| 1. |
- Harnek, Jan, et al.
(författare)
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Insertion of Self-Expandable Nitinol Stents Without Previous Balloon Angioplasty Reduces Restenosis Compared with PTA Prior to Stenting.
- 2002
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer Science and Business Media LLC. - 1432-086X .- 0174-1551. ; 25:3, s. 430-436
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the development of intimal hyperplasia after deployment of a self-expanding nitinol stent with and without previous percutaneous transluminal balloon angioplasty (PTA), with the results after PTA alone. Methods: In nine healthy pigs, the iliac arteries were divided into three groups: group 1 (n = 6 arteries) was treated with PTA; group 2 n = 6) with insertion of self-expanding stents after PTA; and group 3 (n = 6) with stent insertion without previous PTA. After 8 weeks the vessels were examined with intravascular ultrasonography, histologic examination and morphometric analysis. Results: Although the injury index in group 1 (0.17 +/- 0.57) was lower (p <0.05) than in group 2 (0.26 +/- 0.06) and group 3 (0.26 +/- 0.08), PTA-treated arteries showed significantly (p <0.05) reduced mean luminal gain (0.53 +/- 2.84) compared with arteries treated with PTA prior to stenting (2.58 +/- 1.38) and compared with stenting alone (4.65 +/- 5.34). Stenting after PTA resulted in a higher (p <0.05) restenosis index (2.63 +/- 1.06) compared with stenting without PTA (1.35 +/- 0.59). Group 2 also had a significantly thicker intima p <0.05) and 83% and 74% higher intima/media ratio (p <0.05) compared with groups 1 and 3, respectively. Conclusion: Insertion of a self-expandable nitinol stent without previous PTA results in less intimal hyperplasia than if PTA is performed prior to stenting, suggesting that direct stenting can be used in angioplasty sessions with a favorable outcome.
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| 2. |
- Harnek, Jan, et al.
(författare)
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Intimal Hyperplasia in Balloon Dilated Coronary Arteries is Reduced by Local Delivery of the NO Donor, SIN-1 Via a cGMP-Dependent Pathway.
- 2011
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To elucidate the mechanism by which local delivery of 3-morpholino-sydnonimine (SIN-1) affects intimal hyperplasia after percutaneous transluminal coronary angioplasty (PTCA). METHODS: Porcine coronary arteries were treated with PTCA and immediately afterwards locally treated for 5 minutes, with a selective cytosolic guanylate cyclase inhibitor, 1 H-(1,2,4)oxadiazole(4,3-alpha)quinoxaline-1-one (ODQ) + SIN-1 or only SIN-1 using a drug delivery-balloon. Arteries were angiographically depicted, morphologically evaluated and analyzed after one and eight weeks for actin, myosin and intermediate filaments (IF) and nitric oxide synthase (NOS) contents. RESULTS: Luminal diameter after PCI in arteries treated with SIN-1 alone and corrected for age-growth was significantly larger as compared to ODQ + SIN-1 or to controls (p < 0.01). IF/actin ratio after one week in SIN-1 treated segments was not different compared to untreated segments, but was significantly reduced compared to ODQ + SIN-1 treated vessels (p < 0.05). Expression of endothelial NADPH diaphorase activity was significantly lower in untreated segments and in SIN-1 treated segments compared to controls and SIN-1 + ODQ treated arteries (p < 0.01). Restenosis index (p < 0.01) and intimal hyperplasia (p < 0.01) were significantly reduced while the residual lumen was increased (p < 0.01) in SIN-1 segments compared to controls and ODQ + SIN-1 treated vessels. CONCLUSIONS: After PTCA local delivery of high concentrations of the NO donor SIN-1 for 5 minutes inhibited injury induced neointimal hyperplasia. This favorable effect was abolished by inhibition of guanylyl cyclase indicating mediation of a cyclic guanosine 3',5'-monophosphate (cGMP)-dependent pathway. The momentary events at the time of injury play crucial role in the ensuring development of intimal hyperplasia.
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| 3. |
- Nilsson, C., et al.
