Expression profile of endothelin receptors (ETA and ETB) and microRNAs-155 and -199 in the corpus cavernosum of rats submitted to chronic alcoholism and diabetes mellitus.

Recent evidence shows that chronic ethanol consumption increases endothelin (ET)-1 induced sustained contraction of trabecular smooth muscle cells of the corpora cavernosa in corpus cavernosum of rats by a mechanism that involves increased expression of ETA and ETB receptors. Our goal was to evaluate the effects of alcohol and diabetes and their relationship to miRNA-155, miRNA-199 and endothelin receptors in the corpus cavernosum and blood of rats submitted to the experimental model of diabetes mellitus and chronic alcoholism. Forty-eight male Wistar rats were divided into four groups: control (C), alcoholic (A), diabetic (D), and alcoholic-diabetic (AD). Samples of the corpus cavernosum were prepared to study the protein expression of endothelin receptors by immunohistochemistry and expression of miRNAs-155 and -199 in serum and the cavernous tissue. Immunostaining for endothelin receptors was markedly higher in the A, D, and AD groups than in the C group. Moreover, a significant hypoexpression of the miRNA-199 in the corpus cavernosum tissue from the AD group was observed, compared to the C group. When analyzing the microRNA profile in blood, a significant hypoexpression of miRNA-155 in the AD group was observed compared to the C group. The miRNA-199 analysis demonstrated significant hypoexpression in D and AD groups compared to the C group. Our findings in corpus cavernosum showed downregulated miRNA-155 and miRNA-199 levels associated with upregulated protein expression and unaltered mRNA expression of ET receptors suggesting decreased ET receptor turnover, which can contribute to erectile dysfunction in diabetic rats exposed to high alcohol levels.

Serum levels of interleukin-2 and tumor necrosis factor-alpha correlate to tumor progression in gastric cancer.

BACKGROUND/AIMS: The aim of this study was to assess serum levels of Interleukin-2 and tumor necrosis factor-alpha with disease progression and correlate these levels with CEA and CA19-9 serum levels. METHODOLOGY: Serum levels of interleukin-2 and tumor necrosis factor-alpha were measured in 23 patients with gastric cancer (being 9 stage I or II and 14 stage III or IV) and 10 patients without cancer by ELISA using Predicta Genzyme Diagnostica. The patients were followed for at least 2 years or until death. CEA and CA19-9 were also measured in both groups by ELISA (Abbott Diagnostic). RESULTS: Patients with gastric cancer stage III or IV had elevated levels of these cytokines (P = 0.002 for IL-2 and P = 0.003 for tumor necrosis factor-alpha). There was no difference between the serum levels of tumor necrosis factor-alpha and interleukin-2 in patients with gastric cancer stage I or II and the control group (P > 0.05). We also found no difference among the groups for CEA and CA19-9 (P = 0.17 and 0.72, respectively). Only one gastric cancer patient stage I or II had elevated level of IL-2 and none had elevated levels of tumor necrosis factor-alpha. In the group of patients with gastric cancer stage III or IV, 87.5% of them with elevated levels of tumor necrosis factor-alpha and 75% of them with elevated levels of interleukin-2 died during the follow-up. CONCLUSIONS: We conclude that serum interleukin-2 and tumor necrosis factor-alpha are associated with advanced gastric cancer and that these cytokines might be a useful tumor marker for gastric cancer, being associated with poor prognosis.

Resultados tardios da operaçäo de Heller associada à fundoplicatura no tratamento do megaesôfago: análise de 83 casos / Late results of Heller operation and fundoaplication for the treatment of the megaesophagus: analysis of 83 cases

Objetivo. Estudo retrospectivo dos resultados tardios dos pacientes submetidos a miotomia e fundoplicatura para o tratamento do megaesôfago. Casuística e Métodos. Foram estudados 83 pacientes com seguimento de um a 186 meses (média de 40,0 + 47,4 meses). A fundoplicatura em três planos, proposta por Pinotti, foi realizada em 15,7 por cento dos doentes e a fundoplicatura parcial posterior em 83,1 por cento. A queixa pré-operatória principal foi disfagia, seguida de regurgitação e perda ponderal. A etiologia chagásica pode ser comprovada em 72,3 por cento dos doentes, através de teste sorológico. Resultados. No seguimento, 55,4 por cento dos doentes estavam assintomáticos, 34,9 por cento queixavam-se de disfagia esporádica, 14,4 por cento de pirose, 8,4 por cento de regurgitação e 2,4 por cento de disfagia igual pré-operatória, sendo esses últimos pré-operados, com melhora da sintomatologia. Refluxo gastro-esofágico foi constatado em 8,4 por cento dos doentes. Outras complicações tardias foram: hérnia paraesofágica, deslizamento da fundoplicatura, esôfago de Barrett e neoplasia do esôfago. Conlcusões. Os autores salientaram a necessidade de acompanhamento clínico e endoscópico perene dos doentes, mesmo operados, devido à possibilidade de complicações tardias, em especial o câncer. Concluem por bons resultados tardios em relação à disfagia. Propõem, como alternativa à esofagectomia, a operação de Heller em pacientes portadores de megaesôfago para grau IV com más condições clínicas, que não suportariam uma cirurgia de maior porte.

