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1.
Acta Cir Bras ; 28(2): 126-30, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23370926

ABSTRACT

PURPOSE: To investigate the consequences of the association between hyperbaric oxygen therapy and hepatic ischemia / reperfusion. METHODS: Wistar rats were divided into three groups: SHAM, rats submitted to surgical stress and anesthetic but not hepatic ischemia or reperfusion, I / R, rats submitted to total hepatic pedicle ischemia for 30 min, followed by 5 min of reperfusion; HBO120, rats submitted to 120 min of hyperbaric oxygen therapy at two absolute atmospheres and immediately after submitted to the experimental protocol of ischemia and reperfusion. The preservation of the hepatic function was evaluated by determining mitochondrial swelling and malondialdehyde tissue level, as well as alanine aminotransferase and aspartate aminotranferase serum levels. The results were analyzed using the Mann-Whitney test and differences were considered significant for p<0.05. RESULTS: There were significant differences in values: mitochondrial swelling of the I / R group compared to SHAM and HBO120; malondialdehyde between SHAM vs. I / R, SHAM vs HBO120, and I / R vs HBO120, alanine aminotransferase between SHAM vs. I / R . There was no significant difference between groups in aspartate aminotransferase serum levels. CONCLUSION: The association between hyperbaric oxygen therapy and hepatic ischemia and reperfusion process was positive.


Subject(s)
Hyperbaric Oxygenation , Ischemia/therapy , Liver/blood supply , Reperfusion Injury/therapy , Alanine Transaminase/blood , Animals , Aspartate Aminotransferases/blood , Disease Models, Animal , Ischemia/pathology , Liver/pathology , Male , Malondialdehyde/chemistry , Mitochondrial Swelling/physiology , Rats , Rats, Wistar , Statistics, Nonparametric
2.
Acta Cir Bras ; 28 Suppl 1: 61-5, 2013.
Article in English | MEDLINE | ID: mdl-23381826

ABSTRACT

PURPOSE: To analyze the effects of hyperbaric oxygen therapy on liver function in rats previously subjected to ischemia and reperfusion. METHODS: A randomly distribution of 23 Wistar rats was conducted into three groups: SHAM, animals subjected to surgical stress without restricting blood flow by clamping the hepatic pedicle, IR, rats underwent hepatic vascular occlusion intermittently for two complete cycles of 15 minutes of ischemia followed by 5 min of reperfusion, IR / HBO, rats underwent hepatic pedicle clamping and thereafter exposed to hyperbaric oxygen pressure of 2 absolute atmospheres for 60 minutes. We evaluated liver function through mitochondrial function, determined by the stages 3 and 4 of respiration, respiratory control ratio (RCR) and mitochondrial permeability transition (Swelling). Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also quantified . We analyzed the results using the Mann-Whitney test and were considered significant all results with p <0.05. RESULTS: There were significant differences between the results of stage 3 in SHAM vs IR group ; of the stage 4 in the groups IR vs SHAM and SHAM vs IR /HBO; of the Respiratory Control Ratio (RCR) in the group IR vs IR / HBO ; of alanine aminotransferase in the groups IR vs SHAM , SHAM vs IR/HBO and IR vs IR / HBO; aspartate aminotransferase in the groups SHAM vs IR and SHAM vs IR / HBO. CONCLUSION: The whole analysis of the mitochondrial function indicators permits us to conclude that the hyperbaric oxygen therapy acted as a protective agent of the mitochondrial function, minimizing the ischemia-reperfusion injury of the hepatic parenchyma.


Subject(s)
Hyperbaric Oxygenation , Liver/blood supply , Reperfusion Injury/prevention & control , Alanine Transaminase/blood , Animals , Aspartate Aminotransferases/blood , Cell Respiration , Liver/physiopathology , Male , Mitochondria , Mitochondria, Liver/physiology , Protective Agents , Random Allocation , Rats , Rats, Wistar , Reperfusion , Reperfusion Injury/blood
3.
Acta Cir Bras ; 28 Suppl 1: 66-71, 2013.
Article in English | MEDLINE | ID: mdl-23381827

ABSTRACT

PURPOSE: to assess the effect of hyperbaric oxygen (HBO) as pre-conditioning on periodic liver ischemia/reperfusion injury. METHODS: Thirty-six male Wistar rats were divided into 4 groups (SHAM, I/R , HBO-I/R and CONTROL). The surgical technique consisted of total clamping of the hepatic pedicle for 15 min followed by twice repeated reperfusion for 5 min (unclamping). HBO was applied in a collective chamber (simultaneous exposure of 4 rats) directly pressurized with oxygen at 2 ATA for 60 min. Hepatic mitochondrial function was determined using samples of the median lobe obtained after exactly 5 min of reperfusion for the analysis of mitochondrial respiration based on the determination of states 3 and 4, the respiratory control ratio and the transition of mitochondrial permeability (mitochondrial swelling).Data were analyzed by the Mann-Whitney test and the level of significance was set at p < 0.05. RESULTS: There was a statistically significant difference (p < 0.05) in state 3 between the CONTROL and I/R and HBO-I/R groups, in state 4 between the CONTROL and I/R and HBO-I/R groups; in respiratory control ratio (RCR) between the CONTROL and I/R and HBO-I/R groups and between the CONTROL and Sham groups, and in mitochondrial swelling between the CONTROL and I/R and HBO-/R groups and between the Sham and I/R and HBO-I/R groups. CONCLUSION: In this process of periodic ischemia and reperfusion, hyperbaric pre-conditioning did not improve significantly hepatic mitochondrial function.


