Presence of HPV in prostate tissue from patients submitted to prostate biopsy

Purpose: Prostate cancer (PCa) is the second most frequent cancer among men in the Western population. Infections, such as the one caused by the human papillomavirus (HPV), have been shown to promote inflammation that can lead to the appearance of neoplasms. This study aimed to verify the presence of HPV in neoplastic and non-neoplastic prostate tissue in patients undergoing prostate biopsy and its possible relationship with PCa. Methods: Prostate tissue fragments were collected by prostate biopsy and subjected to polymerase chain reaction with primers for the HPV L1 gene to identify the presence of the virus. Results: Among 162 patients, 10 (6.2%) had HPV and in 152 (93.8%) HPV was not identified in prostate biopsies. HPV was detected in 7/95 (7.4%) of patients with PCa, in 2/55 (3.6%) of patients without PCa, and in no patient with an inconclusive diagnosis of PCa. There was no significant difference (p = 0.487) of HPV presence in the tissue of patients with PCa. Conclusions: There were no significant levels of HPV L1 protein in prostate tissue. The findings suggest the absence of HPV oncogenic activity in the prostate tissue of patients with PCa.

Metalloproteinases and colorectal cancer. Correlation of gene expression and clinical-pathological parameters

Purpose: To analyze gene and protein expression of metalloproteinases 1, 2, 9, 11 and 16 and their correlation with clinicopathological variables in colorectal adenocarcinoma. Methods: A retrospective study of 114 patients with colorectal adenocarcinoma treated surgically in the period 2006 to 2008 in Hospital de Câncer de Barretos - Fundação Pio XII. The evaluation of gene expression was performed by RT-PCR, and protein by immunohistochemistry. The analysis of gene expression was classified as overexpressed genes and poorly expressed (fold change of approximately 2, p 0.05). The positivity of the markers in the immunohistochemical study was performed by semi-quantitative analysis. The tissue of TMA (Tissue Microarray) was done by two independent pathologists. Results: The gene expression validated by immuno - histochemical was MMP-1(p= 0.00 and 1.57 fold change) and MMP 2 (p= 0.01 and 1.84 to fold change) when correlated with the histological types mucinous and adenocarcinoma NOS, MMP9 (p=0.01 and fold change of 1.13) and MMP-16 (p=0.03 and 1.61 fold change) when compared with the histological types villous and adenocarcinoma NOS, MMP - 11 statistically significant in relation to male (p = 0.04 and 1.65 fold change). Conclusions: The MMPs 1, 2, 9, 11 and 16 gene and protein expression with statistical significance in at least one of the clinicopathological variables studied. Thus, we conclude that these MMPs have potential as a prognostic factor in colorectal adenocarcinoma.(AU)

Safety and effectiveness of laparoscopic Y-en-Roux gastric bypass surgery in obese elderly patients

Purpose To analyze, in aged obese patients, the weight loss, comorbidity control, and safety postoperative complications of bariatric surgery by Roux-en-Y gastric bypass technique. Methods Twenty-seven patients who underwent laparoscopic weight-reducing gastroplasty with Roux-en-Y gastric bypass to treat obesity were included. All patients were 60 years old at the time of surgery. The Wilcoxon test was used for statistical analysis, and a p-value 0.05it was considered significant. Results Ten (90.9%) patients with dyslipidemia were cured (p 0.001). Nine (81.8%) patients with type 2 diabetes mellitus had total improvement and 2 (18.2%) had partial improvement (p = 0.003). In 23 patients with systemic arterial hypertension, 9 (39.1%) achieved total improvement and 14 (60.9%) partial improvement (p = 0.140). Five (71.4%) patients with obstructive sleep apnea syndrome were cured (p = 0.001). For other comorbidities, no partial improvement or cure was shown. Conclusions Roux-en-Y gastric bypass surgery in obese elderly patients can be performed safely and with low morbidity and mortality rates. The benefits of weight loss and reduced comorbidities are promising and like those of the younger population.(AU)

Safety and effectiveness of laparoscopic Y-en-Roux gastric bypass surgery in obese elderly patients

Purpose. To analyze, in aged obese patients, the weight loss, comorbidity control, and safety postoperative complications of bariatric surgery by Roux-en-Y gastric bypass technique.. Methods. Twenty-seven patients who underwent laparoscopic weight-reducing gastroplasty with Roux-en-Y gastric bypass to treat obesity were included. All patients were ≥ 60 years old at the time of surgery. The Wilcoxon test was used for statistical analysis, and a p-value ≤0.05it was considered significant.. Results. Ten (90.9%) patients with dyslipidemia were cured (p < 0.001). Nine (81.8%) patients with type 2 diabetes mellitus had total improvement and 2 (18.2%) had partial improvement (p = 0.003). In 23 patients with systemic arterial hypertension, 9 (39.1%) achieved total improvement and 14 (60.9%) partial improvement (p = 0.140). Five (71.4%) patients with obstructive sleep apnea syndrome were cured (p = <0.001). For other comorbidities, no partial improvement or cure was shown.. Conclusions. Roux-en-Y gastric bypass surgery in obese elderly patients can be performed safely and with low morbidity and mortality rates. The benefits of weight loss and reduced comorbidities are promising and like those of the younger population.(AU)