[Late results of Heller operation and fundoplication for the treatment of the megaesophagus: analysis of 83 cases]. / Resultados tardios da operação de Heller associada à fundoplicatura no tratamento do megaesôfago: análise de 83 casos.

BACKGROUND: Retrospective study of the late results of the Heller's cardiomyotomy and fundoplication for the treatment of the megaesophagus. MATERIAL AND METHODS: Were studied 83 patients with a follow-up from one to 186 months (average 40.0 +/- 47.4 months). The fundoplications used were in three plans in 15.7% and posterior in 83.1%. The main pre-operatory complain was dysphagia followed by regurgitation and loss of weight. Chagas, Disease as the etiology was confirmed in 72.3% of the patients. RESULTS: In the follow-up 55.4% of the patients were assymptomatic, 34.9% complained of sporadic dysphagia, 14.4% of heartburn, 8.4% of regurgitation and 2.4% did not changed the dysphagia, these being re-operated and had improvement the symptoms. Gastro-esophageal reflux was noted in 8.4% of the patients. Other late complications were par-esophageal hernia, sliping of the fundoplication, Barrett esophagus and cancer. CONCLUSIONS: The necessity of a long-term clinical and endoscopical follow-up, even after surgery, owing to the possibility of late complications, especially cancer was emphasized. The late results are good in relation to the dysphagia. Myotomy is proposed as an alternative to patients with advanced megaesophagus with bad clinical conditions who can not be submitted to an esophagectomy.

Tumoral DNA analysis by flow cytometry in patients submitted to esophagectomy for squamous cell carcinoma of the esophagus

Squamous cell carcinoma of the esophagus has a poor prognosis. There are several factors influencing the prognosis. The study of DNA ploidy by flow cytometry used in many malignant tumors is very valuable in determining, as a tumor marker, this prognosis. In this study 13 cases of resected squamous cell carcinoma of the esophagus were analyzed. Despite the small sample, the authors observed that the worst prognosis was in advanced stage cases (III and IV), an aneuploid DNA pattern. The only case with a 5-year survival had a diploid DNA pattern.

Gastric metastasis of melanoma

We present a case of gastric metastasis, leading to chronic bleeding in a patient already submitted to surgery for a malignant melanoma of the lip. In view of the good clinical conditions, a subtotal gastrectomy as palliative treatment was performed. We discuss the diagnostic and therapeutic aspects of this rare clinical situation

Leiomyosarcoma of the stomach

The smooth muscle neoplasms from the gastrointestinal tract, such as leiomyomas, leiomyosarcoma and leiomyoblastomas, are rare tumors and represent not more than 1 to 3 per cent of all gastric neoplasms (1,2). The authors report a case of gastric leiomyosarcoma (GL) and discuss the difficulties in the diagnosis, surgical treatment and the factors which are important for prognosis

[Carcinosarcoma of the esophagus: diagnostic importance of partial endoscopic polypectomy]. / Carcinossarcoma de esôfago: importância diagnóstica da polipectomia endoscópica parcial.

The clinical and pathological manifestations of a case of carcinosarcoma of the esophagus are reported. Barium swallow and endoscopy revealed a polypoid mass in mid esophagus. The tumor was large, pedunculated, covered by smooth mucosa with some erosions. Histologically the tumor was composed of a mixture of invasion keratinizing cells and intermingled bundle of spindle shaped cells resembling fibrosarcoma. The tumor was removed with surgery and did not show submucosa infiltration. It was not detected any metastasis or local recurrence during the 12 months follow-up period. The diagnosis was made by an endoscopic partial polypectomy. We conclude that partial polypectomy may be of value in preoperative diagnosis of esophageal polypoid mass.

Behaviour of the volume of lymphatic follicles and of the spleen weight in Wistar rats submitted to resection of the distal 80 por cento of the small bowel

The effect of resection of the distal 80 por cento of the small bowel (EIR) of wistar rats on spleen weight, lymphatic follicle volume (LFV) serum albumin and total proteins was studied as compared to sham-operated, pair-fed and control animals. The spleen weight of rats submitted to EIR was lower than that of the other groups. Serum albumin and total proteins presented lower values in the resected animals as compared to those of the other groups. LFV reduction was more pronounced in animals submitted to EIR than in the pair-fed rats

Primary gastric lymphoma: report of one case

Primary gastric lymphoma represents about 2 per cent of all neoplasms located in the stomach. In spite of the low frequency, it is an important diagnosis, since its prognosis differs significantly from gastric carcinomas. The authors present 1 case and underscores the difficulty of establishing a pre-operative diagnosis through clinical, laboratorial and radiological findings and mainly because upper digestive endoscopy hardly differentiates it from carcinoma.