Vocal Characteristics of Patients With Morbid Obesity.

INTRODUCTION: Obesity modifies vocal characteristics, causing abnormal fat deposition in the abdominal region and upper airways. For some authors the voice of the obese is not different from nonobese and the vocal symptoms are scarce; for others dysphonia in obese is reported by 70% of them and the voice becomes hoarse, breathy, and unstable. OBJECTIVE: To characterize the voice of patients with morbid obesity. METHODS: Two groups were included: Obese (n-27), aged between 26 and 59 years, selected for bariatric surgery; Control (n-27), matched in age, with ideal weight for height. PARAMETERS: Vocal self-assessment (Vocal Disadvantage Index-IDV and Quality of Life and Voice-QVV); Perceptual-auditory vocal evaluation (GRBASI scale), maximum phonation time; Acoustic vocal analysis and Videolaryngoscopic exams. RESULTS: In obese, the most frequent symptoms were gastroesophageal and hoarseness. The vocal self-evaluation did not record any relevant complaints in both groups. In obese, the perceptual-auditory voice evaluations indicated significant changes in R (roughness), B (breathiness), I (instability), and S (tension) parameters. Acoustic vocal analysis recorded changes in the noise-harmonic ratio (NHR) and soft phonation index (SPI) parameters. The videolaryngoscopy examinations showed, in control and obese groups, respectively: normal: 92.5% and 55.5%; posterior pachydermia: 11.1% and 33.3%; mid-posterior bowing: 0% and 7.4%; edema/congestion: 0% and 7.40%. CONCLUSION: The voice of the obese becomes discreetly hoarse, breathless, and unstable. The most frequent videolaryngoscopic findings in obese patients are hyperemia and edema of vocal folds and posterior pachydermia, related to acid laryngitis, secondary to gastroesophageal reflux.

Alterations of the gastric stump and not resected stomach mucosa after truncal vagotomy in rats.

PURPOSE: To evaluate morphological changes of the gastric stump and not resected stomach mucosa after the completion of truncal vagotomy. METHODS: Eighty male Wistar rats were divided into four groups: CT, TV, RY and RYTV. In CT group, abdominal viscera were manipulated and the abdominal cavity was closed, in TV vagal trunks were isolated and sectioned, in RY a partial Roux-en-Y gastrectomy was performed and in RYTV the vagal trunks were sectioned and a partial Roux-en-Y gastrectomy was performed. At the 54th week after surgery, the rats were euthanized. The findings were submitted to histological analyses. RESULTS: None macroscopic or histological alterations in groups TV and CT was observed. Specimens from RY and RYTV groups did not show alterations in the gastric stump mucosa. At the jejunal side of the gastroenterostomy we found shallow ulcerative lesions always single, well-defined and with variable diameter 3 to 6 mm, six times in the RY group and none in the RYTV group (RY>RYTV, p=0.008). Neoplastic or preneoplastic lesions were not diagnosed in all groups. CONCLUSION: Truncal vagotomy is a safe and non-carcinogenic method in not resected and partially resected stomach.

Late administration of a specific COX-2 inhibitor does not treat and/or prevent progression of gastric tumors in rats submitted to duodenogastric reflux procedure.

PURPOSE: To assess whether late introduction of a specific COX-2 inhibitor (Meloxicam) can treat and/or prevent the progression of tumors in the stomach of rats submitted to duodenogastric reflux. METHODS: Seventy five male Wistar rats, weighing 150 grams, were submitted to the induction of duodenogastric reflux through the pylorus. At 36 weeks of follow-up were established three experimental groups: DGR36 sacrificed immediately, DGR54 and DGR54MLX both sacrificed at 54th week of follow-up . The animals of the latter group were fed with a rat chow premixed with Meloxicam (2.0 mg/ kg feed; 0.3 mg / kg bw / day) and the other two with standard rat chow. The lesions found in the pyloric mucosa and gastrojejunal anastomosis were analyzed macroscopically and histologically. For statistical analysis was adjusted a generalized linear model assuming a binomial distribution with LOGIT link function. RESULTS: No significant differences were found when comparing the incidences of benign tumor lesions (Adenomatous Hyperplasia), p=0.4915, or malignant (Mucinous Adenocarcinoma), p=0.2731, among groups. CONCLUSION: Late introduction of specific COX-2 inhibitor (Meloxicam) did not treat and was not able to prevent the progression of tumoral lesions induced by duodenogastric reflux in the rat stomachs.

Outcome of superficial squamous cell carcinoma of the esophagus: a clinicopathological study.

PURPOSE: To analyze the clinicopathological features and outcome of patients with pathologically proven superficial squamous cell carcinoma of the esophagus. METHODS: A total of 234 consecutive cases of esophageal carcinoma in a 15-year period were reviewed. RESULTS: Superficial esophageal cancer was found in five patients (2.1%). They were four men and one woman and the mean age was 52.5 years. Smoking and alcohol were the main risk factors. Achalasia due to Chagas disease occurred in one patient and a second primary tumor developed in the larynx in another patient. Four patients underwent esophagectomy and one patient received chemoradiotherapy. The histopathologic diagnosis was of squamous cell carcinoma in all cases. Intramucosal tumor (Tis) was identified in three cases and superficially invasive carcinoma in two cases. Four patients are free of disease with survival times of two, four, six and nine years. The patient who developed laryngeal cancer died six years after esophagectomy. CONCLUSION: Long-term survival in patients with esophageal cancer is related to early diagnosis. Therefore, a less aggressive surgical approach, such as endoscopic resection, may be a good option for these patients, if depth of tumor invasion can be accurately predicted by the new imaging tools.

