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Biomedical subjects

U Tannuri

Publications and source records attributed to U Tannuri.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Effect of branched-chain amino acids and insulin on postinjury protein catabolism in growing animals.

Muscle proteolysis continues to occur in hypercatabolic states despite the administration of carbohydrates and proteins. Recent clinical and experimental studies have demonstrated that, under catabolic conditions, treatment with either branched-chain amino acids (BCAA) or insulin may decrease negative nitrogen balance. However, the use of BCAA-enriched solutions to inhibit muscle proteolysis has never been tested in growing animals. A study was therefore undertaken to assess the effectiveness of such solutions, with or without insulin, as compared to a more balanced amino acid solution, in preventing or diminishing postinjury protein catabolism in growing animals. Fifteen-day-old rabbits, exposed to standard moderate trauma in the form of crushing the muscle mass of one rear thigh, received one of two amino acid formulations--a balanced amino acid solution (18.8% BCAA) or a 35% BCAA-enriched solution--for 96 hr. Insulin was given to subgroups of both series. The results indicate that: (1) nitrogen balance in nontraumatized animals is clearly superior when balanced amino acids are administered; (2) BCAA-enriched solutions may decrease postinjury muscle protein catabolism; (3) after trauma, insulin also has a nitrogen-conserving effect, which is demonstrated when it is combined both with BCAA-enriched (35%) and balanced amino acid (18.8%) solutions. However, a better nitrogen balance is achieved when insulin is associated with the balanced amino acid solution.

Amino Acids, Branched-Chain↗
PubMedDate not supplied

Effects of circular myotomy on the healing of esophageal suture anastomosis: an experimental study.

For esophageal reconstruction in newborns with esophageal atresia, esophageal reunion with an end-to-end anastomosis is the ideal procedure, although it may result in leaks and strictures due to tension on the suture line, mainly in cases with a wide gap between the ends. Circular myotomy (Livaditis' procedure) is the best method to elongate the proximal esophageal pouch and reduce anastomotic tension. This experimental investigation in dogs was undertaken to attempt to verify that circular myotomy decreases the anastomotic leak rate in newborns with wide gap esophageal atresia, and to analyze whether the technique promotes morphologic changes in the anastomotic scar. A pilot study demonstrated that it is necessary to resect more than 8 cm (40% of the total esophageal length) in order to obtain high leak rates. In the experimental project, such resection was performed in dogs divided into two groups (control group, anastomosis only, and experimental group, anastomosis plus circular myotomy in the proximal esophageal segment). The animals were killed in the 14th postoperative day, submitted to autopsy, and were evaluated as to the presence of leaks and strictures, as well as to the features (macroscopic and microscopic aspects) of the anastomosis. Leak rates were the same in both groups. Morphometric analysis revealed that in animals in the experimental group, the anastomotic scar was thinner than the control animals, and the isolated muscular manchette distal to the site of myotomy was replaced by fibrous tissue. Correspondingly, a decreased number of newly formed small vessels were noted in the experimental animals, compared to control animals. We concluded that circular myotomy does not decrease the incidence of anastomotic leaks, and it also promotes deleterious changes in anastomotic healing.

Anastomosis, Surgical↗
PubMedDate not supplied

The effects of glutamine-supplemented diet on the intestinal mucosa of the malnourished growing rat.

UNLABELLED: Glutamine is the most abundant amino acid in the blood and plays a key role in the response of the small intestine to systemic injuries. Mucosal atrophy is an important phenomenon that occurs in some types of clinical injury, such as states of severe undernutrition. Glutamine has been shown to exert powerful trophic effects on the gastrointestinal mucosa after small bowel resection or transplant, radiation injury, surgical trauma, ischemic injury and administration of cytotoxic drugs. Since no study has been performed on the malnourished animal, we examined whether glutamine exerts a trophic effect on the intestinal mucosa of the malnourished growing rat. Thirty-five growing female rats (aged 21 days) were divided into 4 groups: control - chow diet; malnutrition diet; malnutrition+chow diet; and malnutrition+glutamine-enriched chow diet (2%). For the first 15 days of the experiment, animals in the test groups received a malnutrition diet, which was a lactose-enriched diet designed to induce diarrhea and malnutrition. For the next 15 days, these animals received either the lactose-enriched diet, a regular chow diet or a glutamine-enriched chow diet. After 30 days, the animals were weighed, sacrificed, and a section of the jejunum was taken and prepared for histological examination. All the animals had similar weights on day 1 of experiment, and feeding with the lactose-enriched diet promoted a significant decrease in body weight in comparison to the control group. Feeding with both experimental chow-based diets promoted significant body weight gains, although the glutamine-enriched diet was more effective. RESULTS: The morphological and morphometric analyses demonstrated that small intestinal villous height was significantly decreased in the malnourished group, and this change was partially corrected by the two types of chow-based diet. Crypt depth was significantly increased by malnutrition, and this parameter was partially corrected by the two types of chow-based diet. The glutamine-enriched diet resulted in the greatest reduction of crypt depth, and this reduction was also statistically significant when compared with control animals. CONCLUSIONS: Enteral glutamine has some positive effects on body weight gain and trophism of the jejunal mucosa in the malnourished growing rat.

