RESUMO
Diabetes mellitus (DM) is still one of the most common endocrine diseases despite all available technologies in modern medicine. In recent years, it was shown that severity and duration of DM are closely associated with vascular wall lesions (the called micro-and macroangiopathy). One of severe clinical signs is damage to lower limb arteries followed by trophic and purulent-necrotic lesions of soft tissues (diabetic foot syndrome) and risk of amputation. The authors review the possibilities of endovascular treatment of critical limb ischemia in patients with diabetes mellitus. The features of endovascular interventions depending on clinical and morphological peculiarities of vascular lesions are discussed. The authors compared the results of open and endovascular treatment of lower limb ischemia and determined further prospects for improving the treatment of these patients.
Assuntos
Diabetes Mellitus , Procedimentos Endovasculares , Amputação Cirúrgica , Isquemia Crônica Crítica de Membro , Diabetes Mellitus/diagnóstico , Procedimentos Endovasculares/efeitos adversos , Humanos , Isquemia/diagnóstico , Isquemia/etiologia , Isquemia/cirurgia , Salvamento de Membro , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
We describe a method for experimental assessment of endothelial dysfunction in an isolated using extracorporeal machine perfusion and vasoactive substrates agents (norepinephrine and acetylcholine). Quantitative assessment of endothelial vasomotor dysfunction was proposed, based on registration of changes in volumetric perfusate flow rate through the isolated vessel. Functional activity of the isolated aorta endothelium and total content of stable NO degradation products in blood plasma were studied in outbred white male rats after subtotal liver resection. Impaired vasodilation ability of the aorta and increased content of NO degradation products in blood plasma observed after surgery indicate the development of vasomotor endothelial dysfunction associated with oxidative stress, cholemia, and endotoxemia.
Assuntos
Endotélio Vascular/metabolismo , Vasodilatadores/farmacologia , Acetilcolina/metabolismo , Animais , Aorta/efeitos dos fármacos , Aorta/metabolismo , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/patologia , Masculino , Norepinefrina/metabolismo , Estresse Oxidativo/efeitos dos fármacos , RatosRESUMO
We propose an original model of atypical extremely extensive liver resection applicable for studying of the mechanisms of early and late hepatic and extrahepatic postoperative complications. After median laparotomy and mobilization of the middle and left lobes of the liver, 2-4 mattress sutures were applied to each lobe paracavally and 1 mm proximal to the proposed line of resection, the lobe parenchyma was cut off, and electrocoagulation of the wound surface was performed; the removed part was equivalent to 80% of the liver weight. This model of liver resection was used to study the pathogenetic factors of circulatory insufficiency in the postoperative period.
Assuntos
Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Fígado/cirurgia , Animais , Eletrocoagulação , Fígado/anatomia & histologia , Masculino , Modelos Anatômicos , Complicações Pós-Operatórias , Período Pós-Operatório , Ratos , CicatrizaçãoRESUMO
Free radical oxidation in rat myocardial homogenate was studied by chemiluminescent assay during the early terms after maximum permissible liver resection. During this period, activation of free radical oxidation was biphasic. The critical terms characterized by dramatic intensification of free radical oxidation in the myocardium are the first hour and the first day after surgery. The period from 3 to 12 h after surgery, in which the indices of chemiluminescence decrease, can be tentatively termed as the period of "putative wellbeing". Normalization of the free radical oxidation processes in the myocardium occurred by day 7 after surgery.
Assuntos
Radicais Livres/metabolismo , Hepatectomia/efeitos adversos , Fígado/cirurgia , Isquemia Miocárdica/fisiopatologia , Miocárdio/metabolismo , Oxirredução , Animais , Masculino , Ratos , Estresse Fisiológico/fisiologiaAssuntos
Endotoxemia/etiologia , Hipotensão/etiologia , Oligopeptídeos/metabolismo , Choque Hemorrágico/complicações , Animais , Modelos Animais de Doenças , Endotoxemia/sangue , Endotoxemia/metabolismo , Hipotensão/sangue , Hipotensão/metabolismo , Mucosa Intestinal/metabolismo , Intestinos/irrigação sanguínea , Fígado/irrigação sanguínea , Fígado/metabolismo , Pulmão/irrigação sanguínea , Pulmão/metabolismo , Masculino , Peso Molecular , Oligopeptídeos/sangue , Ratos , Choque Hemorrágico/sangue , Choque Hemorrágico/metabolismo , Baço/irrigação sanguínea , Baço/metabolismoRESUMO
Change amylolytic enzyme activity of the mucous small intestine on the hemorrhagic hypotension condition breach of the correlation of the processes cavity and stripped of the digestion. Expressed increasing to activities cavity and stripped factions amylase is connected with ischemia-reperfusion of the pancreaticoduodenal region. In small intestine division distal of these phenomena carry the unabiding nature and gradually are replaced the compensatory processes, directed on maintenance parietal digestions, due to reserve zone iliac gut.