Diclofenac sodium and Imipenem action on rat intestinal mucosa: a biomechanical and histological study.

PURPOSE: To study diclofenac sodium induced histological and mechanical alterations and their prevention with Imipenem in rat intestine. METHODS: Male Wistar rats (n=240) were randomly assigned to four experimental groups: GI: n=60 treated with 0.9% saline IM; GII: n=60 treated with 6 mg/kg body weight diclofenac sodium IM for four days; GIII: n=60 treated with 30 mg/kg body weight Imipenem IM for four days, and GIV n=60 treated with diclofenac sodium plus Imipenem at the above doses IM for 4 days. Each group was further divided into 4 subgroups of 15 rats each and sacrificed at 4, 7, 14, and 21 days of follow-up, respectively. Abdominal cavity macroscopy and histology, and small bowel breaking strength were analyzed at each sacrifice moment. RESULTS: There were no histological or mechanical alterations in normal control rats throughout the study. Ulcerated lesions in intestinal mucosa were observed and breaking strength decreased in all diclofenac sodium treated rats. Ulcerated lesions in intestinal mucosa were prevented by Imipenem in all rats. CONCLUSION: Diclofenac sodium induced ulcerated lesions in rat intestinal mucosa can be prevented by Imipenem treatment.

Aplicación y contribución de la cromoendoscopia con lugol, índigo carmín y azul de metileno en el tracto digestivo superior de los perros / Use and contribution of chromoendoscopy with lugol, indigo carmine and methylene blue in the upper digestive tract of dogs / Aplicação e contribuição da cromoendoscopia com lugol, índigo carmim e azul de metileno no trato digestório superior de cães

La cromoendoscopia se define como la aplicación tópica de colorante acuoso en la mucosa del tracto gastrointestinal. Estos colorantes tienen la función de mostrar cambios tempranos o discretos que pasan sin ser notados para el examen convencional, lo que permite la colecta de tejidos alterados o seguimiento de las enfermedades pre existentes. En medicina veterinaria, no fueron encontrados estudios que han utilizado esta técnica, pero hay muchas situaciones en las que puede ser empleado como la investigación o monitoreo: esofagitis (tales como esófago de Barrett en los seres humanos), lesiones erosivas gástricas o polipoidis y lesiones duodenales . Este trabajo se realizó en diez animales adultos, endoscopia (EGD) seguido por cromoendoscopia (CRE) y la recolección de biopsia del esófago, estómago (fondo, el cuerpo y antro pilórico) y el duodeno cuando esté disponible. Las biopsias fueron enviadas para histopatología e identificación de la presencia o ausencia de daños en el material recogido. El objetivo de este estudio fue demostrar la técnica de la cromoendoscopia en perros, evaluar su eficacia en la identificación y la delimitación de las lesiones en el tracto digestivo superior de estos animales y correlacionar los hallazgos endoscópicos antes y después de la aplicación de la técnica a los resultados histopatológicos. La correlación entre la EGD y la CRE porhistopatología (patrón oro) se evaluó mediante la prueba de Kappa. Los resultados mostraronun acuerdo significativo en la CRE esófago con una precisión de 83,33%. Acuerdo Moderadoen la endoscopia convencional EGD del esófago con una precisión de 83,33% y CRE delfondus, el cuerpo y el antro pilórico con una precisión de 70%. Acuerdo razonable en CREestómago con una precisión de 70%. Concordancia moderada en EGD de antro y EGD y CREde duodeno con una precisión de 50%, 40% y 40% respectivamente. No hubo correlaciónentre los ensayos en el EGD de fondo, el cuerpo y el estómago con una precisión de [...](AU)

Chromoendoscopy is defined as the topical application of aqueous dye in the gastrointestinal tract mucosa. These dyes have the function of showing early or discrete changes which may go unnoticed in conventional examination. Therefore, this procedure enables altered tissue collection or monitoring of pre-existing diseases. In Veterinary Medicine, there were no studies that have used this technique, but there are many conditions in which it can be employed as research or monitoring of esophagitis (such as humans Barrett"s esophagus), erosive or polypoid gastric lesions and duodenal injuries. In the present study, ten adult dogs underwent endoscopy (EGD), followed by chromoendoscopy (CRE) and biopsy of esophagus, stomach (fundus, body and pyloric antrum) and duodenum, when available. Biopsies were sent for histopathology for identification of presence or absence of lesions in the collected samples. The aim of this study was to describe the technique of chromoendoscopy in dogs, evaluate its effectiveness on the identification and delineation of lesions in the upper digestive tract of dogs and correlate endoscopic findings before and after application of the technique with histopathologic results. The correlation between EGD and CRE by histopathology (gold standard) was evaluated using the Kappa test. The results showed significant agreement in CRE of esophagus with accuracy of 83. Moderateagreement in conventional endoscopy (CE) of esophagus and CRE of fundus, body andpyloric antrum were demonstrated with an accuracy of 83.33%, 70%, 70% and 70%respectively. Fair agreement was found in CRE of stomach, with an accuracy of 70%. Therewas poor agreement in EGD of pyloric antrum and EGD and CRE of duodenum, with anaccuracy of 50%, 40% and 40% respectively. There was no correlation between the tests [...](AU)