Subject(s)
Hyperbaric Oxygenation , Ischemic Preconditioning/methods , Mitochondria, Liver/physiology , Reperfusion Injury/therapy , Animals , Cell Respiration , Disease Models, Animal , Liver/physiopathology , Male , Oxygen Consumption , Rats , Rats, Wistar , Reperfusion , Reperfusion Injury/physiopathology
4.
Acta cir. bras ; 28(2): 126-130, Feb. 2013. graf
Article in English | LILACS | ID: lil-662360

ABSTRACT

PURPOSE: To investigate the consequences of the association between hyperbaric oxygen therapy and hepatic ischemia / reperfusion. METHODS: Wistar rats were divided into three groups: SHAM, rats submitted to surgical stress and anesthetic but not hepatic ischemia or reperfusion, I / R, rats submitted to total hepatic pedicle ischemia for 30 min, followed by 5 min of reperfusion; HBO120, rats submitted to 120 min of hyperbaric oxygen therapy at two absolute atmospheres and immediately after submitted to the experimental protocol of ischemia and reperfusion. The preservation of the hepatic function was evaluated by determining mitochondrial swelling and malondialdehyde tissue level, as well as alanine aminotransferase and aspartate aminotranferase serum levels. The results were analyzed using the Mann-Whitney test and differences were considered significant for p<0.05. RESULTS: There were significant differences in values: mitochondrial swelling of the I / R group compared to SHAM and HBO120; malondialdehyde between SHAM vs. I / R, SHAM vs HBO120, and I / R vs HBO120, alanine aminotransferase between SHAM vs. I / R . There was no significant difference between groups in aspartate aminotransferase serum levels. CONCLUSION: The association between hyperbaric oxygen therapy and hepatic ischemia and reperfusion process was positive.


Subject(s)
Animals , Male , Rats , Hyperbaric Oxygenation , Ischemia/therapy , Liver/blood supply , Reperfusion Injury/therapy , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Disease Models, Animal , Ischemia/pathology , Liver/pathology , Malondialdehyde/chemistry , Mitochondrial Swelling/physiology , Rats, Wistar , Statistics, Nonparametric
5.
Acta cir. bras ; 28(supl.1): 61-65, 2013. ilus
Article in English | LILACS | ID: lil-663894

ABSTRACT

PURPOSE: To analyze the effects of hyperbaric oxygen therapy on liver function in rats previously subjected to ischemia and reperfusion. METHODS: A randomly distribution of 23 Wistar rats was conducted into three groups: SHAM, animals subjected to surgical stress without restricting blood flow by clamping the hepatic pedicle, IR, rats underwent hepatic vascular occlusion intermittently for two complete cycles of 15 minutes of ischemia followed by 5 min of reperfusion, IR / HBO, rats underwent hepatic pedicle clamping and thereafter exposed to hyperbaric oxygen pressure of 2 absolute atmospheres for 60 minutes. We evaluated liver function through mitochondrial function, determined by the stages 3 and 4 of respiration, respiratory control ratio (RCR) and mitochondrial permeability transition (Swelling). Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also quantified . We analyzed the results using the Mann-Whitney test and were considered significant all results with p <0.05. RESULTS: There were significant differences between the results of stage 3 in SHAM vs IR group ; of the stage 4 in the groups IR vs SHAM and SHAM vs IR /HBO; of the Respiratory Control Ratio (RCR) in the group IR vs IR / HBO ; of alanine aminotransferase in the groups IR vs SHAM , SHAM vs IR/HBO and IR vs IR / HBO; aspartate aminotransferase in the groups SHAM vs IR and SHAM vs IR / HBO. CONCLUSION: The whole analysis of the mitochondiral function indicators permits us to conclude that the hyperbaric oxygen therapy acted as a protective agent of the mitochondrial function, minimizing the ischemia-reperfusion injury of the hepatic parenchyma.


OBJETIVO: Analisar os efeitos da oxigenoterapia hiperbárica sobre a função hepática de ratos previamente submetidos à isquemia e reperfusão. MÉTODOS: Realizou-se a distribuição aleatória de 23 ratos Wistar em três grupos: SHAM, animais submetidos ao estresse cirúrgico sem restrição de fluxo sanguíneo por clampeamento do pedículo hepático; IR ratos submetidos a oclusão vascular hepática de maneira intermitente em dois ciclos completos de 15 minutos de isquemia, seguidos por 5 min de reperfusão; IR/HBO, ratos submetidos ao clampeamento do pedículo hepático e ,ulteriormente , expostos a oxigenoterapia hiperbárica a pressão de 2 atmosferas absolutas durante 60 minutos. Avaliou-se a função hepática através da função mitocondrial, determinada pelos estados 3 e 4 da respiração mitocondrial, razão de controle respiratório(RCR) e transição de permeabilidade mitocondrial (Swelling) .Quantificou-se também alanina aminotransferase e aspartato aminotransferase séricas. Analisou-se os resultados pelo teste de Mann-Whitney e foram considerados significativos os valores de p < 0,05. RESULTADOS:Houve diferença significativa nos valores do estado 3 no grupo SHAM vs IR; estado 4 nos grupos SHAM vs IR, SHAM vsIR/HBO; Razão de Controle Respiratório(RCR) no grupo IR vs IR/HBO; alanina aminotransferase nos grupos SHAM vs IR, SHAM vs IR/HBO, IR vs IR/HBO; aspartato aminotransferase nos grupos SHAM vs IR , SHAM vs IR/HBO. CONCLUSÃO: A análise dos parâmetros mitocondriais como um todo permitiu concluir que a oxigenoterapia hiperbárica atuou como agente protetor da função mitocondrial, minimizando os efeitos deletérios da lesão de isquemia e reperfusão do parênquima hepático.