Animals↗
PubMedDate not supplied

Heart hypoplasia in an animal model of congenital diaphragmatic hernia.

PURPOSE: In previous papers, we described a new experimental model of congenital diaphragmatic hernia in rabbits, and we also reported noninvasive therapeutic strategies for prevention of the functional and structural immaturity of the lungs associated with this defect. In addition to lung hypoplasia, pulmonary hypertension, biochemical, and structural immaturity of the lungs, the hemodynamics of infants and animals with congenital diaphragmatic hernia are markedly altered. Hence, cardiac hypoplasia has been implicated as a possible cause of death in patients with congenital diaphragmatic hernia, and it is hypothesized to be a probable consequence of fetal mediastinal compression by the herniated viscera. Cardiac hypoplasia has also been reported in lamb and rat models of congenital diaphragmatic hernia. The purpose of the present experiment was to verify the occurrence of heart hypoplasia in our new model of surgically produced congenital diaphragmatic hernia in fetal rabbits. METHODS: Twelve pregnant New Zealand rabbits underwent surgery on gestational day 24 or 25 (normal full gestational time - 31 to 32 days) to create left-sided diaphragmatic hernias in 1 or 2 fetuses per each doe. On gestational day 30, all does again underwent surgery, and the delivered fetuses were weighed and divided into 2 groups: control (non-surgically treated fetuses) (n = 12) and congenital diaphragmatic hernia (n = 9). The hearts were collected, weighed, and submitted for histologic and histomorphometric studies. RESULTS: During necropsy, it was noted that in all congenital diaphragmatic hernia fetuses, the left lobe of the liver herniated throughout the surgically created defect and occupied the left side of the thorax, with the deviation of the heart to the right side, compressing the left lung; consequently, this lung was smaller than the right one. The body weights of the animals were not altered by congenital diaphragmatic hernia, but heart weights were decreased in comparison to control fetuses. The histomorphometric analysis demonstrated that congenital diaphragmatic hernia promoted a significant decrease in the ventricular wall thickness and an increase in the interventricular septum thickness. CONCLUSION: Heart hypoplasia occurs in a rabbit experimental model of congenital diaphragmatic hernia. This model may be utilized for investigations in therapeutic strategies that aim towards the prevention or the treatment of heart hypoplasia caused by congenital diaphragmatic hernia.

Animals↗
PubMedDate not supplied

[Biliary tract dilatation and abnormal choledocho-pancreatic ductal junction in children].

Nine children aged between 2 months and 11 years, who had congenital dilatation of extrahepatic biliary tract, with or without intrahepatic dilatation, are presented. The radiological studies performed in eight patients demonstrated abnormal choledochopancreatico ductal junction. Thus, a long common channel is formed out of the duodenal wall, leading to a continuous reflux of pancreatic juice into the biliary system, chronic inflammation of biliary tract wall, fibrosis of muscular layer and finally different types of dilatations. The main clinical findings were upper abdominal pain, vomiting, or obstructive jaundice. In only one child the dilatation was cystic type and the clinical manifestation was palpable abdominal mass. In eight patients the initial diagnosis of biliary tract dilatation was made through abdominal ultrasound and in one case by direct visualization through emergent exploratory laparotomy. The final confirmation of the presence of long common channel was made by preoperative endoscopic retrograde cholangiopancreatography or intraoperative cholangiogram. The radiologic investigation was not performed in only one case due to bad clinical conditions. The surgical treatment indicated to all cases was Roux- en- Y hepatic- jejunostomy. The late follow up demonstrated that all patients are well and assymptomatic.