A Cromoendoscopia é definida como a aplicação tópica de corantes aquosos na mucosa do trato gastrointestinal. Estes corantes têm a função de evidenciar alterações precoces ou discretas que passariam despercebidas ao exame convencional, permitindo, assim, a coleta de tecido alterado ou o acompanhamento de doenças pré-existentes. Na Medicina Veterinária, não foram encontrados trabalhos que tenham utilizado esta técnica, mas há muitas situações em que ela pode ser empregada, como na pesquisa ou no acompanhamento de: esofagites (como esôfago de Barrett em humanos), lesões gástricas erosivas ou polipoides e lesões duodenais. Neste trabalho, dez cães adultos foram submetidos à endoscopia digestiva alta (EDA) seguida de cromoendoscopia (CRE) e biopsia de esôfago, estômago (fundo, corpo e antro pilórico) e duodeno quando acessível. As biopsias foram enviadas para exame histopatológico com o objetivo de identificar a presença ou ausência de lesão no material coletado. O objetivo deste trabalho foi demonstrar a aplicação da técnica de cromoendoscopia em cães, avaliar sua eficácia quanto à identificação e delimitação de lesões no trato digestório superior destes animais e correlacionar os achados endoscópicos pré e pós-aplicação da técnica com os resultados histopatológicos. A correlação da endoscopia convencional (E.C). e da CRE com o exame histopatológico (padrão ouro) foi avaliada pelo teste de Kappa e osresultados demonstraram concordância importante na CRE de esôfago com acurácia de83,33%. Concordância moderada foi observada na E.C. de esôfago e na CRE de fundo, corpoe antro piloro com acurácia de 83,33%, 70%, 70% e 70%, respectivamente. Concordânciarazoável foi demonstrada na CRE de estômago com acurácia de 70%. Concordância ruim foiencontrada na E.C. de antro pilórico e na E.C. e CRE de duodeno com acurácia de 50%, 40%e 40% [...](AU)

Aplicación y contribución de la cromoendoscopia con lugol, índigo carmín y azul de metileno en el tracto digestivo superior de los perros / Use and contribution of chromoendoscopy with lugol, indigo carmine and methylene blue in the upper digestive tract of dogs / Aplicação e contribuição da cromoendoscopia com lugol, índigo carmim e azul de metileno no trato digestório superior de cães

La cromoendoscopia se define como la aplicación tópica de colorante acuoso en la mucosa del tracto gastrointestinal. Estos colorantes tienen la función de mostrar cambios tempranos o discretos que pasan sin ser notados para el examen convencional, lo que permite la colecta de tejidos alterados o seguimiento de las enfermedades pre existentes. En medicina veterinaria, no fueron encontrados estudios que han utilizado esta técnica, pero hay muchas situaciones en las que puede ser empleado como la investigación o monitoreo: esofagitis (tales como esófago de Barrett en los seres humanos), lesiones erosivas gástricas o polipoidis y lesiones duodenales . Este trabajo se realizó en diez animales adultos, endoscopia (EGD) seguido por cromoendoscopia (CRE) y la recolección de biopsia del esófago, estómago (fondo, el cuerpo y antro pilórico) y el duodeno cuando esté disponible. Las biopsias fueron enviadas para histopatología e identificación de la presencia o ausencia de daños en el material recogido. El objetivo de este estudio fue demostrar la técnica de la cromoendoscopia en perros, evaluar su eficacia en la identificación y la delimitación de las lesiones en el tracto digestivo superior de estos animales y correlacionar los hallazgos endoscópicos antes y después de la aplicación de la técnica a los resultados histopatológicos. La correlación entre la EGD y la CRE porhistopatología (patrón oro) se evaluó mediante la prueba de Kappa. Los resultados mostraronun acuerdo significativo en la CRE esófago con una precisión de 83,33%. Acuerdo Moderadoen la endoscopia convencional EGD del esófago con una precisión de 83,33% y CRE delfondus, el cuerpo y el antro pilórico con una precisión de 70%. Acuerdo razonable en CREestómago con una precisión de 70%. Concordancia moderada en EGD de antro y EGD y CREde duodeno con una precisión de 50%, 40% y 40% respectivamente. No hubo correlaciónentre los ensayos en el EGD de fondo, el cuerpo y el estómago con una precisión de [...]

Chromoendoscopy is defined as the topical application of aqueous dye in the gastrointestinal tract mucosa. These dyes have the function of showing early or discrete changes which may go unnoticed in conventional examination. Therefore, this procedure enables altered tissue collection or monitoring of pre-existing diseases. In Veterinary Medicine, there were no studies that have used this technique, but there are many conditions in which it can be employed as research or monitoring of esophagitis (such as humans Barrett"s esophagus), erosive or polypoid gastric lesions and duodenal injuries. In the present study, ten adult dogs underwent endoscopy (EGD), followed by chromoendoscopy (CRE) and biopsy of esophagus, stomach (fundus, body and pyloric antrum) and duodenum, when available. Biopsies were sent for histopathology for identification of presence or absence of lesions in the collected samples. The aim of this study was to describe the technique of chromoendoscopy in dogs, evaluate its effectiveness on the identification and delineation of lesions in the upper digestive tract of dogs and correlate endoscopic findings before and after application of the technique with histopathologic results. The correlation between EGD and CRE by histopathology (gold standard) was evaluated using the Kappa test. The results showed significant agreement in CRE of esophagus with accuracy of 83. Moderateagreement in conventional endoscopy (CE) of esophagus and CRE of fundus, body andpyloric antrum were demonstrated with an accuracy of 83.33%, 70%, 70% and 70%respectively. Fair agreement was found in CRE of stomach, with an accuracy of 70%. Therewas poor agreement in EGD of pyloric antrum and EGD and CRE of duodenum, with anaccuracy of 50%, 40% and 40% respectively. There was no correlation between the tests [...]

