ABSTRACT
This study aims at establishing whether transverse diameter (TD) and cross sectional-area (CSA) of the ascending aorta (AA), descending aorta (DA) and pulmonary trunk (PT) measured by computerized tomographic angiography (CTA) altered by sex, age, hypertension, smoking and diabetes. CTA examinations of the TD and CSA of the AA, DA and PT of 100 patients aged 49.5±16.9 years (range 1678 years) selected between January 2009 to May 2011 from those referred to Radiology Department, Jordan University Hospital, Faculty of Medicine, University of Jordan, Amman, Jordan for advanced evaluation. Measurements were made in the axial plane at the upper border of the six thoracic vertebrae. Patients were divided into three age groups. Significance of differences in parameters between age groups was calculated. Assessment ratios were considered. It was found that parameters of the three arteries were significantly larger in men than in women (P= < 0.05) and increased with age. Hypertension increased diameters of AA and DA in both genders (P= 0.001) and of PT in men (P= 0.01). Smoking significantly decreased parameters of PT in men (P= 0.01). Diabetes increased parameters of the three arteries in both genders, significantly increased parameters of PT in men (P= <0.05) and parameters of DA in women (P= <0.05). It is concluded that studied parameters were larger in men and increased with age of our patients. Distinctive differences in measurements appeared in hypertensive, smokers, and diabetic patients.
El objetivo fue determinar si el sexo, edad, hipertensión, tabaquismo y la diabetes alteran el diámetro transversal (DT) y área transversal (AT) de la parte ascendente de la aorta (AA), parte descendente de la aorta (AD) y tronco pulmonar (TP), medidos por angiografía por tomografía computadorizada (ATC). Exámenes de ATC de 100 pacientes de 49,5±16,9 años (rango 1678 años) fueron seleccionados entre enero del año 2009 a mayo del año 2011 por el Departamento de Radiología, Hospital de la Universidad de Jordania, Facultad de Medicina de la Universidad de Jordania, Amman, Jordania para una evaluación avanzada del DT y AT de la AA, AD y TP. Las mediciones se realizaron en el plano axial en el margen superior de las seis vértebras torácicas. Los pacientes fueron divididos en tres grupos según edad. Se determinó la existencia de significancia estadística de los diferentes parámetros entre los grupos etarios. La evaluación de las razones también fueron consideradas. Se encontró que los parámetros de las tres arterias fueron significativamente mayores en los hombres que en las mujeres (p= <0,05) y que aumentaron con la edad. La hipertensión aumentó los diámetros de la AA y AD en ambos sexos (p= 0,001) y del TP en los hombres (p= 0,01). En fumadores disminuyeron significativamente los parámetros del TP en los hombres (p= 0,01). La diabetes aumentó los parámetros de las tres arterias en ambos sexos. Ademas, aumentaron significativamente los parámetros del TP en los hombres (p= <0,05) y los parámetros de la AD en las mujeres (p = <0,05). Se concluye que los parámetros estudiados eran mayores en los hombres y aumentaron con la edad de nuestros pacientes. Diferencias distintivas en las mediciones aparecieron en hipertensos, fumadores y pacientes diabéticos.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Aorta/diagnostic imaging , Aorta/pathology , Pulmonary Artery/pathology , Age Factors , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/pathology , Computed Tomography Angiography , Diabetes Mellitus/pathology , Hypertension/pathology , Pulmonary Artery/diagnostic imaging , Sex Factors , Tobacco Use Disorder/pathologyABSTRACT
Diabetes mellitus (DM) is a serious metabolic disorder with micro and macro-vascular complications that result in a significant morbidity and mortality. The present study investigated the effects of Momordica charantia (M. charantia) on histological changes of the aorta and pulmonary trunk in streptozotocin-induced diabetic Wistar rats. Forty healthy adult Wistar rats of both sexes were randomly assigned into five groups A, B, C, D and E of eight rats each. Group A were the control (normal rats); B were the experimentally-induced diabetic rats; C were diabetic rats treated with methanolic extracts of M. charantia for two weeks (withdrawal group); D were diabetic rats treated with methanolic extracts of M. charantia for four weeks. E was diabetic rats treated glimepiride for four weeks. Tissues were harvested, processed routinely in paraffin wax and stained with routine and special stains. Histological results revealed morphological alterations in the aorta and pulmonary trunk of diabetic rats. Histochemical analysis also revealed abnormal deposition of glycogen in these vessels of diabetic rats. M. charantia and glimperide attenuated the morphological alterations and reduced the glycogen deposits. In conclusion M. charantia has a promising ameliorative effect on the morphology of the aorta and pulmonaty trunk in STZ-induced diabetic wistar rats and by extension, may be relevant in the management of cardiovascular alteration associated with DM.