(författare)
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Effect of selective denervation of the rat pancreas on pancreatic endocrine function
- 2001
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Ingår i: European Surgical Research. - : S. Karger AG. - 0014-312X .- 1421-9921. ; 33:2, s. 86-91
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the influence of selective denervation of the rat pancreas on hormone secretion and on peripheral insulin sensitivity. Thirteen rats, 7 denervated and 6 sham operated, received an intravenous glucose challenge for 30 min. The basal plasma levels of insulin, glucagon and glucose did not differ between the two groups. An augmented insulin response to glucose was detected in the denervated group, whereas the glucagon response was unaffected. Glucose tolerance was marginally improved. Twenty-four rats, 12 denervated and 12 sham operated, received a constant infusion of glucose, insulin, epinephrine and propranolol in order to inhibit the endogenous insulin release and thus evaluate insulin sensitivity. No significant change in insulin sensitivity could be detected during our experimental conditions. We conclude that selective denervation brings about an increased insulin response to glucose, probably by interrupting a catecholaminergic negative tone on the beta -cell. The sympathectomized animals did not disclose any apparent changes in peripheral insulin sensitivity.
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| 4. |
- Vagianos, Constantin, et al.
(författare)
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Control of traumatic liver hemorrhage in the cirrhotic rat by intraportal infusion of norepinephrine
- 1987
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Ingår i: Research in Experimental Medicine. - 0300-9130. ; 187:5, s. 339-346
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Tidskriftsartikel (refereegranskat)abstract
- The effect of intraportal infusion of norepinephrine (NE) on primary hemostasis in the cirrhotic rat was investigated at standardized liver trauma. Cirrhosis was induced by simultaneous administration of increasing amounts of carbontetrachloride (CCl4) and phenobarbitone. Infusion of norepinephrine took place after cannulation of the gastroduodenal vein. Intraportal infusion of NE resulted in a significant increase in arterial blood pressure and portal pressure in all animals. No difference was observed between cirrhotic and control rats. Cirrhotic animals bled longer and more profusely as compared with the controls. Infusion of NE resulted in significant decrease in bleeding time and blood loss. NE did not affect hematocrit, hemoglobin, platelet, or white cell count. Platelet aggregation was not influenced by the compound. In conclusion, intraportal infusion of NE proved effective in decreasing hemorrhage at liver trauma in cirrhotic rats.
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| 5. |
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| 6. |
- Vagianos, Constantin, et al.
(författare)
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Increased uptake of 5-FU in experimental liver tumours by simultaneous infusion of norepinephrine
- 1987
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Ingår i: European journal of cancer & clinical oncology. - : Elsevier BV. - 0277-5379. ; 23:9, s. 1323-1327
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Tidskriftsartikel (refereegranskat)abstract
- The effect of the simultaneous administration of norepinephrine and 5-fluorouracil (5-FU) on the uptake of radiolabelled 5-FU by liver tumours was studied in rats. Three different concentrations of 5-FU were used (15, 1.5 and 0.15 microgram/g body weight). The drugs were infused over a 30 min period via the hepatic artery, following cannulation of the gastroduodenal artery. The radioactivity in liver tumour, normal liver, lungs and intestines was estimated by liquid scintillation counting. At all concentrations tested, an increased uptake of radioactive 5-FU was found in the tumour when norepinephrine was infused. Tumour/liver ratios also increased significantly in all these cases. No significant differences were noted between norepinephrine infused and control animals in the radioactivity in normal liver, lungs and intestines. The effects noted were possibly due to changes in blood flow within the liver, but the possibility of a direct effect of norepinephrine on DNA metabolism is discussed.
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| 7. |
- Zoucas, Evita, et al.
(författare)
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Arrest of haemorrhage at experimental liver trauma by intra-portal infusion of nor-epinephrine
- 1989
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Ingår i: Surgical Research Communications. - 0882-9233. ; 7:1, s. 19-25
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Tidskriftsartikel (refereegranskat)abstract
- The efficacy of intraportal (i.p.) nor-epinephrine infusion in controlling bleeding upon liver trauma in the presence of normal as well as defective platelet function was evaluated in the rat. Infusion of nor-epinephrine (10-4 M, NE) took place after cannulation of the gastro-duodenal vein, during 5 min prior to liver trauma. Simultaneously blood pressure (BP) was registered. Platelet aggregation was rendered defective by per os administration of acetyl-salicylic acid (2.5 mg/100 g bW ASA) 30 min prior to liver trauma. Liver trauma constituted of a standardized liver resection involving 2-3 per cent of the total liver weight, bleeding time and blood loss from the wound being registered. Haemoglobin (Hb), Haematocrit (Hct), platelet count (PC), APT-time and platelet aggregation were studied upon resection. I.p. infusion of NE resulted in significant increase of BP from 122.5 3.2 mm Hg in controls to 166.2 ± 3.2 mm Hg. NE infusion significantly decreased bleeding time at liver trauma from 270 ± 15 sec in controls to 154 ± 10 sec. Simultaneously blood-loss was decreased from 0.9 ± 0.1 g to 0.4 ± 0.1 gr. Administration of ASA increased bleeding time to 513 ± 17 sec and blood loss to 2.1 ± 0.1 gr. Infusion of NE in ASA pretreated rats reduced bleeding time to 253 ± 24 sec and blood loss to 1.1 ± 0.2 gr compared with animals receiving only ASA. Hb, Hct, PC and APT-time were not affected. Platelet aggregation was diminished after administration of ASA, but was not affected by NE.
