Presence of ascites in bullfrog breeders reared and kept on a frog farm / Presença de ascite em reprodutores de rã-touro criados e mantidos em ranário

Ascites is a pathology characterized by the extravasation of fluid from blood vessels and its accumulation in the abdominal cavity, caused by several associated factors. In this paper, we report the occurrence of this syndrome in breeding male and female Bullfrogs fed a commercial fish feed with 40% crude protein. Liver malformation was already observed due to lack of protein deposition in adult animals from the same spawning. The culture of ascitic fluid showed absence of bacterial growth. Kidney histopathology showed, in both sexes, a large number of tubular structures with strongly eosinophilic hyaline material suggesting colloid growth in both the cortical region and spinal cord. The analysis also revealed granulomas in various stages of development, many showing central necrotic material. The kidneys, glomerular, were mostly hypoplastic, with enlarged Bowman space, and many were hyalinized or hemorrhagic; the parenchyma showed dystrophic calcification, and many tubules containing fibrinoid material. The liver displayed a large amount of melanomacrophages in the parenchyma and foci of mono-lymphocytic hepatitis and marked cytoplasmic rarefaction, as well as several hepatocytes with pyknotic nuclei and necrotic cells and dissociation of the hepatic trabeculae. Ascites may be caused by the lesions observed in these organs.(AU)

A ascite é uma condição patológica que se caracteriza pelo extravasamento do líquido dos vasos sanguíneos e por seu acúmulo na cavidade abdominal provocado por uma somatória de fatores. É considerada uma síndrome de caráter multifatorial e, uma vez desencadeado o processo ascítico, esse se torna, na maioria dos casos, irreversível. O objetivo deste trabalho foi relatar a ocorrência dessa síndrome em machos e fêmeas reprodutores de rã-touro (Lithobates catesbeianus), alimentados com ração comercial para peixes, com 40% de proteína bruta, durante três anos e já sendo observada má formação de fígado, por falta de deposição proteica, em animais adultos da mesma desova. A cultura do líquido ascítico demonstrou ausência de crescimento bacteriano. Na histopatologia, observou-se, para ambos os sexos, nos rins, grande número de estruturas tubulares com material fortemente eosinofílico e hialino, sugerindo coloide, tanto na região cortical como na medular. Visualizaram-se também granulomas em vários estágios de desenvolvimento, muitos apresentando material necrótico central. Ainda se pôde observar que os aparelhos renais, os glomérulos, em sua maioria, estavam hipoplásicos e com aumento do espaço de Bowman, e muitos hialinizados ou hemorrágicos; além de calcificação distrófica no parênquima e nos dos túbulos, havia material fibrinoide no seu interior. No fígado, pôde-se ver grande quantidade de melanomacrófagos no parênquima e focos de hepatite monolinfocitária e acentuada rarefação citoplasmática, assim como vários hepatócitos com núcleo em picnose e células em necrose e dissociação das trabéculas hepáticas. A causa da ascite pode ser devido às lesões observadas nesses órgãos.(AU)

Influence of arginase polymorphisms and arginase levels/activity on the response to erectile dysfunction therapy with sildenafil.

Arginase 1 (ARG1) and arginase 2 (ARG2) compete with nitric oxide synthases for the substrate l-arginine. Here we aim to assess whether arginase 1 and 2 plasma levels, plasma arginase activity or genetic factors are associated with altered responsiveness to sildenafil. We studied 71 post-prostatectomy erectile dysfunction (ED) patients (PED group) and 72 clinical ED patients (CED). Patients responded to the International Index of Erectile Function questionnaire before and after the treatment. We found positive and negative correlations between plasma levels of arginase 1 and sildenafil responsiveness in the PED and CED groups, respectively. PED group also presented negative correlation between plasma arginase activity and sildenafil responsiveness. Sildenafil poor responders have shown higher plasma arginase activity in PED and higher arginase 1 levels on CED groups. In addition, variant genotypes for the rs2781659, rs2781667 and rs17599586 polymorphisms were associated with reduced arginase activity, as well as the GTTT ARG1 haplotype in CED group.

Apoptosis in follicles of individuals with female pattern hair loss is associated with perifollicular microinflammation.