Expression of P53, HER2 and Ki67 proteins in rats subjected to bladder augmentation with stomach, colon and ileum

PURPOSE:To study the expression of HER2, p53 and Ki67 proteins in cystoplasties.METHODS:Sixty rats were distributed randomly into three groups of 20 animals. Bladder augmentation was held to increase with ileum (Group I), colon (Group II) and stomach (Group III). Tissue samples of neobladder was collected from each rat to its own control. The animals were sacrificed after 12 weeks. The neobladder was withdrawn for immunohistochemitry analysis of p53, HER2 and Ki67 expression. Wilcoxon and Mann-Whitney tests were used for statistical study.RESULTS:There were no significant changes in the expression of p53 and HER2 proteins. It was observed significant increase (p<0.0001) in Ki67 expression in all groups, when compared with their respective controls. When the study groups were compared with each other, there was increase of cell proliferation in the largest gastrocystoplasties in respect of ileocystoplasties (p=0.004) and colocystoplasties (p=0.003).CONCLUSION:We observed significant increase of cell proliferation characterized by Ki67 protein in the digestive tract of the ileocystoplasties, the colocystoplasties and the gastrocystoplasties and this increase was significantly greater in gastrocystoplasties.(AU)

Cervical esophagogastric anastomosis with invagination after esophagectomy / Anastomose esofagogástrica cervical com invaginação após esofagectomia

PURPOSE: To evaluate the incidence of fistula and stenosis of the cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach after subtotal esophagectomy. METHODS: We studied 54 patients who underwent subtotal esophagectomy, 45 (83.3%) patients with carcinoma and nine (16.6%) with advanced megaesophagus. In all cases the cervical esophagogastric anastomosis was performed with the invagination of the proximal esophageal stump inside the stomach. RESULTS: Three (5.5%) patients had a fistula at the esophagogastric anastomosis, two of whom with minimal leakage of air or saliva and with mild clinical repercussion; the third had a low output fistula that drained into the pleural space, and this patient developed empyema that showed good progress with drainage. Fibrotic stenosis of anastomosis occurred in thirteen (24%) subjects and was treated successfully with endoscopic dilatation. CONCLUSION: Cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube presented a low rate of esophagogastric fistula and stenosis, thus becoming an attractive option for the reconstruction of alimentary transit after subtotal esophagectomy.(AU)

OBJETIVO: Avaliar a incidência de fístula e estenose da anastomose esofagogástrica cervical com invaginação do coto esofágico proximal no interior do estômago após esofagectomia subtotal. MÉTODOS: Foram estudados 54 pacientes submetidos à esofagectomia subtotal, 45 (83,3%) com carcinoma e nove (16,6%) com megaesôfago chagásico avançado. Em todos os casos, a anastomose esofagogástrica cervical foi realizada com invaginação do coto esofágico proximal no interior do estômago. RESULTADOS: Três (5,5%) pacientes apresentaram fístula, dois deles com saída mínima de ar e saliva pela incisão cervical que evoluíram com rápida cicatrização; o terceiro apresentou fístula de pequeno débito que drenou para o espaço pleural causando empiema que teve boa evolução após drenagem. Treze (24%) doentes apresentaram estenose fibrótica e foram tratados com sucesso com dilatação endoscópica. CONCLUSÃO: A anastomose esofagogástrica cervical com invaginação do coto esofágico proximal no interior do estômago apresentou baixa incidência de fístula e estenose tornando-se opção atraente para a reconstrução do trânsito alimentar após esofagectomia subtotal.(AU)

Biliopancreatic diversion with duodenojejunal exclusion associated with truncal vagotomy: a new proposal for type 2 diabetes mellitus treatment / Derivação biliopancreática com exclusão duodeno-jejunal associada à vagotomia troncular: uma nova proposta para o tratamento do diabetes melito tipo 2

PURPOSE: To evaluate the effectiveness of the biliopancreatic diversion surgery with duodenojejunal exclusion in combination with truncal vagotomy in type 2 diabetes mellitus (T2DM) patients with overweight or class I or II obesity. METHODS: The study included ten patients with T2DM and class I or II obesity or overweight who were subjected to biliopancreatic diversion with duodenojejunal exclusion in combination with truncal vagotomy. The blood glucose levels during the pre- and postoperative periods were compared using the Friedman test. The significance level adopted was 5%. RESULTS: There were significant differences between preoperative and postoperative blood glucose levels at three months (p=0.01), six months (p=0.001) and 12 months (p=0.001). There was also a significant difference between one month postoperative blood glucose and six months postoperative blood glucose (p=0.01). Glycosylated hemoglobin levels decreased in 80% of patients, there was marked improvement in their lipid profiles, and the average BMI reduction was 7.0±1.5 kg/m² at 12 months after the surgery. CONCLUSION: In patients with type 2 diabetes mellitus associated with class I/II obesity or overweight, performing biliopancreatic diversion with duodenojejunal exclusion in combination with truncal vagotomy resulted in glycemic control, reduction of excess weight, and improvement of lipid profile 12 months after the surgery.(AU)

