Visual lung ultrasound protocol (VLUP) in acute respiratory failure: description and application in clinical cases.

Lung ultrasound (LUS) is widely used as a diagnostic and monitoring tool in critically ill patients. Lung ultrasound score (LUSS) based on the examination of twelve thoracic regions has been extensively validated for pulmonary assessment. However, it has revealed significant limitations: when applied to heterogeneous lung diseases with intermediate LUSS pattern (LUSS 1 and 2), for instance, intra-observer consistency is relatively low. In addition, LUSS is time-consuming and a more rapid overview of the extent of lung pathology and residual lung aeration is often required, especially in emergency setting. We propose a Visual Lung Ultrasound Protocol (VLUP) as a rapid monitoring tool for patients with acute respiratory failure. It consists of a probe sliding along the mid-clavicular, mid-axillary and scapular lines in transversal scan. VLUP allows a visualization of a large portion of the antero-lateral and/or posterior pleural surface. Serial assessments of two clinical cases are recorded and visually compared, enabling rapid understanding of lung damage and its evolution over time. VLUP allows a semi-quantitative and qualitative point-of-care assessment of lung injury. Through this standardized approach it is possible to accurately compare subsequent scans and to monitor the evolution of regional parenchymal damage. VLUP enables a quick estimation of the quantitative-LUSS (qLUSS) as the percentage of pleura occupied by artifacts, more suitable than LUSS in inhomogeneous diseases. VLUP is designed as a standardized, point-of-care lung aeration assessment and monitoring tool. The purpose of the paper is to illustrate this new technique and to describe its applications.

Wernicke's encephalopathy and pancreatic encephalopathy after necrotic-hemorrhagic pancreatitis. A case report.

This case report describes a case of acute necrotic-hemorrhagic pancreatitis complicated by Wernicke's encephalopathy (WE) and stresses the importance of a correct dietetic regimen. A 39-year-old Chinese male patient with negative remote pathological anamnesis was hospitalized in the Medical Department with a diagnosis of gallstones. The clinical course was complicated with the onset of acute pancreatitis. Enteral fasting was imposed with intravenous feeding without vitamin supplementation. The progressive worsening of the clinical, radiodiagnostic and laboratory profile combined with deterioration in the state of consciousness promoted, on the 36th day exploratory laparotomy revealed necrotic-hemorrhagic pancreatitis. The patient was, therefore, admitted to the Intensive Care Unit in a deep coma. The recent medical history, neurological examination, and encephalic computed tomography suggested a revealing diagnosis of WE combined with pancreatic encephalopathy.

One-day surgery for acquired forefoot deformity: sciatic nerve blockade with mepivacaine vs mepivacaine+ropivacaine: a prospective, randomized study.

AIM: The aim of the study was to determine the doses of ropivacaine combined with mepivacaine for sciatic nerve blockade to enable the extension of analgesia without prolonged motor blockade, for the management of very painful operations in one-day surgery. METHODS: After obtaining approval by the ethics committee and written informed consent, we recruited 30 ASA I-III patients undergoing corrective orthopedic surgery of the forefoot in one-day surgery with sciatic nerve blockade. The patients were randomly divided into 3 groups: one control group, treated by 1.5% mepivacaine (300 mg), and two groups differentiated by the dose of 0.5% ropivacaine (25 and 40 mg) used in combination with 1.5% mepivacaine (225 mg). The offset data of the blockade were obtained by a self-assessment form filled in by the patients, and a direct check on discharge by a blinded observer. RESULTS: There was no significant difference in the duration of the blockade among the 3 groups; the extension of analgesia was significant (P<0.003) in the group treated by mepivacaine+ropivacaine 40 mg (mean 477+/-255 min). CONCLUSION: Adequate doses of ropivacaine added to mepivacaine for peripheral blockade produce and increase the duration of analgesia without influencing the criteria for discharge after Day Surgery.

Activation of macrophage functions by growth factor present in uterus and embryo extract of pregnant mouse.