La diabetes mellitus (DM) es una enfermedad metabólica grave con complicaciones micro y macro vasculares que resultan en una significativa morbilidad y mortalidad. El presente estudio investigó los efectos de Momordica charantia (M. charantia) sobre los cambios histológicos de la aorta y el tronco pulmonar en ratas Wistar con diabetes inducida por estreptozotocina. Cuarenta ratas Wistar adultas sanas de ambos sexos fueron asignadas al azar en cinco grupos A, B, C, D y E, 8 ratas cada grupo. El grupo A fue control (ratas normales); el grupo B fue de ratas diabéticas inducidas experimentalmente; el grupo C fue de ratas diabéticas tratadas con extractos metanólicos de M. charantia por dos semanas (grupo de retirada); grupo D fue de ratas diabéticas tratadas con extractos metanólicos de M. charantia durante cuatro semanas, y el grupo E fue de ratas diabéticas tratadas con glimepirida durante cuatro semanas. Los tejidos obtenidos se incluyeron en parafina y se tiñeron con técnica de rutina y tinciones especiales. Los resultados histológicos revelaron alteraciones morfológicas en la aorta y el tronco pulmonar de las ratas diabéticas. El análisis histoquímico reveló también la deposición anormal de glucógeno en estos vasos de ratas diabéticas. Tanto M. charantia y glimperida atenuaron las alteraciones morfológicas y redujeron los depósitos de glucógeno. En conclusión, la M. charantia tiene un efecto de mejora prometedor sobre los cambios en la morfología de la aorta y el tronco pulmonar en ratas Wistar diabéticas inducidas por STZ y, por extensión, pueden ser relevantes en el manejo de alteraciones cardiovasculares asociadas con la DM.
Subject(s)
Male , Animals , Female , Rats , Aorta , Diabetes Mellitus, Experimental , Momordica charantia/chemistry , Plant Preparations/administration & dosage , Lung , Aorta/pathology , Histocytochemistry , Photomicrography , Lung/pathology , Rats, WistarABSTRACT
The purpose of this study was to evaluate the possibility of producing circulatory arrest by occlusion of the pulmonary trunk as an alternative to the venous inflow occlusion through the left hemithorax. Eight healthy mongrel dogs were divided in two groups. Group I underwent 4 minutes of outflow occlusion and Group II was submitted to 8 minutes of circulatory arrest. Outflow occlusion was performed through left thoracotomy and pericardiotomy by passing a Rumel tourniquet around the pulmonary trunk. Physical examination, electrocardiography, echocardiography, blood gas analyses, hemodynamic, and oxygen transport variables were obtained before and after the procedure. The dogs from Group I did not have any clinical, electrocardiographic, echocardiographic, or hemo-dynamic abnormalities after anesthetic recover. In the Group II, only one dog survived, which had no clinical, electrocardiographic, or echocardiographic abnormalities. In this last dog, just after releasing the occlusion, it was detected increases in the following parameters: heart rate (HR), systolic, diastolic and mean arterial blood pressure (SAP; DAP; MAP), pulmonary artery pressure (PAP), pulmonary wedge pressure (PWP), central venous pressure (CVP), cardiac output (CO), systolic index (SI), cardiac index (CI), left and right ventricular stroke work (LVSW; RVSW), oxygen delivery index (DO2), oxygen consumption index (VO2), and oxygen extraction (O2 ext). Moreover, the oxygen content of arterial and mixed venous blood (CaO2; CvO2), and the arterial and mixed venous partial pressure of oxygen (PaO2; PvO2) were decreased 5 minutes after circulatory arrest. Outflow occlusion is a feasible surgical procedure for period of 4 minutes of circulatory arrest.
O objetivo deste estudo foi avaliar a possibilidade de se produzir uma parada circulatória pela oclusão do tronco pulmonar, como alternativa ao "inflow occlusion", pelo hemitórax esquerdo. Oito cães sem raça definida foram divididos em dois grupos. O Grupo I foi submetido a quatro minutos de parada circulatória e o Grupo II, a 8 minutos de parada. Realizou-se o "outflow occlusion" por meio de toracotomia intercostal esquerda e pericardiotomia, passando-se um torniquete de Rumel ao redor do tronco pulmonar. Foram realizados exame físico, eletrocardiografia, ecocardiografia, hemogasometria, avaliação hemodinâmica e cálculo de variáveis de transporte de oxigênio, antes e após o procedimento. Os cães do Grupo I não sofreram alterações clínicas, eletrocardiográficas, ecocardiográficas e hemodinâmicas após a recuperação anestésica. No Grupo II, apenas um animal sobreviveu, sem apresentar alterações clínicas, eletrocardiográficas e ecocardiográficas. Neste cão, após a liberação do torniquete, houve aumento nas seguintes variáveis: freqüência cardíaca, pressões arteriais sistólica, média e diastólica, pressão arterial pulmonar, pressão da artéria pulmonar ocluída, pressão venosa central, débito cardíaco, índice sistólico, índice cardíaco, trabalho ventricular esquerdo e direito, índice de transporte de oxigênio, índice de consumo de oxigênio e taxa de extração de oxigênio. O conteúdo de oxigênio arterial e venoso misto e a pressão parcial de oxigênio arterial e venosa mista diminuíram, cinco minutos após a parada circulatória. Concluiu-se que o "outflow occlusion" é um procedimento viável para a realização de parada circulatória por um período de quatro minutos.