OBJECTIVE: The objective of this study is to evaluate apoptosis in hair follicles of patients with female pattern hair loss (FPHL) and its association with follicular microinflammation. METHOD: Cross-sectional study involving 17 women with FPHL and five controls. Scalp skin samples were processed for HE and TUNEL assays. The variables were compared according to the categories of follicles (terminal versus miniaturized) and groups of patients (FPHL vs. controls). RESULTS: There was a higher apoptosis index among miniaturized follicles and among the test cases (P < 0.01). Microinflammation was prominent among miniaturized follicles, especially from FPHL (P = 0.02). In addition, a positive correlation between inflammatory infiltrate and apoptosis in miniaturized follicles (rS = 0.68; P < 0.01) was found. CONCLUSIONS: Apoptosis was prominent in hair follicles from the FPHL group, as well as in miniaturized ones. Moreover, it was also correlated with the inflammatory infiltrate, which suggests that inflammation can lead to apoptosis and play a role in the pathogenesis of follicle miniaturization.

Fluorescence spectroscopy in renal ischemia and reperfusion: noninvasive evaluation of organ viability.

BACKGROUND: Damage provoked by ischemia in renal transplants is difficult to quantify. To determine whether a donated organ is fit for transplantation. We sought to correlate the findings of fluorescence spectroscopy (FS) with histologic evidence of ischemic injury and organ viability. METHODS: Kidneys of 33 rats were submitted to FS of the upper and lower poles as well as the middle third. Excitation was generated by the laser's wavelengths of 408, 442, and 532 nm. Rats were randomized into groups with the 30, 60, and 120 minutes warm ischemia before analysis by FS, that was repeated at 5 minutes after reperfusion. RESULTS: FS results in the reperfusion phase correlated with ischemia time and degree of histologic injury. After 60 or 120 minutes of ischemia, the excitation lasers of 532 and 442 nm resented a significant negative correlation coefficient with the histological grade (r = -0.61 and r = -0.73, respectively). CONCLUSIONS: There was a strong correlation between FS and histologic changes only in the reperfusion phase after renal ischemia. The method was thus unable to assess the viability of organs before transplantation.

Evaluation by fluorescence spectroscopy of the most appropriate renal region for obtaining biopsies: a study in the rat.

INTRODUCTION: Renal puncture biopsies are directed at the lower poles of the organ to decrease the risk of hemorrhage and complications. OBJECTIVES: To evaluate by fluorescence spectroscopy (FS) the most appropriate renal region (in terms of metabolic changes) to obtain a biopsy. MATERIALS AND METHODS: The kidneys of 33 Rattus norvegicus rats were submitted to FS detection in the upper and lower poles and in the middle third. Excitations were generated with lasers at wavelengths of 408, 442, and 532 nm. Animals were divided at random into groups of warm ischemia (30, 60, and 120 minutes), whose kidneys were again analyzed by FS, as well as after 5 minutes of reperfusion using the same excitation beams in the same renal regions. Then the kidneys underwent histologic preparation and examination. RESULTS: The middle third area of the rat's kidneys proved to be significantly more sensitive to ischemic and reperfusion changes than the renal poles, as determined by FS (P < .001). CONCLUSIONS: The middle third of the kidney was the most appropriate site for a renal biopsy to monitor a transplanted organ.

Gene expression study related with the intrinsic pathway of apoptosis in bladder cancer by real-time PCR technique.

We examined the expression of anti-apoptotic genes (XIAP and Bcl-2) and apoptotic genes (cytochrome c, caspase-9, Apaf-1) in tissue samples of patients with superficial bladder cancer. Thirty-two bladder cancer tissue samples (8 papillary urothelial neoplasm of low malignant potential, 10 low-grade, and 14 high-grade) and 8 normal bladder tissue samples from necropsy were used for the study of gene expression by real-time PCR analysis. Analysis of the expression of apoptotic gene constituents of an apoptosome demonstrated an increase in Apaf-1 expression in the three tumor grades when compared with the control (P < 0.01, P < 0.05, and P < 0.01), low expression of caspase-9 in all groups (P < 0.05), and an increase in cytochrome c expression in all tumor grades in relation to the control, although without statistically significant difference. The expression of anti-apoptotic genes revealed an increase in XIAP expression in all tumor grades in relation to the control, although without statistically significant difference, and low expression of Bcl-2 in all tumor grades and the control (P < 0.05). The results proved that there is low evidence of apoptotic activity by the intrinsic pathway, demonstrated by the low expression of caspase-9 and considerable increase in XIAP expression, which may render these genes potential therapeutic targets in bladder cancer treatment.

