High-fat diet elicits sex-based differences in liver inflammatory cytokines and redox homeostasis.

Sex differences in metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. Oxidative stress and inflammation are involved in the progression of MASLD. Thus, we aimed to evaluate liver redox homeostasis and inflammation in male and female rats fed a high-fat diet (HFD). Male and female Wistar rats were divided into the following groups: standard chow diet (SCD) or HFD during 12 weeks. HFD groups of both sexes had higher hepatocyte injury, with no differences between the sexes. Portal space liver inflammation was higher in females-HFD compared to females-SCD, whereas no differences were observed in males. Lobular inflammation and overall liver inflammation were higher in HFD groups, regardless of sex. TNF-α, IL-6, and IL-1ß levels were higher in males-HFD compared to males-SCD, but no differences were observed in females. Catalase activity was higher in males compared to females, with no differences between the SCD and HFD groups of both sexes. Glutathione peroxidase activity was higher in females compared to males, with no differences between the SCD and HFD groups in both sexes. Lipid peroxidation was higher in female-SCD when compared to male-SCD, and in both male- and female-HFD compared to SCD groups. Furthermore, both cytoplasmic and nuclear NRF2 staining were lower in the HFD group compared to the SCD group in males. However, female-HFD exhibited reduced nuclear NRF2 staining compared to the female-SCD group. In conclusion, our study demonstrated that while both male and female rats developed metabolic dysfunction-associated steatohepatitis after 12 weeks of HFD, the alterations in inflammatory cytokines and redox balance were sexually dimorphic.

Use of nanoparticles in animal models for prostate cancer treatment: a systematic review.

PURPOSE: To conduct a systematic review of nanoparticles' use in the treatment of prostate cancer in animals. METHODS: A systematic review was conducted in the databases PubMed, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Library, and EMBASE, and the descriptors were chosen based on terms indexed in Health Sciences Descriptors (DeCS)/Medical Subject Headings (MESH), which are: nanoparticles, nanomedicine, and prostate cancer. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42021271008. RESULTS: A total of 3,897 articles was chosen; after reading the inclusion and exclusion criteria, six scientific articles with themes involving nanoparticles carrying medications were reached. Among the nanoparticles found, there were carboxymethylcellulose polymer, micellar casein nanoparticles, liquid crystal nanoparticles, serum albumin nanoparticles, and poly(ethylene glycol)-block-polylactide (mPEG-PLA) conjugated nanoparticles encapsulating cabazitaxel, docetaxel, and flutamide, which were nanoparticles used to treat prostate cancer in animals. CONCLUSIONS: Through using nanoparticles to encapsulate medications for treating prostate cancer in animals, studies show a decrease in weight and tumor reduction, with nanoparticles resulting in greater survival time than free medications. The improved permeability and retention effect of nanoparticles in the bloodstream contribute to their effectiveness.

The effect of aerobic and resistance exercise on the progression of colorectal cancer in an animal model.

PURPOSE: The aim of this study was to assess the effects of resistance and aerobic exercise on colorectal cancer (CRC) development in mice induced by azoxymethane (AOM) coupled with colitis. METHODS: Forty animals induced with CRC were used, divided into five groups of eight animals each: sedentary; continuous aerobics; continuous anaerobic; aerobic PI; and anaerobic PI. AOM was administered to the animals in two doses of 10 mg/kg each over the course of two weeks, the first dose administered in the third week and the second administered in the fourth. For the colitis, three cycles of dextran sodium sulfate were administered for five days, separated by two weeks of water. The 14th week of the experiment saw the euthanasia, the removal of their colons, and the creation of microscopy slides for histological analysis. RESULTS: Preneoplastic lesions developed in all five groups; there were no significant differences between them. However, in terms of inflammatory symptoms, mucosal ulceration was much more frequently in the exercise groups than in the sedentary group (p = 0.016). The number of polyps overall (p = 0.002), the distal region's polyp development (p = 0.003), and the proximal region's polyp development (p = 0.04) were all statistically different than sedentary group. CONCLUSIONS: The study discovered no significant difference in disease activity index scores between groups, but there was a significant difference in the number of polyps and the presence of mucosal ulceration in the colon.

