatory cascade released, TNF-alpha appears to play an essential role for the reperfusion-associated injury. On the other hand, the release of IL-10 modulates pro-inflammatory cytokine production and reperfusion-associated tissue injury. IL-1beta, PAF and bradykinin are mediators involved in ischemia and reperfusion injury by regulating the balance between TNF-alpha and IL-10 production. Strategies that enhance IL-10 and/or prevent TNF-alpha concentration may be useful as therapeutic adjuvants in the treatment of the tissue injury that follows ischemia and reperfusion.

  10. A influência do azul de metileno na prevenção da lesão pulmonar após isquemia-reperfusão intestinal The role of the methylene blue as a lung protector after intestinal ischemia and reperfusion

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    Fernando Hintz Greca


    Full Text Available OBJETIVO: Estudar a ação do azul de metileno como supressor da produção de radicais livres de oxigênio, atuando como receptor alternativo de elétrons na enzima xantina oxidase. MÉTODOS: Foram utilizados 32 ratos Wistar (Rattus norvegicus albinus, Rodentia mammalia divididos em 2 grupos de 16 animais, os quais foram denominados grupos: experimento e controle. Ambos os grupos foram submetidos a laparotomia mediana e oclusão da artéria mesentérica cranial por 60 minutos. A reperfusão foi confirmada por meio da verificação do reaparecimento da pulsação na arcada mesentérica. Foi então administrado no grupo experimento 2 ml de azul de metileno 1 % estéril intraperitonealmente, enquanto que no grupo controle foi administrado solução salina isotônica estéril em mesmo volume e pela mesma via de administração. Após 4 horas de reperfusão, os animais foram sacrificados. Amostras dos pulmões foram obtidas para: análise histopatológica, avaliação do edema e para determinação da atividade da xantina oxidase. RESULTADOS: O dano pulmonar encontrado no grupo controle foi superior ao encontrado no grupo experimento. Observou-se uma maior formação de edema nos pulmões do grupo controle. A atividade da xantina oxidase foi semelhante em ambos os grupos. CONCLUSÃO: O azul de metileno diminui a lesão pulmonar após isquemia-reperfusão intestinal.PURPOSE: To study the role of methylene blue as an inibitor of superoxide production by xantine oxidase. METHODS: Thirty two Wistar rats were divided in 2 groups of 16 animals: the control group and the experimental group. All the animals were submitted to a laparotomy for the occlusion of the cranial mesenteric artery during 60 minutes. The reperfusion was confirmed by the 'pulsation of the artery after releasing the temporary ligature. In the animals of the control group, 2 ml of saline were injected in the peritoneal cavity and in the animals of the experimental group 2 ml of methylene

  11. [Acute mesenteric ischemia]. (United States)

    Scheurlen, M


    Acute vascular occlusion within the mesenteric circulation leads to ischemic damage of the corresponding bowel segment, which starts on the mucosal level and progresses transmurally. Report on pathogenesis, clinical picture and treatment of various forms of intestinal ischemia. Analysis of the available literature taking into consideration our own experience. Frequently, predisposing diseases and risk factors are present (e.g., cardiac diseases, hypercoagulability, status post cardiac surgery, circulatory failure, or administration of vasoconstrictive drugs). Acute small bowel ischemia-caused by either mesenteric embolism, mesenteric artery thrombosis, nonocclusive mesenteric ischemia (NOMI) or mesenteric venous thrombosis-represents an acute emergency. If this condition is suspected clinically, the diagnosis must be established immediately by computed tomography of the abdomen with intravenous administration of contrast medium in order to prevent irreversible damage to the small bowel. Medical treatment is supportive. If possible, occluded vessels may be re-opened either by radiologic intervention or surgically. Irreversibly damaged bowel segments must be surgically removed. Ischemic colitis has a benign course in most cases if limited to reversible mucosal damage. The diagnosis is based mainly on colonoscopy and computed tomography findings, and treatment is symptom oriented. Rarely, severe manifestations with a worse prognosis due to considerable comorbidities occur. In such cases, surgical removal of the ischemic bowel is frequently required. Even today, acute mesenteric ischemia is associated with a poor prognosis. To improve survival and to reduce long-term morbidity, a rapid and systematic diagnostic workup is mandatory.

  12. Radiologic and tomographic presentation of pneumatosis intestinalis in a patient with mesenteric ischemia; Apresentacao radiologica e tomografica de pneumatose intestinal em paciente com isquemia mesenterica

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    Antunes, Luciano Magrini; Medeiros, Sergio Cainelli; Fraga, Rafael [Rio Grande do Sul Univ., Porto Alegre, RS (Brazil). Faculdade de Medicina; Friedrich, Mariangela Gheller; Abreu, Marcelo; Furtado, Alvaro Porto Alegre [Hospital de Clinicas de Porto Alegre, RS (Brazil). Servico de Radiologia


    The authors report a case of bowel infarction consequent to sudden occlusion of the superior mesenteric artery, with classical clinical and radiological presentation. The outcome, death of the patient, exemplified the usual difficulty in the early diagnosis. It is important, therefore, the urgent use of arteriography in patients with suspection of mesenteric ischemia, because the time of vascular injury predisposes to necrosis, the main prognostic factor. (author)

  13. Hepatic ischemia (United States)

    ... MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Hepatic ischemia URL of this page: // ...

  14. Effect of short-term ornithine alpha-ketoglutarate pretreatment on intestinal ischemia-reperfusion in rats Efeitos do pré-tratamento em curto prazo com ornitina alfa-cetoglutarato na isquemia-reperfusão intestinal em ratos


    Eduardo Silvio Gouveia Gonçalves; Camila Menezes Rabelo; Alberico Ximenes do Prado Neto; José Huygens Parente Garcia; Sérgio Botelho Guimarães; Paulo Roberto Leitão de Vasconcelos


    PURPOSE: To investigate the effects of preventive enteral administration of ornithine alpha-ketoglutarate (OKG) in an ischemia-reperfusion rat model. METHODS: Sixty rats were randomized into five groups (G1-G5, n = 12). Each group was divided into two subgroups (n = 6) and treated with calcium carbonate (CaCa) or OKG by gavage. Thirty minutes later, the animals were anesthetized with xylazine 15mg + ketamine 1mg ip and subjected to laparotomy. G1-G3 rats served as controls. Rats in groups G4 ...

  15. Propofol and N-Acetylcysteine attenuate oxidative stress induced by intestinal ischemia/reperfusion in rats: Protein carbonyl detection by immunoblotting Propofol e N-Acetilcisteína atenuam o estresse oxidativo induzido pela isquemia/reperfusão intestinal em ratos: Detecção de proteína carbonilada por immunoblotting

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    Marcelo Aragão Insuellas de Azeredo


    Full Text Available PURPOSE: To evaluate the antioxidant effect of Propofol and N-Acetylcysteine (NAC on intestinal ischemia/reperfusion (I/R in rats by determining carbonyl protein level. METHODS: Forty Wistar rats were randomly assigned into the following groups: Control; Sham; I/R with Propofol; I/R with Propofol and NAC; I/R with Ketamine and Xylazine. The I/R groups underwent 60 minutes of ischemia and an equal period of reperfusion. Blood samples, collected by cardiac punction, were centrifuged for plasma obtainment. Protein carbonyl level in plasma samples was determined by immunoblotting. RESULTS: No significant difference in protein carbonyl level was found between Control and Sham groups (P>0.05. The highest reduction in protein carbonyl level (POBJETIVO: Avaliar o efeito antioxidante do Propofol e N-Acetilcisteína (NAC na isquemia/reperfusão (I/R intestinal em ratos através da determinação do nível de proteína carbonilada. MÉTODOS: 40 ratos Wistar foram aleatoriamente distribuídos nos seguintes grupos: Controle; Sham; I/R com Propofol; I/R com Propofol e NAC; I/R com Ketamina e Xilazina. Os grupos I/R foram submetidos à isquemia durante 60 minutos e à reperfusão por igual período de tempo. Amostras de sangue, coletadas por punção cardíaca, foram centrifugadas para a obtenção de plasma. O nível de proteína carbonilada nas amostras de plasma foi determinado por imunoblotting. RESULTADOS: Nenhuma diferença significativa foi encontrada entre os grupos Controle e Sham (P>0.05. Uma redução marcante no nível de proteína carbonilada (P<0.05 foi obtida com a administração combinada de Propofol e NAC (Grupo 4 durante o procedimento de I/R intestinal, comparando-se com os demais grupos I/R testados. CONCLUSÃO: A administração de Propofol e NAC apresentou o melhor efeito antioxidante sobre o estresse oxidativo em ratos submetidos ao procedimento de I/R intestinal, sugerindo-se uma interação sinergística.

  16. Myocardial Ischemia (United States)

    ... occurs when blood flow to the heart muscle (myocardium) is obstructed by a partial or complete blockage of a coronary artery by a buildup of plaques (atherosclerosis). If the plaques rupture, you can have a heart attack (myocardial infarction). Myocardial ischemia occurs when blood flow ...

  17. Acute occlusive mesenteric ischemia in high altitude of ...

    African Journals Online (AJOL)

    in 8 patients (38%) and venous thrombosis in 13 patients (62%). Diabetes mellitus was the most frequent risk factor ... Venous mesenteric thrombosis was more common than arterial mesenteric ischemia in our region. Keywords: Acute mesenteric ... perforated peptic ulcer or peritonitis. As intestinal ischemia progresses from ...

  18. Effects of Intestinal Ischaemia-Reperfusion Injury and Splenectomy ...

    African Journals Online (AJOL)

    Splenectomy has been proposed to alleviate mild and sustained ischemia reperfusion injury (IR). Intestinal ischaemia reperfusion injury (IIR) appears to have remote effects from the gastrointestinal tract. The effects of splenectomy on haematology and serum biochemical parameters in mild and sustained intestinal ischemia ...

  19. Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without ischemic preconditioning Alterações histopatológicas da parede intestinal de coelhos na isquemia-reperfusão com e sem precondicionamento isquêmico

    Directory of Open Access Journals (Sweden)

    Otoni Moreira Gomes


    Full Text Available PURPOSE: To evaluate the histopathology alterations of the intestinal mucosa of rabbits submitted to mesenteric artery ischemia and reperfusion with and without ischemic preconditioning. METHODS: Two groups of ten male New Zealand white rabbits body (weight 2.2-3.0, average 2.5 kg. For mesenteric ischemia induction in all animals the small bowel and mesentery were cut 30cm and 60cm far from the gastroduodenal pyloric transition before the proximal mesenteric artery occlusion. In the Group 1 animals, the proximal mesenteric artery was occluded for 45 min with an atraumatic vascular clamp, followed by reperfusion for 30 min. In the Group 2 the 45 min ischemic phase was preceded by three cycles of ischemia (2 minutes each alternated with three cycles of reperfusion (2 minutes each. For istopathology study small bowel biopsies were obtained before ischemia (control, after 45 min of mesenteric ischemia and at 30 min. of mesenteric artery reperfusion. RESULTS: In the Group I animals, the followings histopathology grade results were observed: t1, mean 2,8; t2, mean 3,3. Using the Kruskal-Wallis non-parameter test, differences between t0 and t1 and t0 and t2 were significants (p0.05. In the Group 2 animals histopathology grade results were: t1 mean 2,6 and t2, mean 2,1. Differences between t0 and t1, t0 and t2 were significant (p0.05 between results of t1 in both groups but histopathology injury observed in Group 1 t2 biopsies were higher (pOBJETIVO: Avaliar as alterações histopatológicas da mucosa intestinal de coelhos submetidos a isquemia-reperfusão com e sem precondicionamento isquêmicol. MÉTODOS: Foram estudados dois grupos de dez coelhos Nova Zelândia machos com pesos variáveis entre 2,2 e 3,0 kg (média de 2,5 kg de peso corpóreo. Para indução da isquemia, em todos os animais, o intestino delgado e o mesentério foram seccionados 30 cm e 60 cm após a transição pilórica gastroduodenal, antes da oclusão da artéria mesent

  20. [Acute mesenteric ischemia: do biomarkers contribute to diagnosis?]. (United States)

    Rosero, Olivér; Harsányi, László; Szijártó, Attila


    Acute mesenteric ischemia is an emergency condition that requires immediate therapy. Despite advances in the fields of surgery and intensive therapy, the mortality of this condition remains high. This is due to the broad variability of clinical presentations and non-specific laboratory findings, which delay the diagnosis allowing the ischemia to progress and further worsening the patients' chances of survival. Thus, there is a significant need for reliable and enhanced serological markers of intestinal ischemia. The authors review the traditionally used and novel experimental serological markers for early diagnosis of mesenteric ischemia.

  1. The influence of methylene blue on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats A influência do azul de metileno na cicatrização de anastomoses intestinais submetidas à isquemia e reperfusão em ratos

    Directory of Open Access Journals (Sweden)

    Eron Fabio Miranda


    Full Text Available PURPOSE: To investigate the influence of methylene blue, on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats. METHODS: Forty-five rats divided into the following three groups were used: control (G1; ischemia without methylene blue (G2; and ischemia with methylene blue (G3. A laparotomy was performed and the cranial mesenteric artery isolated. Whereas the cranial artery was temporarily occluded for 45 minutes in groups G2 and G3, prior to enterotomy and intestinal anastomosis, in group G1 the enterotomy and intestinal anastomosis were performed without prior lesion. Afterwards, 2mL of 0.5% methylene blue were instilled in the peritoneal cavities of the animals in group G3, and 2mL of isotonic saline solution in the peritoneal cavities of the animals in group G2. After the reperfusion, an enterectomy and intestinal anastomosis were performed. After the animals had been sacrificed on the seventh day after the operation, the abdominal cavity was examined by resection of a segment of the intestine containing the anastomosis in order to measure its strength and for histopathological examination. RESULTS: Free fluid or abscesses in the peritoneal cavity were rare. When inflammation was analyzed, the group subjected to ischemia without methylene blue had a higher score for mononuclear cells (p=0.021 and granulation tissue (p=0.044. No significant difference was observed in the density of type I or type III collagens. CONCLUSION: The methylene blue did not show beneficial effect on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats.OBJETIVO: Investigar a influência do azul de metileno, na cicatrização de anastomoses intestinais de ratos submetidas a isquemia e à reperfusão. MÉTODOS: Quarenta e cinco ratos foram divididos em três grupos: controle (G1; isquemia sem azul de metileno (G2 e isquemia com azul de metileno (G3. Foi feita uma laparotomia e a artéria mesentérica cranial

  2. Measurement of small intestinal damage. (United States)

    Takeuchi, Koji; Satoh, Hiroshi


    Many animal models have been devised for investigating the pathogenesis of intestinal lesions and for screening drugs for the treatment of intestinal ulcers in humans. Recently, particular attention has been focused on NSAID-induced intestinal lesions as a result of the development of the capsule endoscope and double-balloon endoscope. Ischemic enteritis, one of the most dramatic abdominal emergencies, is known to cause severe damage to the small intestine by a significant decrease of arterial blood flow in the small intestine. In this unit, two animal models for small intestinal damage induced by NSAIDs or intestinal ischemia are described. Also included are methods for lesion induction and evaluation of the damage as well as the measurement of pathogenic functional and biochemical changes.

  3. Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without exclusion of the collateral mesenteric circulation supply Alterações histopatológicas da parede intestinal de coelhos na isquemia-reperfusão com e sem exclusão da circulação mesentérica colateral

    Directory of Open Access Journals (Sweden)

    Otoni Moreira Gomes


    Full Text Available PURPOSE: To evaluate the histopathology alterations of the intestinal mucosa of rabbits submitted to different times of mesenteric artery ischemia and reperfusion with and without celiac artery collateral circulation supply. METHODS: Two groups of eight male New Zealand white rabbits (weight 2.2-3.5 kg were used in this study. In the Group 1 animals, the proximal mesenteric artery was occluded for 60 min with an atraumatic vascular clamp, followed by reperfusion for 60 min. In the Group 2 animals the small bowel and mesentery were cut 30cm and 60cm far from the gastroduodenal pyloric transition before the proximal mesenteric artery occlusion. Small bowel biopsies were obtained before ischemia (control, after 30 min and 60 min of mesenteric ischemia and at 30 and 60 min. of mesenteric artery reperfusion. RESULTS: In the Group I animals, the followings histopathology grade results were observed: t1, mean 0.4 + 0.29; t2, mean 1.9 ± 0.38; t3, 1.9 ± 0.33; t4, 1.2 ± 0.36 and t5, 1.2 ± 0.32. Differences between t0 and t2 and between t3 and t4 were statistically significant (p0.5. In the Group II animals, it was observed: t1, mean 1.6 ± 0.33; t2, 2.4 ± 0.36; t3, 3.0 ± 0.35; t4 3.4 ± 0.31; t5, 3 ± 031. Differences between t0 and t1, t1 and t2, and t2 and t3 were significant (pOBJETIVO: Avaliar as alterações histopatológicas da mucosa intestinal de coelhos submetidos à isquemia-reperfusão com e sem exclusão da circulação mesentérica colateral. MÉTODOS: Foram estudados dois grupos de oito coelhos Nova Zelândia machos com pesos variáveis entre 2,2 e 3,5 kg de peso corpóreo. Nos animais do Grupo 1, a artéria mesentérica proximal foi ocluida por pinçamento atraumático durante 60 min, seguido de reperfusão por 60 min. No Grupo 2 o intestino delgado e o mesentério foram seccionados 30 cm e 60 após a transição pilórica gastroduodenal antes da oclusão da artéria mesentérica cranial. Biópsias da parede intestinal foram obtidas

  4. Challenges in diagnosing mesenteric ischemia. (United States)

    van den Heijkant, Teun C; Aerts, Bart A C; Teijink, Joep A; Buurman, Wim A; Luyer, Misha D P


    Early identification of acute mesenteric ischemia (AMI) is challenging. The wide variability in clinical presentation challenges providers to make an early accurate diagnosis. Despite major diagnostic and treatment advances over the past decades, mortality remains high. Arterial embolus and superior mesenteric artery thrombosis are common causes of AMI. Non-occlusive causes are less common, but vasculitis may be important, especially in younger people. Because of the unclear clinical presentation and non-specific laboratory findings, low clinical suspicion may lead to loss of valuable time. During this diagnostic delay, progression of ischemia to transmural bowel infarction with peritonitis and septicemia may further worsen patient outcomes. Several diagnostic modalities are used to assess possible AMI. Multi-detector row computed tomographic angiography is the current gold standard. Although computed tomographic angiography leads to an accurate diagnosis in many cases, early detection is a persistent problem. Because early diagnosis is vital to commence treatment, new diagnostic strategies are needed. A non-invasive simple biochemical test would be ideal to increase clinical suspicion of AMI and would improve patient selection for radiographic evaluation. Thus, AMI could be diagnosed earlier with follow-up computed tomographic angiography or high spatial magnetic resonance imaging. Experimental in vitro and in vivo studies show promise for alpha glutathione S transferase and intestinal fatty acid binding protein as markers for AMI. Future research must confirm the clinical utility of these biochemical markers in the diagnosis of mesenteric ischemia.

  5. Mesenteric artery ischemia (United States)

    ... this page: // Mesenteric artery ischemia To use the sharing features on this page, ... be removed. Outlook (Prognosis) The outlook for chronic mesenteric ischemia is good after a successful surgery. However, it ...

  6. Pterostilbene Prevents Intestinal Ischemia Reperfusion Injury in ...

    African Journals Online (AJOL)

    50 % inhibition of NBT reduction. The SOD activity is expressed as U/ mg of protein. Catalase (CAT) activity. The activity was determined according to the method described by Aebi [14]. The reaction mixture contained sample in 30 mM H2O2 in a 50. mM phosphate buffer pH 7.0. The activity was estimated by decreased in ...

  7. Urticarial Vasculitis-Associated Intestinal Ischemia

    National Research Council Canada - National Science Library

    Wong, Uni; Yfantis, Harris; Xie, Guofeng


    Urticarial vasculitis (UV) is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome...

  8. Modulation of Intestinal Microbiome Prevents Intestinal Ischemic Injury (United States)

    Bertacco, Alessandra; Dehner, Carina A.; Caturegli, Giorgio; D'Amico, Francesco; Morotti, Raffaella; Rodriguez, Manuel I.; Mulligan, David C.; Kriegel, Martin A.; Geibel, John P.


    Background: Butyrate protects against ischemic injury to the small intestine by reducing inflammation and maintaining the structure of the intestinal barrier, but is expensive, short-lived, and cannot be administered easily due to its odor. Lactate, both economical and more palatable, can be converted into butyrate by the intestinal microbiome. This study aimed to assess in a rat model whether lactate perfusion can also protect against intestinal ischemia. Materials and Methods: Rat intestinal segments were loaded in an in vitro bowel perfusion device, and water absorption or secretion was assessed based on fluorescence of FITC-inulin, a fluorescent marker bound to a biologically inert sugar. Change in FITC concentration was used as a measure of ischemic injury, given the tendency of ischemic cells to retain water. Hematoxylin and eosin-stained sections at light level microscopy were examined to evaluate intestinal epithelium morphology. Comparisons between the data sets were paired Student t-tests or ANOVA with p < 0.05 performed on GraphPad. Results: Lactate administration resulted in a protective effect against intestinal ischemia of similar magnitude to that observed with butyrate. Both exhibited approximately 1.5 times the secretion exhibited by control sections (p = 0.03). Perfusion with lactate and methoxyacetate, a specific inhibitor of lactate-butyrate conversion, abolished this effect (p = 0.09). Antibiotic treatment also eliminated this effect, rendering lactate-perfused sections similar to control sections (p = 0.72). Perfusion with butyrate and methoxyacetate did not eliminate the observed increased secretion, which indicates that ischemic protection was mediated by microbial conversion of lactate to butyrate (p = 0.71). Conclusions: Lactate's protective effect against intestinal ischemia due to microbial conversion to butyrate suggests possible applications in the transplant setting for reducing ischemic injury and ameliorating intestinal preservation

  9. I-FABP as biomarker for the early diagnosis of acute mesenteric ischemia and resultant lung injury.

    Directory of Open Access Journals (Sweden)

    Rachel G Khadaroo

    Full Text Available Acute mesenteric ischemia (AMI is a life-threatening condition that can result in multiple organ injury and death. A timely diagnosis and treatment would have a significant impact on the morbidity and mortality in high-risk patient population. The purpose of this study was to investigate if intestinal fatty acid binding protein (I-FABP and α-defensins can be used as biomarkers for early AMI and resultant lung injury. C57BL/6 mice were subjected to intestinal ischemia by occlusion of the superior mesenteric artery. A time course of intestinal ischemia from 0.5 to 3 h was performed and followed by reperfusion for 2 h. Additional mice were treated with N-acetyl-cysteine (NAC at 300 mg/kg given intraperitoneally prior to reperfusion. AMI resulted in severe intestinal injury characterized by neutrophil infiltrate, myeloperoxidase (MPO levels, cytokine/chemokine levels, and tissue histopathology. Pathologic signs of ischemia were evident at 1 h, and by 3 h of ischemia, the full thickness of the intestine mucosa had areas of coagulative necrosis. It was noted that the levels of α-defensins in intestinal tissue peaked at 1 h and I-FABP in plasma peaked at 3 h after AMI. Intestinal ischemia also resulted in lung injury in a time-dependent manner. Pretreatment with NAC decreased the levels of intestinal α-defensins and plasma I-FABP, as well as lung MPO and cytokines. In summary, the concentrations of intestinal α-defensins and plasma I-FABP predicted intestinal ischemia prior to pathological evidence of ischemia and I-FABP directly correlated with resultant lung injury. The antioxidant NAC reduced intestinal and lung injury induced by AMI, suggesting a role for oxidants in the mechanism for distant organ injury. I-FABP and α-defensins are promising biomarkers, and may guide the treatment with antioxidant in early intestinal and distal organ injury.

  10. I-FABP as Biomarker for the Early Diagnosis of Acute Mesenteric Ischemia and Resultant Lung Injury (United States)

    Khadaroo, Rachel G.; Fortis, Spyridon; Salim, Saad Y.; Streutker, Catherine; Churchill, Thomas A.; Zhang, Haibo


    Acute mesenteric ischemia (AMI) is a life-threatening condition that can result in multiple organ injury and death. A timely diagnosis and treatment would have a significant impact on the morbidity and mortality in high-risk patient population. The purpose of this study was to investigate if intestinal fatty acid binding protein (I-FABP) and α-defensins can be used as biomarkers for early AMI and resultant lung injury. C57BL/6 mice were subjected to intestinal ischemia by occlusion of the superior mesenteric artery. A time course of intestinal ischemia from 0.5 to 3 h was performed and followed by reperfusion for 2 h. Additional mice were treated with N-acetyl-cysteine (NAC) at 300 mg/kg given intraperitoneally prior to reperfusion. AMI resulted in severe intestinal injury characterized by neutrophil infiltrate, myeloperoxidase (MPO) levels, cytokine/chemokine levels, and tissue histopathology. Pathologic signs of ischemia were evident at 1 h, and by 3 h of ischemia, the full thickness of the intestine mucosa had areas of coagulative necrosis. It was noted that the levels of α-defensins in intestinal tissue peaked at 1 h and I-FABP in plasma peaked at 3 h after AMI. Intestinal ischemia also resulted in lung injury in a time-dependent manner. Pretreatment with NAC decreased the levels of intestinal α-defensins and plasma I-FABP, as well as lung MPO and cytokines. In summary, the concentrations of intestinal α-defensins and plasma I-FABP predicted intestinal ischemia prior to pathological evidence of ischemia and I-FABP directly correlated with resultant lung injury. The antioxidant NAC reduced intestinal and lung injury induced by AMI, suggesting a role for oxidants in the mechanism for distant organ injury. I-FABP and α-defensins are promising biomarkers, and may guide the treatment with antioxidant in early intestinal and distal organ injury. PMID:25541714

  11. Mesenteric ischemia in acute aortic dissection. (United States)

    Orihashi, Kazumasa


    Mesenteric ischemia complicated by acute aortic dissection (AAD) is uncommon, but serious, as there is no established treatment strategy and it can progress rapidly to multi-organ failure. Diagnosing mesenteric ischemia before necrotic change is difficult, not only for primary care physicians, but even for gastrointestinal or cardiovascular surgeons as it can occur at any time during surgery. Thus, measures need to be in place at the bedside to enable us to obtain information on visceral perfusion. It is often difficult to decide which of laparotomy or aortic repair should be performed first, especially when there is associated shock or malperfusion of other vital organs. The standard surgical procedures for mesenteric ischemia are prompt revascularization of the mesenteric artery and, if needed, resection of necrotic intestine. However, the development of endovascular treatment and the introduction of hybrid ORs have improved the treatment strategies for mesenteric ischemia. This article reviews the issues of "diagnosis" in relation to the mechanism of mesenteric ischemia, and discusses the current "treatment strategies".

  12. Haptoglobin descreases in equine serum after induced colon ischemia and reperfusion

    DEFF Research Database (Denmark)

    Pihl, Tina Holberg; Grosche, Astrid; Freeman, David

    of information regarding this during early phases of intestinal vascular compromise and inflammation. The aim of this study was to evaluate serum concentrations of SAA and haptoglobin in response to experimentally induced ischemia and reperfusion of the equine colon. Colon ischemia (1hour) and reperfusion (4...

  13. Prognostic factors in patients with acute mesenteric ischemia. (United States)

    Yıldırım, Doğan; Hut, Adnan; Tatar, Cihad; Dönmez, Turgut; Akıncı, Muzaffer; Toptaş, Mehmet


    Acute mesenteric ischemia, one of the causes of acute abdominal pain due to occlusion of the superior mesenteric artery, has a fatal course as a result of intestinal necrosis. There is no specific laboratory test to diagnose acute mesenteric ischemia. The basis of treatment in cases of acute mesenteric ischemia is composed of early diagnosis, resection of intestinal sections with infarction, regulation of intestinal blood flow, second look laparotomy when required, and intensive care support. The aim of this study is to investigate the factors affecting mortality in patients treated and followed-up with a diagnosis of acute mesenteric ischemia. Forty-six patients treated and followed-up with a diagnosis of acute mesenteric ischemia between January 1 st , 2008 and December 31 st , 2014 at the General Surgery Clinic of our hospitalwere retrospectively evaluated. The patients were grouped as survivor (Group 1) and dead (Group 2). Age, gender, accompanying disorders, clinical, laboratory and radiologic findings, duration until laparotomy, evaluation according to the Mannheim Peritonitis Index postoperative complications, surgical treatment applied, and type of ischemia and outcome following surgery were recorded. A total of 46 patients composed of 22 males and 24 females with a mean age of 67.5±17.9 and with a diagnosis of mesenteric ischemia were included in the study. Twenty-seven patients died (58.7%) while 19 survived (41.3%). The mean MPI score was 16.8±4.7 and 25.0±6 in Group 1 and Group 2, respectively, and the difference between the two groups was statistically significant (pmesenteric ischemia. Prevention of complications with critical intensive care during the postoperative period aids in decreasingthe mortality rate. In addition, using the Mannheim Peritonitis Index can be helpful.

  14. Oxidative stress gene expression profile in inbred mouse after ischemia/reperfusion small bowel injury Perfil da expressão gênica do estresse oxidativo em camundongos isogênicos após lesão de isquemia e reperfusão intestinal

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Bertoletto


    Full Text Available PURPOSE: To determine the profile of gene expressions associated with oxidative stress and thereby contribute to establish parameters about the role of enzyme clusters related to the ischemia/reperfusion intestinal injury. METHODS: Twelve male inbred mice (C57BL/6 were randomly assigned: Control Group (CG submitted to anesthesia, laparotomy and observed by 120min; Ischemia/reperfusion Group (IRG submitted to anesthesia, laparotomy, 60min of small bowel ischemia and 60min of reperfusion. A pool of six samples was submitted to the qPCR-RT protocol (six clusters for mouse oxidative stress and antioxidant defense pathways. RESULTS: On the 84 genes investigated, 64 (76.2% had statistic significant expression and 20 (23.8% showed no statistical difference to the control group. From these 64 significantly expressed genes, 60 (93.7% were up-regulated and 04 (6.3% were down-regulated. From the group with no statistical significantly expression, 12 genes were up-regulated and 8 genes were down-regulated. Surprisingly, 37 (44.04% showed a higher than threefold up-regulation and then arbitrarily the values was considered as a very significant. Thus, 37 genes (44.04% were expressed very significantly up-regulated. The remained 47 (55.9% genes were up-regulated less than three folds (35 genes - 41.6% or down-regulated less than three folds (12 genes - 14.3%. CONCLUSION: The intestinal ischemia and reperfusion promote a global hyper-expression profile of six different clusters genes related to antioxidant defense and oxidative stress.OBJETIVO: Determinar o perfil de expressão dos genes associados com estresse oxidativo e contribuir para estabelecer parâmetros sobre o papel das familias de enzimas relacionadas com a lesão de isquemia / reperfusão intestinal. MÉTODOS: Doze camundongos machos isogênicos (C57BL/6 foram distribuídos aleatoriamente: Grupo Controle (CG submetido à laparotomia anestesia, e observado por 120min; Grupo isquemia/reperfusão (IRG

  15. A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia

    Directory of Open Access Journals (Sweden)

    Rıdvan Çakmaz


    Full Text Available Introduction: There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI. The aim of this study was to measure the plasma levels of diamine oxidase (DAO and citrulline in AMI to gain insight into its early diagnosis. Material and methods: A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. Results: Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p=0.011 and p=0.021, respectively. Intestinal damage was shown to develop more in the prolonged ischemia group (p=0.001. Conclusion: In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.

  16. Acute mesenteric ischemia after heart surgery. (United States)

    Goleanu, V; Alecu, L; Lazar, O


    Acute mesenteric ischemia (AMI) is a rare but very severe complication of heart surgery, due especially to the delay in setting the correct diagnosis and choosing the appropriate treatment. There are 4 types, but the most frequent is nonocclusive mesenteric ischemia (NOMI). The main mechanism is represented by great decrease or maldistribution of the splenic blood flow, with negative impact on the integrity of the intestinal mucosa, bacterial translocation and multiorganic failure. We present a retrospective study conducted on patients who underwent open heart surgery with cardiopulmonary bypass with non-pulsatile flow. 4 cases of angiographically confirmed NOMI (non-occlusive mesenteric ischemia) were identified. When, based on clinical examination and laboratory findings, acute mesenteric ischemia was suspicioned, superior mesenteric artery angiography was performed via the femoral artery. The main risk factors were represented by: age over 70 years old, left ventricle ejection fraction (LVEF) 35%,aortic clamping time 100 min., chronic kidney failure,counter-pulsation balloon implant, inotropic medication use,like levosimendan, use of blood components 1 unit of erythrocyte mass. Clinical signs were nonspecific. All patients presented hypoventilation, arterial hypotension, oliguria and,from a biological standpoint, metabolic acidosis and leucocytosis. Superior mesenteric artery angiography was the investigation method of choice. Treatment approach was initially medical, followed by resection of the intestine.Mortality was 100%. Acute mesenteric ischemia is a rare but very severe complication in cardiac surgery. It is primordial that the main risk factors be known, and in case of diagnosis suspicion, that it be set as early as possible, along with immediate initiation of an appropriate course of treatment. Celsius.

  17. The Temporary Leave Dilemma -

    DEFF Research Database (Denmark)

    Amilon, Anna


    Lone mothers have to take care of a sick child with little or no help from the child’s other parent and have to carry all costs connected to leave-taking. This paper empirically tests whether lone mothers take more temporary parental leave to care for sick children than partnered mothers...... and whether parental leave is associated with a signaling cost. The results from this study of Swedish mothers show that lone mothers use more temporary parental leave than partnered mothers. Further, within the group of lone mothers, those with higher socioeconomic status take less temporary parental leave...... than those with lower socioeconomic status, whereas no such differences are found within the group of partnered mothers. One possible interpretation is that signaling costs negatively influence the utilization of temporary parental leave for lone mothers....

  18. Temporary internal pacing. (United States)

    Ortiz Díaz-Miguel, R; Gómez Grande, M L


    Technology and insertion techniques for cardiac temporary internal pacing have experienced a remarkable development over the last few years. Despite this fact, the procedure continues to have potentially fatal associated complications. Temporary internal pacing is indicated for the treatment of bradyarrhythmias or tachyarrhythmias refractory to conventional treatment, or arrhythmias causing cardiovascular or clinical instability of the patient. On the other hand, the indications of temporary cardiac pacing are far less well defined than those of permanent pacing. Since the decision of implementing temporary pacing is complex and delicate, it should always be carefully considered, and over-indication should be avoided. We must base these decisions on robust knowledge of the arrhythmias that may benefit from temporary internal pacing, and should also acquire the habit of considering external temporary pacing among other less aggressive treatments, and to make the best use of new technologies such as echocardiography that add accuracy to the procedure. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  19. Intestinal Cancer (United States)

    ... connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet ... increase your risk. Possible signs of small intestine cancer include Abdominal pain Weight loss for no reason ...

  20. Postconditioning: "Toll-erating" mesenteric ischemia-reperfusion injury? (United States)

    Rosero, Olivér; Ónody, Péter; Kovács, Tibor; Molnár, Dávid; Fülöp, András; Lotz, Gábor; Harsányi, László; Szijártó, Attila


    Postconditioning may prove to be a suitable method to decrease ischemia-reperfusion injury of intestine after mesenteric arterial occlusion. Toll-like-receptor-4 is involved in the pathophysiology of organ damage after ischemia-reperfusion; therefore, the aim of our study was to investigate the effect of postconditioning on the mucosal expression of toll-like-receptor-4. Male Wistar rats (n = 10/group) underwent 60 minutes of superior mesenteric artery occlusion followed by 6 hours of reperfusion in 3 groups: sham-operated, ischemia-reperfusion, and a postconditioned group. Postconditioning was performed by 6 alternating cycles of 10 seconds of reperfusion/reocclusion. Blood and tissue samples were collected at the end of reperfusion. Intestinal histopathologic changes and immunohistochemical expression of mucosal caspase-3, antioxidant status, and protein levels of high-mobility group box-1 and toll-like-receptor-4 were assessed. Immunofluorescent labeling and confocal microscopic analysis of toll-like-receptor-4 were performed. Mucosal and serum levels of interleukin-6 and tumor necrosis factor-α protein were measured. Histologic alterations in the postconditioned group were associated with decreased caspase-3 positivity, less toll-like-receptor-4 mRNA, and less protein expression of high-mobility group box-1 and toll-like-receptor-4 in the intestinal villi compared with the ischemia-reperfusion group. Furthermore, a significantly improved antioxidant state of the intestinal mucosa and less mucosal and serum protein levels of interleukin-6 and tumor necrosis factor-α were detected in the postconditioned group. Small intestinal ischemia-reperfusion injury in male Wistar rats caused by the occlusion of the superior mesenteric artery was ameliorated by the use of postconditioning, showing a more favorable inflammatory response, which may be attributed to the decreased mucosal expression of toll-like-receptor-4. Copyright © 2016 Elsevier Inc. All rights

  1. Intestinal intraluminal injection of glutamine increases trolox total equivalent antioxidant capacity (TEAC in hepatic ischemia-reperfusion Injeção na luz intestinal de glutamina aumenta a capacidade anti-oxidante total em equivalência ao trolox (TEAC na isquemia-reperfusão hepática

    Directory of Open Access Journals (Sweden)

    Alberto Bicudo Salomão


    Full Text Available PURPOSE: To evaluate the effects of intraluminal injection of glutamine on the serum trolox equivalent antioxidant capacity in an experimental model of ischemia-reperfusion of the liver observing the applicability of modifications on the original assay method. METHODS: Thirty Wistar rats underwent laparotomy to perform a 20 cm blind sac of small bowel and occlusion of the hepatic hilo for 30 minutes and reperfusion for 5 minutes. Into the gut sac it was injected glutamine (glutamine group, n=10 or distilled water (control group, n=10. Ten other animals (sham group underwent laparotomy without artery occlusion. Blood samples were collected for trolox equivalent antioxidant capacity assays in different temperature conditions, reagent quantities and time for spectrophotometer readings. RESULTS: Total antioxidant capacity was significantly greater in glutamine group than in both control group (1,60[1,55-1,77] vs 1,44[1,27-1,53] and sham group (1,60[1,55-1,77] vs 1,48[1,45-1,59]. CONCLUSION: Glutamine enhanced serum antioxidant capacity. The assay technique consistently reflected the changes in the antioxidant defenses in this experimental model.OBJETIVO: Avaliar em um modelo experimental de isquemia-reperfusão hepática os efeitos da injeção intraluminal de glutamina na capacidade anti-oxidante total em equivalência ao trolox (TEAC do plasma, verificando a aplicabilidade de modificações ao método original de dosagem. MÉTODOS: Trinta ratos Wistar foram submetidos a laparotomia e confecção de uma alça fechada de 20 cm de comprimento envolvendo o intestinal delgado distal seguido do clampeamento do hilo hepático por 30 minutos e reperfusão por 5 minutos. Na alça fechada foi injetada glutamina (grupo glutamina; n=10 ou água destilada (grupo controle; n=10. Em dez animais (grupo sham não foi realizado clampeamento hilar. Coletou-se sangue para dosagem da capacidade antioxidante total em equivalência ao trolox em condições modificadas

  2. Temporary labour contracts

    CERN Document Server


    The five contracts for Temporary Labour assignments on the CERN site (L020/PE, L021/PE, L022/PE, L023/PE and L024/PE) approved by the Finance Committee in March 1996 (CERN/FC/3857) will reach the end of their initial three-year contractual period at the end of December 1999. Following the satisfactory execution of these contracts during this period, CERN requests approval to extend them from January 2000 for the first of the two years foreseen in the original adjudication. The Finance Committee is invited: - to take note that the three-year expenditure for Temporary Labour contracts from 1997 to 1999 will not exceed 19 100 000 Swiss francs, compared to the 18 900 000 Swiss francs estimated at the time of the adjudication in March 1996; - to approve an extension of the present Temporary Labour contracts for the year 2000 for a total amount not exceeding 6 000 000 Swiss francs.

  3. Cocaine-associated lower limb ischemia.

    LENUS (Irish Health Repository)

    Collins, Chris G


    Cocaine-associated thrombosis has been reported in the literature with reports of vascular injuries to cardiac, pulmonary, intestinal, placental, and musculoskeletal vessels; however, injury of the pedal vessels is rare. We report on a 31-year-old man who presented 2 months following a cocaine binge with limb-threatening ischemia without an otherwise identifiable embolic source. Angiography confirmed extensive occlusive disease of the tibioperoneal vessels. The patient improved following therapy with heparin and a prostacyclin analogue. Cocaine-induced thrombosis should be considered in patients presenting with acute arterial insufficiency in the lower limb without any other identifiable cause.

  4. Interpretation of Abdominal CT Findings in Patients Who Develop Acute on Chronic Mesenteric Ischemia. (United States)

    Kärkkäinen, Jussi M; Saari, Petri; Kettunen, Hannu-Pekka; Lehtimäki, Tiina T; Vanninen, Ritva; Paajanen, Hannu; Manninen, Hannu


    We studied whether ischemia-specific computed tomography (CT) findings are consistently detectable in patients who develop acute on chronic mesenteric ischemia (AOCMI), whereas absent in chronic mesenteric ischemia (CMI). Consecutive patients with symptomatic angiography-verified atherosclerotic obstruction of the superior mesenteric artery (SMA) were categorized as AOCMI (n = 27) or CMI (n = 20). Three experienced radiologists blindly evaluated the contrast-enhanced CTs for vascular and intestinal findings. Kappa statistics was used to test interobserver agreement. Two observers had substantial agreement (k = 0.66) that two thirds of AOCMI patients showed ischemia-specific CT findings (decreased bowel wall enhancement, pneumatosis, or thrombotic SMA clot); the third observer agreed only fairly regarding pneumatosis and thrombosis (k = 0.3-0.4). All observers had substantial agreement (k = 0.65-0.71) that most patients with AOCMI had unspecific intestinal findings such as mesenteric fat stranding in up to 96%, bowel lumen dilatation in 93%, and bowel wall thickening in 70%, while only few patients with CMI had such findings (due to chronic ischemic colitis) (P ischemia-specific CT signs. However, any intestinal abnormality in CT together with SMA obstruction should raise suspicion of intestinal ischemia. Furthermore, clinicians need to be aware of the interobserver variability in the CT interpretation.

  5. Ischemic Postconditioning Assessment in the Liver of Rats Undergoing Mesenteric Ischemia and Reperfusion. (United States)

    dos Santos, Carlos Henrique Marques; Aydos, Ricardo Dutra; Nogueira, Ed; Miiji, Luciana Nakao Odashiro; Cassino, Pedro Carvalho; Alves, Isadora Ishaq; Calheiros, Nádia Meneguesso; Garcia, Milena


    Ischemic postconditioning is a method that shows evidence of efficacy in minimizing reperfusion injury; however, its effectiveness in preventing injuries in distant organs is still unknown, especially in those who have undergone mesenteric ischemia and reperfusion. To evaluate the effect of ischemic postconditioning in preventing reperfusion injury in the liver of rats submitted to mesenteric ischemia and reperfusion, comparing two different methods of ischemic postconditioning. 30 Wistar male rats were used, distributed into three groups: Group A: Ten rats submitted to intestinal ischemia for 30 minutes followed by reperfusion for 60 minutes; Group B: Ten rats subjected to ischemia and reperfusion; after ischemia, two cycles of reperfusion (two minutes each) interleaved with two cycles of ischemia (two minutes each); and Group C: Ten rats subjected to ischemia and reperfusion; after ischemia, four cycles of reperfusion (30 seconds each) interspersed with four cycles of ischemia (30 seconds each). After the experiment, the left lobe of the liver was resected for subsequent histological analysis, using the following classification: grade 1 - centrilobular congestion; grade 2 - centrilobular congestion with some degeneration of hepatocytes in one or two central veins; and grade 3 - multifocal centrilobular congestion and degeneration of portal hepatocytes. The mean degree of liver damage found was 1.8 in group A, 1.7 in group B and 1.3 in group C. There was no statistically significant difference between the groups. Ischemic postconditioning was unable to minimize reperfusion injury in rats undergoing mesenteric ischemia and reperfusion.

  6. MRI of renal oxygenation and function after normothermic ischemia-reperfusion injury

    NARCIS (Netherlands)

    Oostendorp, M. van; Vries, E.E. de; Slenter, J.M.; Peutz-Kootstra, C.J.; Snoeijs, M.G.; Post, M.J.; Heurn, L.W. van; Backes, W.H.