English Abstract↗
PubMedDate not supplied

[Leiomyoma of the esophagus in children - case report and review of the literature].

The leiomyoma of the esophagus is very rare in children, contrary to what has been observed in adults, with only 26 cases reported up to now. In this paper we present the case of a 9 year-old child in which the tumor was located in the abdominal esophagus, being progressive dysphagia its most important manifestation. Diagnosis was done during the surgical procedure, and the treatment involved sub-total esophagotomy and pyloroplasty, with ulterior esophageal substitution for a colon segment. The only post-surgical complication was dumping which resulted from the pyloroplasty. Its symptoms receded with appropriate diet. The review of the literature shows that leiomyomas in children may be diffuse or located, the former being the more common case (90%). Twelve children presented association with Alport's syndrome (nephropathy with hematuria, deafness and cataract) while others had hiatus hernia, esophageal peptic ulcer and cholelithiasis. In two children the tumor affected the tracheo-bronchial tree, and in four girls there was vulvar or perianal hypertrophy. Finally, there is a rarer kind of tumor in the esophageal muscular layer called benign idiopathic hypertrophy, which has been described for six children. Its basic histological characteristic is non neoplastic hyperplasia of the cells of the internal muscular layer. We conclude that the leiomyomas of the esophagus, although rare, must be considered in the differential diagnosis of the mediastinal mass and the esophageal stenosis in children.

English Abstract↗
PubMedDate not supplied

[Early-onset neonatal sepsis and late-appearing diaphragmatic hernia].

The interesting association between delayed presentation of right-sided diaphragmatic hernia and neonatal Group B streptococcal infections occurs rarely and its pathogenesis is still obscure. Two preterm newborn infants with early onset of neonatal sepsis (one due to Group B Streptococcus) followed by recognition of right-sided diaphragmatic hernia on the 9th and 25th day of life are reported. In both cases the course of neonatal sepsis and pneumonia was complicated due to the appearance of right-sided pleural effusion and atelectasis. On serial chest roentgenograms right-sided bowel gas was noticed and the liver shadow became gradually elevated. Diagnosis was confirmed by ultrasonography and computed tomography. Suspicion of associated diaphragmatic hernia should be raised in neonatal streptococcal infection whenever subsequent progressive respiratory deterioration ensues, requiring mechanical ventilation after initial clinical improvement or in the presence of right-sided pleural effusion.

Female↗
PubMedDate not supplied

Study of fracture healing in protein malnutrition.

The present study was designed to assess the effects of nutrition on fracture healing in a controlled animal model. Tibial fractures were studied in 115 Wistar rats divided into four groups: group 1,50 control animals kept on a normal diet; groups 2 and 3, 45 protein-deprived animals, and group 4, 20 animals submitted to protein malnutrition before the fracture and then placed on a normal laboratory diet. The parameters evaluated during the study were: variation in animal weight during the experiment (confirmation of protein malnutrition), fracture healing as determined by bone callus radiology, macroscopic evaluation of bone callus mechanical resistance, and histological fracture examination by common light microscopy after staining with hematoxylin-eosin. The results showed the beneficial effects of protein nutrition support on the healing of lone bone fractures. Callus formation was significantly improved in groups 1 and 4 compared to groups 2 and 3. In groups 1 and 4, callus development was normal, with regular bone tissue formation, whereas in groups 2 and 3 there was a large amount of fibrous-connective tissue with scarce formation of osseous tissue.

Animals↗
PubMedDate not supplied

Long-term stability of lipid emulsions with parenteral nutrition solutions.

The stability of the mixture of peripheral vein parenteral nutrition (PN) solution with 10% lipid emulsions (Intralipid or Lipofundin MCT) was tested during a prolonged period of refrigerated storage. The analysis included gross visual examination of the bottle, pH determination, and examination by electron microscope. The mixtures of fat emulsions with PN solution demonstrated no physical instability or pH alteration. Examination under electron microscope revealed no alterations after 4 wk, but the surface layer of fat globules was disrupted after 10 and 18 wk. This study demonstrates that complete nutritive mixtures can be prepared and stored in refrigeration for at least 4 wk before clinical use.

