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Análise do efeito do resfriamento da via excretora durante termoablação com radiofreqüência em rim de porco / Analysis of the cooling effect in the urinary system during renal radiofrequency thermoablation in pigsSantos, André Meirelles dos 29 April 2005 (has links)
A ablação de tumores renais com radiofreqüência tem se tornado uma alternativa cada vez mais atraente dentro do arsenal de procedimentos minimamente invasivos. Uma das raras complicações desta forma de tratamento é a lesão térmica do urotélio, desencadeando fístulas urinárias, hidronefrose, estenose ureteral e estenose de junção ureteropiélica, em alguns casos, com necessidade de nefrectomia do órgão acometido. Em lesões hepáticas, ablação tumoral muito perto da via biliar pode evoluir com estenose, a menos que haja um resfriamento dos dutos biliares concomitante à aplicação da radiofreqüência. Desta forma, o objetivo deste estudo foi o de propor um processo semelhante no trato urinário, comparando ablações renais próximas ao urotélio, com e sem irrigação do sistema coletor, com soro fisiológico a 2°C, analisando a integridade da via excretora e a eficácia da ablação. Métodos: Oito suínos do sexo feminino foram submetidos à laparotomia, com abertura da bexiga e cateterização de um dos meatos ureterais com cateter de duplo-lúmen, conforme sorteio realizado antes do início do procedimento. Foi realizada aplicação de radiofreqüência com um ciclo de oito minutos, regulada para atingir uma temperatura média de 100°C e aplicada com uma agulha deflagrada com um centímetro de exposição, sendo produzida uma lesão superficial no terço médio do rim. O grau de profundidade da agulha foi monitorado pelo uso de ultra-som intra-operatório. No total, foram realizadas duas lesões em cada animal, uma no rim sem cateter ureteral, e outra em um rim exposto ao resfriamento da via excretora com soro fisiológico a 2°C, circulando a 30 ml/min. Os animais foram sacrificados no décimo-quarto dia de pósoperatório. Resultados: Os maiores diâmetros da lesão criada pela radiofreqüência e o aspecto radiológico da via excretora, obtido por meio de pielografia ascendente bilateral, foram comparados e não houve diferença significativa entre os rins tratados, estando ou não expostos ao resfriamento da via excretora. Conclusão: O resfriamento da via excretora durante ablação com radiofreqüência não alterou a necrose de coagulação gerada, tampouco afetou a integridade da via excretora / Renal tumor ablation has become quite an attractive alternative among minimally invasive procedures. One of the few complications of this new technology is thermal damage to the urothelium, causing urinary fistula, hydronephrosis and ureteral and ureteropelvic junction obstruction. Some cases required a nephrectomy. In hepatic lesions, tumoral ablation near biliary ducts may cause stenosis, unless intraductal cooling of the main ducts is done simultaneously with radiofrequency ablation. This study proposed using a similar process in the urinary tract, comparing renal ablation near the urothelium, with and without cooling the collecting system with 2°C 0.9% saline, and analyzing the excretory ducts\' integrity and the ablation efficiency. Methods: Eight female porcines were submitted to laparotomy and bladder opening, having one of the ureteral meatus catheterized with a double-lumen catheter according to a random selection made prior to the procedure. An eight minute radiofrequency cycle, planned to achieve a mean temperature of 100°C, was done using a needle with one centimeter of exposition, creating a superficial lesion in the renal cortex. The needle depth was monitored by ultrasound during surgery. Two lesions were made in each animal, one in a kidney without a catheter and the other in a kidney cooled with 2°C 0.9% saline circulating at 30 ml/ min. The pigs were put to death two weeks after the procedure. Results: The largest diameters were determined for each lesion and bilateral retrograde pielography was done to check the radiological aspect of the urinary ducts. No significant difference between the kidneys was observed, regardless of whether the urinary system had been cooled or not. Conclusion: Cooling the excretory ducts during radiofrequency ablation did not alter the coagulation necrosis, nor did it affect the integrity of the urinary collecting system.