A Cromoendoscopia é definida como a aplicação tópica de corantes aquosos na mucosa do trato gastrointestinal. Estes corantes têm a função de evidenciar alterações precoces ou discretas que passariam despercebidas ao exame convencional, permitindo, assim, a coleta de tecido alterado ou o acompanhamento de doenças pré-existentes. Na Medicina Veterinária, não foram encontrados trabalhos que tenham utilizado esta técnica, mas há muitas situações em que ela pode ser empregada, como na pesquisa ou no acompanhamento de: esofagites (como esôfago de Barrett em humanos), lesões gástricas erosivas ou polipoides e lesões duodenais. Neste trabalho, dez cães adultos foram submetidos à endoscopia digestiva alta (EDA) seguida de cromoendoscopia (CRE) e biopsia de esôfago, estômago (fundo, corpo e antro pilórico) e duodeno quando acessível. As biopsias foram enviadas para exame histopatológico com o objetivo de identificar a presença ou ausência de lesão no material coletado. O objetivo deste trabalho foi demonstrar a aplicação da técnica de cromoendoscopia em cães, avaliar sua eficácia quanto à identificação e delimitação de lesões no trato digestório superior destes animais e correlacionar os achados endoscópicos pré e pós-aplicação da técnica com os resultados histopatológicos. A correlação da endoscopia convencional (E.C). e da CRE com o exame histopatológico (padrão ouro) foi avaliada pelo teste de Kappa e osresultados demonstraram concordância importante na CRE de esôfago com acurácia de83,33%. Concordância moderada foi observada na E.C. de esôfago e na CRE de fundo, corpoe antro piloro com acurácia de 83,33%, 70%, 70% e 70%, respectivamente. Concordânciarazoável foi demonstrada na CRE de estômago com acurácia de 70%. Concordância ruim foiencontrada na E.C. de antro pilórico e na E.C. e CRE de duodeno com acurácia de 50%, 40%e 40% [...]

Comparative study between two techniques of incisional hernia repair with polypropylene mesh in rabbits.

PURPOSE: To compare two different incisional hernia repair techniques (repair with a polypropylene mesh reinforcement on the peritonium-aponeurosis versus polypropylene mesh sutured to the borders of the hernial ring as a bridge) in rabbits. METHODS: Incisional hernia was experimentally developed through a 4-cm median incision in 60 rabbits. After 30 days, half of the animals were operated for primary wall closure and placement of a polypropylene mesh reinforcement, while the other half had a polypropylene mesh sutured to the borders of the hernial ring as a bridge. Clinical development, scar breaking strength, as well as gross, microscopic and morphometric parameters were evaluated in all animals 30, 60, and 90 days after repair. RESULTS: No significant differences in breaking strength or histological parameters were observed between groups at any time point studied. No statistical difference regarding complications was detected, although denser and firmer adhesions to the abdominal wall were seen after the mesh was placed as a " bridge" . CONCLUSIONS: No significant differences between the incisional hernia repair techniques assessed were observed regarding breaking strength, and histological and morphometric parameters. The number of complications was similar in both study groups. However, adhesion of abdominal cavity organs to the scar area was much denser after the placement of a mesh to bridge the defect.

Carcinogenesis of the upper gastrointestinal tract induced by N-methyl-N'-nitro-nitrosoguanidine and reflux of duodenal contents in the rat.

PURPOSE: To investigate the combined effects of reflux of duodenal contents through the pylorus and treatment with N-methyl-N'-nitro-nitrosoguanidine (MNNG) on the development of lesions in the glandular stomach, at the gastrojejunal anastomosis and in the forestomach of rats. METHODS: Eighty Male Wistar rats were divided into 4 groups: G1: MNNG + Reflux, G2: Reflux, G3: MNNG and G4: Gastrostomy. MNNG was given in the drinking water (100 mg/ml) for 12 weeks and then two groups (G1 and G2) were submitted to a gastrojejunal anastomosis followed by section of the afferent loop and suture of both stumps to allow reflux of duodenal contents through the pylorus. The animals were sacrificed 18 and 36 weeks after surgery. The lesions obtained in the antral mucosa, at the gastrojejunal anastomosis and in the forestomach were analysed histologically. RESULTS: Duodenal reflux induced proliferative lesions at both glandular and squamous mucosa of the stomach. In the antrum, adenomatous hyperplasia (AH) was observed in 20% and 50% of the animals at the 18th and 36th weeks respectively. Aditionally 85% of the animals presented AH at the gastrojejunal anastomosis and 60% developed squamous hyperplasia at the squamous portion of the stomach. MNNG treatment plus duodenal reflux enhanced the development of malignant tumors at both glandular and squamous mucosa, since there were 30% of antral adenocarcinomas and 45% of squamous carcinomas at the 18th week and the frequency of these malignant tumors rose to 50% in the antrum and 65% in the squamous mucosa at the 36th week. CONCLUSION: The reflux of duodenal contents through the pylorus enhanced the development of proliferative lesions, benign and malignant, in the glandular stomach and in the forestomach of rats.

Alterations of the gastric stump and not resected stomach mucosa after truncal vagotomy in rats

To evaluate morphological changes of the gastric stump and not resected stomach mucosa after the completion of truncal vagotomy. METHODS: Eighty male Wistar rats were divided into four groups: CT, TV, RY and RYTV. In CT group, abdominal viscera were manipulated and the abdominal cavity was closed, in TV vagal trunks were isolated and sectioned, in RY a partial Roux-en-Y gastrectomy was performed and in RYTV the vagal trunks were sectioned and a partial Roux-en-Y gastrectomy was performed. At the 54th week after surgery, the rats were euthanized. The findings were submitted to histological analyses. RESULTS: None macroscopic or histological alterations in groups TV and CT was observed. Specimens from RY and RYTV groups did not show alterations in the gastric stump mucosa. At the jejunal side of the gastroenterostomy we found shallow ulcerative lesions always single, well-defined and with variable diameter 3 to 6 mm, six times in the RY group and none in the RYTV group (RY>RYTV, p=0.008). Neoplastic or preneoplastic lesions were not diagnosed in all groups. CONCLUSION: Truncal vagotomy is a safe and non-carcinogenic method in not resected and partially resected stomach.

