The dynamics of the main biliary duct and the mechanism of the biliopancreatic reflux

Conclusions The terminal portion of the bile duct (the bile-duct sphincter) and the musculature of the ampulla contract together.A functional autonomy of the sphincter of Oddi is rarely observed.A choledochoduodenal synergy was noted in each case. The spasm of Oddi's sphincter is synchronous with duodenal spasm.Pancreatic reflux occurs with pressure levels varying from 12 to 50 cm. of saline solution. A fatty meal may hinder the reflux in the pancreatic duct in individuals without biliary disease.The X-ray equipment used in our studies was donated by the Rockefeller Foundation to the Department of Anatomy of the Faculdade de Medicina da Universidade de São Paulo.     

Alcohol acute intoxication before sepsis impairs the wound healing of intestinal anastomosis: rat model of the abdominal trauma patient

Introduction

Most trauma patients are drunk at the time of injury. Up to 2% of traumatized patients develop sepsis, which considerably increases their mortality. Inadequate wound healing of the colonic repair can lead to postoperative complications such as leakage and sepsis.

Objective

To assess the effects of acute alcohol intoxication on colonic anastomosis wound healing in septic rats.

Methods

Thirty six Wistar rats were allocated into two groups: S (induction of sepsis) and AS (alcohol intake before sepsis induction). A colonic anastomosis was performed in all groups. After 1, 3 or 7 days the animals were killed. Weight variations, mortality rate, histopathology and tensile breaking strength of the colonic anastomosis were evaluated.

Results

There was an overall mortality of 4 animals (11.1%), three in the group AS (16.6%) and one in the S group (5.5%). Weight loss occurred in all groups. The colon anastomosis of the AS group didn’t gain strength from the first to the seventh postoperative day. On the histopathological analysis there were no differences in the deposition of collagen or fibroblasts between the groups AS and S.

Conclusion

Alcohol intake increased the mortality rate three times in septic animals. Acute alcohol intoxication delays the acquisition of tensile strength of colonic anastomosis in septic rats. Therefore, acute alcohol intoxication before sepsis leads to worse prognosis in animal models of the abdominal trauma patients.

     

Myocardial Infarction Area Quantification using High-Resolution SPECT Images in Rats

Background

Imaging techniques enable in vivo sequential assessment of the morphology and function of animal organs in experimental models. We developed a device for high-resolution single photon emission computed tomography (SPECT) imaging based on an adapted pinhole collimator.

Objective

To determine the accuracy of this system for quantification of myocardial infarct area in rats.

Methods

Thirteen male Wistar rats (250 g) underwent experimental myocardial infarction by occlusion of the left coronary artery. After 4 weeks, SPECT images were acquired 1.5 hours after intravenous injection of 555 MBq of 99mTc-Sestamibi. The tomographic reconstruction was performed by using specially developed software based on the Maximum Likelihood algorithm. The analysis of the data included the correlation between the area of perfusion defects detected by scintigraphy and extent of myocardial fibrosis assessed by histology.

Results

The images showed a high target organ/background ratio with adequate visualization of the left ventricular walls and cavity. All animals presenting infarction areas were correctly identified by the perfusion images. There was no difference of the infarct area as measured by SPECT (21.1 ± 21.2%) and by histology (21.7 ± 22.0%; p=0.45). There was a strong correlation between individual values of the area of infarction measured by these two methods.

Conclusion

The developed system presented adequate spatial resolution and high accuracy for the detection and quantification of myocardial infarction areas, consisting in a low cost and versatile option for high-resolution SPECT imaging of small rodents.     

