Gustavo Barreto de Melo

Enhancement of liver regeneration by the association of Hyptis pectinata with laser therapy.

Since new molecules that normally would accelerate regeneration can also be potentialized by light, the use of new substances combined with laser therapy seems to be a natural type of experiment. Therefore, the purpose of this study was to assess the effects of Hyptis pectinata leaves on liver regeneration after partial hepatectomy (PH) associated with laser therapy. Twenty-four rats were divided into four groups—PH(control), PHL (laser therapy), PH200 (200 mg/kg of Hyptis pectinata), and PHL200 (200 mg/kg of the plant and laser)—which were submitted to 67% hepatectomy. Laser treatment consisted of focusing the light on the remaining liver after hepatectomy. The data analyzed were serum levels of aminotransferases, liver regeneration, and mitochondrial function. Group PH200 showed a statistically significant decrease in AST levels, and PHL200 disclosed an augmentation in ALT levels. The liver regeneration index was significantly increased in group PHL200. Concerning liver mitochondrial respiratory assay, groups PH200 and PHL200 showed lower state 3 levels than groups PH and PHL. Group PHL showed an increase in state 4 levels and a reduction in membrane potential and RCR. The present study shows that the association of the aqueous extract of Hyptis pectinata leaves at 200 mg/kg with intraoperative laser therapy can stimulate liver regeneration and cause a reduction in liver mitochondrial respiratory function without altering its phosphorylative activity.

Toxicity and retinal penetration of infliximab in primates

Purpose: To evaluate the retinal penetration and toxicity of two doses of intravitreal infliximab in primates. Methods: Ten marmosets (Callithrix jacchus) were given intravitreal injection of 100 μg or 400 μg of infliximab, and balanced salt solution served as control. At baseline and after 24 hours (5 animals) and 7 days (the other 5), the eyes were examined by electroretinography. They were then killed (at 24 hours and 7 days) and assessed by light microscopy and transmission electron microscopy for toxicity and immunohistochemistry, using a biotinylated anti-human immunoglobulin G, to evaluate retinal penetration. Results: There was no difference over 50% of the electroretinography b-wave between baseline and the time points studied in all animals. Light and electron microscopy, and electroretinography analysis, showed no signs of toxicity in any of the animals. Strong presence of infliximab was observed in all retinal layers 7 days after intravitreal injection at both doses (100 and 400 μg). Conclusion: Infliximab at doses of 100 and 400 μg seemed to cause no damage to the retina 24 hours and 7 days after its intravitreal injection, and deeply penetrated all its layers, in primates. These results encourage future perspectives for the treatment of chronic inflammatory diseases of the retina in humans.

Tuberculosis of the cystic duct lymph node

Tuberculosis of the cystic duct lymph node associated with cholelithiasis is rare. We report a case of a 40 year-old woman with this pathology. She presented with anorexia, biliary colic, postprandial fullness and fever. Imaging studies revealed cholelithiasis and several visible portal lymph nodes. Cholecystectomy was performed and histopathological examination showed tuberculosis of the cystic duct lymph node without affecting the gallbladder. The presence of gallstones and lymphadenopathy in computed tomography, associated with persistent fever and symptoms that resemble cholecystitis, should cause suspicion of tuberculosis. However, diagnosis is usually achieved by microscopic appearance of caseating granulomas and isolation of Mycobacterium tuberculosis. The treatment in this case consisted of cholecystectomy and antitubercular chemotherapy.

Falciform ligament abscess: report of a case

Falciform ligament abscess is rare. We report a case of a 65-year-old man who presented with right upper quadrant abdominal pain, postprandial fullness, and fever. Computed tomography disclosed a cylindrical mass in the anterior abdomen that aroused suspicion of a hepatic abscess. At laparoscopic surgery, an abscess of the falciform ligament was found and drained. Two months later, the patient developed recurrence of the abscess secondary to acute calculous cholecystitis. Abscess drainage and cholecystectomy were performed. The presence of right uppper quadrant abdominal pain, epigastric tenderness, fever, leukocytosis, and a mass in the anterior abdomen should arouse suspicion of falciform ligament abscess. Its treatment consists of abscess drainage.

Efeito do omeprazol e do pantoprazol sobre a regeneração hepática após hepatectomia parcial em ratos

PURPOSE: To assess the effects of omeprazole and pantoprazole on liver regeneration after partial hepatectomy. METHODS: Fifty eight male Wistar rats were divided into 4 groups: SHAM, HP, PANTO and OMEP Groups. They were submitted to 67% partial hepatectomy (HP, PANTO and OMEP Groups) or laparotomy (SHAM Group). Their livers were removed 32 and 56 hours after the operation. Then, the animals were sacrificed. In all groups, the substances (saline solution, omeprazole and pantoprazole) were injected once daily from the moment they were operated on until the time of sacrifice. RESULTS: In SHAM Group the mitotic index was not significant. Thirty two hours after hepatectomy, the mitosis index was 1.2 ± 1.09 in HP Group, 1.2 ± 1.6 in OMEP Group and 2.6 ± 3.2 in PANTO Group. Concerning the 56-hour analysis, the values were 1.6 ± 0.89 in HP Group, 2 ± 1.8 in OMEP Group and 2.6 ± 0.54 in PANTO Group. These results were not statistically significant. CONCLUSION: Omeprazole and pantoprazole, proton pump inhibitors (H+, K+-ATPase), do not cause any change on liver regeneration 32 and 56 hours after 67% partial hepatectomy in rats.

