Assuntos
Imunofilinas/fisiologia , Canal de Liberação de Cálcio do Receptor de Rianodina/fisiologia , Proteínas de Ligação a Tacrolimo/fisiologia , Animais , Calcineurina/metabolismo , Canais de Cálcio/metabolismo , Canais de Cálcio/fisiologia , Ciclosporina/metabolismo , Ciclosporina/farmacologia , Imunofilinas/metabolismo , Imunossupressores/metabolismo , Imunossupressores/farmacologia , Receptores de Inositol 1,4,5-Trifosfato , Ligação Proteica , Receptores Citoplasmáticos e Nucleares/metabolismo , Receptores Citoplasmáticos e Nucleares/fisiologia , Canal de Liberação de Cálcio do Receptor de Rianodina/metabolismo , Tacrolimo/metabolismo , Tacrolimo/farmacologia , Proteínas de Ligação a Tacrolimo/metabolismoRESUMO
We present a case of pulmonary embolism that occurred during the injection of lipiodol during transcatheter arterial chemoembolization under general anaesthesia. A 7-year-old child suffering from a large hepatoblastoma was admitted for arterial chemoembolization and carcinostatic administration. Pulmonary embolism due to lipiodol during arterial chemoembolization was evident by a sudden fall in oxyhaemoglobin saturation from 100 to 90%. This was associated with a spread of lipiodol into both lungs, particularly the middle lung zones and detected by chest fluoroscopy. Arterial blood gases returned to normal values 1 day later but pulmonary infiltration persisted for 7 days before final clearance. Pulmonary embolism caused by lipiodol during arterial chemoembolization is infrequent, but such a complication could prove fatal. Understanding the risk of pulmonary embolism in patients receiving lipiodol, during and after arterial chemoembolization, and late onset pulmonary injury is important and a close follow-up for several days after arterial chemoembolization is advisable.
Assuntos
Quimioembolização Terapêutica/efeitos adversos , Meios de Contraste/efeitos adversos , Doxorrubicina/análogos & derivados , Hepatoblastoma/terapia , Óleo Iodado/efeitos adversos , Neoplasias Hepáticas/terapia , Embolia Pulmonar/etiologia , Antibióticos Antineoplásicos/administração & dosagem , Antineoplásicos/administração & dosagem , Cateterismo Periférico , Criança , Cuidados Críticos , Doxorrubicina/administração & dosagem , Fluoroscopia , Seguimentos , Hepatoblastoma/irrigação sanguínea , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Masculino , Oxigênio/sangue , Oxiemoglobinas/análise , Respiração com Pressão Positiva , Radiografia IntervencionistaRESUMO
Male ICR mice were administered allyl chloride at dose of 496 mg/kg, 600 mg/kg, 720 mg/kg, 864 mg/kg or 1037 mg/kg by a single subcutaneous injection. Sixteen of 25 mice died by the 7th day after the injection and LD50 was calculated 621 mg/kg body weight (95% C.I.: 522-739 mg/kg). A marked congestion with severe hemorrhage and edema were observed in the lung. Liver and kidney damages were also found, and these were characterized by the dilated sinusoids, degenerative change of hepatic cells, and focal necrosis in the liver; and necrosis of epithelium in convoluted tubules of the kidneys. Nine mice have survived by the 7th day after the injection and all of them showed a various degree of damages in the testes. The testicular lesions could be classified into two types. One type of the lesion was characterized by degeneration and exfoliation of germ cells, appearance of polynuclear giant cells in the seminiferous tubules, and mild proliferation of Leydig cells in the interstitium. In another type of the lesion, all type of cells in tubules, including Sertoli cells, and Leydig cells became necrotic. This is the first study reporting the testicular toxicity of allyl chloride.