Use of nanoparticles in animal models for prostate cancer treatment: a systematic review

Purpose: To conduct a systematic review of nanoparticles' use in the treatment of prostate cancer in animals. Methods: A systematic review was conducted in the databases PubMed, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Library, and EMBASE, and the descriptors were chosen based on terms indexed in Health Sciences Descriptors (DeCS)/Medical Subject Headings (MESH), which are: nanoparticles, nanomedicine, and prostate cancer. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42021271008. Results: A total of 3,897 articles was chosen; after reading the inclusion and exclusion criteria, six scientific articles with themes involving nanoparticles carrying medications were reached. Among the nanoparticles found, there were carboxymethylcellulose polymer, micellar casein nanoparticles, liquid crystal nanoparticles, serum albumin nanoparticles, and poly(ethylene glycol)-block-polylactide (mPEG-PLA) conjugated nanoparticles encapsulating cabazitaxel, docetaxel, and flutamide, which were nanoparticles used to treat prostate cancer in animals. Conclusions: Through using nanoparticles to encapsulate medications for treating prostate cancer in animals, studies show a decrease in weight and tumor reduction, with nanoparticles resulting in greater survival time than free medications. The improved permeability and retention effect of nanoparticles in the bloodstream contribute to their effectiveness.

The effect of aerobic and resistance exercise on the progression of colorectal cancer in an animal model

Purpose: The aim of this study was to assess the effects of resistance and aerobic exercise on colorectal cancer (CRC) development in mice induced by azoxymethane (AOM) coupled with colitis. Methods: Forty animals induced with CRC were used, divided into five groups of eight animals each: sedentary; continuous aerobics; continuous anaerobic; aerobic PI; and anaerobic PI. AOM was administered to the animals in two doses of 10 mg/kg each over the course of two weeks, the first dose administered in the third week and the second administered in the fourth. For the colitis, three cycles of dextran sodium sulfate were administered for five days, separated by two weeks of water. The 14th week of the experiment saw the euthanasia, the removal of their colons, and the creation of microscopy slides for histological analysis. Results: Preneoplastic lesions developed in all five groups; there were no significant differences between them. However, in terms of inflammatory symptoms, mucosal ulceration was much more frequently in the exercise groups than in the sedentary group (p = 0.016). The number of polyps overall (p = 0.002), the distal region's polyp development (p = 0.003), and the proximal region's polyp development (p = 0.04) were all statistically different than sedentary group. Conclusions: The study discovered no significant difference in disease activity index scores between groups, but there was a significant difference in the number of polyps and the presence of mucosal ulceration in the colon.

Assessment of stress and anxiety in mice with colorectal cancer submitted to physical exercise.

PURPOSE: To evaluate the effect of physical exercise on the behavior of rodents with colorectal cancer induced through the use of elevated plus maze. METHODS: We used 40 male hairless mice induced to colorectal cancer, divided into five groups: G1) submitted to pre- and post-induction swimming; G2) pre- and post-induction ladder; G3) post-induction swimming; G4) post-induction ladder; G5) sedentary. At the end of the 14th week, the animals were submitted to the plus maze test. RESULTS: The mean length of stay in the open arm for G1 was 4.17 ± 6.50; G2 37.52 ± 40.7; G3 85.84 ± 42.5; G4 32.92 ± 23.17; and G5 4.09 ± 4.43. In the closed arm, it was 264 ± 23.43 in G1, 187.60 ± 47.73 in G2, 147.50 ± 40.03 in G3, 182.00 ± 40.40 in G4, and in G5 235.36 ± 14.28. In the center, G1 remained 31.86 ± 20.18, G2 74.85 ± 28.37, G3 66.69 ± 19.53, G4 60.55 ± 10.46, and G5 60.55 ± 23.65. CONCLUSIONS: Aerobic exercise for seven weeks after tumor induction showed less impact on the behavior of the animals. On the other hand, it significantly increased the animals' stress level when applied for 14 weeks before and after tumor induction.