    The in vivo assessment of renal damage after ischemia-reperfusion injury, such as in sepsis, hypovolemic shock or after transplantation, is a major challenge. This injury often results in temporary or permanent nonfunction. In order to improve the clinical outcome of the kidneys, novel therapies are

  7. Use of Fluorescein Isothiocyanate-Inulin as a Marker for Intestinal Ischemic Injury. (United States)

    AlKukhun, Abedalrazaq; Caturegli, Giorgio; Munoz-Abraham, Armando Salim; Judeeba, Sami; Patron-Lozano, Roger; Morotti, Raffaella; Rodriguez-Davalos, Manuel I; Geibel, John P


    Intestinal ischemia is observed in conditions such as mesenteric ischemia, or during traumatic events such as intestinal transplantation. Intestinal ischemia leads to pathophysiologic disruptions that present as increased fluid secretion into the intestinal lumen. We propose a novel method to detect real-time ischemic injury that is used in an in vitro model applicable to intestinal transplantation. Small intestine segments from rats were procured. The segments were attached to customized perfusion chambers. Both intestines were perfused on the vascular side with a Ringer buffer solution. The experimental buffer solution was bubbled with 100% nitrogen to mimic ischemia. Both lumens were perfused with 3 mL HEPES-Ringer solution containing 50 μM fluorescein isothiocyanate (FITC)-inulin. Intraluminal samples were collected at 15-minute intervals to measure FITC-inulin concentration using a nanofluorospectrophotometer. Intestinal tissue samples were processed and evaluated by a blinded pathologist using the Park/Chiu scoring system for grading intestinal ischemia. Samples collected from the ischemic intestine showed a significant decrease in FITC-inulin fluorescence compared with the control intestine, indicating enhanced fluid secretion. Histopathologic samples from the experimental arm exhibited higher scores of ischemic injury in comparison with the control arm, confirming the FITC-inulin as a correlation to ischemia. Fluorescein isothiocyanate-inulin can be used as a real-time volume marker to monitor the ischemic state of intestinal tissue. A positive correlation between the degree of fluid shift and presence of ischemic injury. The changes in fluorescence signal provide a potential selective method to measure real-time fluid changes inside an intestinal graft to evaluate viability. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Essays on temporary migration


    Mestres Domenech, J.


    My thesis dissertation focuses on the temporariness of migration, its diverse effects as well as on migration selection. The first paper, A Dynamic Model of Return Migration analyzes the decision process underlying return migration using a dynamic model. We explain how migrants decide whether to stay or to go back to their home country together with their savings and consumption decisions. We simulate our model with return intentions and perform policy simulations. The se...

  9. Autophagy in brain ischemia

    Directory of Open Access Journals (Sweden)

    Alicja Kost


    Full Text Available Autophagy is an intracellular process of macromolecule and organelle degradation, which plays an important role both in maintaining homeostasis and in responding to various harmful stimuli. Recent studies clearly indicate upregulation of autophagy in neurons challenged with brain ischemia. In this paper we present biosynthesis of autophagosomes as well as the role and molecular mechanisms of basal and induced neuronal autophagy. We have also reviewed recently published papers concerning the potential role of autophagy in brain ischemia. Results of both in vivo and in vitro experimental studies indicate that signaling pathways related to autophagy might become a target of new neuroprotective strategies.

  10. Mesenteric ischemia: the importance of differential diagnosis for the surgeon (United States)


    Background Intestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies. Methods Basing on our institutions experience, 163 cases of mesenteric ischemia/infarction from various cases, investigated with CT and undergone surgical treatment were retrospectively evaluated, in particular trought the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen). Results To make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial, venous) and non occlusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text. Conclusion The radiological findings of mesenteric ischemia have different course in case of different etiology. In venous etiology the progression of damage results faster than arterial even if the symptomatology is less acute; bowel wall thickening is an early finding and easy to detect, simplifying the diagnosis. In arterial etiology the damage progression is slower than in venous ischemia, bowel wall thinning is typical but difficult to recognize so diagnosis may be hard. In the NOMI before/without reperfusion the ischemic damage is similar to AAMI with additional involvement of large bowel

  11. A temporary face support

    Energy Technology Data Exchange (ETDEWEB)

    Popov, V.I.; Bakhtin, V.N.; Tolkachev, N.I.


    A temporary face support is proposed. It includes a beam supported by hydraulic jacks on the housing of the cutter-loader with a working tool and rotary pressure regulator. It differs in that to decrease the volume of unsecured roofing in the face space between the leading edge of the beam and the cutting tool of the cutter-loader, the beam is hinged onto the housing of the rotary pressure regulator by a fastened connecting rod, and the hydraulic jacks are provided with additional powered elements with a mechanism that regulates the length of the cut-off plate of the hydraulic pump when the seam pressure changes.

  12. Effect of glutamine on the mRNA level of key enzymes of malate-aspartate shuttle in the rat intestine subjected to ischemia reperfusion Efeito da glutamina sobre o nível de RNA Mensageiro das enzimas-chave do ciclo malato-aspartato no intestino de ratos submetidos à isquemia e reperfusão

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Cavalcante de Vasconcelos


    Full Text Available PURPOSE: To determine the effects of oral L-glutamine (L-Gln and the dipeptide l-alanyl-glutamine (L-Ala-Gln upon the activity of the malate-aspartate shuttle in the rat distal small intestine following ischemia and reperfusion. METHODS: Seventy-two Wistar rats (350-400g, were randomized in 2 groups (n = 36: group S (Sham and Group T (Treatment and divided into 12 subgroups (n = 6: A-A6, and B1-B6. The subgroups A1-A3 were subjected to sham procedures at 30 and 60 minutes. Thirty minutes before the study, rats were treated with calcium caseinate, 0.5g/Kg (subgroups A1, A4, B1, B4, L-Gln, 0.5g / kg (subgroups A2, A5, B2 and B5 or L-Ala-Gln, 0.75g/Kg (subgroups A3, A6, B3, B6, administered by gavage. Ischemia was achieved by clamping the mesenteric vessels, delimiting a segment of bowel 5 cm long and 5 cm apart from the ileocecal valve. Samples were collected 30 and 60 minutes after start of the study for real-time PCR assay of malate dehydrogenases (MDH1-2 and aspartate-aminotransferases (GOT1-2 enzymes. RESULTS: Tissue MDH and GOT mRNA expression in intestinal samples from rats preconditioned with either L-Gln or L-Ala-Gln showed no significant differences both during ischemia and early reperfusion. CONCLUSION: Activation of the malate-aspartate shuttle system appears not to be the mechanism of glutamine-mediated elevation of glucose oxidation in rat intestine during ischemia/reperfusion injury.OBJETIVO: Determinar os efeitos da administração oral de L-glutamina (L-Gln e do dipeptídeo L-alanil-glutamina (L-Ala-Gln sobre a atividade do ciclo malato-aspartato no intestino delgado distal de ratos após isquemia/reperfusão. MÉTODOS: Setenta e dois ratos Wistar (350-400g foram randomizados em 2 grupos (n = 36: T grupo S (Sham e grupo (Tratamento e distribuídos em 12 subgrupos (n = 6: A-A6, e B1-B6. Os subgrupos A1-A3 foram submetidos a procedimentos "sham" aos 30 e 60 minutos. Trinta minutos antes do estudo, os ratos foram tratados com

  13. Subendocardial ischemia in hypertrophic cardiomyopathy. (United States)

    Kawasaki, Tatsuya; Sugihara, Hiroki


    Hypertrophic cardiomyopathy (HCM) patients often develop subendocardial ischemia in the left ventricle without atherosclerotic coronary stenosis. Myocardial ischemia plays an important role in the pathophysiology of HCM, but diagnostic techniques for the detection of subendocardial ischemia have not been widely available. We developed specific techniques to quantify subendocardial ischemia on stress scintigraphy, and have compared the results with various clinical features in patients with HCM. This article reviews our understanding of subendocardial ischemia in HCM based on more than 20 years of experience. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  14. Migraine and ischemia

    NARCIS (Netherlands)

    van der Wammes-van der Heijden, E.A.


    An association between migraine and ischemic events, especially ischemic stroke, has been debated for many years. Whether migraine is a risk factor for ischemic events or ischemia triggers migraine, or both, is still unclear. This thesis explores different relationships between migraine and

  15. Intestinal Surgery. (United States)

    Desrochers, André; Anderson, David E


    A wide variety of disorders affecting the intestinal tract in cattle may require surgery. Among those disorders the more common are: intestinal volvulus, jejunal hemorrhage syndrome and more recently the duodenal sigmoid flexure volvulus. Although general principles of intestinal surgery can be applied, cattle has anatomical and behavior particularities that must be known before invading the abdomen. This article focuses on surgical techniques used to optimize outcomes and discusses specific disorders of small intestine. Diagnoses and surgical techniques presented can be applied in field conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas


    brain damage. Finally, the effect on infarct volume one week after MCAO of treatment with Pinokalant, a new broad-spectrum cation channel blocker, was examined in the seventh study. The results of these studies are presented and discussed in relation to the current knowledge of the pathogenetic...... recruitment of penumbra to infarct resulting in mitigation of the final ischemic brain damage. The pathogenetic mechanisms involved in ischemic cell death in the penumbra encompass excitotoxic mechanisms mediated by activation of ionotropic glutamate receptors, loss of cellular calcium homeostasis...... are irreversibly damaged after only 15-30 minutes of ischemia. In contrast, cells in the penumbra may – although threatened and functionally impaired – remain viable for several hours following arterial occlusion but will eventually also succumb if ischemia persists. In this way the initially viable tissue...

  17. Lactobacillus plantarum prevents bacterial translocation in rats following ischemia and reperfusion injury. (United States)

    Wang, Bin; Huang, Qian; Zhang, Wei; Li, Ning; Li, Jieshou


    Bacterial translocation is considered a major cause of initiation and development of systemic sepsis and multiple organ dysfunction in clinic. The aim of this study was to determine the ability of a defined Lactobacillus plantarum to prevent ischemia/reperfusion (I/R) induced intestinal infection. Female Sprague-Dawley rats were randomly allocated into three groups: (1) controls (sham-operated, no treatment), (2) ischemia/reperfusion and (3) ischemia/reperfusion and Lactobacillus plantarum treatment. Lactobacillus plantarum L2 was administered daily intragastrically 14 days prior to induction of I/R. Rats were then sacrificed, and tissue and blood samples were cultured to determine bacterial translocation. Cytokines in plasma were detected by ELISA. Ileal segments were removed for morphological examination. Intestinal I/R induced excess pro-inflammatory cytokine secretion and barrier dysfunction (increased epithelial cell apoptosis, cecal flora dysbiosis, disruption of mucosa and multiple erosions) in the intestine, associated with increased bacterial translocation to extraintestinal sites. Approximately 87.5% of rats exposed to I/R had bacterial translocation while there was no bacterial translocation in controls. However, pretreatment of animals with Lactobacillus plantarum completely prevented I/R induced bacterial translocation, reduced pro-inflammatory cytokine release, and intestinal epithelial cell apoptosis, resulting in recovered microflora and mucosal integrity. These findings indicate that Lactobacillus plantarum L2 can prevent I/R-induced bacterial translocation and intestinal barrier dysfunction and, thereby, exert beneficial effects in the intestinal tract.

  18. Temporal profile of intestinal tissue expression of intestinal fatty acid-binding protein in a rat model of necrotizing enterocolitis

    Directory of Open Access Journals (Sweden)

    Ana Leda Bertoncini Simões

    Full Text Available OBJECTIVES: Necrotizing enterocolitis is a severe multifactorial intestinal disorder that primarily affects preterm newborns, causing 20-40% mortality and morbidity. Intestinal fatty acid-binding protein has been reported to be a biomarker for the detection of intestinal injuries. Our aim was to assess intestinal tissue injury and the molecular expression of intestinal fatty acid-binding protein over time in a necrotizing enterocolitis model. METHODS: A total of 144 Newborn rats were divided into two groups: 1 Control, which received breastfeeding (n=72 and 2 Necrotizing Enterocolitis, which received formula feeding and underwent hypoxia and hypothermia (n=72. A total of six time points of ischemia (2 times a day for 3 days; 12 pups for each time point were examined. Samples were collected for analysis of body weight, morphological and histological characteristics, intestinal weight, intestinal weight/body weight ratio, injury grade, and intestinal fatty acid-binding protein levels. RESULTS: Body and intestinal weights were lower in the Necrotizing Enterocolitis group than in the Control group (p<0.005 and p<0.0005, respectively. The intestinal weight/body weight ratio was higher in the Necrotizing Enterocolitis group than in the Control group (p<0.005 only at the sixth ischemia time point. The Necrotizing Enterocolitis group displayed higher expression of intestinal fatty acid-binding protein (p<0.0005 and showed greater tissue damage than the Control group. CONCLUSION: Intestinal fatty acid-binding protein was an efficient marker of ischemic injury to the intestine and a good correlation was demonstrated between the time of ischemic injury and the grade of intestinal injury.

  19. Mesenteric ischemia--a complex disease requiring an interdisciplinary approach. A review of the current literature. (United States)

    Florian, Anca; Jurcut, Ruxandra; Lupescu, Ioana; Grasu, M; Croitoru, M; Ginghină, Carmen


    Mesenteric ischemia is caused by a reduction in intestinal blood flow with potential catastrophic clinical consequences: sepsis, bowel infarction, and death. In the recent years, the incidence of mesenteric ischemia increased, now accounting for 0.1% of hospital admissions. Among the multiple factors responsible for this change is the heightened awareness for the diagnoses, the advanced mean age of the population and the increasing number of critically ill patients. Acute mesenteric ischemia is a potentially fatal vascular emergency, with overall mortality of 60-80%; prompt diagnosis and treatment are paramount. A high index of suspicion in the setting of a compatible history and physical examination serves as the cornerstone to early diagnosis of mesenteric ischemia. Restoration of intestinal blood flow, as rapidly as possible, is the main goal of treatment in patients with acute mesenteric ischemia. This may be achieved by medical means, endovascular procedures and by surgery. Chronic mesenteric ischemia is an uncommon process that occurs only when severe atherosclerotic narrowing of a major splanchnic vessel exists in association with occlusion of one or two of the remaining vessels. Its diagnosis is mainly based on the characteristic clinical picture, on the presence of an occlusive lesion in the splanchnic vessels and on the absence of other common causes of abdominal pain. The means available for mesenteric revascularization are the surgical techniques of flow restoration and the more recently developed percutaneous transluminal procedures.

  20. Experimental model of mesenteric ischemia: reperfusion by abdominal aorta clamping in Wistar rats. (United States)

    Rocha, Bruno da Costa; Mendes, Rogério Rafael da Silva; Lima, Gabriel Varjão; Albuquerque, Gabriel de Souza; Araújo, Lucas Lacerda; de Jesus, Mateus Neves da Silva; Dos Santos, Washington Luís Conrado; Carreiro, Mário Castro


    To develop an experimental model of global normothermic ischemia able to demonstrate the transient ischemia and reperfusion periods required for development of ischemia/reperfusion injury in the small intestines of Wistar rats by clamping the abdominal aorta. Twenty adult male Wistar rats weighing 250-350g were randomly divided into five groups with four rats each and submitted to increasing times of ischemia (0 - 30 - 45 - 60 - 90 minutes). Within each group, except the control one, two rats underwent 60 minutes of reperfusion and two 90 minutes. After the procedures, histological analysis was conducted by measurement of areas of necrosis. The degree of intestinal necrosis ranged from 15% to 54% (p = 0.0004). There was progressive increase in the degree of injury related to increase in ischemic time. However, greater degrees of injury were observed in the lowest times of reperfusion. The analysis of the coefficient of variation of necrosis among the ten groups of ischemia/reperfusion showed a statistically significant difference in 15 areas, 13 related to the control group. The model was able to show the periods required for the occurrence of ischemia/reperfusion injury by aortic clamping and can serve as a basis to facilitate the development of studies that aim at understanding this kind of injury.

  1. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B.; Nieuwenhuijs, V. B.; Hofker, H. S.; Zijlstra, J. G.

    Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in

  2. Development of a hydrogel-based carbon dioxide sensor : a tool for diagnosing gastrointestinal ischemia

    NARCIS (Netherlands)

    Herber, S.


    In this thesis the development of a new type of CO2 sensor is described. The main application of the sensor is measuring the partial pressure of CO2 in the stomach to diagnose gastrointestinal ischemia, which occurs when blood flow is insufficient to deliver oxygen to the stomach and intestines.

  3. Transcending Organization in Temporary Systems

    DEFF Research Database (Denmark)

    Stjerne, Iben Sandal

    Because of their temporary nature, work and employment in project based organizations are different from what we used to see in traditional organizational forms. Temporary employment, entailing less stability within the organization changes how employment and work are organized. Temporary systems...... are organized by transcending organization that go beyond the individual firm and replaces what used to be organized inside the firm. Following several calls for further research on these topics, this dissertation is a small step along the way as it investigates how work and employment are organized...... in temporary systems that lack stability and formal order. It advances our understanding of transcending organization in creative industries by adopting a practice based perspective. Empirically, the dissertation presents an in-depth study of the Danish film industry, which is an extreme case of a project...

  4. 42 CFR 488.415 - Temporary management. (United States)


    ... 42 Public Health 5 2010-10-01 2010-10-01 false Temporary management. 488.415 Section 488.415... Compliance for Long-Term Care Facilities with Deficiencies § 488.415 Temporary management. (a) Definition. Temporary management means the temporary appointment by CMS or the State of a substitute facility manager or...

  5. Oligodendrogenesis after Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ruilan eZhang


    Full Text Available AbstractNeural stem cells in the subventricular zone (SVZ of the lateral ventricle of adult rodent brain generate oligodendrocyte progenitor cells (OPCs that disperse throughout the corpus callosum and striatum where some of OPCs differentiate into mature oligodendrocytes. Studies in animal models of stroke demonstrate that cerebral ischemia induces oligodendrogenesis during brain repair processes. This article will review evidence of stroke-induced proliferation and differentiation of OPCs that are either resident in white matter or are derived from SVZ neural progenitor cells and of therapies that amplify endogenous oligodendrogenesis in ischemic brain.

  6. Intestinal Oxygenotherapy of Critical Conditions

    Directory of Open Access Journals (Sweden)

    V. A. Mazurok


    Full Text Available The latent or mist diagnosed dysfunction of the small intestine is a common disorder in critically ill patients. Intestinal oxygenotherapy is one of the alternative ways to normalize the coordinated activity of the smooth muscles of the digestive tract.Purpose of the study. To determine the effect of intestinal oxygenotherapy in patients with enteropathies of critical conditions on the dynamics of biomarkers of the intestinal wall permeability and ischemia.Materials and methods. An open prospective descriptive study of 12 critically ill patients (7 adults, 5 children with multiple organ failure and evident or saspected dysfunction of the gastrointestinal tract. Pediatric patients included children with congenital heart disease who underwent open-heart surgery for the purpose of radical or palliative correction.Results. Complications related to the intestinal oxygenotherapy were not observed. On the contrary, its use in children coincided with the positive clinical dynamics: elimination of intestinal paresis, normalization of digestion of enteral nutrition. However, it is difficult to interpret the results unambiguously. Serum citrulline concentration in children is an objective marker of the functional state of the gastrointestinal tract: in the vast majority of the control points its level was <20 μmol/l; it means a very severe intestinal damage. Serum I-FABP concentration was<100 pg/ml in a significant number of control points, which, by contrast, does not allow to talk about the intestinal wall severe ischemic disturbances. In adults, the initial serum citrulline concentration was <20 μmol/l in the vast majority of control points; but by days 5—6 after the onset of intestinal oxygenation, in the majority of patients the citrulline levels exceeded >20 μmol/l (up to 80 μmol/l. No correlation between serum citrulline and I-FABP concentrations in adults was found.Conclusion. Intestinal oxygenotherapy is a promising therapeutic technique for

  7. Acute mesenteric ischemia (Part II) - Vascular and endovascular surgical approaches. (United States)

    Kärkkäinen, Jussi M; Acosta, Stefan


    The modern treatment of acute mesenteric ischemia (AMI) requires seamless collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. The treatment strategy is straightforward aiming at rapid restoration of blood flow to the intestine. Bowel resection is performed on demand. The first thing to consider is the patient's clinical condition at presentation, whether there are signs of peritonitis or not, and whether the patient is hemodynamically stable or not. Second, there are four etiologies of AMI that need to be distinguished as they differ in treatment: superior mesenteric artery embolism, mesenteric arterial occlusive disease, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia. In this review, we describe the basic vascular and endovascular treatment modalities accompanied by a simple algorithm for the various situations in AMI. Furthermore, the indications for damage control and primary definitive surgery are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Oxidative DNA damage after transplantation of the liver and small intestine in pigs

    DEFF Research Database (Denmark)

    Loft, S; Larsen, P N; Rasmussen, A


    Oxidative damage is thought to play an important role in ischemia/reperfusion injury, including the outcome of transplantation of the liver and intestine. We have investigated oxidative DNA damage after combined transplantation of the liver and small intestine in 5 pigs. DNA damage was estimated...... to DNA results from reperfusion of transplanted small intestine and liver in pigs, as estimated from the readily excreted repair product 8-oxodG....

  9. Temporary Clusters and Knowledge Creation

    DEFF Research Database (Denmark)

    Maskell, Peter; Bathelt, Harald; Malmberg, Anders


    to distant markets and technologies. Third, it compares such temporaryclusters with permanent territorial hubs within their respective sector or industry. If regularparticipation in temporary clusters could satisfy a firm's need to learn through interactionwith suppliers, customers, peers and rivals, why...... or participating in such events are means toidentify the current market frontier, take stock of relative competitive positions and formfuture plans. These events exhibit many of the characteristics ascribed to permanentclusters, albeit in a temporary, periodic and intensified form. The temporary clusters...... is the phenomenon of permanent clusteringso pervasive?The answer, it is claimed, lies in the restrictions imposed on economic activity whenknowledge and ideas are transformed into valuable products and services. The paper shedsnew light on how interaction among firms in current clusters coincides...

  10. Ischemia causes muscle fatigue (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D. M.


    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P muscle oxygenation (r = 0.78, P muscle oxygenation causes decreased muscle force production in the forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue.

  11. Espiroquetosis intestinal


    Vera Sempere, Francisco José


    El término “espiroquetosis intestinal” fue introducido por Harland y Lee en 1967 -en una breve comunicación publicada en el British Medical Journal- para describir una infección intestinal que morfológicamente se manifiesta en la biopsia de colon/recto por la presencia de una banda de microorganismos, adheridos a la superficie del epitelio de la mucosa intestinal y que fueron identificados al microscopio electrónico como espiroquetas. La definición por lo tanto de este pr...

  12. The protective effect of autophagy on ischemia/reperfusion-induced hearing loss: implications for sudden hearing loss. (United States)

    Yang, Haidi; Pang, Jiaqi; Xiong, Hao; Sun, Yingfeng; Lai, Lan; Chen, Suijun; Ye, Yongyi; Yang, Zhengfei; Zheng, Yiqing


    The present study aimed to determine the effects of ischemia/reperfusion (IR) injury for the carotid system on hearing, particularly, the role of autophagy in this process. Sixty-three Sprague-Dawley rats were divided randomly into three groups: sham surgery animals (S), temporary carotid artery occlusion (ischemia) for 30 min (I30), and temporary carotid artery occlusion for 60 min (I60). Auditory brainstem response measurements were performed on mice. After 72 h of reperfusion, the microcirculation was measured in mice after ischemia injury. Immunofluorescence was used to examine the expression of caspase-3 and light chain 3B in the cochlear sections. Temporary carotid artery occlusion lasting for 30 (I30) or 60 min (I60) caused significant hearing loss in the ischemia phase. Following a recovery during the postreperfusion phase, the temporal threshold shift occurred in the I30 group, whereas a permanent threshold shift occurred in the I60 group. Moreover, both microcirculation and autophagy affected hearing 24 h after reperfusion, whereas at 72 h, autophagy works as an intrinsic cellular process that protects against death from the IR effect. These results suggest that the sooner the reperfusion, the better the hearing recovery. In conclusion, autophagy promotes cell survival in the cochlea; however, excessive IR damage counteracts the beneficial potential of autophagy protection and leads to a permanent threshold shift.

  13. Intestinal Cgi-58 deficiency reduces postprandial lipid absorption.

    Directory of Open Access Journals (Sweden)

    Ping Xie

    Full Text Available Comparative Gene Identification-58 (CGI-58, a lipid droplet (LD-associated protein, promotes intracellular triglyceride (TG hydrolysis in vitro. Mutations in human CGI-58 cause TG accumulation in numerous tissues including intestine. Enterocytes are thought not to store TG-rich LDs, but a fatty meal does induce temporary cytosolic accumulation of LDs. Accumulated LDs are eventually cleared out, implying existence of TG hydrolytic machinery in enterocytes. However, identities of proteins responsible for LD-TG hydrolysis remain unknown. Here we report that intestine-specific inactivation of CGI-58 in mice significantly reduces postprandial plasma TG concentrations and intestinal TG hydrolase activity, which is associated with a 4-fold increase in intestinal TG content and large cytosolic LD accumulation in absorptive enterocytes during the fasting state. Intestine-specific CGI-58 knockout mice also display mild yet significant decreases in intestinal fatty acid absorption and oxidation. Surprisingly, inactivation of CGI-58 in intestine significantly raises plasma and intestinal cholesterol, and reduces hepatic cholesterol, without altering intestinal cholesterol absorption and fecal neutral sterol excretion. In conclusion, intestinal CGI-58 is required for efficient postprandial lipoprotein-TG secretion and for maintaining hepatic and plasma lipid homeostasis. Our animal model will serve as a valuable tool to further define how intestinal fat metabolism influences the pathogenesis of metabolic disorders, such as obesity and type 2 diabetes.

  14. Objects as Temporary Autonomous Zones

    Directory of Open Access Journals (Sweden)

    Tim Morton


    Full Text Available From Hakim Bey's instructions on creating temporary autonomous zones we see an oscillation "between performance art and politics, circus clowning and revolution." In this essay Tim Morton discusses anarchist politics as, "the creation of fresh objects in a reality without a top or a bottom object, or for that matter a middle object."

  15. Nursing Intervention During Temporary Care (United States)

    Curry, Judith B.


    The role of the professional nurse in asseviating or minimizing the separation anxiety and traumatic impact on families during temporary placement of a retarded child in a residential facility is seen in two case studies of girls 3 and 12 years of age. (Author/MC)

  16. Temporary risk identification in urolithiasis. (United States)

    Marickar, Y M Fazil; Salim, Abiya


    We have been using a risk index calculation for urolithiasis, which included most of the identifiable factors promoting calculogenesis. However, it was observed that the frequency of a patient getting stone problem was not uniform in spite of similarity of the risk index in the permanent setting. Also, many of the risk indices could be changed by dietary or lifestyle modifications. The objective of this paper was to calculate the temporary risk index of a patient at the time of each visit and correlate with stone activity during such periods, so that appropriate advice could be given on drugs, diet and lifestyle changes. The temporary risk index score was based on four symptoms, namely pain (0, nil; 1, vague pain; 2, mild; 3, moderate; 4, severe; 5, excruciating), haematuria (0, nil; 1, turbid; 2, cloudy; 3, reddish; 4, occasional frank blood; 5, continuous frank blood), burning sensation (0, nil; 1, minimal; 2, moderate; 3, terminal severe; 4, occasional excruciating; 5, continuous excruciating), and dysuria (0, nil; 1, minimal; 2, moderate; 3, terminal severe; 4, occasional excruciating, 5, continuous excruciating), ultrasonography for back pressure (0, nil; 1, mild; 2, moderate; 3, severe kidney and ureter; 4, unilateral total; 5, bilateral total anuria) and eight urine deposit findings (0, nil; 1, +; 2, 2+; 3, 3+; 4, 4+; 5, plenty), red blood cells, pus cells, whewellite crystals, weddellite crystals, phosphate crystals, uric acid/ammonium urate crystals, crystal clumping and crystal aggregation making a total of 13 parameters. Each parameter was given values ranging from 0 to 5. The total score was calculated and chemotherapeutic regimes were decided base on the score, which varied from 0 to 65. Hundred randomly selected patients who had been visiting the stone clinic for a minimum of five occasions were included in the study. The total scores of temporary risk were correlated with the permanent clinical risk score mentioned earlier. The temporary risk of the

  17. The effect of right vagus nerve stimulation on focal cerebral ischemia: an experimental study in the rat (United States)

    Sun, Zhenghui; Baker, Wesley; Hiraki, Teruyuki; Greenberg, Joel H.


    Background The aim of this study was to determine the effect of vagus nerve stimulation (VNS) on infarct size after transient and after permanent focal cerebral ischemia in rats and to test the hypothesis that VNS-induced neuroprotection is due to changes in cerebral blood flow. Methods Ischemia was produced by either temporary proximal middle cerebral artery occlusion (TMCAO) or permanent distal middle cerebral artery occlusion (PMCAO). Stimulating electrodes were implanted on the cervical part of the right vagus nerve, and electrical stimulation was initiated 30 minutes after the induction of ischemia and delivered for 30 seconds every 5 minutes for 1 hour. All the procedures were duplicated but no stimulus was delivered in control groups. Cerebral blood flow in the MCA territory was continuously monitored with laser speckle contrast imaging. A neurological evaluation was undertaken after 24 hours of ischemia, and animals were euthanized and neuronal damage evaluated. Results Ischemic lesion volume was smaller in VNS-treated animals in both the temporary and permanent ischemic groups (p<0.01). VNS-treated animals in TMCAO had better functional scores at 24 h as compared with control animals (p<0.01), but there were no statistically significant differences in the neurobehavioral scores in PMCAO (p=0.089). CBF changes in the MCA territory during ischemia did not differ between the VNS-treated animals and control animals in either group. Conclusion VNS offers neuroprotection against stroke in both temporary and permanent ischemia. Although the precise mechanism of this effect remains to be determined, alterations in cerebral blood flow do not appear to play a role. VNS could readily be translated to clinical practice. PMID:22037134

  18. [Intestinal stimulation in patients with colostomy]. (United States)

    Quesada, Ramón Ruiz


    We presented/displayed our experience in the recovery of the evacuator function of the intestine in patients entered in our service with direction diagnoses of Ileo Paralitico or Adinámico (Functional), that by some cause has been taken part surgically and is carrying of a temporary or permanent colostomia. Our experience is based on more than 10 patients, but we have only gathered the data of ten clinical histories. This stimulation we have obtained it, introducing a sounding Foley type through estoma, trying not to produce to the patient the minimum annoyance to him. We have looked for justification, as much physiological as anatomical, that it entails this answer of recovery of the intestinal peristaltismo, using body solid and not liquid, with idea that thus we respected better the normal intestinal operation in these patients, that already has it altered, to the being carrying of a colostomia.

  19. Temporary Residences: a becoming project

    Directory of Open Access Journals (Sweden)

    Luisa Ingaramo


    Full Text Available Among the experimental actions fostered so far by the Compagnia di San Paolo through its Housing Program, committed in handling the complex and fragmented housing discomfort issue, the Temporary Dwellings initiative represents a unique and innovative experience, as it actually offers the chance to activate a proper managerial direction around and about the real estate development processes. In particular, the Temporary Dwellings action is marked by two key aspects: a structured co-planning vision and projects selected through a requests for proposal system. The process in the whole aims on the one hand at reaching an high transparent level of decision making , while, on the other hand, at developing a continuous and mutual monitoring and matching activity between the Housing Program and the group of cross-curricular experts teamed up in the project: technicians, designers, managers, psychologists, contractors, and the other local stakeholders.

  20. Large capacity temporary visual memory (United States)

    Endress, Ansgar D.; Potter, Mary C.


    Visual working memory (WM) capacity is thought to be limited to three or four items. However, many cognitive activities seem to require larger temporary memory stores. Here, we provide evidence for a temporary memory store with much larger capacity than past WM capacity estimates. Further, based on previous WM research, we show that a single factor — proactive interference — is sufficient to bring capacity estimates down to the range of previous WM capacity estimates. Participants saw a rapid serial visual presentation (RSVP) of 5 to 21 pictures of familiar objects or words presented at rates of 4/s or 8/s, respectively, and thus too fast for strategies such as rehearsal. Recognition memory was tested with a single probe item. When new items were used on all trials, no fixed memory capacities were observed, with estimates of up to 9.1 retained pictures for 21-item lists, and up to 30.0 retained pictures for 100-item lists, and no clear upper bound to how many items could be retained. Further, memory items were not stored in a temporally stable form of memory, but decayed almost completely after a few minutes. In contrast, when, as in most WM experiments, a small set of items was reused across all trials, thus creating proactive interference among items, capacity remained in the range reported in previous WM experiments. These results show that humans have a large-capacity temporary memory store in the absence of proactive interference, and raise the question of whether temporary memory in everyday cognitive processing is severely limited as in WM experiments, or has the much larger capacity found in the present experiments. PMID:23937181

  1. Metabolic and hemodynamic effects of saline infusion to maintain volemia on temporary abdominal aortic occlusion

    Directory of Open Access Journals (Sweden)

    Fábio Ferreira Amorim


    Full Text Available OBJECTIVE: To analyze hemodynamic and metabolic effects of saline solution infusion in the maintenance of blood volume in ischemia-reperfusion syndrome during temporary abdominal aortic occlusion in dogs. METHODS: We studied 20 dogs divided into 2 groups: the ischemia-reperfusion group (IRG, n=10 and the ischemia-reperfusion group with saline solution infusion aiming at maintaining mean pulmonary arterial wedge pressure between 10 and 20 mmHg (IRG-SS, n=10. All animals were anesthetized with sodium thiopental and maintained on spontaneous ventilation. Occlusion of the supraceliac aorta was obtained with inflation of a Fogarty catheter inserted through the femoral artery. After 60 minutes of ischemia, the balloon was deflated, and the animals were observed for another 60 minutes of reperfusion. RESULTS: IRG-SS dogs did not have hemodynamic instability after aortic unclamping, and the mean systemic blood pressure and heart rate were maintained. However, acidosis worsened, which was documented by a greater reduction of arterial pH that occurred especially due to the absence of a respiratory response to metabolic acidosis that was greater with the adoption of this procedure. CONCLUSION: Saline solution infusion to maintain blood volume avoided hemodynamic instability after aortic unclamping. This procedure, however, caused worsening in metabolic acidosis in this experimental model.

  2. Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia

    DEFF Research Database (Denmark)

    Fakhri, Yama; Schoos, Mikkel Malby; Sejersten-Ripa, Maria


    PCI), the severity of ischemia (according to Sclarovsky-Birnbaum severity grades of ischemia) and the acuteness-score were obtained from prehospital ECG. Patients were classified according to the presence of severe ischemia or non-severe ischemia and acute ischemia or non-acute ischemia. Plasma NT-proBNP (pmol...

  3. Effects of n-3 PUFAs on Intestinal Mucosa Innate Immunity and Intestinal Microbiota in Mice after Hemorrhagic Shock Resuscitation

    Directory of Open Access Journals (Sweden)

    Feng Tian


    Full Text Available n-3 polyunsaturated fatty acids (PUFAs can improve the function of the intestinal barrier after damage from ischemia-reperfusion or hemorrhagic shock resuscitation (HSR. However, the effects of n-3 PUFAs on intestinal microbiota and the innate immunity of the intestinal mucosa after HSR remain unclear. In the present study, 40 C57BL/6J mice were randomly assigned to five groups: control, sham, HSR, HSR + n-3 PUFAs and HSR + n-6 PUFAs. Mice were sacrificed 12 h after HSR. Liver, spleen, mesenteric lymph nodes and terminal ileal tissues were collected. Intestinal mucosae were scraped aseptically. Compared with the HSR group, the number of goblet cells increased, expression of mucin 2 was restored and disturbed intestinal microbiota were partly stabilized in the PUFA-administered groups, indicating that both n-3 and n-6 PUFAs reduced overproliferation of Gammaproteobacteria while promoting the growth of Bacteroidetes. Notably, n-3 PUFAs had an advantage over n-6 PUFAs in improving ileal tissue levels of lysozyme after HSR. Thus, PUFAs, especially n-3 PUFAs, partly improved the innate immunity of intestinal mucosa in mice after HSR. These findings suggest a clinical rationale for providing n-3 PUFAs to patients recovering from ischemia-reperfusion.

  4. Remote Ischemic Preconditioning Decreases the Magnitude of Hepatic Ischemia-Reperfusion Injury on a Swine Model of Supraceliac Aortic Cross-Clamping. (United States)

    Martikos, Georgios; Kapelouzou, Alkistis; Peroulis, Michael; Paspala, Anna; Athanasiadis, Dimitris; Machairas, Anastasios; Liakakos, Theodoros; Moulakakis, Konstantinos; Vasdekis, Spyros; Lazaris, Andreas M


    Temporary hepatic ischemia is inevitable during open aortic surgery when supraceliac clamping is necessary, as in thoracoabdominal or pararenal aneurysms. Remote ischemic preconditioning (RIPC) has been described as a potential protective means against ischemia-reperfusion injury (IRI) in various tissues including the liver. The aim of this experimental study was to detect the effect of RIPC on liver IRI in a model of supraceliac aortic cross-clamping. An animal study was performed. Four groups of 6 swines each were examined: the control (sham) group, the ischemia-reperfusion (IR) group, and 2 remote ischemic preconditioning groups (RIPC I and RIPC II group). In the IR group, the animals underwent a complete cessation of the splanchnic arterial circulation for 30 min by a concomitant occlusion of the supraceliac and the infrarenal aorta. In the RIPC groups, a remote preconditioning was applied before the splanchnic ischemia. This consisted of a temporary occlusion of the infrarenal aorta for 15 min followed by 15 min of reperfusion (RIPC I group), and 3 cycles of 5 min similar ischemia, followed by 5 min of reperfusion each (RIPC II group). All animals were followed for 24 hr after the ischemia (reperfusion period). The liver ischemia-reperfusion injury was assessed by examining specific serum biomarkers indicating the magnitude of metabolic injury from selective blood samples of the hepatic circulation. In particular, the following parameters were examined: C-reactive protein, interleukin 6, tumor necrosis factor a, ferritin, and L-arginine. All parameters were affected in the IR group as compared to the sham group. Both RIPC groups developed a less serious change as compared to the IR group, in all examined parameters. In an animal study of splanchnic ischemia produced in a way to this produced during a supraceliac aortic aneurysm open repair, the remote ischemic preconditioning seemed to attenuate the effect of hepatic ischemia-reperfusion injury. Remote

  5. Intestinal myiasis

    Directory of Open Access Journals (Sweden)

    U S Udgaonkar


    Full Text Available Purpose: Intestinal myiasis is a condition when the fly larvae inhabit the gastrointestinal tract and are passed out in faeces. This type of infestation results when eggs or larvae of the fly, deposited on food are inadvertently taken by man. They survive the unfavourable conditions within the gastrointestinal tract and produce disturbances, which may vary from mild to severe. The condition is not uncommon and is often misdiagnosed as pinworm infestation. Correct diagnosis by the clinical microbiologist is important to avoid unnecessary treatment. Materials and Methods: We had 7 cases of intestinal myiasis. In 2 cases the larvae were reared to adult fly in modified meat and sand medium (developed by Udgaonkar. This medium is simple and can be easily prepared in the laboratory. Results: Of the 7 larvae, 5 were Sarcophaga haemorrhoidalis, 1 Megaselia species and 1 was identified as Muscina stabulans. Conclusions: S. haemorrhoidalis was the commonest maggot involved. A high index of suspicion is required for clinical diagnosis when the patient complains of passing wriggling worms in faeces for a long period without any response to antihelminthics. The reason for long duration of illness and recurrence of infestation is baffling. The nearest to cure was colonic wash. We feel prevention is of utmost importance, which is to avoid eating food articles with easy access to flies.

  6. Effect of supplementary feeding during the sucking period on net absorption from the small intestine of weaned pigs

    NARCIS (Netherlands)

    Nabuurs, M.J.A.; Hoogendoorn, A.; Zijderveld-van Bemmel, van A.


    An intestinal perfusion technique was used to measure the effects of supplementary feeding (experiment 1) and temporary weaning (experiment 2) during the sucking period on the net absorption of fluid, sodium, chloride and potassium from the small intestine of pigs after weaning. The technique was

  7. Oxidative stress in brain ischemia. (United States)

    Love, S


    Brain ischemia initiates a complex cascade of metabolic events, several of which involve the generation of nitrogen and oxygen free radicals. These free radicals and related reactive chemical species mediate much of damage that occurs after transient brain ischemia, and in the penumbral region of infarcts caused by permanent ischemia. Nitric oxide, a water- and lipid-soluble free radical, is generated by the action of nitric oxide synthases. Ischemia causes a surge in nitric oxide synthase 1 (NOS 1) activity in neurons and, possibly, glia, increased NOS 3 activity in vascular endothelium, and later an increase in NOS 2 activity in a range of cells including infiltrating neutrophils and macrophages, activated microglia and astrocytes. The effects of ischemia on the activity of NOS 1, a Ca2+-dependent enzyme, are thought to be secondary to reversal of glutamate reuptake at synapses, activation of NMDA receptors, and resulting elevation of intracellular Ca2+. The up-regulation of NOS 2 activity is mediated by transcriptional inducers. In the context of brain ischemia, the activity of NOS 1 and NOS 2 is broadly deleterious, and their inhibition or inactivation is neuroprotective. However, the production of nitric oxide in blood vessels by NOS 3, which, like NOS 1, is Ca2+-dependent, causes vasodilatation and improves blood flow in the penumbral region of brain infarcts. In addition to causing the synthesis of nitric oxide, brain ischemia leads to the generation of superoxide, through the action of nitric oxide synthases, xanthine oxidase, leakage from the mitochondrial electron transport chain, and other mechanisms. Nitric oxide and superoxide are themselves highly reactive but can also combine to form a highly toxic anion, peroxynitrite. The toxicity of the free radicals and peroxynitrite results from their modification of macromolecules, especially DNA, and from the resulting induction of apoptotic and necrotic pathways. The mode of cell death that prevails probably

  8. Spatial Organization of Acute Myocardial Ischemia (United States)

    Aras, Kedar; Burton, Brett; Swenson, Darrell; MacLeod, Rob


    Introduction Myocardial ischemia is a pathological condition initiated by supply and demand imbalance of the blood to the heart. Previous studies suggest that ischemia originates in the subendocardium, i.e., that nontransmural ischemia is limited to the subendocardium. By contrast, we hypothesized that acute myocardial ischemia is not limited to the subendocardium and sought to document its spatial distribution in an animal preparation. The goal of these experiments was to investigate the spatial organization of ischemia and its relationship to the resulting shifts in ST segment potentials during short episodes of acute ischemia. Methods We conducted acute ischemia studies in open-chest canines (N=19) and swines (N=10), which entailed creating carefully controlled ischemia using demand, supply or complete occlusion ischemia protocols and recording intramyocardial and epicardial potentials. Elevation of the potentials at 40% of the ST segment between the J-point and the peak of the T-wave (ST40%) provided the metric for local ischemia. The threshold for ischemic ST segment elevations was defined as two standard deviations away from the baseline values. Results The relative frequency of occurrence of acute ischemia was higher in the subendocardium (78% for canines and 94% for swines) and the mid-wall (87% for canines and 97% for swines) in comparison with the subepicardium (30% for canines and 22% for swines). In addition, acute ischemia was seen arising throughout the myocardium (distributed pattern) in 87% of the canine and 94% of the swine episodes. Alternately, acute ischemia was seen originating only in the subendocardium (subendocardial pattern) in 13% of the canine episodes and 6% of the swine episodes (p < 0.05). Conclusions Our findings suggest that the spatial distribution of acute ischemia is a complex phenomenon arising throughout the myocardial wall and is not limited to the subendocardium. PMID:26947437

  9. Extracorporeal Hypothermic Perfusion Device for Intestinal Graft Preservation to Decrease Ischemic Injury During Transportation. (United States)

    Muñoz-Abraham, Armando Salim; Patrón-Lozano, Roger; Narayan, Raja R; Judeeba, Sami S; Alkukhun, Abedalrazaq; Alfadda, Tariq I; Belter, Joseph T; Mulligan, David C; Morotti, Raffaella; Zinter, Joseph P; Geibel, John P; Rodríguez-Dávalos, Manuel I


    The small intestine is one of the most ischemia-sensitive organs used in transplantation. To better preserve the intestinal graft viability and decrease ischemia-reperfusion injury, a device for extracorporeal perfusion was developed. We present the results for the first series of perfused human intestine with an intestinal perfusion unit (IPU). Five human intestines were procured for the protocol. (1) An experimental segment was perfused by the IPU delivering cold preservation solution to the vascular and luminal side continually at 4 ºC for 8 h. (2) Control (jejunum and ileum) segments were preserved in static cold preservation. Tissue samples were obtained for histopathologic grading according to the Park/Chiu scoring system (0 = normal, 8 = transmural infarction). Jejunal experimental segments scored 2.2 with the Park/Chiu system compared to the control segments, which averaged 3.2. Overall scoring for ileum experimental and control segments was equal with 1.6. This data presents proof of concept that extracorporeal intestinal perfusion is feasible. The evidence shows that the IPU can preserve the viability of human intestine, and histopathologic evaluation of perfused intestine is favorable. Our early results can eventually lead to expanding the possibilities of intestinal preservation.