OBJETIVO: Avaliar a eficácia da operação de derivação biliopancreática com exclusão duodeno-jejunal associada com vagotomia troncular em doentes com diabetes tipo 2 com sobrepeso ou obesidade classe I ou II. MÉTODOS: Foram estudados dez doentes com diabetes melito tipo 2 e sobrepeso ou obesidade grau I ou II submetidos à derivação biliopancreática com exclusão duodeno-jejunal associada à vagotomia troncular. Os valores de glicemia no pré e no pós-operatório foram comparados pelo teste de Friedman. O nível de significância adotado foi de 5%. RESULTADOS: Houve diferença significante (p=0,01) nas glicemias pré e pós-operatórias de três meses, de seis meses (p=0,001) e de 12 meses (p=0,001). Houve diferença significante entre a glicemia pós-operatória de um mês e glicemia pós-operatória de seis meses (p=0,01). O nível de hemoglobina glicosilada reduziu-se em 80% dos doentes, houve melhora acentuada do perfil lipídico e a média da redução do IMC foi de 7,0±1,5 kg/m² após 12 meses da operação. CONCLUSÃO: No paciente com diabetes melito tipo 2 associado com sobrepeso ou obesidade grau I/II, a realização da derivação biliopancreática com exclusão duodeno-jejunal associada à vagotomia troncular proporcionou controle glicêmico, redução do excesso de peso e melhora do perfil lipídico após 12 meses da operação.(AU)

Alotransplante de ilhotas pancreáticas no baço com imunossupressão com ciclosporina. Modelo experimental em cães / Pancreatic islet allograft in spleen with immunossuppression with cyclosporine. Experimental model in dogs

PURPOSE: To study the functional behavior of the allograft with immunosuppression of pancreatic islets in the spleen. METHODS: Five groups of 10 Mongrel dogs were used: Group A (control) underwent biochemical tests; Group B underwent total pancreatectomy; Group C underwent total pancreatectomy and pancreatic islet autotransplant in the spleen; Group D underwent pancreatic islet allograft in the spleen without immunosuppressive therapy; Group E underwent pancreatic islet allograft in the spleen and immunosuppression with cyclosporine. All of the animals with grafts received pancreatic islets prepared by the mechanical-enzymatic method - stationary collagenase digestion and purification with dextran discontinuous density gradient, implanted in the spleen. RESULTS: The animals with autotransplant and those with allografts with immunosuppression that became normoglycemic showed altered results of intravenous tolerance glucose (p < 0.001) and peripheral and splenic vein plasmatic insulin levels were significantly lower (p < 0.001) in animals that had allografts with immunosuppression than in those with just autotransplants. CONCLUSIONS: In the animals with immunosupression with cyclosporine subjected to allograft of pancreatic islets prepared with the mechanical-enzymatic preparation method (stationary collagenase digestion and purification with dextran discontinuous density gradient), the production of insulin is decreased and the response to intravenous glucose is altered.(AU)

OBJETIVO: Avaliar o comportamento funcional do alotransplante com imunossupressão de ilhotas pancreáticas no baço. MÉTODOS: Foram utilizados cinco grupos de 10 cães mestiços: grupo A (controle) submetido aos exames bioquímicos; grupo B, submetido à pancreatectomia total; grupo C (autotransplante) submetido à pancreatectomia total e autotransplantação de ilhotas pancreáticas no baço; grupo D, submetido à alotransplantação de ilhotas pancreáticas no baço sem terapia imunossupressiva; grupo E, submetido à alotransplantação de ilhotas no baço e imunossupressão com ciclosporina. Todos os animais transplantados receberam ilhotas pancreáticas isoladas pelo método mecânico-enzimático, digestão estacionária com colagenase e purificação com gradiente de densidade descontínua de dextran e foram implantadas no baço. RESULTADOS: Animais autotransplantados e alotransplantados com imunossupressão que se tornaram normoglicêmicos apresentaram testes de tolerância à glicose intravenosa alterados (p<0,001) e o nível de insulina plasmática periférica e na veia esplênica foram significantemente menores (p<0,001) nos animais alotransplantados com imunossupressão em relação aos autotransplantados. CONCLUSÃO: Nos animais submetidos ao alotransplante de ilhotas pancreáticas com imunossupressão com ciclosporina e preparadas pelo método mecânico-enzimático, digestão estacionária com colagenase e purificação com gradiente de densidade descontínua de dextran, a produção de insulina está diminuída e a resposta à sobrecarga de glicose intravenosa alterada.(AU)

Equipamento para anestesia inalatória em ratos com oferta simultânea de anestésico e oxigênio / Inhalation anesthesia equipment for rats with provision of simultaneous anesthetic and oxygen