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Candida albicans agglutinin-like sequence (ALS) gene expression in an in vitro dynamic catheter adhesion model.January 2010 (has links)
Jin, Dawei. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 83-93). / Abstracts in English and Chinese. / ABSTRACT (IN CHINESE) --- p.ii / ABSTRACT (IN ENGLISH) --- p.iv / ACKNOWLEDGEMENTS --- p.vii / CONTENTS --- p.ix / LIST OF TABLES --- p.vxiii / LIST OF FIGURES --- p.xiv / LIST OF ABBREVIATIONS --- p.xvi / Chapter CHAPTER I --- INTRODUCTION --- p.1 / Chapter 1.1 --- Biology of C. albicans --- p.2 / Chapter 1.1.1 --- Taxonomy --- p.2 / Chapter 1.1.2 --- Basic cell biology --- p.2 / Chapter 1.1.2.1 --- Cell cycle and phenotypic switch --- p.2 / Chapter 1.1.2.2 --- Cell wall --- p.3 / Chapter 1.1.3 --- "Morphological, culture and biochemical characteristics" --- p.4 / Chapter 1.1.4 --- Genomics --- p.5 / Chapter 1.1.5 --- Pathogenecity --- p.6 / Chapter 1.2 --- Catheter-related bloodstream infections (CRBSI) caused by C. albicans --- p.7 / Chapter 1.2.1 --- Intravenous catheter type --- p.7 / Chapter 1.2.2 --- Epidemiology of CRBSI caused by C. albicans --- p.8 / Chapter 1.2.3 --- Pathogenesis of intravascular catheter-related infections --- p.9 / Chapter 1.2.4 --- Diagnosis of catheter-related infections --- p.10 / Chapter 1.2.5 --- Prevention and control --- p.11 / Chapter 1.3 --- Mechanism of C. albicans adhesion to catheters --- p.12 / Chapter 1.3.1 --- The definition of microbial adhesion --- p.12 / Chapter 1.3.2 --- Relationship between microbial adhesion and biofilm formation --- p.12 / Chapter 1.4 --- Agglutinin-like sequence (ALS) gene family of C. albicans --- p.14 / Chapter 1.4.1 --- Members of ALS gene family --- p.14 / Chapter 1.4.2 --- Chromosomal location of ALS genes --- p.14 / Chapter 1.4.3 --- ALS gene organization --- p.14 / Chapter 1.4.3.1 --- Three-domain structure of ALS genes --- p.15 / Chapter 1.4.3.2 --- Characterization of ALS genes. --- p.15 / Chapter 1.4.4 --- ALS gene allelic variation --- p.17 / Chapter 1.5 --- Experimental models for catheter adhesion study of C. albicans --- p.17 / Chapter 1.5.1 --- "Static adhesion model for C, albicans" --- p.18 / Chapter 1.5.1.1 --- Advantage of static adhesion model --- p.19 / Chapter 1.5.1.2 --- Limitation of static adhesion model --- p.19 / Chapter 1.5.2 --- Dynamic adhesion model for C. albicans --- p.19 / Chapter 1.5.2.1 --- Advantage of dynamic adhesion model --- p.20 / Chapter 1.5.2.2 --- Limitation of dynamic adhesion model --- p.20 / Chapter 1.5.3 --- Quantification methods of adherent cells --- p.21 / Chapter 1.5.4 --- ALS gene expression study in the in vitro model --- p.22 / Chapter 1.6 --- Aim of study --- p.22 / Chapter CHAPTER II --- MATERIALS & METHODS --- p.24 / Chapter 2.1 --- Strains used in this study --- p.25 / Chapter 2.2 --- Design of an in vitro dynamic adhesion model for C. albicans --- p.26 / Chapter 2.2.1 --- Flask --- p.26 / Chapter 2.2.2 --- Peristaltic pump --- p.26 / Chapter 2.2.3 --- Glass tube and vascular catheters. --- p.27 / Chapter 2.2.4 --- Sterility check of in vitro dynamic adhesion model --- p.27 / Chapter 2.3 --- Construction of C. albicans growth curve --- p.27 / Chapter 2.4 --- Measurement of C. albicans adhesion to catheters --- p.29 / Chapter 2.5 --- Detection of C. albicans ALS genes --- p.30 / Chapter 2.5.1 --- DNA extraction of C. albicans --- p.30 / Chapter 2.5.2 --- ALS primers design --- p.31 / Chapter 2.5.3 --- PCR reaction --- p.32 / Chapter 2.5.4 --- Gel electrophoresis --- p.32 / Chapter 2.5.5 --- Purification of PCR products --- p.33 / Chapter 2.6 --- Construction of E. coli plasmid containing gene --- p.34 / Chapter 2.6.1 --- Ligation using the pGEM®-T Easy Vector --- p.34 / Chapter 2.6.2 --- Preparation of E. coli DH5a electro-competent cells --- p.35 / Chapter 