  10. On the Sharing of Temporary Parental Leave

    DEFF Research Database (Denmark)

    Amilon, Anna


    This paper views temporary parental leave (leave from work to take care of a sick child) as a household public good, produced with time inputs of the parents as the only input. Assuming equal productivities in the production of temporary parental leave and equal utility functions of the spouses......-point of the female is found to push the intra household allocation of temporary parental leave towards greater sharing between the spouses. In addition, an increase in the insurance ceiling will further sharing of temporary parental leave in some families, while reducing it in others....

  11. Intraperitoneal Bilirubin Administration Decreases Infarct Area in a Rat Coronary Ischemia/Reperfusion Model

    Directory of Open Access Journals (Sweden)

    Ron eBen-Amotz


    Full Text Available Bilirubin was previously considered a toxin byproduct of heme catabolism. However, a mounting body of evidence suggests that at physiological doses, bilirubin is a powerful antioxidant and anti-atherosclerotic agent. Recent clinical studies have shown that human beings with genetically-induced hyperbilirubinemia (Gilbert Syndrome are protected against coronary heart disease. The purpose of this study was to investigate whether administration of exogenous bilirubin to normal rats would convey similar protective effects in an experimental model of coronary ischemia. We hypothesized that intraperitoneal bilirubin administration 1 hour before injury would decrease infarct area and preserve left ventricular (LV systolic function when compared to non-treated rats. Coronary ischemia was induced by temporary (30 min ligation of the left anterior descending coronary artery in control or bilirubin treated rats, followed by a 1-hour period of reperfusion. LV function was estimated by measurements of fractional shortening and fractional area shortening using echocardiography. LV function decreased in both experimental groups after ischemia and reperfusion, although in bilirubin-treated rats fractional shortening was less depressed during the period of ischemia (18.8 vs 25.8%, p = 0.034. Infarct size was significantly reduced in the bilirubin treated group compared to the non-treated group (13.34% vs 25.5%, p = 0.0067. Based on the results of this study, bilirubin supplementation appears to provide significant decrease in infarct size although protective effects on LV function were noted only during the period of ischemia. This result also suggests that lipid soluble antioxidant bilirubin prevents the oxidation of cardiolipin and decreases the infarct size in the heart during ischemia.

  12. Histomorphological Features of Intestinal Atresia and its Clinical Correlation. (United States)

    Subbarayan, Devi; Singh, Meeta; Khurana, Nita; Sathish, Agarwal


    Intestinal atresia accounts for approximately one third of all cases of neonatal intestinal obstruction. There is controversy regarding pathogenesis of congenital atresia and stenosis of small bowel. Studies regarding clinical manifestations and specific histopathological features of neonatal intestinal atresia are scarce in Indian literature. To understand the histomorphological features and thus suggest pathophysiology of cases with Intestinal Atresia. Out of 147 cases, of intestinal obstruction in newborn studied over a period of 5 years, 39 cases of intestinal atresia were found. Their histomorphological details with clinical manifestations were studied. Type II was the commonest type of atresia. Associated anomalies noted were gastroschisis, volvulus, anal stenosis, microcolon, annular pancreas, meconium cyst and duplication cyst. Histological changes observed were ulceration, flattening, abnormal villous configuration, luminal obliteration, narrowing, haemangiomatous proliferation of blood vessels, fibrosis, haemorrhage, calcification, and mesenchymal condensation around the blood vessels. Gangrene and perforation has also noted in some cases. An intrauterine intestinal ischemia due to vascular pathology followed by resorption of the bowel is the possible explanation for the development of intestinal atresia.

  13. Ischemia/Reperfusion Injury Alters Sphingolipid Metabolism in the Gut

    Directory of Open Access Journals (Sweden)

    Richard S. Hoehn


    Full Text Available Background: Intestinal ischemia/reperfusion injury (I/R is a significant cause of morbidity and mortality in surgical patients. Ceramide is a mediator of apoptosis and has been implicated as increasing bacterial infection susceptibility. The metabolite of ceramide, sphingosine, was recently shown to play an important role in the cell-autonomous, innate immune response of the upper respiratory tract by killing bacterial pathogens. The role of ceramide and/or sphingosine after mesenteric I/R is unknown. We investigated the specific effects of intestinal I/R on tissue ceramide and sphingosine concentration and resulting susceptibility to bacterial invasion. Methods: To simulate intestinal I/R, C57BL/6 mice underwent 30 minutes of vascular clamp-induced occlusion of the superior mesenteric artery followed by variable reperfusion times. Jejunum segments and intraluminal contents were analyzed for ceramide, sphingosine and bacteria using immunohistochemistry. Jejunum samples were also homogenized and cultured to quantify bacterial presence in the proximal intestine. Results: We hypothesized that I/R induces an increase of ceramide in the intestine resulting in increased permeability, while a concomitant decrease of sphingosine may permit bacterial overgrowth. Control mice had no measurable bacteria in their proximal jejunum as measured by tissue culture and immunohistochemistry. After I/R, bacterial counts in the jejunum increased in a time-dependent manner, reaching a peak at 12 hours after reperfusion. Immunohistochemical analysis revealed a marked increase in ceramide in the vasculature of jejunal villi. In contrast, while ceramide concentrations in the epithelial cells decreased after I/R, sphingosine levels appeared to remain unchanged. Surprisingly, bacteria present in the jejunal lumen following I/R contained a ceramide coat. Conclusion: These data indicate that intestinal I/R leads to small intestine bacterial overgrowth as well as ceramide

  14. 40 CFR 264.553 - Temporary Units (TU). (United States)


    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Temporary Units (TU). 264.553 Section... Provisions for Cleanup § 264.553 Temporary Units (TU). (a) For temporary tanks and container storage areas... Administrator may designate a unit at the facility, as a temporary unit. A temporary unit must be located within...

  15. Silent myocardial ischemia during coronary angioplasty. (United States)

    Dellborg, M; Emanuelsson, H; Swedberg, K


    Silent myocardial ischemia is a marker in patients with coronary artery disease identifying those at high risk for subsequent cardiac events. During provoked myocardial ischemia some patients with angina pectoris do not develop chest pain. Are there clinical, angiographic or electrocardiographic differences between patients with chest pain as compared with patients without chest pain during provoked myocardial ischemia? Coronary angioplasty is a well-established method for the treatment of coronary stenosis, but it is also an interesting model for the study of myocardial ischemia as a result of coronary occlusion. We monitored 114 patients with angina pectoris during coronary angioplasty with dynamic, computerized vectorcardiography. During inflation of the balloon 33 of 114 patients had silent ischemia. Patients with silent myocardial ischemia had similar reasons for terminating the preangioplasty exercise test and where on similar anti-ischemic drug regimes. Silent myocardial ischemia was significantly associated with a history of diabetes, presence of collaterals, a history of less severe previous angina and less ST segment changes during angioplasty as compared with patients with painful ischemia. It is suggested that during coronary angioplasty silent ischemia may be caused by a less severe degree of ischemia, possibly as a result of the protective effect of collaterals.

  16. Oxidized tissue proteins after intestinal reperfusion injury in rats

    Directory of Open Access Journals (Sweden)

    Schanaider Alberto


    Full Text Available PURPOSE: To analyse if the carbonyl proteins measurement could be validated as a method that allows the identification of an intestinal oxidative stress after ischemia and reperfusion injury. METHODS: Twenty-five male Wistar rats (n =21 weighting 200 to 250g were divided into three groups. Group I - control (n = 10. Group II - sham (n = 5 and Group III (n = 10 subjected to 60 minutes of intestinal ischemia and equal period of reperfusion. For this purpose it was clamped the superior mesenteric artery in its distal third. Histological changes and carbonyl protein levels were determined in the samples of all groups. In group III, samples of both normal and reperfused ileal segment were studied. RESULTS: All the reperfused segments showed mucosal and submucosal swelling and inflammatory infiltrate of the lamina propria. Levels of carbonyl protein rose in group III, including in the non-ischemic segments. The sensitivity and specificity of the carbonyl protein tissue levels were respectively 94% and 88%. CONCLUSION: The carbonyl protein method is a useful biologic marker of oxidative stress after the phenomenon of intestinal ischemia and reperfusion in rats. It was also noteworthy that the effects of oxidative stress could be seen far from the locus of the primary injury.

  17. Effect of Glycine, Pyruvate, and Resveratrol on the Regeneration Process of Postischemic Intestinal Mucosa

    Directory of Open Access Journals (Sweden)

    Lisa Brencher


    Full Text Available Background. Intestinal ischemia is often caused by a malperfusion of the upper mesenteric artery. Since the intestinal mucosa is one of the most rapidly proliferating organs in human body, this tissue can partly regenerate itself after the onset of ischemia and reperfusion (I/R. Therefore, we investigated whether glycine, sodium pyruvate, and resveratrol can either support or potentially harm regeneration when applied therapeutically after reperfusion injury. Methods. I/R of the small intestine was initiated by occluding and reopening the upper mesenteric artery in rats. After 60 min of ischemia and 300 min of reperfusion, glycine, sodium pyruvate, or resveratrol was administered intravenously. Small intestine regeneration was analyzed regarding tissue damage, activity of saccharase, and Ki-67 positive cells. Additionally, systemic parameters and metabolic ones were obtained at selected periods. Results. Resveratrol failed in improving the outcome after I/R, while glycine showed a partial beneficial effect. Sodium pyruvate ameliorated metabolic acidosis, diminished histopathologic tissue injury, and increased cell proliferation in the small intestine. Conclusion. While glycine could improve in part regeneration but not proliferation, sodium pyruvate seems to be a possible therapeutic agent to facilitate proliferation and to support mucosal regeneration after I/R injury to the small intestine.

  18. Lessons learnt from experimental temporary octopus fishing ...

    African Journals Online (AJOL)

    This paper presents evidence of the fisheries effect of experimental temporary fishing closures for Octopus in the then-emergent Velondriake Locally Managed Marine Area (LMMA) in south-west Madagascar during 2004–2006. We present an analysis of the O. cyanea catch data for the first two years of temporary closures ...

  19. Diversity patterns of temporary wetland macroinvertebrate ...

    African Journals Online (AJOL)

    Although macroinvertebrates are potentially useful for assessing the condition of temporary wetlands, little is yet known about them. Macroinvertebrate assemblages were assessed in 138 temporary wetlands in the south-western Cape, recording 126 taxa. However, predicted richness estimates were all higher than the ...

  20. Cardiac metabolism in myocardial ischemia. (United States)

    Rosano, Giuseppe M C; Fini, Massimo; Caminiti, Giuseppe; Barbaro, Giuseppe


    Myocardial ischemia occurs for a mismatch between blood flow and metabolic requirements, when the rate of oxygen and metabolic substrates delivery to the myocardium is insufficient to meet the myocardial energy requirements for a given myocardial workload. During ischemia, substantial changes occur in cardiac energy metabolism, as a consequence of the reduced oxygen availability. Some of these metabolic changes are beneficial and may help the heart adapt to the ischemic condition. However, most of the changes are maladaptive and contribute to the severity of the ischemic injury leading stunned or hibernating myocardium, cell death and ultimately to contractile disfunction. Dramatic changes in cardiac metabolism and contractile function, also occur during myocardial reperfusion as a consequence of the generation of oxygen free radicals, loss of cation homeostasis, depletion of energy stores, and changes in subcellular activities. The reperfusion injury may cause in the death of cardiac myocytes that were still viable immediately before myocardial reperfusion. This form of myocardial injury, by itself can induce cardiomyocyte death and increase infarct size. During acute ischemia the relative substrate concentration is the prime factor defining preference and utilization rate. Allosteric enzyme regulation and protein phosphorylation cascades, partially controlled by hormones such as insulin, modulate the concentration effect; together they provide short-term adjustments of cardiac energy metabolism. The expression of metabolic genes is also dynamically regulated in response to developmental and (patho)physiological conditions, leading to long-term adjustments. Specific nuclear receptor transcription factors and co-activators regulate the expression of these genes. Understanding the functional role of these changes is critical for developing the concept of metabolic intervention for heart disease. The paper will review the alterations in energy metabolism that occur

  1. Neuroglobin protection in retinal ischemia. (United States)

    Chan, Anita S Y; Saraswathy, Sindhu; Rehak, Matus; Ueki, Mari; Rao, Narsing A


    Neuroglobin (Ngb) is a vertebrate globin that is predominantly expressed in the retina and brain. To explore the role of Ngb in retinal neuroprotection during ischemia reperfusion (IR), the authors examined the effect of Ngb overexpression in the retina in vivo by using Ngb-transgenic (Ngb-Tg) mice. Retinal IR was induced in Ngb overexpressing Ngb-Tg mice and wild type (WT) mice by cannulating the anterior chamber and transiently elevating the IOP for 60 minutes. After Day 7 of reperfusion, the authors evaluated Ngb mRNA and protein expression in nonischemic control as well as ischemic mice and its effect on retinal histology, mitochondrial oxidative stress, and apoptosis, using morphometry and immunohistochemistry, quantitative PCR analysis and Western blot techniques. Ngb-Tg mice without ischemia overexpress Ngb mRNA 11.3-fold (SE ± 0.457, P layers, and photoreceptor inner segments. This overexpression of Ngb is associated with decreased mitochondrial DNA damage in Ngb-Tg mice with IR in comparison with WT. Ngb-Tg mice with IR also revealed significant preservation of retinal thickness, significantly less activated caspase 3 protein expression, and apoptosis in comparison with WT mice. Neuroglobin overexpression plays a neuroprotective role against retinal ischemia reperfusion injury due to decreasing of mitochondrial oxidative stress-mediated apoptosis.

  2. After the sunset: the residual effect of temporary legislation

    NARCIS (Netherlands)

    F.J. Fagan (Frank)


    textabstractThe difference between permanent legislation and temporary legislation is the default rule of termination: permanent legislation governs perpetually, while temporary legislation governs for a limited time. Recent literature on legislative timing rules considers the effect of temporary

  3. [Intestinal microbiota]. (United States)

    Perez, Horacio Joaquín; Menezes, Maria Elisabeth; d'Acâmpora, Armando José


    There is accumulative evidence on the multiple functions of the intestinal microflora in relation to the homeostasis of the host. At first considered as a simple mutualism, today this relationship proves to be essential to the health and to pathologic processes, particularly metabolic (eg, obesity) and gastrointestinal (eg, inflammatory bowel disease and functional disorders). The first studies were conducted on the microbiota from fecal material cultured anaerobically. With the advent of molecular biology, it has become possible to determine qualitative and quantitatively the dominant, subdominant and transients species. In recent years, there were advances in the understanding of the relationship betwen the microbiota and the host, as well as among the microorganisms in their respective niches. These advances result from translational integration of microbiology with specialities such as molecular biology, cell phisiology, immunology and ecology. There are few studies on the spatial distribution of the microflora in the gut. Unravelling the topography of the microflora in mammals is a way to validate new animal models for the study of microflora.

  4. Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor (United States)


    Background Midgut carcinoids are neuroendocrine tumors that commonly metastasize to the intestinal mesentery, where they predispose to intestinal obstruction, ischemia and/or congestion. Because of their location, many mesenteric carcinoid tumors are deemed unresectable due to the risk of uncontrollable bleeding and prolonged intestinal ischemia. Case Presentation We report the case of a 60-year-old male with a mesenteric carcinoid tumor obstructing his superior mesenteric vein, resulting in intestinal varices and severe recurrent GI bleeds. While his tumor was thought to be unresectable by conventional techniques, it was successfully resected using intestinal autotransplantation to safely gain access to the tumor. This case is the first described application of this technique to carcinoid tumors. Conclusions Intestinal autotransplantation can be utilized to safely resect mesenteric carcinoid tumors from patients who were not previously thought to be surgical candidates. We review the literature concerning both carcinoid metastases to the intestinal mesentery and the use of intestinal autotransplantation to treat lesions involving the mesenteric root. PMID:21281518

  5. Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor

    Directory of Open Access Journals (Sweden)

    Cosimi A Benedict


    Full Text Available Abstract Background Midgut carcinoids are neuroendocrine tumors that commonly metastasize to the intestinal mesentery, where they predispose to intestinal obstruction, ischemia and/or congestion. Because of their location, many mesenteric carcinoid tumors are deemed unresectable due to the risk of uncontrollable bleeding and prolonged intestinal ischemia. Case Presentation We report the case of a 60-year-old male with a mesenteric carcinoid tumor obstructing his superior mesenteric vein, resulting in intestinal varices and severe recurrent GI bleeds. While his tumor was thought to be unresectable by conventional techniques, it was successfully resected using intestinal autotransplantation to safely gain access to the tumor. This case is the first described application of this technique to carcinoid tumors. Conclusions Intestinal autotransplantation can be utilized to safely resect mesenteric carcinoid tumors from patients who were not previously thought to be surgical candidates. We review the literature concerning both carcinoid metastases to the intestinal mesentery and the use of intestinal autotransplantation to treat lesions involving the mesenteric root.

  6. Melatonin prevents ischemia - reperfusion injury following superior mesenteric artery occlusion in the rat

    Directory of Open Access Journals (Sweden)

    Pasbakhsh P.


    Full Text Available Background: Free radicals derived from molecular oxygen have been reported to be responsible for changes in motility and mucosal damages observed in intestinal Ischemia-Reperfusion (I/R injury. Melatonin has been considered as an antioxidant that prevents injuries resulting from Ischemia/Reperfusion in various tissues. This study was designed to determine the effects of melatonin at a dose dependent manner in intestinal I/R damages by contractile responses of Malondialdehyde (MDA, a product of lipid peroxidation in rats.Material and methods: A total of 36 young male Wistar - Albino rats (80 - 120 g were divided equally in to 6 groups and subjected to different concentration of melatonin (10, 20, 30 mg/Kg .Group 1 was control, group 2 was sham that were subjected to surgical process for Superior Mesenteric Artery (SMA dissection. Groups 3, 4, 5 and 6 were I/R that were given melatonin at 0, 10, 20 and 30 mg/kg respectively. After laparatomy, a microvascular traumatic clip was placed across the SMA under general anesthesia, and following ischemia for 30 minutes it was removed. The first dose of melatonin was administrated before, and the second dose was administrated just after reperfusion, and the third dose was administrated on the second day, all by intramuscular route. On the third day of the experiment all rats were killed, and their bowels were removed. Results: The levels of tissue malondialdehyde were found to be significantly lower in group 4 compared to group 3 (P < 0.05.There was significant differences in histopathological patterns of group 4 compared with group 3 (P < 0.01. MDA levels, in groups 5 and 6, showed no significant changes in comparison to I/R group.Conclusion: These results showed that Melatonin at dose of 10 mg/Kg has antioxidant effects and prevents rat intestinal ischemia - reperfusion damages. 

  7. Purkinje fibers after myocardial ischemia-reperfusion. (United States)

    García Gómez-Heras, Soledad; Álvarez-Ayuso, Lourdes; Torralba Arranz, Amalia; Fernández-García, Héctor


    The purpose of this study was to evaluate the effects of ischemia-reperfusion on Purkinje fibers, comparing them with the adjacent cardiomyocytes. In a model of heterotopic heart transplantation in pigs, the donor heart was subjected to 2 hours of ischemia (n=9), preserved in cold saline, and subjected to 24 hours of ischemia with preservation in Wisconsin solution, alone (n=6), or with an additive consisting of calcium (n=4), Nicorandil (n=6) or Trolox (n=7). After 2 hours of reperfusion, we evaluated the recovery of cardiac electrical activity and took samples of ventricular myocardium for morphological study. The prolonged ischemia significantly affected atrial automaticity and A-V conduction in all the groups subjected to 24 hours of ischemia, as compared to 2 hours. There were no significant differences among the groups that underwent prolonged ischemia. Changes in the electrical activity did not correlate with the morphological changes. In the Purkinje fibers, ischemia-reperfusion produced a marked decrease in the glycogen content in all the groups. In the gap junctions the immunolabeling of connexin-43 decreased significantly, adopting a dispersed distribution, and staining the sarcolemma adjacent to the connective tissue. These changes were less marked in the group preserved exclusively with Wisconsin solution, despite the prolonged ischemia. The addition of other substances did not improve the altered morphology. In all the groups, the injury appeared to be more prominent in the Purkinje fibers than in the neighboring cardiomyocytes, indicating the greater susceptibility of the former to ischemia-reperfusion injury.

  8. Portal-venous gas unrelated to mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, Walter; Mortele, Koenraad J.; Ji, Hoon; Ros, Pablo R. [Department of Radiology, Brigham and Women' s Hospital, Boston, MA (United States); Glickman, Jonathan N. [Department of Pathology, Brigham and Women' s Hospital, Boston, MA (United States)


    The aim of this study was to report on 8 patients with all different non-ischemic etiologies for portal-venous gas and to discuss this rare entity and its potentially misleading CT findings in context with a review of the literature. The CT examinations of eight patients who presented with intrahepatic portal-venous gas, unrelated to bowel ischemia or infarction, were reviewed and compared with their medical records with special emphasis on the pathogenesis and clinical impact of portal-venous gas caused by non-ischemic conditions. The etiologies for portal-venous gas included: abdominal trauma (n=1); large gastric cancer (n=1); prior gastroscopic biopsy (n=1); prior hemicolectomy (n=1); graft-vs-host reaction (n=1); large paracolic abscess (n=1); mesenteric recurrence of ovarian cancer superinfected with clostridium septicum (n=1); and sepsis with Pseudomonas aeruginosa (n=1). The clinical outcome of all patients was determined by their underlying disease and not negatively influenced by the presence of portal-venous gas. Although the presence of portal-venous gas usually raises the suspicion of bowel ischemia and/or intestinal necrosis, this CT finding may be related to a variety of non-ischemic etiologies and pathogeneses as well. The knowledge about these conditions may help to avoid misinterpretation of CT findings, inappropriate clinical uncertainty and unnecessary surgery in certain cases. (orig.)

  9. Remote ischemic preconditioning: a novel protective method from ischemia reperfusion injury--a review. (United States)

    Tapuria, Niteen; Kumar, Yogesh; Habib, Meer Mohammad; Abu Amara, Mahmoud; Seifalian, Alexander M; Davidson, Brian R


    Restoration of blood supply to an organ after a critical period of ischemia results in parenchymal injury and dysfunction of the organ referred to as reperfusion injury. Ischemia reperfusion injury is often seen in organ transplants, major organ resections and in shock. Ischemic preconditioning (IPC) is an adaptational response of briefly ischemic tissues which serves to protect against subsequent prolonged ischemic insults and reperfusion injury. Ischemic preconditioning can be mechanical or pharmacological. Direct mechanical preconditioning in which the target organ is exposed to brief ischemia prior to prolonged ischemia has the benefit of reducing ischemia-reperfusion injury (IRI) but its main disadvantage is trauma to major vessels and stress to the target organ. Remote (inter organ) preconditioning is a recent observation in which brief ischemia of one organ has been shown to confer protection on distant organs without direct stress to the organ. To discuss the evidence for remote IPC (RIPC), underlying mechanisms and possible clinical applications of RIPC. METHODS OF SEARCH: A Pubmed search with the keywords "ischemic preconditioning," "remote preconditioning," "remote ischemic preconditioning," and "ischemia reperfusion" was done. All articles on remote preconditioning up to September 2006 have been reviewed. Relevant reference articles from within these have been selected for further discussion. Experimental studies have demonstrated that the heart, liver, lung, intestine, brain, kidney and limbs are capable of producing remote preconditioning when subjected to brief IR. Remote intra-organ preconditioning was first described in the heart where brief ischemia in one territory led to protection in other areas. Translation of RIPC to clinical application has been demonstrated by the use of brief forearm ischemia in preconditioning the heart prior to coronary bypass and in reducing endothelial dysfunction of the contra lateral limb. Recently protection of the

  10. Avaliação da viabilidade de intestino delgado com isquemia experimental pelo uso de fluoresceína sódica em eqüinos Evaluation of the small intestine viability with experimental ischemia by the use of sodic fluorescein in horses

    Directory of Open Access Journals (Sweden)

    Augusto Sampaio


    Full Text Available Com o objetivo de testar o sal sódico de fluoresceína na indicação da viabilidade intestinal em casos de processos isquêmicos do intestino delgado de eqüinos, desenvolveu-se um modelo isquêmico através de ligadura artério-venosa durante 120 minutos. Foram utilizados 10 animais, SRD, sendo seis machos, com peso e idade médios de 293kg e 11 anos. Cada animal foi submetido a duas cirurgias, uma para a realização das ligaduras e observação do desempenho da fluoresceína e outra, 24 horas após, para confirmação macroscópica das informações obtidas na primeira cirurgia. O acesso adotado foi pela linha média, sendo exteriorizado um segmento de aproximadamente 20 cm de intestino delgado. Após o período estabelecido para a isquemia, as ligaduras foram desfeitas e o segmento intestinal foi avaliado através da fluoresceína sódica, aplicada sistematicamente na dose de 100 mg/kg, quanto às condições de viabilidade tecidual. A fluoresceína sódica mostrou-se como um objetivo e seguro método de indicação da viabilidade intestinal.The purpose of this study was to evaluate the use of fluorescein as an indicator of intestinal viability under schemic processes induced by A-V ligature during 120 minutes. Ten mixed-breed horses, 6 males and 4 females, with an average weight and age of 293kg and 11 years, respectively were submitted to two surgeries, one to make the ligatures and to observe the effects of fluorescein; the second, 24 hours later, to confirm macroscopically the information obtained during the first. The surgical approach was made through the abdominal midline and a 20cm long segment of the small intestine was exteriorized. After the ischemic period the ligatures were removed and the intestinal segment was evaluated for tissue viability by the systemic injection of 100mg/B.W. of sodic fluorescein. The results revealed that sodicfluorescein is a good and safe indicator of intestinal viability.

  11. Intestinal microbiota in healthy adults: temporal analysis reveals individual and common core and relation to intestinal symptoms.

    Directory of Open Access Journals (Sweden)

    Jonna Jalanka-Tuovinen

    Full Text Available BACKGROUND: While our knowledge of the intestinal microbiota during disease is accumulating, basic information of the microbiota in healthy subjects is still scarce. The aim of this study was to characterize the intestinal microbiota of healthy adults and specifically address its temporal stability, core microbiota and relation with intestinal symptoms. We carried out a longitudinal study by following a set of 15 healthy Finnish subjects for seven weeks and regularly assessed their intestinal bacteria and archaea with the Human Intestinal Tract (HIT Chip, a phylogenetic microarray, in conjunction with qPCR analyses. The health perception and occurrence of intestinal symptoms was recorded by questionnaire at each sampling point. PRINCIPAL FINDINGS: A high overall temporal stability of the microbiota was observed. Five subjects showed transient microbiota destabilization, which correlated not only with the intake of antibiotics but also with overseas travelling and temporary illness, expanding the hitherto known factors affecting the intestinal microbiota. We identified significant correlations between the microbiota and common intestinal symptoms, including abdominal pain and bloating. The most striking finding was the inverse correlation between Bifidobacteria and abdominal pain: subjects who experienced pain had over five-fold less Bifidobacteria compared to those without pain. Finally, a novel computational approach was used to define the common core microbiota, highlighting the role of the analysis depth in finding the phylogenetic core and estimating its size. The in-depth analysis suggested that we share a substantial number of our intestinal phylotypes but as they represent highly variable proportions of the total community, many of them often remain undetected. CONCLUSIONS/SIGNIFICANCE: A global and high-resolution microbiota analysis was carried out to determine the temporal stability, the associations with intestinal symptoms, and the

  12. The metabolism of C-glucose by neurons and astrocytes in brain subregions following focal cerebral ischemia in rats. (United States)

    Thoren, Anna E; Helps, Stephen C; Nilsson, Michael; Sims, Neil R


    To provide insights into the effects of temporary focal ischemia on the function of neurons and astrocytes in vivo, we measured the incorporation of radiolabel from [U-14C]glucose into both glutamate and glutamine in brain subregions at 1 h of reperfusion following occlusion of the middle cerebral artery for 2 or 3 h. Under the experimental conditions used, 14C-glutamate is mainly produced in neurons whereas 14C-glutamine is generated in astrocytes from 14C-glutamate of both neuronal and astrocytic origin. Radiolabel incorporation into both amino acids was greatly decreased. The change in 14C-glutamate accumulation provides strong evidence for substantial reductions in neuronal glucose metabolism. The resulting decrease in delivery of 14C-glutamate from the neurons to astrocytes was probably also the major contributor to the change in 14C-glutamine content. These alterations probably result in part from a marked depression of glycolytic activity in the neurons, as suggested by previous studies assessing deoxyglucose utilization. Alterations in 14C-glucose metabolism were not restricted to tissue that would subsequently become infarcted. Thus, these changes did not inevitably lead to death of the affected cells. The ATP : ADP ratio and phosphocreatine content were essentially preserved during recirculation following 2 h of ischemia and showed at most only moderate losses in some subregions following 3 h of ischemia. This retention of energy reserves despite the decreases in 14C-glucose metabolism in neurons suggests that energy needs were substantially reduced in the post-ischemic brain. Marked increases in tissue lactate accumulation during recirculation, particularly following 3 h of ischemia, provided evidence that impaired pyruvate oxidation probably also contributed to the altered 14C-glucose metabolism. These findings indicate the presence of complex changes in energy metabolism that are likely to greatly influence the responses of neurons and astrocytes to

  13. Temporary closure of the tunnel

    CERN Multimedia

    Relations with the Host States Service


    Owing to major maintenance work, the tunnel linking the various parts of the CERN site will be closed from Monday 4 July to Sunday 24 July 2005 The Host State authorities have given authorisation for persons employed by CERN or the Institutes to travel and for goods belonging to these entities to be transported between the various parts of the site via Gate E (Charles de Gaulle) while this work is being carried out, subject to strict compliance with the Rules for the Use of the Tunnel (see Gate E will thus be open between 7.00 a.m. and 7.00 p.m. from Monday to Friday during the period concerned. The rules governing the use of Gate E to enter the Meyrin site between 7.30 a.m. and 9.00 a.m. or to leave the site between 5.00 p.m. and 6.30 p.m. (see will remain unaffected by this temporary authorisation. Relations with the Host States Service and TS-FM Group

  14. History and definition of delayed cerebral ischemia. (United States)

    Macdonald, R Loch


    A list of the vasospasm meetings is provided. The early descriptions of angiographic vasospasm and delayed cerebral ischemia are presented. Selected advances in knowledge in the field and some controversies are described. A proposal for definitions of neurological deterioration due to delayed cerebral ischemia, of cerebral infarction, and of vasospasm is reviewed.

  15. Intestinal microbiome landscaping

    NARCIS (Netherlands)

    Shetty, Sudarshan A.; Hugenholtz, Floor; Lahti, Leo; Smidt, Hauke; Vos, de Willem M.


    High individuality, large complexity and limited understanding of the mechanisms underlying human intestinal microbiome function remain the major challenges for designing beneficial modulation strategies. Exemplified by the analysis of intestinal bacteria in a thousand Western adults, we discuss

  16. Vasoactive intestinal peptide test (United States)

    ... Vasoactive intestinal peptide test To use the sharing features on this page, please enable JavaScript. Vasoactive intestinal peptide (VIP) is a test that measures the amount ...

  17. PC based temporary shielding administrative procedure (TSAP)

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, D.E.; Pederson, G.E. [Sargent & Lundy, Chicago, IL (United States); Hamby, P.N. [Commonwealth Edison Co., Downers Grove, IL (United States)


    A completely new Administrative Procedure for temporary shielding was developed for use at Commonwealth Edison`s six nuclear stations. This procedure promotes the use of shielding, and addresses industry requirements for the use and control of temporary shielding. The importance of an effective procedure has increased since more temporary shielding is being used as ALARA goals become more ambitious. To help implement the administrative procedure, a personal computer software program was written to incorporate the procedural requirements. This software incorporates the useability of a Windows graphical user interface with extensive help and database features. This combination of a comprehensive administrative procedure and user friendly software promotes the effective use and management of temporary shielding while ensuring that industry requirements are met.

  18. Temporary Authorizations at Permitted Waste Management Facilities (United States)

    This rule under the Code of Federal Regulations (CFR) provides EPA with the authority to grant a permittee temporary authorization, without prior public notice and comment, to conduct activities necessary to respond promptly to changing conditions.

  19. Intestinal lymphangiectasia in adults


    Freeman, Hugh James; Nimmo, Michael


    Intestinal lymphangiectasia in the adult may be characterized as a disorder with dilated intestinal lacteals causing loss of lymph into the lumen of the small intestine and resultant hypoproteinemia, hypogammaglobulinemia, hypoalbuminemia and reduced number of circulating lymphocytes or lymphopenia. Most often, intestinal lymphangiectasia has been recorded in children, often in neonates, usually with other congenital abnormalities but initial definition in adults including the elderly has bec...

  20. Estimation of temporary emigration in male toads. (United States)

    Muths, Erin; Scherer, Rick D; Corn, Paul Stephen; Lambert, Brad A


    Male boreal toads (Bufo boreas) are thought to return to the breeding site every year but, if absent in a particular year, will be more likely to return the following year. Using Pollock's robust design we estimated temporary emigration (the probability a male toad is absent from a breeding site in a given year) at three locations in Colorado, USA: two in Rocky Mountain National Park and one in Chaffee County. We present data that suggest that not all male toads return to the breeding site every year. Our analyses indicate that temporary emigration varies by site and time (for example, from 1992 to 1998, the probability of temporary emigration ranged from 10% to 29% and from 3% to 95% at Lost Lake and Kettle Tarn, respectively). Although the results provide weak evidence that males are more likely to return after a year's hiatus, a general pattern of state-dependent temporary emigration was not supported. We also hypothesized relationships between temporary emigration and a number of weather variables. While some competitive models included weather covariates, imprecise and variable estimates of the effects of these covariates precluded fully defining their impact on temporary emigration.

  1. Ischemic preconditioning increased the intestinal stem cell activities in the intestinal crypts in mice. (United States)

    Chen, Yun; Lee, Shih-Hua; Tsai, Ya-Hui; Tseng, Sheng-Hong


    Ischemic preconditioning (IPC) can protect against ischemia-reperfusion injury in the small intestine. Because intestinal stem cells (ISCs) control the recovery and growth of intestinal villi, this study investigated whether IPC had any effects on the activity of ISCs. The small intestines of mice were treated with IPC, laparotomy only (sham), or no surgery. The crypt fractions were isolated and the characteristics of ISCs among various groups were compared. The regenerative ability and the number of organoids grown from various crypt fractions were compared. The expression of hypoxia-inducible factor-1α (HIF-1α) and the related proteins of the Wnt-/β-catenin pathway in the crypt fractions were studied. The IPC group had higher messenger RNA levels of various stem cell markers than the sham group at days 1 and 2 after surgery. The IPC group exhibited greater regenerative activity and more crypt organoids than the sham group (P IPC-treated crypt fractions in vivo and cultured crypt organoid cells with deferoxamine-mimicked hypoxia in vitro. IPC significantly upregulated the activity of ISCs, possibly through the HIF-1α response and Wnt-/β-catenin signaling pathway. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. (United States)

    Bala, Miklosh; Kashuk, Jeffry; Moore, Ernest E; Kluger, Yoram; Biffl, Walter; Gomes, Carlos Augusto; Ben-Ishay, Offir; Rubinstein, Chen; Balogh, Zsolt J; Civil, Ian; Coccolini, Federico; Leppaniemi, Ari; Peitzman, Andrew; Ansaloni, Luca; Sugrue, Michael; Sartelli, Massimo; Di Saverio, Salomone; Fraga, Gustavo P; Catena, Fausto


    Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions. Therefore, although the entity is an uncommon cause of abdominal pain, diligence is always required because if untreated, mortality has consistently been reported in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment and are essential to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques may provide new options. Thus, we believe that a current position paper from World Society of Emergency Surgery (WSES) is warranted, in order to put forth the most recent and practical recommendations for diagnosis and treatment of AMI. This review will address the concepts of AMI with the aim of focusing on specific areas where early diagnosis and management hold the strongest potential for improving outcomes in this disease process. Some of the key points include the prompt use of CT angiography to establish the diagnosis, evaluation of the potential for revascularization to re-establish blood flow to ischemic bowel, resection of necrotic intestine, and use of damage control techniques when appropriate to allow for re-assessment of bowel viability prior to definitive anastomosis and abdominal closure.

  3. [Acute mesenteric ischemia and rhinopharyngeal carcinoma]. (United States)

    Pigneret, S; Baudon Lecame, M; Chédru Legros, V; Choussy, O; Babin, E


    This work is a part of a pharmacovigilancy survey. To determine the links between radiation therapy, chemotherapy, nasopharyngeal carcinoma and mesenteric ischemia. A case of 69 year old man with a nasopharyngeal carcinoma, treated by radiation therapy and chemotherapy, who developed a lethal mesenteric ischemia is described. Etiology of mesenteric ischemia was unknown. A review of literature had been made on Pubmed with terms: "Mesenteric ischemia" and cisplatin, 5-FU or fluorouracil, radiation therapy, cancer or neoplasm, "head and neck cancer" or "carcinoma of the nasopharynx. In our case, the origin of the mesenteric ischemia is not atheromatous. Chimiotherapy with 5-fluorouracile and cisplatine, radiation therapy and morphine were suspected. According to literature, responsibility of morphine and radiation therapy is uncertain. In opposition, the 5-FU and the cisplatine can be incriminated. Mesenteric ischemia is an uncommon adverse effect of a treatment with cisplatin and 5-FU. It's the second case of mesenteric ischemia associated with a treatment with 5-FU and cisplatin in a patient with a nasopharyngeal carcinoma. ENT physicians must be aware of this complication.

  4. Regional blood flow distribution and oxygen metabolism during mesenteric ischemia and congestion. (United States)

    Cruz, Ruy J; Garrido, Alejandra G; Ribeiro, Cristiane M F; Harada, Tomoyuki; Rocha-e-Silva, Mauricio


    Acute mesenteric ischemia is a potentially fatal vascular emergency with mortality rates ranging between 60% and 80%. Several studies have extensively examined the hemodynamic and metabolic effects of superior mesenteric artery occlusion. On the other hand, the cardiocirculatory derangement and the tissue damage induced by intestinal outflow obstruction have not been investigated systematically. For these reasons we decided to assess the initial impact of venous mesenteric occlusion on intestinal blood flow distribution, and correlate these findings with other systemic and regional perfusion markers. Fourteen mongrel dogs were subjected to 45 min of superior mesenteric artery (SMAO) or vein occlusion (SMVO), and observed for 120 min after reperfusion. Systemic hemodynamics were evaluated using Swan-Ganz and arterial catheters. Regional blood flow (ultrasonic flow probes), intestinal O(2)-derived variables, and mesenteric-arterial and tonometric-arterial pCO(2) gradients (D(mv-a)pCO(2) and D(t-a)pCO(2)) were also calculated. SMVO was associated with hypotension and low cardiac output. A significant increase in the regional pCO(2) gradients was also observed in both groups during the ischemic period. After reperfusion, a progressive reduction in D(mv-a)pCO(2) occurred in the SMVO group; however, no improvement in D(t-a)pCO(2) was observed. The histopathologic injury scores were 2.7 +/- 0.5 and 4.8 +/- 0.2 for SMAO and SMVO, respectively. SMV occlusion promoted early and significant hemodynamic and metabolic derangement at systemic and regional levels. Additionally, systemic pCO(2) gradient is not a reliable parameter to evaluate the local intestinal oxygenation. Finally, the D(t-a)pCO(2) correlates with histologic changes during intestinal congestion or ischemia. However, minor histologic changes cannot be detected using this methodology. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  5. Leg ischemia post-varicocelectomy

    Directory of Open Access Journals (Sweden)

    Al-Wahbi AM


    Full Text Available Abdullah M Al-Wahbi1, Shaza Elmoukaied2 1Division of Vascular Surgery, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2Department of Surgery, Dr Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia Abstract: Varicocelectomy is the most commonly performed operation for the treatment of male infertility. Many surgical approaches are used as each of them has advantages over the other and is preferred by surgeons. Vascular injury has never been reported as a complication of varicocelectomy apart from testicular artery injury. We present a 36-year-old male who developed leg ischemia post-varicocelectomy due to common femoral artery injury. He was successfully treated by using a vein graft. Keywords: varicocele, varicocelectomy, complications, vascular injuries

  6. Autophagy and tight junction proteins in the intestine and intestinal diseases

    Directory of Open Access Journals (Sweden)

    Chien-An A. Hu


    Full Text Available The intestinal epithelium (IE forms an indispensible barrier and interface between the intestinal interstitium and the luminal environment. The IE regulates water, ion and nutrient transport while providing a barrier against toxins, pathogens (bacteria, fungi and virus and antigens. The apical intercellular tight junctions (TJ are responsible for the paracellular barrier function and regulate trans-epithelial flux of ions and solutes between adjacent cells. Increased intestinal permeability caused by defects in the IE TJ barrier is considered an important pathogenic factor for the development of intestinal inflammation, diarrhea and malnutrition in humans and animals. In fact, defects in the IE TJ barrier allow increased antigenic penetration, resulting in an amplified inflammatory response in inflammatory bowel disease (IBD, necrotizing enterocolitis and ischemia-reperfusion injury. Conversely, the beneficial enhancement of the intestinal TJ barrier has been shown to resolve intestinal inflammation and apoptosis in both animal models of IBD and human IBD. Autophagy (self-eating mechanism is an intracellular lysosome-dependent degradation and recycling pathway essential for cell survival and homeostasis. Dysregulated autophagy has been shown to be directly associated with many pathological processes, including IBD. Importantly, the crosstalk between IE TJ and autophagy has been revealed recently. We showed that autophagy enhanced IE TJ barrier function by increasing transepithelial resistance and reducing the paracellular permeability of small solutes and ions, which is, in part, by targeting claudin-2, a cation-selective, pore-forming, transmembrane TJ protein, for lysosome (autophagy-mediated degradation. Interestingly, previous studies have shown that the inflamed intestinal mucosa in patients with active IBD has increased claudin-2 expression. In addition, inflammatory cytokines (for example, tumor necrosis factor-α, interleukin-6

  7. The Effects of Apelin on Mesenteric Ischemia and Reperfusion Damage in an Experimental Rat Model

    Directory of Open Access Journals (Sweden)

    Mustafa Burak Sayhan


    Full Text Available Objective: Intestinal ischemia-reperfusion (I/R injury is associated with high morbidity and mortality rates. There is ongoing research to find an effective preventive or treatment agent. We aimed to evaluate the effects of apelin 13 (AP on intestinal I/R injury in a rat model. Material and Methods: Twenty-four male Sprague-Dawley rats aged 6-8 weeks and weighing 280±20 g were equally divided into three groups (control, I/R and I/R+AP. The control group underwent superior mesenteric artery (SMA mobilization alone without any clamping. In the I/R and I/R+AP groups, an atraumatic microvascular bulldog clamp was placed across the SMA at its point of origin from the aorta. In the I/R+AP group, 2 µg/kg/d apelin was administered intraperitoneally. After 60 minutes of ischemia, relaparotomy was performed to remove the microvascular clamp on the SMA for 3 hours of reperfusion. After 3 hours, tissue samples were obtained for biochemical [malondialdehyde (MDA and glutathione (GSH levels] and histopathological analyses.Results: MDA levels were significantly higher in the I/R group compared to the control group. Although MDA levels were lower in the I/R+AP group compared tothe I/R group, the difference was not statistically significant. There was also no significant difference between the I/R+AP and I/R groups regarding GSH levels. The median histopathological grade was significantly lower in the I/R+AP group compared to the I/R group (p=0.001.Conclusion: Apelin appeared to have a positive effect on oxidative injury; this did not reach statistical significance. Thus, the role of apelin and associated findings in the initial treatment of intestinal ischemia needs further large-scale animal studies before human use.