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| 8. |
- Zoucas, Evita, et al.
(författare)
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Differential roles of endogenous nitric oxide on neural regulation of basal exocrine pancreatic secretion in intact and denervated pancreas
- 2001
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Ingår i: Pancreatology. - : Elsevier BV. - 1424-3903. ; 1:2, s. 96-101
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Tidskriftsartikel (refereegranskat)abstract
- Background. Autonomic nerves and humoral factors regulate pancreatic secretion. Nerves containing nitric oxide (NO) synthase (NOS) are in close proximity and located within cholinergic, adrenergic and sensory nerve bundles. Yet, the interactive mechanisms between various nerve populations remain elusive. Aims: To evaluate the role of endogenous NO in basal exocrine pancreatic secretion in the extrinsically denervated rat pancreas. Methods: Male Sprague-Dawley rats were assigned to 2 groups of 11 animals. The first group of sham-operated animals served as controls. In the second group extrinsic pancreatic innervation was surgically interrupted. One week later, after selective catheterization of the celiac axis and the bile-pancreatic duct, the animals received intra-arterial infusions of N-G-nitro-L-arginine (L-NNA; 0.48 mg/kg b.w./h) followed by intraarterial infusions of L-arginine (110 mg/kg b.w./h). Total protein and amylase were measured in bile-pancreatic secretions collected at 15-min intervals. Results: In controls, total protein and amylase output showed a biphasic secretion pattern with an increase during L-NNA infusion followed by a decrease when the infusion ceased and further augmentation 1 h later. In denervated animals, L-NNA caused a sustained decrease in pancreatic secretion followed by an increase 1 h later. Infusion of L-arginine at the time of maximum decrease slowed the second phase of protein and amylase output in sham-operated rats, but accentuated the onset of secretion in denervated animals. Conclusion: Inhibition of endogenous NO release was shown to increase baseline secretion in the intact pancreas. Superposition of extrinsic denervation on neural NOS-blockade decreased basal exocrine secretion, indicating that intra-pancreatic NO release is regulated by extra-pancreatic nerves. Copyright (C) 2001 S. Karger AG, Basel and IAP.
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| 9. |
- Zoucas, Evita, et al.
(författare)
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Pelvic Exenteration for Advanced and Recurrent Malignancy.
- 2010
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; Jul 1, s. 2177-2184
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Improved surgical techniques and oncological treatment render many advanced pelvic tumors amenable to curative resection. We evaluated morbidity, survival, and quality of life (QoL) after extended pelvic procedures. METHODS: From January 2003 to November 2008, 85 patients underwent multivisceral pelvic resection; 87% had colorectal or anal malignancies. Preoperatively, endoscopy and imaging procedures were performed, followed by multidisciplinary assessment. Fifty-eight percent received preoperative chemotherapy and pelvic irradiation. Exenteration was total in 32 patients and posterior in 48. Five posterior resections included partial cystectomy and 21 encompassed resection of the bony pelvis. Myocutaneous flaps were used for reconstruction in 33 cases. Urinary diversion was achieved by ileal conduit in 24 and by continent pouch in 8. QoL was evaluated prospectively in 22 late cases. RESULTS: All patients were evaluated. Clear margins were obtained in 66%. Median duration of surgery was 680 (310-1,320) min, and blood loss was 1,800 (350-19,000) ml. Morbidity was 68%, whereof major complications constituted 13%. Median hospital stay was 18 (5-70) days. There was no 90-day mortality. Median follow-up was 24 (3-71) months. Local control was obtained in 77 patients. Twenty-seven manifested disseminated disease without local recurrence, two developed isolated local recurrence, and six had local and systemic recurrences. Twenty-one died after a median of 11 (4-55) months follow-up. Survival was correlated with clear margins and time to relapse. QoL was improved at 16 months after surgery. CONCLUSIONS: Multivisceral pelvic surgery is possible with acceptable morbidity and QoL. Thorough patient selection and multimodal therapy are necessary to attain maximum benefit.
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