Phyto-mediated nanostructured carriers based on dual vegetable actives involved in the prevention of cellular damage.

The growing scientific interest in exploitation of vegetable bioactives has raised a number of questions regarding their imminent presence in pharmaceutical formulations. This study intends to demonstrate that a dual combination between vegetable oil (e.g. thistle oil, safflower oil, sea buckthorn oil) and a carrot extract represents an optimal approach to formulate safe carrier systems that manifest cell regeneration effect and promising antioxidant and anti-inflammatory activity. Inclusion of both natural actives into lipid carriers imparted a strong negative charge on the nanocarrier surface (up to -45mV) and displayed average sizes of 70nm to 140nm. The entrapment efficiency of carrot extract into nanostructured carriers ranged between 78.3 and 88.3%. The in vitro release study has demonstrated that the entrapment of the extract represents a viable way for an equilibrated release of carotenoids. Besides the excellent antioxidant properties (e.g. scavenging up to 98% of the free oxygen radicals), the results of cellular integrity (e.g. cell viability of 133%) recommend these nanocarriers based on dual carrot extract-bioactive oil as a promising trend for the treatment of certain disorders in which oxidative stress plays a prominent role. In addition, the lipid nanocarriers based on safflower oil and sea buckthorn oil demonstrated an anti-inflammatory effect on LPS induced THP-1 macrophages, by inhibiting the secretion of two pro-inflammatory cytokines, IL-6 and TNF-α.

P235Relation between myocardial deformation by three-dimensional speckle tracking analysis , control of the hypertension and functional capacity in patients with systemic hypertension.

The purpose of this study was to investigate left ventricular (LV) function in hypertensive patients by 3-dimensional (3D) speckle tracking imaging, and determine the relation between the LV mechanics and functional capacity in this population. This cross-sectional study included 20 treated subjects with well-controlled arterial hypertension (group B) and 20 treated participants with uncontrolled hypertension (group A), adjusted by gender and age. All the subjects underwent 24-hour blood pressure monitoring, complete 2-dimensional and 3D examination, and exercise testing. Patients had similar 3D LV ejection fraction. LV mass was higher in group of uncontrolled hypertension (154.71 ± 49.7 g/m2 versus 147.12±44.8 g/m2 p < 0.01), as well as E/E'ratio (11.4 versus 8.9, p =0.02). 3D global longitudinal and circumferential strain and strain rate were significantly decreased in patients with inadequately controlled hypertension (LS 16.25% versus -19.24%, p=0.007, L-SR -0.97/sec versus -1.48/sec, p=0.04, CS -17.89%versus -21.76%, p=0.04, respectively), while the difference of radial strain and strain rate did not reach statistical significance. Group A of patients had also a significantly lower functional capacity (mean duration of test 13,3 min. versus 17,4 min, nr. of METS 9.4 versus 13.7). Duration of exercise was independently associated with LV mass , mean BP at daytime , E/E' ratio and 3D global longitudinal strain (ß = 0.34, p = 0.02) in the whole hypertensive population in our study. In conclusion, LV longitudinal strain and functional capacity are significantly impaired in the patients with uncontrolled hypertension in comparison with the well-controlled hypertensive patients and are independently associated.

Lipid nanocarriers based on natural oils with high activity against oxygen free radicals and tumor cell proliferation.

The development of nano-dosage forms of phytochemicals represents a significant progress of the scientific approach in the biomedical research. The aim of this study was to assess the effectiveness of lipid nanocarriers based on natural oils (grape seed oil, fish oil and laurel leaf oil) in counteracting free radicals and combating certain tumor cells. No drug was encapsulated in the nanocarriers. The cytotoxic effect exerted by bioactive nanocarriers against two tumor cells, MDA-MB 231 and HeLa cell lines, and two normal cells, L929 and B16 cell lines, was measured using the MTT assay, while oxidative damage was assessed by measuring the total antioxidant activity using chemiluminescence analysis. The best performance was obtained for nanocarriers based on an association of grape seed and laurel leaf oils, with a capacity to scavenge about 98% oxygen free radicals. A dose of nanocarriers of 5mg·mL(-1) has led to a drastic decrease in tumor cell proliferation even in the absence of an antitumor drug (e.g. about 50% viability for MDA-MB 231 cell line and 60% viability for HeLa cell line). A comparative survival profile of normal and tumor cells, which were exposed to an effective dose of 2.5mg·mL(-1) lipid nanocarriers, has revealed a death rate of 20% for normal B16 cells and of 40% death rate for MDA-MB 231 and HeLa tumor cells. The results in this study imply that lipid nanocarriers based on grape seed oil in association with laurel leaf oil could be a candidate to reduce the delivery system toxicity and may significantly improve the therapeutic efficacy of antitumor drugs in clinical applications.