Sentinel Lymph Node Navigation Surgery for Early Gastric Cancer: Is It a Safe Procedure in Countries with Non-Endemic Gastric Cancer Levels? A Preliminary Experience.

PURPOSE: Early diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels. MATERIALS AND METHODS: From September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye. RESULTS: Antrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence. CONCLUSIONS: Sentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer.

Effectiveness of current disinfection procedures against biofilm on contaminated GI endoscopes.

BACKGROUND AND AIMS: Attention to patient safety has increased recently due to outbreaks of nosocomial infections associated with GI endoscopy. The aim of this study was to evaluate current cleaning and disinfection procedures of endoscope channels with high bioburden and biofilm analysis, including the use of resistant mycobacteria associated with postsurgical infections in Brazil. METHODS: Twenty-seven original endoscope channels were contaminated with organic soil containing 10(8) colony-forming units/mL of Pseudomonas aeruginosa, Staphylococcus aureus, or Mycobacterium abscessus subsp bolletii. Biofilms with the same microorganisms were developed on the inner surface of channels with the initial inoculum of 10(5) colony-forming units/mL. Channels were reprocessed following current protocol, and samples from cleaning and disinfection steps were analyzed by bioluminescence for adenosine triphosphate, cultures for viable microorganisms, and confocal microscopy. RESULTS: After contamination, adenosine triphosphate levels increased dramatically, and high bacterial growth was observed in all cultures. After cleaning, adenosine triphosphate levels decreased to values comparable to precontamination levels, and bacterial growth was demonstrated in 5 of 27 catheters, 2 with P aeruginosa and 3 with M abscessus. With regard to induced biofilm, a remarkable reduction occurred after cleaning, but significant microbial growth inhibition occurred only after disinfection. Nevertheless, viable microorganisms within the biofilm were still detected by confocal microscopy, more so with glutaraldehyde than with peracetic acid or O-phataladehyde. CONCLUSION: After the complete disinfection procedure, viable microorganisms could still be detected within the biofilm on endoscope channels. Prevention of biofilm development within endoscope channels should be a priority in disinfection procedures, particularly for ERCP and EUS.

Minor gastric resections with modified lymphadenectomy in early gastric cancer with negative sentinel node.

OBJECTIVE: To study the sentinel lymph node in early gastric cancer as a diagnostic method of unsuspected lymph node metastasis, which may allow the performance, in those with negative lymph nodes, of smaller gastric resections with limited lymphadenectomy. METHODS: We studied seven patients with early gastric cancer treated at the Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, from September 2008 to May 2011, who underwent sentinel lymph node exams, performed by intraoperative peritumoral endoscopic injection of patent blue dye. RESULTS: We found an average of three sentinel nodes per patient. The frozen biopsy of lymph nodes was negative for metastases, which allowed the realization of atypical gastric resection in three cases and antrectomy with BI reconstruction in four. The performed lymphadenectomy was modified D1. There was no operative mortality. The duration of postoperative follow-up ranged from five to 37 months, without evidence of recurrence. One patient developed a second early tumor 13 months after the initial surgery and underwent total gastrectomy. CONCLUSION: The sentinel lymph node in early gastric cancer proved to be an effective method for the evaluation of nodal metastases in seven patients and allowed for smaller gastric resections and limited lymphadenectomies. These minor procedures reduce the risk of postoperative complications, maintaining, on the other hand, the oncological radicality that is required in the treatment of gastric cancer.

Ressecções gástricas menores com linfadenectomia modificada em câncer gástrico precoce com linfonodo sentinela negativo / Minor gastric resections with modified lymphadenectomy in early gastric cancer with negative sentinel node