Subject(s)
Animals , Male , Rats , Hyperbaric Oxygenation , Liver/blood supply , Reperfusion Injury/prevention & control , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Cell Respiration , Liver/physiopathology , Mitochondria , Mitochondria, Liver/physiology , Protective Agents , Random Allocation , Rats, Wistar , Reperfusion , Reperfusion Injury/blood
6.
Acta cir. bras ; 28(supl.1): 66-71, 2013. ilus
Article in English | LILACS | ID: lil-663895

ABSTRACT

PURPOSE: to assess the effect of hyperbaric oxygen (HBO) as pre-conditioning on periodic liver ischemia/reperfusion injury. METHODS: Thirty-six male Wistar rats were divided into 4 groups (SHAM, I/R , HBO-I/R and CONTROL). The surgical technique consisted of total clamping of the hepatic pedicle for 15 min followed by twice repeated reperfusion for 5 min (unclamping). HBO was applied in a collective chamber (simultaneous exposure of 4 rats) directly pressurized with oxygen at 2 ATA for 60 min. Hepatic mitochondrial function was determined using samples of the median lobe obtained after exactly 5 min of reperfusion for the analysis of mitochondrial respiration based on the determination of states 3 and 4, the respiratory control ratio and the transition of mitochondrial permeability (mitochondrial swelling).Data were analyzed by the Mann-Whitney test and the level of significance was set at p < 0.05. RESULTS: There was a statistically significant difference (p< 0.05) in state 3 between the CONTROL and I/R and HBO-I/R groups, in state 4 between the CONTROL and I/R and HBO-I/R groups; in respiratory control ratio (RCR) between the CONTROL and I/R and HBO-I/R groups and between the CONTROL and Sham groups, and in mitochondrial swelling between the CONTROL and I/R and HBO-/R groups and between the Sham and I/R and HBO-I/R groups. CONCLUSION: In this process of periodic ischemia and reperfusion, hyperbaric pre-conditioning did not improve significantly hepatic mitochondrial function.


OBJETIVO: Avaliar os efeitos da oxigenoterapia hiperbárica (HBO), como pré-condicionamento, em lesão hepática de isquemia/reperfusão intermitente. MÉTODOS: Foram avaliados 36 ratos Wistar machos, distribuídos em 4 grupos (SHAM, I/R , HBO - I/R e CONTROLE). A técnica operatória consistiu em pinçamento total do pedículo hepático durante 15min, seguido de reperfusão por 5 min (desclampeamento), por duas vezes. A aplicação de HBO foi realizada em câmara coletiva (exposição simultânea de 4 ratos) diretamente pressurizada com oxigênio a 2ATA, durante 60min. Determinou-se a função mitocondrial hepática através de amostras do lobo mediano colhidas com exatos 5min de reperfusão para análise da respiração mitocondrial, através da determinação dos estados 3 e 4, razão de controle respiratório e transição de permeabilidade mitocondrial (intumescimento osmótico - swelling mitocondrial).Os resultados foram analisados pelo teste de Mann-Whitney e foi considerado significativo todo valor de p < 0,05. RESULTADOS: Houve diferença estatistica significativa (p< 0,05) no Estado 3 nos grupos CONTROLE vs I/R e HBO - I/R, no Estado 4 nos grupos CONTROLE vs I/R e HBO - I/R; na Razão de controle respiratório(RCR) nos grupos CONTROLE vs I/R e HBO-IRe CONTROLE vs Sham e no Swelling mitocondrial nos grupos CONTROLE vs I/R e HBO - I/R, I/R vs HBO-IRe Sham vs I/R e HBO-IR. CONCLUSÃO: O pré-condicionamento hiperbárico não melhorou a função mitocondrial hepática significativamente neste processo de isquemia e reperfusão intermitente.


Subject(s)
Animals , Male , Rats , Hyperbaric Oxygenation , Ischemic Preconditioning/methods , Mitochondria, Liver/physiology , Reperfusion Injury/therapy , Cell Respiration , Disease Models, Animal , Liver/physiopathology , Oxygen Consumption , Rats, Wistar , Reperfusion , Reperfusion Injury/physiopathology
7.
Acta cir. bras ; 26(6): 530-534, Nov.-Dec. 2011. ilus, tab
Article in English | LILACS | ID: lil-604205

ABSTRACT

PURPOSE: To analyze pre-, intra- and immediate postoperative parameters of patients submitted to liver transplantation. METHODS: Eighty-three consecutive orthotopic liver transplants performed from January 2009 to July 2011 were analyzed. The patients were divided into 2 groups: A, survivors (MELD between 9 and 60) and B, non-survivors (MELD between 14 and 40), with 30.6 percent of group A patients being CHILD C, 51℅ CHILD B and 18,4℅ CHILD A. In group B ,32.1℅ of the patients were CHILD C, 42,9℅ CHILD B, and 25℅ CHILD A. All orthotopic liver transplantations were performed using the piggyback technique without a portacaval shunt. Systemic arterial pressure and serum ALT and AST levels were determined preoperatively and 5, 60 and 1440 minutes after arterial graft revascularization. Serum ALT and AST profiles were evaluated for seven days after surgery. RESULTS: Systemic arterial blood pressure levels, time of hot and hypothermic ischemia and time of graft implant were statistically similar for the two groups (p>0.05). Serum levels (U/L) of ALT and AST at the 5, 60 and 1440 minute time points after arterial revascularization of the graft were also similar for the two groups studied, as also were the serum ALT and AST profiles. CONCLUSIONS: No statistically significant difference in any of the parameters studied was detected between the two groups. Under the conditions of the present study and on the basis of the parameters evaluated, no direct relation was detected between the intraoperative period and the type of patient outcome in the two groups studied.


