Luciana Nakao Odashiro Miiji

The ischemic preconditioning and postconditioning effect on the intestinal mucosa of rats undergoing mesenteric ischemia/reperfusion procedure

PURPOSE To evaluate the effect of the ischemic preconditioning and the ischemic postconditioning over the tissue injury in the intestinal mucosa of rats undergoing the procedure of mesenteric ischemia and reperfusion. METHODS Thirty Wistar rats were studied, divided in three groups: group A, undergoing mesenteric ischemia (30 minutes) and reperfusion (60 minutes); group B, mesenteric ischemia and reperfusion preceded by ischemic preconditioning; group C, mesenteric ischemia and reperfusion and, before the beginning of reperfusion, the ischemic postconditioning was performed. At the end, a segment of the small intestine was dissected for histological analysis. The results were evaluated using the CHIU et al.6 classification followed by the statistic treatment. RESULTS The mean values of the tissue injury levels were: group A, 3.5; group B, 1.2; and group C, 1. The difference between the result of group A with the results of groups B and C was considered statistically significant (p < 0,05). CONCLUSION The ischemic preconditioning and postconditioning are able to minimize the tissue injury in the intestines of rats that underwent the procedure of mesenteric ischemia and reperfusion.

Evaluation of ischemic postconditioning effect on mesenteric ischemia treatment: experimental study in rats

OBJECTIVE To assess the preconditioning and postconditioning effect on intestinal mucosal lesions in rats undergone mesenteric ischemia and reperfusion procedure. METHODS Thirty Wistar rats were studied and divided into three groups: Group A, 10 rats undergone mesenteric ischemia (30 minutes) and reperfusion (60 minutes); Group B, 10 rats undergone mesenteric ischemia and reperfusion preceded by ischemic preconditioning for three cycles of ischemia and reperfusion for two minutes each; Group C, 10 rats undergone mesenteric ischemia and reperfusion and, preceding the beginning of reperfusion, ischemic postconditioning was performed for three cycles of reperfusion and ischemia for two minutes each. Then, a segment of small intestine was resected for histological analysis. We assessed the results by Chiu et al. score and the statistical analysis was performed. RESULTS According to Chiu et al. score, the means of lesion degree were: In the group A, 3.5; Group B, 1.2; Group C, 1. The difference between group A with the groups B and C was considered statistically significant (P < 0.05). CONCLUSION Ischemic pre- and postconditioning were capable of minimizing - in a similar intensity - the tissue injury on the intestinal mucosa of rats undergone mesenteric ischemia and reperfusion process.

Serum calprotectin levels correlate with biochemical and histological markers of disease activity in TNBS colitis

BACKGROUND AND AIM Serum calprotectin is elevated in patients with inflammatory bowel disease (IBD). Whether it correlates other markers of disease activity is unknown. The aim of this study was to correlate serum calprotectin with biochemical and histological measures of intestinal inflammation. MATERIALS AND METHODS TNBS colitis was induced in wistar rats, and serial blood samples were collected at 0, 3, and 12 days. Animals were subsequently sacrificed for pathological evaluation at day 12. Serum calprotectin and cytokines were measured by ELISA. Pathologic changes were classified at the macroscopic and microscopic levels. RESULTS TNBS colitis induced elevated serum calprotectin, TNF and IL-6 within 24 h. Levels of serum calprotectin remained elevated in parallel to persistence of loose stool and weight loss to day 12. Serum calprotectin levels correlated with serum levels of TNF-α and IL6 (p < 0.001), but not CRP. Animals with liquid stool had significantly higher levels of serum calprotectin than control animals. There was a correlation between macroscopic colitis scores, and levels of serum calprotectin. CONCLUSION Serum calprotectin levels correlate with biochemical and histological markers of inflammation in TNBS colitis. This biomarker may have potential for diagnostic use in patients with IBD.