VEGF genetic polymorphisms affect the responsiveness to sildenafil in clinical and postoperative erectile dysfunction.

Vascular endothelial growth factor (VEGF) is a cytokine involved in angiogenesis and is closely related to the nitric oxide-cyclic guanosine monophosphate pathway, a target for sildenafil. We investigated for the first time whether three clinically relevant polymorphisms in the VEGF gene are associated with altered responsiveness to sildenafil treatment in postoperative erectile dysfunction (PED) and clinical erectile dysfunction (CED). We determined VEGF genotypes for three polymorphisms in VEGF promoter: -2578C>A (rs699947), -1154G>A (rs1570360) and -634G>C (rs2010963) in 126 patients with erectile dysfunction (ED; 66 patients with PED and 60 patients with CED). The patients were classified as good or poor responders to sildenafil (GR and PR groups, respectively) according to their responses with basis on the changes in five-item version of the International Index for Erectile Function (5-IIEF). We found an association of the -1154AA genotype with PR in both PED and CED patients (P<0.05), whereas the -2578AA and the -2578CA genotypes were associated with PR only in the CED group (P<0.05). The AAG haplotype was more common in PR than in GR patients (38% versus 20%, respectively; P=0.032) in the CED group, thus increasing the risk for a worse response to sildenafil (odds ratio, OR=2.33, 95% confidence interval, CI=1.07-5.09). However, this finding does not resist to Bonferroni's correction (P>0.0125). Our results indicate that VEGF polymorphisms affect the responsiveness of PED and CED patients to sildenafil. These findings may help to improve the therapy of patients with ED.

Endothelial nitric oxide synthase genotypes and haplotypes modify the responses to sildenafil in patients with erectile dysfunction.

Erectile dysfunction (ED) is usually treated with sildenafil. Although genetic polymorphisms in the endothelial nitric oxide synthase (eNOS) gene may impair endogenous NO formation, there is little information about how eNOS polymorphisms and haplotypes affect the responses to sildenafil. We studied 118 patients; 63 patients had ED secondary to radical prostatectomy (PED) and 55 had organic, clinical ED. eNOS genotypes for three eNOS polymorphisms (T(-786)C, rs2070744; a variable number of tandem repeats (VNTR) in intron 4; and Glu298Asp, rs1799983) were determined, and eNOS haplotypes were estimated using PHASE 2.1. The clinical responses to sildenafil were evaluated and the patients were classified as good responders (GR) or poor responders (PR) when their changes in five-item version of International Index for Erectile Function questionnaire were above or below the median value. The TC/CC genotypes and the C allele for the T(-786)C polymorphism were more common in GR, compared with PR patients with PED. However, the 4b4a/4a4a genotypes and the 4a allele for the VNTR polymorphism in intron 4 were more common in GR, compared with PR patients with clinical ED. The C-4a-Glu haplotype was more common in GR than in PR patients with PED. Conversely, the T-4b-Asp haplotype was less common in GR than in PR patients with PED. No other significant differences were found. Our findings show evidence that eNOS polymorphisms affect the responses of PED and clinical ED patients to sildenafil.

Immunohistochemistry analysis of proteins related with apoptosis as prognostic factor in epidermoid carcinomaof penis / Análisis inmunohistoquímico de proteínas relacionadas con la apoptosis como factor pronóstico en el carcinoma epidermoide de pene

The aim was to analyze the protein expression of apoptotic genes caspase-3, caspase-8 and bcl-2 with the immunohistochemistry technique, correlating with tumor grade (I, II and III) and with the patient survival in order to understand the basic mechanism of tumoral transformation. The immunohistochemistry reactions on 50 samples of squamous cell carcinoma were carried out with the avidin-biotin immunoperoxidase method and antigen recovery. The analyses were made using the graduation method "in crosses" (0 to 4 crosses - no stain to more than 75 percent of positives cells) and in categories (low, intermediate, high) of the cytoplasm immunoreactivity of the epidermoid penile carcinoma cells. It was observed a statistically significant difference when the expression of caspase-3 were compared with the grades I and II of the tumor (p=0.0010) and when comparing the patient survival with the grades I and II of the tumor (p=0.0212). The protein bcl-2 was more expressed than caspase-3 and caspase-8 proteins, suggesting that the apoptotic rate in this carcinoma is low. The higher expression of the anti-apoptotic protein bcl-2 suggests a higher preservation of the tumoral cells...