OBJETIVO: Estudar a pesquisa de linfonodo sentinela em câncer gástrico precoce como método diagnóstico de metástase ganglionar insuspeita, e que permita a realização, naqueles com gânglios negativos, de ressecções gástricas menores, com linfadenectomia limitada. MÉTODOS: Foram avaliados sete pacientes portadores de câncer gástrico precoce, tratados no Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, no período de setembro de 2008 a maio de 2011, e submetidos à pesquisa de linfonodo sentinela, realizada através da injeção endoscópica, peritumoral, transoperatória, do corante azul patente. RESULTADOS: Foram encontrados, em média, três linfonodos sentinelas por paciente. A biópsia por congelação destes linfonodos foi negativa para metástases, o que permitiu a realização de ressecção gástrica atípica em três casos e antrectomia com reconstrução a BI em quatro. A linfadenectomia realizada foi a D1 modificada. Não houve mortalidade operatória. O tempo de acompanhamento pós-operatório variou de cinco a 37 meses, sem evidências de recidivas. Uma paciente apresentou um segundo tumor precoce 13 meses depois da primeira cirurgia e foi submetida à gastrectomia total. CONCLUSÃO: A pesquisa de linfonodo sentinela em câncer gástrico precoce, nos sete pacientes estudados, mostrou-se um método eficaz para a avaliação de metástases ganglionares e permitiu a realização de ressecções gástricas menores e linfadenectomias limitadas. Estes procedimentos de menor porte diminuem o risco de complicações pós-operatórias, mantendo, por outro lado, a radicalidade oncológica que se exige no tratamento do câncer gástrico.

OBJECTIVE: To study the sentinel lymph node in early gastric cancer as a diagnostic method of unsuspected lymph node metastasis, which may allow the performance, in those with negative lymph nodes, of smaller gastric resections with limited lymphadenectomy. METHODS: We studied seven patients with early gastric cancer treated at the Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, from September 2008 to May 2011, who underwent sentinel lymph node exams, performed by intraoperative peritumoral endoscopic injection of patent blue dye. RESULTS: We found an average of three sentinel nodes per patient. The frozen biopsy of lymph nodes was negative for metastases, which allowed the realization of atypical gastric resection in three cases and antrectomy with BI reconstruction in four. The performed lymphadenectomy was modified D1. There was no operative mortality. The duration of postoperative follow-up ranged from five to 37 months, without evidence of recurrence. One patient developed a second early tumor 13 months after the initial surgery and underwent total gastrectomy. CONCLUSION: The sentinel lymph node in early gastric cancer proved to be an effective method for the evaluation of nodal metastases in seven patients and allowed for smaller gastric resections and limited lymphadenectomies. These minor procedures reduce the risk of postoperative complications, maintaining, on the other hand, the oncological radicality that is required in the treatment of gastric cancer.

Avaliação da qualidade do leite e seu processamento na produção de leite em pó associado a Análise de Perigos e Pontos Críticos de Controle / Quality evaluation of milk and its processing for producing milk powder in accordance with Hazard Analysis and Critical Control Points

Este trabalho descreve a implantação de programa de qualidade baseado no Sistema de Análise de Perigos e Pontos Críticos de Controle (APPCC) na produção de leite em pó. O programa de qualidade definiu três operações críticas: a recepção do leite, pasteurização e embalagem do produto final. Não houve diferenças significativas (p > 0,05) entre as médias dos valores de variáveis físico-químicas, exceto para os teores de lactose (4,9 ± 0,37 e 4,5 ± 0,22 g/100 g) que apresentaram variações (p < 0,05) no segundo ensaio analítico. Quanto à contagem total de micro-organismos aeróbios viáveis, houve diferenças (p <0,05) nas três operações consideradas críticas. A pasteurização do leite cru mostrou redução na contagem desses microrganismos em mais de seis ciclos logarítmicos, com valor inicial de 6,8 Log10.mL-1 (leite cru)reduzindo-se para 2,8 Log10.mL-1 (leite pasteurizado) e 0,7 Log10.g-1 (leite em pó). Considerando-se estas mesmas operações e associando-as com a determinação de coliformes totais a 45 °C, não houve variações(p > 0,05) entre a pasteurização e a embalagem, mas somente na recepção do leite cru. Não houve detecção de Staphylococcus coagulase positiva nas etapas do processo produtivo. As avaliações microbiológicas e físico-químicas do leite cru e do leite em pó apresentaram valores preconizados pela legislação vigente.