2.6.3 --- Clean up of DNA ligation reaction for electro-transformation --- p.36 / Chapter 2.6.4 --- Electro-transformation of E. coli DH5a electro-competent cells --- p.37 / Chapter 2.6.5 --- Blue / white screening for positive transformation of E. coli DH5a. --- p.37 / Chapter 2.6.6 --- Extraction of plasmid containing ALS1 gene --- p.39 / Chapter 2.6.7 --- Plasmid validation by PCR and gel electrophoresis --- p.39 / Chapter 2.6.8 --- Serial dilution of plasmid solutions for ALS1 standard curve construction --- p.40 / Chapter 2.7 --- C. albicans ALS1 gene expression in dynamic adhesion model --- p.41 / Chapter 2.7.1 --- Design of real-time PCR primers specific for C. albicans ALS1 --- p.41 / Chapter 2.7.2 --- Validation of primers specificity --- p.42 / Chapter 2.7.3 --- RNA extraction of C. albicans cells adhered on catheters --- p.43 / Chapter 2.7.4 --- Complementary DNA (cDNA) synthesis --- p.45 / Chapter 2.7.5 --- Quantitative real-time RT-PCR --- p.46 / Chapter 2.8 --- Statistical analyses --- p.48 / Chapter CHAPTER III --- RESULTS --- p.49 / Chapter 3.1. --- Validation of the in vitro dynamic adhesion model for C. albicans --- p.50 / Chapter 3.2. --- C. albicans growth curve construction --- p.50 / Chapter 3.3. --- Measurement of C. albicans adhesion on catheters --- p.50 / Chapter 3.4. --- Detection of C. albicans SC5314 ALS genes --- p.52 / Chapter 3.5. --- Validation of E. coli plasmid containing ALS1 gene --- p.54 / Chapter 3.6. --- C. albicans ALS 1 gene expression in dynamic adhesion model --- p.54 / Chapter 3.6.1. --- Specificity validation of ALS1 real-time primers --- p.55 / Chapter 3.6.2. --- Quantitative real-time RT-PCR --- p.55 / Chapter CHAPTER IV --- DISCUSSION --- p.57 / Chapter 4.1 --- Experimental design of the in vitro dynamic adhesion model --- p.58 / Chapter 4.1.1 --- Advantages of this in vitro dynamic adhesion model --- p.58 / Chapter 4.1.2 --- Limitation of this in vitro dynamic adhesion model --- p.58 / Chapter 4.1.3 --- Catheter arrangement inside the glass tube --- p.60 / Chapter 4.1.4 --- Reproducibility of experiments in the model --- p.62 / Chapter 4.1.5 --- Identification of potential contamination in the model --- p.63 / Chapter 4.1.6 --- Advantages of removing method for C. albicans adherent cells --- p.64 / Chapter 4.1.7 --- Limitation of removing method for C. albicans adherent cells --- p.64 / Chapter 4.1.8 --- Limitation of statistical analysis --- p.66 / Chapter 4.1.9 --- Primers design --- p.67 / Chapter 4.1.9.1 --- Primers of C. albicans ALS gene detection --- p.67 / Chapter 4.1.9.2 --- Validation of ALS 1 real-time primers specificity --- p.69 / Chapter 4.2 --- C. albicans adhesion to catheters --- p.70 / Chapter 4.2.1 --- Theoretical explanation of C. albicans adhesion to different catheters --- p.71 / Chapter 4.3 --- C. albicans ALS gene expression --- p.74 / Chapter 4.3.1 --- Functions of Als proteins --- p.75 / Chapter 4.3.1.1 --- Adhesive functions --- p.75 / Chapter 4.3.1.2 --- Other functions in C. albicans pathogenesis --- p.75 / Chapter 4.3.2 --- Analysis of ALS1 gene expression pattern in the in vitro model --- p.76 / Chapter 4.4 --- Clinical application of our study --- p.78 / Chapter 4.5 --- Future study --- p.80 / Chapter 4.6 --- Conclusion --- p.81 / REFERENCES --- p.83
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Análise do efeito do resfriamento da via excretora durante termoablação com radiofreqüência em rim de porco / Analysis of the cooling effect in the urinary system during renal radiofrequency thermoablation in pigsAndré Meirelles dos Santos 29 April 2005 (has links)