OBJETIVO: Analisar parâmetros do pré, intra e pós-operatório imediato de pacientes submetidos ao transplante de fígado. MÉTODOS: Foram analisados 83 transplantes ortotópicos de fígado realizados consecutivamente no período janeiro de 2009 a julho de 2011. Os pacientes foram dividos em dois grupos: A, survivors (MELD entre 16 e 60), e B, non-survivors (MELD entre 14 e 40) sendo que 30,6℅ dos pacientes do grupo A eram CHILD C, 51℅ CHILD B e 18,4℅ CHILD A. No grupo B, 32,1℅ dos pacientes eram CHILD C, 42,9℅ CHILD B, e 25℅ CHILD A. Todos os transplantes ortotópicos de fígado foram feitos com a técnica de piggyback sem "shunt" porto cava. Foram analisados os valores de pressão arterial sistêmica e os níveis séricos de ALT e AST, no pré-operatório, 5, 60 e 1440 minutos após revascularização arterial do enxerto. Avaliaram-se os perfis séricos da ALT e AST durante sete dias de pós-operatorio. RESULTADOS: Verificou-se que em ambos os grupos, os níveis de pressão arterial sistêmica, os tempos de isquemia normotérmica, hipotérmica e de implante do enxerto foram estatisticamente semelhantes (p>0,05). Os níveis séricos (U/L) de ALT e AST nos tempos de 5, 60 e 1440 minutos após a revascularização arterial do enxerto também foram semelhantes nos grupos estudados. Os perfis séricos da ALT e AST foram semelhantes nos dois grupos estudados. CONCLUSÕES: Não se verificou diferença estatisticamente significante entre todos os parâmetros estudados, em ambos os grupos. Nas condições do presente estudo, não se verificou relação direta do intra-operatório com o tipo de evolução (outcome) dos pacientes nos dois grupos estudados.


Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , End Stage Liver Disease/surgery , Liver Transplantation , Blood Pressure , Brazil , Biomarkers/blood , End Stage Liver Disease/enzymology , End Stage Liver Disease/mortality , Liver Transplantation/mortality , Liver Transplantation/statistics & numerical data , Perioperative Period , Retrospective Studies , Survival Analysis , Time Factors , Treatment Outcome
8.
Acta Cir Bras ; 26(6): 530-4, 2011 12.
Article in English | MEDLINE | ID: mdl-22042119

ABSTRACT

PURPOSE: To analyze pre-, intra- and immediate postoperative parameters of patients submitted to liver transplantation. METHODS: Eighty-three consecutive orthotopic liver transplants performed from January 2009 to July 2011 were analyzed. The patients were divided into 2 groups: A, survivors (MELD between 9 and 60) and B, non-survivors (MELD between 14 and 40), with 30.6% of group A patients being CHILD C, 51℅ CHILD B and 18,4℅ CHILD A. In group B, 32.1℅ of the patients were CHILD C, 42,9℅ CHILD B, and 25℅ CHILD A. All orthotopic liver transplantations were performed using the piggyback technique without a portacaval shunt. Systemic arterial pressure and serum ALT and AST levels were determined preoperatively and 5, 60 and 1440 minutes after arterial graft revascularization. Serum ALT and AST profiles were evaluated for seven days after surgery. RESULTS: Systemic arterial blood pressure levels, time of hot and hypothermic ischemia and time of graft implant were statistically similar for the two groups (p>0.05). Serum levels (U/L) of ALT and AST at the 5, 60 and 1440 minute time points after arterial revascularization of the graft were also similar for the two groups studied, as also were the serum ALT and AST profiles. CONCLUSIONS: No statistically significant difference in any of the parameters studied was detected between the two groups. Under the conditions of the present study and on the basis of the parameters evaluated, no direct relation was detected between the intraoperative period and the type of patient outcome in the two groups studied.


Subject(s)
Alanine Transaminase/blood , Aspartate Aminotransferases/blood , End Stage Liver Disease/surgery , Liver Transplantation , Adolescent , Adult , Aged , Biomarkers/blood , Blood Pressure , Brazil , Child , End Stage Liver Disease/enzymology , End Stage Liver Disease/mortality , Female , Humans , Liver Transplantation/mortality , Liver Transplantation/statistics & numerical data , Male , Middle Aged , Perioperative Period , Retrospective Studies , Survival Analysis , Time Factors , Treatment Outcome , Young Adult
9.
Acta Cir Bras ; 26 Suppl 2: 120-4, 2011.
Article in English | MEDLINE | ID: mdl-22030827

ABSTRACT

PURPOSE: The aim of the present study was to assess the advantages and disadvantages of liver vascular partial exclusion (LVPE) (liver dysfunction due to ischemia) during liver resection in patients submitted to partial hepatectomy. METHODS: A total of 114 patients were submitted to partial hepatectomy (minor versus major resections) with LPVE being used in 57 of them but not in the remaining 57. Patient age ranged from 35 to 73 years and 57 % were women. Mitochondrial function was assessed 30 minutes after liver resection in the remnant liver and serum aminotransferases were determined before surgery and for seven days postoperatively. LPVE time ranged from 30 to 60 minutes. Data were analyzed statistically by the Student T test (5 % level of significance). RESULTS: Mitochondrial function was similar in the minor and major liver resections. The maximum postoperative aminotransferase peak was similar in the groups with and without LPVE. CONCLUSION: LPVE did not induce mitochondrial changes in hepatic tissue in either type of surgery, and aminotransferase levels were similar for patients with and without LPVE. Thus, the results show that LPVE is a safe procedure that does not induce the significant changes typical of ischemia and reperfusion in the liver remnant.


