Biomarkers track damage after graded injury severity in a rat model of penetrating brain injury.

The goal of this project was to determine whether biochemical markers of brain damage can be used to diagnose and assess the severity of injury in a rat model of penetrating ballistic-like brain injury (PBBI). To determine the relationship between injury magnitude and biomarker levels, rats underwent three discrete PBBI severity levels defined by the magnitude of the ballistic component of the injury, calibrated to equal 5%, 10%, or 12.5% of total rat brain volume. Cortex, cerebrospinal fluid (CSF), and blood were collected at multiple time points. Levels of three biomarkers (αII-spectrin breakdown product [SBDP150], glial fibrillary acidic protein [GFAP], and ubiquitin C-terminal hydrolase-L1 [UCH-L1]), were measured using quantitative immunoblotting and/or enzyme-linked immunosorbent assays. In injured cortex, SBDP150 and GFAP levels were increased significantly over controls. Cortical SBDP150 was elevated at 1 day but not 7 days, and GFAP at 7 days but not 1 day. At their respective time points, mean levels of SBDP150 and GFAP biomarkers in the cortex rose stepwise as injury magnitude increased. In the CSF, increasing severity of PBBI was associated with increasing concentrations of both neuronal and glial biomarkers acutely at 1 day after injury, but no trends were observed at 7 days. In plasma, SBDP150 was elevated at 5 min after 10% PBBI and at 6 h after 12.5% PBBI. UCH-L1 levels in plasma were elevated acutely at 5 min post-injury reflecting injury severity and rapidly decreased within 2 h. Overall, our results support the conclusion that biomarkers are effective indicators of brain damage after PBBI and may also aid in the assessment of injury magnitude.

Nylon de pescar en las derivaciones bilio-digestivas / Fishing nylon in biliary-enteric derivations

Con el fin de evaluar el Nylon de pescar en la construcción de derivaciones bilio-digestivas, estudiamos a 15 pacientes en quienes se realizó coledoco-duodenoanastomosis y hepático-yeyunoanastomosis. Hubieron 8 mujeres y 7 hombres cuyas edades variaron entre 40 y 76 años; 10 fueron operados electivamente; los diagnósticos incluyeron: colecistitis crónica calculosa + coledocolitiasis, colecistitis aguda + coledocolitiasis con y sin colangitis, parasitosis biliar y litiasis residual coledociana + colangitis. En 5 pacientes utilizamos Nylon de pescar tradicional con aguja traumática y en 10 Nylon de pescar conaguja atraumática (WENCHY (MR). Todas las anatomosis fueron en un solo plano y puntos separados. No encontramos ninguna complicación dependiente del material utilizado en la anastomosis, no hubo escape anastomótico y se restableció la ingesta oral total a los 4 días en promedio. La utilización del Nylon de pescar, tanto el tradicional como el comercial (WENCHY (MR) determinaron reducción de costos respecto a otras suturas comerciales. El uso de nylon con aguja atraumática facilitó la realización de la anastomosis, sobre todo cuando estuvo presente un proceso inflamatorio agudo