Alterations of the gastric stump and not resected stomach mucosa after truncal vagotomy in rats

To evaluate morphological changes of the gastric stump and not resected stomach mucosa after the completion of truncal vagotomy. METHODS: Eighty male Wistar rats were divided into four groups: CT, TV, RY and RYTV. In CT group, abdominal viscera were manipulated and the abdominal cavity was closed, in TV vagal trunks were isolated and sectioned, in RY a partial Roux-en-Y gastrectomy was performed and in RYTV the vagal trunks were sectioned and a partial Roux-en-Y gastrectomy was performed. At the 54th week after surgery, the rats were euthanized. The findings were submitted to histological analyses. RESULTS: None macroscopic or histological alterations in groups TV and CT was observed. Specimens from RY and RYTV groups did not show alterations in the gastric stump mucosa. At the jejunal side of the gastroenterostomy we found shallow ulcerative lesions always single, well-defined and with variable diameter 3 to 6 mm, six times in the RY group and none in the RYTV group (RY>RYTV, p=0.008). Neoplastic or preneoplastic lesions were not diagnosed in all groups. CONCLUSION: Truncal vagotomy is a safe and non-carcinogenic method in not resected and partially resected stomach.(AU)

Late administration of a specific COX-2 inhibitor does not treat and/or prevent progression of gastric tumors in rats submitted to duodenogastric reflux procedure

PURPOSE:To assess whether late introduction of a specific COX-2 inhibitor (Meloxicam) can treat and/or prevent the progression of tumors in the stomach of rats submitted to duodenogastric reflux. METHODS: Seventy five male Wistar rats, weighing 150 grams, were submitted to the induction of duodenogastric reflux through the pylorus. At 36 weeks of follow-up were established three experimental groups: DGR36 sacrificed immediately, DGR54 and DGR54MLX both sacrificed at 54th week of follow-up . The animals of the latter group were fed with a rat chow premixed with Meloxicam (2.0 mg/ kg feed; 0.3 mg / kg bw / day) and the other two with standard rat chow. The lesions found in the pyloric mucosa and gastrojejunal anastomosis were analyzed macroscopically and histologically. For statistical analysis was adjusted a generalized linear model assuming a binomial distribution with LOGIT link function. RESULTS: No significant differences were found when comparing the incidences of benign tumor lesions (Adenomatous Hyperplasia), p=0.4915, or malignant (Mucinous Adenocarcinoma), p=0.2731, among groups. CONCLUSION: Late introduction of specific COX-2 inhibitor (Meloxicam) did not treat and was not able to prevent the progression of tumoral lesions induced by duodenogastric reflux in the rat stomachs.

Late administration of a specific COX-2 inhibitor does not treat and/or prevent progression of gastric tumors in rats submitted to duodenogastric reflux procedure

PURPOSE:To assess whether late introduction of a specific COX-2 inhibitor (Meloxicam) can treat and/or prevent the progression of tumors in the stomach of rats submitted to duodenogastric reflux. METHODS: Seventy five male Wistar rats, weighing 150 grams, were submitted to the induction of duodenogastric reflux through the pylorus. At 36 weeks of follow-up were established three experimental groups: DGR36 sacrificed immediately, DGR54 and DGR54MLX both sacrificed at 54th week of follow-up . The animals of the latter group were fed with a rat chow premixed with Meloxicam (2.0 mg/ kg feed; 0.3 mg / kg bw / day) and the other two with standard rat chow. The lesions found in the pyloric mucosa and gastrojejunal anastomosis were analyzed macroscopically and histologically. For statistical analysis was adjusted a generalized linear model assuming a binomial distribution with LOGIT link function. RESULTS: No significant differences were found when comparing the incidences of benign tumor lesions (Adenomatous Hyperplasia), p=0.4915, or malignant (Mucinous Adenocarcinoma), p=0.2731, among groups. CONCLUSION: Late introduction of specific COX-2 inhibitor (Meloxicam) did not treat and was not able to prevent the progression of tumoral lesions induced by duodenogastric reflux in the rat stomachs.(AU)

Outcome of superficial squamous cell carcinoma of the esophagus: a clinicopathological study

PURPOSE: To analyze the clinicopathological features and outcome of patients with pathologically proven superficial squamous cell carcinoma of the esophagus. METHODS: A total of 234 consecutive cases of esophageal carcinoma in a 15-year period were reviewed. RESULTS: Superficial esophageal cancer was found in five patients (2.1%). They were four men and one woman and the mean age was 52.5 years. Smoking and alcohol were the main risk factors. Achalasia due to Chagas disease occurred in one patient and a second primary tumor developed in the larynx in another patient. Four patients underwent esophagectomy and one patient received chemoradiotherapy. The histopathologic diagnosis was of squamous cell carcinoma in all cases. Intramucosal tumor (Tis) was identified in three cases and superficially invasive carcinoma in two cases. Four patients are free of disease with survival times of two, four, six and nine years. The patient who developed laryngeal cancer died six years after esophagectomy. CONCLUSION: Long-term survival in patients with esophageal cancer is related to early diagnosis. Therefore, a less aggressive surgical approach, such as endoscopic resection, may be a good option for these patients, if depth of tumor invasion can be accurately predicted by the new imaging tools.(AU)