  8. Synergistic Effect of Ischemic Preconditioning and Antithrombin in Ischemia-Reperfusion Injury. (United States)

    Vrakas, Georgios; Tsalis, Konstantinos; Roidos, Georgios Nikolaos; Christoforidis, Emmanuel; Kouzi-Koliakou, Kokkona; Lazaridis, Charalampos; Vaidya, Anil


    Our study aimed to determine whether antithrombin plays a synergistic role in accentuating the effects of intestinal ischemic preconditioning. Fifty rats were randomly allocated to 5 groups (10 rats/group) as follows: sham treatment (group 1); ischemia-reperfusion (group 2); ischemic preconditioning followed by ischemia-reperfusion (group 3); antithrombin + ischemia-reperfusion, similar to group 2 but including antithrombin administration (group 4); and antithrombin + ischemic preconditioning, similar to group 3 but including antithrombin administration (group 5). Blood samples and liver specimens were obtained for measurement of cytokines, myeloperoxidase, and malondialdehyde. Liver biopsies were examined by electron microscopy. Intestinal ischemia-reperfusion induced a remote hepatic inflammatory response as evidenced by the striking increase of proinflammatory cytokines, myeloperoxidase, and malondialdehyde. Tumor necrosis factor-α levels in group 5 (12.48 ± 0.7 pg/mL) were significantly lower than in group 3 (13.64 ± 0.78 pg/mL; P = .014). Mean interleukin 1β was lower in group 5 (9.52 ± 0.67pg/mL) than in group 3 (11.05 ± 1.9 pg/mL; P > .99). Mean interleukin 6 was also significantly lower in group 5 (17.13 ± 0.54 pg/mL) than in group 3 (23.82 ± 1 pg/mL; P ≤ .001). Myeloperoxidase levels were significantly higher in group 3 (20.52 ± 2.26 U/g) than in group 5 (18.59 ± 1.03 U/g; P = .025). However, malondialdehyde levels did not significantly improve in group 5 (4.55 ± 0.46 μmol) versus group 3 (5.17 ± 0.61 μmol; P = .286). Tumor necrosis factor-α, interleukin 6, and myeloperoxidase findings show that antithrombin administration further attenuated the inflammatory response caused by ischemia-reperfusion, suggesting a synergistic effect with ischemic preconditioning. These findings were confirmed by electron microscopy. The addition of antithrombin to ischemic preconditioning may act to attenuate or prevent damage from ischemia-reperfusion injury

  9. Need for adaptation: transformation of temporary houses. (United States)

    Wagemann, Elizabeth


    Building permanent accommodation after a disaster takes time for reasons including the removal of debris, the lack of available land, and the procurement of resources. In the period in-between, affected communities find shelter in different ways. Temporary houses or transitional shelters are used when families cannot return to their pre-disaster homes and no other alternative can be provided. In practice, families stay in a standard interim solution for months or even years while trying to return to their routines. Consequently, they adapt their houses to meet their midterm needs. This study analysed temporary houses in Chile and Peru to illustrate how families modify them with or without external support. The paper underlines that guidance must be given on how to alter them safely and on how to incorporate the temporary solution into the permanent structure, because families adapt their houses whether or not they are so designed. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  10. Generation of in vivo activating factors in the ischemic intestine by pancreatic enzymes (United States)

    Mitsuoka, Hiroshi; Kistler, Erik B.; Schmid-Schönbein, Geert W.


    One of the early events in physiological shock is the generation of activators for leukocytes, endothelial cells, and other cells in the cardiovascular system. The mechanism by which these activators are produced has remained unresolved. We examine here the hypothesis that pancreatic digestive enzymes in the ischemic intestine may be involved in the generation of activators during intestinal ischemia. The lumen of the small intestine of rats was continuously perfused with saline containing a broadly acting pancreatic enzyme inhibitor (6-amidino-2-naphthyl p-guanidinobenzoate dimethanesulfate, 0.37 mM) before and during ischemia of the small intestine by splanchnic artery occlusion. This procedure inhibited activation of circulating leukocytes during occlusion and reperfusion. It also prevented the appearance of activators in portal venous and systemic artery plasma and attenuated initiating symptoms of multiple organ injury in shock. Intestinal tissue produces only low levels of activators in the absence of pancreatic enzymes, whereas in the presence of enzymes, activators are produced in a concentration- and time-dependent fashion. The results indicate that pancreatic digestive enzymes in the ischemic intestine serve as an important source for cell activation and inflammation, as well as multiple organ failure.

  11. Water-soluble contrast media in obstructed and in ischemic intestine; A clinical and experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Stordahl, A. (Rikshospitalet, Oslo (Norway))


    The present work was undertaken to study the diagnostic efficacy of the water-soluble contrast media iohexol and sodium diatrizoate in the gastrointestinal tract, and to establish a method for the discrimination between intestinal obstruction and ischemia. The effects of the two contrast media were evaluated in 50 patients and in rats. The study gave the following results: Iohexol is a good, or better alternative to sodium diatrizoate regarding taste acceptance and patient reactions. Water-soluble contrast media may have therapeutic effects on intestinal obstruction when preceded by conventional gastric suction using a short gastric tube. The water-soluble, low-osmolar contrast media seem promising as diagnostic aids in the examination of the gastrointestinal tract. Waster-soluble contrast media may aid the diagnosis of bowel ischemia and the evaluation of the degree of ischemic injury. The chief route of absorption of water-soluble contrast media from ischemic bowel to blood is transmural and transperitoneal (>90% of the total absorption) before subsequent excretion in the urine. The use of hyperosmolar contrast media in the ischemic small intestine may enhance intestinal ischemia and systematic dehydration, and provoke septic complications by the enteric microflora. 68 refs.

  12. Chronic cerebral ischemia, neuroplasticity, possibilities of therapy

    Directory of Open Access Journals (Sweden)

    E. I. Chukanova


    Full Text Available The paper presents current views on the pathogenetic mechanisms of cerebral ischemia. It discusses the role of neurotrophins in the processes of neuroplasticity. Experimental and clinical studies of the neuropeptide drug Cerebrolysin are reviewed. The authors describe in detail the results of the clinical trial and a health economic analysis of the effects of Cerebrolysin on the time course of clinical changes, progression, and risk of exacerbations in patients with chronic cerebral ischemia

  13. Ischemic small intestine-in vivo versus ex vivo bioimpedance measurements. (United States)

    Strand-Amundsen, Runar J; Reims, Henrik M; Tronstad, Christian; Kalvøy, Håvard; Martinsen, Ørjan G; Høgetveit, Jan O; Ruud, Tom E; Tønnessen, Tor I


    Bioimpedance has been used to investigate changes in electrical parameters during ischemia in various tissues. The small intestine is a multi-layered structure, with several distinct tissue types, and ischemia related changes occur at different times in the different intestinal layers. When investigating how the electrical properties in the small intestine is affected by ischemia, some researchers have used ex vivo models while others have used in vivo models. In this study, we compare ischemic time development of electrical parameters in ischemic in vivo versus ex vivo small intestine. Measurements were performed using a two-electrode setup, with a Solartron 1260/1294 impedance gain-phase analyser. Electrodes were placed on the surface of ischemic pig jejunum, applying a voltage and measuring the resulting electrical admittance. In each pig, 4 segments of the jejunum were made ischemic by clamping the mesenteric arteries and veins, resulting in a 30 cm central zone of warm ischemia and edema. The in vivo part of the experiment lasted 10 h, after which 3 pieces of perfused small intestine were resected, stored in Ringer-acetat at 38 °C, and measured during a 10 h ex vivo experiment. Main results and significance: We found significant differences (p  vivo and ex vivo measurements as a function of ischemic time development. We also observed some similarities in the trends. In vivo, we measured an overall decrease in impedance during the duration of the experiment, probably as a result from the formation of edema. Ex vivo, the low frequency impedance increased initially for approximately 3 h before starting to decrease.

  14. Closing a temporary ileostomy within two weeks. (United States)

    Hindenburg, Tommy; Rosenberg, Jacob


    Temporary ileostomy is frequently constructed to relieve a rectal anastomosis and avoid peritonitis if the anastomosis is leaking. Ostomy is a burden for both the patient and society and early closure is therefore desirable to counteract increased morbidity. Several prospective studies and a single randomized controlled trial have shown that closure in less than two weeks was associated with lower or equal morbidity compared with later closure. Thus, current data support early closure of temporary ileostomy performed to cover rectal anastomosis in routine clinical practice.

  15. Nurses' perceptions of temporary nursing service agencies. (United States)

    Sorrentino, E A; Simunek, L A


    Temporary staffing agencies have indeed carved out a role for themselves, and our free enterprise system lends itself to the perpetuation of the entrepreneurial spirit in all: nurses, agencies, and hospitals alike. It is wiser to learn to work with current structure realizing that supply and demand plays an important role in the survival and success of agencies. Although there are problems associated with temporary nursing staffing, they are surmountable. Orientation programs, performance monitoring, ensuring accountability of both nurse and agency are but a few that can enhance utilization and quality of service.

  16. Utilization of donors who have suffered cardiopulmonary arrest and resuscitation in intestinal transplantation. (United States)

    Matsumoto, Cal S; Kaufman, Stuart S; Girlanda, Raffaele; Little, Cheryl M; Rekhtman, Yuliya; Raofi, Vandad; Laurin, Jaqueline M; Shetty, Kirti; Fennelly, Erin M; Johnson, Lynt B; Fishbein, Thomas M


    Cardiopulmonary resuscitation (CPR) of a person destined to become an organ donor has been associated with overall poor donor quality, especially for the intestinal donor, as splanchnic vasoconstriction that is intended to preserve coronary and cerebral blood flow may result in clinically relevant intestinal ischemia. Outcomes of recipients who receive intestine grafts that have suffered CPR are unknown. We sought to analyze our clinical experience in using intestinal grafts from donors who suffered cardiopulmonary arrest and resuscitation and to evaluate the outcome of recipients of organs coming from resuscitated donors when compared with recipients of nonresuscitated donors. We retrospectively analyzed the donor and recipient charts of all of our intestinal transplants with regard to the performance of donor CPR. Sixty-seven intestinal transplants were performed in 65 patients from November 2003 to December 2007. Twelve donors (18%) were identified as having suffered cardiac arrest and subsequent CPR. Mean duration of CPR was 19.3+/-12.7 min. Terminal laboratory profiles of CPR donors and non-CPR donors were similar. Of the 12 resuscitated grafts, two were used for multivisceral, one for a modified multivisceral, seven for liver-intestine, and two for isolated intestinal transplant. There were no significant differences in outcome parameters such as operative time, blood use, ventilation days, length of stay, time to enteral independence, rejection, enteric bacteremia, and survival between the 12 resuscitated grafts and the 55 nonresuscitated grafts. A donor history of cardiac arrest should not automatically exclude the use of the intestine graft for transplantation.

  17. Deletion of TRAAK potassium channel affects brain metabolism and protects against ischemia.

    Directory of Open Access Journals (Sweden)

    Christophe Laigle

    Full Text Available Cerebral stroke is a worldwide leading cause of disability. The two-pore domain K⁺ channels identified as background channels are involved in many functions in brain under physiological and pathological conditions. We addressed the hypothesis that TRAAK, a mechano-gated and lipid-sensitive two-pore domain K⁺ channel, is involved in the pathophysiology of brain ischemia. We studied the effects of TRAAK deletion on brain morphology and metabolism under physiological conditions, and during temporary focal cerebral ischemia in Traak⁻/⁻ mice using a combination of in vivo magnetic resonance imaging (MRI techniques and multinuclear magnetic resonance spectroscopy (MRS methods. We provide the first in vivo evidence establishing a link between TRAAK and neurometabolism. Under physiological conditions, Traak⁻/⁻ mice showed a particular metabolic phenotype characterized by higher levels of taurine and myo-inositol than Traak⁺/⁺ mice. Upon ischemia, Traak⁻/⁻ mice had a smaller infarcted volume, with lower contribution of cellular edema than Traak⁺/⁺ mice. Moreover, brain microcirculation was less damaged, and brain metabolism and pH were preserved. Our results show that expression of TRAAK strongly influences tissue levels of organic osmolytes. Traak⁻/⁻ mice resilience to cellular edema under ischemia appears related to their physiologically high levels of myo-inositol and of taurine, an aminoacid involved in the modulation of mitochondrial activity and cell death. The beneficial effects of TRAAK deletion designate this channel as a promising pharmacological target for the treatment against stroke.

  18. Common intestinal parasites

    National Research Council Canada - National Science Library

    Kucik, Corry Jeb; Martin, Gary L; Sortor, Brett V


    Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E...

  19. Intestinal parasites and pregnancy. (United States)

    D'Alauro, F; Lee, R V; Pao-In, K; Khairallah, M


    Intestinal parasites and pregnancy commonly coexist. Environmental, nutritional, and immunologic factors influence the clinical manifestations and determine the need for treatment of intestinal parasitism during pregnancy. No serious medical or obstetric problems attributable to intestinal parasites developed among 147 parasitized pregnant refugees living and delivering in a refugee camp in Southeast Thailand. These patients received adequate nutrition, careful prenatal monitoring, and no antiparasitic drug therapy. During pregnancy chemotherapy for intestinal parasites should not be used unless required for appropriate clinical and public health reasons.

  20. Intestinal parasites and tuberculosis

    Directory of Open Access Journals (Sweden)

    Anuar Alonso Cedeño-Burbano


    Conclusions: The available evidence was insufficient to affirm that intestinal parasites predispose to developing tuberculous. The studies carried out so far have found statistically insignificant results.

  1. [Mesenteric ischemia in hemodialysis patients]. (United States)

    Picazo, M; Cuxart, M; Sans, R; Sardá, C; Expósito, E


    Mesenteric ischaemia is an abdominal pathology with a high mortality rate. Among the population under dialysis treatment it presents some different traits such as non-occlusive mesenteric attacks in most of the cases. Its diagnosis is difficult and it is usually the result of an interdisciplinary collaboration. It is necessary to know better the symptoms of this illness among dialytic patients in order to improve its prognosis. Eleven haemodialytic patients in our hospital (0.87% per patient-year) have diagnosed with mesenteric ischaemia confirmed by a laparothomy. We will list the main risk factors of this pathology, its symptoms, its evolution, some radiological and laboratory data more pointed out, the surgical findings anf its treatment. Ten patients (91%) had suffer from cardiovascular pathologies, five of them (45%) had suffer an ischaemia cardiopathy. Seven patients (64%) had a spell of arterial hypotension during their haemodialysis session, which preceded mesenteric ischaemia. The reason for consulting a physician was abdominal pain, specially on the right hemiabdomen (64%). The analytical date most frequently observed was leucocytosis (54%). The usual radiological tests such as abdominal plain radiography and ecography didn't give any detailed formation. Ten out of eleven patients (91%) had necrosis on the intestinal wall. The ileum was the most affected intestinal section. Five of the patients presented only a limited damage of the ileum (45%). Two patients (18%) presented an extensive damage in the whole small intestine and part of the right colon. Intestinal resection was the most chosen way of treatment, which was practiced on eight patients (73%). Only three of them (27%) survived the mesenteric ischaemia and were sent to their homes. The key factor of their survival was that they were operated on in less than 8 hours from their arrival at emergency room. Mesenteric ischaemia must be expected among patients under haemodialysis who suffer from

  2. Time-dependent variations in ischemia-modified albumin levels in mesenteric ischemia. (United States)

    Gunduz, Abdulkadir; Turkmen, Suha; Turedi, Suleyman; Mentese, Ahmet; Yulug, Esin; Ulusoy, Hülya; Karahan, Suleyman Caner; Topbas, Murat


    The objective was to determine the value of ischemia-modified albumin (IMA) in the diagnosis of mesenteric embolism. The authors investigated whether or not plasma IMA levels rose in the acute period in a rat model of mesenteric ischemia and the related time-dependent changes. In this randomized, controlled, nonblinded trial, 36 mature female Wistar rats were divided into six groups: three control (Groups I, III, and V) and three ischemia (Groups II, IV, and VI). In the control groups, blood was sampled at 30 minutes (Group I), 2 hours (Group III), and 6 hours (Group V) following a simple laparotomy. In the ischemia groups, following laparotomy, the superior mesenteric artery (SMA) was clamped using a bulldog clamp, and blood samples were taken at 30 minutes (Group II), 2 hours (Group IV), and 6 hours (Group VI). Plasma IMA levels in the ischemia groups were significantly higher compared to those of the control groups (p ischemia group than in the 2-hour and 30-minute samples (p ischemia group than in the 30-minute samples (p mesenteric ischemia and that further studies are necessary. (c) 2009 by the Society for Academic Emergency Medicine.

  3. Current Paradigm for Ischemia in Kidney Surgery. (United States)

    Mir, Maria C; Pavan, Nicola; Parekh, Dipen J


    Partial nephrectomy is the accepted standard of care for treatment of patients with small renal masses. The primary goal while performing partial nephrectomy is cancer control with a secondary important goal of maximizing renal function preservation with minimal perioperative morbidity. Recent studies have highlighted the importance of renal parenchymal quality and quantity postoperatively rather than duration of ischemia in determining long-term renal function. We review the available data regarding perioperative renal function optimization with special interest in ischemia during partial nephrectomy, highlighting the controversies and establishing future lines of investigation. We performed a comprehensive literature review for the years 1970 to 2014 via MEDLINE(®), PubMed(®) and the Cochrane Library. Review was consistent with the PRISMA (Preferred Reporting Items for Systemic Reviews and Meta-Analyses) criteria. We used MeSH (Medical Subject Headings) terms for the search including "acute kidney injury/failure," "carcinoma, renal cell/carcinoma of kidney/neoplasm of kidney," "kidney failure, chronic/end-stage kidney disease," "ischemia-reperfusion" and "warm ischemia/cold ischemia." Relevant review articles were included. Abstracts from major urological/surgical conferences were reviewed. All studies included were performed in adults, were written in English and had an abstract available. Our traditional knowledge of renal ischemia is derived from animal studies, ie kidney transplant and retrospective partial nephrectomy series that indicate the risk of renal function impairment for every minute of ischemia. Careful evaluation of historical studies highlights flaws of the use of ischemia duration as a dichotomous marker (25 or 30 minutes) while predicting renal function outcomes. Recent studies have revealed no effect of duration of ischemia on ultimate kidney function in the short or long term. Quality and quantity of parenchyma preserved postoperatively are

  4. 7 CFR 205.290 - Temporary variances. (United States)


    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Temporary variances. 205.290 Section 205.290 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic...

  5. Temporary Tattoos and Henna/Mehndi (United States)

    ... For example, we can issue Import Alerts and Warning Letters. An Import Alert allows FDA to detain products that violate or ... Awareness of Safety: FDA Webinar, May 13, 2014 Warning Letter Issued to Black Henna Ink, Inc. Import Alert #53-14: Intensified Coverage of Temporary Tattoos Containing ...

  6. Closing a temporary ileostomy within two weeks

    DEFF Research Database (Denmark)

    Hindenburg, Tommy; Rosenberg, J.


    Temporary ileostomy is frequently constructed to relieve a rectal anastomosis and avoid peritonitis if the anastomosis is leaking. Ostomy is a burden for both the patient and society and early closure is therefore desirable to counteract increased morbidity. Several prospective studies and a sing...

  7. Temporary tattoos: a novel OSCE assessment tool. (United States)

    Gormley, Gerry; Menary, Allison; Layard, Brooke; Hart, Nigel; McCourt, Collette


    There are many issues regarding the use of real patients in objective structured clinical examinations (OSCEs). In dermatology OSCE stations, standardised patients (SPs) with clinical photographs are often used. Temporary transfer tattoos can potentially simulate skin lesions when applied to an SP. This study aims to appraise the use of temporary malignant melanoma tattoos within an OSCE framework. Within an 11-station OSCE, a temporary malignant melanoma tattoo was developed and applied to SPs in a 'skin lesion' OSCE station. A questionnaire captured the opinions of the candidate, SP and examiners, and the degree of perceived realism of each station was determined. Standard post hoc OSCE analysis determined the psychometric reliability of the stations. The response rates were 95.9 per cent of candidates and 100 per cent of the examiners and SPs. The 'skin lesion' station achieved the highest realism score compared with other stations: 89.0 per cent of candidates felt that the skin lesion appeared realistic; only 28 per cent of candidates had ever seen a melanoma before in training. The psychometric performance of the melanoma station was comparable with, and in many instances better than, other OSCE stations. Transfer tattoo technology facilitates a realistic dermatology OSCE station encounter. Temporary tattoos, alongside trained SPs, provide an authentic, standardised and reliable experience, allowing the assessment of integrated dermatology clinical skills. © 2013 John Wiley & Sons Ltd.

  8. Closing a temporary ileostomy within two weeks

    DEFF Research Database (Denmark)

    Hindenburg, Tommy; Rosenberg, J.


    Temporary ileostomy is frequently constructed to relieve a rectal anastomosis and avoid peritonitis if the anastomosis is leaking. Ostomy is a burden for both the patient and society and early closure is therefore desirable to counteract increased morbidity. Several prospective studies and a single...

  9. 40 CFR 180.31 - Temporary tolerances. (United States)


    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Temporary tolerances. 180.31 Section 180.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS... period designed to allow the orderly marketing of the raw agricultural commodities produced while testing...

  10. Temporary Chinese Migration to Madagascar: Local Perceptions ...

    African Journals Online (AJOL)

    This article fills a knowledge-gap in the literature on China in Africa by exploring local perceptions of temporary Chinese migrants in Madagascar, the growth of small-scale Chinese-owned import and retail businesses in the capital, and their impacts on Malagasy producers, utilizing the country's blanket and paper industries ...

  11. Temporary Chinese Migration to Madagascar: Local Perceptions ...

    African Journals Online (AJOL)

    However, as public debate over their impact in Madagascar intensifies, the temporary Chinese migrant ... economic and political engagement of the continent. Following the .... all focus on either the earlier waves of migration or on the relations between the resident Chinese community and the new migrants. Notable ...

  12. 47 CFR 74.537 - Temporary authorizations. (United States)


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Temporary authorizations. 74.537 Section 74.537 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO.... However, in the case of events of widespread interest and importance which cannot be transmitted...

  13. 47 CFR 74.633 - Temporary authorizations. (United States)


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Temporary authorizations. 74.633 Section 74.633 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... wide-spread interest and importance which cannot be transmitted successfully on these frequencies...

  14. 47 CFR 74.833 - Temporary authorizations. (United States)


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Temporary authorizations. 74.833 Section 74.833 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... interest and importance which cannot be transmitted successfully on these frequencies, frequencies assigned...

  15. 47 CFR 74.433 - Temporary authorizations. (United States)


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Temporary authorizations. 74.433 Section 74.433 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... of events of wide-spread interest and importance which cannot be transmitted successfully on these...

  16. Estrogen protects the inner retina from apoptosis and ischemia-induced loss of Vesl-1L/Homer 1c immunoreactive synaptic connections. (United States)

    Kaja, Simon; Yang, Shao-Hua; Wei, Jiao; Fujitani, Kazuko; Liu, Ran; Brun-Zinkernagel, Anne-Marie; Simpkins, James W; Inokuchi, Kaoru; Koulen, Peter


    Protective effects of estrogen on nerve cells including retinal neurons have been described previously. However, subcellular effects on synaptic connectivity in mild ischemia more closely resembling ischemic conditions found in diabetic or sickle cell retinopathy and stenosis of the carotid artery have not been identified. The present study quantitatively analyzed effects of estrogen administration on synaptic connections of neurons in the ganglion cell layer (GCL) of the retina. Staining of Vesl-1L/Homer 1c (V-1L) immunoreactivity and TUNEL cytochemistry were used to quantify neuroprotective effects at the synaptic level in a model of mild retinal ischemia induced by temporary middle cerebral artery occlusion in the adult rat. V-1L immunoreactivity was found in both synaptic layers, postsynaptic to glutamatergic ribbon synapses. Mild retinal ischemia led to a significantly higher percentage reduction in the number of V-1L-positive synapses in the inner plexiform layer (IPL) compared with the percentage of TUNEL-positive apoptotic neurons in the GCL. Estrogen prevented ischemia-induced loss of V-1L-immunoreactive synapses in the IPL and apoptosis of cells in the GCL. Immunoreactivity for V-1L can be used as a synaptic marker for early changes before more severe neurodegenerative events. The present results suggest that estrogen protects neurons in the GCL including RGCs from both apoptosis and early changes in synaptic connections associated with ischemia and potentially preceding apoptosis.

  17. Branded prescription drug fee. Final regulations, temporary regulations, and removal of temporary regulations. (United States)


    This document contains final regulations that provide guidance on the annual fee imposed on covered entities engaged in the business of manufacturing or importing branded prescription drugs. This fee was enacted by section 9008 of the Patient Protection and Affordable Care Act, as amended by section 1404 of the Health Care and Education Reconciliation Act of 2010. This document also withdraws the Branded Prescription Drug Fee temporary regulations and contains new temporary regulations regarding the definition of controlled group that apply beginning on January 1, 2015. The final regulations and the new temporary regulations affect persons engaged in the business of manufacturing or importing certain branded prescription drugs. The text of the temporary regulations in this document also serves as the text of proposed regulations set forth in a notice of proposed rulemaking (REG-123286-14) on this subject in the Proposed Rules section in this issue of the Federal Register.

  18. Expression of somatostatin mRNA and peptide in rat hippocampus after cerebral ischemia

    DEFF Research Database (Denmark)

    Bering, Robert; Johansen, Flemming Fryd


    Somatostatin, ischemia, hippocampus, rat, in situ hybridisation, immunocytochemistry, neuropathology......Somatostatin, ischemia, hippocampus, rat, in situ hybridisation, immunocytochemistry, neuropathology...

  19. adhesive intestinal obstruction

    African Journals Online (AJOL)


    Jun 1, 2006 ... ABSTRACT. Background: Adhesions after abdominal and pelvic surgery are a major cause of intestinal obstruction in the western world and the pathology is steadily gaining prominence in our practice. Objective: To determine the magnitude of adhesive intestinal obstruction; to determine the types.

  20. Neuromodulation of intestinal inflammation

    NARCIS (Netherlands)

    Costes, L.M.M.


    Interactions between the central nervous system and the immune system have been shown to exert a crucial role in the tight regulation of the immune response in the intestine. In particular, the vagus nerve was recently unraveled as an important player in this neuromodulation of intestinal

  1. Congenital intestinal lymphangiectasia

    Directory of Open Access Journals (Sweden)

    Popović Dušan Đ.


    Full Text Available Background. Congenital intestinal lymphangiectasia is a disease which leads to protein losing enteropathy. Tortous, dilated lymphatic vessels in the intestinal wall and mesenterium are typical features of the disease. Clinical manifestations include malabsorption, diarrhea, steatorrhea, edema and effusions. Specific diet and medication are required for disease control. Case report. A 19-year old male patient was hospitalized due to diarrhea, abdominal swelling, weariness and fatigue. Physical examination revealed growth impairment, ascites, and lymphedema of the right hand and forearm. Laboratory assessment indicated iron deficiency anaemia, lymphopenia, malabsorption, inflammatory syndrome, and urinary infection. Enteroscopy and video capsule endoscopy demonstrated dilated lymphatic vessels in the small intestine. The diagnosis was confirmed by intestinal biopsy. The patient was put on high-protein diet containing medium-chain fatty acids, somatotropin and suportive therapy. Conclusion. Congenital intestinal lymphangiectasia is a rare disease, usually diagnosed in childhood. Early recognition of the disease and adequate treatment can prevent development of various complications.

  2. Temporary Employment and Perceived Employability: Mediation by Impression Management (United States)

    De Cuyper, Nele; De Witte, Hans


    Perceived employability (PE) has been advanced as the upcoming resource for career development, particularly for temporary workers. The question is how temporary workers become employable. Our hypothesis is that temporary workers more than permanent workers use impression management to become employable, both on the internal and the external labor…

  3. 30 CFR 47.44 - Temporary, portable containers. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Temporary, portable containers. 47.44 Section... TRAINING HAZARD COMMUNICATION (HazCom) Container Labels and Other Forms of Warning § 47.44 Temporary, portable containers. (a) The operator does not have to label a temporary, portable container if he or she...

  4. 21 CFR 872.3770 - Temporary crown and bridge resin. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Temporary crown and bridge resin. 872.3770 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3770 Temporary crown and bridge resin. (a) Identification. A temporary crown and bridge resin is a device composed of a material, such as...

  5. Non-occlusive mesenteric ischemia localized in the transverse colon: a case report. (United States)

    Murono, Koji; Ishihara, Soichiro; Kawai, Kazushige; Kaneko, Manabu; Sasaki, Kazuhito; Yasuda, Koji; Otani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Hata, Keisuke; Nozawa, Hiroaki; Hayashi, Akimasa; Ushiku, Tetsuo; Fukayama, Masashi; Watanabe, Toshiaki


    Non-occlusive mesenteric ischemia (NOMI) is ischemia of the mesentery that is caused by hypoperfusion or vasospasm without any thrombosis. NOMI is difficult to diagnose by physical examination alone. Although angiographic examination of the superior mesenteric artery (SMA) is the usual diagnostic method used, it is an invasive examination. Usually, a long range of the bowel becomes discontinuously necrotic in NOMI. Here, we report a rare case of NOMI localized in the transverse colon that was diagnosed by computed tomography (CT) angiography which is a minimally invasive examination. A 72-year-old woman was referred to our hospital for further treatment of abdominal pain that developed 1 day before presentation. Contrast-enhanced abdominal CT scan revealed attenuated enhancement of the transverse colon. CT angiography showed SMA irregularities due to vasospasm. The middle colic artery could not be detected by CT angiography. No occlusion due to thrombus or embolism in the SMA and superior mesenteric vein was observed. Based on the findings, NOMI was suspected, and emergency laparotomy was performed, which revealed a segmentally necrotic transverse colon. The necrotic bowel was resected, and stomas were created. The presence of hypotension in the patient necessitated the use of CT angiography, which proved very useful in the early diagnosis of the present case. Thus, if intestinal ischemia is suspected, even in case of a short segment, CT angiography should be performed.

  6. Proper Treatment of Acute Mesenteric Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Kwan; Han, Young Min [Dept. of Radiology, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of); Kwak, Hyo Sung [Research Institue of Clinical Medicine, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of); Yu, Hee Chul [Dept. of Radiology, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of)


    To evaluate the effectiveness of treatment options for Acute Mesenteric Ischemia and establish proper treatment guidelines. From January 2007 to May 2010, 14 patients (13 men and 1 woman, mean age: 52.1 years) with acute mesenteric ischemia were enrolled in this study. All of the lesions were detected by CT scan and angiography. Initially, 4 patients underwent conservative treatment. Eleven patients were managed by endovascular treatment. We evaluated the therapeutic success and survival rate of each patient. The causes of ischemia included thromboembolism in 6 patients and dissection in 8 patients. Nine patients showed bowel ischemia on CT scans, 4 dissection patients underwent conservative treatment, 3 patients had recurring symptoms, and 5 dissection patients underwent endovascular treatment. Overall success and survival rate was 100%. However, overall success was 83% and survival rate was 40% in the 6 thromboembolism patients. The choice of 20 hours as the critical time in which the procedure is ideally performed was statistically significant (p = 0.0476). A percutaneous endovascular procedure is an effective treatment for acute mesenteric ischemia, especially in patients who underwent treatment within 20 hours. However, further study and a long term follow-up are needed.

  7. Assessment of Renal Ischemia By Optical Spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, J T; Demos, S; Michalopoulou, A; Pierce, J L; Troppmann, C


    Introduction: No reliable method currently exists for quantifying the degree of warm ischemia in kidney grafts prior to transplantation. We describe a method for evaluating pretransplant warm ischemia time using optical spectroscopic methods. Methods: Lewis rat kidney vascular pedicles were clamped unilaterally in vivo for 0, 5, 10, 20, 30, 60, 90 or 120 minutes; 8 animals were studied at each time point. Injured and contra-lateral control kidneys were then flushed with Euro-Collins solution, resected and placed on ice. 335 nm excitation autofluorescence as well as cross polarized light scattering images were taken of each injured and control kidney using filters of various wavelengths. The intensity ratio of the injured to normal kidneys was compared to ischemia time. Results: Autofluorescence intensity ratios through a 450 nm filter and light scattering intensity ratios through an 800 nm filter both decreased significantly with increasing ischemia time (p < 0.0001 for each method, one-way ANOVA). All adjacent and non-adjacent time points between 0 and 90 minutes were distinguishable using one of these two modalities by Fisher's PLSD. Conclusions: Optical spectroscopic methods can accurately quantify warm ischemia time in kidneys that have been subsequently hypothermically preserved. Further studies are needed to correlate results with physiological damage and posttransplant performance.

  8. Intestinal Thromboangiitis Obliterans in a Woman: A Case Report and Discussion of Chronic Ischemic Changes

    Directory of Open Access Journals (Sweden)

    Shaun AC Medlicott


    Full Text Available Although traditionally regarded as a disease of distal extremities, mesenteric vasculature can also manifest thromboangiitis obliterans (TAO. There are 31 cases of intestinal TAO in the English literature and the majority of subjects are male. However, cases of women with TAO are becoming more common, coinciding with an increased incidence of smoking in this sex. We describe the sixth case of a female patient with classic extremity manifestations paralleled by paroxysms of abdominal angina. Intestinal TAO can mimic extremity disease of smoldering chronic ischemia punctuated by unpredictable acute episodes of gangrene. In the present case, chronic ischemia manifested as partial bowel obstruction due to stricture deformity of the ileum and profound adipocyte atrophy of mesentery.

  9. Use of rapid sampling microdialysis for intraoperative monitoring of bowel ischemia. (United States)

    Deeba, S; Corcoles, E P; Hanna, G B; Hanna, B G; Pareskevas, P; Aziz, O; Boutelle, M G; Darzi, A


    Intestinal ischemia is a major cause of anastomotic leak and death and remains a clinical challenge as the physician relies on several nonspecific signs, biologic markers, and radiologic studies to make the diagnosis. This study used rapid sampling online microdialysis to evaluate the biochemical changes occurring in a segment of human bowel during and after resection, and assessed for the feasibility and reproducibility of this technique in monitoring intestinal ischemia. A custom made, rapid sampling online microdialysis analyzer was used to monitor the changes in the bowel wall of specimens being resected intraoperatively. Two patients were recruited for the pilot study to optimize the analyzer and seven patients undergoing colonic resections were recruited for the data collection and analysis. The concentration of glucose in the extracellular bowel wall fluid decreased transiently after division of individual feeding arteries followed by a rebound increase in the concentration back to baseline concentrations. After completion of resection, glucose concentrations continued to decrease while lactate concentrations increased constantly. Rapid sampling microdialysis was feasible in the clinical environment. These results suggest that tissue responds to ischemic insult by mobilizing glucose stores which later decrease again, whereas lactate concentrations constantly increased.

  10. Organ distribution of gut-derived bacteria caused by bowel manipulation or ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Redan, J.A.; Rush, B.F. Jr.; Lysz, T.W.; Smith, S.; Machiedo, G.W. (Univ. of Medicine and Dentistry of New Jersey, Newark (USA))


    Translocation of carbon-14-labeled Escherichia coli from the gut was studied at the specified times in the following groups of rats: Group 1, 5 hours after ligation of the superior mesenteric artery; Group 2, 5 hours after laparotomy and exposure of the superior mesenteric artery with gentle removal and replacement of the intestines; and Group 3, 5 hours after handling but no surgical manipulation. Both living and dead bacteria were administered by means of gavage, and the effect of viability, intestinal ischemia without reperfusion, and bowel manipulation on the translocation of enteric bacteria was assessed. We demonstrated that (1) even gentle bowel manipulation causes bacteremia as great as that associated with ligation of the superior mesenteric artery; (2) dead E. coli are absorbed into the blood in the presence of bowel manipulation or ischemia but less effectively than are live E. coli; (3) live bacteria are found in highest concentration in the lung and in descending order in the liver, kidney, heart, and spleen; (4) dead bacteria absorbed from the gut are found in highest concentration in the kidney and the liver. Lesser amounts are found in the lung, spleen, and heart.

  11. 77 FR 71825 - Notice of Temporary Restriction of Vehicle Use and Temporary Closure to Tree Cutting and Wood... (United States)


    ...: 14X1125] Notice of Temporary Restriction of Vehicle Use and Temporary Closure to Tree Cutting and Wood... harvesting and/or tree cutting on public land within the Topaz Ranch Estates (TRE) and Preacher fires burn... and a temporary closure to tree cutting and wood collecting on areas burned by the TRE and Preacher...

  12. Phagocytosis executes delayed neuronal death after focal brain ischemia


    Neher, Jonas J.; Emmrich, Julius V.; Fricker, Michael; Mander, Palwinder K.; Théry, Clotilde; Brown, Guy C.


    Brain ischemia is a major cause of death and disability worldwide, but the cellular mechanisms of delayed neuronal loss and brain atrophy after cerebral ischemia are poorly understood and thus currently untreatable. Surprisingly, we find that after cerebral ischemia, brain macrophages phagocytose viable and functional neurons, causing brain atrophy and motor dysfunction. Our data show that delayed neuronal death and functional impairment after cerebral ischemia can be prevented by blocking sp...

  13. Platelet-associated CD40/CD154 mediates remote tissue damage after mesenteric ischemia/reperfusion injury.

    Directory of Open Access Journals (Sweden)

    Peter H Lapchak

    Full Text Available Several innate and adaptive immune cell types participate in ischemia/reperfusion induced tissue injury. Amongst them, platelets have received little attention as contributors in the process of tissue damage after ischemia reperfusion (I/R injury. It is currently unknown whether platelets participate through the immunologically important molecules including, CD40 and when activated, CD154 (CD40L, in the pathogenesis of I/R injury. We hypothesized that constitutive expression of CD40 and activation-induced expression of CD154 on platelets mediate local mesenteric and remote lung tissue damage after I/R injury. Wild type (WT; C57BL/6J, CD40 and CD154 deficient mice underwent mesenteric ischemia for 30 minutes followed by reperfusion for 3 hours. WT mice subjected to mesenteric I/R injury displayed both local intestinal and remote lung damage. In contrast, there was significantly less intestinal damage and no remote lung injury in CD40 and CD154 deficient mice when compared to WT mice. Platelet-depleted WT mice transfused with platelets from CD40 or CD154 deficient mice failed to reconstitute remote lung damage. In contrast, when CD40 or CD154 deficient mice were transfused with WT platelets lung tissue damage was re-established. Together, these findings suggest that multiple mechanisms are involved in local and remote tissue injury and also identify platelet-expressed CD40 and/or CD154 as mediators of remote tissue damage.

  14. C3a Enhances the Formation of Intestinal Organoids through C3aR1

    Directory of Open Access Journals (Sweden)

    Naoya Matsumoto


    Full Text Available C3a is important in the regulation of the immune response as well as in the development of organ inflammation and injury. Furthermore, C3a contributes to liver regeneration but its role in intestinal stem cell function has not been studied. We hypothesized that C3a is important for intestinal repair and regeneration. Intestinal organoid formation, a measure of stem cell capacity, was significantly limited in C3-deficient and C3a receptor (C3aR 1-deficient mice while C3a promoted the growth of organoids from normal mice by supporting Wnt-signaling but not from C3aR1-deficient mice. Similarly, the presence of C3a in media enhanced the expression of the intestinal stem cell marker leucine-rich repeat G-protein-coupled receptor 5 (Lgr5 and of the cell proliferation marker Ki67 in organoids formed from C3-deficient but not from C3aR1-deficient mice. Using Lgr5.egfp mice we showed significant expression of C3 in Lgr5+ intestinal stem cells whereas C3aR1 was expressed on the surface of various intestinal cells. C3 and C3aR1 expression was induced in intestinal crypts in response to ischemia/reperfusion injury. Finally, C3aR1-deficient mice displayed ischemia/reperfusion injury comparable to control mice. These data suggest that C3a through interaction with C3aR1 enhances stem cell expansion and organoid formation and as such may have a role in intestinal regeneration.

  15. Infrared laser hemotherapy in cerebral ischemia modeling (United States)

    Musienko, Julia I.; Nechipurenko, Natalia I.


    Use of intravenous laser irradiation of blood (ILIB) is considered to be the most effective method of laser therapy and its application is expedient pathogenetically in the ischemic disturbances. The aim of this study is to investigate ILIB influence with infrared laser (IL) with 860 nm wavelength on hemostasis, acid-base status (ABS) of blood in normal rabbits and after modeling of local ischemia of brain (LIB). Experimental cerebral ischemia is characterized by development of hypercoagulation syndrom and metabolic acidosis. ILIB with infrared radiation of 2.0 mW power provokes hypocoagulation in intact animals. Application of ILIB in rabbits after LIB contributes for hemostasis and acid-base status normalizing compared to operated animals. IL radiation with 8,5 mW power results in marked hemostatic activation in all animals. Therefore, beneficial effect of low power laser radiation (LPLR) manifests in narrow power diapason in experimental brain ischemia.

  16. Open surgery for atherosclerotic chronic mesenteric ischemia. (United States)

    Kruger, Allan J; Walker, Philip J; Foster, Wallace J; Jenkins, Jason S; Boyne, Nicholas S; Jenkins, Julie


    This study was undertaken to document the results of our current practice of open mesenteric revascularization to enable comparison with the recent trend of percutaneous endovascular therapy for the treatment of chronic mesenteric ischemia. Patients were identified via operation code data as well ongoing audit data from 1992 until 2006. Only patients with a history of chronic mesenteric ischemia secondary to atherosclerosis for 3 months or longer were included in the study. Follow-up data have been collected prospectively and include clinical examination and history, as well as graft surveillance consisting of mesenteric duplex ultrasonography, computed tomography, and/or angiography every 6 months for 3 years and then yearly thereafter. Thirty-nine consecutive patients underwent 41 open revascularization procedures for chronic mesenteric ischemia, comprising 67 bypass grafts. The mean patient age was 65 years (range, 45-85 years), and 44% (n = 17) were male. Symptoms were present on average for 11 months (range, 4-48 months) before treatment. The average weight loss was 11.4 kg, and three patients (7.6%) also had evidence of ischemic enteritis. There was one perioperative death, thus giving a perioperative mortality rate of 2.5%. Perioperative morbidity occurred in five patients (12.2%). Primary graft patency was 92% at 5 years. Seven patients died during follow-up, which ranged from 4 to 161 months (mean, 39 months)-one (2.5%) from mesenteric ischemia. Two (5%) other patients have had recurrent mesenteric ischemic symptoms. Open surgical mesenteric revascularization by bypass grafting for atherosclerotic-induced chronic mesenteric ischemia can be performed with low mortality and morbidity and provides excellent long-term primary patency rates and symptom-free outcomes. Pending more data on the acute and long-term results of endovascular techniques, open mesenteric revascularization remains the gold standard for most patients with chronic mesenteric ischemia.

  17. Inhibition of apoptosis induced by ischemia-reperfusion prevents inflammation

    NARCIS (Netherlands)

    Daemen, M. A.; van 't Veer, C.; Denecker, G.; Heemskerk, V. H.; Wolfs, T. G.; Clauss, M.; Vandenabeele, P.; Buurman, W. A.


    Ischemia followed by reperfusion leads to severe organ injury and dysfunction. Inflammation is considered to be the most important cause of tissue injury in organs subjected to ischemia. The mechanism that triggers inflammation and organ injury after ischemia remains to be elucidated, although

  18. Temporary Vacuum-Assisted Closure of the Open Abdomen in Neonates. (United States)

    Hattori, Kengo; Numanoglu, Alp; Cox, Sharon


    Introduction The need for open abdomen in the treatment of severely ill neonates will increase in time as more complex abdominal procedures are undertaken. However, the experience of temporary closure of an open abdomen using vacuum-assisted closure (VAC) system is still relatively limited in premature and term neonates. The aim of this study is to describe and review our experience in the use of temporary VAC of the open abdomen for neonates with varying pathological processes. Materials and Methods A retrospective folder review of all neonates treated with VAC for open abdomen over the study period of 2010 to 2014 at our institution was performed. Results A total of 15 neonates were included in this study. Mean gestational age and postbirth age at VAC application were 33.6 ± 4.1 (28-40) weeks and 14 ± 10.2 (2-30) days, respectively. Mean weight at VAC application was 1,797.7 ± 730.8 (960-3,200) g. Initial diagnoses were necrotizing enterocolitis (seven), intestinal perforation (three), gastroschisis (two), congenital diaphragmatic hernia (two), and primary abdominal compartment syndrome (ACS) (one). Reasons for VAC application included confirmed ACS (2) and application to prevent ACS (13). Duration of VAC use was 4 ± 3.4 (0-13) days during which 2 ± 1.2 (1-5) applications were performed. Overall survival rate was 80% (12 of 15 patients). One patient with primary ACS died from sepsis with an open abdomen. The only potential VAC-related complication was an enterocutaneous fistula. Conclusion Temporary VAC of the open abdomen is a safe method of temporary abdominal closure to prevent ACS in high-risk postoperative conditions in neonates of any gestational age and birth weight. Georg Thieme Verlag KG Stuttgart · New York.

  19. Repeated episodes of focal cerebral ischemia in a patient with mitral valve prolapse and migraine headache

    Directory of Open Access Journals (Sweden)

    Raičević Ranko


    Full Text Available Migraine is episodic, paroxysmal disorder where the headache represents the central symptom and is followed with different combinations of neurological gastrointestinal and vegetative changes. Not until the diagnostic procedures were developed, ischemic lesions were verified even in the patients with ordinary migraine. This is a report of a patient with migraine headache followed twice by verified episodes of temporary ischemic attacks and verified focal ischemic lesion of cerebral parenchyma. The mitral valve prolapse was also detected. This all imposed the administration of combined prophylactic antimigrainous and anticoagulant therapy as an imperative because of the risk of the development of repeated ischemia of cerebral tissue. This association also confirmed an opinion that migraine is a wider disorder with the dominant dysfunction of limbic system.