PURPOSE: To introduce a model of equipment for inhalation anesthesia in rats that offers better control of both flow and losses of ether during induction, maintenance, and recuperation. METHODS: The equipment consists of an air compressor with two outlets, a closed glass induction chamber, a glass reservoir for the anesthetic agent, a pediatric inhalation mask, a three-way stopcock, a Y-connector, and urinary catheters. Three hundred Wistar rats (Rattus norvegicus albinus) were given inhalation anesthesia. The evaluated parameters were equipment operation, duration of each phase of anesthesia, corneal reflex, muscular tonus, respiration during induction and maintenance, and volume of anesthesia. RESULTS: The average time taken for induction was 7.3 minutes; the average anesthetic recuperation time was 6.4 minutes. The amount of anesthetic used varied according to the weight of the animal, with the average volume of ether used being 6.5ml/hour. The availability of oxygen (room air) decreased the recuperation time and averted both respiratory depression and insufficient depth of anesthesia. CONCLUSION: The proposed equipment is practical, inexpensive, and allows for satisfactory control of anesthetic parameters during the entire procedure, making inhalation anesthesia in rats safe and essentially complication free.(AU)

OBJETIVO: Apresentar modelo de equipamento para anestesia inalatória em ratos, com melhor controle do fluxo, das perdas de anestésico na indução, da manutenção e da recuperação anestésica. MÉTODOS: O equipamento é constituído por compressor de ar com saída dupla, câmara de vidro fechada para indução, reservatório de vidro para o agente anestésico, máscara de inalação pediátrica, torneira de três vias, conexão em "Y" e sondas uretrais. Trezentos ratos Wistar (Rattus norvegicus albinus) foram anestesiados por via inalatória. Os parâmetros avaliados foram: viabilidade do equipamento, tempo de cada fase, reflexo corneano, tônus muscular e movimentos respiratórios na indução e na manutenção anestésica, além do volume de anestésico. RESULTADOS: A média do tempo gasto na indução anestésica foi de 7,3 minutos. A média do tempo de recuperação anestésica foi de 6,4 minutos. A média do volume de éter utilizado foi de 6,5 ml/h. Não foram observadas neste experimento morte dos animais, aumento excessivo de secreção traqueobrônquica ou interrupção da operação por superficialização anestésica. CONCLUSÃO: O equipamento proposto é prático, possui baixo custo e permite o controle adequado dos parâmetros de controle da anestesia durante todo o procedimento, tornando a anestesia inalatória em ratos segura e praticamente isenta de complicações.(AU)

Early morphological and histochemical alterations in rats subjected to ileocystoplasty / Alterações morfológicas e histoquímicas precoces em ratos submetidos à ileocistoplastia

PURPOSE: To study morphologic and histochemical alterations arising at the ileocystoplasty site. METHODS: Sixteen Wistar female rats were subjected to ileocystoplasty and sacrificed after eight weeks. Material collected was divided into four groups for histological and histochemical studies: Group I (control) - isolated ileum segment removed during ileocystoplasty; Group II - ileoileal anastomosis; Group III - ileovesical anastomosis and Group IV - ileal segment from the neobladder. Histological and histochemical study assessed dysplasia, metaplasia, acute and chronic inflammation, fibrosis, atrophy, hypertrophy, total mucins, sialomucins and sulfomucins. The non-parametric Wilcoxon and Mann-Whitney tests were employed in statistical analysis. RESULTS: None of the groups presented dysplasia. Acute inflammation and atrophy occurred in Groups II, III and IV, not reaching statistical significance. Metaplasia was significant only in Group III (p=0.012). Chronic inflammation, fibrosis and hypertrophy were significant in Groups II, III and IV. There was a significant increase in total mucin content in Group IV (p=0.014) and a reduction in Group III (p=0.016). Increases in sialomucins were observed in samples for Groups III (p=0.003) and IV (p=0.002) along with reduced sulfomucins in samples from Groups III (p=0.013) and IV (p=0.008). CONCLUSION: Ileocystoplasty in female rats caused squamous metaplasia, chronic inflammatory infiltration, fibrosis, hypertrophy, increase in sialomucin content, reduction in sulfomucins, and alterations in total mucin content with statistical significance, as well acute inflammatory infiltration and muscular atrophy with less intensity.(AU)

OBJETIVO: Estudar alterações morfológicas e histoquímicas nas ileocistoplastias em ratos fêmea. MÉTODOS: 16 ratos fêmea foram submetidos à ileocistoplastia, sacrificadas após oito semanas. O material coletado foi e dividido em quatro grupos para análise morfológica e histoquímica: Grupo I (controle) biópsia intestinal no momento da cirurgia; Grupo II - anastomose íleo-ileal; Grupo III - anastomose íleo-vesical e Grupo IV - segmento intestinal da neobexiga. Os parâmetros avaliados foram: displasia, metaplasia, processo inflamatório agudo e crônico, fibrose, atrofia, hipertrofia, conteúdo total de mucinas, sialomucinas e sulfomucinas. Utilizou-se os testes não-paramétricos de Wilcoxon e Mann-Whitney para estudo estatístico. RESULTADOS: Não houve displasia. Processo inflamatório agudo e atrofia ocorreram nos grupos II, III e IV, sem significância estatística. Metaplasia com significância estatística ocorreu somente no grupo III (p=0.012). Processo inflamatório crônico, fibrose e hipertrofia foram significantes nos grupos II, III e IV. Observou-se aumento significante no conteúdo total de mucinas no grupo IV (p=0.014) e redução no grupo III (p=0.013). Aumento significante de sialomucinas foi observado nos grupos III (p=0.003) e IV (p=0.002) e redução significante das sulfomucinas nos grupos III (p=0.013) e IV (p=0.008). CONCLUSÃO: Nas ileocistoplastias em ratos fêmea observou-se metaplasia escamosa, processo inflamatório crônico, fibrose, hipertrofia, aumento do conteúdo de sialomucinas, redução das sulfomucinas e alterações no conteúdo total de mucinas com significância estatística, bem como atrofia e processo inflamatório agudo em menor intensidade.(AU)