Proliferative effect of the aqueous extract of Hyptis pectinata on liver regeneration after partial hepatectomy in rats

PURPOSE This study was carried out to assess the effects of the aqueous extract of Hyptis pectinata leaves on liver regeneration and on serum enzymes (AST, ALT and gamma-GT) after 67% partial hepatectomy in rats. METHODS AST, ALT and gamma-GT, were determined by conventional procedures using a spectrophotometer (Model E2250-CELM). Liver regeneration was evaluated by immunohistochemical staining for proliferating cell nuclear antigen (PCNA). RESULTS Oral pretreatment during 4 days at 100 mg/kg increased liver regeneration index. At 200 mg/kg, AST level was statistically decreased in comparison to the group submitted to distilled water administration. The other enzymes assessed disclosed no difference when all groups were compared. CONCLUSION The present study shows that the aqueous extract of Hyptis pectinata leaves contains some biological active principles that stimulate liver regeneration at 100 mg/kg and cause slight hepatic protection at 200 mg/kg.

Staining Properties of Brilliant Blue Depending on Different Incubation Times and Solvents in Humans

Purpose: Intravitreous injection of vital dyes, e.g. brilliant blue (BBG), promotes better visualization of the internal limiting membrane (ILM). This paper investigates the staining properties of BBG depending on different incubation times and 2 types of solvents - 5% glucose (GL) or saline solution - in a prospective study in patients. Methods: This paper investigates various aspects of BBG in various methods. An interventional prospective study was conducted in patients to examine the binding properties of the blue dye diluted in either saline or 5% GL to epiretinal membranes (ERMs) and ILMs. Forty-nine consecutive patients older than 18 years scheduled for macular ERM, vitreomacular traction and macular hole surgeries were prospectively recruited. The primary outcomes of this study were the degree of ILM and ERM staining. The secondary outcomes of the study were the need of reinjection of BBG or any other dye, the ability of BBG to stain the vitreous, and frequency of complications. The staining of the ILM and ERM were graded as no staining, little, moderate or strong staining. Results: There was no correlation between age (p = 0.32) or gender (p = 0.33) in the staining affinity of BBG to either the ILM or ERM. BBG may be an appropriate staining agent for the ILM in the majority (82%) of surgeries; however, in approximately half of the cases (45%) surgeons considered BBG not enough for ERM coloring and visualization. There is a tendency of BBG to stain the ILM better when saline solution is used compared to GL 5%; however, this was not statistically significant (p = 0.64). There was no difference in the staining efficacy of BBG to the ERMs by either solution (p = 0.70), despite the low staining affinity. Conclusion: BBG became the state-of-the-art dye for ILM identification. Differences in staining properties may imply that BBG should not be considered as first-line stain for ERM surgery. BBG is effective in ILM staining in over 80% of macular hole surgeries.

Alterações bioquímicas e morfológicas após anastomose porto-cava e hepatectomia parcial: estudo experimental em cães

PURPOSE: The aim of this study was to assess the effect of portocaval shunt on liver biochemical and morphological aspects in dogs. METHODS: Twenty animals were divided into 2 groups: Group I was submitted to 28.7% partial hepatectomy and Group II underwent partial hepatectomy associated with portocaval shunt. The data analyzed were: body weight, serum cholesterol and triglyceride, hepatic lipids and glycogen and liver regeneration index. All these data were measured preoperatively and 30 days after surgery. RESULTS: In Group I, only hepatic lipids levels were statistically increased post-operatively. In Group II, serum cholesterol and hepatic glycogen values were reduced while hepatic lipids levels were increased 30 days after surgery. When both groups were compared to each other, serum cholesterol, hepatic glycogen and liver regeneration index showed statistically significant difference. CONCLUSION: Portocaval shunt causes morphological and biochemical impairment of the liver as well as reduction of body weight.

Avaliação da anamastose espleno-renal distal, com e sem ligadura da artéria esplênica, para tratamento a hipertensão portal esquistossomática

BACKGROUND: A prospective study was developed throughout two years of observation to assess the results of distal splenorenal shunt (DSRS) associated with splenic artery ligation (SAL) in patients with schistosomal portal hypertension and history of gastroesophageal varices bleeding. METHODS: Thirty patients were divided into two groups: fifteen were submited to DSRS (Group I) and the other 15 were submited to DSRS associated with SAL (Group II). They were observed through 24 months of follow-up. In this period, it was assessed: recurrence of gastrointestinal bleeding, variceal endoscopic control and anastomosis patency at ultrasound and angiography. RESULTS: One patient from Group I (6.67%) developed thrombosis of the shunt and hemorrhage recurrence due to varices. In Group II, none of the patients, throughout 2 years of observation, disclosed anastomosis thrombosis and gastrointestinal bleeding. There was no statistically significant difference between the groups. Concerning with the endoscopic analysis six months after surgery, there was decrease in the size or disappearance of varices in 80% of patients from Group I and in 93% of those from Group II. CONCLUSIONS: Distal splenorenal shunt with splenic artery ligation is not associated with a higher incidence of thrombosis of the anastomosis, hemorrhage recurrence and did not change gastroesophageal variceal size in comparison to distal splenorenal shunt isolated.