A ablação de tumores renais com radiofreqüência tem se tornado uma alternativa cada vez mais atraente dentro do arsenal de procedimentos minimamente invasivos. Uma das raras complicações desta forma de tratamento é a lesão térmica do urotélio, desencadeando fístulas urinárias, hidronefrose, estenose ureteral e estenose de junção ureteropiélica, em alguns casos, com necessidade de nefrectomia do órgão acometido. Em lesões hepáticas, ablação tumoral muito perto da via biliar pode evoluir com estenose, a menos que haja um resfriamento dos dutos biliares concomitante à aplicação da radiofreqüência. Desta forma, o objetivo deste estudo foi o de propor um processo semelhante no trato urinário, comparando ablações renais próximas ao urotélio, com e sem irrigação do sistema coletor, com soro fisiológico a 2°C, analisando a integridade da via excretora e a eficácia da ablação. Métodos: Oito suínos do sexo feminino foram submetidos à laparotomia, com abertura da bexiga e cateterização de um dos meatos ureterais com cateter de duplo-lúmen, conforme sorteio realizado antes do início do procedimento. Foi realizada aplicação de radiofreqüência com um ciclo de oito minutos, regulada para atingir uma temperatura média de 100°C e aplicada com uma agulha deflagrada com um centímetro de exposição, sendo produzida uma lesão superficial no terço médio do rim. O grau de profundidade da agulha foi monitorado pelo uso de ultra-som intra-operatório. No total, foram realizadas duas lesões em cada animal, uma no rim sem cateter ureteral, e outra em um rim exposto ao resfriamento da via excretora com soro fisiológico a 2°C, circulando a 30 ml/min. Os animais foram sacrificados no décimo-quarto dia de pósoperatório. Resultados: Os maiores diâmetros da lesão criada pela radiofreqüência e o aspecto radiológico da via excretora, obtido por meio de pielografia ascendente bilateral, foram comparados e não houve diferença significativa entre os rins tratados, estando ou não expostos ao resfriamento da via excretora. Conclusão: O resfriamento da via excretora durante ablação com radiofreqüência não alterou a necrose de coagulação gerada, tampouco afetou a integridade da via excretora / Renal tumor ablation has become quite an attractive alternative among minimally invasive procedures. One of the few complications of this new technology is thermal damage to the urothelium, causing urinary fistula, hydronephrosis and ureteral and ureteropelvic junction obstruction. Some cases required a nephrectomy. In hepatic lesions, tumoral ablation near biliary ducts may cause stenosis, unless intraductal cooling of the main ducts is done simultaneously with radiofrequency ablation. This study proposed using a similar process in the urinary tract, comparing renal ablation near the urothelium, with and without cooling the collecting system with 2°C 0.9% saline, and analyzing the excretory ducts\' integrity and the ablation efficiency. Methods: Eight female porcines were submitted to laparotomy and bladder opening, having one of the ureteral meatus catheterized with a double-lumen catheter according to a random selection made prior to the procedure. An eight minute radiofrequency cycle, planned to achieve a mean temperature of 100°C, was done using a needle with one centimeter of exposition, creating a superficial lesion in the renal cortex. The needle depth was monitored by ultrasound during surgery. Two lesions were made in each animal, one in a kidney without a catheter and the other in a kidney cooled with 2°C 0.9% saline circulating at 30 ml/ min. The pigs were put to death two weeks after the procedure. Results: The largest diameters were determined for each lesion and bilateral retrograde pielography was done to check the radiological aspect of the urinary ducts. No significant difference between the kidneys was observed, regardless of whether the urinary system had been cooled or not. Conclusion: Cooling the excretory ducts during radiofrequency ablation did not alter the coagulation necrosis, nor did it affect the integrity of the urinary collecting system.