Avaliação do pós-condicionamento isquêmico no tratamento da isquemia mesentérica: estudo experimental em ratos

OBJECTIVE To assess the preconditioning and postconditioning effect on intestinal mucosal lesions in rats undergone mesenteric ischemia and reperfusion procedure. METHODS Thirty Wistar rats were studied and divided into three groups: Group A, 10 rats undergone mesenteric ischemia (30 minutes) and reperfusion (60 minutes); Group B, 10 rats undergone mesenteric ischemia and reperfusion preceded by ischemic preconditioning for three cycles of ischemia and reperfusion for two minutes each; Group C, 10 rats undergone mesenteric ischemia and reperfusion and, preceding the beginning of reperfusion, ischemic postconditioning was performed for three cycles of reperfusion and ischemia for two minutes each. Then, a segment of small intestine was resected for histological analysis. We assessed the results by Chiu et al. score and the statistical analysis was performed. RESULTS According to Chiu et al. score, the means of lesion degree were: In the group A, 3.5; Group B, 1.2; Group C, 1. The difference between group A with the groups B and C was considered statistically significant (P < 0.05). CONCLUSION Ischemic pre- and postconditioning were capable of minimizing - in a similar intensity - the tissue injury on the intestinal mucosa of rats undergone mesenteric ischemia and reperfusion process.

Postconditioning effect in the hepatic ischemia and reperfusion in rats

PURPOSE To evaluate the effect of postconditioning protection in liver tissue of rats submitted to ischemia and reperfusion. METHODS 25 Wistar male rats were randomized in three groups: Group A (ischemia and reperfusion - I/R), with 10 rats, which was made ischemia by vascular clamp application in hepatic hilum for 30 minutes and reperfusion for 60 minutes by removal of the clamp; Group B (Postconditioning - IPo), with 10 rats, with same procedure plus postconditioning (3 cycles of reperfusion inserted by 3 cycles of ischemia, 30 seconds for each phase, between ischemia and reperfusion phases); and Group C (Sham), with 5 rats, which took place only laparotomy and manipulation of the hepatic hilum. Specimens were examined (histological evaluation) and dosage of serum AST and ALT was made. The statistical analysis was made with t Student test, with significant difference when p<0.05. RESULTS In the Sham group there was no histological or enzymatic changes; In group A the mean tissue lesion was 1.6 and in group B 1.1 (p=0.014). In group A the mean ALT level was 355U/l and in group B was 175.9U/l (p=0.016). The mean of AST was 828.8U/l in group A and 295.5U/l in group B (p=0.001). CONCLUSION The postconditioning was able to minimize the severity of liver injury in rats submitted to ischemia and reperfusion.

Breast cancer with choriocarcinomatous and neuroendocrine features

CONTEXT Breast cancer may express the presence of b-human chorionic gonadotrophin in 12% to 18% of cases, using immunohistochemical reactions. Usually the tumors will show positivity in a few scattered cells. Breast cancer with choriocarcinomatous features, as reported by Saigo and Rosen, is a distinct variant of breast cancer. We report a case of breast cancer with choriocarcinomatous and neuroendocrine features. OBJECTIVE This is a case report of an invasive ductal carcinoma of the breast with choriocarcinomatous and neuroendocrine features. DESIGN Case Report. CASE REPORT A 50-year-old Brazilian woman underwent surgery for a lump in the right breast, which had been first noticed about 3 months earlier. The surgery consisted of quadrantectomy followed by right mastectomy with ipsilateral axillary lymph node dissection. The specimen from the quadrantectomy revealed a 7 x 6.5 x 4.5 cm tumor. Histology of the lesion showed the presence of an invasive ductal carcinoma with areas of giant cells and intense atypia. The immunohistochemistry was positive in the pleomorphic areas for human chorionic gonadotrophin, while the less pleomorphic areas showed positivity for synaptophysin and chromogranin.