A pregnant mouse uterus and embryo extract (PMUE) that contains growth hematopoietic factor (M-CSF or CSF-1), was used to test its action on the phagocytic and digestive functions of macrophage. Macrophages incubated with and without PMUE for 24 hours previous to each experiment were compared. A good phagocytosis of Trypanosoma cruzi by macrophages incubated with PMUE, was observed on video microscopy. No phagocytic activity was observed in the macrophages deprived of PMUE 24 hours before. The studies of phagocytic and degradative behavior of macrophages by both soluble and particulated (S. aureus) complex 125I-antibodies showed that total binding of soluble ligands was almost double in the group of macrophages incubated with PMUE. Both the soluble and particulated ligands were digested more efficiently by the macrophages stimulated by PMUE. Counting the macrophages with trypan blue, an equal viability was found, of the cells incubated with and without PMUE. From the experimental data obtained, we may conclude that the hematopoietic growth factor present in PMUE is essential for phagocytic and degradative functions of macrophages.

Activation of macrophage functions by growth factor present in uterus and embryo extract of pregnant mouse

A pregnant mouse uterus and embryo extract (PMUE) that contains growth hematopoietic factor (M-CSF or CSF-1), was used to test its action on the phagocytic and digestive functions of macrophage. Macrophages incubated with and without PMUE for 24 hours previous to each experiment were compared. A good phagocytosis of Trypanosoma cruzi by macrophages incubated with PMUE, was observed on video microscopy. No phagocytic activity was observed in the macrophages deprived of PMUE 24 hours before. The studies of phagocytic and degradative behavior of macrophages by both soluble and particulated (S. aureus) complex 125I-antibodies showed that total binding of soluble ligands was almost double in the group of macrophages incubated with PMUE. Both the soluble and particulated ligands were digested more efficiently by the macrophages stimulated by PMUE. Counting the macrophages with trypan blue, an equal viability was found, of the cells incubated with and without PMUE. From the experimental data obtained, we may conclude that the hematopoietic growth factor present in PMUE is essential for phagocytic and degradative functions of macrophages.(AU)

Activation of macrophage functions by growth factor present in uterus and embryo extract of pregnant mouse

A pregnant mouse uterus and embryo extract (PMUE) that contains growth hematopoietic factor (M-CSF or CSF-1), was used to test its action on the phagocytic and digestive functions of macrophage. Macrophages incubated with and without PMUE for 24 hours previous to each experiment were compared. A good phagocytosis of Trypanosoma cruzi by macrophages incubated with PMUE, was observed on video microscopy. No phagocytic activity was observed in the macrophages deprived of PMUE 24 hours before. The studies of phagocytic and degradative behavior of macrophages by both soluble and particulated (S. aureus) complex 125I-antibodies showed that total binding of soluble ligands was almost double in the group of macrophages incubated with PMUE. Both the soluble and particulated ligands were digested more efficiently by the macrophages stimulated by PMUE. Counting the macrophages with trypan blue, an equal viability was found, of the cells incubated with and without PMUE. From the experimental data obtained, we may conclude that the hematopoietic growth factor present in PMUE is essential for phagocytic and degradative functions of macrophages.

Role of endogenous polyamines in the proliferation of normal hematopoietic progenitor cells: high-proliferative potential colony-forming cells (HPP-CFC), and low-proliferative potential colony-forming cells (LPP-CFC). Studies "in vitro".

This study concerns the role of endogenous polyamines in the proliferation of normal hematopoietic progenitor cells: high-proliferative potential colony-forming cells (HPP-CFC), and low-proliferative potential colony-forming cells (LPP-CFC) in CFW/ep mouse bone marrow cells in the agar culture system. DL-a-difluoromethylornithine (DFMO) was used as a selective and irreversible inhibitor of ornithine decarboxylase which is the first limiting step in polyamine biosynthesis. The polyamines have been implicated in cell proliferation and differentiation. The results showed that DFMO significantly inhibited the formation of LPP-CFC colonies and completely inhibited the growth of the HPP-CFC colonies. Addition of exogenous putrescine at the concentration of 10(-7) M reverses the suppressive action of DFMO in both progenitor cells. At this concentration putrescine alone had no affect on the number or the size of the colonies. It was then concluded that endogenous polyamines appear to be essential for HPP-CFC proliferation and an important requirement for LPP-CFC proliferation.