Subject(s)
Hepatectomy/methods , Liver/physiology , Mitochondria, Liver/physiology , Adult , Aged , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Female , Humans , Liver/blood supply , Liver/enzymology , Liver/surgery , Liver Function Tests , Male , Middle Aged , Postoperative Period , Time Factors , Treatment Outcome
10.
Acta cir. bras ; 26(supl.2): 120-124, 2011. ilus, graf
Article in English | LILACS | ID: lil-602656

ABSTRACT

PURPOSE: The aim of the present study was to assess the advantages and disadvantages of liver vascular partial exclusion (LVPE) (liver dysfunction due to ischemia) during liver resection in patients submitted to partial hepatectomy. METHODS: A total of 114 patients were submitted to partial hepatectomy (minor versus major resections) with LPVE being used in 57 of them but not in the remaining 57. Patient age ranged from 35 to 73 years and 57 percent were women. Mitochondrial function was assessed 30 minutes after liver resection in the remnant liver and serum aminotransferases were determined before surgery and for seven days postoperatively. LPVE time ranged from 30 to 60 minutes. Data were analyzed statistically by the Student T test (5 percent level of significance). RESULTS: Mitochondrial function was similar in the minor and major liver resections. The maximum postoperative aminotransferase peak was similar in the groups with and without LPVE. CONCLUSION: LPVE did not induce mitochondrial changes in hepatic tissue in either type of surgery, and aminotransferase levels were similar for patients with and without LPVE. Thus, the results show that LPVE is a safe procedure that does not induce the significant changes typical of ischemia and reperfusion in the liver remnant.


OBJETIVO: Avaliar as vantagens e desvantagens da oclusão vascular parcial do fígado durante ressecções hepáticas parciais. MÉTODOS: Cento e quatorze pacientes foram submetidos a hepatectomia parcial(ressecção maior versus ressecção menor) com liver partial vascular exclusion (LPVE) sendo utilizada em 57 deles. A idade dos pacientes variou entre 35 e 73 anos e 57 por cento deles eram mulheres. A função mitocondrial foi avaliada por método polarografico avaliada 30 minutos após a ressecção hepática no fígado remanescente, e o perfil das aminotransferase foi determinado antes da cirurgia e durante sete dias de pós-operatório. A EVPH variou de 30 a 60 minutos. Dados foram analisados estatisticamente pelo teste T Student (nível de significância de 5 por cento). RESULTADOS: Nas ressecções hepáticas maiores e menores, a função mitocondrial do fígado remanescente foi semelhante dos dois grupos. O pico máximo de aminotransferases ocorreu as 24 horas de pós-operatório e o perfil enzimático de ALT e AST foi semelhante nos grupos estudados ( minor vs major hepatectomy.) CONCLUSÃO: A EVPH não induziu alterações mitocondriais no tecido hepático em qualquer tipo de cirurgia, e os níveis de aminotransferases foram similares para pacientes hepatectomizados com e sem LPVE.Assim a LPVE foi um procedimento seguro que não induziu alterações significativas típicos de isquemia e reperfusão no fígado remanescente.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Hepatectomy/methods , Liver/physiology , Mitochondria, Liver/physiology , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Liver Function Tests , Liver/blood supply , Liver/enzymology , Liver/surgery , Postoperative Period , Time Factors , Treatment Outcome
11.
Acta cir. bras ; 25(2): 206-213, Mar.-Apr. 2010. graf, tab
Article in English | LILACS | ID: lil-540498

ABSTRACT

Purpose: Standardization of a simple and low cost technique of exhaled breath condensate (EBC) collection to measure nitrite. Methods: Two devices were mounted in polystyrene boxes filled either with crushed ice/salt crystals or dry ice/crushed ice. Blood samples were stored at -70º C for posterior nitrite dosages by chemiluminescence and the Griess reaction. Results: a) The use of crushed ice/dry ice or salt revealed sufficient EBC room air collection, but was not efficient for patients under ventilation support; b) the method using crushed ice/salt collected greater EBC volumes, but the nitrite concentrations were not proportional to the volume collected; c) The EBC nitrite values were higher in the surgical group using both methods; d) In the surgical group the nasal clip use diminished the EBC nitrite concentrations in both methods. Conclusions: The exhaled breath condensate (EBC) methodology collection was efficient on room air breathing. Either cooling methods provided successful EBC collections showing that it is possible to diminish costs, and, amongst the two used methods, the one using crushed ice/salt crystals revealed better efficiency compared to the dry ice method.


Objetivo: Padronizar técnica simples e barata de coleta do condensado do ar exalado pulmonar (CEP) para medir nitrito. Métodos: Dois dispositivos foram montados em caixas de isopor e preenchidos com gelo picado/sal grosso ou gelo picado/gelo seco. Amostras de sangue foram armazenadas a -70º C para dosagem de nitrito por quimiluminescência e pela reação de Griess. Resultados: a) a utilização de gelo picado/gelo seco ou sal foi eficiente para a coleta em respiração espontânea, mas ineficiente durante ventilação mecânica; b) o método gelo picado/sal coletou volumes maiores, sem aumento proporcional do nitrito; c) os valores do nitrito foram mais elevados no grupo cirúrgico utilizando os dois métodos; d) no grupo cirúrgico com clipe nasal ocorreu diminuição do nitrito em ambos os métodos. Conclusões: A metodologia do condensado do ar exalado pulmonar (CEP) foi eficiente na coleta respirando em ar ambiente. Os dois métodos de congelamento foram eficientes mostrando que é possível diminuir os custos, e, entre os dois métodos utilizados, o uso de gelo picado/sal mostrou melhor eficiência quanto ao volume da coleta do CEP em comparação com o uso de gelo seco.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Breath Tests/methods , Nitrites/analysis , Biomarkers/analysis , Breath Tests/instrumentation , Case-Control Studies , Costs and Cost Analysis , Ethylenediamines , Luminescence , Sulfanilamides
12.
Acta Cir Bras ; 25(2): 206-13, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20305890