Drug Stability↗
PubMedDate not supplied

[Liver transplantation in children: initial experience of the Instituto da Criança of the Hospital das Clínicas of Universidade de São Paulo].

The initial experience at the Instituto da Criança do Hospital das Clínicas--School of Medicine of São Paulo University with liver transplantation in children is presented. A staff experienced in the management of children, including pediatric surgeons, hepatologists, critical care specialists, anesthesiologists, and other has been joined to draw therapeutic protocols. Afterward, more than 100 experimental liver transplant were performed in animals of medium size (dogs and pigs). From September, 1989 to July 1991, 12 liver transplants were performed on 9 children (3 retransplants) ranging in age from 2.5 to 17 years, being 5 boys and 4 girls. The donors had been selected according to the ABO blood group and body weight. Just once a blood A+ recipient received a liver from a blood O+ donor. The regular postoperative immunosuppression consisted of triple therapy with cyclosporin, prednisone and azathioprine. The postoperative stay in the Intensive Care Unit ranged from 3 to 24 days, according to the necessity of ventilatory support. These was no intraoperative mortality, arterial or venous thromboses, or early biliary complications. The overall survival is 78% (7/9). Primary non-function of the graft was the cause of death in two of our children. Although the number of cases is still small our results are comparable to those of the best liver transplant centers in the world.

Adolescent↗
PubMedDate not supplied

Effect of ifosfamide on bone healing.

The effect of ifosfamide on bone healing was tested in a controlled experiment of fibular osteotomy in immature rabbits. Standardized shaft osteotomy was implemented in 10 experimental subjects (group 2) and 10 controls (group 1). Experimental animals received a 50 mg/kg ifosfamide dose by intraperitoneal injection on the fourth post-operative day, and for five days thereafter, while controls received injections of distilled water. After five weeks, all animals were submitted to pharmacological euthanasia and the resulting bone callus samples were studied with histomorphometry, using hematoxylin-eosin stain. Group 2 presented smaller bone volume (69.03% versus 84.98%), larger fibrosis volume (30.96% versus 15.02%), and larger resorption surface (22.02% versus 16.17%) than group 1 (all p< or = 0.05). We conclude that ifosfamide is able to alter the physiological bone healing process by producing a less mature callus (characterized by a smaller quantity of bone tissue), a larger quantity of fibrous tissue, and a smaller resorption surface.

Animals↗
PubMedDate not supplied

[Common bile duct syndrome in children].

Two children bile duct dilatation due to anomalous junction of the pancreato-biliary ductal system are reported. A long common channel comes out of the duodenal wall and, thus, reflux of pancreatic juice into the biliary tree and dilatation of biliary ducts may occur. Clinical findings were upper abdominal pain, vomiting, or jaundice. Diagnosis was accomplished by abdominal ultrasonography and endoscopic or intra-operative colangiography. Both cases were treated by Roux-en-Y hepatico-jejunostomy, the best technique for these cases. Follow-up showed that the patients are well and free of symptoms.

Anastomosis, Roux-en-Y↗
PubMedDate not supplied

[Stability of the mixture of a new fat emulsion with parenteral nutrition solutions].

The stability of the mixture of various parenteral nutrition (PN) solutions with a new fat emulsion containing 50% soybean oil and 50% medium chain triglycerides (MCT) was tested. Five different mixtures were analyzed under transmission electron microscopy 24 hours after the preparation: 1) 10% fat emulsion (FE); 2) FE + PN solution with 5% glucose; 3) FE + PN solution with 12.5% glucose; 4) FE + PN solution with 25% glucose; 5) FE + pure 50% glucose. The pH of each PN solution, fat emulsion and mixture was determined in order to verify if the stability was dependent on the pH of the surrounding medium. The mixture of lipid emulsion with PN solutions did not cause any coalescence of the liposomes or damage to their membranes. However, the addition of 50% glucose to FE coalesced the liposomes, probably due to a decreased pH of the medium (pH = 3.3). We conclude that mixtures of this specific lipid emulsion with PN solutions containing glucose up to 25% are stable for at least 24 hours, and suitable for clinical use in parenteral nutrition.

Drug Combinations↗