Role of endogenous polyamines in the proliferation of normal hematopoietic progenitor cells: high-proliferative potential colony-forming cells (HPP-CFC), and low-proliferative potential colony-forming cells (LPP-CFC). Studies "in vitro"

This study concerns the role of endogenous polyamines in the proliferation of normal hematopoietic progenitor cells: high-proliferative potential colony-forming cells (HPP-CFC), and low-proliferative potential colony-forming cells (LPP-CFC) in CFW/ep mouse bone marrow cells in the agar culture system. DL-a-difluoromethylornithine (DFMO) was used as a selective and irreversible inhibitor of ornithine decarboxylase which is the first limiting step in polyamine biosynthesis. The polyamines have been implicated in cell proliferation and differentiation. The results showed that DFMO significantly inhibited the formation of LPP-CFC colonies and completely inhibited the growth of the HPP-CFC colonies. Addition of exogenous putrescine at the concentration of 10(-7) M reverses the suppressive action of DFMO in both progenitor cells. At this concentration putrescine alone had no affect on the number or the size of the colonies. It was then concluded that endogenous polyamines appear to be essential for HPP-CFC proliferation and an important requirement for LPP-CFC proliferation.(AU)

Role of endogenous polyamines in the proliferation of normal hematopoietic progenitor cells: high-proliferative potential colony-forming cells (HPP-CFC), and low-proliferative potential colony-forming cells (LPP-CFC). Studies "in vitro"

This study concerns the role of endogenous polyamines in the proliferation of normal hematopoietic progenitor cells: high-proliferative potential colony-forming cells (HPP-CFC), and low-proliferative potential colony-forming cells (LPP-CFC) in CFW/ep mouse bone marrow cells in the agar culture system. DL-a-difluoromethylornithine (DFMO) was used as a selective and irreversible inhibitor of ornithine decarboxylase which is the first limiting step in polyamine biosynthesis. The polyamines have been implicated in cell proliferation and differentiation. The results showed that DFMO significantly inhibited the formation of LPP-CFC colonies and completely inhibited the growth of the HPP-CFC colonies. Addition of exogenous putrescine at the concentration of 10(-7) M reverses the suppressive action of DFMO in both progenitor cells. At this concentration putrescine alone had no affect on the number or the size of the colonies. It was then concluded that endogenous polyamines appear to be essential for HPP-CFC proliferation and an important requirement for LPP-CFC proliferation.

Interaction of Trypanosoma cruzi with macrophages influence of temperature.

The interaction of macrophages and T. cruzi has been studied in vitro culture under three different temperatures. After 24 hours incubation at 29 degree C a large number of recognizable parasites inside macrophages is observed with evidences of cell divisions. At video microscopy they show a slow motion and a predominance of epimastigotes and some round shapes (amastigotes). This was corroborated at the light and electron microscopes. No evidence of lysis in the phagosome vacuoles was observed. At 40 degrees C, macrophages show a large number of residual bodies and phagocytic vacuoles with digested parasites. At 37 degrees C, an intermediate stage with normal and digested parasites inside macrophages is observed. No significant evidences of affected phagocytic and degradative properties of the macrophages were obtained at those temperatures. It is postulated that temperature mainly affects the parasite resistance to intracellular digestion.