El objetivo fue analizar la expresión de las proteínas de genes de apoptosis caspasa-3, caspasa-8 y Bcl-2-con la técnica de inmunohistoquímica, en correlación con el grado tumoral (I, II y III) y la supervivencia del paciente con el fin de comprender el mecanismo básico de la transformación tumoral. Se analizaron las reacciones inmunohistoquímicas sobre 50 muestras de carcinoma de células escamosas mediante el método de la inmunoperoxidasa avidina-biotina y la recuperación de antígeno. Los análisis se realizaron utilizando el método de graduación "en cruces" (0 a 4 cruces - no tinción a más del 75 por ciento de las células positivas) y en categorías (baja, media, alta) de la inmunorreactividad citoplasmática de las células de carcinoma epidermoide de pene. Se observó una diferencia estadísticamente significativa cuando la expresión de la caspasa-3 se comparó con los grados I y II del tumor (p = 0,0010) y cuando se comparan la supervivencia de los pacientes con los grados I y II del tumor (p = 0,0212). La proteína bcl-2 se expresa más que la caspasa-3 y caspasa-8, lo que sugiere que la tasa de apoptosis en este carcinoma es baja. La mayor expresión de la proteína anti-apoptótica bcl-2 sugiere una mayor preservación de las células tumorales...

Circulating matrix metalloproteinases and their endogenous inhibitors in patients with erectile dysfunction.

Erectile dysfunction (ED) may reflect vascular alterations associated with imbalanced matrix metalloproteinases (MMPs) activities. However, no previous study has compared MMPs levels in ED patients with those found in healthy subjects. We measured the circulating MMP-2, MMP-9, TIMP-1 and TIMP-2 levels in ED patients, with or without diabetes mellitus (DM), and in healthy controls. We studied 28 healthy men (control group), 35 men with ED (ED group), and 33 men with ED and DM (ED/DM group). MMP-2, MMP-9, TIMP-1 and TIMP-2 plasma levels were measured by enzyme-linked immunosorbent assay and zymography. We found no differences in MMP-9 levels (P>0.05) among groups. However, while patients in the ED group had similar TIMP-1 levels compared with those found in the control group, we found higher TIMP-1 levels and lower MMP-9/TIMP-1 ratios in the ED/DM group compared with controls (P<0.05). While both groups of patients (ED and ED/DM) had slightly lower MMP-2 levels compared with controls (P<0.05), we found no differences in TIMP-2 levels among the study groups (P>0.05), and no differences in MMP-2/TIMP-2 ratios (P>0.05). We found evidence indicating lack of significant alterations in circulating net MMP-9 and MMP-2 activities in patients with ED, and lower net MMP-9 activity in diabetic patients with ED.

Why not to use kidney grafts from elderly donors.

BACKGROUND: Kidney transplantation is widely recognized as the best treatment in patients who require renal replacement therapy. Although considered a clinical and surgical triumph, it is also a source of frustration because of lack of donor organs and the growth of waiting lists. Strategies need to be developed to increase the supply of organs. One measure is use of expanded criteria for donation. OBJECTIVE: To evaluate the effect of donor age on cadaver graft survival. MATERIALS AND METHODS: We reviewed the medical records for 454 patients who underwent kidney transplantation with cadaver donors from April 1987 to December 2003. RESULTS: Donor age had a significant effect on kidney transplant survival. Survival of grafts from donors aged 16 to 40 years (mean, 143.30 months) was significantly greater compared with that of grafts from donors older than 40 years (66.46 months) (P = .005). The HLA matching and cold ischemia time did not significantly affect transplant survival (P = .98 and P = .16, respectively). CONCLUSIONS: Kidneys from cadaver donors older than 40 years significantly compromised graft survival, generating a negative effect via early return of recipients to waiting lists and increasing the rate of repeat transplantation, risk of death, and unnecessary costs.

Therapeutic option for infected urinary tract fistulas in renal transplantation.

