Vascular endothelial growth factor association with angiopoietin 1 promotes improvement in ventricular function after ischemic cardiomyopathy induced in mini pigs.

PURPOSE: To investigate the safety and clinical, hemodynamic and tissue improvement ability in mini pigs undergoing cell and gene therapy for the treatment of acute myocardial infarction. METHODS: Thirty-two mini pigs Br1 lineage, 12 months old, undergoing induction of acute myocardial infarction by occlusion of the diagonal branch of the paraconal coronary. They were divided into 4 groups: one control group and 3 treatment groups (cell therapy and gene cell therapy). Echocardiography reviews were performed on three occasions and histopathological analysis was performed after 4 weeks. Analysis of variance (ANOVA), Tukey and Wilcoxon tests, were performed. RESULTS: Association of vascular endothelial growth factor (VEGF) with angiopoietin1 (Ang1) presented satisfactory results in the improvement of ventricular function following ischemic cardiomyopathy in mini pigs when compared to the results of the other treated groups. CONCLUSION: The therapy with VEGF and the combination of VEGF with Ang1, promoted recovered function of the myocardium, characterized by reduced akinetic area and induction of neovascularization.

Vascular endothelial growth factor association with angiopoietin 1 promotes improvement in ventricular function after ischemic cardiomyopathy induced in mini pigs

Abstract Purpose: To investigate the safety and clinical, hemodynamic and tissue improvement ability in mini pigs undergoing cell and gene therapy for the treatment of acute myocardial infarction. Methods: Thirty-two mini pigs Br1 lineage, 12 months old, undergoing induction of acute myocardial infarction by occlusion of the diagonal branch of the paraconal coronary. They were divided into 4 groups: one control group and 3 treatment groups (cell therapy and gene cell therapy). Echocardiography reviews were performed on three occasions and histopathological analysis was performed after 4 weeks. Analysis of variance (ANOVA), Tukey and Wilcoxon tests, were performed. Results: Association of vascular endothelial growth factor (VEGF) with angiopoietin1 (Ang1) presented satisfactory results in the improvement of ventricular function following ischemic cardiomyopathy in mini pigs when compared to the results of the other treated groups. Conclusion: The therapy with VEGF and the combination of VEGF with Ang1, promoted recovered function of the myocardium, characterized by reduced akinetic area and induction of neovascularization.

Unsupported valvuloplasty for degenerative mitral regurgitation: long-term results.

BACKGROUND: The advantages of valve repair for treatment of degenerative mitral regurgitation are well established. The procedure is associated with low mortality and morbidity rates, and low indices of reoperation, thromboembolic events and endocarditis have been reported. In most series, annuloplasty rings are implanted, but some institutions give preference to unsupported valvuloplasty. OBJECTIVE: To assess the clinical outcome of patients submitted to unsupported valvuloplasty for degenerative mitral regurgitation. METHODS: Between January 1980 and January 2003, 116 patients were submitted to the procedure. A total of 62 (53.4%) were men, and mean age was 47.2 +/- 16.5 years. The procedures included: Wooler annuloplasty (65.5%), unilateral annuloplasty (15.5%), quadrangular resection of the posterior leaflet (35.3%), anterior chordal shortening (20.7%), posterior chordal shortening (6.9%), and calcium debridement (0.9%). Mean follow-up was 6.5 +/- 5.1 years, and the longest follow-up was 24 years. RESULTS: Mortality was 0.86% (1 pt) early and 6.03% (7 pt) late. Actuarial survival was 85.3% in 20 years. Most patients (55.2%) presented preoperative NYHA functional class III, whereas class I was more frequent in the postoperative period (66.4%). Thromboembolic complications were observed in 4 patients (3.4%), and no correlation was seen with atrial fibrillation. Freedom from thromboembolic events was 94.8%, and similar results were observed for bacterial endocarditis. Survival free from reoperation was 79%, and 53% at 5 and 10 years, respectively. CONCLUSION: Unsupported valvuloplasty is effective and safe for treatment of degenerative mitral regurgitation, representing an adequate therapeutic alternative for selected cases.