  20. Helical CT findings in mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hoon; Lim, Hyo Keun; Lee, Won Jae; Choi, Sang Hee; Lee, Soon Jin; Cho, Jae Min; Kim, Kyung Ah; Lee, Yon Ok [Sungkyunkwan Univ. College of Medicine. Samsung Medical Center, Seoul (Korea, Republic of)


    Ischemic bowel disease is one of the common causes of acute abdomen, which results from insufficient blood flow to the small bowel and colon caused by arterial or venous occlusion or mesenteric vasoconstriction. Early diagnosis by clinical, laboratory, and radiologic findings is often difficult and delay in adequate therapy results in substantial morbidity and mortality. CT is known to be useful for the evaluation of patients with suspected bowel ischemia or infarction. This study describes the spectrum of helical CT findings in acute and chronic mesenteric ischemia due to various causes, and explains the value of CT findings for specific diagnosis.

  1. A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report

    Directory of Open Access Journals (Sweden)

    Senadhi Viplove


    Full Text Available Abstract Introduction Chronic mesenteric ischemia is a condition that is classically associated with significant atherosclerosis of the abdominal arteries, causing postprandial abdominal pain out of proportion to physical examination. The abdominal pain is exacerbated after meals due to the shunting of blood away from the intestines to the stomach, causing relative ischemia. More than 95% of chronic mesenteric ischemia cases are due to atherosclerosis. We report the first known case of chronic mesenteric ischemia from fibromuscular dysplasia. To the best of our knowledge, this is also the first known case in the literature where postprandial abdominal pain was the presenting symptom of fibromuscular dysplasia. Case presentation A 44-year-old Caucasian woman with a history of hypertension and preeclampsia, who had taken oral contraceptive pills for 15 years, presented with an intractable, colicky abdominal pain of two weeks duration. This abdominal pain worsened with oral intake. It was also associated with diarrhea and vomiting. Physical examination revealed stage III hypertension out of proportion to her risk factors and diffuse abdominal pain without peritoneal signs. An abdominal computed tomography scan, completed in the emergency room, revealed nonspecific colitis. Laboratory work revealed leukocytosis with a left shift, an erythrocyte sedimentation rate of 79 and a C-reactive protein level of 100. She was started on intravenous flagyl and intravenous ciprofloxacin. However, all microbial cultures were negative including three cultures for clostridium difficile. Urine analysis revealed nephritic range proteinuria. The laboratory profile was within normal limits for perinuclear-anti-neutrophil cytoplasmic antibody, cytoplasmic-anti-neutrophil cytoplasmic antibody, anti-saccharomyces cerevisiae antibody, antinuclear antibody test, celiac profile, lactate, carbohydrate antigen-125 and thyroid stimulating hormone. A colonoscopy was completed

  2. Fracture resistance of various temporary crown materials. (United States)

    Yilmaz, Asude; Baydaş, Seyfettin


    The aim of this study was to evaluate the fracture resistance of various provisional crown materials using an in vitro model test system. In the present study polycarbonate crowns, prefabricated by the manufacturer (3M Polycarbonate Crown), and the temporary crowns, fabricated in the dental laboratory environment, were fabricated using bis-acryl composite (Protemp II), autopolymerizing PMMA resin (BISICO Temp S), and heat-polymerized PMMA resin (Major C&B-V Dentine). All temporary crowns were stored in distilled water for 24 hours at room temperature prior to testing. The crowns were seated on metal dies, fabricated from Cr-Co alloy (AZ Dental, Konstanz, Germany), and then tested using the indenter of a Hounsfield testing machine (Hounsfield Tensometer, Hounsfield Test Equipment, Raydon, England). The tip of the indenter was located at a position one-third of the way down the inciso-palatine surface at 135 masculine. The data were statistically analyzed for differences using one-way analysis of variance (ANOVA) and the Tukey HSD test (P polycarbonate crowns were significantly different from the BISICO Temp S, Protemp II, and Major C&B-V Dentine (P polycarbonate crowns may be preferable to the other types of temporary crowns used in this study.

  3. Nonocclusive Mesenteric Ischemia after Chemotherapy in an Adolescent Patient with a History of Three Allogeneic Hematopoietic Stem Cell Transplantations for Acute Lymphoblastic Leukemia. (United States)

    Hirabayashi, Koichi; Takatsuki, Mitsuho; Motobayashi, Mitsuo; Kurata, Takashi; Saito, Shoji; Shigemura, Tomonari; Nakazawa, Yozo; Sakashita, Kazuo; Ishizone, Satoshi; Ota, Hiroyoshi; Koike, Kenichi


    Nonocclusive mesenteric ischemia (NOMI) is induced by intestinal vasospasm without thromboembolic occlusion and is associated with high morbidity and mortality. The estimated overall incidence of autopsy-verified fatal NOMI is 2.0 cases/100,000 person-years; however, no pediatric or adolescent cases have yet been reported. An 18-year-old female was diagnosed with B-cell precursor acute lymphoblastic leukemia at the age of 10 years. Our patient received three allogeneic hematopoietic stem cell transplantations but experienced hematological relapse after each. She received combination therapy of prednisolone, L-asparaginase, vincristine, and bortezomib after the third relapse. On Day 16 after the initiation of chemotherapy, she developed NOMI; therefore, we performed a right-sided hemicolectomy on Day 27. Nonocclusive mesenteric ischemia should be considered during the differential diagnosis of intestinal complications after chemotherapy, even in pediatric and adolescent patients. Copyright © 2014. Published by Elsevier B.V.

  4. Transplantation of intestinal microbiota

    Directory of Open Access Journals (Sweden)

    I. Yu. Chicherin


    Full Text Available The results are presented of evaluation of the efficiency of the filtered aqueous suspension of white mice (donors feces and microorganisms of indigenous microflora in the correction of intestinal microbiocenosis of conventional white mice with antibiotic-associated dysbacteriosis with administration of suspension and microorganisms per os and per rectum. After the start of administration of suspension and microorganisms of fecal microflora to experimental animals the dynamics of the total content of microorganisms and the number of some representatives of intestinal microflora in 1 g of feces were evaluated in comparison with self-recovery of intestinal microflora in the control group animals. Results showed that the supernatant of an aqueous suspension of white mice (donors feces, containing microbial exometabolites and other biologically active compounds, has in a short time the most pronounced effect on the recovery of the normal intestinal microflora in experimental animals.

  5. The role of CB1 in intestinal permeability and inflammation. (United States)

    Karwad, Mustafa A; Couch, Daniel G; Theophilidou, Elena; Sarmad, Sarir; Barrett, David A; Larvin, Michael; Wright, Karen L; Lund, Jonathan N; O'Sullivan, Saoirse E


    The endocannabinoid system has previously been shown to play a role in the permeability and inflammatory response of the human gut. The goal of our study was to determine the effects of endogenous anandamide (AEA) and 2-arachidonoyl glycerol (2-AG) on the permeability and inflammatory response of intestinal epithelium under normal, inflammatory, and hypoxic conditions. Human intestinal mucosa was modeled using Caco-2 cells. Human tissue was collected from planned colorectal resections. Accumulation of AEA and 2-AG was achieved by inhibiting their metabolizing enzymes URB597 (a fatty acid amide hydrolase inhibitor) and JZL184 (a monoacylglycerol lipase inhibitor). Inflammation and ischemia were simulated with TNF-α and IFN-γ and oxygen deprivation. Permeability changes were measured by transepithelial electrical resistance. The role of the CB1 receptor was explored using CB1-knockdown (CB1Kd) intestinal epithelial cells. Endocannabinoid levels were measured using liquid chromatography-mass spectrometry. Cytokine secretion was measured using multiplex and ELISA. URB597 and JZL184 caused a concentration-dependent increase in permeability via CB1 (P permeability via CB1 (P permeability caused by inflammation and hypoxia (P permeability response to inflammation (P permeability and in inflammatory and hypoxic conditions.-Karwad, M. A., Couch, D. G., Theophilidou, E., Sarmad, S., Barrett, D. A., Larvin, M., Wright, K. L., Lund, J. N., O'Sullivan, S. E. The role of CB1 in intestinal permeability and inflammation. © FASEB.

  6. Can Human Recombinant Epidermal Growth Factor Improve Ischemia and Induce Healing of Anastomosis in an Experimental Study in a Rabbit Model? (United States)

    Şenocak, Rahman; Özer, Mustafa Tahir; Kaymak, Şahin; Kılbaş, Zafer; Günal, Armağan; Uyanık, Metin; Kozak, Orhan


    Anastomotic leaks following intestinal operations may cause devastating effects on patients. Ischemia may also occur at the intestinal walls in the presence of strangulations. In this study, we examined the effects of human recombinant (Hr)-epidermal growth factor (EGF) given at a single intramural dose into the intestinal walls and daily intraperitoneal cavity on ischemia and the healing process of anastomosis. Sixteen male New Zeland white rabbits were randomly divided into four groups (n = 4 in each group). In Group 1, two different segments of ileum were identified and, then, transected and the free ends were sutured each other. In the other groups, ischemia was induced by ligating the mesenteric vascular arcade. After the ischemic induction, Group 2 received intramural injections of %0.9 saline, Group 3 received intramural injections of a single dose of EGF, and Group 4 received intramural and intraperitoneal injections of EGF. Bursting pressures and tissue hydroxyproline levels were analyzed. Necrosis, fibroblastic activity, collagen deposition and neovascularization were also studied. The mean levels of bursting pressures in Group 4 (148.6 ± 25.3 mmHg) were higher than Group 2 (70 ± 21.5 mmHg) (p = 0.001). The mean level of bursting pressures was not statistically significant between Group 1 (170.1 ± 35 mmHg) and Group 4 (p = 0.073). Hydroxyproline levels in Group 2 were lower than Groups 3 and 4. There was a statistically significant difference in the mucosal ischemia, mucosal healing and degree of adhesion, but not in the mural anastomotic healing among the groups. Intramural injection with daily intraperitoneal administration of low-dose EGF enhances the bursting pressure and collagen accumulation in ischemic anastomosis, improving many histological variables associated with ischemic intestinal anastomosis.

  7. Effects of Sulphasalazine in Cerebral Ischemia Reperfusion Injury in Rat. (United States)

    Cetin, Cansel; Erdogan, Ahmet Melih; Dincel, Gungor Cagdas; Bakar, Bulent; Kisa, Ucler


    Management of cerebral ischemia/reperfusion (I/R) injury is still difficult process today. Aim of present study was to investigate therapeutic properties of sulfasalazine in cerebral transient I/R injury in rat. Except Control group (n = 5), 20 Wistar albino rats were allocated for acute and chronic stage investigation of I/R injury, and temporary aneurysm clips were attempted to both internal carotid arteries for thirty min. Four hours later, 40 mg/kg once a day sulfasalazine was administered to animals of SL-A and SL-C groups, orally. Animals were decapitated, following which pyknotic and necrotic neuronal cells, perivascular edema, irregularities of intercellular organization (IIO) of hippocampal regions, and cortical necrotic neurons of parietal lobe were counted or scaled histopathologically. Tissue malonyldialdehyde (MDA), myeloperoxidation (MPO), total nitrite/nitrate (NO), interleukin 1-beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) level values were evaluated biochemically. Sulfasalazine could reduce perivascular edema, IIO, cortical and hippocampal neuronal cell death in both stages. It could decrease MDA in acute stage, but not reduce IL-1β, IL-6, MPO, NO, and TNFα levels. It could increase IL-1β levels in chronic stage but not affect to IL-6, MPO, MDA, NO, TNF-α levels. Sulfasalazine could improve histopathological architecture of hypoxic tissue in both stages of I/R injury in rat. It could inhibit lipid peroxidation cascades just in acute stage. These results suggested that therapeutic mechanisms of sulfasalazine in cerebral I/R injury should be investigated by using more specific laboratory methods in future studies. Copyright © 2017 IMSS. Published by Elsevier Inc. All rights reserved.

  8. Renal ischemia reperfusion causes brain hippocampus oxidative ...

    African Journals Online (AJOL)

    Background: The acute kidney injury (AKI) may do damage to remote organs. Objective of the study is to investigate effect of seaweed extract (SE) on brain oxidative damage in kidney ischemia/reperfusion rats. Material and Methods: Animals were randomly divided into five groups. SE pre-fed to rats. Results: Kidney I/R ...

  9. [Epidemiology of critical ischemia of the limbs]. (United States)

    Estevan, J M; Valle, A; Pacho, J


    Authors report their results from a study made during 1991. The study was made in order to analyze the clinical complications (morbidity and mortality) and the socioeconomic consequences that are related to the cure of patients with highly developed ischemic diseases (critical ischemia). Economic expenses mean a 1.5% from the total budget of the Public Sanity into the Asturian Autonomic Community.

  10. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H


    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction the prevale...

  11. Acute mesenteric ischemia: current multidisciplinary approach. (United States)

    Savlania, Ajay; Tripathi, Ramesh K


    The aim of this review was to describe and discuss the mechanisms of acute mesenteric ischemia (AMI) and the rationale and conduct of currently available endovascular and open surgical techniques in its management. We also propose an algorithm to support the current multidisciplinary approach in decision-making for mesenteric revascularization to manage this high-risk entity.

  12. Clinical features of development of chronic cerebral ischemia against background of pronounced decrease of cognitive functions

    Directory of Open Access Journals (Sweden)

    Zalisna Yu.D.


    Full Text Available The paper presents the results of analyses of cognitive failure in chronic cerebral ischemia (CCI with lesion of deep divisions of the brain white matter and basal ganglia, leading to disruption of communication of frontal and subcortical brain structures (the phenomenon of separation. Mechanism of separation primarily is associated with hypertension, which leads to secondary changes of the vascular wall microvasculature. For cerebral vascular insufficiency and for diseases, primarily involving basal ganglia, intellectual inertia, bradyphreniya and decreased concentration are more common. According to studies, chronic cerebral ischemia (CCI is recorded in 20-30% of people of working age. The main etiological forms of CCI are considered to be hypertensive, atherosclerotic and mixed. For CCI of the second stage formation of neurological syndromes (pseu¬dobulbar, pyramidal, extrapyramidal, atactic, increased cognitive disorder that causes temporary or permanent disa¬bility of patients, reduction of their quality of life are characteristic. The aim of the study was to determine the cha¬racteristics of cognitive impairment in patients with CCI (hypertonic and mixed origin and their relationship to clinical and neurological manifestations of the disease. Based on the data obtained through clinical examination and neu¬ropsychological testing, marked processes of attention exhaustion and a higher risk of progression of cognitive impairment in the group with a mixed form (hypertension and atherosclerotic were revealed.

  13. Microscopy of bacterial translocation during small bowel obstruction and ischemia in vivo – a new animal model

    Directory of Open Access Journals (Sweden)

    Hafner Mathias


    Full Text Available Abstract Background Existing animal models provide only indirect information about the pathogenesis of infections caused by indigenous gastrointestinal microflora and the kinetics of bacterial translocation. The aim of this study was to develop a novel animal model to assess bacterial translocation and intestinal barrier function in vivo. Methods In anaesthetized male Wistar rats, 0.5 ml of a suspension of green fluorescent protein-transfected E. coli was administered by intraluminal injection in a model of small bowel obstruction. Animals were randomly subjected to non-ischemic or ischemic bowel obstruction. Ischemia was induced by selective clamping of the terminal mesenteric vessels feeding the obstructed bowel loop. Time intervals necessary for translocation of E. coli into the submucosal stroma and the muscularis propria was assessed using intravital microscopy. Results Bacterial translocation into the submucosa and muscularis propria took a mean of 36 ± 8 min and 80 ± 10 min, respectively, in small bowel obstruction. Intestinal ischemia significantly accelerated bacterial translocation into the submucosa (11 ± 5 min, p E. coli were visible in frozen sections of small bowel, mesentery, liver and spleen taken two hours after E. coli administration. Conclusions Intravital microscopy of fluorescent bacteria is a novel approach to study bacterial translocation in vivo. We have applied this technique to define minimal bacterial transit time as a functional parameter of intestinal barrier function.

  14. Electroacupuncture at Zusanli Prevents Severe Scalds-Induced Gut Ischemia and Paralysis by Activating the Cholinergic Pathway

    Directory of Open Access Journals (Sweden)

    Huan Wang


    Full Text Available Severe burn injuries may result in gastrointestinal paralysis, and barrier dysfunction due to gut ischemia and lowered vagus excitability. In this study we investigate whether electroacupuncture (EA at Zusanli (ST36 could prevent severe scalds-induced gut ischemia, paralysis, and barrier dysfunction and whether the protective role of EA at ST36 is related to the vagus nerve. 35% burn area rats were divided into six groups: (a EAN: EA nonchannel acupoints followed by scald injury; (b EA: EA at ST36 after scald injury; (c VGX/EA: vagotomy (VGX before EA at ST36 and scald injury; (d VGX/EAN: VGX before EAN and scald injury; (e atropine/EA: applying atropine before scald injury and then EA at ST36; (f atropine/EAN: applying atropine before scald injury and then EA at nonchannel acupoints. EA at the Zusanli point significantly promoted the intestinal impelling ratio and increased the amount of mucosal blood flow after scald injury. The plasma diamine oxidase (DAO and intestinal permeability decreased significantly after scald injury in the EA group compared with others. However, EA after atropine injection or cervical vagotomy failed to improve intestinal motility and mucosa blood flow suggesting that the mechanism of EA may be related to the activation of the cholinergic nerve pathway.

  15. Effect of acute subendocardial ischemia on ventricular refractory periods. (United States)

    Ma, Longle; Wang, Lexin


    To investigate the impact of acute subendocardial ischemia on the dispersion of ventricular refractory periods. Acute subendocardial ischemia was induced in sheep by partial ligation of the left circumflex coronary artery and rapid pacing of the left atrium. The ventricular effective refractory period (ERP) was measured in five areas of the left ventricle by a programmed premature stimulation technique. The average ERP and ERP dispersion remained unchanged in the control group (n=5, P>0.05). In the study group (n=5), the ERP was shortened following subendocardial ischemia. ERP dispersion decreased significantly from 48+/-9 ms to 36+/-13 ms 30 min after the ischemia (P=0.02). There was neither spontaneous nor stimulation-induced ventricular arrhythmia after ischemia. Acute subendocardial ischemia leads to a homogenous reduction of ventricular ERP. This may partially explain why subendocardial ischemia is associated with a low incidence of ventricular arrhythmia.

  16. Intestinal lymphangiectasia in adults. (United States)

    Freeman, Hugh James; Nimmo, Michael


    Intestinal lymphangiectasia in the adult may be characterized as a disorder with dilated intestinal lacteals causing loss of lymph into the lumen of the small intestine and resultant hypoproteinemia, hypogammaglobulinemia, hypoalbuminemia and reduced number of circulating lymphocytes or lymphopenia. Most often, intestinal lymphangiectasia has been recorded in children, often in neonates, usually with other congenital abnormalities but initial definition in adults including the elderly has become increasingly more common. Shared clinical features with the pediatric population such as bilateral lower limb edema, sometimes with lymphedema, pleural effusion and chylous ascites may occur but these reflect the severe end of the clinical spectrum. In some, diarrhea occurs with steatorrhea along with increased fecal loss of protein, reflected in increased fecal alpha-1-antitrypsin levels, while others may present with iron deficiency anemia, sometimes associated with occult small intestinal bleeding. Most lymphangiectasia in adults detected in recent years, however, appears to have few or no clinical features of malabsorption. Diagnosis remains dependent on endoscopic changes confirmed by small bowel biopsy showing histological evidence of intestinal lymphangiectasia. In some, video capsule endoscopy and enteroscopy have revealed more extensive changes along the length of the small intestine. A critical diagnostic element in adults with lymphangiectasia is the exclusion of entities (e.g. malignancies including lymphoma) that might lead to obstruction of the lymphatic system and "secondary" changes in the small bowel biopsy. In addition, occult infectious (e.g. Whipple's disease from Tropheryma whipplei) or inflammatory disorders (e.g. Crohn's disease) may also present with profound changes in intestinal permeability and protein-losing enteropathy that also require exclusion. Conversely, rare B-cell type lymphomas have also been described even decades following initial

  17. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Directory of Open Access Journals (Sweden)

    Ghodratollah Maddah


    Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

  18. [Acute intestinal tuberculosis]. (United States)

    Nguyen Duc, C; Pha Hai, B; Pham Van, T; Ton That, B; Huguier, M


    To report cases from Vietnam of intestinal tuberculosis disease, which is uncommon but did not disappear in occidental countries. Seventy-six patients were included in this retrospective study. Mean age was 40 years and sex ratio M/F was 6. Diagnosis was established on pathological examination of resected specimen or on presence of Mycobacterium tuberculosis or by polymerase chain reaction. Intestinal obstruction or subobstruction was the most usual symptom (68%), and thereafter peritoneal symptoms with pain and tenderness (17%). Five patients had intractable digestive haemorrhage. Thirty-six patients had no past history or active pulmonary tuberculosis (47%). Lesions of stenosis on barium enema and thickness of intestinal wall on CT-scan were not specific. Sixty-two patients were operated on (82%) and 14 were not. Surgical techniques differed according symptoms, site and type of lesions. Intestinal resections were performed in half of the patients, others undergoing stomies or enterolysis. There were eight postoperative deaths (13% of patients operated on), seven out of these deaths were attributable to cachexy. In the postoperative period, all the patients were medically treated and follow-up in the antituberculosis centre of Hanoi. Symptomatology and operative findings of intestinal tuberculosis are similar to those observed in Crohn's disease, and sometimes in amoeboma or lymphoma. In face of stenosis and intestinal wall thickness, probability of intestinal tuberculosis is high in endemic area, but diagnosis must be suspected in occidental countries, mainly in patients immigrated coming from these areas, patients with immuno-deficiency even if they did not have past or present pulmonary tuberculosis.

  19. Empirical correlation methods for temporary anions. (United States)

    Sommerfeld, Thomas; Weber, Rebecca J


    A temporary anion is a short-lived radical anion that decays through electron autodetachment into a neutral molecule and a free electron. The energies of these metastable species are often predicted using empirical correlation methods because ab initio predictions are computationally very expensive. Empirical correlation methods can be justified in the framework of Weisskopf-Fano-Feshbach theory but tend to work well only within closely related families of molecules or within a restricted energy range. The reason for this behavior can be understood using an alternative theoretical justification in the framework of the Hazi-Taylor stabilization method, which suggests that the empirical parameters do not so much correct for the coupling of the computed state to the continuum but for electron correlation effects and that therefore empirical correlation methods can be improved by using more accurate electronic structure methods to compute the energy of the confined electron. This idea is tested by choosing a heterogeneous reference set of temporary states and comparing empirical correlation schemes based on Hartree-Fock orbital energies, Kohn-Sham orbital energies, and attachment energies computed with the equation-of-motion coupled-cluster method. The results show that using more reliable energies for the confined electron indeed enhances the predictive power of empirical correlation schemes and that useful correlations can be established beyond closely related families of molecules. Certain types of σ* states are still problematic, and the reasons for this behavior are analyzed. On the other hand, preliminary results suggest that the new scheme can even be useful for predicting energies of bound anions at a fraction of the computational cost of reliable ab initio calculations. It is then used to make predictions for bound and temporary states of the furantrione and croconic acid radical anions.

  20. Temporary new opening hours for Gate C

    CERN Multimedia

    GS Department


    Please note the new temporary opening hours for the gate C as from 22 September 2010 until 29 October 2010 (working days): Morning: between 7:00 a.m. and 9:00 a.m. Lunch: between 12:00 and 2:00 p.m. Evening: between 5:00 pm and 7:00 p.m. Traffic flow will be permitted in both directions during this period. Please minimize your speed accordingly and respect all road signs. GS-SEM Group General Infrastructure Services Department

  1. Criteria for diagnosis of temporary gluten intolerance. (United States)

    McNeish, A S; Rolles, C J; Arthur, L J


    Strict criteria for the diagnosis of temporary gluten intolerance are formulated in the light of the case of an 8-week-old infant with severe diarrhoea and failure to thrive, who recovered on an elimination diet that was gluten-free. 8 weeks later an oral challenge with 2.5 g twice daily of powdered gluten for one day produced diarrhoea, weight loss, and impaired xylose absorption. Gluten was successfully reintroduced into the diet 9 months later without incident. Jejunal histology remains normal after 26 months of a daily diet that contains 5 to 10 g gluten.

  2. Temporary effects of alcohol on color vision (United States)

    Geniusz, Maciej K.; Geniusz, Malwina; Szmigiel, Marta; Przeździecka-Dołyk, Joanna


    The color vision has been described as one to be very sensitive to the intake of several chemicals. The present research reviews the published literature that is concerned with color vision impairment due to alcohol. Most of this research considers people under long-term effects of alcohol. However, there is little information about temporary effects of alcohol on color vision. A group of ten volunteers aged 18-40 was studied. During the study levels of alcohol in the body were tested with a standard breathalyzer while color vision were studied using Farnsworth Munsell 100 Hue Color Vision Tests. Keywords: Col

  3. Intestinal and multivisceral transplantation. (United States)

    Meira Filho, Sérgio Paiva; Guardia, Bianca Della; Evangelista, Andréia Silva; Matielo, Celso Eduardo Lourenço; Neves, Douglas Bastos; Pandullo, Fernando Luis; Felga, Guilherme Eduardo Gonçalves; Alves, Jefferson André da Silva; Curvelo, Lilian Amorim; Diaz, Luiz Gustavo Guedes; Rusi, Marcela Balbo; Viveiros, Marcelo de Melo; Almeida, Marcio Dias de; Epstein, Marina Gabrielle; Pedroso, Pamella Tung; Salvalaggio, Paolo; Meirelles Júnior, Roberto Ferreira; Rocco, Rodrigo Andrey; Almeida, Samira Scalso de; Rezende, Marcelo Bruno de


    Intestinal transplantation has shown exceptional growth over the past 10 years. At the end of the 1990's, intestinal transplantation moved out of the experimental realm to become a routine practice in treating patients with severe complications related to total parenteral nutrition and intestinal failure. In the last years, several centers reported an increasing improvement in survival outcomes (about 80%), during the first 12 months after surgery, but long-term survival is still a challenge. Several advances led to clinical application of transplants. Immunosuppression involved in intestinal and multivisceral transplantation was the biggest gain for this procedure in the past decade due to tacrolimus, and new inducing drugs, mono- and polyclonal anti-lymphocyte antibodies. Despite the advancement of rigid immunosuppression protocols, rejection is still very frequent in the first 12 months, and can result in long-term graft loss. The future of intestinal transplantation and multivisceral transplantation appears promising. The major challenge is early recognition of acute rejection in order to prevent graft loss, opportunistic infections associated to complications, post-transplant lymphoproliferative disease and graft versus host disease; and consequently, improve results in the long run.

  4. A new method to measure intestinal secretion using fluorescein isothiocyanate-inulin in small bowel of rats. (United States)

    Munoz-Abraham, Armando Salim; Judeeba, Sami; Alkukhun, Abedalrazaq; Alfadda, Tariq; Patron-Lozano, Roger; Rodriguez-Davalos, Manuel I; Geibel, John P


    Small intestine ischemia can be seen in various conditions such as intestinal transplantation. To further understand the pathologic disruption in ischemia-reperfusion injury, we have developed a method to measure fluid changes in the intestinal lumen of rats. Two 10-cm rat intestine segments were procured, connected to the terminal apertures of a perfusion device, and continuously infused with 3 mL of HEPES solution (control solution) containing 50 μM of fluorescein isothiocyanate (FITC)-inulin. The perfusion device consists of concentric chambers that contain the perfused bowel segments, which are maintained at 37°C via H₂O bath. The individual chamber has four apertures as follows: two fill and/or drain the surrounding HEPES solution on the blood side of the tissue. The others provide flow of HEPES solution containing FITC-inulin through the lumens. The experimental intestine was infused with the same solution with 100 μM of Forskolin. A pump continuously circulated solutions at 6 mL/min. Samples were collected at 15-min intervals until 150 min and were measured by the nanoflourospectrometer. A mean of 6-μM decrease in the FITC-inulin concentration in the Forskolin-treated experimental intestine was observed in comparison with that in the control intestine. The FITC-inulin count dilution in the experimental intestine is a result of an increase of fluid secretion produced by the effect of Forskolin, with P values inulin to allow real-time determinations of fluid and/or electrolyte movement along the small intestine. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Local hypertrichosis: A rare complication of a temporary henna tattoo. (United States)

    Akpolat, Nebahat Demet; Aras, Arzu


    Temporary henna tattoos have become increasingly widespread among children and young people, especially in holiday spots in recent years. Although reactions to henna tattoo are becoming progressively more common, only few cases of a henna pseudo-tattoo resulting in temporary hypertrichosis have been reported so far. Here, we have reported a 5-year-old girl who developed allergic contact dermatitis and localized hypertrichosis on her right arm after application of temporary henna tattoo during summer holiday.

  6. Quality improvement of microsurgery through telecommunication--the postoperative care after microvascular transfer of intestine. (United States)

    Chen, Hung-Chi; Kuo, Hsin-Chih; Chung, Kuo-Piao; Chen, Shih-Heng; Tang, Yueh-Bih; Su, Syi


    The purpose of this report is to describe the use of telecommunication to improve the quality of postoperative care following microsurgery, especially following microvascular transfer of intestinal transfer for which shortening of ischemia time is of utmost importance to achieve high success rate. From 2003 to 2009 microvascular transfer of intestinal flaps had been performed in 112 patients. After surgery the patients were put in intensive care unit and the flaps were checked every 1 hour. The image for circulatory status of the flaps was sent directly to the attending surgeon for judgment. The information was sent through intranet and the surgeon can get access to the intranet through internet if necessary. Among the 112 cases, there were 9 cases of reexploration. The average duration between the time of problem detection and the time of starting reexploration was 54 min in 7 cases, and other 2 cases were delayed to enter the operating room which had been occupied by other cases of major trauma. Only two flaps were lost completely, two patients developed narrowing at the junction of cervical esophagus and thoracic esophagus. The rate of salvage for intestinal flap is apparently higher than those reported in the literature. In the postoperative management of microsurgery in ICU, telecommunication can help to reduce the ischemia time after vascular compromise in the transfer of free intestinal flap. Telecommunication is really an easy and effective tool in improving the outcome of reconstructive surgery. Copyright © 2012 Wiley Periodicals, Inc.

  7. Acute type B aortic dissection complicated by visceral ischemia. (United States)

    Jonker, Frederik H W; Patel, Himanshu J; Upchurch, Gilbert R; Williams, David M; Montgomery, Daniel G; Gleason, Thomas G; Braverman, Alan C; Sechtem, Udo; Fattori, Rossella; Di Eusanio, Marco; Evangelista, Arturo; Nienaber, Christoph A; Isselbacher, Eric M; Eagle, Kim A; Trimarchi, Santi


    Acute type B aortic dissection (ABAD) can lead to visceral malperfusion, a potentially life-threatening complication. The purpose of this study was to investigate the presentation, management, and outcomes of ABAD patients with visceral ischemia who are enrolled in the International Registry of Acute Aortic Dissection. Patients with ABAD enrolled in the registry between 1996 and 2013 were identified and stratified based on presence of visceral ischemia at admission. Demographics, medical history, imaging results, management, and outcomes were compared for patients with versus without visceral ischemia. A total of 1456 ABAD patients were identified, of which 104 (7.1%) presented with visceral ischemia. Preoperative limb ischemia (28% vs 7%, P < .001) and acute renal failure (41% vs 14%, P < .001) were more common among patients with visceral ischemia. Endovascular treatment and surgery were offered to 49% and 30% of the visceral ischemia cohort, respectively; remaining patients were managed conservatively. The in-hospital mortality was 30.8% for patients with visceral ischemia and 9.1% for those without visceral ischemia (odds ratio [OR] 4.44; 95% confidence interval [CI], 2.8-7.0, P < .0001). Mortality rates were similar after surgical and endovascular management of visceral ischemia (25.8% and 25.5%, respectively, P = not significant). Among the visceral ischemia group, medical management was a predictor of mortality in multivariate analysis (OR, 5.91; 95% CI, 1.2-31.0; P = .036). Patients with ABAD complicated by visceral ischemia have a high risk of mortality. We observed similar outcomes for patients treated by endovascular management versus surgery, whereas medical management was an independent predictor of mortality. Early diagnosis and intervention for visceral ischemia seems to be crucial. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  8. Chronic intestinal pseudoobstruction syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Yeon, Kyung Mo; Seo, Jeong Kee; Lee, Yong Seok [Seoul National University Children' s Hospital, Seoul (Korea, Republic of)


    Chronic intestinal pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel, and may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distension and deflection difficulty. Five had urinary bladder distension. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepses within one year. All had gaseous distension of small and large bowel on abdominal films. In small bowel series, consistent findings were variable degree of dilatation, decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome.

  9. Intestinal solute carriers

    DEFF Research Database (Denmark)

    Steffansen, Bente; Nielsen, Carsten Uhd; Brodin, Birger


    /or prodrugs to these carriers in order to increasing oral bioavailability and distribution. A number of absorptive intestinal transporters are described in terms of gene and protein classification, driving forces, substrate specificities and cellular localization. When targeting absorptive large capacity...... membrane transporters in the small intestine in order to increase oral bioavailabilities of drug or prodrug, the major influence on in vivo pharmacokinetics is suggested to be dose-dependent increase in bioavailability as well as prolonged blood circulation due to large capacity facilitated absorption......, and renal re-absorption, respectively. In contrast, when targeting low-capacity transporters such as vitamin transporters, dose independent saturable absorption kinetics are suggested. We thus believe that targeting drug substrates for absorptive intestinal membrane transporters could be a feasible strategy...

  10. Caffeine reduces dipyridamole-induced myocardial ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Smits, P.; Aengevaeren, W.R.; Corstens, F.H.; Thien, T. (Univ. of Nijmegen (Netherlands))


    The mechanism of action of coronary vasodilation after dipyridamole may be based on inhibition of cellular uptake of circulating endogenous adenosine. Since caffeine has been reported to be a competitive antagonist of adenosine we studied the effect of caffeine on the outcome of dipiridamole-{sup 201}Tl cardiac imaging in one patient. During caffeine abstinence dipyridamole induced myocardial ischemia with down-slope ST depressions on the ECG, and reversible perfusion defects on the scintigrams. When the test was repeated 1 wk later on similar conditions, but now shortly after infusion of caffeine (4 mg/kg), the ECG showed nodepressions, and the scintigrams only slight signs of ischemia. We conclude that when caffeine abstinence is not sufficient, the widespread use of coffee and related products may be responsible for false-negative findings in dipyridamole-201Tl cardiac imaging.

  11. Vascular access in critical limb ischemia. (United States)

    Kang, Won Yu; Campia, Umberto; Ota, Hideaki; Didier, Romain J; Negi, Smita I; Kiramijyan, Sarkis; Koifman, Edward; Baker, Nevin C; Magalhaes, Marco A; Lipinski, Michael J; Escarcega, Ricardo O; Torguson, Rebecca; Waksman, Ron; Bernardo, Nelson L


    Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Ischemia signalling to Alzheimer-related genes. (United States)

    Pluta, Ryszard; Kocki, Janusz; Maciejewski, Ryszard; Ułamek-Kozioł, Marzena; Jabłoński, Mirosław; Bogucka-Kocka, Anna; Czuczwar, Stanisław J


    In this paper we review the hard-earned data, which present ischemic induction of amyloid precursor protein, presenilins, apolipoproteins and secretases genes, playing key roles in β-amyloid peptide generation. Presented data are strongly supporting a hypothesis that brain ischemia may be involved in the aetiology of sporadic Alzheimer's disease. Potential contribution and impact of ischemically activated genes on the development of sporadic Alzheimer's disease remain to be established at both genetic and functional levels. The identification of the genes involved in sporadic Alzheimer's disease induced by ischemia will enable to further define the events leading to Alzheimer's disease-related abnormalities. Additionally, knowledge gained from the reviewed studies should facilitate the elaboration of effective treatment and/or prevention of sporadic Alzheimer's disease.

  13. Update in management of mesenteric ischemia (United States)

    Chang, Robert W; Chang, John B; Longo, Walter E


    Mesenteric ischemia disorders are precipitated by a circulation insufficiency event that deprives one or several abdominal organs of adequate respiration to meet metabolic demands. Although mesenteric ischemia occurs infrequently, the mortality rate is from 60% to 100%, depending on the source of obstruction. The successful outcome is dependent upon a high index of suspicion and prompt management. We briefly review the pathophysiology and presentation of the various ischemic entities and review the current state of the art in diagnosis and treatment. Despite advances in both diagnosis and treatment, prompt diagnosis and supportive care remain critical for successful outcome. New imaging techniques, endovascular therapy and emerging research may improve our approach to this deadly condition. PMID:16718846

  14. Intestinal microbiota and ulcerative colitis. (United States)

    Ohkusa, Toshifumi; Koido, Shigeo


    There is a close relationship between the human host and the intestinal microbiota, which is an assortment of microorganisms, protecting the intestine against colonization by exogenous pathogens. Moreover, the intestinal microbiota play a critical role in providing nutrition and the modulation of host immune homeostasis. Recent reports indicate that some strains of intestinal bacteria are responsible for intestinal ulceration and chronic inflammation in inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). Understanding the interaction of the intestinal microbiota with pathogens and the human host might provide new strategies treating patients with IBD. This review focuses on the important role that the intestinal microbiota plays in maintaining innate immunity in the pathogenesis and etiology of UC and discusses new antibiotic therapies targeting the intestinal microbiota. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Intestinal obstruction repair - series (image) (United States)

    The most common causes of intestinal obstruction in adults are adhesions, hernias, and colon cancer. Adhesions are scars that form between loops of intestine, usually caused by prior surgery, which causes such scar formation. ...

  16. Small intestine aspirate and culture (United States)

    ... ency/article/003731.htm Small intestine aspirate and culture To use the sharing features on this page, please enable JavaScript. Small intestine aspirate and culture is a lab test to check for infection ...

  17. Congenital Diseases of the Intestine

    NARCIS (Netherlands)

    D. Halim (Danny)


    markdownabstractAll research described in this dissertation is focused on understanding the pathophysiology of three rare congenital diseases of the intestine, including megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS), congenital short bowel syndrome (CSBS), and hereditary multiple

  18. Disorders of the Large Intestine (United States)

    ... of Medicine, Division of Digestive Diseases; Professor of Psychology, University of North Carolina, Chapel Hill, NC, IFFGD ... Intestine Large Intestine Anorectal and Pelvic Floor Area Personal Stories Resources We provide a wide range of ...

  19. Disorders of the Small Intestine (United States)

    ... of Medicine, Division of Digestive Diseases Professor of Psychology University of North Carolina, Chapel Hill, NC. Digestive ... Intestine Large Intestine Anorectal and Pelvic Floor Area Personal Stories Resources We provide a wide range of ...

  20. Colonic urticaria pattern due to early ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Greenberg, H.M.; Goldberg, H.I.; Axel, L.


    The unusual radiographic pattern of bleb-like mounds on the surface of the colon mucosa, previously described as colonic urticaria, was seen in 3 patients in whom no allergic state was present. This urticaria-like pattern was due to colonic distention in all 3, and represented only submucosal edema on the gross and microscopic specimens. We hypothesize that this pattern is due to early changes of ischemia caused by colon distention.

  1. Endovascular Management of Acute Limb Ischemia.

    LENUS (Irish Health Repository)

    Hynes, Brian G


    Despite major advances in pharmacologic and endovascular therapies, acute limb ischemia (ALI) continues to result in significant morbidity and mortality. The incidence of ALI may be as high as 13-17 cases per 100,000 people per year, with mortality rates approaching 18% in some series. This review will address the contemporary endovascular management of ALI encompassing pharmacologic and percutaneous interventional treatment strategies.

  2. Intestinal microdialysis--applicability, reproducibility and local tissue response in a pig model

    DEFF Research Database (Denmark)

    Emmertsen, K J; Wara, P; Sørensen, Flemming Brandt


    BACKGROUND AND AIMS: Microdialysis has been applied to the intestinal wall for the purpose of monitoring local ischemia. The aim of this study was to investigate the applicability, reproducibility and local response to microdialysis in the intestinal wall. MATERIALS AND METHODS: In 12 pigs two...... microdialysis probes were inserted into the ileal wall, one in the peritoneal cavity and one in the psoas muscle. Relative recovery was measured for all probes by the no net flux method. Metabolic measurements of glucose, lactate and glycerol were performed over six hours. The ileal wall segments containing....... A severe inflammatory reaction was seen in the ileal wall around all probes. CONCLUSION: Measurement of the relative recovery is essential for valid measurements of metabolites when using microdialysis. The inflammatory reaction around the probe in the intestinal wall is likely to affect metabolism...

  3. Intestinal microdialysis – applicability, reproducibility and local tissue response in a pig model

    DEFF Research Database (Denmark)

    Emmertsen, Katrine; Wara, Pål Edvard; Sørensen, Flemming Brandt


    ACKGROUND AND AIMS: Microdialysis has been applied to the intestinal wall for the purpose of monitoring local ischemia. The aim of this study was to investigate the applicability, reproducibility and local response to microdialysis in the intestinal wall. MATERIALS AND METHODS: In 12 pigs two...... microdialysis probes were inserted into the ileal wall, one in the peritoneal cavity and one in the psoas muscle. Relative recovery was measured for all probes by the no net flux method. Metabolic measurements of glucose, lactate and glycerol were performed over six hours. The ileal wall segments containing....... A severe inflammatory reaction was seen in the ileal wall around all probes. CONCLUSION: Measurement of the relative recovery is essential for valid measurements of metabolites when using microdialysis. The inflammatory reaction around the probe in the intestinal wall is likely to affect metabolism...

  4. Intestinal microdialysis--applicability, reproducibility and local tissue response in a pig model

    DEFF Research Database (Denmark)

    Emmertsen, K J; Wara, P; Sørensen, Flemming Brandt


    BACKGROUND AND AIMS: Microdialysis has been applied to the intestinal wall for the purpose of monitoring local ischemia. The aim of this study was to investigate the applicability, reproducibility and local response to microdialysis in the intestinal wall.MATERIALS AND METHODS: In 12 pigs two...... microdialysis probes were inserted into the ileal wall, one in the peritoneal cavity and one in the psoas muscle. Relative recovery was measured for all probes by the no net flux method. Metabolic measurements of glucose, lactate and glycerol were performed over six hours. The ileal wall segments containing....... A severe inflammatory reaction was seen in the ileal wall around all probes.CONCLUSION: Measurement of the relative recovery is essential for valid measurements of metabolites when using microdialysis. The inflammatory reaction around the probe in the intestinal wall is likely to affect metabolism...

  5. Purine Metabolism in Acute Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ye. V. Oreshnikov


    Full Text Available Objective: to study the specific features of purine metabolism in clinically significant acute cerebral ischemia. Subjects and materials. Three hundred and fifty patients with the acutest cerebral ischemic stroke were examined. The parameters of gas and electrolyte composition, acid-base balance, the levels of malonic dialdehyde, adenine, guanine, hypox-anthine, xanthine, and uric acid, and the activity of xanthine oxidase were determined in arterial and venous bloods and spinal fluid. Results. In ischemic stroke, hyperuricemia reflects the severity of cerebral metabolic disturbances, hemodynamic instability, hypercoagulation susceptiility, and the extent of neurological deficit. In ischemic stroke, hyperuri-corachia is accompanied by the higher spinal fluid levels of adenine, guanine, hypoxanthine, and xanthine and it is an indirect indicator of respiratory disorders of central genesis, systemic acidosis, hypercoagulation susceptibility, free radical oxidation activation, the intensity of a stressor response to cerebral ischemia, cerebral metabolic disturbances, the depth of reduced consciousness, and the severity of neurological deficit. Conclusion. The high venous blood activity of xanthine oxidase in ischemic stroke is associated with the better neurological parameters in all follow-up periods, the better early functional outcome, and lower mortality rates. Key words: hyperuricemia, stroke, xanthine oxidase, uric acid, cerebral ischemia.

  6. Post-Traumatic Late Onset Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Gencer Genc


    Full Text Available Artery-to-artery emboli or occlusion of craniocervical arteries mostly due to dissection are the most common causes of ischemia after trauma. A 29 year-old male had been admitted to another hospital with loss of consciousness lasting for about 45 minutes after a hard parachute landing without head trauma three days ago. As his neurological examination and brain CT were normal, he had been discharged after 24 hours of observation. Two days after his discharge, he was admitted to our department with epileptic seizure. His neurological examination revealed left hemianopia. After observing occipital subacute ischemia at right side in brain magnetic resonance imaging (MRI, we performed cerebral angiography and no dissection was observed. Excluding the rheumatologic, cardiologic and vascular events, our final diagnosis was late onset cerebral ischemia. Anti-edema and antiepileptic treatment was initiated. He was discharged with left hemianopia and mild cognitive deficit. We suggest that it will be wise to hospitalize patients for at least 72 hours who has a history of unconsciousness following trauma.

