Intravesical ligation as a new technique to manage a refluxing native ureter without simultaneous nephrectomy in renal transplantation.

BACKGROUND: This article aims to describe an original technique to correct refluxing native ureters observed during a prerenal transplantation study. The correction is performed by intravesical ligation of the native refluxing ureters at the same time as renal transplantation without simultaneous nephrectomy. METHODS: Between January 2004 and December 2010 we performed intravesical ligation of a refluxing ureter simultaneous with a transplantation procedure without a concomittant native nephrectomy in 12 of 345 subjects (3.47%). The 8 bilateral and 4 unilateral ligations were performed on 11 cadaveric and 1 living-related nonidentical donor transplantations. The implantation of the kidney donor ureter was performed anatomically in the bladder trigone through a transvesical ureteroneocystostomy with a transmural, submucosal antireflux tunnel. RESULTS: Early and late postoperative recovery was satisfactory in all patients. There was no documented kidney area pain, proven urinary tract infection, morbidity or mortality attributed to the procedure. CONCLUSIONS: Intravesical ligation is a practical technique to manage vesicoureteral reflux into the native ureters simultaneously with the ureteral implantation of the kidney donor in a single surgical renal transplant procedure without native kidney nephrectomy.

Antibody seroprevalences against rabies in dogs vaccinated under field conditions in Bolivia.

Bolivia currently has one of the highest numbers of cases for human and canine rabies and is thus clue to the elimination process. The objective of the present study was to assess antibody seroprevalences against rabies in dogs vaccinated under field conditions and other factors that might influence the success of the on-going rabies control programmes in an endemic area of the disease, Santa Cruz de la Sierra, Bolivia. All 240 study animals, selected using area-stratified random sampling, were investigated in April 2007. Test prevalences were adjusted for the imperfect test characteristics using the Rogan-Gladen estimator (deterministic and stochastic functions) and Bayesian inference. Ninety-four of the tested 240 vaccinated dogs were classified as test-positive for rabies-specific antibodies. With regard to adjusted overall antibody seroprevalence, Bayesian true prevalence estimates (41%, 95% CI: 37-46%) were lower than both of the Rogan-Gladen estimates. The effect of various epidemiological factors on post-vaccination response was also assessed.

Antibody response to an anti-rabies vaccine in a dog population under field conditions in Bolivia.

Rabies remains an important public health issue in Bolivia, South America. Public concern and fears are most focussed on dogs as the source of rabies. The objective of the present study was to assess immunity of an inactivated suckling mouse brain vaccine against canine rabies used for the official vaccination campaigns under field conditions in an endemic area of rabies in Bolivia. A total of 236 vaccinated and 44 unvaccinated dogs in Santa Cruz de la Sierra, selected using stratified random sampling, were investigated in order to obtain owned dog characteristics and antibody titres against rabies in April 2007. The proportion of vaccinated dogs with an antibody titre exceeded the protection threshold value of 0.5 EU/ml was 58% [95% confidence intervals (CI): 52-65], indicating that vaccination is likely to elicit an antibody response (odds ratio 6.3, 95% CI: 1.2-11.5). The range of geometric mean of antibody titre for vaccinated dogs (0.89 EU/ml; 95% CI: 0.75-1.04) was considered to meet the minimal acceptable level indicating an adequate immune response to the vaccine. However, the titre level was not satisfactory in comparison with the results from other field investigations with inactivated tissue culture vaccines. It is recommended for public health authorities to (1) consider modernizing their vaccine manufacturing method because the level of immunity induced by the current vaccine is comparably low, (2) conduct frequent vaccination campaigns to maintain high levels of vaccination coverage, and (3) actively manage the domestic dog population in the study area, which is largely responsible for rabies maintenance.

Antidiarrheal activity of dehydroleucodine isolated from Artemisia douglasiana.