Early morphological and histochemical alterations in rats subjected to ileocystoplasty

PURPOSE: To study morphologic and histochemical alterations arising at the ileocystoplasty site. METHODS: Sixteen Wistar female rats were subjected to ileocystoplasty and sacrificed after eight weeks. Material collected was divided into four groups for histological and histochemical studies: Group I (control) - isolated ileum segment removed during ileocystoplasty; Group II - ileoileal anastomosis; Group III - ileovesical anastomosis and Group IV - ileal segment from the neobladder. Histological and histochemical study assessed dysplasia, metaplasia, acute and chronic inflammation, fibrosis, atrophy, hypertrophy, total mucins, sialomucins and sulfomucins. The non-parametric Wilcoxon and Mann-Whitney tests were employed in statistical analysis. RESULTS: None of the groups presented dysplasia. Acute inflammation and atrophy occurred in Groups II, III and IV, not reaching statistical significance. Metaplasia was significant only in Group III (p=0.012). Chronic inflammation, fibrosis and hypertrophy were significant in Groups II, III and IV. There was a significant increase in total mucin content in Group IV (p=0.014) and a reduction in Group III (p=0.016). Increases in sialomucins were observed in samples for Groups III (p=0.003) and IV (p=0.002) along with reduced sulfomucins in samples from Groups III (p=0.013) and IV (p=0.008). CONCLUSION: Ileocystoplasty in female rats caused squamous metaplasia, chronic inflammatory infiltration, fibrosis, hypertrophy, increase in sialomucin content, reduction in sulfomucins, and alterations in total mucin content with statistical significance, as well acute inflammatory infiltration and muscular atrophy with less intensity.

OBJETIVO: Estudar alterações morfológicas e histoquímicas nas ileocistoplastias em ratos fêmea. MÉTODOS: 16 ratos fêmea foram submetidos à ileocistoplastia, sacrificadas após oito semanas. O material coletado foi e dividido em quatro grupos para análise morfológica e histoquímica: Grupo I (controle) biópsia intestinal no momento da cirurgia; Grupo II - anastomose íleo-ileal; Grupo III - anastomose íleo-vesical e Grupo IV - segmento intestinal da neobexiga. Os parâmetros avaliados foram: displasia, metaplasia, processo inflamatório agudo e crônico, fibrose, atrofia, hipertrofia, conteúdo total de mucinas, sialomucinas e sulfomucinas. Utilizou-se os testes não-paramétricos de Wilcoxon e Mann-Whitney para estudo estatístico. RESULTADOS: Não houve displasia. Processo inflamatório agudo e atrofia ocorreram nos grupos II, III e IV, sem significância estatística. Metaplasia com significância estatística ocorreu somente no grupo III (p=0.012). Processo inflamatório crônico, fibrose e hipertrofia foram significantes nos grupos II, III e IV. Observou-se aumento significante no conteúdo total de mucinas no grupo IV (p=0.014) e redução no grupo III (p=0.013). Aumento significante de sialomucinas foi observado nos grupos III (p=0.003) e IV (p=0.002) e redução significante das sulfomucinas nos grupos III (p=0.013) e IV (p=0.008). CONCLUSÃO: Nas ileocistoplastias em ratos fêmea observou-se metaplasia escamosa, processo inflamatório crônico, fibrose, hipertrofia, aumento do conteúdo de sialomucinas, redução das sulfomucinas e alterações no conteúdo total de mucinas com significância estatística, bem como atrofia e processo inflamatório agudo em menor intensidade.

Pancreatic islet isolation by mechanical-enzymatic separation, stationary collagenase digestion and dextran discontinuous density gradient purification: experimental study in dogs

The prospects for allotransplantation of pancreatic islets in man depend on the development of methods that provide sufficient quantities of pancreatic islets from a single donor, which are capable, when transplanted, of achieve the normalization of carbohydrate metabolism. Objective: Evaluate the efficacy of the isolation of Langerhans islets from dogs, by means of mechanical-enzymatic separation technique with stationary digestion using collagenase, and purification with a discontinuous dextran density gradient. Methods: The counting of islet numbers and evaluation of their sizes was accomplished by staining with diphenylthiocarbazone and using stereoscopic microscopes equipped with eyepiece reticule for the measurement of average diameters of stained islets. Results: The results disclosed that the average number of islets isolated was 81032.20 ± 24736.79 and the average number of islets isolated per kg of body weight was 6938.70 ± 1392.43. The average number of islets isolated per kg of body weight showed significant correlation with body weight and weight of the pancreas resected. Conclusion: The number of islets isolated, of a single donor, by mechanical-enzymatic separation, stationary collagenase digestion and discontinuous dextran density gradient purification can be sufficient to success of pancreatic islets transplant in dogs.