Outcome of superficial squamous cell carcinoma of the esophagus: a clinicopathological study

PURPOSE: To analyze the clinicopathological features and outcome of patients with pathologically proven superficial squamous cell carcinoma of the esophagus. METHODS: A total of 234 consecutive cases of esophageal carcinoma in a 15-year period were reviewed. RESULTS: Superficial esophageal cancer was found in five patients (2.1%). They were four men and one woman and the mean age was 52.5 years. Smoking and alcohol were the main risk factors. Achalasia due to Chagas disease occurred in one patient and a second primary tumor developed in the larynx in another patient. Four patients underwent esophagectomy and one patient received chemoradiotherapy. The histopathologic diagnosis was of squamous cell carcinoma in all cases. Intramucosal tumor (Tis) was identified in three cases and superficially invasive carcinoma in two cases. Four patients are free of disease with survival times of two, four, six and nine years. The patient who developed laryngeal cancer died six years after esophagectomy. CONCLUSION: Long-term survival in patients with esophageal cancer is related to early diagnosis. Therefore, a less aggressive surgical approach, such as endoscopic resection, may be a good option for these patients, if depth of tumor invasion can be accurately predicted by the new imaging tools.

Diclofenac sodium and Imipenem action on rat intestinal mucosa: a biomechanical and histological study / Ação do Diclofenaco de sódio e Imipenem na mucosa intestinal do rato: estudo biomecânico e histológico

PURPOSE: To study diclofenac sodium induced histological and mechanical alterations and their prevention with Imipenem in rat intestine. METHODS: Male Wistar rats (n=240) were randomly assigned to four experimental groups: GI: n=60 treated with 0.9 percent saline IM; GII: n=60 treated with 6mg/kg body weight diclofenac sodium IM for four days; GIII: n=60 treated with 30mg/kg body weight Imipenem IM for four days, and GIV n=60 treated with diclofenac sodium plus Imipenem at the above doses IM for 4 days. Each group was further divided into 4 subgroups of 15 rats each and sacrificed at 4, 7, 14, and 21 days of follow-up, respectively. Abdominal cavity macroscopy and histology, and small bowel breaking strength were analyzed at each sacrifice moment. RESULTS: There were no histological or mechanical alterations in normal control rats throughout the study. Ulcerated lesions in intestinal mucosa were observed and breaking strength decreased in all diclofenac sodium treated rats. Ulcerated lesions in intestinal mucosa were prevented by Imipenem in all rats. CONCLUSION: Diclofenac sodium induced ulcerated lesions in rat intestinal mucosa can be prevented by Imipenem treatment.(AU)

OBJETIVO: Avaliar as alterações histológicas e biomecânicas do diclofenaco de sódio na mucosa intestinal do rato e a associação com o uso de Imipenem. MÉTODOS: Foram estudados 240 ratos Wistar distribuídos aleatoriamente em quatro grupos experimentais: GI: 60 ratos tratados com injeção IM de soro fisiológico 0,9 por cento; GII: 60 ratos tratados com injeção IM de diclofenaco de sódio na dose de 6mg/kg de peso por 4 dias; GIII: 60 ratos tratados com injeção IM de Imipenem na dose de 30 mg/kg de peso por 4 dias; GIV: 60 ratos tratados com injeção IM de soro fisiológico e diclofenaco de sódio nas doses acima. Em cada grupo os animais foram posteriormente divididos em 4 momentos de 15 animais em cada um para sacrifício, respectivamente, no 4º, 7º, 14º e 21º dias após o início do tratamento. As alterações da cavidade abdominal, assim como as características histológicas e de força de ruptura do intestino delgado foram analisadas em cada momento, em cada grupo. RESULTADOS: Não foram encontradas alterações histológicas e biomecânicas nos animais do Grupo I nesse estudo. Lesões ulceradas na mucosa do intestino delgado foram observadas nos animais tratados com diclofenaco de sódio, assim como diminuição da força de ruptura. As lesões ulceradas encontradas foram prevenidas pelo uso de Imipenem. CONCLUSÃO: O diclofenaco de sódio induz lesões ulceradas na mucosa intestinal do rato que podem ser prevenidas pelo uso de Imipenem.(AU)

Diclofenac sodium and Imipenem action on rat intestinal mucosa: a biomechanical and histological study / Ação do Diclofenaco de sódio e Imipenem na mucosa intestinal do rato: estudo biomecânico e histológico

PURPOSE: To study diclofenac sodium induced histological and mechanical alterations and their prevention with Imipenem in rat intestine. METHODS: Male Wistar rats (n=240) were randomly assigned to four experimental groups: GI: n=60 treated with 0.9 percent saline IM; GII: n=60 treated with 6mg/kg body weight diclofenac sodium IM for four days; GIII: n=60 treated with 30mg/kg body weight Imipenem IM for four days, and GIV n=60 treated with diclofenac sodium plus Imipenem at the above doses IM for 4 days. Each group was further divided into 4 subgroups of 15 rats each and sacrificed at 4, 7, 14, and 21 days of follow-up, respectively. Abdominal cavity macroscopy and histology, and small bowel breaking strength were analyzed at each sacrifice moment. RESULTS: There were no histological or mechanical alterations in normal control rats throughout the study. Ulcerated lesions in intestinal mucosa were observed and breaking strength decreased in all diclofenac sodium treated rats. Ulcerated lesions in intestinal mucosa were prevented by Imipenem in all rats. CONCLUSION: Diclofenac sodium induced ulcerated lesions in rat intestinal mucosa can be prevented by Imipenem treatment.

