CAPITULO 2. ESTRUCTURA Y DIMENSIÓN INTERNACIONAL DEL DEPORTE
2.4. EL ALTO NIVEL Y LOS RESULTADOS DEPORTIVOS
2.4.1. EL ALTO RENDIMIENTO DEPORTIVO. EL MODELO SPLISS
2.4.1.2. El modelo de rendimiento de los nueve pilares
Radiation is a well-established carcinogen for humans, and 10% of invasive can-cers are related to radiation.38 A study was conducted that used high linear energy transfer (LET) particles, which are used in radiotherapy, to irradiate a human bron-chial epithelial cell line, a stepwise neoplastic transformation of these cells occurred together with a consistent downregulation of the tumor suppressor TGFBI gene.39 The irradiated cells showed fragmentation and shrinking of mitochondria, which was
accompanied by a reduction in mitochondrial functions. The reduced mitochondrial functions were seen as lowering of cytochrome C oxidase, superoxide production, as well as succinate dehydrogenase activities when compared with nonirradiated con-trols.39 Cytochrome C oxidase is the last enzyme in the respiratory electron transport chain of mitochondria and is important in the synthesis of ATP, the energy fuel of all cells. DMSO exposure of the irradiated epithelial cells was able to control the super-oxide production and the damage caused by this free radical on the mitochondria.39
A combination therapy using DMSO and sodium bicarbonate infusion was recently reported by Hoang et al.40 DMSO and sodium bicarbonate were mixed into a solution and infused daily for 6 months to nine patients suffering from advanced nonresectable biliary tract carcinoma, a highly fatal malignancy that has a poor response to chemotherapy. The treatment was well tolerated by all nine patients, and no adverse effects were recorded. The combined DMSO–sodium bicarbonate infu-sion was seen to improve pain control, blood biochemical parameters, and quality of life for the patients. Notably, this treatment led to a 6-month period of progression-free survival for all nine patients in the trial, a finding the authors consider signifi-cant of further research and application for the palliative care and extended survival of patients with this condition.40
These findings add fuel to the conclusion that more research is needed using anti-cancer agents mixed in DMSO solutions, a procedure that may provide more effec-tive penetration and effeceffec-tiveness in cancer suppression.
Onyx EMBOLIZATION
Onyx is composed of ethylene–vinyl alcohol copolymer dissolved in DMSO and sus-pended with micronized tantalum powder to provide contrast for visualization under fluoroscopy. Onyx liquid is used as an embolic agent of the vascular endothelium for a number of conditions including carotid-cavernous fistulas and cerebral arteriove-nous malformations (AVMs).41,42 Embolization of these vessels may prevent lethal hemorrhage if they burst or leak.
Onyx has been used with radiosurgery where it was successful in 80% of patients treated for AVMs, showing safety and efficacy with a low rate (5%) of clinical com-plications.43 Radiosurgery involves a single high-dose fraction of radiation directed stereotactically at an intracranial region of interest.44,45
The flow-directed catheters used to deliver the liquid Onyx for embolization can be coated with DMSO to prevent early polymerization within the catheter.46 It has not been investigated whether DMSO may serve a secondary role during emboliza-tion in stabilizing AVMs besides being a vehicle for the copolymer.
Transvenous occlusion of the cavernous sinus in dural arteriovenous fistula using Onyx embolization has been tried on patients with some success.47 Onyx with DMSO was injected through the superior pharyngeal branch of the ascending pha-ryngeal artery where small transosseous feeders to the fistula arising from the supe-rior pharyngeal branch of the ascending pharyngeal artery could be occluded by this approach especially when more conventional approaches cannot be achieved.47
Arteriovenous fistula of the spinal dura is also amenable to Onyx endovas-cular embolization. Although vasendovas-cular malformation of the spinal cord is a rare
clinical condition, it occurs when congestion of the spinal cord medullary venous plexus results in edema and neuronal ischemia.48 If not repaired, axial or radicular back pain, gait imbalance, weakness of the lower limbs, numbness, and bladder or bowel disturbances can result.49
Onyx has been tried in order to embolize the abnormal communicating vessels to the dura and relieve the spinal cord edema that develops with a relatively high rate of suc-cess.49 However, the neuronal ischemia is not always improved in arteriovenous fistula of the spinal dura using Onyx, and it is only speculative whether a high dose of intrave-nous DMSO separate from the Onyx embolization could aid control of this condition.50
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