  7. Myocardic extended ischemia after scombroid syndrome

    Directory of Open Access Journals (Sweden)

    Maria Serena Bassoni


    Full Text Available We describe a case of a healthy woman, presenting to the emergency department because of sudden onset of diffuse pruriginous erythema, profound arterial hypotension and anginal chest pain, just after consuing a meal with cooked fresh tuna fish. She developed progressive ECG signs of myocardial ischemia suggesting subendocardial infarction and increased serum level of troponin I. After vigourous fluid resuscitation with iv fluids and treatment with anti-hystamine drugs, corticosteroids, beta-blockers and calcium-channell blockers she progressively recovered. A clinical diagnosis of sgombroid syndrome was established: it is a syndrome which may follow the ingestion of some spoiled fish, characterized by urticara, headhache, gastrointestinal upset and rarely bronchospasm, shock, coronary ischemia and arrythmias. A sample of the consumed fish could be analysed, finding a very high level of hystamine concentration, conferming the diagnosis of sgombroid syndrome. A coronary angiography was performed and confermed the patient had a normal coronary tree, devoid of atherosclerotic lesions. Her anginal symptoms and ECG signs were probably due to functional ischemia determined by hystamine mediated vasoconstriction and hypotension. This not so rare but not well known syndrome is further discussed and addressed to the emergency physicians’ attention, because of its importance in the differential diagnoses of suspected food allergies

  8. Beneficial effect of the oxygen free radical scavenger amifostine (WR-2721 on spinal cord ischemia/reperfusion injury in rabbits

    Directory of Open Access Journals (Sweden)

    Karanikolas Menelaos


    Full Text Available Abstract Background Paraplegia is the most devastating complication of thoracic or thoraco-abdominal aortic surgery. During these operations, an ischemia-reperfusion process is inevitable and the produced radical oxygen species cause severe oxidative stress for the spinal cord. In this study we examined the influence of Amifostine, a triphosphate free oxygen scavenger, on oxidative stress of spinal cord ischemia-reperfusion in rabbits. Methods Eighteen male, New Zealand white rabbits were anesthetized and spinal cord ischemia was induced by temporary occlusion of the descending thoracic aorta by a coronary artery balloon catheter, advanced through the femoral artery. The animals were randomly divided in 3 groups. Group I functioned as control. In group II the descending aorta was occluded for 30 minutes and then reperfused for 75 min. In group III, 500 mg Amifostine was infused into the distal aorta during the second half-time of ischemia period. At the end of reperfusion all animals were sacrificed and spinal cord specimens were examined for superoxide radicals by an ultra sensitive fluorescent assay. Results Superoxide radical levels ranged, in group I between 1.52 and 1.76 (1.64 ± 0.10, in group II between 1.96 and 2.50 (2.10 ± 0.23, and in group III (amifostine between 1.21 and 1.60 (1.40 ± 0.19 (p = 0.00, showing a decrease of 43% in the Group of Amifostine. A lipid peroxidation marker measurement ranged, in group I between 0.278 and 0.305 (0.296 ± 0.013, in group II between 0.427 and 0.497 (0.463 ± 0.025, and in group III (amifostine between 0.343 and 0.357 (0.350 ± 0.007 (p Conclusion By direct and indirect methods of measuring the oxidative stress of spinal cord after ischemia/reperfusion, it is suggested that intra-aortic Amifostine infusion during spinal cord ischemia phase, significantly attenuated the spinal cord oxidative injury in rabbits.

  9. CT recognition of intestinal lipomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Ormson, M.J.; Stephens, D.H.; Carlson, H.C.


    Lipomas are among the most common benign tumors of the small intestine. They are generally solitary lesions and asymptomatic. The extensive involvement of the small intestine with multiple lipomas is rare. The authors report a case of intestinal lipomatosis of the small bowel in which CT was specific enough to make the diagnosis without resorting to more invasive procedures.

  10. Cardiac Ischemia Model for +Gz Using Miniature Swine and Baboons (United States)


    held closed by two radio- paque tantalum clips. The nylon tubing was bored to various diameters to achieve an approximate 30 – 40% constriction of...and posterior left ventricular wall ischemia. Apical ischemia was masked by apical thinning, seen in both control and diseased swine and, therefore...interpretations of apical ischemia. The thorax of the baboon is smaller than the human or the swine thorax. Thus, the gall bladder, which collects

  11. CT diagnosis of acute mesenteric ischemia from various causes. (United States)

    Furukawa, Akira; Kanasaki, Shuzo; Kono, Naoaki; Wakamiya, Makoto; Tanaka, Toyohiko; Takahashi, Masashi; Murata, Kiyoshi


    Acute mesenteric ischemia can be caused by various conditions such as arterial occlusion, venous occlusion, strangulating obstruction, and hypoperfusion associated with nonocclusive vascular disease, and the CT findings vary widely depending on the cause and underlying pathophysiology. The aim of this article is to review the CT appearances of acute mesenteric ischemia in various conditions. Recognition of characteristic CT appearances and the variations associated with each cause may help in the accurate interpretation of CT in the diagnosis of mesenteric ischemia.

  12. adhesive intestinal obstruction

    African Journals Online (AJOL)


    Jun 1, 2006 ... obstruction. Brit. I. Surg. 1998; 85: 1071-1074. The acute abdomen: Intestinal obstruction. In: Primary surgery, Vol. 1. Edited by Maurice King et al. Oxford. Med. PubL, Oxford. 1990; 142-169. Fluids and electrolyte management. In: Essentials of pediatric surgery. Edited by Marc Rowe et al. Mosby,. St. Louis ...

  13. 8 CFR 245a.2 - Application for temporary residence. (United States)


    ... (No. 76-C-4268 (N.D. ILL. March 22, 1977)); that is, an alien from an independent country of the... States was due merely to a brief temporary trip abroad due to emergent or extenuating circumstances... employment and travel abroad for temporary resident status applicants under section 245A(a) of the Act may...

  14. 14 CFR 47.16 - Temporary registration numbers. (United States)


    ...) Temporary registration numbers may not be used to fly aircraft into the United States for the purpose of... for as many temporary registration numbers as are necessary for his business. The application must be... used on a flight outside the United States for delivery purposes, the holder shall record the...

  15. 23 CFR 1235.5 - Temporary removable windshield placards. (United States)


    ... 23 Highways 1 2010-04-01 2010-04-01 false Temporary removable windshield placards. 1235.5 Section 1235.5 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GUIDELINES UNIFORM SYSTEM FOR PARKING FOR PERSONS WITH DISABILITIES § 1235.5 Temporary removable windshield placards. (a)...

  16. Temporary Employment Contracts in Academia: A Real Option View (United States)

    Brady, Malcolm


    This paper examines the strategic use of temporary employment contracts in dealing with supply uncertainty in the form of employee ability that is slow to reveal itself, for example in academia where there exist significant time lags in demonstration of research ability. A temporary contract is modeled as a real option, specifically as a…

  17. 25 CFR 700.175 - Temporary emergency moves. (United States)


    ... move not been made. (iv) The Commission will pay all costs in connection with the move to temporary... temporary move, based upon the criteria set forth by the Commission. (2) The estimated duration of the... Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES...

  18. 22 CFR 123.3 - Temporary import licenses. (United States)


    ... articles, unless exempted from this requirement pursuant to § 123.4. This requirement applies to: (1) Temporary imports of unclassified defense articles that are to be returned directly to the country from... DEFENSE ARTICLES § 123.3 Temporary import licenses. (a) A license (DSP-61) issued by the Directorate of...

  19. 32 CFR Attachment 5 to Part 855 - Sample Temporary Agreement (United States)


    ... 32 National Defense 6 2010-07-01 2010-07-01 false Sample Temporary Agreement 5 Attachment 5 to Part 855 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE AIRCRAFT CIVIL AIRCRAFT USE OF UNITED STATES AIR FORCE AIRFIELDS Pt. 855, Att. 5 Attachment 5 to Part 855—Sample Temporary...

  20. 29 CFR 1926.154 - Temporary heating devices. (United States)


    ... 29 Labor 8 2010-07-01 2010-07-01 false Temporary heating devices. 1926.154 Section 1926.154 Labor... Temporary heating devices. (a) Ventilation. (1) Fresh air shall be supplied in sufficient quantities to... heating devices shall be installed to provide clearance to combustible material not less than the amount...

  1. The effect of lesion size and tissue remodeling on ST deviation in partial-thickness ischemia

    NARCIS (Netherlands)

    Potse, Mark; Coronel, Ruben; Falcao, Stéphanie; LeBlanc, A.-Robert; Vinet, Alain


    BACKGROUND: Myocardial ischemia causes ST segment elevation or depression in electrocardiograms and epicardial leads. ST depression in epicardium overlying the ischemic zone indicates that the ischemia is nontransmural. However, nontransmural ischemia does not always cause ST depression. Especially

  2. Hepatic and intestinal blood flow following thermal injury

    Energy Technology Data Exchange (ETDEWEB)

    Carter, E.A.; Tompkins, R.G.; Burke, J.F.


    Because cardiac output decreases after burn injuries, investigators have assumed, based upon dye clearance techniques, that hepatic and intestinal blood flow are also decreased following these injuries. Blood flow to the liver, stomach, small intestine, and kidney was determined by the uptake of 201thallium and 125I-labeled fatty acid (para-125I-phenyl-3-methyl pentanoic acid) in a 20% body surface area scald injury that also included plasma volume replacement resuscitation. Uptake of these radioisotopes was determined 15 minutes, 18 hours, and 72 hours after injury. The uptake of the 201thallium and 125I-labeled fatty acid by the gastrointestinal tissues was not statistically different at any of the time periods after comparison of the injured and control (sham-treated) animals. 201Thallium uptake by the kidney was significantly diminished 15 minutes after the burn injury (P less than 0.01). Based on these blood flow measurement techniques, the data suggest that the 20% body surface area scald injury did not alter blood flow to the liver or gastrointestinal tract within the initial 72 hours after the burn injury even though a decrease in renal blood flow was easily detected. These results suggest that the dysfunction of the gastrointestinal system or hepatic system observed after an acute burn injury is not simply the result of hypovolemic shock, which reduces both renal and mesenteric blood flow. These gastrointestinal and hepatic alterations may be related to a factor or factors other than intestinal ischemia.


    Directory of Open Access Journals (Sweden)

    Paran Haim


    Full Text Available Background: Somatostatin has an inhibitory effect on the endocrine and exocrine secretions of the gut. It may have a beneficial effect in the conservative treatment of intestinal obstruction. The aim of the present study is to investigate the effect of octreotide in mechanical intestinal obstruction in rats. Method: Intestinal obstruction was induced in rats by ligation of a segment of the distal ileum. Animals were treated with the somatostatin analogue octreotide (n=16, or saline (n=16. Eight rats were operated but their intestine was not ligated (n=8 serving as sham controls. Forty eight hours after the operation, the animals were operated upon again and blood samples from the femoral vein were tested for electrolytes, urea, glucose, lactic acid, amylase, ph and bicarbonate. Portal vein blood samples were also obtained and tested for lactic acid and amylase. Results: Intestinal obstruction resulted, after 48 hours, in severe dilatation of bowel loops. A significant increase in plasma levels of urea, amylase and lactic acid was observed. Plasma pH decreased. In blood samples from the portal vein, a significant increase in lactic acid was observed, indicating metabolic acidosis, probably secondary to bowel ischemia. Octreotide treatment, resulted in less acidosis, with concomitant lower urea and lactic acid levels in the plasma and especially in the portal vein. Conclusion: Octreotide treatment may have a beneficial effect in the conservative treatment of selected cases of intestinal obstruction.

  4. Temporary anchorage devices – Mini-implants (United States)

    Singh, Kamlesh; Kumar, Deepak; Jaiswal, Raj Kumar; Bansal, Amol


    Orthodontists are accustomed to using teeth and auxiliary appliances, both intraoral and extraoral, to control anchorage. These methods are limited in that it is often difficult to achieve results commensurate with our idealistic goals. Recently, a number of case reports have appeared in the orthodontic literature documenting the possibility of overcoming anchorage limitations via the use of temporary anchorage devices—biocompatible devices fixed to bone for the purpose of moving teeth, with the devices being subsequently removed after treatment. Although skeletal anchorage is here to stay in orthodontics, there are still many unanswered questions. This article describes the development of skeletal anchorage and provides an overview of the use of implants for orthodontic anchorage. PMID:22442547

  5. Interaction between food components, intestinal microbiota and intestinal mucosa as a function of intestinal health

    NARCIS (Netherlands)

    Venema, K.; Sandt, H. van de


    Interaction between food components, intestinal microbiota and intestinal mucosa was studied as a function of intestinal health. A microbiota was found to be important for the onset and progression of inflammatory diseases. Studies revealed a prominent effect of micro-organisms on the gene

  6. Schedules of Controlled Substances: Temporary Placement of 4-Fluoroisobutyryl Fentanyl into Schedule I. Temporary scheduling order. (United States)


    The Administrator of the Drug Enforcement Administration is issuing this temporary scheduling order to schedule the synthetic opioid, N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl fentanyl or para-fluoroisobutyryl fentanyl), and its isomers, esters, ethers, salts and salts of isomers, esters, and ethers, into schedule I pursuant to the temporary scheduling provisions of the Controlled Substances Act. This action is based on a finding by the Administrator that the placement of 4-fluoroisobutyryl fentanyl into schedule I of the Controlled Substances Act is necessary to avoid an imminent hazard to the public safety. As a result of this order, the regulatory controls and administrative, civil, and criminal sanctions applicable to schedule I controlled substances will be imposed on persons who handle (manufacture, distribute, reverse distribute, import, export, engage in research, conduct instructional activities or chemical analysis, or possess), or propose to handle, 4-fluoroisobutyryl fentanyl.

  7. Comments and hypotheses on the mechanism of methane against ischemia/reperfusion injury

    Directory of Open Access Journals (Sweden)

    He Li


    Full Text Available As we all know, methane is a kind of fuel. Previous studies have shown that methanogens in the colon can react with carbon dioxide and hydrogen to produce methane. In a recent study, the anti-inflammatory effects of methane were shown in a dog model of small intestinal ischemia/reperfusion. The mechanism of this anti-inflammatory effect needs further investigation. Recently, studies have shown anti-inflammatory, anti-apoptotic and anti-oxidative effects of methane on different organic injuries. According to the results of these studies, we hypothesize that the initial effects of methane are to react with free radicals and enhance expression of antioxidase through forkhead box transcription factor class O pathway. The anti-inflammatory effect is following the anti-oxidative effect, and the anti-apoptotic effect relies on anti-inflammatory and anti-oxidative effects.

  8. Isoflurane administration before ischemia and during reperfusion attenuates ischemia/reperfusion-induced injury of isolated rabbit lungs. (United States)

    Liu, R; Ishibe, Y; Ueda, M; Hang, Y


    To investigate the effects of isoflurane on ischemia/ reperfusion (IR)-induced lung injury, we administered isoflurane before ischemia or during reperfusion. Isolated rabbit lungs were divided into the following groups: control (n = 6), perfused and ventilated for 120 min without ischemia; ISO-control (n = 6), 1 minimum alveolar anesthetic concentration (MAC) isoflurane was administered for 30 min before 120 min continuous perfusion; IR (n = 6), ischemia for 60 min, followed by 60 min reperfusion; IR-ISO1 and IR-ISO2, ischemia followed by reperfusion and 1 MAC (n = 6) or 2 MAC (n = 6) isoflurane for 60 min; ISO-IR (n = 6), 1 MAC isoflurane was administered for 30 min before ischemia, followed by IR. During these maneuvers, we measured total pulmonary vascular resistance (Rt), coefficient of filtration (Kfc), and lung wet to dry ratio (W/D). The results indicated that administration of isoflurane during reperfusion inhibited an IR-induced increase in Kfc and W/D ratio. Furthermore, isoflurane at 2 MAC, but not 1 MAC, significantly inhibited an IR-induced increase in Rt. The administration of isoflurane before ischemia significantly attenuated the increase in IR-induced Kfc, W/D, and Rt. Our results suggest that the administration of isoflurane before ischemia and during reperfusion protects against ischemia-reperfusion-induced injury in isolated rabbit lungs.

  9. 78 FR 44965 - Notice of Temporary Closure and Temporary Restrictions of Specific Uses on Public Lands for the... (United States)


    ... human body a controlled substance in violation of any state or Federal law, or regulation issued... Desert playa. DATES: The temporary closure and temporary restrictions will be in effect from August 12... approved by the BLM authorized officer. B. Alcohol 1. Possession of an open container of an alcoholic...

  10. Lung ischemia reperfusion injury: the therapeutic role of dipeptidyl peptidase 4 inhibition. (United States)

    Beckers, Paul A J; Gielis, Jan F; Van Schil, Paul E; Adriaensen, Dirk


    Dipeptidyl peptidase 4 (DPP4) is a cell surface protease that has been reported to play a role in glucose homeostasis, cancer, HIV, autoimmunity, immunology and inflammation. A role for DPP4 in ischemia-reperfusion injury (IRI) in the heart has been established. Dipeptidyl peptidase 4 inhibition (DPP4i) appeared to decrease infarct size, improves cardiac function and promotes myocardial regeneration. Lung ischemia reperfusion injury is caused by a complex mechanism in which macrophages and neutrophils play an important role. Generation of reactive oxygen species (ROS), uncoupling of nitric oxide synthase (NOS), activation of nuclear factor-κB (NF-κB), activation of nicotinamide adenine dinucleotide phosphate metabolism, and generation of pro-inflammatory cytokines lead to acute lung injury (ALI). In this review we present the current knowledge on DPP4 as a target to treat IRI in the lung. We also provide evidence of the roles of the DPP4 substrates glucagon-like peptide 1 (GLP-1), vasoactive intestinal peptide (VIP) and stromal cell-derived factor-1α (SDF-1α) in protection against oxidative stress through activation of the mitogen-activated protein kinase (MAPK) 1/2 and phosphatidylinositol 3'-kinase (PI3K)/Akt signal transduction pathways.

  11. Non-obstructive mesenteric ischemia: a potentially lethal complication after cardiovascular surgery: report of two cases. (United States)

    Kazui, Toshinobu; Yamasaki, Manabu; Abe, Kohei; Watanabe, Sunao; Kawazoe, Kohei


    We report two cases of non-obstructive mesenteric ischemia (NOMI), a rare but potentially lethal complication after cardiovascular surgery, which was successfully managed. In both cases (a 74-year-old chronic hemodialysis patient who underwent emergency aortic valve replacement and coronary artery bypass graft (CABG), and a 74-year-old patient who underwent emergency abdominal aortic aneurysm operation), NOMI occurred early postoperatively (on day 8 and 22, respectively). They suffered from severe abdominal pain, confusion, and metabolic acidosis. Contrast-enhanced multi-detector CT (MDCT) scan and subsequent selective mesenteric angiography revealed characteristic signs of NOMI, for which selective papaverine infusion through the angiography catheter was performed. It was effective in both cases to halt progressive bowel ischemia and bided our time to perform a hemicolectomy of the necrotic segment. Contrast-enhanced MDCT scan and subsequent selective angiography are vital for diagnosis. If the condition does not improve after selective papaverine infusion, exploratory laparotomy and resection of necrotic intestinal segment should be performed immediately.

  12. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Schaaf, Irene C. van der; Velthuis, Birgitta K.; Dankbaar, Jan Willem [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands)


    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95 % confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88 %) with and 6 of 16 patients (38 %) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71 % (95%CI: 48-89 %) and NPV of 83 % (95%CI: 52-98 %) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63 % (95%CI: 41-81 %) and a NPV of 78 % (95%CI: 40-97 %) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation. (orig.)

  13. Small intestinal transplantation.

    LENUS (Irish Health Repository)

    Quigley, E M


    The past few years have witnessed a considerable shift in the clinical status of intestinal transplantation. A great deal of experience has been gained at the most active centers, and results comparable with those reported at a similar stage in the development of other solid-organ graft programs are now being achieved by these highly proficient transplant teams. Rejection and its inevitable associate, sepsis, remain ubiquitous, and new immunosuppressant regimes are urgently needed; some may already be on the near horizon. The recent success of isolated intestinal grafts, together with the mortality and morbidity attendant upon the development of advanced liver disease related to total parenteral nutrition, has prompted the bold proposal that patients at risk for this complication should be identified and should receive isolated small bowel grafts before the onset of end-stage hepatic failure. The very fact that such a suggestion has begun to emerge reflects real progress in this challenging field.

  14. Cerebral ischemia-induced angiogenesis is dependent on tumor necrosis factor receptor 1-mediated upregulation of α5β1 and αVβ3 integrins. (United States)

    Huang, Heng; Huang, Qijuan; Wang, Fuxin; Milner, Richard; Li, Longxuan


    The pro-inflammatory cytokine, tumor necrosis factor-α (TNF-α), is expressed in ischemic tissue and is known to modulate angiogenesis; however, the role of the two distinct TNF-α receptors, TNFR1 and TNFR2, in mediating angiogenic signaling after cerebral ischemic stroke is relatively unknown. C57BL6 mice were subject to 90 min of ischemia by temporary occlusion of the middle cerebral artery (MCAO) and given daily intra-cerebroventricular injections of antibodies against TNFR1, TNFR2 or control IgG (doses of 10, 50, and 100 ng/day) for 4 days following 90 min MCAO. Vascular remodeling and α5β1 and αVβ3 integrin expression were then examined in the brains of these mice after 4, 7, and 14 days post-ischemia. In parallel in vitro studies, flow cytometry was used to determine the influence of TNF-α on proliferation and integrin expression of human brain microvascular endothelial cells (HBMECs). The post-ischemic cerebral angiogenic response was inhibited by antibodies against TNFR1 but not TNFR2, and this correlated with reduced endothelial proliferation and decreased α5β1 and αVβ3 integrin expression after 4 and 7 days post-ischemia. Consistent with these findings, in vitro studies showed that TNF-α induced endothelial proliferation and upregulation of α5β1 and αVβ3 integrins was abrogated by anti-TNFR1 but not anti-TNFR2 antibodies in cultured HBMECs. In addition, blocking antibodies to α5β1 and αVβ3 integrins significantly inhibited TNF-α-induced HBMEC proliferation. Our results suggest that TNFR1-mediated signaling plays a critical role in triggering angiogenic integrins and subsequent angiogenic responses following cerebral ischemia. These novel findings could form a platform for future therapeutic strategies aimed at stimulating angiogenesis following cerebral ischemia.

  15. Anterior Segment Ischemia after Strabismus Surger

    Directory of Open Access Journals (Sweden)

    Emine Seyhan Göçmen


    Full Text Available A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day, cyclopentolate hydrochloride drops (3 times/day and 20 mg oral fluocortolone (3 times/day was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken.

  16. Permanent and temporary pacemaker implantation after orthotopic heart transplantation

    Directory of Open Access Journals (Sweden)

    Bacal Fernando


    Full Text Available PURPOSE:To determine the indication for and incidence and evolution of temporary and permanent pacemaker implantation in cardiac transplant recipients. METHODS: A retrospective review of 114 patients who underwent orthotopic heart transplantation InCor (Heart Institute USP BR between March 1985 and May 1993. We studied the incidence of and indication for temporary pacing, the relationship between pacing and rejection, the need for pemanent pacing and the clinical follow-up. RESULTS: Fourteen of 114 (12%heart transplant recipients required temporary pacing and 4 of 114 (3.5% patients required permanent pacing. The indication for temporary pacing was sinus node dysfunction in 11 patients (78.5% and atrioventricular (AV block in 3 patients (21.4%. The indication for permanent pacemaker implantation was sinus node dysfunction in 3 patients (75% and atrioventricular (AV block in 1 patient (25%. We observed rejection in 3 patients (21.4% who required temporary pacing and in 2 patients (50% who required permanent pacing. The previous use of amiodarone was observed in 10 patients (71.4% with temporary pacing. Seven of the 14 patients (50% died during follow-up. CONCLUSION: Sinus node dysfunction was the principal indication for temporary and permanent pacemaker implantation in cardiac transplant recipients. The need for pacing was related to worse prognosis after cardiac transplantation.

  17. Development of an in vitro co-culture model to mimic the human intestine in healthy and diseased state. (United States)

    Kämpfer, Angela A M; Urbán, Patricia; Gioria, Sabrina; Kanase, Nilesh; Stone, Vicki; Kinsner-Ovaskainen, Agnieszka


    The intestine forms the largest interface between the environment and the human organism. Its integrity and functioning are crucial for the uptake of nutrients while preventing access of harmful antigens. Inflammatory conditions can significantly change the normal functioning of the intestine. In vitro models that adequately reproduce both healthy and inflamed intestinal tissue could provide a useful tool for studying the mechanisms of intestinal inflammation and investigating new therapeutic drugs. We established a co-culture of Caco-2 and PMA-differentiated THP-1 cells that mimics the intestine in healthy and controlled inflamed states. In homoeostatic conditions without stimulation, Caco-2 and THP-1 cells were co-cultured for 48h without affecting the barrier integrity and with no increase in the release of cytokines, nitric oxide or lactate dehydrogenase. To simulate the inflamed intestine, the Caco-2 barrier was primed with IFN-γ and THP-1 cells were pre-stimulated with LPS and IFN-γ. In these conditions a significant but temporary reduction in barrier integrity was measured, and large concentrations of pro-inflammatory cytokines and cytotoxicity markers detected. With its ability to feature numerous hallmarks of intestinal inflammation the presented co-culture model of epithelial cells and macrophages offers a unique possibility to study exposure effects in relation to the health status of the intestine. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Effect of intestinal pressure on fistula closure during vacuum assisted treatment: a computational approach. (United States)

    Cattoni, Diego I; Ravazzola, Constanza; Tüngler, Victoria; Wainstein, Daniel E; Chara, Osvaldo


    Enterocutaneous fistulae, pathological communications between the intestinal lumen and the abdominal skin, can arise as serious complication of gastrointestinal surgery. A current non-surgical treatment for this pathology involves topical application of sub-atmospheric pressure, also known as vacuum assisted closure (VAC). While this technique appears to be promising, surgeons report a number of cases in which its application fails to achieve fistula closure. Here, we evaluate the fistula's physical properties during the vacuum assisted closure process in a computational approach exploring the relevance of intraluminal intestinal pressure. A mathematical model formulated by differential equations based on tissue elasticity properties and principles of fluid mechanics was created and forcing functions were integrated to mimic intestinal pressure dynamics. A software to solve equations and to fit the model to experimentally obtained data was developed. This enabled simulations of vacuum assisted fistula closure under different intestinal pressure. The simulation output indicates conditions, in which fistula closure can or cannot be expected suggesting favoured or impeded healing, respectively. When modifications of intestinal pressure, as observed in fistula accompanying pathologies, are integrated, the outcome of fistula closure changes considerably. Rise of intestinal pressure is associated with delay of fistula closure and temporary fistula radius augmentation, while reduction of intestinal pressure during sub-atmospheric pressure treatment contributes to a faster and direct fistula closure. From the model predictions, we conclude that administration of intestinal pressure decreasing compounds (e.g. butylscopolamine, glucagon) may improve VAC treatment, while intestinal pressure increasing drugs should be avoided. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Acute occlusive mesenteric ischemia in high altitude of ...

    African Journals Online (AJOL)

    Background and Objectives: Mesenteric ischemia which can be acute or chronic depending on the rapidity of compromised blood flow produces bowel ischemia, infarction, bacterial transmigration, endotoxemia, multisystem organ failure and death. High altitude can precipitate thrombosis because of hypobaric hypoxia and ...

  20. EEG Monitoring in Cerebral Ischemia: Basic Concepts and Clinical Applications

    NARCIS (Netherlands)

    van Putten, Michel Johannes Antonius Maria; Hofmeijer, Jeannette


    EEG is very sensitive to changes in neuronal function resulting from ischemia. The authors briefly review essentials of EEG generation and the effects of ischemia on the underlying neuronal processes. They discuss the differential sensitivity of various neuronal processes to energy limitations,

  1. Ergotamine-induced upper extremity ischemia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk; Lee, Gun [Bundang CHA General Hospital, Pochon (China); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  2. Functional testing in the diagnosis of chronic mesenteric ischemia

    NARCIS (Netherlands)

    van Noord, Desiree; Kolkman, Jeroen J.

    Chronic mesenteric ischemia (CMI) results from insufficient oxygen delivery or utilization to meet metabolic demand. Two main mechanisms may lead to mesenteric ischemia: occlusion in the arteries or veins of the gastrointestinal tract, or reduced blood flow from shock states or increased

  3. Diagnosis and treatment of chronic mesenteric ischemia : An update

    NARCIS (Netherlands)

    Kolkman, Jeroen J.; Geelkerken, Robert H.

    Although the prevalence of mesenteric artery stenoses (MAS) is high, symptomatic chronic mesenteric ischemia (CMI) is rare. The collateral network in the mesenteric circulation, a remnant of the extensive embryonal vascular network, serves to prevent most cases of ischemia. This explains the high

  4. Mesenteric ischemia after abdominal aortic aneurysm repair : a systemic review

    NARCIS (Netherlands)

    Bruggink, J. L. M.; Tielliu, I. F. J.; Zeebregts, C. J.; Pol, R. A.


    Mesenteric ischemia after abdominal aneurysm repair is a devastating complication with mortality rates up to 70%. Incidence however is relatively low. The aim of this review was to provide an overview on current insights, diagnostic modalities and on mesenteric ischemia after abdominal aortic

  5. Transmesenteric hernia with bowel ischemia in unusual site

    Directory of Open Access Journals (Sweden)

    Praveen S


    Full Text Available An 8-year-old girl presented with distal ileal obstruction secondary to transmesenteric hernia. The ileum just proximal to the herniated loop was ischemic, while the herniated bowel did not show ischemia. The ischemia was due to stretching and torsion of the vessels around the mesenteric defect by the herniated bowel. Such a mechanism has not been reported before.

  6. Influence of prolonged cold ischemia in renal transplantation.

    NARCIS (Netherlands)

    Vliet, J.A. van der; Warle, M.C.; Cheung, C.L.; Teerenstra, S.; Hoitsma, A.J.


    van der Vliet JA, Warle MC, Cheung CLS, Teerenstra S, Hoitsma AJ. Influence of prolonged cold ischemia in renal transplantation. Clin Transplant 2011: 25: E612-E616. (c) 2011 John Wiley & Sons A/S. Abstract: Aim: To determine to what extent current cold ischemia times (CITs) affect the results of

  7. [Prognostic significance of post-infarction "silent" ischemia]. (United States)

    Chikavashvili, D I; Blokhin, A B; Rado, Iu; Iliasov, A A; Ruda, M Ia


    To study the predictive value of silent ischemia, a total of 132 patients with first transmural myocardial infarction were examined, 69 had anterior and 63 had inferior myocardial infarction. On days 8-12 of onset of the disease, all the patients underwent loading two-dimensional echocardiography along with transesophageal pacing, as well as polyposition coronary angiography. According to the echocardiographic findings, 3 groups of patients were identified: 1) 34 (25.8%) with painful ischemia; 2) 37 (28.0%) with silent ischemia; 3) 61 (46.2%) with a negative test. Ischemic alterations were more frequently seen in inferior (73%) than in anterior (36.2%) myocardial infarction. The patients with painful ischemia showed a lower threshold of ischemia occurrence, more severe and prolonged ST segment depression, and greater extent of an asynergic area than did the patients with silent ischemia. A 1-5-year (mean 2.4) follow-up revealed that in terms of the risk for postinfarction angina, recurrent myocardial infarction and fatal outcomes, patients with silent ischemia represent an intermediate group between those with painful ischemia and those who have a negative load test.

  8. Effects of dexmedetomidine on renal tissue after lower limb ischemia ...

    African Journals Online (AJOL)

    Aim: The aim of this study was to investigate whether dexmedetomidine – administered before ischemia – has protective effects against lower extremity ischemia reperfusion injury that induced by clamping and subsequent declamping of infra-renal abdominal aorta in streptozotocin-induced diabetic rats. Material and ...

  9. Silent ischemia and beta-blockade

    DEFF Research Database (Denmark)

    Egstrup, K


    and should also be directed at the other coronary artery risk factors of the patients. The effects of beta-blockers, which reduce the duration and frequency of silent ischemic episodes, is well described. The effect is most pronounced in the morning, when the frequency of ischemia is highest......, and the mechanism of action seems mainly mediated through a reduction in myocardial oxygen demand. beta-Blockers have shown effectiveness in both effort-induced angina and mixed angina, and increased anti-ischemic potency may be achieved by combination therapy with a calcium antagonist. Abrupt withdrawal of beta-blockers...

  10. Return to Work After Temporary Disability Pension in Finland. (United States)

    Laaksonen, Mikko; Gould, Raija


    When it is possible that the employee's work ability can be restored through treatment or rehabilitation, disability pension in Finland is granted for a fixed period. We examined which factors are associated with return to work (RTW) after such temporary disability pension. The study included all Finnish residents whose temporary disability pension from the earnings-related pension system started in 2008 (N = 10,269). Competing risks regression analysis was applied to examine register-based determinants for RTW after temporary disability pension due to mental disorders, musculoskeletal diseases, other diseases, and injury over a 4-year follow-up period. The overall cumulative incidence of RTW was 25%. RTW was more probable after temporary disability pension due to injury and musculoskeletal diseases and less probable after temporary disability pension due to mental disorders. Younger age and higher education increased RTW but differences between genders, private and public sector employees, and occupational classes were relatively small. The probability of RTW was higher among those who were employed before their temporary disability pension (subhazard ratio in multivariate analysis 2.41 (95% CI 2.13-2.72) and among the 9% who participated in vocational rehabilitation during their pension [SHR 2.10 (95% CI 1.90-2.31)]. With some exceptions, the results were fairly similar for all diagnostic causes of temporary disability pension. Return to work after temporary disability pension was relatively uncommon. Nevertheless, in all diagnostic groups RTW continued for the whole follow-up period. The low educated and those not employed before temporary disability pension need more support in their RTW. The strong association between vocational rehabilitation and RTW suggests that increasing rehabilitation among those with impaired work ability may promote RTW.

  11. Myosin light chain kinase mediates intestinal barrier dysfunction via occludin endocytosis during anoxia/reoxygenation injury. (United States)

    Jin, Younggeon; Blikslager, Anthony T


    Intestinal anoxia/reoxygenation (A/R) injury induces loss of barrier function followed by epithelial repair. Myosin light chain kinase (MLCK) has been shown to alter barrier function via regulation of interepithelial tight junctions, but has not been studied in intestinal A/R injury. We hypothesized that A/R injury would disrupt tight junction barrier function via MLCK activation and myosin light chain (MLC) phosphorylation. Caco-2BBe1 monolayers were subjected to anoxia for 2 h followed by reoxygenation in 21% O 2 , after which barrier function was determined by measuring transepithelial electrical resistance (TER) and FITC-dextran flux. Tight junction proteins and MLCK signaling were assessed by Western blotting, real-time PCR, or immunofluorescence microscopy. The role of MLCK was further investigated with select inhibitors (ML-7 and peptide 18) by using in vitro and ex vivo models. Following A/R injury, there was a significant increase in paracellular permeability compared with control cells, as determined by TER and dextran fluxes (P endocytosis caused by A/R injury. Application of MLCK inhibitors to ischemia-injured porcine ileal mucosa induced significant increases in TER and reduced mucosal-to-serosal fluxes of 3 H-labeled mannitol. These data suggest that MLCK-induced occludin endocytosis mediates intestinal epithelial barrier dysfunction during A/R injury. Our results also indicate that MLCK-dependent occludin regulation may be a target for the therapeutic treatment of ischemia/reperfusion injury. Copyright © 2016 the American Physiological Society.

  12. Biodegradable intestinal stents: A review

    Directory of Open Access Journals (Sweden)

    Zhanhui Wang


    Full Text Available Biodegradable stents are an attractive alternative to self-expanding metal stents in the treatment of intestinal strictures. Biodegradable stent can be made of biodegradable polymers and biodegradable metals (magnesium alloys. An overview on current biodegradable intestinal stents is presented. The future trends and perspectives in the development of biodegradable intestinal stents are proposed. For the biodegradable polymer intestinal stents, the clinical trials have shown promising results, although improved design of stents and reduced migration rate are expected. For the biodegradable magnesium intestinal stents, results of preliminary studies indicate magnesium alloys to have good biocompatibility. With many of the key fundamental and practical issues resolved and better methods for adjusting corrosion resistance and progressing biocompatibilities of magnesium alloys, it is possible to use biodegradable intestinal stents made of magnesium alloys in hospital in the not too distant future.

  13. [Impact of ishemia-reperfusion injury on long survival rate in intestinal transplantation in rats]. (United States)

    Lausada, Natalia; Stringa, Pablo; Cabanne, Ana; Ramisch, Diego; Machuca, Mariana; Galvao, Flavio; Coronato, Silvia; Raimondi, Jorge Clemente; Gondolesi, Gabriel


    The intestine is a highly sensitive tissue to ischemia-reperfusion (IR) injury that will early respond increasing its permeability. Later this response is translated in morphologic and histological changes that reveal the degree of damage. The heterotopic intestinal transplantation model in rats allows to evaluate the evolution of intestinal tissue injury after ischemia-reperfusion without affecting the long survival rate. The aim of this paper is to establish a relationship between the ischemic reperfusion injury with the long-term survival Ten intestinal transplants were analyzed in adult, Wistar, inbred, male rats. Light microscopical examination was performed on intestine graft: 1) immediately post-dissection, 2) at the end of cold isquemia, 3) 30 min, 4) 48hs and 5) 5 days post-transplant procedure, respectively. Biopsies were reported according to Park's classification and extension of staining using immunohistochemestry to malondialdehyde (MDA) products. The Park's classification indexes reported in samples were 1) 0,57 +/- 1,13 (N=10); 2) 2,71 +/- 1,25 (N=10); 3) 4,14 +/- 0,89 (N=10); 4) 1,0 +/- 0,81 (N=7); 5) 0 (N=7). The highest levels of immunohistochemical detection of MDA were observed thirty minutes post-reperfusion (extension of staining between 51% to 75%). Three animals died when they were sampled at 48 hours, and the biopsies had Park's classification > or = 4 at 30 minutes post-reperfusion and endotoxemic signology. The highest degree of mucosal damage was observed immediately post-reperfusion. At 48hs the graft tended to be normalized Failure to repair the immediately I-R injury signficantly affects the long term survival.

  14. Temporary tattoo for wireless human pulse measurement (United States)

    Pepłowski, Andrzej; Janczak, Daniel; Krzemińska, Patrycja; Jakubowska, Małgorzata


    Screen-printed sensor for measuring human pulse was designed and first tests using a demonstrator device were conducted. Various materials and sensors' set ups were compared and the results are presented as the starting point for fabrication of fully functional device. As a screen printing substrate, commercially available temporary tattoo paper was used. Using previously developed nanomaterials-based pastes design of a pressure sensor was printed on the paper and attached to the epidermis. Measurements were aimed at determining sensors impedance constant component and its variability due to pressure wave caused by the human pulse. The constant component was ranging from 2kΩ to 6kΩ and the variations of the impedance were ranging from +/-200Ω to +/-2.5kΩ, depending on the materials used and the sensor's configuration. Calculated signal-to-noise ratio was 3.56:1 for the configuration yielding the highest signal level. As the device's net impedance influences the effectiveness of the wireless communication, the results presented allow for proper design of the sensor for future health-monitoring devices.

  15. Sealing of temporary cements in endodontics

    Directory of Open Access Journals (Sweden)

    Eduardo Gomes Ferraz


    Full Text Available Objective: The aim of this study was to assess the coronal leakage of three temporary cements in endodontics: Bioplic® (Biodinâmica, Londrina, Brazil, IRM® (Dentsply, Petrópolis, Brazil and Coltosol® (Vigodent, Bonsucesso, Brazil. Methods: Forty human pre-molars were divided into four groups: I (Bioplic® + adhesive system, II (Bioplic®, Biodinâmica, Londrina, Brasil, III (IRM®, Dentsply, Petrópolis, Brasil, and IV (Coltosol®, Vigodent, Bonsucesso, Brasil. The teeth were immersed in 1% Rodamine and kept at 37°C for 24h. They were then thermal cycled for seven days. Temperatures ranged between 5, 37 and 50°C. After longitudinal sectioning the leakage was measured in mm and statistical analysis was performed using the ANOVA and Tukey tests with a level of significance of 5%.Results: In the group in which Bioplic® was used with adhesive, a lower level of leakage was detected (0.37 ± 0.24. There was significant difference (p<0.05 between groups I and III, I and IV, II and III. Conclusion: It was concluded that all the tested material showed coronal leakage and that the use of the (Bioplic® Biodinâmica, Londrina, Brasilplus adhesive system showed the lowest level of leakage.

  16. Heparin-Binding EGF-like Growth Factor (HB-EGF) Therapy for Intestinal Injury: Application and Future Prospects (United States)

    Yang, Jixin; Su, Yanwei; Zhou, Yu; Besner, Gail E.


    Throughout the past 20 years, we have been investigating the potential therapeutic roles of heparin-binding EGF-like growth factor (HB-EGF), a member of the epidermal growth factor family, in various models of intestinal injury including necrotizing enterocolitis (NEC), intestinal ischemia/reperfusion (I/R) injury, and hemorrhagic shock and resuscitation (HS/R). Our studies have demonstrated that HB-EGF acts as an effective mitogen, a restitution-inducing reagent, a cellular trophic factor, an anti-apoptotic protein and a vasodilator, via its effects on various cell types in the intestine. In the current paper, we have reviewed the application and therapeutic effects of HB-EGF in three classic animal models of intestinal injury, with particular emphasis on its protection of the intestines from NEC. Additionally, we have summarized the protective functions of HB-EGF on various target cells in the intestine. Lastly, we have provided a brief discussion focusing on the future development of HB-EGF clinical applications for the treatment of various forms of intestinal injury including NEC. PMID:24345808

  17. Doxycycline protects human intestinal cells from hypoxia/reoxygenation injury: Implications from an in-vitro hypoxia model. (United States)

    Hummitzsch, Lars; Zitta, Karina; Berndt, Rouven; Kott, Matthias; Schildhauer, Christin; Parczany, Kerstin; Steinfath, Markus; Albrecht, Martin


    Intestinal ischemia/reperfusion (I/R) injury is a grave clinical emergency and associated with high morbidity and mortality rates. Based on the complex underlying mechanisms, a multimodal pharmacological approach seems necessary to prevent intestinal I/R injury. The antibiotic drug doxycycline, which exhibits a wide range of pleiotropic therapeutic properties, might be a promising candidate for also reducing I/R injury in the intestine. To investigate possible protective effects of doxycycline on intestinal I/R injury, human intestinal CaCo-2 cells were exposed to doxycycline at clinically relevant concentrations. In order to mimic I/R injury, CaCo-2 were thereafter subjected to hypoxia/reoxygenation by using our recently described two-enzyme in-vitro hypoxia model. Investigations of cell morphology, cell damage, apoptosis and hydrogen peroxide formation were performed 24h after the hypoxic insult. Hypoxia/reoxygenation injury resulted in morphological signs of cell damage, elevated LDH concentrations in the respective culture media (Pdoxycycline (5µM, 10µM, 50µM) reduced the hypoxia induced signs of cell damage and LDH release (Pdoxycycline protects human intestinal cells from hypoxia/reoxygenation injury in-vitro. Further animal and clinical studies are required to prove the protective potential of doxycycline on intestinal I/R injury under in-vivo conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Autophagy and Liver Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Raffaele Cursio


    Full Text Available Liver ischemia-reperfusion (I-R injury occurs during liver resection, liver transplantation, and hemorrhagic shock. The main mode of liver cell death after warm and/or cold liver I-R is necrosis, but other modes of cell death, as apoptosis and autophagy, are also involved. Autophagy is an intracellular self-digesting pathway responsible for removal of long-lived proteins, damaged organelles, and malformed proteins during biosynthesis by lysosomes. Autophagy is found in normal and diseased liver. Although depending on the type of ischemia, warm and/or cold, the dynamic process of liver I-R results mainly in adenosine triphosphate depletion and in production of reactive oxygen species (ROS, leads to both, a local ischemic insult and an acute inflammatory-mediated reperfusion injury, and results finally in cell death. This process can induce liver dysfunction and can increase patient morbidity and mortality after liver surgery and hemorrhagic shock. Whether autophagy protects from or promotes liver injury following warm and/or cold I-R remains to be elucidated. The present review aims to summarize the current knowledge in liver I-R injury focusing on both the beneficial and the detrimental effects of liver autophagy following warm and/or cold liver I-R.

  19. Mixed models in cerebral ischemia study

    Directory of Open Access Journals (Sweden)

    Matheus Henrique Dal Molin Ribeiro


    Full Text Available The data modeling from longitudinal studies stands out in the current scientific scenario, especially in the areas of health and biological sciences, which induces a correlation between measurements for the same observed unit. Thus, the modeling of the intra-individual dependency is required through the choice of a covariance structure that is able to receive and accommodate the sample variability. However, the lack of methodology for correlated data analysis may result in an increased occurrence of type I or type II errors and underestimate/overestimate the standard errors of the model estimates. In the present study, a Gaussian mixed model was adopted for the variable response latency of an experiment investigating the memory deficits in animals subjected to cerebral ischemia when treated with fish oil (FO. The model parameters estimation was based on maximum likelihood methods. Based on the restricted likelihood ratio test and information criteria, the autoregressive covariance matrix was adopted for errors. The diagnostic analyses for the model were satisfactory, since basic assumptions and results obtained corroborate with biological evidence; that is, the effectiveness of the FO treatment to alleviate the cognitive effects caused by cerebral ischemia was found.