Valvoplastia sem suporte para insuficiência mitral degenerativa: resultados a longo prazo / Unsupported valvuloplasty for degenerative mitral regurgitation: long-term results

FUNDAMENTO: As vantagens do reparo valvar para tratamento de insuficiência mitral degenerativa estão bem estabelecidas. O procedimento está associado com baixas taxas de morbimortalidade, e foram relatados baixos índices de reoperação, eventos tromboembólicos e endocardite. Na maior parte das séries, são implantados anéis para anuloplastia, mas algumas instituições preferem valvoplastia sem suporte. OBJETIVO: Avaliar a evolução clínica de pacientes submetidos à valvoplastia sem suporte para tratamento de insuficiência mitral degenerativa. MÉTODOS: Entre janeiro de 1980 e janeiro de 2003, 116 pacientes foram submetidos ao procedimento. Sessenta e dois (53,4 por cento) eram do sexo masculino, e a media de idade era 47,2 ± 16,5 anos. Os procedimentos empregados foram: Anuloplastia tipo Wooler (65,5 por cento), anuloplastia unilateral (15,5 por cento), ressecção quadrangular da cúspide posterior (35,3 por cento), encurtamento de corda tendínea anterior (20,7 por cento), encurtamento de corda tendínea posterior (6,9 por cento) e desbridamento do cálcio (0,9 por cento). O período médio de acompanhamento foi de 6,5 ± 5,1, e o acompanhamento mais longo foi de 24 anos. RESULTADOS: A mortalidade precoce foi de 0,86 por cento (1 paciente), e a mortalidade tardia foi de 6,03 por cento (7 pacientes). A sobrevida atuarial foi de 85,3 por cento em vinte anos. A maioria dos pacientes (55,2 por cento) apresentava classe funcional III no período pré-operatório, enquanto no período pós-operatório a classe funcional I foi mais freqüente (66,4 por cento). Quatro pacientes (3,4 por cento) tiveram complicações tromboembólicas, e não foi observada correlação com fibrilação atrial. A sobrevida livre de eventos tromboembólicos foi de 94,8 por cento, e resultados semelhantes foram observados para endocardite bacteriana. A sobrevida livre de reoperação foi de 79 por cento e 53 por cento aos 5 e 10 anos, respectivamente. CONCLUSÃO: Valvoplastia sem suporte é um procedimento...

BACKGROUND: The advantages of valve repair for treatment of degenerative mitral regurgitation are well established. The procedure is associated with low mortality and morbidity rates, and low indices of reoperation, thromboembolic events and endocarditis have been reported. In most series, annuloplasty rings are implanted, but some institutions give preference to unsupported valvuloplasty. OBJECTIVE: To assess the clinical outcome of patients submitted to unsupported valvuloplasty for degenerative mitral regurgitation. METHODS: Between January 1980 and January 2003, 116 patients were submitted to the procedure. A total of 62 (53.4 percent) were men, and mean age was 47.2 ± 16.5 years. The procedures included: Wooler annuloplasty (65.5 percent), unilateral annuloplasty (15.5 percent), quadrangular resection of the posterior leaflet (35.3 percent), anterior chordal shortening (20.7 percent), posterior chordal shortening (6.9 percent), and calcium debridement (0.9 percent). Mean follow-up was 6.5 ± 5.1 years, and the longest follow-up was 24 years. RESULTS: Mortality was 0.86 percent (1 pt) early and 6.03 percent (7 pt) late. Actuarial survival was 85.3 percent in 20 years. Most patients (55.2 percent) presented preoperative NYHA functional class III, whereas class I was more frequent in the postoperative period (66.4 percent). Thromboembolic complications were observed in 4 patients (3.4 percent), and no correlation was seen with atrial fibrillation. Freedom from thromboembolic events was 94.8 percent, and similar results were observed for bacterial endocarditis. Survival free from reoperation was 79 percent, and 53 percent at 5 and 10 years, respectively. CONCLUSION: Unsupported valvuloplasty is effective and safe for treatment of degenerative mitral regurgitation, representing an adequate therapeutic alternative for selected cases.

Primary splenic angiosarcoma: case report and literature review

É relatado um caso de angiossarcoma primário de baço em um homem de 29 anos, fazendo-se a revisäo dos achados clínicos, diagnóstico anatomopatológico, tratamento e prognóstico. Angiossarcomas correspondem a menos de 1 porcento dos sarcomas de tecidos moles, e somente uma pequena fraçäo surge no baço. Esses tumores freqüentemente apresentam-se como um desafio diagnóstico para o patologista, tendo em vista as variaçöes na histologia, e o desenvolvimento de novos marcadores em painéis de imuno histoquímica, como o CD31, ajudam a descartar outros diagnósticos. Devido à raridade desse tumor näo existe um consenso em relaçäo ao tratamento quimioterápico e, via de regra, o prognóstico é ruim.

Contribuiçao técnica à histerectomia abdominal / Technical contribution to abdominal hysterectomy

A histerectomia abdominal apresenta como complicaçao mais frequente a infecçao da ferida operatória. Os autores descrevem uma técnica que pode diminuir a incidência de complicaçoes infecciosas pós-operatórias em histerectomias abdominais. A técnica envolve o emprego de um aspirador cirúrgico na vagina, de forma a impedir a contaminaçao da pelve a partir de secreçoes da vagina