[Ultrasound studies of the portal vein system in liver tumors]. / Sonographische Untersuchungen des Pfortadersystems bei Lebertumoren.

The study was carried out on a group of 21 patients with liver tumours (20 of them primary) and thrombosis of the portal venous system. Thrombosis in the left portal vein system was found in 10 patients, in the portal vein stem in 9 patients and in the portal confluence in 2 patients. In 15 patients thrombosis developed in the presence of a multicentric liver neoplasm. Proaf of the presence of a thrombus on the main portal trunk in patients with documented liver tumour contraindicates surgical or non-surgical therapeutic manoeuvres. If a thrombus is incidentally found in the portal venous system, a careful search for a tumour in the portal vein systems is imperative. In case of any suspicious modification, fine needle-aspiration should be performed.

The role of transvaginal sonography as compared with endorectal sonography in the evaluation of rectal cancer: preliminary study.

We carried out a preliminary study on the efficacy of endovaginal sonography (EVS) in the evaluation of rectal cancer. The study included 12 women with endoscopically documented rectal cancer, 10 of which were treated surgically. We found that EVS evidenced metastasized lymph nodes (7/9) and infiltration of the rectovaginal space more clearly; moreover, this technique can also be performed in cases of stenosing cancer. Endorectal sonography (ERS) evidenced infiltration of the rectal wall but was less accurate both in detecting metastasized lymph nodes (6/9) and for exploration of the rectovaginal space. We concluded that the two methods complement one another and improve ultrasonographic staging of rectal cancer.

[The value and limits of endorectal sonography in the preoperative stage classification of rectal cancer]. / Wert und Grenzen der endorektalen Sonographie in der präoperativen Stadieneinteilung des Rektumkarzinoms.

The article deals with the valuation of endorectal and abdominal sonography in preoperative staging of rectal carcinoma. Data processing of 40 patients suffering from tumours of the rectum examined rectoscopically, by biopsy and via sonography showed that endorectal sonography can achieve preoperative staging (T) with a sensitivity of 89%, a specificity of 100%, a positive predictive value of 89% and a negative predictive value of 100%, the overall accuracy being 81%. Identification of pararectal adenopathies can be performed with a sensitivity of 16% and a specificity of 100%. Liver metastases were determined with a sensitivity and specificity of 100%. Hence, endorectal sonography is a valuable method for preoperative staging of carcinoma of the rectum.

The impact of advances in radiologic biliary imaging on the diagnosis of obstructive jaundice. Comparative analysis of two groups of patients hospitalized at a 5-year interval.

The study evaluates the impact of advances in biliary imaging techniques on the accuracy and rapidity of diagnosis in patients with obstructive jaundice. Two series of patients hospitalized at an interval of 5 years in the same clinic were prospectively analyzed. In both series, the results of ultrasonography (US) and percutaneous transhepatic cholangiography (PTC) were compared with the intraoperative findings. The performances of US in the assessment of ductal dilatation and choledocholithiasis significantly improved during this period. The fine-needle biopsies taken from the solid masses in liver or pancreatic parenchyma under US guidance in the second series of patients contributed to the greater proportion of correct preoperative diagnoses in this group. The number of PTC investigations increased in the second group (p less than 0.001) given the clinicians' confidence in the safety and easy performance of this method. Using both methods, the etiology of biliary obstruction was correctly diagnosed preoperatively in 85.2 per cent of the second series of patients, significantly more frequently than in the first series of patients (62.7 per cent) (p less than 0.05). The mean period in hospital necessary for the diagnosis decreased during the period analyzed from 15.4 +/- 10.8 days to 10.2 +/- 7.8 days (p less than 0.05), a fact with direct impact on the course of disease, and also on the hospital costs.

[Ultrasonic diagnosis of echinococcal cholangitis]. / Ultraschalldiagnose der Echinokokken-Cholangitis.

The role of sonographic examination in echinococcal cholangitis is stressed based on a clinical case. Due to perforation of the hepatic hydatid cyst into the bile ducts the clinical picture of acute cholangitis occurred, this being difficult to differentiate from that of choledochal stones. The correct diagnosis was made by sonographic examination and was confirmed intraoperatively. The importance of emergency sonographic examination in severely ill patients is stressed.

Ultrasonically guided fine needle aspiration biopsy for the diagnosis of abdominal tumors.

The authors report on the value of ultrasonically guided fine needle (0.6 mm = 23 gauge) biopsy in the morphological diagnosis of abdominal tumors. The method is characterized by a high specificity, resulting from the direct evidencing of the tumoral cells. The accuracy of the method bears on the ultrasonographist's experience, who must puncture the tumor in its peripheral, un-necrotized, zones. The method is rapid and only slightly invasive, involving low risk for the patients. Our results correlate well with the existing literature.

