[The virtual discussion: a new model of clinical session].
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Biomedical subjects
Publications and source records attributed to J Vallet.
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BACKGROUND: Experimental studies have shown that 21-aminosteroids (21-A) are powerful inhibitors of superoxide-mediated iron-dependent lipid peroxidation. This study was aimed at determining how far the blocking effect of one of these substances (lazaroid U74389G) on lipid peroxidation protects intestinal grafts morphologically and biologically in a heterotopic transplant model (SBT) in rats. ANIMALS AND METHODS: Heterotopic LEW were performed using Ringer lactate (4 degrees C) as preservation solution. In Group 1 (n = 7) the donor and recipient animals received 3 and 6 mg/kg of the 21-A U74389G, respectively. Group 2 (n = 7) received the same doses of the vehicle of the drug. Sham group underwent only a laparotomy. Bacterial translocation (BT) was determined in mesenteric lymph nodes (MLN), liver (L), and spleen (S) 60 min after reperfusion. Tissue myeloperoxidase (MPO), malondialdehyde (MDA), and percentage conversion xanthine dehydrogenase/xanthine oxidase (XD/XO) were also determined in the ileal graft. Histological damage was graded according to Park's classification. RESULTS: Tissue MDA (nmol/mg prot) was significantly lower in Group 1 (0.53 +/- 0.09) than in Group 2 (3.66 +/- 1, P < 0.05) and showed levels similar to those of the sham-operated group (0.40 +/- 0.05). Injury grades were also significantly different in both study groups (Group 1, 0-1; Group 2, 2-3, P < 0.05). BT (log CFU/g tissue) in Group 1 were MLN, 0; L, 0.36; and S, 0. In Group 2, MLN, 1.07; L, 0.81; and S, 1.49 (P < 0.05 in MLN). Increase in MPO activity (U/g prot) in comparison with sham-operated animals was similar in the two study groups (Group 1, 1.49 +/- 0.58; Group 2, 1.22 +/- 0.46; Sham, 0.34 +/- 0.37 (P < 0.05 1,2 vs sham). Conversion of XD to XO was unaffected by the supplementation of the drug. CONCLUSION: 21A U74389G inhibits lipid peroxidation, protects intestinal graft, and reduces BT after heterotopic SBT in rats.
The aim of this study was to analyze the possible protective effects of a glutamine and arginine precursor (ornithine-alpha-ketoglutarate [OKG]) on the mucosa of a transplanted intestine when administered with either a defined formula oral diet (DFD) or a standard chow. Isogenic male Lewis rats (250 g) were submitted to a laparotomy (groups 1 and 2) or to an orthotopic small bowel transplantation (SBT; groups 3-6). Groups 1, 3, and 5 received a DFD 14 days after surgery. Groups 2, 4, and 6 received standard chow. In addition, groups 5 and 6 received a daily oral supplementation of 1.4 g/kg of OKG. Weight changes and food intake were recorded daily. At the end of the study, bacterial translocation (BT) was measured in mesenteric lymph nodes, liver, and spleen. The protein/DNA index was also determined in intestinal mucosa. SBT induced BT in all transplanted groups, especially in those fed DFD. Addition of OKG (groups 5 and 6) significantly reduced BT in comparison with groups 3 and 4 and improved the protein/DNA index as well as weight gain. It is concluded that OKG supplementation protects the intestinal barrier after SBT, and that this effect is more marked when it is added to a standard chow.
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To study comparative results between laparoscopic and open appendectomy, all the patients with suspected acute appendicitis who presented between January 1992 and December 1994 (N = 210) were randomized into two groups: laparoscopic (LA, n = 106) and open appendectomy (OA, n = 104). Patient demographics, pathological findings, operative time, postoperative course, and cost were analyzed. Age, gender, previous laparotomy, intraoperative diagnosis, and perforated appendix rate were comparable between both groups. Mean operative time was longer in the LA group (p < 0.05). Earlier resumption of a regular diet, shorter postoperative stay, and less postoperative analgesia also were observed in the LA group (p < 0.05). Postoperative morbidity and hospital readmissions were similar in both groups (p > 0.05). Higher operative cost was observed in the LA group, but global cost was lower in this group (p < 0.05). Laparoscopic appendectomy shows a more comfortable postoperative course (oral resumption, postoperative stay, and analgesia) over open appendectomy, with similar postoperative morbidity. The LA group showed more operative but less global cost.
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The aim of the study was to determine the nutritional and intestinal effects of grape seed tannins. For this purpose, tannins were incorporated in diets of rats at levels of 0.2 or 2.0% for 31 days in comparison to a control diet. The animals were pair-fed. Nutritional balances were not affected by feeding 0.2% tannins. At the highest dose (2%) grape seed tannins reduced growth as well as dry matter (DM) and nitrogen (N) digestibility. In rats fed protein-free diets, 2% tannins significantly increased endogenous fecal N. Starch and fat were well digested in all groups of rats. No changes in organ weights were observed. Duodenal alkaline phosphatase activity (AP) was never affected by tannins. On the other hand, in the jejunum, along the vilus-crypt unit, a reduction of AP and sucrase appeared at the tip villus which was balanced by an enhancement of 3H-thymidine incorporation in the middle of the crypt zone, giving evidence of endogenous N loss. This study did not reveal a major toxic effect of tannins except a reduced DM and N digestibility; nevertheless tannins directly interfere with mucosal proteins, thereby stimulating the cell renewal.
The case of a patient with all manifestations of pancreatic glucagonoma is presented. The real prevalence of this disease is unknown for in many cases there are no clinical manifestations. It is usually an accidental finding during autopsy and it is considered as an infrequent entity. Patients with glucagonomas may have different hydroelectrolytic and metabolic changes causing myocardial dysfunction and thromboembolic alterations. Anesthesia for this type of patients requires a strict control of glycemia, a careful evaluation of the nutritional and hydroelectrolytic state and adequate thromboembolic prophylaxis.