OBJETIVO: Avaliar as alterações histológicas e biomecânicas do diclofenaco de sódio na mucosa intestinal do rato e a associação com o uso de Imipenem. MÉTODOS: Foram estudados 240 ratos Wistar distribuídos aleatoriamente em quatro grupos experimentais: GI: 60 ratos tratados com injeção IM de soro fisiológico 0,9 por cento; GII: 60 ratos tratados com injeção IM de diclofenaco de sódio na dose de 6mg/kg de peso por 4 dias; GIII: 60 ratos tratados com injeção IM de Imipenem na dose de 30 mg/kg de peso por 4 dias; GIV: 60 ratos tratados com injeção IM de soro fisiológico e diclofenaco de sódio nas doses acima. Em cada grupo os animais foram posteriormente divididos em 4 momentos de 15 animais em cada um para sacrifício, respectivamente, no 4º, 7º, 14º e 21º dias após o início do tratamento. As alterações da cavidade abdominal, assim como as características histológicas e de força de ruptura do intestino delgado foram analisadas em cada momento, em cada grupo. RESULTADOS: Não foram encontradas alterações histológicas e biomecânicas nos animais do Grupo I nesse estudo. Lesões ulceradas na mucosa do intestino delgado foram observadas nos animais tratados com diclofenaco de sódio, assim como diminuição da força de ruptura. As lesões ulceradas encontradas foram prevenidas pelo uso de Imipenem. CONCLUSÃO: O diclofenaco de sódio induz lesões ulceradas na mucosa intestinal do rato que podem ser prevenidas pelo uso de Imipenem.

Comparative study between two techniques of incisional hernia repair with polypropylene mesh in rabbits / Estudo comparativo entre duas técnicas de tratamento da hérnia incisional em coelhos utilizando a tela de polipropileno

PURPOSE: To compare two different incisional hernia repair techniques (repair with a polypropylene mesh reinforcement on the peritonium-aponeurosis versus polypropylene mesh sutured to the borders of the hernial ring as a bridge) in rabbits. METHODS: Incisional hernia was experimentally developed through a 4-cm median incision in 60 rabbits. After 30 days, half of the animals were operated for primary wall closure and placement of a polypropylene mesh reinforcement, while the other half had a polypropylene mesh sutured to the borders of the hernial ring as a bridge. Clinical development, scar breaking strength, as well as gross, microscopic and morphometric parameters were evaluated in all animals 30, 60, and 90 days after repair. RESULTS: No significant differences in breaking strength or histological parameters were observed between groups at any time point studied. No statistical difference regarding complications was detected, although denser and firmer adhesions to the abdominal wall were seen after the mesh was placed as a " bridge" . CONCLUSIONS: No significant differences between the incisional hernia repair techniques assessed were observed regarding breaking strength, and histological and morphometric parameters. The number of complications was similar in both study groups. However, adhesion of abdominal cavity organs to the scar area was much denser after the placement of a mesh to bridge the defect.

OBJETIVO: Comparar duas técnicas de tratamento da hérnia incisional em coelhos utilizando a tela de polipropileno apoiando um reforço peritônio - aponeurótico ou suturada nas bordas do anel herniário 'em ponte" . MÉTODOS: Foram operados 60 coelhos para a produção de hérnia incisional, em uma incisão mediana de 4 centímetros. Após 30 dias, metade dos animais foram operados com o fechamento primário da parede, com colocação de uma tela de polipropileno apoiando o reforço e a outra metade dos animais com a colocação da tela suturada nas bordas do anel herniário " em ponte" . Os animais foram avaliados com 30 (M1), 60 (M2)e 90 (M3) dias de pós-operatório. Os parâmetros analisados foram a evolução clínica, análise da força de ruptura da cicatriz, estudo macroscópico, análise microscópica e morfométrica. RESULTADOS: Não foram observadas diferenças significantes com relação a força de ruptura e estudos histológicos nos dois grupos e vários momentos estudados. Não houve diferença estatística com relação às complicações, embora os animais que receberam a tela " em ponte" tiveram aderências mais firmes e intensas à parede abdominal. CONCLUSÕES: As duas técnicas utilizadas para correção da hérnia incisional em coelhos não mostraram diferenças significantes quanto a força de ruptura, análise histológica e morfométrica. O número de complicações foi semelhante, porém a aderência de órgãos da cavidade abdominal à área de cicatriz foi muito mais intensa no grupo em que a tela foi colocada " em ponte" .

Comparative study between two techniques of incisional hernia repair with polypropylene mesh in rabbits / Estudo comparativo entre duas técnicas de tratamento da hérnia incisional em coelhos utilizando a tela de polipropileno

PURPOSE: To compare two different incisional hernia repair techniques (repair with a polypropylene mesh reinforcement on the peritonium-aponeurosis versus polypropylene mesh sutured to the borders of the hernial ring as a bridge) in rabbits. METHODS: Incisional hernia was experimentally developed through a 4-cm median incision in 60 rabbits. After 30 days, half of the animals were operated for primary wall closure and placement of a polypropylene mesh reinforcement, while the other half had a polypropylene mesh sutured to the borders of the hernial ring as a bridge. Clinical development, scar breaking strength, as well as gross, microscopic and morphometric parameters were evaluated in all animals 30, 60, and 90 days after repair. RESULTS: No significant differences in breaking strength or histological parameters were observed between groups at any time point studied. No statistical difference regarding complications was detected, although denser and firmer adhesions to the abdominal wall were seen after the mesh was placed as a " bridge" . CONCLUSIONS: No significant differences between the incisional hernia repair techniques assessed were observed regarding breaking strength, and histological and morphometric parameters. The number of complications was similar in both study groups. However, adhesion of abdominal cavity organs to the scar area was much denser after the placement of a mesh to bridge the defect.(AU)