[Cystic echinococcosis of the liver--problems of ultrasound diagnosis]. / Die zystische Echinokokkose der Leber--Probleme der Ultraschalldiagnostik.

The authors examined 100 patients with a total of 119 cysts of the liver. The diagnosis was subsequently confirmed via scintigraphy, radiology and laparotomy. This paper reports on a sonographic analysis of cystic echinococcosis of the liver, its sonographically demonstrable types, structures and complications and their differential diagnosis. In 58% of the cases the classical aspect of cystic echinococcosis was seen (Type A). 22.7% of the cases pointed toward a sediment within the cyst (Type B). 8.4% of the cysts were septated (Type C), whereas 6.7% had daughter cysts (Type D). However, only 4.2% of the cysts were important for differential diagnosis, since they had to be set off against other space-occupying growths on account of their solid tumorous structure.

Ultrasonic diagnosis in gallbladder diseases: comparison with the morphopathologic findings in a series of 151 cholecystectomized patients

Foram estudados 151 pacientes submetidos à colecistectomia após estudo ultra-sonográfico da vesícula biliar, numa tentativa de correlacionar os achados cirúrgicos com os dados fornecidos pela ultra-sonografia. Desta maneira, foi diagnosticada colelitíase em 114 dos 151 pacientes operados, sendo comprovada cirurgicamente em 103 pacientes, determinando, portanto, um índice de falsa positividade de 7%. A sensibilidade na detecçäo da colelitíase foi de 96%, com especificidade de 75% e exatidäo de 90%. O diagnóstico de colecistopatia alitiásica foi feito em 37 pacientes e comprovado somente em 19, sendo constatado nos restantes, no ato operatório, a presença de cálculos. Assim, a sensibilidade na detecçäo da colecistopatia alitiásica foi de 63%, com especificidade de 85% e exatidäo de 80%. Nos casos nos quais a sonografia detectou espessamento da parede da vesícula biliar, houve índice de acerto de 100%, considerando-se o aspecto macroscópico na operaçäo, näo havendo portanto, falsa positividade nos 27 pacientes nos quais tal particularidade foi assinalada pré-operatoriamente. É realçada, ainda, a possibilidade de avaliaçäo do esvaziamento vesicular após ingestäo de gordurosos pela sonografia, sendo considerado de valor no diagnóstico das discinesia vesiculares, após serem analisados 16 pacientes nos quais o método foi empregado e comparado ao estudo radiológico obtido por colecistografia oral

Pathogenetic interrelations between cholesterolosis and cholesterol gallstone disease.

In order to define the relationship between cholesterolosis (COL) and cholesterol gallstone disease (CGD), risk factors were comparatively investigated in a great number of patients. Sex, age and metabolic risk factors were the same for both diseases, but gallbladder anomalies and neuroendocrine disturbances were more often associated with COL. The lipid composition of the gallbladder bile was determined in patients with COL. The bile acid decrease and the increase of cholesterol molar concentration (moles %) were found, similar to those known in CGD. The similarity of risk factors and of bile lithogenicity, as well as the frequent association of COL and CGD suggest a pathogenic relationship of both diseases. Local morphological changes in conditions of high biliary cholesterol levels may be responsible for the intraparietal precipitation of cholesterol in COL. Thus, COL seem to be a peculiar variant of CGD and its classification into the heterogeneous group of cholecystoses is at present questionable.

[Oddi's sphincterotomy or sphincteroplasty. Considerations on the results obtained with a personal sphincteroplasty technic]. / Sfincterotomie sau sfincteroplastie oddiana. Consideratii pe marginca rezultatelor obtinute cu o tehnica personala de sfincteroplastie.

A total of 21 cases are presented, of patients in whom Oddian sphincteroplasty was performed, according to an original technique. In 19 cases the indication was due to Oddian stenosis associated to lithiasis or hepatic hydatic cysts which had ruptured in the biliary pathways. In two other cases security sphincteroplasty of the Oddi sphincter was performed for lithiasis of the choledocus. The decision was based on macroscopic changes of the biliary pathways, on the control of the main biliary pathway. Sphincteroplasty was achieved with the aid of an original probe, and the incision of the ampullary area was in the average 25 mm in length. The postoperative control, made by tube cholangiography and barium examination, has evidenced the presence of a wide, open choledocoduodenal orifice. Duodenal fistula was one of the complications which followed duodenostomy. This however was fully repaired in 14 days after conservative treatment. After a confrontation of the results achieved with this method, and the data published in the literature the authors support oddian sphincteroplasty, and stress its advantages by comparison with the results provided by sphincterotomy.