Avaliação da analgesia pós-operatória em artroplastias de quadril com morfina por via subaracnoidea associada ao bloqueio "3 em 1": estudo aleatório e encoberto / Post hip replacement arthroplasty analgesia with subarachnoid morphine associated to "3 in 1" blockade: a randomized double-blind study

JUSTIFICATIVA E OBJETIVOS: A dor é um fator agravante da morbimortalidade pós-operatória, principalmente em cirurgias como a artroplastia de quadril. O objetivo deste estudo foi avaliar a dor pós-operatória, o consumo de opioide, as complicações e o bloqueio motor por mais de 6 horas em pacientes que receberam morfina por via subaracnoidea associada ou não ao bloqueio "3 em 1" para artroplastia de quadril. MÉTODO: Ensaio clínico aleatório, encoberto com 49 pacientes submetidos à artroplastia de quadril eletiva distribuídos em dois grupos, 24 pacientes no Grupo 1 (G1) e 25 pacientes no Grupo 2 (G2). Ambos os grupos receberam raquianestesia com morfina por via subaracnoidea, e nos pacientes do grupo G2 foi associado o bloqueio "3 em 1". No pós-operatório foi avaliada a dor, o número de doses de opioides de resgate, a incidência de prurido, náuseas e vômitos e presença de bloqueio motor nos membros inferiores por mais de 6 horas. RESULTADOS: Treze pacientes, 54,2% do G1, relataram dor com intensidade ≥ 1, enquanto que no G2, a dor foi relatada por 6 pacientes (24%), diferença estatisticamente significativa (p = 0,029). Nenhum paciente apresentou dor intensa. O tramadol, usado como opioide de resgate foi administrado em 25% dos pacientes do G1 e em 8% dos pacientes do G2, sem diferença significativa (p = 0,11). Não houve diferença entre os grupos quanto ao prurido, náuseas, vômitos e bloqueio motor por mais de 6 horas. CONCLUSÃO: A associação de morfina por via subaracnoidea com o bloqueio "3 em 1" reduz a incidência de dor em pacientes submetidos à artroplastia de quadril, sem aumentar a incidência de complicações.

BACKGROUND AND OBJECTIVES: Pain worsens postoperative morbidity and mortality, especially in surgeries such as hip replacement arthroplasty. This study aimed at evaluating postoperative pain, opioid consumption, complications and motor block for more than 6 hours in patients receiving subarachnoid morphine associated or not to "3 in 1" blockade for hip replacement arthroplasty. METHOD: Randomized, double-blind clinical trial with 49 patients submitted to elective hip replacement arthroplasty who were distributed in two groups: 24 patients in Group 1 (G1) and 25 patients in Group 2 (G2). Both groups received spinal anesthesia with subarachnoid morphine and "3 in 1" blockade was associated in Group 2. Pain, number of rescue opioid doses, incidence of pruritus, nausea and vomiting, and motor block in lower limbs for more than 6 hours were evaluated in the postoperative period. RESULTS: Thirteen G1 patients (54.2%) reported pain intensity ≥ 1, while in G2 pain was reported by 6 patients (24%) with statistically significant difference (p = 0.029). No patient reported severe pain. Tramadol, used as rescue opioid, was administered to 25% G1 patients and 8% of G2 patients, without significant difference (p = 0.11). There has been no difference between groups in pruritus, nausea, vomiting and motor block for more than 6 hours. CONCLUSION: The association of subarachnoid morphine and "3 in 1" blockade decreases the incidence of pain in patients submitted to hip replacement arthroplasty without increasing the incidence of complications.

Mechanical circular stapler device loaded with nonabsorbable titanium staples for ileo-prostate capsuloplasty following prostate capsule sparing cystectomy: initial experience in cadavers.