Interaction of Trypanosoma cruzi with macrophages influence of temperature

Se estudió la interacción de macrófagos y T.cruzi cultivados in vitro a tres diferentes temperaturas. Luego de 24 horas de incubación a 29-C se observó un gran número de parásitos dentro de los macrófagos con evidencias de división celular. Estos parásitos presentaban un predominio de formas epimastihotas y algunas redondeadas (amastigotes) y movimientos lentos vistos por videomicroscopía. Se corroboró esta observación con los microscopios de luz y electrónico. No se observó evidencias de lisis en los fagosomas. A 40-C los macrófagos muestran un gran número de cuerpos residuales y vacuolas fagocíticas con parásitos digeridos. A 37-C se observó un estado intermedio con parásitos digeridos y normales. Se comprobó que estas temperaturas no afectan al macrófago en su capacidad fagocítica y digestiva. Se postula que la temperatura afecta principalmente al parásito en su resistencia a la digestión intracelular (AU)

Interaction of Trypanosoma cruzi with macrophages influence of temperature

Se estudió la interacción de macrófagos y T.cruzi cultivados in vitro a tres diferentes temperaturas. Luego de 24 horas de incubación a 29-C se observó un gran número de parásitos dentro de los macrófagos con evidencias de división celular. Estos parásitos presentaban un predominio de formas epimastihotas y algunas redondeadas (amastigotes) y movimientos lentos vistos por videomicroscopía. Se corroboró esta observación con los microscopios de luz y electrónico. No se observó evidencias de lisis en los fagosomas. A 40-C los macrófagos muestran un gran número de cuerpos residuales y vacuolas fagocíticas con parásitos digeridos. A 37-C se observó un estado intermedio con parásitos digeridos y normales. Se comprobó que estas temperaturas no afectan al macrófago en su capacidad fagocítica y digestiva. Se postula que la temperatura afecta principalmente al parásito en su resistencia a la digestión intracelular

Interaction of Trypanosoma cruzi with macrophages influence of temperature.

The interaction of macrophages and T. cruzi has been studied in vitro culture under three different temperatures. After 24 hours incubation at 29 degree C a large number of recognizable parasites inside macrophages is observed with evidences of cell divisions. At video microscopy they show a slow motion and a predominance of epimastigotes and some round shapes (amastigotes). This was corroborated at the light and electron microscopes. No evidence of lysis in the phagosome vacuoles was observed. At 40 degrees C, macrophages show a large number of residual bodies and phagocytic vacuoles with digested parasites. At 37 degrees C, an intermediate stage with normal and digested parasites inside macrophages is observed. No significant evidences of affected phagocytic and degradative properties of the macrophages were obtained at those temperatures. It is postulated that temperature mainly affects the parasite resistance to intracellular digestion.

Synergistic activity for high-proliferative-potential colony-forming cell (HPP-CFC) development, stable to trypsin digestion, present in pregnant mouse uterus and placenta extract.

In this paper we describe a crude pregnant mouse uterus and embryo extract (PMUE) prepared from CFW/ep mice which was able to stimulate the proliferation of high-proliferative-potential colony-forming cells (HPP-CFC) of bone marrow of normal mice, in vitro, in semisolid agar culture system. The development of that primitive murine progenitor cells requires the presence of a macrophage-stimulating factor (CSF-1) plus a synergistic factor (SF). The biological activity of both factors was present in our extracts. The higher SF activity was found in uterine plus placental tissues extracts. The SF was precipitated over 45 per cent ammonium sulfate saturation, and behaved as a nondialyzable substance, remained unaffected by trypsin digestion, and was heat-stable (70 degrees C for 15 min).

Synergistic activity for high-proliferative-potential colony-forming cell (HPP-CFC) development, stable to trypsin digestion, present in pregnant mouse uterus and placenta extract.

In this paper we describe a crude pregnant mouse uterus and embryo extract (PMUE) prepared from CFW/ep mice which was able to stimulate the proliferation of high-proliferative-potential colony-forming cells (HPP-CFC) of bone marrow of normal mice, in vitro, in semisolid agar culture system. The development of that primitive murine progenitor cells requires the presence of a macrophage-stimulating factor (CSF-1) plus a synergistic factor (SF). The biological activity of both factors was present in our extracts. The higher SF activity was found in uterine plus placental tissues extracts. The SF was precipitated over 45 per cent ammonium sulfate saturation, and behaved as a nondialyzable substance, remained unaffected by trypsin digestion, and was heat-stable (70 degrees C for 15 min).