ABSTRACT

PURPOSE: Standardization of a simple and low cost technique of exhaled breath condensate (EBC) collection to measure nitrite. METHODS: Two devices were mounted in polystyrene boxes filled either with crushed ice/salt crystals or dry ice/crushed ice. Blood samples were stored at -70 degrees C for posterior nitrite dosages by chemiluminescence and the Griess reaction. RESULTS: a) The use of crushed ice/dry ice or salt revealed sufficient EBC room air collection, but was not efficient for patients under ventilation support; b) the method using crushed ice/salt collected greater EBC volumes, but the nitrite concentrations were not proportional to the volume collected; c) The EBC nitrite values were higher in the surgical group using both methods; d) In the surgical group the nasal clip use diminished the EBC nitrite concentrations in both methods. CONCLUSIONS: The exhaled breath condensate (EBC) methodology collection was efficient on room air breathing. Either cooling methods provided successful EBC collections showing that it is possible to diminish costs, and, amongst the two used methods, the one using crushed ice/salt crystals revealed better efficiency compared to the dry ice method.


Subject(s)
Breath Tests/methods , Nitrites/analysis , Adult , Aged , Biomarkers/analysis , Breath Tests/instrumentation , Case-Control Studies , Costs and Cost Analysis , Ethylenediamines , Female , Humans , Luminescence , Male , Middle Aged , Sulfanilamides , Young Adult
13.
Rev. bras. ter. intensiva ; 21(2): 204-211, abr.-jun. 2009.
Article in English, Portuguese | LILACS | ID: lil-521500

ABSTRACT

A produção endógena de óxido nítrico pode ser detectada e monitorada no ar exalado de homens e animais. O óxido nítrico exalado tem se tornado um instrumento valioso de diagnóstico e monitorização da inflamação e estresse oxidativo dos pulmões. Dessa forma, a presente revisão foi elaborada com a intenção de discutir o papel do óxido nítrico no condensado do exalado pulmonar como uma ferramenta útil em investigações de disfunções respiratórias na unidade de tratamento intensivo. Observa-se, na literatura especializada, um aumento do interesse no uso do condensado do exalado pulmonar como um método não invasivo para investigar doenças pulmonares. Entretanto, praticamente não existe um método padronizado para a sua coleta, ressaltando-se que o uso de vários métodos de assistência respiratória dificulta a comparação de diferentes estudos. O conteúdo da revisão aponta para prováveis dificuldades da utilização rotineira do condensado exalado pulmonar em pacientes internados em unidades de terapia intensiva, principalmente quando submetidos à ventilação mecânica. Estudos específicos e tecnologias ainda são necessários para que o condensado exalado pulmonar se torne uma ferramenta rotineira de pesquisas e monitorização de pacientes gravemente enfermos com comprometimento do sistema respiratório. A literatura aponta para a realização de esforços nessa direção.


Endogenous production of nitric oxide can be detected and monitored in exhaled air of men and animals. The main objective of this review was to discuss if nitric oxide in exhaled breath condensate is a useful tool when investigating respiratory dysfunctions in intensive care units. Specialized literature reveals an increasing interest in the use of exhaled breath condensate as a non-invasive method to investigate pulmonary disease. However, a standardized method for its collection is lacking, and use of different methods of respiratory support complicates comparison among different studies. In addition, the same specialized literature review emphasized possible difficulties for routine use of the exhaled breath condensate in intensive care patients, mainly under mechanical ventilation. Until exhaled breath condensate becomes a routine tool of research and monitoring of intensive care patients, more specific studies and technologies are still necessary. Its importance has been related to physiological control of the pulmonary function and to physiopathology of pulmonary disease involving chronic inflammation and oxidative stress.

14.
Rev Bras Ter Intensiva ; 21(2): 204-11, 2009 Jun.
Article in English, Portuguese | MEDLINE | ID: mdl-25303352

ABSTRACT

Endogenous production of nitric oxide can be detected and monitored in exhaled air of men and animals. The main objective of this review was to discuss if nitric oxide in exhaled breath condensate is a useful tool when investigating respiratory dysfunctions in intensive care units. Specialized literature reveals an increasing interest in the use of exhaled breath condensate as a non-invasive method to investigate pulmonary disease. However, a standardized method for its collection is lacking, and use of different methods of respiratory support complicates comparison among different studies. In addition, the same specialized literature review emphasized possible difficulties for routine use of the exhaled breath condensate in intensive care patients, mainly under mechanical ventilation. Until exhaled breath condensate becomes a routine tool of research and monitoring of intensive care patients, more specific studies and technologies are still necessary. Its importance has been related to physiological control of the pulmonary function and to physiopathology of pulmonary disease involving chronic inflammation and oxidative stress.

15.
Dig Dis Sci ; 52(10): 2610-5, 2007 Oct.
Article in English | MEDLINE | ID: mdl-17410446

ABSTRACT

This study was designed to evaluate the influence of hemorrhagic shock on hepatic regeneration in rats submitted to partial hepatectomy. The experimental protocol included 26 male Wistar rats, randomly assigned to 4 groups: GI: simulated operation; GII: 30% hepatectomy without hemorrhagic shock; GIII: only hemorrhagic shock; GIV: 30% hepatectomy associated with hemorrhagic shock. The methodologies used were: determination of aminotranspherases plasma levels; analysis of mitochondrial respiration, membrane potential and osmotic swelling; and markers of hepatocellular replication. Aminotranspherases increased only in GIV. There were no differences in mitochondrial respiration. Mitochondrial membrane potential decreased only in the GIV. There were no differences in mitochondrial swelling among the groups; cellular replication markers increased significantly in the Groups II and IV but without difference between these two groups. Despite the conditions imposed on the organism by hemorrhagic shock, the hepatic regenerative capacity is preserved in animals submitted to partial hepatectomy.


