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Journal of the American College of Surgeons The effects of propofol and isoflurane on ischemia reperfusion injury in free flaps—a genomic...
The effects of propofol and isoflurane on ischemia reperfusion injury in free flaps—a genomic analysis
Kevin J. Bruen, Danesh K. Gupta, Robert W. Weiss, Diane M. Dunn, Susan L. Thibeault, Scott McJames, Wenhua Li, Marga F. Masseyयह पुस्तक आपको कितनी अच्छी लगी?
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खंड:
203
साल:
2006
भाषा:
english
पृष्ठ:
1
DOI:
10.1016/j.jamcollsurg.2006.05.164
फ़ाइल:
PDF, 49 KB
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आप पुस्तक समीक्षा लिख सकते हैं और अपना अनुभव साझा कर सकते हैं. पढ़ूी हुई पुस्तकों के बारे में आपकी राय जानने में अन्य पाठकों को दिलचस्पी होगी. भले ही आपको किताब पसंद हो या न हो, अगर आप इसके बारे में ईमानदारी से और विस्तार से बताएँगे, तो लोग अपने लिए नई रुचिकर पुस्तकें खोज पाएँगे.
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Vol. 203, No. 3S, September 2006 Plastic Surgery II METHODS: The anti-neoplastic properties of Tamoxifen were investigated on Estrogen receptor negative CAL-62 and BHT101 Anaplastic Thyroid tumour cell lines. The anti-proliferative effects observed using colorimetric dimethyl-thiazol-diphenyltetrazolium bromide (MTT), pro-apoptotic effects observed using flow cytometry (annexin V). Tumour metastatic potential was investigated with a Matrigel invasion assay with tamoxifen and chemotactic agent Vascular Endothelial Growth Factor. A Fluro-4 Calcium label dye was employed to investigate induction of apoptosis via calcium intracellular flux. RESULTS: Tamoxifen Proliferation Apoptosis Migration Invasion Assay Control 100 4.7 ⫾ 0.46 Control 95.8 ⫾ 3.1 1 ug/ml 97 ⫾ 1.07* 11.2 ⫾ 2.39 Tamoxifen 0* 2 ug/ml 93 ⫾ 0.75 26.4 ⫾ 14* Vegf 124⫾3.15** 5 ug/ml 64 ⫾ 1.07** 24.8 ⫾ 2.19 Tamx ⫹vegf 10 ug/ml S63 METHODS: Female swine were sedated with a telazol, xylazine and ketamine cocktail. A vertical rectus abdominus flap was outlined and control muscle and fat biopsies taken. Animals were anesthetized with either isoflurane (n⫽2) or propofol (n⫽2) before undergoing a 3 hour period of ischemia. Following 3 hours of reperfusion, muscle and fat biopsies were taken. RNA was extracted and gene expression characterized using the Affymetrix GeneChip Porcine Array (n⫽16). Overall gene expression of the combined muscle and fat change relative to baseline was calculated using a rank products test. Relative expression was reported as a ratio of isoflurane to propofol anesthesia, with ⬎⫽2 or ⬍⫽0.5 being considered significant changes for isoflurane and propofol respectively. 23 ⫾ 1.07** 22.9 ⫾ 6.89 45.6⫾3.14** P ⬍0.05 vs. control Anova Scheffe post hoc analysis RESULTS: Relative gene expression changes and isoflurane/ propofol expression ratios are shown in the table. Table Category Propofol I/P Ratio Inflammation Interleukin 6 (IL-6) 6.3 121.4 .05 6.8 39.2 .17 4.5 25.1 .18 6.9 36.9 .19 109.3 29.6 Thrombosis; Monocyte chemoattractant protein (MCP-1) Alveolar macrophagederived chemotactic factor (AMCF-I) Chemokine ligand 2 (CXCL2) Macrophage Inflammatory Protein (MIP-1 Beta) Plasminogen activator inhibitor (PLANHI) Plasminogen activator (PLAU) Tissue factor (TF) Heme oxygenase (HO) Heat Shock Protein (HSP70) HSP1 HSP5 13.2 74.2 .18 4.9 30.5 .16 3.6 4.0 9.6 9.2 17.2 35.4 .39 .23 .27 23.1 4.0 9.0 1.5 Anaplastic thyroid tumour cells are acutely sensitive to Tamoxifen. It induces apoptosis via a calcium dependent pathway, decreases proliferation and reduces the metastatic potential through blockade of a VEGF dependant mechanism. CONCLUSIONS: Tamoxifen now merits a phase 1 clinical trial as part of a multimodal chemotherapeutic agent in the treatment of anaplastic thyroid cancer. The effects of propofol and isoflurane on ischemia reperfusion injury in free flaps—a genomic analysis Kevin J Bruen MD, Danesh K Gupta MD, Robert W Weiss PhD, Diane M Dunn MS, Susan L Thibeault PhD, Scott McJames BS, Wenhua Li MS, Marga F Massey MD University of Utah, Salt Lake City, UT INTRODUCTION: Ischemia reperfusion is characterized by inflammation, thrombosis and oxidative injury. Anesthetic agents modulate these states in myocardium and brain. We hypothesize that in free flaps for oncologic reconstruction, propofol acts as an antioxidant and isoflurane acts as an anti-inflammatory agent. Antioxidant Protective Gene Title Isoflurane 3.7 2.6 2.6 CONCLUSIONS: Propofol induces the antioxidant HO, but an inflammatory and pro-coagulation state exists. Isoflurane produces a relative anti-inflammatory state while both agents induce expression of HSPs. This data suggests that on a genomic level, isoflurane has a greater protective effect and may be the preferred agent in free flap reconstruction.