Synergistic activity for high proliferative potential colony forming cell (HPP CFC) development, stable to trypsin digestion, present in pregnant mouse uterus and placenta extract

Se estudió la ación "in vitro" del extracto de embriones y úteros de ratón preñado (PMUE), que promueve el desarrollo de grandes colonias de células progenitoras comprometidas de alto potencial prolifarativo (HPP-CFC) y su diferenciación a macrófagos. El extracto se obtuvo de la cepa CFW/ep y tanto las células de la médula ósea de ésta como las de ratones suizos normales se cultivaron en medio semisólido con agar para demostrar la acción biológica del PMUE y medio condicionante de placenta humana (HPCM). La proliferación de esas células progenitoreas muy primitivas requiere la presencia concurrente de un factor estimulante de macrófagos - CSF - y de un factor sinergístico (SF). La actividad biológica de ambos está presente en el extracto, encontrándose la mayor actividad en útero y placenta. El SF precipita con sulfato de amonio con más de 45% de saturación, no es dializable y es termiestable (a 70-C durante 15 min). Se destaca su resistencia a la acción enzimática de la tripsina (AU)

Synergistic activity for high proliferative potential colony forming cell (HPP CFC) development, stable to trypsin digestion, present in pregnant mouse uterus and placenta extract

Se estudió la ación "in vitro" del extracto de embriones y úteros de ratón preñado (PMUE), que promueve el desarrollo de grandes colonias de células progenitoras comprometidas de alto potencial prolifarativo (HPP-CFC) y su diferenciación a macrófagos. El extracto se obtuvo de la cepa CFW/ep y tanto las células de la médula ósea de ésta como las de ratones suizos normales se cultivaron en medio semisólido con agar para demostrar la acción biológica del PMUE y medio condicionante de placenta humana (HPCM). La proliferación de esas células progenitoreas muy primitivas requiere la presencia concurrente de un factor estimulante de macrófagos - CSF - y de un factor sinergístico (SF). La actividad biológica de ambos está presente en el extracto, encontrándose la mayor actividad en útero y placenta. El SF precipita con sulfato de amonio con más de 45% de saturación, no es dializable y es termiestable (a 70-C durante 15 min). Se destaca su resistencia a la acción enzimática de la tripsina

Immunohistochemical localization of erythropoietin in the rat and mouse submandibular gland.

There is a great deal of evidence to indicate that organs other than the kidney are involved in erythropoietin production. In this paper, it is reported that erythropoietin has been localized with an immunocytochemical method in the granular ducts of the submandibular glands of the rat and mouse.

Reduced extrarenal erythropoietin production in rats treated with isoproterenol.

Erythropoietin production was studied in 30-day-old and adult rats previously injected with pharmacological doses of isoproterenol. The animals were stimulated either by hypobaric hypoxia or by a combination of hypoxia and acute anemia. The erythropoietic activity of the plasma was measured by 59Fe incorporation in total circulating red blood cells of mice made polycythemic by chronic hypoxia. The results were converted to units of erythropoietin (IRP). A significant reduction of erythropoietin production was observed only in young rats. Our interpretation of the findings is that isoproterenol induced the differentiation of the salivary glands in the young animals hence reducing hormone production at the extrarenal (submandibular) level.

The role of the submandibular glands in extrarenal erythropoietin production in mice.

The plasma erythropoietic activity of anephric mice and anephric mice without submandibular glands was compared. The erythropoietin production was stimulated by anemia (phenylhydrazine) and hypobaric hypoxia (0.4 atm). The activity was measured by the 59Fe incorporation in total circulating red blood cells in mice rendered polycythemic by hypoxia. The results were also calculated in units (IRP) of erythropoietin. The plasma erythropoietic activity of anephric mice was neutralized by antiserum against normal erythropoietin. Extrarenal erythropoietin production was significantly reduced in mice deprived of submandibular glands. These data indicate that this phenomenon is not restricted to the rat and support the concept that the submandibular glands are important extrarenal sources of erythropoietin.