PURPOSE: Mechanical linear staplers have been safely used in urology with an acceptable 0% to 7.9% rate of stone formation in long-term follow-up. We sought to evaluate the feasibility of using mechanical circular stapler devices to perform ileocapsuloplasty following cystoadenomectomy in cadavers. MATERIAL AND METHOD: Three unfrozen cadavers were used in this study. The prostate was enucleated and removed along with the bladder, leaving an ample cavity wherein the 21-mm anvil could be easily accommodated. A 2-0 purse string suture was then placed at the prostate capsule rim and tightly tied around the anvil. Following this, the circular stapler device was introduced into the neobladder through its opened limb and the center rod of the stapler device was passed through an opening made at the most dependent portion of the pouch where another purse string suture was placed and tied around it. Finally, the center rod of the stapler was connected to the anvil and fired, thus completing the anastomosis. RESULTS: The procedure was feasible in all cases and 2 intact rings of prostatic capsule and bowel tissue were obtained, thus attesting the integrity of the anastomoses. Retrograde injection of methylene blue reassured that a watertight anastomosis was achieved whereas cystoscopic and macroscopic examination of the anastomotic site demonstrated a wide patent anastomosis in all cases. CONCLUSIONS: Use of mechanical circular stapler to perform ileocapsuloplasty in cadavers is feasible and has potential advantages such as decreased anastomotic time, diminished chances of urinary extravasations, and reduced degree of difficulty.

Impacto da doação de sangue nos depósitos de ferro do organismo de doadores: [carta ao editor] / Impact of blood donation on donor iron reserves: [letter to the editor]

Iron is a vital element in the human metabolism. It plays a central role in erythropoiesis and is also involved in many other intracellular processes in all the tissues of the body. Blood donation results in a substantial (200 to 250 ng) loss of iron at each donation (425 to 475 ml) with subsequent mobilization of iron from body deposits. Repetitive donations of blood my cause the depletion of iron reserves in blood donors and thus cause health disorders. Recent reports have shown that iron reserves are generally small and iron depletion is more common in blood donors than in non-donors. The high frequency of iron deficiency in blood donors reported by these studies suggests a need for more accurate studies, as measurement of hemoglobin and hematicrit alone is insufficient to identify and exclude prospective blood donors with iron deficiency but without anemia. It is important, therefore, that blood banks evaluate the risk-benefit of implanting tests to analyze organism iron reserves such as the measurement of serum ferritin of all individuals who donate more than three times per year in order to make the blood donation process safer for both donors and transfused patients.

Retroperitoneoscopic nephrectomy in benign pathology.

INTRODUCTION: We report our experience with 43 retroperitoneal laparoscopic nephrectomy for benign kidney disease. MATERIALS AND METHODS: All patients had a poor function from obstructive uropathology and renal atrophy. None of these patients had a previous lumbotomy. Retroperitoneoscopy was performed with 4 trocar port technique in a lateral position. The retroperitoneal space is created by using a Gaur's balloon made of sterile glove. The approach to vascular pedicle was done posteriorly and vessels were clipped by metal and Hem-o-lock (Weck Closure Systems, North Carolina, USA) clips. The sample was intact extracted in an Endo-Bag prolonging one trocar incision. RESULTS: Median operative time was 160 minutes and median blood loss was 200 mL. Four cases (9%) were converted to open surgery: one case due to bleeding and 3 cases due to technical difficulties regarding perirenal adherences. Most patients (39) checked out from the Hospital in day two. Four of them were left over 3 days due to wound complications. CONCLUSIONS: Retroperitoneoscopy offers a safe, effective and reproductive access to nephrectomy for benign pathologies.

Distinct patterns of mucosal apoptosis in H pylori-associated gastric ulcer are associated with altered FasL and perforin cytotoxic pathways.