Subject(s)
Hepatectomy/methods , Liver Regeneration/physiology , Mitochondria, Liver/metabolism , Shock, Hemorrhagic/metabolism , Animals , Biomarkers/metabolism , Blood Loss, Surgical , Cell Division , Disease Models, Animal , Follow-Up Studies , Male , Membrane Potential, Mitochondrial , Proliferating Cell Nuclear Antigen/metabolism , Rats , Rats, Wistar , Severity of Illness Index , Shock, Hemorrhagic/etiology , Shock, Hemorrhagic/pathology , Spectrometry, Fluorescence , Spectrophotometry , Transaminases/metabolism
16.
Acta Cir Bras ; 21 Suppl 1: 19-23, 2006.
Article in English | MEDLINE | ID: mdl-17013507

ABSTRACT

PURPOSE: Hepatic ischemia and reperfusion can cause several problems in hepatic surgery. The aim of this study was to determine pyruvate kinase activation and lipid peroxidation after hepatic ischemia. METHODS: Twenty-four Wistar rats were submitted to 90 minutes of selective liver ischemia and 15 minutes of reperfusion. Twelve animals were submitted to selective liver ischemia and reperfusion (Group A) and the other 12 were submitted to sham operation (Group B). After 15 minutes of reperfusion, the following parameters were measured: mean arterial pressure (MAP), alanine aminotransferase (ALT), glycemia (GLY), hepatic glycogen (GH), pyruvate kinase (PK) activation, hepatic glutathione (GSH) and malondialdehyde (MDA). Analysis of the results were made by the Student t-test and has been considered significant difference for p<0.05. RESULTS: A and B were differents for all parameters analized. CONCLUSION: The animals of group A showed reperfusion syndrome with a fall in MAP, activation of glycid metabolism through the glycolitic pathway and presence of lipid peroxidation compared to group B.


Subject(s)
Ischemia/metabolism , Lipid Peroxidation , Liver/blood supply , Pyruvate Kinase/metabolism , Reperfusion Injury/metabolism , Animals , Blood Glucose/metabolism , Energy Metabolism/physiology , Enzyme Activation , Ischemia/complications , Lipid Peroxidation/physiology , Liver Circulation/drug effects , Liver Circulation/physiology , Liver Glycogen/metabolism , Male , Mitochondria, Liver/enzymology , Rats , Rats, Wistar , Reperfusion Injury/etiology , Syndrome
17.
Acta Cir Bras ; 21 Suppl 1: 33-6, 2006.
Article in English | MEDLINE | ID: mdl-17013510

ABSTRACT

PURPOSE: This study was carried out to assess the effects of the aqueous extract of Hyptis pectinata leaves on liver regeneration and on serum enzymes (AST, ALT and gamma-GT) after 67% partial hepatectomy in rats. METHODS: AST, ALT and gamma-GT, were determined by conventional procedures using a spectrophotometer (Model E2250-CELM). Liver regeneration was evaluated by immunohistochemical staining for proliferating cell nuclear antigen (PCNA). RESULTS: Oral pretreatment during 4 days at 100 mg/kg increased liver regeneration index. At 200 mg/kg, AST level was statistically decreased in comparison to the group submitted to distilled water administration. The other enzymes assessed disclosed no difference when all groups were compared. CONCLUSION: The present study shows that the aqueous extract of Hyptis pectinata leaves contains some biological active principles that stimulate liver regeneration at 100 mg/kg and cause slight hepatic protection at 200 mg/kg.


Subject(s)
Hyptis , Liver Regeneration/drug effects , Phytotherapy , Plant Leaves , Plant Preparations/therapeutic use , Animals , Disease Models, Animal , Hepatectomy , Male , Plant Extracts/therapeutic use , Proliferating Cell Nuclear Antigen , Rats , Rats, Wistar , Spectrophotometry , Statistics, Nonparametric , Transaminases/blood , gamma-Glutamyltransferase/blood
18.
Acta cir. bras ; 21(supl.1): 19-23, 2006. ilus
Article in English, Portuguese | LILACS | ID: lil-438799

ABSTRACT

PURPOSE: Hepatic ischemia and reperfusion can cause several problems in hepatic surgery. The aim of this study was to determine pyruvate kinase activation and lipid peroxidation after hepatic ischemia. METHODS: Twenty-four Wistar rats were submitted to 90 minutes of selective liver ischemia and 15 minutes of reperfusion. Twelve animals were submitted to selective liver ischemia and reperfusion (Group A) and the other 12 were submitted to sham operation (Group B). After 15 minutes of reperfusion, the following parameters were measured: mean arterial pressure (MAP), alanine aminotransferase (ALT), glycemia (GLY), hepatic glycogen (GH), pyruvate kinase (PK) activation, hepatic glutathione (GSH) and malondialdehyde (MDA). Analysis of the results were made by the Student t-test and has been considered significant difference for p<0.05. RESULTS: A and B were differents for all parameters analized. CONCLUSION: The animals of group A showed reperfusion syndrome with a fall in MAP, activation of glycid metabolism through the glycolitic pathway and presence of lipid peroxidation compared to group B.