Dehydroleucodine (DhL), a sesquiterpene lactone obtained from Artemisia douglasiana, was screened for antidiarrheal effects. DhL inhibited castor oil-induced diarrhea in mice by judged by a decrease in the number of wet faeces in the DhL-treatment groups. DhL significantly reduced intestinal transit in mice. Yohimbine and phentolamine counteracted the inhibitory effect of DhL. It is suggested that alpha2-adrenergic receptors mediate the effect of DhL in intestinal motility. DhL reduced also intraluminal accumulation of fluid. Thus, the antidiarrheal activity of DhL is possibly related, at least in part, to its inhibitory action against gastrointestinal motility and the inhibition of enteropooling property.

Anti-inflammatory activity and effect on gastric acid secretion of dehydroleucodine isolated from Artemisia douglasiana.

The effect of Dehydroleucodine (DhL) on gastric acid secretion in rats was investigated at a dose of 40 mg/kg, while its anti-inflammatory effect was investigated in two experimental models: arthritis induced by Freund's adjuvant carrageenan- and cotton pellet-induced granuloma. DhL did not inhibit gastric acid secretion, suggesting that its anti-ulcerogenic effect can be attributed to its action on the mucosa defense factors. On the other hand, DhL inhibited both chronic and acute adjuvant carrageenan-induced inflammation phases, being most effective in the chronic phase. In the granuloma test, DhL also inhibited inflammation. It is suggested that the anti-inflammatory activity of DhL may be attributed to interference with multiple targets on the level of transcription factors, such as NF-kappaB, and cytokines.

Lithium effect on testicular tissue and spermatozoa of viscacha (Lagostomus maximus maximus). A comparative study with rats.

We investigated the effect of lithium chloride administration (Sigma): 1 mmol/kg b.w. i.p./day for 35 days on the testes and sperm of viscacha (Lagostomus maximus maximus), a nocturnal rodent found only in the pampas of Argentina. The histological study showed that hypospermatogenesis and the sperm number per mL decreased markedly in comparison with the controls (treatment group: 315 x 10(6) +/- 77 x 10(6); control group: 693 x 10(6) +/- 39 x 10(6), Means +/- SEM, Student's t-test: p < 0.05). The sperm motility and viability were also affected. Under the same treatment, the testicular tissue and the sperm of rats were not damaged. Moreover, lithium induced these changes when the plasm levels were within the therapeutic range in humans. Our results provide evidence for the claim that viscacha testes and sperm react very sensitively to low doses of lithium, whereas these concentrations do not produce damage in rats.

Gastric anti-ulcer activity of several alpha,beta-unsaturated carbonyl compounds in rats.

The gastric cytoprotective activity of several molecules containing an alpha,beta-unsaturated carbonyl system is reported. We attributed this gastroprotective activity to the presence of a non-hindered Michael acceptor in the molecules assayed and suggested that the mechanism of protection would involve, at least in part, a nucleophilic attack of the sulphydryl group of the gastric mucosa to the beta carbon of the Michael acceptors of the compounds assayed.

Effect of dehydroleucodine in experimental colitis in rats and mice.

Dehydroleucodine (DhL), a sesquiterpene lactone (SQL) of the guaianolide type isolated from Artemisia douglasiana Besser, shows a pharmacological cytoprotective effect and significantly prevents the formation of gastric and duodenal lesions induced by various necrotising agents in rodents. The effects of DhL, on two models of experimental colitis were examined. Colitis was produced in male Wistar rats by rectal instillation of 5 and 10% acetic acid, following the methods of Eliakim et al. and Le Duc et al., respectively. In mice colitis was produced by rectal instillation of 0.1 ml of 2,4,6-trinitrobenzene sulphonic acid (5 mg in 50% ethanol) (TNB) as previously described by Chin et al. In this study, the administration of DhL 40 mg kg(-1)(1 h before the induction of colitis) significantly decreased mucosal damage. This effect was consistent in both models. The protection provided by DhL was accompanied by significant decreases in diarrhoea and colon weight; and histologically normal mucosa without ulceration and mucus production were observed. This study shows that both TNB and acetic acid colitis can be pharmacologically controlled by DhL. Our results suggest that the protective activity of DhL in experimental colitis is mediated, at least in part, through the increase of glycoprotein synthesis, anti-inflammatory effect and inhibition of COX-2 induction, and by inhibiting the degranulation of cells containing monoamines.