AIM: To analyze the level of apoptosis in different mucosal compartments and the differential expression of Fas/Fas-ligand and perforin in H pylori-associated gastric ulcer. METHODS: Antral specimens from patients with H pylori-related active gastric ulcer (GU), H pylori-related gastritis, and non-infected controls were analysed for densities and distribution of apoptotic cells determined by the TdT-mediated dUDP-biotin nick-end-labelling method. GU patients were submitted to eradication therapy with follow-up biopsy after 60 d. Fas, FasL, and perforin-expressing cells were assessed by immunoperoxidase, and with anti-CD3, anti-CD20 and anti-CD68 by double immunofluorescence and confocal microscopy. Quantitative analysis was performed using a computer-assisted image analyser. RESULTS: H pylori-infected antrum showed greater surface epithelial apoptosis which decreased after eradication therapy. In the lamina propria, higher rates of mononuclear cell apoptosis were observed in H pylori-gastritis. Co-expression of Fas with T-cell and macrophage markers was reduced in GU. FasL- and perforin-expressing cells were increased in H pylori-infection and correlated with epithelial apoptosis. Perforin-expressing cells were also increased in GU compared with H pylori-gastritis. CONCLUSION: Epithelial apoptosis is increased in H pylori-infection and correlates to FasL- and perforin-expression by T cells. Expression of perforin is correlated with the tissue damage, and may represent the enhancement of a distinct cytotoxic pathway in GU. Increased expression of FasL not paralleled by Fas on T-cells and macrophages may indicate a reduced susceptibility to the Fas/FasL-mediated apoptosis of lymphoid cells in H pylori-infection.

Retroperitoneoscopic nephrectomy in benign pathology

INTRODUCTION: We report our experience with 43 retroperitoneal laparoscopic nephrectomy for benign kidney disease. MATERIALS AND METHODS: All patients had a poor function from obstructive uropathology and renal atrophy. None of these patients had a previous lumbotomy. Retroperitoneoscopy was performed with 4 trocar port technique in a lateral position. The retroperitoneal space is created by using a Gaur's balloon made of sterile glove. The approach to vascular pedicle was done posteriorly and vessels were clipped by metal and Hem-o-lock (Weck Closure Systems, North Carolina, USA) clips. The sample was intact extracted in an Endo-Bag prolonging one trocar incision. RESULTS: Median operative time was 160 minutes and median blood loss was 200 mL. Four cases (9 percent) were converted to open surgery: one case due to bleeding and 3 cases due to technical difficulties regarding perirenal adherences. Most patients (39) checked out from the Hospital in day two. Four of them were left over 3 days due to wound complications. CONCLUSIONS: Retroperitoneoscopy offers a safe, effective and reproductive access to nephrectomy for benign pathologies.

Reação tecidual e perfil de fosfatases após o implante de matriz óssea desmineralizada xenogênica em músculo de ratos / Tissue reaction and phosphatases profile after implant of xenogenic demineralized bone matrix in rat muscle

Neste estudo correlacionou-se o perfil da atividade das fosfatases ácidas com os aspectos histológicos do tecido reacional em resposta à implantação subcutânea de biomaterial de enxerto preparado com matriz óssea desmineralizada bovina. Cinqüenta ratos Wistar machos foram submetidos a implantação do enxerto e sacrificados após 7, 14, 21, 30 e 67 dias. As biópsias obtidas foram fixadas em formalina 10% em tampão fosfato e cortes histológicos de 6 µm de espessura foram corados com hematoxilina e eosina. As atividades enzimáticas específicas (AE) das fosfatases ácidas foram determinadas utilizando-se o p-nitrofenilfosfato (pNFF) como substrato em tampão acetato, pH 5,0, e inibidores específicos. Para a fosfatase alcalina (FALc) foi utilizado o pNFF em tampão glicina, pH 9,2, contendo CaCl2. A análise histológica mostrou infiltrado inflamatório crônico com predomínio de macrófagos e linfócitos e presença de células gigantes multinucleadas,reabsorção do enxerto ao longo do tempo, estando ausente aos 67 dias; não pode ser observada formação óssea heterotópica. A atividade da fosfatase ácida total foi elevada e constante entre 7 e 30 dias, cerca de 30,0 nmol min-1mg-1, decaindo, em seguida, para 6,9 nmol min-1mg-1, enquanto a atividade da fosfatase alcalina foi baixa, com valor máximo de 6,0 nmol min-1mg-1 aos 30 dias. As atividades PTP, FAL e TRAP corresponderam, respectivamente, a cerca de 70, 25 e 10% da FAT. Concluímos que o enxerto de matriz óssea bovina desmineralizada não induziu a osteogênese heterotópica e que as fosfatases ácida e alcalina participaram da resposta tecidual, sendo moduladas em função do tempo