OBJETIVO: A isquemia e reperfusão hepática podem causar graves repercussões hepatocelulares em cirurgias hepáticas. O objetivo deste estudo foi determinar o comportamento da piruvato EM PORTUGUES quinase e a lipoperoxidação após isquemia hepática. MÉTODOS: Foram utilizados vinte e quatro ratos Wistar machos divididos em dois grupos. Doze animais foram submetidos a 90 minutos de isquemia hepática seletiva e reperfusão hepática de por 15 minutos (pressão arterial média (PAM), alanina aminotransferase (ALT), glicemia (GLI), gicogênio hepático (GH), ativação da piruvato quinase (PQ), glutationa hepática (GSH) e malondialdeído (MDA). Os resultados foram analisados utilizando o teste t de Student sendo as diferenças consideradas significativas para p<0,05. RESULTADOS: Verificou-se diferença significativa entre os grupos em todos os parâmetros analisados. CONCLUSÃO: Verificou-se que os animais do grupo A mostraram síndrome de reperfusão com queda da PAM, ativação do metabolismo da glicose através da via glicolítica e presença de lipoperoxidação quando comparada com o grupo B.


Subject(s)
Animals , Rats , Energy Metabolism/physiology , Ischemia/metabolism , Liver/blood supply , Pyruvate Kinase/metabolism , Reperfusion/adverse effects , Blood Glucose/metabolism , Ischemia/complications , Lipid Peroxidation/physiology , Liver Circulation/drug effects , Liver Circulation/physiology , Liver Glycogen/metabolism , Mitochondria, Liver/enzymology , Rats, Wistar , Reperfusion Injury/etiology , Syndrome
19.
Acta cir. bras ; 21(supl.1): 33-36, 2006. graf, tab
Article in English, Portuguese | LILACS | ID: lil-438802

ABSTRACT

PURPOSE: This study was carried out to assess the effects of the aqueous extract of Hyptis pectinata leaves on liver regeneration and on serum enzymes (AST, ALT and gamma-GT) after 67 percent partial hepatectomy in rats. METHODS: AST, ALT and gamma-GT, were determined by conventional procedures using a spectrophotometer (Model E2250-CELM). Liver regeneration was evaluated by immunohistochemical staining for proliferating cell nuclear antigen (PCNA). RESULTS:Oral pretreatment during 4 days at 100 mg/kg increased liver regeneration index. At 200 mg/kg, AST level was statistically decreased in comparison to the group submited to distilled water administration. The other enzymes assessed disclosed no difference when all groups were compared. CONCLUSION: The present study shows that the aqueous extract of Hyptis pectinata leaves contains some biological active principles that stimulate liver regeneration at 100 mg/kg and cause slight hepatic protection at 200 mg/kg.


OBJETIVO: Este estudo foi realizado com o objetivo de verificar o efeito do extrato aquoso da Hyptis pectinata na regeneração hepática bem como nos níveis das enzimas séricas (AST, ALT e gama-GT) após hepatectomia parcial de 67 por cento em ratos. MÉTODOS: AST, ALT e gama-GT, foram determinadas pelo método cinético utilizando um espectrofotômetro (Modelo E2250-CELM). A regeneração hepática foi avaliada por imunohistoquímica (PCNA). RESULTADOS: O pré-tratamento oral de 100 mg/kg foi realizado durante 4 dias e causou aumento na regeneração hepática O pré-tratamento oral com 200 mg/kg diminuiu significativamente os níveis de AST quando comparado com o grupo submetido ao pré-tratamento com água destilada. As demais enzimas avaliadas não apresentaram diferenças quando comparadas entre os grupos estudados. CONCLUSÃO: O presente estudo mostra que o extrato aquoso da Hyptis pectinata, numa concentração de 100 mg/kg possui alguma atividade biológica estimulando a regeneração hepática e causando também um leve efeito hepatoprotetor numa concentração de 200 mg/kg.


Subject(s)
Animals , Male , Rats , Hyptis , Liver Regeneration/drug effects , Phytotherapy , Plant Leaves , Plant Extracts/therapeutic use , Plant Preparations/therapeutic use , Disease Models, Animal , Hepatectomy , Proliferating Cell Nuclear Antigen , Plant Extracts/pharmacology , Plant Preparations/pharmacology , Rats, Wistar , Spectrophotometry , Statistics, Nonparametric , Transaminases/blood , gamma-Glutamyltransferase/blood
20.
Acta cir. bras ; 15(supl.2): 76-7, 2000. tab, graf
Article in Portuguese | LILACS | ID: lil-282441

ABSTRACT

A atividade compensatória mitocondrial é um mecanismo que permite a alguns orgãos manter seu nível energético em situações adversas. Este presente estudo visa analisar a função mitocondrial hepática em ratos submetidos à OBEH. Foram estudados 10 ratos Wistar machos (180 a 230 g), divididos em dois grupos. Grupo operação simulada - OS e grupo obstrução biliar extra hepática (OBEH). Após 24 h. foram coletadas amostras de sangue e biópsia hepática para a dosagem do nível sérico das enzimas hepáticas e a atividade mitocondrial. Houve aumento significativo das aminotranferases, da FA e BT (tabela 1).Verificou-se aumento do Estado 3 da respiração mitocondrial. Analisando os resultados, observou-se que as mitocôndrias hepáticas apresentaram atividade compensatória no sentido de preservação da função hepatocelular.


Subject(s)
Animals , Male , Rats , Cholestasis, Extrahepatic/surgery , Mitochondria, Liver/physiology , Acute Disease , Oxygen Consumption/physiology , Hepatic Duct, Common/surgery , Ligation , Rats, Wistar
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