[Granulomatous mastitis. Report of 16 cases]. / Mastitis granulomatosa. Informe de 16 casos.

Sixteen cases of granulomatous mastitis were seen in the Breast Clinic of the Rio Blanco Regional Hospital in Veracruz, México. The mean age was 41.7 years (range 22-62), mean previous pregnancies was 5. Lactancy in last 6 months was registered in 50% of the cases, but no cases of puerperal mastitis were seen. Seventy five percent of the patients presented with a breast mass (mean 6 cm), suspicious of cancer in 62.5%. In 2 of 16 cases (12.5) there was an associated breast carcinoma, and in one case tuberculosis was the etiology. Surgical treatment consisted in wide local excision in 100% and mastectomy in 2 cases. Steroids were not used. Recurrent disease was seen in 2 cases at a mean follow-up of 20 months. Awareness of this rare entity is important for the surgeon and the pathologist because the definitive diagnosis is made microscopically, through evaluation of a wide breast tissue sample.

Gastric cytoprotective activity of dehydroleucodine in rats. Role of prostaglandins.

Previously, we reported that dehydroleucodine (DhL), a sesquiterpene lactone, protected the gastric mucosa of rats from absolute ethanol-induced lesions in a dose-dependent fashion. The mechanism is not mediated by an antiacid secretory action and DhL stimulated mucous production. In the present study, we report the effect of DhL on the mucosal production of prostaglandin E (PGE) and the mucosal release of PGE2 in rats stomach. DhL in acute treatment does not modify these values decreased by previous treatment with indomethacin or absolute ethanol. However, DhL in subchronic treatment significantly enhanced the mucosal production of PGE and the mucosal release of PGE2. Also, indomethacin pretreatment resulted in a significant reduction of the cytoprotective action of DhL. These results indicate the participation of endogenous prostaglandins in DhL protection against ethanol damage. Moreover, we suggest that the gastric protective activity of DhL against ethanol induced gastric mucosal damage is mediated, at least in part, through PGE and PGE2 in subchronic treatment.

Gastroduodenal mucosal protection induced by dehydroleucodine: mucus secretion and role of monoamines.

In previous work we have demonstrated that dehydroleucodine (DhL) prevents gastric damage induced by necrosis-inducing agents such as absolute ethanol (EtOH). In this study we examine the effects of DhL on gastroduodenal morphology and monoamine levels by histological and biochemical methods, respectively, as an approach to elucidating the cytoprotective mechanism of the drug. Histological evidence shows that DhL prevents formation of gastroduodenal mucosal lesions induced by EtOH and that this protective effect is related to the ability of the drug to stimulate mucus production. DhL itself does not affect the tissue concentration of NE, DA and 5-HT. However, it prevents the depletion of DA and 5-HT provoked by EtOH. We propose that the abundant mucoid blanket secreted after treatment with DhL acts as a diffusion barrier against EtOH. It is also possible that DhL could act as a "cell stabilizer," by inhibiting the degranulation of cells containing monoamines.

[Cervico-uterine cancer and age]. / Cáncer cervicouterino y edad.

A retrospective study of 182 cases of invasive squamous cell carcinoma of the uterine cervix and 133 cases cases of in situ carcinoma, based on histological classification studies and their relation with mean age, during 1985-1994, is reported in a second level Hospital in Rio Blanco, Veracruz, Mexico. The mean age of invasive cervix carcinoma is 50.2 years and the mean age is not the same in the different clinical stages, stage I 45.1 years; stage II 48.6 years; stage III 54.9 years and stage IV 57.4 years. This finding maybe has clinical importance. The mean age of in situ carcinoma is 43.9 years, late when compare with other series in the literature. Plan some considerations about mass screening cervical cancer program in Mexico.

Gastric cytoprotective activity of 2-cyclopenten-1-one and related compounds.

The cytoprotective activity of the isolated functional groups of several sesquiterpene lactones is reported. Among them the highest activity is shown by alpha-methylen-gamma-butyrolactone and 2-cyclopenten-1-one. The activity shown by those Michael acceptors with a beta carbon hindered by an alkyl substituent was always lower or almost null. A three-way mechanism of action is proposed: a) reduced glutathione synthesis, b) prostaglandin synthesis and c) mucosal glycoprotein synthesis.