BACKGROUND: Approximately 20% of urinary tract fistulas after renal allografting are complicated by urinary tract infection, which presents a therapeutic challenge. OBJECTIVE: To evaluate an option for treatment of urinary tract fistulas associated with urinary tract infection and unsuitable for minimally invasive or primary surgical urinary tract repair. PATIENTS AND METHODS: The study included 650 recipients who underwent transplantation over 17 years. Urinary leakage was initially treated with indwelling bladder catheterization. Patients with fistulas refractory to treatment underwent surgical intervention to repair the urinary tract. In patients who were not candidates for primary repair of the urinary tract, temporary urinary diversion was performed, rather than classic percutaneous or open nephrostomy, using a ureteral stent (ie, a 6F or 8F Foley catheter with the balloon placed inside the renal pelvis). RESULTS: Overall, urinary leakage occurred in 36 patients (5.5%). Conservative management was successful in 14 vesical fistulas (42.4%) and no ureteral fistulas (0%). Three patients died of sepsis during conservative treatment, before the new surgical approach. Five of 36 urinary leaks (13.9%) were managed using ureteral intubation with an 8F Foley catheter, with a success rate of 80%. CONCLUSION: Ureteral catheterization with an 8F Foley catheter is a feasible therapeutic option to treat complicated urinary tract fistulas unsuitable for primary surgical repair of the urinary tract.

Comparison of two models for evaluation histopathology of experimental renal ischemia.

Renal ischemia/reperfusion (I/R) injury is one of the frequent causes of acute renal failure (ARF) due to the complex, interrelated sequence of events, that result in damage to and death of kidney cells. Cells of the proximal tubular epithelium are especially susceptible to I/R injury, leading to acute tubular necrosis, which plays a pivotal role in the pathogenesis of ARF. Several models have been explicated to assess morphological changes, including those of Jabonski et al. and Goujon et al. We compared the 2 models for histopathological evaluation of 30- or 120-minute periods of renal ischemia followed by 24-hour reperfusion in rats. Several changes were observed after application of the 2 models: proximal tubular cell necrosis, loss of brush border, vacuolization, denudation of tubular basement membrane as a consequence of flattening of basal cells, and presence of intratubular exfoliated cells in the lumen of proximal convoluted tubules at various stages of degeneration (karyorexis, kariopyknosis and karyolysis). Evaluating tubular lesions after 2 periods of experimental ischemia with light microscopy allowed us to conclude that the Goujon classification better characterized the main changes in cortical renal tubules after ischemia.

Renal ischemia in rats: mitochondria function and laser autofluorescence.

Ischemia-reperfusion injury is the major cause of organ dysfunction or even nonfunction following transplantation. It can attenuate the long-term survival of transplanted organs. To evaluate the severity of renal ischemia injury determined by histology, we applied laser- (442 nm and 532 nm) induced fluorescence (LIF), mitochondria respiration, and membrane swelling to evaluate 28 Wistar rats that underwent left kidney warm ischemia for 20, 40, 60, or 80 minutes. LIF performed before ischemia (control) was repeated at 20, 40, 60, and 80 minutes thereafter. We harvested left kidney tissue samples immediately after LIF determination for histology and mitochondrial analyses: state 3 and 4 respiration, respiration control rate (RCR), and membrane swelling. The association of optic spectroscopy with histological damage showed: LIF, 442 nm (r2 = 0.39, P < .001) and 532 nm, (r2 = 0.18, P = .003); reflecting laser/fluorescence-induced, 442 nm (r2 = 0.20, P = .002) and 532 nm (r2 = 0.004, P = .67). The associations between mitochondria function and tissue damage were: state 3 respiration (r2 = 0.43, P = .0004), state 4 respiration (r2 = 0.03, P = 0.38), RCR (r2 = 0.28, P = .007), and membrane swelling (r2 = 0.02, P = .43). The intensity of fluorescence emitted by tissue excited by laser, especially at a wave length of 442 nm, was determined in real time. Mitochondrial state 3 respiration and respiratory control ratio also exhibited good correlations with the grade of ischemic tissue damage.

Communication between organ donor families and recipients: a definitely controversial subject.

In transplant centers, few topics are more controversial than communication between organ donor families (ODF) and recipients (RE). The Organ Procurement Organizations and transplant centers have felt obliged to protect the confidentiality and interests of ODF and RE. However, some authors have reported favorable effects of contact between ODF and RE. This study sought to investigate the current situation of the communication between ODF and RE from the viewpoint of transplanted patients (n = 50) and waiting transplant patients (n = 50) at a Brazilian University Hospital, ODF (n = 10), physicians from transplant centers (n = 50), as well as the opinion of the general population of a Brazilian city (n = 100). This work was developed as a survey whose questions related to the issue of communication between ODF and RE. The results showed that the majority of transplanted patients (82%) and patients awaiting transplant (60%) wanted to meet ODF to express their gratitude for receiving the organ. Likewise, ODF (67%) wanted to have a meeting with recipients, which allowed them to confirm the benefit of their donation. The general population was also favorable (66%) to ODF and RE communication. In contrast, the physicians (74%) were opposed to the ODF and RE contact. They affirmed that direct contact could lead to serious emotional conflicts or attempts of material involvement. One believes that decisions concerning the contact between ODF and RE would have to be determined by the involved parties. The transplant team could analyze the requests case by case, but ODF and RE must have the right to make the final decision.