  20. The Liminality of Temporary Agency Work: Exploring the Dimensions of Temporary Agency Workers’ Liminal Experience

    DEFF Research Database (Denmark)

    Winkler, Ingo; Mahmood, Mustafa Khalil


    along which liminality can unfold in organizational and work-related contexts. We argue that future studies should explore the various dimensions in other contexts of passages from one relatively stable state to another. In doing so, similarities and differences between various liminal experiences...... on political anthropology we identify the dimensions of ‘types of subjects,’‘time,’ ‘space,’ and ‘scale’ in order to analytically unlock the liminal experience. Exemplifying our concept we present the findings from an own study of temporary agency workers in Denmark. Exploring the workers’ interpretations...

  1. 20 CFR 655.20 - Applications for temporary employment certification. (United States)


    ... Nursing in the United States (H-2B Workers) § 655.20 Applications for temporary employment certification..., the employer will be required to conduct another labor market for the portion of time beyond 12 months. ...

  2. 20 CFR 655.21 - Supporting evidence for temporary need. (United States)


    ... Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United... containing the following: (1) A description of the employer's business history and activities (i.e., primary...

  3. 44 CFR 9.13 - Particular types of temporary housing. (United States)


    ... is the only practicable alternative. The following factors shall be substituted for the factors in... risk to the temporary housing occupant; (iii) Cost effectiveness; (iv) Social and neighborhood patterns...

  4. 7 CFR 160.41 - Issuance of temporary license. (United States)


    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) NAVAL STORES REGULATIONS AND... processor of the need therefor and the competency of the applicant for such temporary license. Such...

  5. Non-Occlusive Mesenteric Ischemia (NOMI) in Parkinson’s disease: case report (United States)



    Non-occlusive mesenteric ischemia (NOMI) is a severe pathological condition characterized by signs and symptoms of bowel obstruction, intestinal necrosis resulting from acute and/or chronic inadequate blood perfusion, in the absence of an organic vascular obstruction detectable by imaging techniques. A 64 years old man case with a history of Parkinson’s disease in high-functioning levodopa treatment is presented. Clinical and radiological signs of intestinal obstruction were observed. He underwent surgical operation with total colectomy and terminal ileostomy for generalized secondary peritonitis due to perforation of sigmoid colon. Ischemic pancolitis was first suspected. In third post-operative day a contrast-enhanced CT scan was performed in the evidence of fever and sub-occlusive symptoms. It was found absence of reliable evidence of vascular changes; superior mesenteric artery and vein patency is maintained A NOMI was then diagnosed. NOMI represents about 0.04% of mesenteric artery diseases. It is correlated with a poor prognosis with a mortality estimated of 70–90%. Parkinson’s disease, considering neurodegenerative alterations that characterize it, can be considered as a predisposing factor. The combined treatment with high doses of levodopa and vasodilators, such as PGE (Prostaglandin E), can contribute to an improvement in prognosis. PMID:28691670

  6. Drying firewood in a temporary solar kiln: a case study. (United States)

    George R. Sampson; Anthony F. Gasbarro


    A pilot study was undertaken to determine drying rates for small diameter, unsplit paper birch firewood that was dried: (1) in a conventional top-covered pile; (2) in a simple, temporary solar kiln; and (3) in tree length. Drying rates were the same for firewood piles whether they were in the temporary solar kilns or only covered on top to keep rain or snow from...

  7. The savings behavior of temporary and permanent migrants in Germany


    Bauer, Thomas K.; Sinning, Mathias


    This paper examines the relative savings position of migrant households in West Germany, paying particular attention to differences between temporary and permanent migrants. Utilizing household level data from the German Socio-Economic Panel (GSOEP), our findings reveal significant differences in the savings rates between foreign-born and German-born individuals. These differences disappear, however, for temporary migrants, if their remittances are taken into account. Fixed effects estimation...

  8. The impacts of temporary and anticipated tourism spending


    Grant Allan; Patrizio Lecca; Kim Swales


    Part of the local economic impact of a major sporting event comes from the associated temporary tourism expenditures. Typically demand-driven Input-Output (IO) methods are used to quantify the impacts of such expenditures. However, IO modelling has specific weaknesses when measuring temporary tourism impacts; particular problems lie in its treatment of factor supplies and its lack of dynamics. Recent work argues that Computable General Equilibrium (CGE) analysis is more appropriate and this h...

  9. The Unusual Suspect: A Case of Non-occlusive Mesenteric Ischemia in a Patient With Cirrhosis


    Bawany, Muhammad Z.; Nawras, Ali; Youssef, Wael I.; Sodeman, Thomas


    Acute mesenteric ischemia has a variety of etiologies. Non-occulusive mesenteric ischemia accounts for 20-30% of patients with acute mesenteric ischemia. We describe a case of non-occulusive jejunal ischemia leading to infarction that occurred in a patient with cirrhosis and no previous history of cardiovascular disease.

  10. Temporary worsening of kidney function following aortic reconstructive surgery. (United States)

    Ghaheri, Hafez; Kazemzadeh, Gholam Hossein; Beigi, Ali Akbar


    Little is known about the incidence of temporary kidney dysfunction following major vascular surgeries. We aimed to assess the frequency of temporary decreased kidney function following aortic surgeries. In a retrospective study, we assessed 108 hospital records of the patients who had undergone elective open abdominal surgery of aortic aneurysm. Preoperative and postoperative (days 1, 2, and 3) data on estimated glomerular filtration rate (GFR) were collected and evaluated in relation to the patients' clinical characteristics and outcomes. A decline greater than 10% in GFR on day 1 or 2, and then, an increase of GFR to a level of maximum 10% below the baseline value on the third postoperative day was considered as temporary worsening of kidney function. Postoperative alterations of GFR not greater than 10% in relation to the baseline were considered as improved or unchanged kidney function. Two patients with persistent decrease in GFR were excluded. Temporary worsening of kidney function was seen in 25 patients (23.6%). Short-term mortality rate was 44.0% in this group of patients, while it was 17.3% in those without decreased GFR (P = .006). According to the regression analysis, the only predictor of mortality was temporary worsening of kidney function, with a hazard ratio of 4.03 (95% confidence interval, 1.44 to 11.31; P = .008). Nearly 1 out of 4 aortic surgeries results in kidney dysfunction. Albeit temporary in most cases, it seems to be associated with a higher short-term mortality rate.

  11. Amino Acids as Metabolic Substrates during Cardiac Ischemia (United States)

    Drake, Kenneth J.; Sidorov, Veniamin Y.; McGuinness, Owen P.; Wasserman, David H.; Wikswo, John P.


    The heart is well known as a metabolic omnivore in that it is capable of consuming fatty acids, glucose, ketone bodies, pyruvate, lactate, amino acids and even its own constituent proteins, in order of decreasing preference. The energy from these substrates supports not only mechanical contraction, but also the various transmembrane pumps and transporters required for ionic homeostasis, electrical activity, metabolism and catabolism. Cardiac ischemia – for example, due to compromise of the coronary vasculature or end-stage heart failure – will alter both electrical and metabolic activity. While the effects of myocardial ischemia on electrical propagation and stability have been studied in depth, the effects of ischemia on metabolic substrate preference has not been fully appreciated: oxygen deprivation during ischemia will significantly alter the relative ability of the heart to utilize each of these substrates. Although changes in cardiac metabolism are understood to be an underlying component in almost all cardiac myopathies, the potential contribution of amino acids in maintaining cardiac electrical conductance and stability during ischemia is underappreciated. Despite clear evidence that amino acids exert cardioprotective effects in ischemia and other cardiac disorders, their role in the metabolism of the ischemic heart has yet to be fully elucidated. This review synthesizes the current literature of the metabolic contribution of amino acids during ischemia by analyzing relevant historical and recent research. PMID:23354395

  12. Functional testing in the diagnosis of chronic mesenteric ischemia. (United States)

    van Noord, Desirée; Kolkman, Jeroen J


    Chronic mesenteric ischemia (CMI) results from insufficient oxygen delivery or utilization to meet metabolic demand. Two main mechanisms may lead to mesenteric ischemia: occlusion in the arteries or veins of the gastrointestinal tract, or reduced blood flow from shock states or increased intra-abdominal pressure, so-called non-occlusive mesenteric ischemia. Severe stenoses in the three main mesenteric vessels as demonstrated with CT-angiography or MR-angiography are sufficient to proof mesenteric ischemia, for example in patients who present with weight loss, postprandial pain and diarrhea. Still in many clinical situations mesenteric ischemia is only one of many possible explanations. Especially in patients with a single vessel stenosis in the celiac artery or superior mesenteric artery with postprandial pain, mesenteric ischemia remains a diagnosis of probability or assumption without functional proof of actual ischemia. This review is aimed to provide an overview of all past, present and future ways to functionally proof CMI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The biological effect of contralateral forepaw stimulation in rat focal cerebral ischemia: a multispectral optical imaging study

    Directory of Open Access Journals (Sweden)

    Janos Luckl


    Full Text Available Our group has already published the possible neuroprotective effect of contralateral forepaw stimulation in temporary focal ischemia in a study. However, the background is still unclear. In the present study we investigated the possible mechanism by monitoring focal ischemia with multispectral (laser speckle, imaging of intrinsic signals (OIS imaging. Sprague-Dawley rats were prepared using 1.2% isoflurane anesthesia. The middle cerebral artery was occluded by photothrombosis (4mW and the common carotid artery was ligated permanently. Physiological variables were constantly monitored during the experiment. A 6x6 mm area centered 3 mm posterior and 4 mm lateral to Bregma was thinned for laser speckle and OIS imaging. Nine circular regions-of-interests (0.3 mm in diameter were evenly spaced on the speckle contrast image for the analysis of peri-infarct flow transients, blood flow and metabolic changes. Both the sham (n=7 and forepaw stimulated animals (n=7 underwent neurological examinations 24 h after ischemia at which point all animals were sacrificed and the infarct size was determined by triphenyltetrazolium chloride. The physiological variables were in normal range and the experimental protocol did not cause significant differences between groups. Both the neurological scores (sham:3.6±1.7, stimulated:4.3±1.4, and the infarct volume (sham:124±39 mm3, stimulated: 147±47 mm3, did not show significant differences between groups. The forepaw stimulation did not increase the intraischemic flow neither over the penumbral or the peri-ischemic area. However, the hemoglobin transients related metabolic load (CMRO2 was significantly lower (p<0.001 while the averaged number of hyperemic flow transients were significantly (p=0.013 higher in the forepaw (sham:3.5±2.2, stimulated: 7.0±2.3, stimulated animals.

  14. The Effects of Spinal, Inhalation, and Total Intravenous Anesthetic Techniques on Ischemia-Reperfusion Injury in Arthroscopic Knee Surgery

    Directory of Open Access Journals (Sweden)

    Müge Koşucu


    Full Text Available Purpose. To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA, ischemia-modified albumin (IMA and neuromuscular side effects. Methods. Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia (t1, 30 min after tourniquet inflation (t2, immediately before (t3, and 5 min (t4, 15 min (t5, 30 min (t6, 1 h (t7, 2 h (t8, and 6 h (t9 after tourniquet release. Results. MDA and IMA levels increased significantly compared with baseline values in Group S at t2–t9 and t2–t7. MDA levels in Group T and Group I were significantly lower than those in Group S at t2–t8 and t2–t9. IMA levels in Group T were significantly lower than those in Group S at t2–t7. Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I. Conclusions. TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion.

  15. Cytokines and intestinal inflammation. (United States)

    Bamias, Giorgos; Cominelli, Fabio


    Cytokines of the intestinal microenvironment largely dictate immunological responses after mucosal insults and the dominance of homeostatic or proinflammatory pathways. This review presents important recent studies on the role of specific cytokines in the pathogenesis of intestinal inflammation. The particular mucosal effects of cytokines depend on their inherent properties but also the cellular origin, type of stimulatory antigens, intermolecular interactions, and the particular immunological milieu. Novel cytokines of the interleukin-1 (IL-1) family, including IL-33 and IL-36, have dominant roles in mucosal immunity, whereas more established ones such as IL-18 are constantly enriched with unique properties. Th17 cells are important mucosal constituents, although their profound plasticity, makes the specific set of cytokines they secrete more important than their mere numbers. Finally, various cytokines, such as tumor necrosis factor-α, IL-6, tumor necrosis factor-like cytokine 1A, and death receptor, 3 demonstrate dichotomous roles with mucosa-protective function in acute injury but proinflammatory effects during chronic inflammation. The role of cytokines in mucosal health and disease is increasingly revealed. Such information not only will advance our understanding of the pathogenesis of gut inflammation, but also set the background for development of reliable diagnostic and prognostic biomarkers and cytokine-specific therapies.

  16. Lung ischemia reperfusion injury: a bench-to-bedside review. (United States)

    Weyker, Paul D; Webb, Christopher A J; Kiamanesh, David; Flynn, Brigid C


    Lung ischemia reperfusion injury (LIRI) is a pathologic process occurring when oxygen supply to the lung has been compromised followed by a period of reperfusion. The disruption of oxygen supply can occur either via limited blood flow or decreased ventilation termed anoxic ischemia and ventilated ischemia, respectively. When reperfusion occurs, blood flow and oxygen are reintroduced to the ischemic lung parenchyma, facilitating a toxic environment through the creation of reactive oxygen species, activation of the immune and coagulation systems, endothelial dysfunction, and apoptotic cell death. This review will focus on the mechanisms of LIRI, the current supportive treatments used, and the many therapies currently under research for prevention and treatment of LIRI.

  17. Review on herbal medicine on brain ischemia and reperfusion

    Directory of Open Access Journals (Sweden)

    Nahid Jivad


    Cerebral ischemia and reperfusion is known to induce the generation of reactive oxygen species that can lead to oxidative damage of proteins, membrane lipids and nucleic acids. A decrease in tissue antioxidant capacity, an increase in lipid peroxidation as well as an increase in lipid peroxidation inhibitors have been demonstrated in several models of brain ischemia. This paper reviews the number of commonly used types of herbal medicines effective for the treatment of stroke. The aim of this paper was to review evidences from controlled studies in order to discuss whether herbal medicine can be helpful in the treatment of brain ischemia and reperfusion.

  18. Silent ischemia and severity of pain in acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F


    An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly...... in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may...

  19. MDCT in blunt intestinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy)]. E-mail:; Scaglione, Mariano [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Tortora, Giovanni [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Martino, Antonio [Trauma Center, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Di Pietto, Francesco [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Romano, Luigia [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Grassi, Roberto [Department ' Magrassi-Lanzara' , Section of Radiology, Second University of Naples, 80138 Naples (Italy)


    Injuries to the small and large intestine from blunt trauma represent a defined clinical entity, often not easy to correctly diagnose in emergency but extremely important for the therapeutic assessment of patients. This article summarizes the MDCT spectrum of findings in intestinal blunt lesions, from functional disorders to hemorrhage and perforation.

  20. Intestinal Failure (Short Bowel Syndrome) (United States)

    ... or bile How is intestinal failure treated? The diet needs to be adjusted according to the intestine’s ability to absorb nutrients. TPN is usually required at the beginning to maintain nutrition and good hydration although it is hoped that the small intestine ...

  1. Hippo signalling directs intestinal fate

    DEFF Research Database (Denmark)

    le Bouteiller, Marie Catherine M; Jensen, Kim Bak


    Hippo signalling has been associated with many important tissue functions including the regulation of organ size. In the intestinal epithelium differing functions have been proposed for the effectors of Hippo signalling, YAP and TAZ1. These are now shown to have a dual role in the intestinal epit...

  2. Vitreal Ocygenation in Retinal Ischemia Reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Abdallab, Walid [Doheny Eye Institute, Los Angeles; AmeriMD, Hossein [Doheny Eye Institute, Los Angeles; Barron, Ernesto [Arnold and Mabel Beckman Macular Research Center, Doheny Eye Institute, Los Angeles; ChaderPhD, Gerald [Doheny Eye Institute, Los Angeles; Greenbaum, Elias [ORNL; Hinton, David E [ORNL; Humayun, Mark S [Doheny Eye Institute, Los Angeles


    PURPOSE. To study the feasibility of anterior vitreal oxygenation for the treatment of acute retinal ischemia. METHODS. Twenty rabbits were randomized into an oxygenation group, a sham treatment group, and a no treatment group. Baseline electroretinography (ERG) and preretinal oxygen (PO2) measurements were obtained 3 to 5 days before surgery. Intraocular pressure was raised to 100 mm Hg for 90 minutes and then normalized. The oxygenation group underwent vitreal oxygenation for 30 minutes using intravitreal electrodes. The sham treatment group received inactive electrodes for 30 minutes while there was no intervention for the no treatment group. Preretinal PO2 in the posterior vitreous was measured 30 minutes after intervention or 30 minutes after reperfusion (no treatment group) and on postoperative days (d) 3, 6, 9, and 12. On d14, rabbits underwent ERG and were euthanatized.

  3. Temporary jobs and the severity of workplace accidents. (United States)

    Picchio, Matteo; van Ours, Jan C


    From the point of view of workplace safety, it is important to know whether having a temporary job has an effect on the severity of workplace accidents. We present an empirical analysis on the severity of workplace accidents by type of contract. We used microdata collected by the Italian national institute managing the mandatory insurance against work related accidents. We estimated linear models for a measure of the severity of the workplace accident. We controlled for time-invariant fixed effects at worker and firm levels to disentangle the impact of the type of contract from the spurious one induced by unobservables at worker and firm levels. Workers with a temporary contract, if subject to a workplace accident, were more likely to be confronted with severe injuries than permanent workers. When correcting the statistical analysis for injury under-reporting of temporary workers, we found that most of, but not all, the effect is driven by the under-reporting bias. The effect of temporary contracts on the injury severity survived the inclusion of worker and firm fixed effects and the correction for temporary workers' injury under-reporting. This, however, does not exclude the possibility that, within firms, the nature of the work may vary between different categories of workers. For example, temporary workers might be more likely to be assigned dangerous tasks because they might have less bargaining power. The findings will help in designing public policy effective in increasing temporary workers' safety at work and limiting their injury under-reporting. Copyright © 2017. Published by Elsevier Ltd.

  4. The Use of Temporary Fecal Diversion in Colonic and Perianal Crohn's Disease Does Not Improve Outcomes. (United States)

    Bafford, Andrea C; Latushko, Anastasiya; Hansraj, Natasha; Jambaulikar, Guruprasad; Ghazi, Leyla J


    To determine whether temporary fecal diversion for refractory colonic and/or perianal Crohn's disease can lead to clinical remission and restoration of intestinal continuity after optimization of medical therapy. We retrospectively reviewed our prospectively maintained database of patients treated at the University of Maryland for Crohn's disease between May 2004 and July 2014. Patients with colonic, perianal, or colonic and perianal Crohn's disease, who had fecal diversion for control of medically refractory and/or severe disease, were included. Outcomes, including disease activity and rate of ileostomy reversal, were evaluated up to 24 months from stoma formation. Thirty patients were identified. Fecal diversion was performed for perianal disease in 37%, colonic disease in 33%, and both in 30% of patients. Twelve (40%) patients underwent ileostomy reversal. Twenty-five percent of patients with perianal disease had their ostomies reversed compared to 70% of patients with colonic disease alone. More patients with complex compared to simple perianal disease remained diverted (p = 0.02). Six (20%) patients required colectomy. Of these, 50% had complex perianal disease, all had received two or more biologics, and two-thirds were on combination therapy pre-diversion. Our study found that nearly two-thirds of patients with medically refractory colonic and/or severe perianal Crohn's disease treated with fecal diversion and optimization of postoperative medical therapy remain diverted or require colectomy within two years after ileostomy formation. In patients with severe, refractory perianal disease and those treated with combination therapy and >1 biologic exposure pre-diversion, colectomy rather than temporary fecal diversion should be considered.

  5. Mechanisms of symptomatic spinal cord ischemia after TEVAR

    DEFF Research Database (Denmark)

    Czerny, Martin; Eggebrecht, Holger; Sodeck, Gottfried


    To test the hypothesis that simultaneous closure of at least 2 independent vascular territories supplying the spinal cord and/or prolonged hypotension may be associated with symptomatic spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR)....

  6. Myocardial ischemia in hypertrophic cardiomyopathy; Isquemia miocardica na cardiomiopatia hipertrofica

    Energy Technology Data Exchange (ETDEWEB)

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia


    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  7. Hippocampal neurogenesis in the new model of global cerebral ischemia (United States)

    Kisel, A. A.; Chernysheva, G. A.; Smol'yakova, V. I.; Savchenko, R. R.; Plotnikov, M. B.; Khodanovich, M. Yu.


    The study aimed to evaluate the changes of hippocampal neurogenesis in a new model of global transient cerebral ischemia which was performed by the occlusion of the three main vessels (tr. brachiocephalicus, a. subclavia sinistra, and a. carotis communis sinistra) branching from the aortic arch and supplying the brain. Global transitory cerebral ischemia was modeled on male rats (weight = 250-300 g) under chloral hydrate with artificial lung ventilation. Animals after the same surgical operation without vessel occlusion served as sham-operated controls. The number of DCX-positive (doublecortin, the marker of immature neurons) cells in dentate gyrus (DG) and CA1-CA3 fields of hippocampus was counted at the 31st day after ischemia modeling. It was revealed that global cerebral ischemia decreased neurogenesis in dentate gyrus in comparison with the sham-operated group (Pneurogenesis in CA1-CA3 fields was increased as compared to the control (P<0.05).

  8. Quantitative Ischemia Detection During Cardiac MR Stress Testing

    National Research Council Canada - National Science Library

    Kraitchman, D


    .... During a second ischemic episode, conventional cine wall motion images were acquired. The time from occlusion to the detection of ischemia by each MR technique, as well as ECG ischemic alterations, was determined...

  9. Intestinal malrotation during pregnancy. (United States)

    Rothstein, R D; Rombeau, J L


    Malrotation of the intestine is an uncommon anomaly most often seen in infants, but occasionally in adults. Rarely, symptoms from malrotation may occur during pregnancy. A 30-year-old woman, with a long history of abdominal pain and constipation, developed more frequent and severe symptoms in the second trimester of pregnancy. She was monitored closely and treated conservatively and went on to deliver a full-term, healthy infant. In the postpartum period, barium radiographs demonstrated a midgut malrotation. During exploratory laparotomy, obstructive peritoneal bands were noted and were transected. The mobile cecum and ascending colon were fixated to the abdominal wall. Symptoms from a malrotation may develop during pregnancy and may be nonspecific and vague. Although complications from malrotation can be life-threatening, a conservative approach with surgical intervention in the postpartum period may be appropriate in the proper clinical setting.

  10. Risk Factors for Mortality in Lower Intestinal Bleeding (United States)

    Strate, Lisa L.; Ayanian, John Z.; Kotler, Gregory; Syngal, Sapna


    Background and Aims Previous studies of Lower Intestinal Bleeding (LIB) have limited power to study mortality. We sought to identify characteristics associated with in-hospital mortality in a large cohort of patients with LIB. Methods We used the 2002 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) to study a cross-sectional cohort of 227,022 hospitalized patients with discharge diagnoses indicating LIB. Predictors of mortality were identified using multiple logistic regression. Results In 2002, an estimated 8,737 patients with LIB (3.9%) died while hospitalized. Independent predictors of in-hospital mortality were age (age >70 vs. <50, odds ratio (OR) 4.91; 95% CI 2.45–9.87), intestinal ischemia (OR 3.47; 95% CI 2.57–4.68), comorbid illness (≥ 2 vs. 0 comorbidities, OR 3.00; 95% CI 2.25–3.98), bleeding while hospitalized for a separate process (OR 2.35; 95% CI 1.81–3.04), coagulation defects (OR 2.34; 95% CI 1.50–3.65), hypovolemia (OR 2.22; 95% CI 1.69–2.90), transfusion of packed red blood cells (OR 1.60; 95% CI 1.23–2.08), and male gender (OR 1.52; 95% CI 1.21–1.92). Colorectal polyps (OR 0.26, 95% CI 0.15–0.45), and hemorrhoids (OR 0.42; 95% CI 0.28–0.64) were associated with a lower risk of mortality, as was diagnostic testing for LIB when added to the multivariate model (OR 0.37, 95% CI 0.28–0.48; p<0.001). Hospital characteristics were not significantly related to mortality. Predictors of mortality were similar in an analysis restricted to patients with diverticular bleeding. Conclusions The all-cause in-hospital mortality rate in LIB is low (3.9%). Advanced age, intestinal ischemia and comorbid illness were the strongest predictors of mortality. PMID:18558513

  11. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener


    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  12. Targeted photocoagulation of peripheral ischemia to treat rebound edema

    Directory of Open Access Journals (Sweden)

    Singer MA


    Full Text Available Michael A Singer,1 Colin S Tan,2 Krishna R Surapaneni,3 Srinivas R Sadda4 1Medical Center Ophthalmology Associates, San Antonio, TX, USA; 2National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; 3University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; 4Doheny Eye Institute, Los Angeles, CA, USA Introduction: Peripheral retinal ischemia not detectable by conventional fluorescein angiography has been proposed to be a driving force for rebound edema in retinal vein occlusions. In this report, we examine the treatment of peripheral retinal ischemia with targeted retinal photocoagulation (TRP to manage a patient’s rebound edema.Methods: To assess the extent of peripheral nonperfusion, an Optos 200Tx device was used. To target the treatment to peripheral ischemia areas, a Navilas Panretinal Laser was used.Results: A 64-year-old male with a central retinal vein occlusion and a visual acuity 20/300, and central macular thickness 318 µm presented with rubeosis. Angiography revealed extensive peripheral nonperfusion. Despite TRP to areas of irreversible ischemia, after 2 months, he continued show rubeosis and rebound edema. Additional TRP laser was repeatedly added more posteriorly to areas of reversible nonperfusion, resulting in eventual resolution of rubeosis and edema.Conclusion: In this study, we demonstrate the use of widefield imaging with targeted photocoagulation of peripheral ischemia to treat rebound edema, while preserving most peripheral vision. In order to treat rebound edema, extensive TRP, across reversible and nonreversible areas of ischemia, had to be performed – not just in areas of nonreversible peripheral ischemia. These areas need to be mapped during episodes of rebound edema, when ischemia is at its maximum. In this way, by doing the most TRP possible, the cycle of rebound edema can be broken. Keywords: macular edema, retinal vein occlusion 


    Directory of Open Access Journals (Sweden)

    An. A. Alexandrov


    Full Text Available Review is devoted to the pathogenesis of microcirculatory ischemia. Microcirculatory dysfunction has been identified in different groups of patients including syndrome X, diabetes mellitus 2 type, coronary heart disease. In coronary patients after transluminal angioplasty microcirculatory dysfunction is the reason of phenomenon of “non-reflow”. In result the procedure of revascularization is less effective. Therapy by statins can be beneficial for patients with microcirculatory ischemia.

  14. Temporary henna tattoo is unsafe in atopic children. (United States)

    Corrente, Stefania; Moschese, Viviana; Chianca, Marco; Graziani, Simona; Iannini, Roberta; La Rocca, Maria; Chini, Loredana


    Temporary henna tattoos have become increasingly popular as a safe alternative to permanent tattoos among American and European children and teenagers during the summer holidays. Currently, temporary henna tattoos contain not only henna, but also other additives such as para-phemylenediamine (PPD), which is considered to be the chemical agent that most frequently causes skin reactions associated with the use of commercial black henna. In this report, we describe an 11-year-old boy who applied a temporary black henna tattoo on his right arm during the summer holidays in Greece and developed a severe contact dermatitis at the tattoo site with residual hypopigmentation. He had no previous history of contact dermatitis, however he did suffer from seasonal allergic rhinitis and atopic dermatitis. Patch testing revealed a strong reaction to PPD, a substance commonly contained in temporary henna tattoo preparations. Henna tattoos are an increasing problem worldwide since they carry an increased risk of severe skin reactions; therefore we suggest that the use of temporary henna tattoos in children be discouraged.

  15. Intestinal flora, probiotics, and cirrhosis. (United States)

    Guerrero Hernández, Ignacio; Torre Delgadillo, Aldo; Vargas Vorackova, Florencia; Uribe, Misael


    Intestinal microflora constitutes a symbiotic ecosystem in permanent equilibrium, composed mainly of anaerobic bacteria. However, such equilibrium may be altered by daily conditions as drug use or pathologies interfering with intestinal physiology, generating an unfavorable environment for the organism. Besides, there are factors which may cause alterations in the intestinal wall, creating the conditions for translocation or permeation of substances or bacteria. In cirrhotic patients, there are many conditions that combine to alter the amount and populations of intestinal bacteria, as well as the functional capacity of the intestinal wall to prevent the permeation of substances and bacteria. Nowadays, numerous complications associated with cirrhosis have been identified, where such mechanisms could play an important role. There is evidence that some probiotic microorganisms could restore the microbiologic and immunologic equilibrium in the intestinal wall in cirrhotic patients and help in the treatment of complications due to cirrhosis. This article has the objective to review the interactions between intestinal flora, gut permeability, and the actual role of probiotics in the field of cirrhotic patients.

  16. Cannabidiol treatment ameliorates ischemia/reperfusion renal injury in rats. (United States)

    Fouad, Amr A; Al-Mulhim, Abdulruhman S; Jresat, Iyad


    To investigate the protective effect of cannabidiol, the major non-psychotropic Cannabis constituent, against renal ischemia/reperfusion injury in rats. Bilateral renal ischemia was induced for 30 min followed by reperfusion for 24h. Cannabidiol (5mg/kg, i.v.) was given 1h before and 12h following the procedure. Ischemia/reperfusion caused significant elevations of serum creatinine and renal malondialdehyde and nitric oxide levels, associated with a significant decrease in renal reduced glutathione. Cannabidiol significantly attenuated the deterioration in the measured biochemical parameters induced by ischemia/reperfusion. Histopathological examination showed that cannabidiol ameliorated ischemia/reperfusion-induced kidney damage. Immunohistochemical analysis revealed that cannabidiol significantly reduced the expression of inducible nitric oxide synthase, tumor necrosis factor-α, cyclooxygenase-2, nuclear factor-κB, Fas ligand and caspase-3, and increased the expression of survivin in ischemic/reperfused kidney tissue. Cannabidiol, via its antioxidant and anti-inflammatory properties, may represent a potential therapeutic option to protect against ischemia/reperfusion renal injury. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Role of Histamine and Its Receptors in Cerebral Ischemia (United States)


    Histamine is recognized as a neurotransmitter or neuromodulator in the brain, and it plays a major role in the pathogenic progression after cerebral ischemia. Extracellular histamine increases gradually after ischemia, and this may come from histaminergic neurons or mast cells. Histamine alleviates neuronal damage and infarct volume, and it promotes recovery of neurological function after ischemia; the H1, H2, and H3 receptors are all involved. Further studies suggest that histamine alleviates excitotoxicity, suppresses the release of glutamate and dopamine, and inhibits inflammation and glial scar formation. Histamine may also affect cerebral blood flow by targeting to vascular smooth muscle cells, and promote neurogenesis. Moreover, endogenous histamine is an essential mediator in the cerebral ischemic tolerance. Due to its multiple actions, affecting neurons, glia, vascular cells, and inflammatory cells, histamine is likely to be an important target in cerebral ischemia. But due to its low penetration of the blood-brain barrier and its wide actions in the periphery, histamine-related agents, like H3 antagonists and carnosine, show potential for cerebral ischemia therapy. However, important questions about the molecular aspects and pathophysiology of histamine and related agents in cerebral ischemia remain to be answered to form a solid scientific basis for therapeutic application. PMID:22860191

  18. Tissue engineering the small intestine. (United States)

    Spurrier, Ryan G; Grikscheit, Tracy C


    Short bowel syndrome (SBS) results from the loss of a highly specialized organ, the small intestine. SBS and its current treatments are associated with high morbidity and mortality. Production of tissue-engineered small intestine (TESI) from the patient's own cells could restore normal intestinal function via autologous transplantation. Improved understanding of intestinal stem cells and their niche have been coupled with advances in tissue engineering techniques. Originally described by Vacanti et al of Massachusetts General Hospital, TESI has been produced by in vivo implantation of organoid units. Organoid units are multicellular clusters of epithelium and mesenchyme that may be harvested from native intestine. These clusters are loaded onto a scaffold and implanted into the host omentum. The scaffold provides physical support that permits angiogenesis and vasculogenesis of the developing tissue. After a period of 4 weeks, histologic analyses confirm the similarity of TESI to native intestine. TESI contains a differentiated epithelium, mesenchyme, blood vessels, muscle, and nerve components. To date, similar experiments have proved successful in rat, mouse, and pig models. Additional experiments have shown clinical improvement and rescue of SBS rats after implantation of TESI. In comparison with the group that underwent massive enterectomy alone, rats that had surgical anastomosis of TESI to their shortened intestine showed improvement in postoperative weight gain and serum B12 values. Recently, organoid units have been harvested from human intestinal samples and successfully grown into TESI by using an immunodeficient mouse host. Current TESI production yields approximately 3 times the number of cells initially implanted, but improvements in the scaffold and blood supply are being developed in efforts to increase TESI size. Exciting new techniques in stem cell biology and directed cellular differentiation may generate additional sources of autologous intestinal

  19. Ultrasound of selected pathologies of the small intestine

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński


    Full Text Available Intestines, especially the small bowel, are rarely subject to US assessment due to the presence of gases and chyme. The aim of this paper was to analyze ultrasound images in selected pathologies of the small intestine in adults, including the aspects of differential diagnosis. Material and methods: In 2001–2012, abdominal ultrasound examinations were conducted in 176 patients with the following small bowel diseases: Crohn’s disease (n=35, small bowel obstruction (n=35, yersiniosis (n=28, infectious diarrhea (n=26, bacterial overgrowth syndrome (n=25, coeliac disease (n=15 and small bowel ischemia (n=12. During examinations patients were fasting and no other particular preparations were needed. Convex transducers of 3.5–6 MHz and linear ones of 7–12 MHz were used. The assessment of the small intestine in four abdominal quadrants constituted an integral element of the examination. The following features of the small bowel ultrasound presentation were subject to analysis: thickness and perfusion of the walls, presence of thickened folds in the jejunum, reduction of their number, presence of fluid and gas contents in the intestine, its peristaltic activity, jejunization of the ileum and enteroenteric intussusception. Furthermore, the size of the mesenteric lymph nodes and the width of the superior mesenteric artery were determined and the peritoneal cavity was evaluated in terms of the presence of free fluid. Results: Statistically significant differences were obtained between the thickness of the small intestine in Crohn’s disease or in ischemic conditions and the thickness in the remaining analyzed pathological entities. Small bowel obstruction was manifested by the presence of distended loops due to gas and fluid as well as by severe peristaltic contractions occurring periodically. In the course of ischemic disease, the intestinal walls were thickened without the signs of increased perfusion and

  20. Tratamento da isquemia mesentérica pelo pós-condicionamento isquêmico Mesenteric ischemia's treatment by postconditioning

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Marques dos Santos


    Full Text Available Sabe-se que o pré-condicionamento isquêmico tem a capacidade de minimizar as lesões decorrentes do processo de isquemia e reperfusão. Recentemente foi descrito que o pós-condicionamento isquêmico apresenta resultados semelhantes em isquemia e reperfusão miocárdica, cerebral, renal e da medula espinhal, mas não há relatos de utilização deste método na isquemia mesentérica. OBJETIVO: O objetivo deste estudo é avaliar o efeito do pós-condicionamento isquêmico sobre a lesão tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica. MÉTODO: Foram estudados 20 ratos Wistar, distribuídos em dois grupos: grupo A, em que se realizou isquemia (30 minutos e reperfusão (60 minutos mesentérica; grupo B, isquemia e reperfusão mesentérica e, precedendo o início da reperfusão, foi realizado o pós-condicionamento isquêmico. Ao final, ressecou-se um segmento do intestino delgado para análise histológica. Avaliaram-se os resultados pela classificação de Chiu e procedeu-se o tratamento estatístico. RESULTADO: As médias dos graus de lesão tecidual foram: grupo A, 3,5; grupo B, 1. A diferença entre os grupos foi considerada estatisticamente significativa (p It is known that the preconditioning has the capacity to minimize the current lesions of the ischemia and reperfusion process. Recently it was described that the postconditioning presents similar results in miocardic ischemia and reperfusion, brain, kidneys and of the spinal cord, but there are no reports of use of this method in the mesenteric ischemia. OBJECTIVE: The objective of this study is to evaluate the effect of the postconditioning on the tissue lesion in the intestinal mucosa of rats submitted to the ischemia and reperfusion process. METHOD: 20 Wistar rats were studied, distributed in two groups: group A, in that was done mesenteric ischemia (30 minutes and reperfusion (60 minutes; group B, mesenteric ischemia and reperfusion

  1. Temporary Cementitious Sealers in Enhanced Geothermal Systems

    Energy Technology Data Exchange (ETDEWEB)

    Sugama T.; Pyatina, T.; Butcher, T.; Brothers, L.; Bour, D.


    Unlike conventional hydrothennal geothermal technology that utilizes hot water as the energy conversion resources tapped from natural hydrothermal reservoir located at {approx}10 km below the ground surface, Enhanced Geothermal System (EGS) must create a hydrothermal reservoir in a hot rock stratum at temperatures {ge}200 C, present in {approx}5 km deep underground by employing hydraulic fracturing. This is the process of initiating and propagating a fracture as well as opening pre-existing fractures in a rock layer. In this operation, a considerable attention is paid to the pre-existing fractures and pressure-generated ones made in the underground foundation during drilling and logging. These fractures in terms of lost circulation zones often cause the wastage of a substantial amount of the circulated water-based drilling fluid or mud. Thus, such lost circulation zones must be plugged by sealing materials, so that the drilling operation can resume and continue. Next, one important consideration is the fact that the sealers must be disintegrated by highly pressured water to reopen the plugged fractures and to promote the propagation of reopened fractures. In response to this need, the objective of this phase I project in FYs 2009-2011 was to develop temporary cementitious fracture sealing materials possessing self-degradable properties generating when {ge} 200 C-heated scalers came in contact with water. At BNL, we formulated two types of non-Portland cementitious systems using inexpensive industrial by-products with pozzolanic properties, such as granulated blast-furnace slag from the steel industries, and fly ashes from coal-combustion power plants. These byproducts were activated by sodium silicate to initiate their pozzolanic reactions, and to create a cemetitious structure. One developed system was sodium silicate alkali-activated slag/Class C fly ash (AASC); the other was sodium silicate alkali-activated slag/Class F fly ash (AASF) as the binder of temper

  2. Endovascular Management for Symptomatic Chronic Mesenteric Ischemia: A Single-Center Experience. (United States)

    Guo, Baolei; Guo, Daqiao; Xu, Xin; Chen, Bin; Jiang, Junhao; Yang, Jue; Shi, Zhenyu; Fu, Weiguo


    Chronic mesenteric ischemia (CMI) is an uncommon condition encountered by clinicians. Presentation may vary from asymptomatic to classical intestinal ischemia, although a clear pathophysiology has yet to be elucidated. Here, we have presented our institution's experience in the management of symptomatic CMI. From February 2007 to February 2016, a retrospective study was performed of all consecutive patients with symptomatic CMI managed by endovascular treatment (ET). We reviewed these patients' demographics, comorbidities, clinical presentations, and treatment modalities. Perioperative and midterm outcomes included technical success, clinical symptom relief, complications, symptomatic recurrence, mortality, restenosis, and reintervention. Thirty-five mesenteric arteries (74.3% stenotic/25.7% occluded) identified in 32 patients (12 females, 20 males) were treated with endovascular procedures. There were no 30-day deaths; the perioperative complication rate was 12.5%. Overall, the median postprocedural time to symptom relief was 7.6 days (range: 1-30 days). Twenty-two (68.8%) had complete remission of symptom, whereas 7 (21.9%) had partial improvement in symptom after ET. After a mean follow-up of 35.4 (25.9) months, 5 (15.6%) patients developed recurrent symptoms, with 4 requiring reinterventions. The primary patency was 93.7%, 82.6%, and 73.1% at 12, 24, and 36 months, respectively, and the freedom from symptomatic recurrence was 90.6%, 84.0%, 84.0%, and 84.0% at 6, 12, 24, and 36 months, respectively. Endovascular treatment for patients with CMI had a high technical success rate and satisfactory clinical outcomes. Symptomatic recurrence was not frequent but found mainly within 12 months following the initial procedure.

  3. Impact of acquired and innate immunity on spinal cord ischemia and reperfusion injury. (United States)

    Yamanaka, Katsuhiro; Sasaki, Naoto; Fujita, Yasuyuki; Kawamoto, Atsuhiko; Hirata, Ken-ichi; Okita, Yutaka


    The aim of this study was to clarify the impact of acquired and innate immunity on spinal cord ischemia and reperfusion injury using a mouse model of spinal cord ischemia. To define the ischemic duration that caused paraplegia, wild-type and severe combined immunodeficiency (SCID) mice were subjected to cross-clamping of the aorta for 7, 9, 9.5, or 10.5 min with ischemic preconditioning for intestinal protection. In wild-type and SCID mice with paraplegia, histological analyses were performed to investigate viable neurons, inflammatory cells, and reactive astrocytes at 12, 24, 48, and 72 h as well as 7 days after reperfusion. In both wild-type and SCID mice, immediate paraplegia was induced by occlusion for 10.5 min. In both wild-type and SCID mice, no infiltration of T or B lymphocytes was observed at any point after reperfusion, but reactive astrocytes were clearly visible at 7 days after reperfusion, and the number of activated microglia peaked at 12 and 48 h after reperfusion. Although there was no significant difference, wild-type mice had a tendency to have more activated microglia than SCID mice at 12 h after reperfusion, and to have less viable neurons than SCID mice at 12, 24, 48, and 72 h after reperfusion. There was a tendency that the frequency of immediate paraplegia in wild-type mice was more than SCID mice though no statistical difference was observed. Innate immunity, rather than acquired immunity, may be involved in the developing immediate paraplegia in our mouse model.

  4. Transforming knowledge across domains in the temporary development spaces

    DEFF Research Database (Denmark)

    Brønnum, Louise

    This paper addresses transformation of knowledge across different knowledge domains and competencies in the Front End of Innovation (FEI) [Koen 2002].We examine the temporary spaces [Clausen, Yoshinaka 2007] that emerge when different knowledge domains are brought into play (implicit or explicit......) in staging innovative concept development. FEI appears as temporary spaces for innovative processes; and studies have pointed out the limited uptake of user knowledge (Elgaard Jensen 2012). This paper will discuss the possibilities and barriers for uptake of user knowledge in FEI in relation...... to the constitutions of these temporary spaces. There seems to be a limited understanding of: how knowledge is transferred and transformed into design objects facilitating a process where knowledge enables innovative thinking across knowledge boundaries. The paper is based on empirical data primarily from case studies...

  5. Small intestinal submucosa: utilization as a wound dressing in full-thickness rodent wounds. (United States)

    Prevel, C D; Eppley, B L; Summerlin, D J; Sidner, R; Jackson, J R; McCarty, M; Badylak, S F


    Wound dressings are used as a temporary wound covering to promote wound healing, control wound exudate, and decrease wound contamination as well as evaporative water loss. A new material, porcine small intestinal submucosa, has been used successfully as an arterial and venous graft in both canine and primate animal models with graft patency and infection rates equal to autologous vein. Based on these studies, small intestinal submucosa was used as a biological wound dressing in 20 x 20 mm full-thickness wounds made on Sprague-Dawley rats. In the controls (group I, n = 12), an acrylic frame (20 x 20 mm) was sutured to the wound edges, followed by placement of a thin polyurethane film. In the small intestinal submucosa-treated animals (group II, n = 12), the wound was covered with small intestinal submucosa and then with the acrylic frame and polyurethane film. The wounds were examined both visually and histologically at postapplication days 3, 7, 14, 28, 42 and 56. In addition, the wound contraction rate of 6 animals in both groups were recorded at postapplication day 0 and then at 1 week, 1 month, 2 months, and 3 months. Histological analysis (hematoxylin-eosin and periodic acid-Schiff stains) of the small intestinal submucosa-treated wounds revealed no host-versus-graft rejection and a rate of epithelialization equal to that of the control group. The wound contraction rate was statistically significant (higher; p < .05) in the control group compared to the small intestinal submucosa-treated group. Porcine small intestinal submucosa merits further study as both a biological wound dressing and as a substrate for cultured cells.