A perspectiva do alotransplante de ilhotas pancreáticas no homem está na dependência do desenvolvimento de métodos que propiciem quantidades suficientes de ilhotas pancreáticas, originadas de doador único, capazes de, quando transplantadas, levarem à normalização do metabolismo dos hidratos de carbono. Objetivo: Avaliar, em cães, a eficácia do isolamento das ilhotas de Langerhans por meio da técnica de separação mecânica-enzimática, digestão estacionária com colagenase e purificação pelo gradiente de densidade descontínua de dextran. Métodos: A contagem do número e avaliação do tamanho das ilhotas foi realizada pela coloração com difeniltiocarbazona e exame em microscópio estereoscópico munido de retícula ocular para medição do diâmetro médio das ilhotas coradas. Resultados: O número médio de ilhotas isoladas foi de 81032,20 ± 24736.79 e o número médio de ilhotas/kg de peso corpóreo foi de 6938,70± 1392,43. O número médio de ilhotas/kg de peso corpóreo obtido mostrou correlação significativa com peso corpóreo e peso do pâncreas extirpado. Conclusão: Estes resultados sugerem que o número de ilhotas isoladas, de um único doador, por meio da separação mecânica-enzimática, digestão estacionária com colagenase e purificação pelo gradiente de densidade descontínua de dextran pode ser suficiente para o sucesso do transplante de ilhotas pancreáticas em cães.

Análise quantitativa das ondas fisiológicas do intestino delgado após plicatura parcial e ordenada do íleo em ratos

The present experimental study analyzed the spontaneous intestinal movements of proximal jejunum and distal ileum in rats, after ordered plication in ileum. Thirty-one albino rats were utilized, distributed into three groups submitted to the same experiment: group A - animals reoperated on 10th day after ordered ileal plication; group B - animals reoperated on 20th day; group C - animals reoperated on 60th day. Ordered plication of the ileum was performed in four intestinal segments, each of length 2 cm. In the reoperation, a sectioning procedure was performed, removing the plicated intestinal segments with the pre-plication jejunal segment and post-plication ileal segment, as a single piece. Two chemographs were utilized for simultaneous recording of the spontaneous intestinal waves. Analysis was done of frequencies of types I, II and III physiological waves in the proximal jejunal and distal ileal segments of groups A, B and C, separately and together. The statistical study was performed using the non-parametric methods of Kruskal-Wallis, Friedman and Wilcoxon. The results of the present experiment concluded that ordered partial ileal plication does not interfere in spontaneous intestinal movements represented by types I, II and III waves in the pre-plication jejunal segment and in the post-plication ileal segment after two months of the operation.

O presente estudo experimental analisou os movimentos intestinais espontâneos do jejuno proximal e íleo distal, em ratos, após plicatura ordenada no íleo. Foram utilizados 31 ratos albinos distribuídos em três grupos submetidos ao mesmo experimento: grupo A - animais reoperados no 10º pós-operatório da plicatura ileal ordenada; grupo B - animais reoperados no 20º pós-operatório; grupo C - animais reoperados no 60º pós-operatório. Realizou-se plicatura ordenada do íleo, em quatro segmentos intestinais com 2cm de extensão cada. Na reoperação procedeu-se à secção, em peça única, dos segmentos intestinais plicados, do segmento jejunal pré-plicatura e do segmento ileal pós-plicatura. Utilizou-se dois quimógrafos para registro simultâneo das ondas intestinais espontâneas. Foram analisadas as freqüências das ondas fisiológicas do tipo I, II e III nos segmentos do jejuno proximal e do íleo distal nos grupos A, B e C, separadamente e em conjunto. O estudo estatístico foi realizado pelos métodos não paramétricos de Kruskal-Wallis, Friedman e Wilcoxon. Os resultados do presente experimento permitiram concluir que a plicatura ileal parcial ordenada não interferiu de maneira definitiva nos movimentos intestinais espontâneos representados pelas ondas tipos I, II e III no segmento jejunal pré plicatura e no segmento ileal pós plicatura após dois meses do procedimento.

Distribuição anatômica da árvore ductal pancreática do cão: implicações para o isolamento das ilhotas de Langerhans

The knowledge of normal pancreatic ductal tree anatomy in dogs is important for the preparation and isolation of islets of Langerhans. The aim of this study is to demonstrate the anatomical configuration of the pancreatic ductal tree, especially concerning its implications in the preparation of pancreatic tissue for Langerhans islets transplantation techniques. The main pancreatic duct ( Santorini ) was dissected, and the upper and the lower branches were catheterized. Total pancreatectomy was performed without duodenectomy. Through the catheters an acetone solution was administered to the ducts, a blue ink solution was administered to the upper branch, and a red ink solution was administered to the lower branch. The ductal tree was then carefully dissected. A global distension of the pancreatric parenquima was observed due to the complete envelopment of the gland by the tributary branches of the main pancreatic duct. The lower branch only distended the uncinated process region, and the upper branch only distended the body and tail regions of the pancreatic tissue. This study suggests that the use of these sites of infusion are adequate in the procedures for isolating islets of Langerhans in dogs.