Avaliaçäo urodinâmica de pacientes chagásicos / Urodynamic assessement in patients with Chagas disease

No presente trabalho estudou-se a fisiologia urinária de pacientes com Doença de Chagas nas suas diversas formas. Grupo A (controle) com 21 indivíduos normais; Gupo B: 16 pacientes com sorologia positiva; Grupo C: com 16 pacientes com cardiopatia chagásica e Grupo D: 21 pacientes com esofagopatia e/ou megacolon chagásicos. Os resultados mostraram que näo houve diferenças significantes (p > 0,05) entre os 4 grupos estudados para os parâmetros: capacidade cistométrica, pressäo de micçäo e fluxo urinário. Entretanto, houve diferenças significantes (p < 0,05) para os parâmetros: pressäo abdominal, pressäo do detrusor, pressäo uretral e tempo de micçäo na análise comparativa entre o grupo D e o controle A. Esses achados sugerem que a Doença de Chagas, em sua forma digestiva, também pode comprometer o trato urinário baixo, alterando sua fisiologia.

Proteçäo funcional do rim com lovastatina após isquemia e reperfusäo renal / Renal functional protection with lovastatin after kidney ischemia-reperfusion

Introduçäo - a isquemia renal é causa de graves lesöes nesse órgäo, estando presente em diferentes situaçöes como em cirurgias renais, vasculares e no transplante renal. Assim, a procura de substâncias protetoras da funçäo renal tem amplo interesse clínico. Neste estudo o objetivo foi o de analisar o efeito da lovastatina na isquemia renal normotérmica seguida da reperfusäo.

Avaliaçäo dos gânglios regionais do carcinoma epidermóide do pênis (CEP) através de um índice de risco / Evaluation of the regional lymphatic nodes in epidermoid carcinoma of the penis (CEP) by of the risk index

O objetivo desse estudo foi investigar a validade de um índice de risco (IR) no prognóstico de metástases ganglionares no carcinoma epidermóide do pênis (CEP). Foram analisados 53 pacientes com CEP atendidos no Hospital das Clínicas da FMRP-USP, de janeiro de 1978 a dezembro de 1995. A idade variou de 32 a 97 anos. Os tumores foram graduados de acordo com a classificaçäo de Broders e estadiados retrospectivamente (TNM 1999). O IR foi determinado pela soma de TeG (IR = T+G). A linfadenectomia inguinal bilateral (LD) foi indicada naqueles que apresentaram gânglios suspeitos após a antibioticoterapia ou que vieram apresentar alteraçöes durante o período de observaçäo. Faleceram 17 pacientes; A LD foi realizada em 14 pacientes e os 39 restantes permaneceram em observaçäo clínica, sendo que em 8 deles foi feito LD após tempo mediano de 9 meses. Dos pacientes com índice de risco 2 e 3 92 por cento e 80 por cento respectivamente näo apresentavam metastase ganglionar, ao passo que a totalidade daqueles com IR=6 tinha gânglios comprometidos. A associaçäo dos grupos 2 e 3, comparada ao conjunto 4, 5 e 6, mostrou percentual maior de comprometimento nestes últimos (p = 0,0046). Dos 36 pacientes inicialmente No, 27 apresentavam IR 2 ou 3, dos quais 5 evoluíram para N+ (19 por cento); os 9 restantes eram IR >/= 4 e 3 também evoluíram para N+ (33 por cento). Apesar da diferença, näo houve significância estatística entre eles (p = 0,3837). Embora tenha ocorrido maior comprometimento naqueles com IR >/= 4, o índice de risco näo foi capaz de identificar previamente pacientes que evoluíram para N+.

