ABSTRACT
AIM: The purpose of this study was to examine the effects of N-acetylcysteine (NAC), calcium dobesilate (DOBE) and aprotinin on the amelioration of lung damage following ischemia/reperfusion injury in a rat hind limb model. A well known antioxidant dimethyl-sulfoxide (DMSO) was also tested for comparison. METHODS: Ischemia was induced in the lower limb for 4 h by vascular clamping and followed by 1 h of reperfusion. Lung injury was evaluated in 5 groups as a saline (control), DMSO, NAC, DOBE and aprotinin group. Plasma creatine kinase, lactate dehydrogenase, thiobarbituric acid reactive substances (TBARS) as well as lung tissue TBARS levels were measured. Lung tissue samples were taken for histological examination. P<0.005 was considered statistically significant. RESULTS: Plasma TBARS values were found to be significantly lower in the DMSO (P<0.005), NAC (P<0.005) and aprotinin (P<0.005) groups compared to the control group. Lung TBARS values were significantly lower in the DMSO, NAC, DOBE and aprotinin groups compared to the control group (P<0.001, P<0.001, P<0.001). Also in the aprotinin group lung TBARS values were found to be significantly lower compared to DMSO (P<0.001), NAC (P<0.001) and DOBE (P<0.001) groups. Histological examination showed less prominent peribronchial leukostasis (P<0.005) and interstitial leukostasis (P<0.005) in all drug groups compared to the control group. CONCLUSION: These observations indicate that DOBE and NAC, which are known to have antioxidant properties and aprotinin, a serine proteinase inhibitor, acted effectively on the prevention of lung injury in a rat hind limb ischemia/reperfusion model. The reason why aprotinin exerts a more protective effect than the other drugs is not clear, however, its clinical use may have the dual advantage of hemostasis and lung protection in surgical practice.
Subject(s)
Acetylcysteine/therapeutic use , Aprotinin/therapeutic use , Calcium Dobesilate/therapeutic use , Lower Extremity/blood supply , Reperfusion Injury/complications , Respiratory Distress Syndrome/drug therapy , Animals , Biomarkers/metabolism , Creatine Kinase/blood , Disease Models, Animal , Drug Therapy, Combination , Free Radical Scavengers/therapeutic use , Hemostatics/therapeutic use , L-Lactate Dehydrogenase/blood , Male , Rats , Rats, Sprague-Dawley , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/metabolism , Thiobarbituric Acid Reactive Substances/metabolism , Treatment OutcomeABSTRACT
BACKGROUND: Neo-intimal hyperplasia is one of the most common causes of failure of arterial patency following cardiovascular interventions. It has been proposed that clopidogrel and calcium dobesilate may play an important role in the amelioration of intimal hyperplasia. The aim of this study is to examine the effect of these agents on intimal hyperplasia occurring after experimental balloon catheter injury. MATERIAL AND METHODS: Twenty-four male New Zealand rabbits were divided into three groups. Endothelial injury was caused by introducing a 2.5 x 20 mm balloon angioplasty-catheter into the left iliac artery. After the procedure, clopidogrel (25 mg/kg/day/orally) or calcium dobesilate (100 mg/kg/day/orally) were given for 2 weeks. Eight rabbits were given a placebo and served as controls. The contralateral non-injured iliac arteries of the control group were considered as normal iliac artery samples. Iliac artery specimens were examined planimetrically and the intima/media ratio was obtained for each vessel. RESULTS: In the control group, the intima/media ratio was still significantly higher (p < 0.05) than the contralateral normal artery 14 days after the balloon catheter injury. In the clopidogrel and calcium dobesilate groups, this ratio had significantly decreased when compared with the control group (p < 0.05). No significant difference was found when the clopidogrel and calcium dobesilate groups were compared. CONCLUSION: The anti-agregant agent clopidogrel, and the venous endothelial regulator calcium dobesilate, ameliorate intimal hyperplasia after experimentally induced vascular injury in rabbit iliac arteries.
Subject(s)
Angioplasty, Balloon/adverse effects , Calcium Dobesilate/therapeutic use , Hemostatics/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Ticlopidine/analogs & derivatives , Tunica Intima/pathology , Animals , Calcium Dobesilate/pharmacology , Clopidogrel , Hemostatics/pharmacology , Hyperplasia/etiology , Hyperplasia/prevention & control , Iliac Artery/pathology , Male , Platelet Aggregation Inhibitors/pharmacology , Rabbits , Ticlopidine/pharmacology , Ticlopidine/therapeutic use , Tunica Intima/drug effects , Vascular Patency/drug effectsABSTRACT
Aortoduodenal fistulae are an unusual complication of aortic pathology or surgery and a life-threatening entity. The results of surgical treatment may be disappointing because of postoperative complications. We report here two cases and discuss the diagnostic investigations and characteristics of aortoduodenal fistulae.
Subject(s)
Aorta, Abdominal/pathology , Aortic Diseases/diagnosis , Duodenal Diseases/diagnosis , Intestinal Fistula/diagnosis , Vascular Fistula/diagnosis , Abscess/diagnosis , Aged , Aorta, Abdominal/surgery , Aortic Aneurysm, Abdominal/diagnosis , Blood Vessel Prosthesis/adverse effects , Femoral Artery/surgery , Gastrointestinal Hemorrhage/diagnosis , Humans , Male , Middle Aged , Postoperative Complications , Prosthesis-Related Infections/diagnosisABSTRACT
Obturator bypass is the preferred method when infectious groin problems are challenging. However, this method can not be applied either in some special settings including the dissemination of the infection towards retroperitoneum and some technical difficulties in handling obturator bypass area (like fibrosis and inability to expose the obturator foramen). We present an alternative bypass method in two cases.
