ABSTRACT
For children with diminished quality of life and chronic pain caused by acute recurrent or chronic pancreatitis who are undergoing total pancreatectomy with islet autotransplantation, postoperative nutrition support has several unique characteristics. Surgical complications may lead to delays in nutrition support initiation or require modifications to the regimen. Early postoperative dysmotility requires the use of temporary enteral nutrition until this improves. The resultant complete exocrine pancreatic insufficiency necessitates lifelong pancreatic enzyme replacement therapy and fat-soluble vitamin supplementation. A low-oxalate diet is recommended to prevent kidney stones. Carbohydrate counting is needed for the provision of short-term insulin dosing and possibly long-term as well, depending on the transplanted islet yield. Children should have careful nutrition assessment and monitoring at several follow-up visits during the first year, then annually, and at any time with concerns.
Subject(s)
Islets of Langerhans Transplantation , Pancreatitis, Chronic , Humans , Child , Pancreatectomy/adverse effects , Transplantation, Autologous , Quality of Life , Pancreatitis, Chronic/surgery , Pancreatitis, Chronic/complications , Treatment OutcomeABSTRACT
Understanding vascular development in vertebrates is an important scientific endeavor. Normal vasculatures generally start off as a disorganized capillary lattice which progressively matures into a well-organized vascular loop comprising a hierarchy of arteries and veins. One striking feature of vascular development is the interlacing of arteries and veins. How arteries and veins manage to avoid themselves and interlace with such a perfect architecture is not understood. Here we present a detailed view of the development of the vasculature in the chorioallantoic membrane of the chicken embryo. We find that the origin of arteriovenous interlacing lies in the presence of an increased hemodynamic resistance at the distal part of the arteries due to vascular flattening onto the ectodermal surface. This reduces the vascular conductance distally, thus repelling veins away. In more proximal parts, vessels round off into cylinders and the increased flow attracts veins.
ABSTRACT
Efficient photodynamic therapy with meta-tetra(hydroxyphenyl)chlorine requires the application of specific nanoformulations. mTHPC liposomal formulation (Foslip®) demonstrated favorable pharmacokinetics properties. However, rapid liposomes destruction in circulation and rapid mTHPC release impedes Foslip® applications. Alternatively, mTHPC nanovectorization using extracellular vesicles (EVs) could be an attractive option. EVs are naturally secreted by the organism to play a role in intercellular communication due to the capacity to transport proteins and nucleic acids. EVs also possess a natural ability to deliver therapeutic molecules into cancer cells. The aim of the present study was to evaluate photophysical and photobiological properties of mTHPC loaded in endothelial EVs as nanocarriers. We also studied efficiency of nanovectorisation on mTHPC distribution and PDT activity in multicellular tumor spheroids (MCTSs). MCTS is a nonvascularized in vitro 3D model of cells that mimics a similar microenvironment to in vivo situation. mTHPC-EVs were characterized by means of spectroscopic techniques, flow cytometry and nanoparticle tracking analysis. Compared with Foslip®, mTHPC-EVs are stable in murine plasma. Better mTHPC accumulation and penetration (up to 100 µm) in MCTS was observed for mTHPC-EVs compared with liposomal mTHPC. These factors could explain enhanced photodynamic activity of mTHPC-EVs compared with free and liposomal mTHPC. The light dose inducing 50% of cell death with mTHPC-EVs was 4 and 2.5-times lower than that of free and liposomal mTHPC. The obtained results demonstrate that EVs should be considered as perspective nanocarriers for mTHPC-mediated PDT.
