Protective effect of carboxymethyl-glucan (CM-G) against DNA damage in patients with advanced prostate cancer

Carboxymethyl-glucan (CM-G) is a soluble derivative from Saccharomyces cerevisiae (1 → 3)(1 → 6)-β-D-glucan. The protective efficiency of CM-G against DNA damage in cells from patients with advanced prostate cancer (PCa), and undergoing Androgen Deprivation Therapy (ADT), was evaluated. DNA damage scores were obtained by the comet assay, both before and after treatment with CM-G. The reduction in DNA damage, ranging from 18 percent to 87 percent, with an average of 59 percent, was not related to the increased number of leukocytes in peripheral blood. The results demonstrate for the first time the protective effect of CM-G against DNA damage in patients with advanced PCa. Among smokers, three presented the highest reduction in DNA damage after treatment with CM-G. There was no observable relationship between DNA damage scores before and after treatment, and age, alcoholism and radiotherapy.

Tratamento cirúrgico das estenoses da via biliar / Surgical management of the biliary tract stricture

OBJETIVO: As estenoses benignas da via biliar (EBVB) decorrem de lesões iatrogênicas em 95 por cento casos. Embora pouco freqüentes seu prognóstico é sombrio, e a prevenção é o melhor tratamento. O objetivo deste trabalho é estudar a conduta cirúrgica nas EBVB e seus resultados. MÉTODO: Foram analisados retrospectivamente, 11 pacientes submetidos à correção de EBVB no Hospital Universitário Regional do Norte do Paraná (HURNP) no período de Julho/1992 a Dezembro/2001. RESULTADOS: Nove pacientes eram do sexo feminino e dois do masculino,com média de idade de 43,71 (± 17,05) anos. A cirurgia que originou a lesão foi colecistectomia aberta em 81,8 por cento dos pacientes e por laparoscopia em 18,2 por cento. Os sinais e sintomas mais freqüentes foram icterícia (64,3 por cento), dor (64,3 por cento), e febre (21,4 por cento). O diagnóstico foi confirmado por colangiopancreatografia retrógrada endoscópica (CPRE) em 90,9 por cento dos casos e por colangiografia transparieto- hepática (CTPH) em 9,1 por cento. Segundo os critérios de Bismuth lesões do tipo I ocorreram em 18,2 por cento dos casos, tipo II em 45,4 por cento, tipo III em 18,2 por cento e tipo IV em 18,2 por cento. O tratamento cirúrgico para as EBVB foi anastomose colédoco-duodenal, anastomose hepático-jejunal em Y de Roux , anastomose hepático-jejunal à Hepp- Couinaud e anastomose hepático-jejunal com enxertia de mucosa (Smith), para as lesões tipo I,II,III e IV, respectivamente. Seis (54,55 por cento) pacientes apresentaram complicações pós-operatórias , e dois (18,2 por cento) evoluíram para óbito CONCLUSÕES: As correções cirúrgicas das EBVB apresentam altos índices de complicações e devem ser realizadas em centros especializados. Em geral estas estenoses decorrem de lesões iatrogênicas durante colecistectomias.

BACKGROUND: Benign stricture of biliary tract (BSBT) are iatrogenic in about 95 percent of the cases. Although rare, its outcome is poor; therefore prevention is the best option. The objective of this study is to evaluate the surgical management and its results in BSBT. METHODS: We retrospectively analyzed 11 patients submitted to corrective surgery for BSBT at Hospital Universitario Regional do Norte do Paraná, from July / 92 to December / 01. RESULTS: There were nine female patients and the mean age was 43.71 years old. Previous surgeries were classic cholecistectomies (81.8 percent) and videocholescistectomies (18.2 percent).The most frequent signs and symptoms were jaundice (64.3 percent), abdominal pain (64.3 percent) and fever (21.4). The diagnosis was confirmed by CPRE in 90.9 percent of the patients and CTP in 9.1 percent. According to Bismuth‘s classification, 18.2 percent of the patients were considered grade I, 45.4 percent grade II, 18.2 percent grade III and 18.2 percent grade IV. The corrective surgery for BSBT was choledochoduodenostomy in two cases of grade I, hepaticojejunostomy using a Roux-en-Y loop of jejunum in five cases of grade II, Hepp-Couinaud's operations in two cases of grade III, hepaticojejunostomy with mucosal graft (Smith's technique) in two cases of grade IV. The postoperative complications were fistula (18.2 percent), death (18.2 percent), pneumonia (9.1 percent) and hemobilia (9.1 percent). CONCLUSION: Complexity of the surgical treatment requires prevention of injuries. Bile duct lesions repair should be considered as a specialist's procedure and should be performed in a center with special interest in this disease.