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Ablação do istmo cavo-tricuspídeo para controle do flutter atrial: estudo prospectivo e randomizado comparando eficácia e segurança de cateter irrigado com cateter de 8 mm. / Cavotricuspid isthmus ablation for the treatment of atrial flutter: prospective randomized study comparing efficacy and safety of cooled-tip versus 8-mm-tip catheters.Melo, Sissy Lara 21 February 2005 (has links)
O cateter irrigado foi comparado com o de 8 mm para ablação com radiofrequência do istmo cavo-tricuspídeo(Ist-CT). Foram randomizados 52 pacientes portadores de flutter atrial típico para ablação com cateter irrigado(grupoI) ou com cateter de 8 mm(grupo II). O bloqueio do Ist-CT foi obtido em 51 pacientes. Não houve diferença estatística em relação aos parâmetros de aplicação de RF entre os dois grupos. A ablação do Ist-CT com cateter irrigado versus cateter de 8mm foi igualmente eficaz e segura no controle do flutter atrial típico. / A 4-mm cooled tip catheter was compared to an 8-mm tip catheter to cavotricuspid isthmus(CTI) ablation. This prospective study enrolled 52 patients with typical atrial flutter to ablation with a closed cooled-tip catheter(group1) or an 8-mm tip catheter. Radiofrequency(RF) applications were performed to achieve complete CTI block wich was achieved in 51 patients. No significant differences were found in the procedure parameters. CTI ablation with an irrigated tip catheter versus an 8-mm tip catheter was equally effective and satisfactorily safe for ablation of typical atrial flutter.
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Ablação do istmo cavo-tricuspídeo para controle do flutter atrial: estudo prospectivo e randomizado comparando eficácia e segurança de cateter irrigado com cateter de 8 mm. / Cavotricuspid isthmus ablation for the treatment of atrial flutter: prospective randomized study comparing efficacy and safety of cooled-tip versus 8-mm-tip catheters.Sissy Lara Melo 21 February 2005 (has links)
O cateter irrigado foi comparado com o de 8 mm para ablação com radiofrequência do istmo cavo-tricuspídeo(Ist-CT). Foram randomizados 52 pacientes portadores de flutter atrial típico para ablação com cateter irrigado(grupoI) ou com cateter de 8 mm(grupo II). O bloqueio do Ist-CT foi obtido em 51 pacientes. Não houve diferença estatística em relação aos parâmetros de aplicação de RF entre os dois grupos. A ablação do Ist-CT com cateter irrigado versus cateter de 8mm foi igualmente eficaz e segura no controle do flutter atrial típico. / A 4-mm cooled tip catheter was compared to an 8-mm tip catheter to cavotricuspid isthmus(CTI) ablation. This prospective study enrolled 52 patients with typical atrial flutter to ablation with a closed cooled-tip catheter(group1) or an 8-mm tip catheter. Radiofrequency(RF) applications were performed to achieve complete CTI block wich was achieved in 51 patients. No significant differences were found in the procedure parameters. CTI ablation with an irrigated tip catheter versus an 8-mm tip catheter was equally effective and satisfactorily safe for ablation of typical atrial flutter.