[Biochemical-histological study of the effects of lithium on various organs of vizcacha (Lagostomus maximus maximus)]. / Estudio bioquímico-histológico de los efectos de litio en algunos órganos de vizcacha (Lagostomus maximus maximus).

Considering that the vizcacha (Lagostomus maximus maximus) is a very Lithium sensitive rodent, we planned a biochemical-histological study injecting IP doses of 1 mEq/kg/day LiCl during one month to adult vizcachas, and they were divided into three lots: Lot I the optical microscopy revealed evident renal, gonadal, hyphophyseal and adrenal damages; the biochemical analysis showed that Li significantly decreased the female serum LH levels while testosterone and estradiol levels were not affected. The male Li serum values resulted to be significantly higher than those of female animals. The damage was greater in male specimens. Lott II: the tissue recovery from the damage observed in Lot I was the following: total in hyphophysis, partial in testis, the same in kidney and was enhanced in adrenal and ovary. The Li renal clearance was determined in Lot III verifying no changes in both sexs. According to our results, Li (1 mEq/kg/day during one month) produce modifications in different tissues probably the gonadal damage may be consequence of a direct Li effect and not for a hyphophysis alteration, since in male vizcacha the LH serum level was not changed. In regard to the selective effect in the suprarenal glomerulus structure, this Li effect is produced via hyphophysis. In conclusion, the selective effect of Li on adrenal and gonada organs of this rodent is a contribution in order to warm about the possible reproduction of such effects in human beings.

Estudio bioquímico-histológico de los efectos de litio en algunos organos de vizcacha (Lagostomus maximus maximus) / Biochemical-histological study of the effects of lithium in some organs of vizcacha (Lagostomus maximus maximus)

Considerando que la vizcacha (lagostomus maximus maximus) es un roedor muy sensible al Litio (Li), planificamos un estudio bioquímico-histológico inyectando cloruro de Li 1 mEq/Kg/día vía intraperitoneal durante un mes a vizcachas adultas de ambos sexos agrupadas en tres lotes. En el lote I se comprobó por técnicas de microscopía óptica un evidente dano renal, gonodal, hipofisario y adrenal; por métodos bioquímicos se comprobó que el Li disminuyó significativamente los niveles séricos de LH en hembra, el contenido de testosterona y estradiol no fue modificado. En machos el Li sérico resultó significativamente mayor (p<0.01, Prueba de t) que en hembras. El dano fue mayor en machos. en el Lote II se estudió a 30 días de la última administración el grado de recuperación tisular del dano comprobado en el Lote I. Se verificó una recuperación total en hipófisis, parcial en testículo, nula en rinón y se incrementó el dano en adrenal y ovario. Con respecto al efecto seletivo sobre la zona glomerulosa adrenal del Li sería producido via hipófisis. En conclusión el efecto selectivo de Li en adrenal y gónadas en este roedor es una contribución para alertar sobre la posible producción de estos efectos en humanos

Estudio bioquímico-histológico de los efectos de litio en algunos organos de vizcacha (Lagostomus maximus maximus) / Biochemical-histological study of the effects of lithium in some organs of vizcacha (Lagostomus maximus maximus)

Considerando que la vizcacha (lagostomus maximus maximus) es un roedor muy sensible al Litio (Li), planificamos un estudio bioquímico-histológico inyectando cloruro de Li 1 mEq/Kg/día vía intraperitoneal durante un mes a vizcachas adultas de ambos sexos agrupadas en tres lotes. En el lote I se comprobó por técnicas de microscopía óptica un evidente dano renal, gonodal, hipofisario y adrenal; por métodos bioquímicos se comprobó que el Li disminuyó significativamente los niveles séricos de LH en hembra, el contenido de testosterona y estradiol no fue modificado. En machos el Li sérico resultó significativamente mayor (p<0.01, Prueba de t) que en hembras. El dano fue mayor en machos. en el Lote II se estudió a 30 días de la última administración el grado de recuperación tisular del dano comprobado en el Lote I. Se verificó una recuperación total en hipófisis, parcial en testículo, nula en rinón y se incrementó el dano en adrenal y ovario. Con respecto al efecto seletivo sobre la zona glomerulosa adrenal del Li sería producido via hipófisis. En conclusión el efecto selectivo de Li en adrenal y gónadas en este roedor es una contribución para alertar sobre la posible producción de estos efectos en humanos (AU)