Clorpromazina e funçäo mitocondrial na isquemia-reperfusäo renal / Chlorpromazine and mitochondrial function in kidney ischemia-reperfusion

Introduçäo e objetivo - em transplante renal com doador cadáver, a funçäo do enxerto depende da manutençäo da integridade celular e subcelular, principalmente mitocondrial. Neste estudo o objetivo foi analisar a funçäo mitocondrial do rins submetidos a período prolongado de isquemia fria, seguido de reperfusäo por uma hora, empregando-se, ou näo, a clorpromazina previamente à isquemia. Métodos - utilizando autotransplante renal em cäes, subdivididos em dois grupos, foram extraidas mitocôndrias de rins submetidos à isquemia fria de 48 horas, seguida de 1 hora de reperfusäo pós-transplante. Um grupo recebeu clorpromazina antes da nefrectomia. A análise da fosforilaçäo oxidativa e do intumescimento osmótico ("swelling") mitocôndrial foi comparada com dados obtidos de rins normais, sem isquemia. Resultados - Os dados obtidos para o estado III e IV da respiraçäo näo mostraram diferença significativa entre os grupos experimentais. A primeira fase do "swelling" ocorreu em tempo semelhante em todos os grupos experimentais. Durante a reversäo, os grupos I e II se comportaram de maneira estatisticamente semelhante, com fraçöes de reversäo de 57 por cento, e 68 por cento, respectivamente, valores significativamente menores que os obtidos para o grupo normal (99 por cento) (grupo I: p = 0,0374 e grupo II: p = 0,0221). Discussäo - é conhecida a açäo protetora da clorpromazina na isquemia renal normotérmica. Entretanto, os dados aqui obtidos mostram que após 48 horas de isquemia fria, o grupo II (clorpromazina) comportou-se de maneira semelhante ao grupo I (hipotermia isolada) tanto no estudo da fosforilaçäo oxidativa, quanto no "swelling", embora os valores apresentem tendência a serem maiores no grupo II. Isto pode ser devido a alguns fatores, como: 1) a clorpromazina possui efeito protetor mínimo quando o tempo de isquemia é prolongado; 2) seu efeito pode ser afetado ou sua açäo protetora sobreposta àquela imposta pela hipotermia; 3) tempo de reperfusäo curto para manifestaçäo de seus efeitos.

Antígeno nuclear de proliferaçäo celular (PCNA) em carcinoma de células transicionais de bexiga / Proliferative cell nuclear antigen (PCNA) in the urinary transitional cell carcinoma

O antígeno nuclear de proliferaçäo celular (PCNA) foi descrito como marcador da atividade proliferativa. Correlacionamos a marcaçäo do PCNA com a evoluçäo dos pacientes com carcinoma de células transicionais de bexiga. Revisamos 90 pacientes do HC-FMRP-USP de 1980-2000; com idade variando de 29 a 93 anos e média de 71 anos; sendo 77,8 por cento homens e 22,2 por cento mulheres; seguimento médio de 55 meses (2-231 meses). Constatamos 50 por cento de tumores grau I, (32,2 por cento) grau II e 17,8 por cento grau III; estadiados em pTA-60 por cento, pT1-8,9 por cento e >pT1 31,1 por cento. Utilizamos o anticorpo primário Monoclonal Mouse Anti-Proliferating Cell Nuclear Antigen (PCNA) Clone PC10 (DAKO). Foram contadas 500 células (X400), e utilizado ponto de corte de 50 por cento. A análise estatística foi realizada com o teste de Mann-Whitney. Kaplan-Meier e Logrank Oitenta e sete tumores (96,66 por cento) expressaram PCNA (mediana 72.5 por cento, média 60,16 por cento). Observamos diferença näo significativa (P=0,39) na imunomarcaçäo do PCNA entre tumores pT2-4 e pTA-1. A comparaçäo de medias entre G1 e G2 (P=0,087), G1 e G3 (P=0,11) e entre G2 e G3 (P=0,66) näo mostraram significado estatístico,assim como entre tumores com recidiva e sem recidiva (P=0,84). Os indivíduos PCNA positivos näo tiveram intervalo livre de doença significativamente diferente (P=0,86); entretanto foi significativa a diferença nas curvas de sobrevida (P=0,003) e nas curvas de intervalos livres de metástase (P=0,01). A expressäo imunohistoquímica do PCNA näo foi efetiva para diferenciar os tumores mais avançados e agressivos, assim como para predizer recidivas. Desta forma, apesar da correlaçäo com o tempo livre de metástase e a sobrevida, näo mostrou utilidade prática.