Use of Slag/Sugar Cane Bagasse Ash (SCBA) Blends in the Production of Alkali-Activated Materials

Blast furnace slag (BFS)/sugar cane bagasse ash (SCBA) blends were assessed for the production of alkali-activated pastes and mortars. SCBA was collected from a lagoon in which wastes from a sugar cane industry were poured. After previous dry and grinding processes, SCBA was chemically characterized: it had a large percentage of organic matter (ca. 25%). Solutions of sodium hydroxide and sodium silicate were used as activating reagents. Different BFS/SCBA mixtures were studied, replacing part of the BFS by SCBA from 0 to 40% by weight. The mechanical strength of mortar was measured, obtaining values about 60 MPa of compressive strength for BFS/SCBA systems after 270 days of curing at 20 °C. Also, microstructural properties were assessed by means of SEM, TGA, XRD, pH, electrical conductivity, FTIR spectroscopy and MIP. Results showed a good stability of matrices developed by means of alkali-activation. It was demonstrated that sugar cane bagasse ash is an interesting source for preparing alkali-activated binders.     

Pharmacokinetics of intravenous and intraperitoneal ceftriaxone in chronic ambulatory peritoneal dialysis

Summary The kinetics of ceftriaxone was investigated in 8 patients without infection, who were receiving continuous ambulatory peritoneal dialysis (CAPD). Ceftriaxone 1 g was injected i.v. and 1 g was given intraperitoneally in the CAPD fluid during a 4-h dwell time. Ceftriaxone was assayed by HPLC. After intravenous administration, the kinetic parameters of ceftriaxone were: plasma t_1/2, 12.3 h, total plasma clearance, 14.0 ml/min, volume of distribution at steady state 0.18 l/kg, and peritoneal clearance 0.59 ml/min. Over 72 hours only 5.5% of the dose was eliminated by the peritoneal route. After intraperitoneal administration, ceftriaxone rapidly appeared in serum; the absorption t_1/2 was 1.1 h and the mean peak concentration was 38.8 µg/ml. The absorption of ceftriaxone from the peritoneal space was 39%. A single 1.0 g IP dose led to serum and dialysate concentrations of ceftriaxone above the minimum inhibitory concentration for susceptible pathogens for 24 hours.     

Action of sublingual nifedipine on left ventricular filling in hypertensive crisis

We studied the left ventricular filling before and 15 minutes after sublingual absorption of one Nifedipine capsule in 33 untreated hypertensive patients (mean age: 68.6) without other cardiac disease and presenting an hypertensive access. This study was carried out with Doppler-echocardiography. Sample volume was set at the tips of mitral leaflets. The protocol included: early peak filling velocity (VE), atrial peak velocity (VA), mitral pressure half-time (T1/2), isovolumic relaxation time (TRIV), velocity time integral of total mitral curve (VTIT) and velocity time integral of atrial curve (VTIA). We also studied VE/VTIT ratio which has been correlated to peak filling rate/mitral stroke volume ratio in radionuclide angiography. RESULTS: [table: see text] The variations of VA/VE, VTIA/VTIT, VE/VTIT and T1/2 are statistically significant but decrease of TRIV is not significant. The arterial blood pressure decreases from 184/103 to 153/83 and cardiac rate increases from 81.8 to 87.9 beats/minute. CONCLUSION: On hypertensive emergencies sublingual nifedipine significantly improves rapid left ventricular filling without change of TRIV. Acceleration of cardiac rate is moderate.     

BNP as a marker of the heart failure in the treatment of imatinib mesylate

Since its introduction 6 years ago, imatinib mesylate, a selective tyrosine kinase inhibitor, has been a phenomenon in treating chronic myelogenous leukemia (CML) with remarkably superior cytogenetic and molecular response rates at all stages of CML followed by longer progression free survival. Despite its extraordinarily high efficacy, adverse effects of imatinib mesylate such as edema, liver toxicity and fluid retention syndromes have been reported. Here we, for the first time, report development of heart failure in patients on imatinib mesylate medication and the possibility of brain natriuretic peptide (BNP) as a potential diagnostic (or predicting) marker for heart failure. Since plasma BNP levels in the two patients were exceptionally high, we then explored the possibility of genetic association of BNP with the development of heart failure to find no positive association.