Estudio bioquímico-histológico de los efectos de litio en algunos órganos de vizcacha (Lagostomus maximus maximus). / [Biochemical-histological study of the effects of lithium on various organs of vizcacha (Lagostomus maximus maximus)]

Considering that the vizcacha (Lagostomus maximus maximus) is a very Lithium sensitive rodent, we planned a biochemical-histological study injecting IP doses of 1 mEq/kg/day LiCl during one month to adult vizcachas, and they were divided into three lots: Lot I the optical microscopy revealed evident renal, gonadal, hyphophyseal and adrenal damages; the biochemical analysis showed that Li significantly decreased the female serum LH levels while testosterone and estradiol levels were not affected. The male Li serum values resulted to be significantly higher than those of female animals. The damage was greater in male specimens. Lott II: the tissue recovery from the damage observed in Lot I was the following: total in hyphophysis, partial in testis, the same in kidney and was enhanced in adrenal and ovary. The Li renal clearance was determined in Lot III verifying no changes in both sexs. According to our results, Li (1 mEq/kg/day during one month) produce modifications in different tissues probably the gonadal damage may be consequence of a direct Li effect and not for a hyphophysis alteration, since in male vizcacha the LH serum level was not changed. In regard to the selective effect in the suprarenal glomerulus structure, this Li effect is produced via hyphophysis. In conclusion, the selective effect of Li on adrenal and gonada organs of this rodent is a contribution in order to warm about the possible reproduction of such effects in human beings.

Mucus synthesis and sulfhydryl groups in cytoprotection mediated by dehydroleucodine, a sesquiterpene lactone.

The aerial parts of Artemisia douglasiana have been used in folk medicine as a cytoprotective agent against the development of peptic ulcer. Dehydroleucodine [1], its active principle, significantly prevents the formation of gastric lesions induced by the exposure of the rats to absolute ErOH. It was found in this study that (a) pretreatment of rats with 1 (40 mg/kg, po) caused a significant increase in glycoprotein synthetic activity, approximately sevenfold as large as that of the control; and (b) pretreatment of the rats with the thiol reagent N-methylmaleimide (NEM) significantly diminished the cytoprotection provided by 1. However, the protective effect of 1 was not totally abolished by pretreatment with a combination of indomethacin and NEM, indicating additional mechanisms are involved in the cytoprotective action of 1.

Seasonal variations in testicular LH, FSH, and PRL receptors; in vitro testosterone production; and serum testosterone concentration in adult male vizcacha (Lagostomus maximus maximus).

Seasonal changes in the reproductive activity of the adult male vizcacha (Lagostomus maximus maximus), a South American rodent, were investigated. Monthly, for 1 year, the animals were captured during the night near their burrows in the vicinity of San Luis, Argentina. The animals were killed, and samples of blood and the testes were collected. The testosterone serum levels were determined and the testicular tissue was used for biochemical and structural studies. Significant changes associated with seasonal cycles were found. In July-August (winter in South America), a short hibernal period of sexual quiescence, decline in testicular volume, and a significant decrease in serum testosterone were observed. The in vitro testosterone production and testicular LH, FSH, and PRL receptors revealed a significant decrease during this period. During September-November (spring season), recovery was observed, with a significant increase in gonadal activity during April-May (autumn season). During this season, the gonadal volume was increased, the serum testosterone and the in vitro stimulation of testosterone production by hCG (as well as the basal levels) also revealed a significant increase. Correspondingly, the concentration of testicular LH, FSH, and PRL receptors was elevated. These results indicate an increase in parameters related to testicular function. A gradual reduction in the testicular activity was observed in June-July (early winter). Our findings indicate that the male adult vizcacha, under natural conditions, exhibits characteristics of an annual reproductive cycle.