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      An experimental study to compare inflammatory response due to liquid or gas joint distension in horses submitted to arthroscopy Translated title: Estudo experimental para comparar a resposta inflamatória decorrente da distensão líquida ou gasosa em cavalos submetidos à artroscopia

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          Abstract

          PURPOSE: To assess comparatively the inflammatory response that follows CO2 or Ringer's lactate joint capsular distension of horses submitted to experimental arthroscopy METHODS: Each animal was submitted to a bilateral tarsocrural arthroscopy employing gas distention in one joint and fluid distention in the contralateral joint. Synovial fluid was evaluated at 0, six, 12, 24 and 48 hours post-operative. RESULTS: The use of CO2 for arthroscopy causes an acute and mild synovitis alike to the liquid capsular distension, showing similar synovial fluid increase of leukocytes, TP, and TNF-α. Although synovial fluid PGE2 content was higher in joints submitted to CO2 distension, lower levels of hemoglobin and leukocytes oxidative burst after surgery indicates that CO2 arthroscopy decreased intra-articular bleeding and activation of infiltrating leukocytes. CONCLUSIONS: The use of CO2 for arthroscopic examination causes acute and mild synovitis that is similar to the effects caused by the liquid capsular distension. CO2 also seems to decrease intra-articular bleeding and activation of leukocytes.

          Translated abstract

          OBJETIVO: Avaliar comparativamente a resposta inflamatória decorrente da distensão líquida ou gasosa em cavalos submetidos ao exame artroscópico. MÉTODOS: Cada animal foi submetido a uma artroscopia bilateral tarsocrural empregando uma distensão com gás em uma articulação e líquido na articulação contralateral. O líquido sinovial foi avaliado as zero, seis, 12, 24 e 48 horas do pós-operatório. RESULTADOS: A utilização de CO2 para a artroscopia provoca uma sinovite aguda e leve tal como a distensão capsular por líquido, mostrando um aumento similar de leucócitos, TP (proteína total) e TNF-a. Embora no líquido sinovial a quantidade de PGE2 tenha sido maior nas articulações submetidas à distensão por CO2, níveis mais baixos de hemoglobina e explosão oxidativa de leucócitos após a cirurgia indica que a artroscopia com CO2 diminuiu o sangramento intra-articular e ativação de leucócitos. CONCLUSÕES: A utilização de CO2 para exame artroscópico provoca uma sinovite aguda e leve que são semelhantes aos efeitos causados pela distensão capsular por líquido. O CO2 também parece diminuir o sangramento intra-articular e a ativação de leucócitos.

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          Simultaneous measurement by flow cytometry of phagocytosis and hydrogen peroxide production of neutrophils in whole blood.

          Bacterial ingestion and hydrogen peroxide production by polymorphonuclear leukocytes (PMN) were simultaneously measured using flow cytometry and 2',7'-dichlorofluorescein diacetate and fluorescent Staphylococcus aureus. Only 100 microliters of a whole blood specimen were required for these determinations, and the results were found to be independent of the absolute numbers of PMN, making the purification and adjustment of PMN numbers unnecessary. A positive correlation between phagocytosis and hydrogen peroxide production by individual PMN was demonstrated in healthy adults.
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            Acute phase response to surgery of varying intensity in horses: a preliminary study.

            To evaluate the postoperative inflammatory response of horses to elective surgery of varying intensity. Prospective longitudinal study. Horses referred to 2 hospitals for either arthroscopic removal of a unilateral osteochondritic lesion in the tibiotarsal joint (minimal surgical trauma, n=11), correction of recurrent laryngeal neuropathy by laryngoplasty and ventriculectomy (intermediate surgical trauma, n=10) or removal of an ovarian tumor by laparotomy (major surgical trauma, n=5). Horses had a thorough clinical examination every day. White blood cell (WBC) counts and concentrations of serum amyloid A (SAA), fibrinogen, and iron were assessed in blood samples obtained before, and 1-3, 5, 7, 9, and 11 days after surgery. Differences in levels of the inflammatory markers between the 3 surgical groups were analyzed using repeated measures ANOVA. Postoperative concentrations of SAA and fibrinogen were significantly higher in horses that had laparotomy and ovariectomy than in horses that had laryngoplasty and ventriculectomy, or arthroscopy. Iron concentrations decreased to lower levels after intermediate and major surgical trauma than after small surgical trauma. WBC count did not differ between the 3 groups. Levels of SAA, fibrinogen, and iron reflected the intensity of the surgical trauma, whereas WBC count did not. Postoperative measurements of SAA, fibrinogen, and iron may be useful for comparing surgical trauma associated with new and established surgical techniques. Moreover, knowledge of the normal postoperative acute phase response is essential, if acute phase reactants are to be used for monitoring occurrence of postoperative infections.
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              Hemoglobin stimulates the expression of matrix metalloproteinases, MMP-2 and MMP-9 by synovial cells: a possible cause of joint damage after intra-articular hemorrhage.

              Intra-articular bleeding causes degradation of articular cartilage leading to joint disorders, but the mechanisms is not well understood. The present study examined the effect of hemoglobin on the ability of synovial tissues to produce plasminogen activators and matrix metalloproteinases that play important roles in the degradation of articular cartilage. Human Hb added to primary cultures of human knee synovial cells markedly increased fibrinolytic activity and gelatinolytic activity. The fibrinolytic activity was due to an increase in uPA activity. Western blot analysis and gelatin zymography indicated that the increased gelatinolytic activity was due to increased MMP-2 and -9. In order to know whether the effect of Hb on cultured synovial tissue is also true in in vivo system or not, rabbit hemoglobin was injected into rabbit knee joints. Coinciding with in vitro study, hemoglobin elicited considerable increase in fibrinolytic and gelatinolytic activity. The level of proteoglycan fragments in the hemoglobin-treated joint fluid was significantly elevated, indicating cartilage matrix degradation. Cartilage damage after hemoglobin treatment was also confirmed by histological study. These findings suggest that hemoglobin stimulates the secretion of uPA, MMP-2 and MMP-9 by synovial tissues, and raise a possible role of hemoglobin in joint damage after intra-articular bleeding.
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                Author and article information

                Journal
                acb
                Acta Cirúrgica Brasileira
                Acta Cir. Bras.
                Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia (São Paulo, SP, Brazil )
                0102-8650
                1678-2674
                December 2012
                : 27
                : 12
                : 848-854
                Affiliations
                [01] Sao Paulo SP orgnameUSP orgdiv1Faculty of Veterinary Medicine orgdiv2Department of Pathology Brazil
                [02] Sao Paulo SP orgnameUSP orgdiv1Faculty of Veterinary Medicine orgdiv2Department of Surgery Brazil
                Article
                S0102-86502012001200004 S0102-8650(12)02701204
                2356b1e6-154b-49cb-9cda-05726a3a7ea3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 10 July 2012
                : 11 September 2012
                : 15 October 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 7
                Product

                SciELO Brazil

                Self URI: Full text available only in PDF format (EN)
                Categories
                Original Articles

                Flow Cytometry,Synovial Fluid,Carbon Dioxide,Cavalos,Citometria de Fluxo,Sinovite,Artropatias,Líquido Sinovial,Dióxido de Carbono,Horses,Synovitis,Joint Diseases

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