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"Avaliação dos resultados a médio prazo da ablação cirúrgica por radiofreqüência da fibrilação atrial permanente em pacientes portadores de valvopatia mitral reumática" / Mid-term results of the maze procedure using radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve diseaseAbreu Filho, Carlos Alberto Cordeiro de 21 June 2005 (has links)
A ablação cirúrgica por radiofreqüência (RF) é uma nova técnica para tratar a fibrilação atrial (FA) permanente. O objetivo deste estudo é avaliar a eficácia da ablação cirúrgica por RF da FA permanente em pacientes com valvopatia mitral reumática (VMR). Entre Fevereiro de 2002 e Abril de 2003, 70 pacientes com FA permanente e VMR foram submetidos à operação da valva mitral associada à ablação por RF da FA (Grupo A); ou à operação da valva mitral isolada (Grupo B). No seguimento pós-operatório foram avaliados: a reversão para o ritmo sinusal (RS) e a contratilidade atrial. Após 12 meses de seguimento, os índices de reversão para o RS e de restabelecimento da contratilidade atrial foram significativamente superiores no Grupo A. A ablação cirúrgica por RF é eficaz para o tratamento da FA permanente em pacientes com VMR / Radiofrequency ablation is a new surgical technique to treat permanent atrial fibrillation. The aim of this study was to evaluate the effectiveness of the (RF) ablation for the treatment of permanent AF in patients with rheumatic mitral valve (MV) disease. Between February 2002 and April 2003, 70 patients with permanent AF and rheumatic MV disease were assigned to undergo a MV surgery associated with RF ablation (Group A), or MV surgery alone (Group B). After 12 months of follow-up, the cumulative rates of sinus rhythm conversion and atrial transport function restoration were higher in Group A.The RF ablation is effective for treating permanent AF associated with rheumatic MV disease
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"Avaliação dos resultados a médio prazo da ablação cirúrgica por radiofreqüência da fibrilação atrial permanente em pacientes portadores de valvopatia mitral reumática" / Mid-term results of the maze procedure using radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve diseaseCarlos Alberto Cordeiro de Abreu Filho 21 June 2005 (has links)
A ablação cirúrgica por radiofreqüência (RF) é uma nova técnica para tratar a fibrilação atrial (FA) permanente. O objetivo deste estudo é avaliar a eficácia da ablação cirúrgica por RF da FA permanente em pacientes com valvopatia mitral reumática (VMR). Entre Fevereiro de 2002 e Abril de 2003, 70 pacientes com FA permanente e VMR foram submetidos à operação da valva mitral associada à ablação por RF da FA (Grupo A); ou à operação da valva mitral isolada (Grupo B). No seguimento pós-operatório foram avaliados: a reversão para o ritmo sinusal (RS) e a contratilidade atrial. Após 12 meses de seguimento, os índices de reversão para o RS e de restabelecimento da contratilidade atrial foram significativamente superiores no Grupo A. A ablação cirúrgica por RF é eficaz para o tratamento da FA permanente em pacientes com VMR / Radiofrequency ablation is a new surgical technique to treat permanent atrial fibrillation. The aim of this study was to evaluate the effectiveness of the (RF) ablation for the treatment of permanent AF in patients with rheumatic mitral valve (MV) disease. Between February 2002 and April 2003, 70 patients with permanent AF and rheumatic MV disease were assigned to undergo a MV surgery associated with RF ablation (Group A), or MV surgery alone (Group B). After 12 months of follow-up, the cumulative rates of sinus rhythm conversion and atrial transport function restoration were higher in Group A.The RF ablation is effective for treating permanent AF associated with rheumatic MV disease
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