O conhecimento da anatomia normal da árvore ductal pancreática no cão e de sua variações reveste-se de importância para a execução dos protocolos de preparação e isolamento das ilhotas de Langerhans. A proposta deste estudo é demonstrar a configuração anatômica da dutal pancreática com especial atenção para as implicações sobre as técnicas de preparação do tecido pancreático para o transplante de ilhotas de Langerhans no cão. Os autores realizaram a dissecção do duto pancreático principal (Santorini) e a cateterização dos seus ramos ascendente e descendente. Em seguida procederam à pancreatectomia total sem duodenectomia. Através destes cateteres, infundiu-se solução de acetona no interior dos ductos e solução de tinta nanquim de cor azul no ramo ascendente e de cor vermelha no ramo descendente. Posteriormente, os autores dissecaram a árvore ductal pancreática com pinças delicadas e digitoclasia. Através desta técnica, os autores verificaram a distensão universal do parênquima pancreático devido ao envolvimento de toda a glândula pelos ramos tributários do ducto pancreático principal. O ramos descendente distendeu exclusivamente a região do processo uncinado, ao passo que o ramo ascendente distendeu exclusivamente as regiões do corpo e cauda do pâncreas canino. Esta constatação enfatiza a utilização destas vias para a infusão das soluções apropriadas nos procedimentos de isolamento das ilhotas de Langerhans no modelo canino.

Determinação do antígeno carcinoembrionário biliar na detecção das metástases hepáticas do carcinoma colorretal

PURPOSE: Carcinoembryonic antigen (CEA) determination in gallbladder bile was used in a prospective study concerning the morphological and clinical features of the neoplasm and the occurrence of hepatic metastasis. METHODS: CEA levels in the gallbladder and peripheral blood were studied in 44 patients with colorectal carcinoma and 10 patients with uncomplicated cholelithiasis from samples collected immediately before extirpating the colorectal neoplasms or cholecystectomy (values of up to 5 ng/ml were considered normal). RESULTS: In the 44 patients with colorectal carcinoma who underwent operation with curative intent, the average level of serum CEA was 8.5 ng/ml and for bile CEA, 74.5 ng/ml. In the patients with uncomplicated cholelithiasis who underwent cholecystectomy, the average level of serum CEA was 1.9 ng/ml and for bile CEA, 1.2 ng/ml. Four patients who underwent extirpation of the colorectal carcinoma without evidence of hepatic metastasis and with an average bile CEA value of 213.2 ng/ml presented hepatic metastasis between three and seventeen months after removal of the neoplasms. CONCLUSION: The high CEA levels in gallbladders of patients undergoing curative operation for colorectal carcinoma may indicate the presence of hepatic metastasis. Such patients must be followed up with special attention to the diagnosis of such lesions.

OBJETIVO: Analisar, prospectivamente, os resultados da determinação do antígeno carcinoembriário (CEA) na bile vesicular, relacionando-os com os aspectos morfológicos e clínicos da neoplasia e recidiva hepática. MÉTODOS: Os níveis do CEA foram estudados na bile vesicular e no sangue periférico de 44 doentes com carcinoma colorretal e 10 com colelitíase não complicada, a partir de amostras do CEA colhidas imediatamente antes da extirpação da neoplasia colo-retal e da colecistectomia (considerou-se valor normal até 5 ng/ml). RESULTADOS: Os 44 carcinomas colorretais extirpados com intenção curativa tiveram nível médio do CEA sérico de 8,5 ng/ml e CEA biliar, 74,5 ng/ml. Nas colelitíases não complicadas submetidas a colecistectomia, o nível médio do CEA sérico foi de 1,9 ng/ml e CEA biliar, 1,2 ng/ml. Quatro doentes submetidos à extirpação do carcinoma colo-retal, sem evidências de metástases hepáticas e com valor médio de CEA biliar de 213,2 ng/ml apresentaram metástases hepáticas entre três a 17 meses após a extirpação. CONCLUSÃO: o nível elevado de CEA biliar dos operados por carcinoma colo-retal pode indicar presença de metástases hepáticas e esses enfermos devem ser acompanhados com especial atenção para diagnosticar essas lesões.