OBJETIVO: Comparar duas técnicas de tratamento da hérnia incisional em coelhos utilizando a tela de polipropileno apoiando um reforço peritônio - aponeurótico ou suturada nas bordas do anel herniário 'em ponte" . MÉTODOS: Foram operados 60 coelhos para a produção de hérnia incisional, em uma incisão mediana de 4 centímetros. Após 30 dias, metade dos animais foram operados com o fechamento primário da parede, com colocação de uma tela de polipropileno apoiando o reforço e a outra metade dos animais com a colocação da tela suturada nas bordas do anel herniário " em ponte" . Os animais foram avaliados com 30 (M1), 60 (M2)e 90 (M3) dias de pós-operatório. Os parâmetros analisados foram a evolução clínica, análise da força de ruptura da cicatriz, estudo macroscópico, análise microscópica e morfométrica. RESULTADOS: Não foram observadas diferenças significantes com relação a força de ruptura e estudos histológicos nos dois grupos e vários momentos estudados. Não houve diferença estatística com relação às complicações, embora os animais que receberam a tela " em ponte" tiveram aderências mais firmes e intensas à parede abdominal. CONCLUSÕES: As duas técnicas utilizadas para correção da hérnia incisional em coelhos não mostraram diferenças significantes quanto a força de ruptura, análise histológica e morfométrica. O número de complicações foi semelhante, porém a aderência de órgãos da cavidade abdominal à área de cicatriz foi muito mais intensa no grupo em que a tela foi colocada " em ponte" .(AU)

Carcinogenesis of the upper gastrointestinal tract induced by N-methyl-N'-nitro-nitrosoguanidine and reflux of duodenal contents in the rat / Carcinogênese do trato gastrointestinal alto induzida pelo N-methyl-N'-nitro-nitrosoguanidina e pelo refluxo duodenogástrico no rato

PURPOSE: To investigate the combined effects of reflux of duodenal contents through the pylorus and treatment with N-methyl-N'-nitro-nitrosoguanidine (MNNG) on the development of lesions in the glandular stomach, at the gastrojejunal anastomosis and in the forestomach of rats. METHODS: Eighty Male Wistar rats were divided into 4 groups: G1: MNNG + Reflux, G2: Reflux, G3: MNNG and G4: Gastrostomy. MNNG was given in the drinking water (100 mg/ml) for 12 weeks and then two groups (G1 and G2) were submitted to a gastrojejunal anastomosis followed by section of the afferent loop and suture of both stumps to allow reflux of duodenal contents through the pylorus. The animals were sacrificed 18 and 36 weeks after surgery. The lesions obtained in the antral mucosa, at the gastrojejunal anastomosis and in the forestomach were analysed histologically. RESULTS: Duodenal reflux induced proliferative lesions at both glandular and squamous mucosa of the stomach. In the antrum, adenomatous hyperplasia (AH) was observed in 20% and 50% of the animals at the 18th and 36th weeks respectively. Aditionally 85% of the animals presented AH at the gastrojejunal anastomosis and 60% developed squamous hyperplasia at the squamous portion of the stomach. MNNG treatment plus duodenal reflux enhanced the development of malignant tumors at both glandular and squamous mucosa, since there were 30% of antral adenocarcinomas and 45% of squamous carcinomas at the 18th week and the frequency of these malignant tumors rose to 50% in the antrum and 65% in the squamous mucosa at the 36th week. CONCLUSION: The reflux of duodenal contents through the pylorus enhanced the development of proliferative lesions, benign and malignant, in the glandular stomach and in the forestomach of rats.(AU)

OBJETIVO: Investigar os efeitos do refluxo duodenogástrico e sua interação com o cancerígeno químico N-methil-N'-nitro-nitrosoguanidina (MNNG) no desenvolvimento de lesões no estômago glandular, anastomose gastrojejunal e no estômago escamoso do rato. MÉTODOS: Foram utilizados 80 ratos Wistar divididos em 4 grupos: G1: MNNG + Refluxo, G2: Refluxo, G3: MNNG e G 4: Gastrostomia. O MNNG foi oferecido na água de beber (100mg/ml) por 12 semanas. A seguir foi feita anastomose gastrojejunal na porção glandular do estômago nos grupos G1 e G2, com secção da alça aferente junto ao estômago e sutura de ambos os cotos para permitir o refluxo do conteúdo duodenal para o estômago pelo piloro. Os animais foram sacrificados 18 e 36 semanas após a cirurgia. As lesões identificadas foram submetidas à exame histopatológico. RESULTADOS: O refluxo duodenogástrico levou ao desenvolvimento de lesões proliferativas no estômago glandular e na porção escamosa. No antro, hiperplasia adenomatosa (HA) foi diagnosticada em 20 e 50% dos animais (G2) na 18ª e 36ª semanas, respectivamente. Na anastomose gastrojejunal 85 por cento dos animais (G2) apresentaram HA e 60% apresentaram hiperplasia escamosa no estômago escamoso, na 36ª semana. No grupo MNNG+Refluxo foram identificados na 18ª semana, 30% adenocarcinomas no antro e 45%carcinomas escamosos. A freqüência destas lesões malignas aumentou, respectivamente, para 50% e 65% na 36ª semana. CONCLUSÃO: O refluxo duodenogástrico potencializou o desenvolvimento de lesões proliferativas benignas e malignas no estômago glandular e em sua porção escamosa, no rato.(AU)