  6. Desmopressin improves intestinal functional capillary density and decreases leukocyte activation in experimental endotoxemia. (United States)

    Wafa, K; Lehmann, C; Wagner, L; Drzymulski, I; Wegner, A; Pavlovic, D


    Blood flow to the intestine is decreased in sepsis in favor of vital organs resulting in ischemic damage of the gut mucosa. Once the mucosa is damaged, increased translocation of intestinal bacteria to the systemic circulation may occur. This in turn aggravates the inflammatory response contributing to the development of multi-organ failure. Desmopressin is a synthetic analog of vasopressin, an anti-diuretic hormone which has been shown to induce vasodilation and is thought to be implicated in immunomodulation. In this study, we investigate the effects of desmopressin on the intestinal microcirculation during sepsis in an experimental endotoxemia model in rats using intravital microscopy. In addition, we investigate the effects of desmopressin on systemic inflammation. Forty Lewis rats were subdivided into four groups, where rats received intravenous saline (control), desmopressin (1μg/kg/ml), lipopolysaccharide (5mg/kg) or lipopolysaccharide followed by desmopressin. Inflammatory response was assessed by quantifying the number of temporary and firmly adherent leukocytes in submucosal venules. Capillary perfusion was determined by assessing the number of functional, non-functional and dysfunctional capillaries in the intestinal wall layers (muscularis longitudinalis, muscularis circularis and mucosa). Additionally, inflammatory cytokine levels were determined by multiplex assays. The number of firmly adhering leukocytes in V1 venules of rats receiving lipopolysaccharide and treated with desmopressin was significantly reduced compared to lipopolysaccharide only group (LPS: 259±25.7 vs. LPS+DDAVP: 203±17.2; n/mm(2); pdesmopressin treatment improved impaired intestinal microcirculation by improving functional capillary density following lipopolysaccharide administration in all examined layers of the intestinal wall. We also observed a significant decrease in TNF-α levels in rats which received desmopressin in endotoxemia compared to untreated rats (LPS: 383±64

  7. Temporary sharing prompts unrestrained disclosures that leave lasting negative impressions. (United States)

    Hofstetter, Reto; Rüppell, Roland; John, Leslie K


    With the advent of social media, the impressions people make on others are based increasingly on their digital disclosures. However, digital disclosures can come back to haunt, making it challenging for people to manage the impressions they make. In field and online experiments in which participants take, share, and evaluate self-photographs ("selfies"), we show that, paradoxically, these challenges can be exacerbated by temporary-sharing media-technologies that prevent content from being stored permanently. Relative to permanent sharing, temporary sharing affects both whether and what people reveal. Specifically, temporary sharing increases compliance with the request to take a selfie (study 1) and induces greater disclosure risks (i.e., people exhibit greater disinhibition in their selfies, studies 1 and 2). This increased disclosure is driven by reduced privacy concerns (study 2). However, observers' impressions of sharers are insensitive to permanence (i.e., whether the selfie was shared temporarily versus permanently) and are instead driven by the disinhibition exhibited in the selfie (studies 4-7). As a result, induced by the promise of temporary sharing, sharers of uninhibited selfies come across as having worse judgment than those who share relatively discreet selfies (studies 1, 2, and 4-7)-an attributional pattern that is unanticipated by sharers (study 3), that persists days after the selfie has disappeared (study 5), is robust to personal experience with temporary sharing (studies 6A and 6B), and holds even among friends (studies 7A and 7B). Temporary sharing may bring back forgetting, but not without introducing new (self-presentational) challenges. Copyright © 2017 the Author(s). Published by PNAS.

  8. Deploying temporary networks for upscaling of sparse network stations (United States)

    Coopersmith, Evan J.; Cosh, Michael H.; Bell, Jesse E.; Kelly, Victoria; Hall, Mark; Palecki, Michael A.; Temimi, Marouane


    Soil observations networks at the national scale play an integral role in hydrologic modeling, drought assessment, agricultural decision support, and our ability to understand climate change. Understanding soil moisture variability is necessary to apply these measurements to model calibration, business and consumer applications, or even human health issues. The installation of soil moisture sensors as sparse, national networks is necessitated by limited financial resources. However, this results in the incomplete sampling of the local heterogeneity of soil type, vegetation cover, topography, and the fine spatial distribution of precipitation events. To this end, temporary networks can be installed in the areas surrounding a permanent installation within a sparse network. The temporary networks deployed in this study provide a more representative average at the 3 km and 9 km scales, localized about the permanent gauge. The value of such temporary networks is demonstrated at test sites in Millbrook, New York and Crossville, Tennessee. The capacity of a single U.S. Climate Reference Network (USCRN) sensor set to approximate the average of a temporary network at the 3 km and 9 km scales using a simple linear scaling function is tested. The capacity of a temporary network to provide reliable estimates with diminishing numbers of sensors, the temporal stability of those networks, and ultimately, the relationship of the variability of those networks to soil moisture conditions at the permanent sensor are investigated. In this manner, this work demonstrates the single-season installation of a temporary network as a mechanism to characterize the soil moisture variability at a permanent gauge within a sparse network.

  9. Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Edivaldo Massazo Utiyama

    Full Text Available OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years; 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

  10. Gadolinium decreases inflammation related to myocardial ischemia and reperfusion injury

    Directory of Open Access Journals (Sweden)

    Nicolosi Alfred C


    Full Text Available Abstract Background The lanthanide cation, gadolinium (GdCl3 protects the myocardium against infarction following ischemia and reperfusion. Neutrophils and macrophages are the main leukocytes responsible for infarct expansion after reperfusion. GdCl3 interferes with macrophage and neutrophil function in the liver by decreasing macrophage secretion of inflammatory cytokines and neutrophil infiltration. We hypothesized that GdCl3 protects against ischemia and reperfusion injury by decreasing inflammation. We determined the impact of GdCl3 treatment for reperfusion injury on 1 circulating monoctye and neutrophil counts, 2 secretion of inflammatory cytokines, and 3 influx of monocytes and neutrophils into the myocardium. Methods Rats (n = 3-6/gp were treated with saline or GdCl3 (20 μmol/kg 15 min prior to a 30 min period of regional ischemia and 120 min reperfusion. Sham rats were not subject to ischemia. Blood was collected either after 30 min ischemia or 120 min reperfusion and hearts were harvested at 120 min reperfusion for tissue analysis. Blood was analyzed for leukocytes counts and cytokines. Tissue was analyzed for cytokines and markers of neutrophil and monocyte infiltration by measuring myeloperoxidase (MPO and α-naphthyl acetate esterase (ANAE. Results GdCl3 did not affect the number of circulating neutrophils prior to ischemia. Two hours reperfusion resulted in a 2- and 3- fold increase in circulating monocytes and neutrophils, respectively. GdCl3 decreased the number of circulating monocytes and neutrophils during reperfusion to levels below those present prior to ischemia. Furthermore, after 120 min of reperfusion, GdCl3 decreased ANAE and MPO activity in the myocardium by 1.9-fold and 6.5-fold respectively. GdCl3 decreased MPO activity to levels below those measured in the Sham group. Serum levels of the major neutrophil chemoattractant cytokine, IL-8 were increased from pre-ischemic levels during ischemia and reperfusion in both

  11. [Temporary hearing threshold shift in policemen after firearm training]. (United States)

    Cassano, F; Montesano, Roberta; Bobbio, Elena; Borraccia, V; Volpe, C; Bavaro, P; Quaranta, N


    The paper involves exposure to noise of the State Police officers connected with the use of firearms. The noise generated by these weapons is of short duration and high intensity. The research was carried out during the sessions of firearm training of State Police officers to assess exposure to noise. The values of the various investigations, both audiometric and phonometric, carried out made it possible to demonstrate a significant exposure and a temporary increase in the threshold, above the frequency of 6000 Hz. Even taking account of the abatement from use of headphones, an exposure was demonstrated that was above the statutory limits, as was confirmed by the temporary hearing threshold shift.

  12. [Development and research of temporary demand pacemaker with electrocardiosignal display]. (United States)

    Fan, Shounian; Jiang, Chenxi; Cai, Yunchang; Pan, Yangzhong; Yang, Tianhe; Wu, Qiang; Zheng, Yaxi; Liu, Xiaoqiao; Li, Shiying


    A temporary demand pacemaker with electrocardiosignal display is introduced in this paper. Double way low-noise electrocardiosignal preamplifier, amplitude limiter, high and low pass filter, 50 Hz notch filter, TTL level generator and stimulating pulse formation circuit are components of the hardware electrocircuit. The demand pacing and the electrocardiosignal display are separately controlled by the software in which the double microcontrollers communications technique is used. In this study, liquid crystal display is firstly used in body surface electrocardiosignal display or intracardial electrophysiologic signal display when the temporary demand pacemaker is installed and put into use. The machine has proven clinically useful and can be of wide appliation.

  13. Demand for temporary agency nurses and nursing shortages. (United States)

    Seo, Sukyong; Spetz, Joanne


    There is an ongoing debate about the reasons for the growth of temporary employment of registered nurses (RNs). Some argue that efficiency incentives to increase flexibility and reduce labor costs are the principal cause, while others point to shortages of RNs as the stronger determinant. Using hospital-level data from California's Office of Statewide Health Planning and Development, we find a significant trend of increasing demand for agency nurses during the years of RN shortage. Demand rose with inpatient days, patient demand fluctuation, and the level of fringe benefits. Competition between hospitals and unionization, however, did not affect hospitals' demand for temporary RNs. © The Author(s) 2014.

  14. Event-related temporary collocations in modern english newspaperdiscourse

    Directory of Open Access Journals (Sweden)

    Е В Терехова


    Full Text Available The paper discusses collocations called by the author as «temporary collocations». The temporary collocations (TC under discussion are understood as expressions with one marked component, being peripheral to the mainstream of idioms and phrasal expressions, which enables us to treat the analyzed TC in a narrow slightly idiomatic meaning. Quite a few examples borrowed from the authentic English newspapers and magazines are used to demonstrate the relationship between the event and the emergence of the TC; also the discourse definition is provided with a focus on interdependence between the TC and the discourse.

  15. A Case of Localized Hypertrichosis Due to Temporary Henna Tattoo

    Directory of Open Access Journals (Sweden)

    Deren Özcan


    Full Text Available Temporary henna tattoos have become very popular among children and teenagers in recent years. However, the use of additives to shorten the application time and darken the color of commercial henna, such as para-phenylenediamine, has led to an increased risk of complications due to those tattoos. The most commonly seen complications are allergic contact dermatitis, hypertrophic scarring, keloid formation, hyperpigmentation, and hypopigmentation. Herein; a 13-year-old girl who developed localized hypertrichosis after a temporary henna tattoo application was presented.

  16. Temporary emergency pacing-an orphan in district hospitals

    DEFF Research Database (Denmark)

    Gjesdal, Knut; Johansen, Jens Brock; Gadler, Fredrik


    This editorial discusses a report on the 1 year experience with temporary pacing, especially in the emergency setting, in several Norwegian district hospitals. The vast majority of the patients received transvenous temporary pacing, and the majority of leads were placed by noncardiologists....... The procedure times were long and complications were frequent. The organization of emergency pacing is discussed, and we suggest that unless qualified physicians can establish transvenous pacing, the patients who need that should be transferred with transcutaneous pacing as back-up during transport...

  17. Exits from Temporary Jobs in Europe: A Competing Risks Analysis

    DEFF Research Database (Denmark)

    D'Addio, Anna Christina; Rosholm, Michael


    We study transitions out of temporary jobs using the waves 1994-1999 of the European Community Household Panel applying a discrete time duration model. Specifically, we use a multinomial logitmodel distinguishing between exits into permanent employment and non-employment. Two different specificat......We study transitions out of temporary jobs using the waves 1994-1999 of the European Community Household Panel applying a discrete time duration model. Specifically, we use a multinomial logitmodel distinguishing between exits into permanent employment and non-employment. Two different...

  18. Multiple Institutional Logics in Inter-Institutional Temporary Organizations

    DEFF Research Database (Denmark)

    Pemsel, Sofia; Söderlund, Jonas

    distinct response strategies the project actors relied upon to deal with the multiplicity of logics: total integration, partial decoupling, avoidance, and surfing. We discuss how these response strategies were used, in what situations, and what effects they had on the organization. The paper contributes......The idea of multiple institutional logics currently draws more and more attention as many organizational actors are forced to operate in ever more complex, temporary and vivid collaborations. We draw on findings from a unique case study of a temporary organization that carried the responsibility...

  19. on gastro intestinal smooth muscle

    African Journals Online (AJOL)


    , Kaduna State. Correspondence author: ABSTRACT. The effects of the aqueous leaf extract of Combretum micranthum were studied on gastro intestinal smooth muscle of rodents. The extract was screened using ...

  20. Telescoping Intestine in an Adult

    Directory of Open Access Journals (Sweden)

    Khaldoon Shaheen


    Full Text Available Protrusion of a bowel segment into another (intussusception produces severe abdominal pain and culminates in intestinal obstruction. In adults, intestinal obstruction due to intussusception is relatively rare phenomenon, as it accounts for minority of intestinal obstructions in this population demographic. Organic lesion is usually identifiable as the cause of adult intussusceptions, neoplasms account for the majority. Therefore, surgical resection without reduction is almost always necessary and is advocated as the best treatment of adult intussusception. Here, we describe a rare case of a 44-year-old male with a diffuse large B-cell lymphoma involving the terminal ileum, which had caused ileocolic intussusception and subsequently developed intestinal obstruction requiring surgical intervention. This case emphasizes the importance of recognizing intussusception as the initial presentation for bowel malignancy.

  1. Usefulness of MR imaging for diseases of the small intestine: comparison with CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hoon; Ha, Hyun Kwon; Sohn, Min Jae; Shin, Byung Suck; Lee, Young Suk; Chung, Soo Yoon; Kim, Pyo Nyun; Lee, Moon Gyu; Auh, Yong Ho [Ulsan University College of Medicine, Seoul (Korea, Republic of)


    To evaluate the usefulness of MR imaging for diseases of the small intestine, emphasizing a comparison with CT. Thirty-four patients who underwent both CT and MR imaging using FLASH 2D and HASTE sequences were analyzed. All patients had various small bowel diseases with variable association of peritoneal lesions. We compared the detectabilities of CT and MR imaging using different MR pulse sequences. The capability for analyzing the characteristics of small intestinal disease was also compared. MR imaging was nearly equal to CT for detecting intraluminal or peritoneal masses, lesions in the bowel and mesentery, and small bowel obstruction, but was definitely inferior for detecting omental lesions. The most successful MR imaging sequence was HASTE for demonstrating bowel wall thickening, coronal FLASH 2D for mesenteric lesions, and axial FLASH 2D for omental lesions. MR imaging yielded greater information than CT in six of 12 inflammatory bowel diseases, while it was equal to CT in six of seven neoplasms and inferior in five of seven mesenteric ischemia. In determining the primary causes of 15 intestinal obstructions, MR imaging was correct in 11 (73%) and CT in nine (60%) patients. MR imaging can serve as an alternative diagnostic tool for patients with suspected inflammatory bowel disease, small intestinal neoplasm or obstruction.

  2. Primary intestinal lymphangiectasia (Waldmann's disease)


    Bellanger Jérôme; Vignes Stéphane


    Abstract Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. PIL is generally diagnosed before 3 years of age but may be diagnosed in older patients. Prevalence is unknown. The main symptom is predominantly bilateral lower limb edema. Edema may be moderate to severe with ana...

  3. Treatment of Digital Ischemia with Liposomal Bupivacaine

    Directory of Open Access Journals (Sweden)

    José Raul Soberón


    Full Text Available Objective. This report describes a case in which the off-label use of liposomal bupivacaine (Exparel in a peripheral nerve block resulted in marked improvement of a patient’s vasoocclusive symptoms. The vasodilating and analgesic properties of liposomal bupivacaine in patients with ischemic symptoms are unknown, but our clinical experience suggests a role in the management of patients suffering from vasoocclusive disease. Case Report. A 45-year-old African American female was admitted to the hospital with severe digital ischemic pain. She was not a candidate for any vascular surgical or procedural interventions. Two continuous supraclavicular nerve blocks were placed with modest clinical improvement. These effects were also short-lived, with the benefits resolving after the discontinuation of the peripheral nerve blocks. She continued to report severe pain and was on multiple anticoagulant medications, so a decision was made to perform an axillary nerve block using liposomal bupivacaine (Exparel given the compressibility of the site as well as the superficial nature of the target structures. Conclusions. This case report describes the successful off-label usage of liposomal bupivacaine (Exparel in a patient with digital ischemia. Liposomal bupivacaine (Exparel is currently FDA approved only for wound infiltration use at this time.

  4. Parenteral Nutrition and Intestinal Failure (United States)

    Bielawska, Barbara; Allard, Johane P.


    Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient’s home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes. PMID:28481229

  5. Endogenous Protease Nexin-1 Protects against Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Jonathan Thevenet


    Full Text Available The serine protease thrombin plays a role in signalling ischemic neuronal death in the brain. Paradoxically, endogenous neuroprotective mechanisms can be triggered by preconditioning with thrombin (thrombin preconditioning, TPC, leading to tolerance to cerebral ischemia. Here we studied the role of thrombin’s endogenous potent inhibitor, protease nexin-1 (PN-1, in ischemia and in tolerance to cerebral ischemia induced by TPC. Cerebral ischemia was modelled in vitro in organotypic hippocampal slice cultures from rats or genetically engineered mice lacking PN-1 or with the reporter gene lacZ knocked into the PN-1 locus PN-1HAPN-1-lacZ/HAPN-1-lacZ (PN-1 KI exposed to oxygen and glucose deprivation (OGD. We observed increased thrombin enzyme activity in culture homogenates 24 h after OGD. Lack of PN-1 increased neuronal death in the CA1, suggesting that endogenous PN-1 inhibits thrombin-induced neuronal damage after ischemia. OGD enhanced β-galactosidase activity, reflecting PN-1 expression, at one and 24 h, most strikingly in the stratum radiatum, a glial cell layer adjacent to the CA1 layer of ischemia sensitive neurons. TPC, 24 h before OGD, additionally increased PN-1 expression 1 h after OGD, compared to OGD alone. TPC failed to induce tolerance in cultures from PN-1−/− mice confirming PN-1 as an important TPC target. PN-1 upregulation after TPC was blocked by the c-Jun N-terminal kinase (JNK inhibitor, L-JNKI1, known to block TPC. This work suggests that PN-1 is an endogenous neuroprotectant in cerebral ischemia and a potential target for neuroprotection.

  6. [Malaria and intestinal protozoa]. (United States)

    Rojo-Marcos, Gerardo; Cuadros-González, Juan


    Malaria is life threatening and requires urgent diagnosis and treatment. Incidence and mortality are being reduced in endemic areas. Clinical features are unspecific so in imported cases it is vital the history of staying in a malarious area. The first line treatments for Plasmodium falciparum are artemisinin combination therapies, chloroquine in most non-falciparum and intravenous artesunate if any severity criteria. Human infections with intestinal protozoa are distributed worldwide with a high global morbid-mortality. They cause diarrhea and sometimes invasive disease, although most are asymptomatic. In our environment populations at higher risk are children, including adopted abroad, immune-suppressed, travelers, immigrants, people in contact with animals or who engage in oral-anal sex. Diagnostic microscopic examination has low sensitivity improving with antigen detection or molecular methods. Antiparasitic resistances are emerging lately. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. Intestinal, segmented, filamentous bacteria. (United States)

    Klaasen, H L; Koopman, J P; Poelma, F G; Beynen, A C


    Segmented, filamentous bacteria (SFBs) are autochthonous, apathogenic bacteria, occurring in the ileum of mice and rats. Although the application of formal taxonomic criteria is impossible due to the lack of an in vitro technique to culture SFBs, microbes with a similar morphology, found in the intestine of a wide range of vertebrate and invertebrate host species, are considered to be related. SFBs are firmly attached to the epithelial cells of the distal ileal mucosa, their preferential ecological niche being the epithelium covering the Peyer's patches. Electron microscopic studies have demonstrated a considerable morphological diversity of SFBs, which may relate to different stages of a life cycle. Determinants of SFB colonization in vivo are host species, genotypical and phenotypical characteristics of the host, diet composition, environmental stress and antimicrobial drugs. SFBs can survive in vitro incubation, but do not multiply. On the basis of their apathogenic character and intimate relationship with the host, it is suggested that SFBs contribute to development and/or maintenance of host resistance to enteropathogens.

  8. Adult intestinal failure

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J., E-mail: [Salford Royal Hospital, Salford (United Kingdom); Plumb, A.; Burnett, H. [Salford Royal Hospital, Salford (United Kingdom)


    Intestinal failure (IF) is the inability of the alimentary tract to digest and absorb sufficient nutrition to maintain normal fluid balance, growth, and health. It commonly arises from disease affecting the mesenteric root. Although severe IF is usually managed in specialized units, it lies at the end of a spectrum with degrees of nutritional compromise being widely encountered, but commonly under-recognized. Furthermore, in the majority of cases, the initial enteric insult occurs in non-specialist IF centres. The aim of this article is to review the common causes of IF, general principles of its management, some commoner complications, and the role of radiology in the approach to a patient with severe IF. The radiologist has a crucial role in helping provide access for feeding solutions (both enteral and parenteral) and controlling sepsis (via drainage of collections) in an initial restorative phase of treatment, whilst simultaneously mapping bowel anatomy and quality, and searching for disease complications to assist the clinicians in planning a later, restorative phase of therapy.

  9. Haemorrhage and intestinal lymphoma

    Directory of Open Access Journals (Sweden)

    Attilia M. Pizzini


    Full Text Available Background: The prevalence of coeliac disease is around 1% in general population but this is often unrecognised. The classical presentation of adult coeliac disease is characterized by diarrhoea and malabsorption syndrome, but atypical presentations are probably more common and are characterized by iron deficiency anaemia, weight loss, fatigue, infertility, arthralgia, peripheral neuropathy and osteoporosis. Unusual are the coagulation disorders (prevalence 20% and these are due to vitamin K malabsorption (prolonged prothrombin time. Clinical case: A 64-year-old man was admitted to our Department for an extensive spontaneous haematoma of the right leg. He had a history of a small bowel resection for T-cell lymphoma, with a negative follow-up and he didn’t report any personal or familiar history of bleeding. Laboratory tests showed markedly prolonged prothrombin (PT and partial-thromboplastin time (PTT, corrected by mixing studies, and whereas platelet count and liver tests was normal. A single dose (10 mg of intravenous vitamin K normalized the PT. Several days before the patient had been exposed to a superwarfarin pesticide, but diagnostic tests for brodifacoum, bromadiolone or difenacoum were negative. Diagnosis of multiple vitamin K-dependent coagulationfactor deficiencies (II, VII, IX, X due to intestinal malabsorption was made and coeliac disease was detected. Therefore the previous lymphoma diagnosis might be closely related to coeliac disease. Conclusions: A gluten free diet improves quality of life and restores normal nutritional and biochemical status and protects against these complications.

  10. Brain caspase-3 and intestinal FABP responses in preterm and term rats submitted to birth asphyxia

    Directory of Open Access Journals (Sweden)

    R.L. Figueira


    Full Text Available Neonatal asphyxia can cause irreversible injury of multiple organs resulting in hypoxic-ischemic encephalopathy and necrotizing enterocolitis (NEC. This injury is dependent on time, severity, and gestational age, once the preterm babies need ventilator support. Our aim was to assess the different brain and intestinal effects of ischemia and reperfusion in neonate rats after birth anoxia and mechanical ventilation. Preterm and term neonates were divided into 8 subgroups (n=12/group: 1 preterm control (PTC, 2 preterm ventilated (PTV, 3 preterm asphyxiated (PTA, 4 preterm asphyxiated and ventilated (PTAV, 5 term control (TC, 6 term ventilated (TV, 7 term asphyxiated (TA, and 8 term asphyxiated and ventilated (TAV. We measured body, brain, and intestine weights and respective ratios [(BW, (BrW, (IW, (BrW/BW and (IW/BW]. Histology analysis and damage grading were performed in the brain (cortex/hippocampus and intestine (jejunum/ileum tissues, as well as immunohistochemistry analysis for caspase-3 and intestinal fatty acid-binding protein (I-FABP. IW was lower in the TA than in the other terms (P<0.05, and the IW/BW ratio was lower in the TA than in the TAV (P<0.005. PTA, PTAV and TA presented high levels of brain damage. In histological intestinal analysis, PTAV and TAV had higher scores than the other groups. Caspase-3 was higher in PTAV (cortex and TA (cortex/hippocampus (P<0.005. I-FABP was higher in PTAV (P<0.005 and TA (ileum (P<0.05. I-FABP expression was increased in PTAV subgroup (P<0.0001. Brain and intestinal responses in neonatal rats caused by neonatal asphyxia, with or without mechanical ventilation, varied with gestational age, with increased expression of caspase-3 and I-FABP biomarkers.

  11. PARP Inhibition Attenuates Histopathological Lesion in Ischemia/Reperfusion Renal Mouse Model after Cold Prolonged Ischemia

    Directory of Open Access Journals (Sweden)

    Raimundo M. G. del Moral


    Full Text Available We test the hypothesis that PARP inhibition can decrease acute tubular necrosis (ATN and other renal lesions related to prolonged cold ischemia/reperfusion (IR in kidneys preserved at 4°C in University of Wisconsin (UW solution. Material and Methods. We used 30 male Parp1+/+ wild-type and 15 male Parp10/0 knockout C57BL/6 mice. Fifteen of these wild-type mice were pretreated with 3,4-dihydro-5-[4-(1-piperidinylbutoxyl]-1(2H-isoquinolinone (DPQ at a concentration of 15 mg/kg body weight, used as PARP inhibitor. Subgroups of mice were established (A: IR 45 min/6 h; B: IR + 48 h in UW solution; and C: IR + 48 h in UW solution plus DPQ. We processed samples for morphological, immunohistochemical, ultrastructural, and western-blotting studies. Results. Prolonged cold ischemia time in UW solution increased PARP-1 expression and kidney injury. Preconditioning with PARP inhibitor DPQ plus DPQ supplementation in UW solution decreased PARP-1 nuclear expression in renal tubules and renal damage. Parp10/0 knockout mice were more resistant to IR-induced renal lesion. In conclusion, PARP inhibition attenuates ATN and other IR-related renal lesions in mouse kidneys under prolonged cold storage in UW solution. If confirmed, these data suggest that pharmacological manipulation of PARP activity may have salutary effects in cold-stored organs at transplantation.

  12. Indole-TEMPO conjugates alleviate ischemia-reperfusion injury via attenuation of oxidative stress and preservation of mitochondrial function. (United States)

    Bi, Wei; Bi, Yue; Gao, Xiang; Li, Pengfei; Hou, Shanshan; Zhang, Yanrong; Bammert, Cathy; Jockusch, Steffen; Legalley, Thomas D; Michael Gibson, K; Bi, Lanrong


    Mitochondrial oxidative damage contributes to a wide range of pathologies including ischemia/reperfusion injury. Accordingly, protecting mitochondria from oxidative damage should possess therapeutic relevance. In the present study, we have designed and synthesized a series of novel indole-TEMPO conjugates that manifested good anti-inflammatory properties in a murine model of xylene-induced ear edema. We have demonstrated that these compounds can protect cells from simulated ischemia/reperfusion (s-I/R)-induced reactive oxygen species (ROS) overproduction and mitochondrial dysfunction. Furthermore, we have demonstrated that indole-TEMPO conjugates can attenuate organ damage induced in rodents via intestinal I/R injury. We therefore propose that the pharmacological profile and mechanism of action of these indole-TEMPO conjugates involve convergent roles, including the ability to decrease free radical production via lipid peroxidation which couples to an associated decrease in ROS-mediated activation of the inflammatory process. We further hypothesize that the protective effects of indole-TEMPO conjugates partially reside in maintaining optimal mitochondrial function. Copyright © 2017. Published by Elsevier Ltd.

  13. The Liminality of Temporary Agency Work: Exploring the Dimensions of Danish Temporary Agency Workers’ Liminal Experience

    Directory of Open Access Journals (Sweden)

    Ingo Winkler


    Full Text Available The concept of liminality refers to the experience to be betwixt-and-between social structures and the associated positions, statuses, and roles. We advance the original use of the concept by introducing the various meanings that the experience of being in a liminal state can take. Drawing on political anthropology we identify the dimensions of ‘types of subjects,’ ‘time,’ ‘space,’ and ‘scale’ in order to analytically unlock the liminal experience. Exemplifying our concept we present the findings from an own study of temporary agency workers in Denmark. Exploring the workers’ interpretations allows us to illustrate to what extent their employment situation constitutes a multi-dimensional liminal experience between established social structures and employment categories. The article emphasizes the complexity of the liminal experience. Theoretically and empirically, we show the many meanings along which liminality can unfold in organizational and work-related contexts. We argue that future studies should explore the various dimensions in other contexts of passages from one relatively stable state to another. In doing so, similarities and differences between various liminal experiences and the role the various dimensions play could be identified.

  14. 47 CFR 90.159 - Temporary and conditional permits. (United States)


    ... SERVICES PRIVATE LAND MOBILE RADIO SERVICES Applications and Authorizations § 90.159 Temporary and... minimum of ten business days has passed between submission of the application to the Commission and the... MHz (subpart T), Business Radio (subpart D), 929-930 MHz Paging (subpart P), and Specialized Mobile...

  15. Temporary and long-term consequences of bereavement on happiness

    NARCIS (Netherlands)

    Moor, J.A.; de Graaf, P.M.

    In this article, we examine the temporary and long-term consequences of the death of a parent or child on happiness. According to set-point theory external conditions are expected to only have a short-term or limited influence on happiness. This directly contradicts the basic assumption of affective

  16. The terrestrial invertebrate fauna of a temporary stream in southern ...

    African Journals Online (AJOL)

    The terrestrial invertebrate fauna of an intermittent stream was examined in the absence of surface flows within the context of the flood pulse concept. ... The concept of the flood pulse should be expanded to include aseasonal and secular variations in flow which in temporary streams create lateral movements that provide ...

  17. 18 CFR 2.57 - Temporary certificates-pipeline companies. (United States)


    ...-pipeline companies. 2.57 Section 2.57 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Policy and Interpretations Under the Natural Gas Act § 2.57 Temporary certificates—pipeline companies... the proposed construction is of major proportions. Pipeline companies are accordingly urged to conduct...

  18. Genre-related temporary collocations in english discourse

    Directory of Open Access Journals (Sweden)

    Е В Терехова


    Full Text Available The paper discusses genre-related temporary collocations (TC. It also provides genre definition, analyzes different genre-related TC which are used in TV speeches, diplomatic texts, and English media texts. TC implementing in genre-related texts, preferential reinterpretation criteria which characterize terminology formation, their interpretation, and their translation from English into Russian is considered.

  19. Temporary Jobs and the Severity of Workplace Accidents

    NARCIS (Netherlands)

    Picchio, Matteo; van Ours, Jan


    From the point of view of workplace safety, it is important to know whether having a temporary job has an effect on the severity of workplace accidents. We present an empirical analysis on the severity of workplace accidents by type of contract. Method: We used micro data collected by the Italian

  20. Evolution of a Biosynthetic Temporary Skin Substitute: A Preliminary Study. (United States)

    Woodroof, Aubrey; Phipps, Richard; Woeller, Collynn; Rodeheaver, George; Naughton, Gail K; Piney, Emmett; Hickerson, William; Branski, Ludwik; Holmes, James H


    To compare PermeaDerm to first temporary biosynthetic skin substitute (Biobrane, cleared by the Food and Drug Administration in 1979). Different temporary skin substitutes (Biobrane, PermeaDerm, and PermeaDerm derivatives) were tested for physical differences, impact on healing wounds, inflammatory response, and ability to allow adequate growth of dermal fibroblasts and mesenchymal stem cells without accumulation of excessive scar-forming myofibroblasts. Proliferation of fibroblasts and stem cells on various skin substitutes was measured, and myofibroblast marker accumulation was evaluated by the expression of α-smooth muscle actin and fibronectin. Fibroblast migration was measured by tracking viable cells with MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] dye. In vivo testing shows PermeaDerm works well as a temporary skin substitute, performing better than Biobrane with respect to inflammation and fluid accumulation. Tissue culture techniques revealed that cells on PermeaDerm grow in a more uniform fashion and migrated to a greater extent than cells on Biobrane. Furthermore, cells grown in the presence of PermeaDerm expressed lower levels of the myofibroblast markers α-smooth muscle actin and fibronectin than cells grown on Biobrane. PermeaDerm with variable porosity possesses all attributes and properties known to be important for a successful temporary skin substitute and enables the clinician to control porosity from essentially zero to what the wound requires. The ability of the clinician to minimize wound desiccation without fluid accumulation is related to the reduction of punctate scarring.

  1. 17 CFR 232.201 - Temporary hardship exemption. (United States)


    ... no later than one business day after the date on which the filing was to be made. (1) An electronic... submitted to the Commission within six business days of filing the paper format document. The electronic... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Hardship Exemptions § 232.201 Temporary...

  2. 76 FR 35909 - Temporary Concession Contract for Blue Ridge Parkway (United States)


    ... lodging accommodations, food and beverage, retail sales, boat rentals, and other services at Crabtree... Doc No: 2011-15060] DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-CONC-0511-7182; 2410-OYC] Temporary Concession Contract for Blue Ridge Parkway AGENCY: National Park Service, Interior...

  3. Performance of yam microtubers from temporary immersion system ...

    African Journals Online (AJOL)

    The yam clones ´Pacala Duclos´ and ´Belep´ of Dioscorea alata were used to evaluate the performance of microtubers formed in temporary immersion systems (TIS) in field conditions. Previously sprouted microtubers with a fresh weight higher than 3.0 gFW were used while in vitro plants and tuber crowns from conventional ...

  4. Performance of yam microtubers from temporary immersion system ...

    African Journals Online (AJOL)



    Aug 22, 2011 ... as research tools: a review. Am. J. Potato Res. 78: 47-55. Escalona M (2006) Temporary inmersion beats traditional techniques on all fronts. Prophyta annual. pp. 48-50. Hernandez A, Perez JM, Bosh D, Rivero L, Camacho E (1999) Nueva versión de clasificación de los suelos de Cuba. Instituto de Suelos.

  5. 19 CFR 146.33 - Temporary deposit for manipulation. (United States)


    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Temporary deposit for manipulation. 146.33 Section 146.33 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT... deposit for manipulation. Imported merchandise for which an entry has been made and which has remained in...

  6. Understanding the development of temporary agency work in Europe

    NARCIS (Netherlands)

    B.A.S. Koene (Bas); J. Paauwe (Jaap); J.P.M. Groenewegen (John)


    textabstractThis article develops an explanatory framework for understanding the growth and development of temporary agency work (TAW) and the related industry. The analysis shows that explanations based on economic logic are helpful in understanding the choice of TAW in general. These explanations,

  7. Distribution, Density and Diversity of Dipterans in a Temporary Pond ...

    African Journals Online (AJOL)

    Some aspects of the ecology of Diptera were studied in a temporary pond in Okomu Forest Reserve, southern Nigeria between January 1988 and December 1989. Twenty six morphologically distinct taxa were identified, of which 14 were chironomids. The dominant taxa were Polypedilum (43%), Alluaudomyia (21%), Culex ...

  8. Training "Expendable" Workers: Temporary Foreign Workers in Nursing (United States)

    Taylor, Alison; Foster, Jason; Cambre, Carolina


    The purpose of this article is to explore the experiences of Temporary Foreign Workers in health care in Alberta, Canada. In 2007-2008, one of the regional health authorities in the province responded to a shortage of workers by recruiting 510 health-care workers internationally; most were trained as Registered Nurses (RNs) in the Philippines.…

  9. 41 CFR 101-1.103 - FPMR temporary regulations. (United States)


    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true FPMR temporary regulations. 101-1.103 Section 101-1.103 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 1-INTRODUCTION 1.1-Regulation System § 101...

  10. Temporary Anorgasmia Following Uterine Artery Embolization for Symptomatic Uterine Fibroids. (United States)

    Speir, Ethan; Shekhani, Haris; Peters, Gail


    We report a rare case of temporary anorgasmia following uterine artery embolization (UAE) performed for symptomatic uterine fibroids. To our knowledge, this is only the second time that this complication has been reported in the literature. We briefly explore the possible pathophysiologic explanations for this complication and review the effects of UAE compared to hysterectomy on sexual functioning in women.

  11. Difficulty Processing Temporary Syntactic Ambiguities in Lewy Body Spectrum Disorder (United States)

    Grossman, Murray; Gross, Rachel G.; Moore, Peachie; Dreyfuss, Michael; McMillan, Corey T.; Cook, Philip A.; Ash, Sherry; Siderowf, Andrew


    While grammatical aspects of language are preserved, executive deficits are prominent in Lewy body spectrum disorder (LBSD), including Parkinson's disease (PD), Parkinson's dementia (PDD) and dementia with Lewy bodies (DLB). We examined executive control during sentence processing in LBSD by assessing temporary structural ambiguities. Using an…

  12. 47 CFR 78.33 - Special temporary authority. (United States)


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Special temporary authority. 78.33 Section 78.33 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES CABLE... with § 78.18: Provided, however, That in the case of events of widespread interest and importance that...

  13. 76 FR 68192 - Temporary Certification Program; Notice of Extension (United States)


    ... of Certified EHR Technology for EPs and hospitals that seek to achieve meaningful use and participate... Extension AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice... Technology (the National Coordinator) to extend the Temporary Certification Program. Authority: Section 3001...

  14. Normobaric Oxygen Therapy for Scleral Ischemia or Melt

    Directory of Open Access Journals (Sweden)

    Farideh Sharifipour


    Full Text Available Purpose: To investigate the efficacy of normobaric oxygen (NBO therapy for treatment of scleral ischemia or melt. Methods: This prospective interventional case series includes 9 eyes of 8 patients with scleral ischemia or melt of diverse etiologies. Following the failure of conventional medical and/or surgical therapy to improve ischemia or upon clinical deterioration, NBO was initiated. All patients received 100% NBO at flow rate of 10 liters/minute by face mask for 1 hour, twice daily until complete vascularization of ischemic areas. Main outcome measures were improvement of scleral ischemia and healing of conjunctival epithelial defects. Results: NBO therapy led to epithelialization and vascularization of the ischemic sclera in all eyes; the repair process began 3-4 days after NBO had been initiated and was completed in 18.1±4.7 (range, 10-25 days. All patients remained stable over a 9-month follow-up period. Conclusion: NBO therapy seems effective for treatment of scleral ischemia or melt, and hence can be considered as a non-invasive alternative to surgical intervention in these conditions.

  15. Rat model of focal cerebral ischemia in the dominant hemisphere. (United States)

    Zhang, Hua; Shen, Yan; Wang, Wei; Gao, Huanmin


    In the human brain, the dominant hemisphere is more complex than the non-dominant hemisphere. Hence, cerebral ischemia of the dominant hemisphere often leads to serious consequences. This study aims to establish a rodent model of focal cerebral ischemia in the dominant hemisphere. The quadruped feeding test was used to screen 70 male Sprague Dawley rats. From this test, 48 rats with right paw preference were selected and randomly assigned numbers. Half were assigned to the dominant hemisphere ischemia (DHI) group, and the other half were assigned to the non-dominant hemisphere ischemia (NDHI) group. The middle cerebral artery was occluded 2 h before reperfusion. Neurological functions were tested. TTC and HE staining were performed. The volume of cerebral infarction was calculated. Rats in the DHI group had significantly worse neurological scores than rats in the NDHI group (P dominant hemisphere than in the non-dominant hemisphere. The dominant hippocampus indicated severe neuronal loss and disorderly cellular arrangement. The volume of cerebral infarction was also greater in the DHI group compared to the NDHI group (P dominant hemisphere, MCA occlusion in the dominant hemisphere caused greater impairment in neurological functions. The proposed rodent model is reliable and has high levels of reproducibility. Therefore, his model can be reliably for investigating the mechanism of focal cerebral ischemia in the dominant hemisphere of human brains.

  16. Fluorometry of ischemia reperfusion injury in rat lungs in vivo (United States)

    Sepehr, R.; Staniszewski, K.; Jacobs, E. R.; Audi, S.; Ranji, Mahsa


    Previously we demonstrated the utility of optical fluorometry to evaluate lung tissue mitochondrial redox state in isolated perfused rats lungs under various chemically-induced respiratory states. The objective of this study was to evaluate the effect of acute ischemia on lung tissue mitochondrial redox state in vivo using optical fluorometry. Under ischemic conditions, insufficient oxygen supply to the mitochondrial chain should reduce the mitochondrial redox state calculated from the ratio of the auto-fluorescent mitochondrial metabolic coenzymes NADH (Nicotinamide Adenine Dinucleotide) and FAD (Flavoprotein Adenine Dinucleotide). The chest of anesthetized, and mechanically ventilated Sprague-Dawley rat was opened to induce acute ischemia by clamping the left hilum to block both blood flow and ventilation to one lung for approximately 10 minutes. NADH and FAD fluorescent signals were recorded continuously in a dark room via a fluorometer probe placed on the pleural surface of the left lung. Acute ischemia caused a decrease in FAD and an increase in NADH, which resulted in an increase in the mitochondrial redox ratio (RR=NADH/FAD). Restoration of blood flow and ventilation by unclamping the left hilum returned the RR back to its baseline. These results (increase in RR under ischemia) show promise for the fluorometer to be used in a clinical setting for evaluating the effect of pulmonary ischemia-reperfusion on lung tissue mitochondrial redox state in real time.

  17. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

    Energy Technology Data Exchange (ETDEWEB)

    Trompeter, Markus; Brazda, Thurid; Remy, Christopher T.; Reimer, Peter [Department of Radiology, Staedtisches Klinikum Karlsruhe (Germany); Vestring, Thomas [Department of Radiology, Diakonie-Krankenhaus Rotenburg/Wuemme, Goettingen (Germany)


    Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective. (orig.)

  18. Mesenteric ischemia: still a deadly puzzle for the medical community. (United States)

    Stamatakos, Michael; Stefanaki, Charikleia; Mastrokalos, Dimitrios; Arampatzi, Helen; Safioleas, Panagiotis; Chatziconstantinou, Constantinos; Xiromeritis, Constantinos; Safioleas, Michael


    The main goal of this article is to update etiology, epidemiology, diagnosis, treatment and outcome of the various causes of mesenteric ischemia in order to elucidate its labyrinthine clinical riddle, by reviewing the current English medical literature. Mesenteric ischemia is a quite uncommon disorder, observed in the emergency department. It is a life-threatening vascular emergency that requires early diagnosis and intervention to restore mesenteric blood flow and to prevent bowel necrosis and patient death. Consequently, it is a vital diagnosis to make because of its high mortality rate and its thorny complications. The underlying causes vary, and the prognosis depends on the specific findings during clinical examination. Vague and nonspecific clinical findings and limitations of diagnostic studies make the diagnosis a significant challenge. The prognosis of acute mesenteric ischemia of any type is grave. The complications following this medical jigsaw puzzle are also severe. Patients in whom the diagnosis is missed until infarction occurs have a mortality rate of 90%. Even with good treatment, up to 50-80% of patients die. Survivors of extensive bowel resection face lifelong disability. Despite the progress in understanding the pathogenesis of mesenteric ischemia and the development of treatment modalities, the entity remains a diagnostic challenge for clinicians. Delay in diagnosis contributes to a high mortality rate. Early diagnosis and adequate treatment can improve the clinical outcome. Even if diagnostic modalities have improved since the first successful attempts to confront effectively this clinical entity, mesenteric ischemia still remains a lethal diagnostic enigma for the medical community.

  19. Transmural anoxic wave front and regional dysfunction during early ischemia. (United States)

    Kanaide, H; Taira, Y; Nakamura, M


    The relative time courses of early changes in myocardial metabolism and function during anoxia, global ischemia, and regional ischemia were compared in isolated rat hearts. Transmural anoxic wave front was determined with NADH fluorescence photography, and oxygen saturation of myoglobin and dynamic systolic wall thickening were measured with spectrophotometry of light transmitted through the left ventricular free wall. In all three treatments, anoxic wave front first appeared in the subendocardium and reached the epicardial half of the myocardium in 10 s, when oxygen saturation of myoglobin decreased by 50% and tissue ATP and creatine phosphate remained at aerobic levels. During this period, systolic wall thickening decreased gradually in anoxia and global ischemia, whereas a marked decrease in systolic wall thickening and appearance of dyskinesia (wall thinning) occurred in regional ischemia. Thus the early extension of anoxic wave front and metabolic changes are similar with all three treatments, and dyskinesia, observed only in case of regional ischemia, occurs when the inner half is ischemic or anoxic.

  20. Physical performance deterioration of temporary housing residents after the Great East Japan Earthquake

    Directory of Open Access Journals (Sweden)

    Takeaki Ishii


    We revealed that standing stability was impaired among elderly temporary housing residents 1.5 years after the disaster. Disaster responders should take into account the health risks associated with living in temporary housing.