Determinação do antígeno carcinoembrionário biliar na detecção das metástases hepáticas do carcinoma colorretal

PURPOSE: Carcinoembryonic antigen (CEA) determination in gallbladder bile was used in a prospective study concerning the morphological and clinical features of the neoplasm and the occurrence of hepatic metastasis. METHODS: CEA levels in the gallbladder and peripheral blood were studied in 44 patients with colorectal carcinoma and 10 patients with uncomplicated cholelithiasis from samples collected immediately before extirpating the colorectal neoplasms or cholecystectomy (values of up to 5 ng/ml were considered normal). RESULTS: In the 44 patients with colorectal carcinoma who underwent operation with curative intent, the average level of serum CEA was 8.5 ng/ml and for bile CEA, 74.5 ng/ml. In the patients with uncomplicated cholelithiasis who underwent cholecystectomy, the average level of serum CEA was 1.9 ng/ml and for bile CEA, 1.2 ng/ml. Four patients who underwent extirpation of the colorectal carcinoma without evidence of hepatic metastasis and with an average bile CEA value of 213.2 ng/ml presented hepatic metastasis between three and seventeen months after removal of the neoplasms. CONCLUSION: The high CEA levels in gallbladders of patients undergoing curative operation for colorectal carcinoma may indicate the presence of hepatic metastasis. Such patients must be followed up with special attention to the diagnosis of such lesions.

OBJETIVO: Analisar, prospectivamente, os resultados da determinação do antígeno carcinoembriário (CEA) na bile vesicular, relacionando-os com os aspectos morfológicos e clínicos da neoplasia e recidiva hepática. MÉTODOS: Os níveis do CEA foram estudados na bile vesicular e no sangue periférico de 44 doentes com carcinoma colorretal e 10 com colelitíase não complicada, a partir de amostras do CEA colhidas imediatamente antes da extirpação da neoplasia colo-retal e da colecistectomia (considerou-se valor normal até 5 ng/ml). RESULTADOS: Os 44 carcinomas colorretais extirpados com intenção curativa tiveram nível médio do CEA sérico de 8,5 ng/ml e CEA biliar, 74,5 ng/ml. Nas colelitíases não complicadas submetidas a colecistectomia, o nível médio do CEA sérico foi de 1,9 ng/ml e CEA biliar, 1,2 ng/ml. Quatro doentes submetidos à extirpação do carcinoma colo-retal, sem evidências de metástases hepáticas e com valor médio de CEA biliar de 213,2 ng/ml apresentaram metástases hepáticas entre três a 17 meses após a extirpação. CONCLUSÃO: o nível elevado de CEA biliar dos operados por carcinoma colo-retal pode indicar presença de metástases hepáticas e esses enfermos devem ser acompanhados com especial atenção para diagnosticar essas lesões.

Morphometric study of gastric mucosa in dogs submitted to proximal gastric vagotomy, splenectomy or proximal gastric vagotomy associated with splenectomy

OBJECTIVE: The aim of the present study was to evaluate the effects of total splenectomy and proximal gastric vagotomy (PGV) isolated or associated to the vascularization of the stomach. METHODS: Twenty-eight dogs were distributed in: group A - animals undergoing laparotomy and gastric manipulation; group B - animals undergoing PGV; group C - animals undergoing PGV and splenectomy; and group D - animals undergoing splenectomy alone. All animals were sacrificed on the 7th postoperative day, and immediately followed by infusion of xanthene dye into the thoracic aorta. On the gastric mucous surface, the formation of stained areas and other areas lacking staining was measured by millimeter squares, planimetry and the computerized morphometry method. RESULTS: The formation of an area lacking in staining along the lesser gastric curvature was seen in all animals of groups B and C, which was significantly increased in group C, although in groups A and D such areas were not observed. CONCLUSION: These results showed that, in animals with splenectomy, the vascularization of the stomach was capable of perfusing the whole organ surface, but in animals with PGV alone or associated with splenectomy there was a notable decrease in blood supply throughout the area of the lesser gastric curvature, which suggests the ischemic impairment of this region.

OBJETIVO: Avaliar os efeitos da esplenectomia total e da vagotomia gástrica proximal (VGP) isoladas e associadas sobre a vascularização gástrica. MÉTODOS: Utilizaram-se 28 cães, distribuídos em quatro grupos: grupo A, laparotomia e manipulação gástrica; grupo B, VGP; grupo C, VGP associada à esplenectomia; grupo D, esplenectomia isolada. Todos os animais foram mortos no 7º pós-operatório e imediatamente infundiu-se o corante na aorta torácica. O estômago aberto pela grande curvatura foi fotografado. Na superfície mucosa gástrica, a formação de áreas coradas e desprovidas de coloração foi mensurada por três métodos: decomposição milimétrica, planimétrico e morfometria computadorizada. RESULTADOS: Verificou-se nos grupos B e C formação de área desprovida de coloração na pequena curvatura gástrica, sendo significativamente maior no grupo C (p 0,05). Nos grupos A e D tais áreas não foram observadas. A análise estatística não revelou diferenças significativas entre os resultados dos três métodos utilizados. CONCLUSÕES: Nas condições desse estudo os resultados permitiram concluir que nos animais com o estômago íntegro e naqueles onde a esplenectomia foi realizada de forma isolada, a vascularização do estômago permitiu a perfusão de toda a superfície do órgão. Nos animais submetidos a VGP isolada e principalmente quando a VGP foi associada ã esplenectomia ocorreu significativa diminuição do suprimento sangüíneo na curvatura gástrica menor, sugerindo a potencialidade isquêmica dessa região.