ABSTRACT
Progenitor cell transplantation has been considered as a potential angiogenesis therapy for the ischemic hindlimb. In this work we performed an ischemic hindlimb model in dogs. We ligated the middle sacra and the external right iliac arteries. After 7 days, the femoral artery was ligated and removed, and three Silastic tubes were inserted into the gracilis muscle to create fibrocollagenous tunnels. After Silastic implantation, we administered saline or granulocyte colony stimulating factor (G-CSF) subcutaneously daily during 5 days. Fourteen days after device positioning we transplanted bone marrow mononuclear cells (BMMC) into the tunnels previously formed by Silastic tube reaction. Twenty-eight days later, contrasted angiographies were performed and angiographic scores were calculated. Also, vessels and endothelial cells and proliferating cells were identified by immunochemistry of muscle sections. Results demonstrated that BMMC transplantation enriched by G-CSF administration significantly stimulates angiogenesis in the ischemic hindlimb, and more than BMMC transplantation alone. Transplantation of progenitor cells in an appropriate extracellular matrix is a potential therapy for hindlimb ischemia.
Subject(s)
Angiogenesis Inducing Agents/administration & dosage , Granulocyte Colony-Stimulating Factor/administration & dosage , Hindlimb/blood supply , Ischemia/surgery , Leukocytes, Mononuclear/transplantation , Neovascularization, Physiologic , Angiography , Animals , Collagen/analysis , Collagen/genetics , Disease Models, Animal , Dogs , Endothelial Cells/cytology , Endothelial Cells/drug effects , Ischemia/diagnostic imaging , Leukocytes, Mononuclear/drug effects , Statistics, NonparametricABSTRACT
BACKGROUND: Whether H. pylori infection plays a role in FD is ill defined; however, it is recommended to prescribe eradication treatment in patients with dyspepsia without alarm symptoms. Results of this advice are controversial, principally due to absence of instruments that provide an objective measure of changes in symptoms and quality of life. OBJECTIVE: Our aim was to evaluate significant changes in symptom severity and quality of life in patients with functional dyspepsia (FD) following Helicobacter pylori (H. pylori) eradication treatment. METHODS: We conducted an open clinical trial in adult patients with FD who were H. pylori-positive by means of 14C breath test. Treatment consisted of 2 weeks on lanzoprazole, amoxicillin, and clarithromycin. Score change on the severity of dyspepsia assessment (SODA) test instrument was used to evaluate modifications in symptom severity and quality of life. RESULTS: One hundred patients were included in this trial; treatment compliance was observed in 77% of these, while cure of H. pylori infection was obtained in 82.7% of patients. Only 11.7% displayed absence of dyspepsia symptoms and improvement in quality of life. No significant changes were obtained in global assessment nor in pain, or symptoms in health perception quality of life when initial SODA scores were compared with after-treatment results. CONCLUSIONS: There was no improvement of FD symptoms or quality of life after H. pylori eradication treatment.
Subject(s)
Dyspepsia/microbiology , Dyspepsia/physiopathology , Helicobacter Infections/drug therapy , Helicobacter pylori , Omeprazole/analogs & derivatives , 2-Pyridinylmethylsulfinylbenzimidazoles , Adult , Amoxicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Anti-Ulcer Agents/therapeutic use , Clarithromycin/therapeutic use , Drug Therapy, Combination , Female , Humans , Lansoprazole , Male , Middle Aged , Omeprazole/therapeutic use , Quality of LifeABSTRACT
Helicobacter pylori infection is relevant, due to its role in different gastric pathologies; there are several diagnostic methods, which are divided into invasive and non-invasive. In the first category histology has been considered the gold standard, while other methods include imprint with Gram stain and rapid urease test, which can produce dependable results. The aim of this study is to compare several available techniques for H. pylori diagnosis to know their sensitivity and specificity. We studied 88 patients, 50 women and 38 men, with age range from 17 to 83 years (48.8+/-14.3) from the Endoscopy Department of the 20 de Noviembre Medical Center; in all five to eight biopsies were taken from gastric mucosa to perform rapid urease test, Gram-stained imprint and histology. Endoscopic findings included gastritis (87.50%), pangastritis (2.30%) and another diagnoses (10.22%). Rapid urease test was positive in 40 patients and negative in 48, while imprint was 34 and 54, respectively. Sensitivity and specificity were as follows: rapid urease test, 84.8 and 78.5%, and imprint 75.8 and 83.6%, respectively. In conclusion, H. pylori diagnosis by rapid urease test is a dependable and quick method. On the other hand, imprint is useful but depends on the ability of the personnel who perform the test.
Subject(s)
Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Peptic Ulcer/pathology , Urease , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy , Breath Tests/methods , Cross-Sectional Studies , Female , Gastric Mucosa/microbiology , Gastric Mucosa/pathology , Gastritis/microbiology , Gastritis/pathology , Gastroscopy , Helicobacter Infections/microbiology , Humans , Male , Middle Aged , Peptic Ulcer/microbiology , Prospective Studies , Sensitivity and SpecificityABSTRACT
We established a comparative model of angiogenic induction in previously formed fibrocollagenous tunnels in rat inner thigh muscles. A unilateral hindlimb chronic ischemia model was performed in male Sprague-Dawley rats. A device was then inserted in the central portion of the inner thigh muscles. Vascularity in the ischemic limb was determined by means of an angiographic score, capillary/fiber ratio, and endothelial proliferation by histochemistry and immunohistochemistry. Autologous transplant of bone marrow, vascular endothelial growth factor (VEGF), or collagen-polyvinylpyrrolidone plus heparin induced significant vascularization of the ischemic hindlimb when compared to saline solution. However, the bone marrow group presented a higher angiographic score than the other two. No differences among groups were observed in capillary/fiber ratio or proliferation, except for the VEGF group, where capillary proliferating cells were significantly higher than in controls. Based on these results, bone marrow-derived progenitor cells may constitute a safe and viable alternative for the induction of therapeutic angiogenesis.