Importance of duration and number of ischemic postconditioning cycles in preventing reperfusion mesenteric injuries. Experimental study in rats

PURPOSE To evaluate the effect of ischemic postconditioning(IPC) on intestinal mucosa of rats subjected to ischemia and reperfusion process comparing two cycles of reperfusion and ischemia lasting two minutes each and four cycles of reperfusion and ischemia lasting 30 seconds each. METHODS Thirty Wistar rats were distributed into three groups: group A (10 rats), ischemia (30 minutes) and reperfusion (60 minutes); group B (10 rats), ischemia and reperfusion plus IPC by two lasting two minutes each; and Group C (10 rats), ischemia and reperfusion plus IPC by four cycles lasting 30 seconds each. Finally, a segment of small intestine was resected for histological analysis. We analysed the results according to Chiu et al. classification and proceeded to the statistical treatment by Kruskal-Wallis test (p<0.05). RESULTS The mean degree of tissue injury according to Chiu et al. classification were: Group A, 2.77; in group B, 1.4; and group C, 1.4. B X C (p<0.05). CONCLUSIONS Ischemic postconditioning was able to minimize reperfusion injury of rats undergone mesenteric ischemia and reperfusion process. There was no difference in the effectiveness of the method comparing two cycles of two minutes with four cycles of 30 seconds by H&E histological evaluation of the ileum after 60-minute reperfusion.

Tratamento da isquemia mesentérica pelo pós-condicionamento isquêmico

Sabe-se que o pre-condicionamento isquemico tem a capacidade de minimizar as lesoes decorrentes do processo de isquemia e reperfusao. Recentemente foi descrito que o pos-condicionamento isquemico apresenta resultados semelhantes em isquemia e reperfusao miocardica, cerebral, renal e da medula espinhal, mas nao ha relatos de utilizacao deste metodo na isquemia mesenterica. OBJETIVO: O objetivo deste estudo e avaliar o efeito do pos-condicionamento isquemico sobre a lesao tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusao mesenterica. METODO: Foram estudados 20 ratos Wistar, distribuidos em dois grupos: grupo A, em que se realizou isquemia (30 minutos) e reperfusao (60 minutos) mesenterica; grupo B, isquemia e reperfusao mesenterica e, precedendo o inicio da reperfusao, foi realizado o pos-condicionamento isquemico. Ao final, ressecou-se um segmento do intestino delgado para analise histologica. Avaliaram-se os resultados pela classificacao de Chiu e procedeu-se o tratamento estatistico. RESULTADO: As medias dos graus de lesao tecidual foram: grupo A, 3,5; grupo B, 1. A diferenca entre os grupos foi considerada estatisticamente significativa (p < 0,05). CONCLUSAO: Concluiu-se que o pos-condicionamento isquemico foi capaz de minimizar a lesao tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusao mesenterica.

Isolated metachronous splenic metastasis from renal cell carcinoma after 5 years

Primary and metastatic tumours of the spleen are uncommon. The incidence of isolated metastasis from other organs is less than 1%. We report the case of a 55-year-old woman with clear cell carcinoma of the kidney, who underwent radical nephrectomy. After a 5-year follow-up period, a hypervascular nodule was detected in the spleen on MRI. Six months later, control MRI showed that its appearance had changed to a hypervascular mass with areas of central necrosis. A splenectomy was performed and histopathological examination of the spleen confirmed the presence of clear cell carcinoma with infiltration of the capsule. This is only the seventh case described in the literature of isolated splenic metastasis from clear cell carcinoma and the first such case containing MRI.

Evaluation of Pulmonary Reperfusion Injury in Rats Undergoing Mesenteric Ischemia and Reperfusion and Protective Effect of Postconditioning on this Process

INTRODUCTION Some publications have demonstrated the presence of lung reperfusion injury in mesenteric ischemia and reperfusion (I/R), but under to diverse methods. Postconditioning has been recognized as effective in preventing reperfusion injury in various organs and tissues. However, its effectiveness has not been evaluated in the prevention of lung reperfusion injury after mesenteric ischemia and reperfusion. OBJECTIVE To evaluate the presence of pulmonary reperfusion injury and the protective effect of ischemic postconditioning on lung parenchyma in rats submitted to mesenteric ischemia and reperfusion. METHODS Thirty Wistar rats were distributed into three groups: group A (10 rats), which was held mesenteric ischemia (30 minutes) and reperfusion (60 minutes); group B (10 rats), ischemia and reperfusion, interspersed by postconditioning with two alternating cycles of reperfusion and reocclusion, for two minutes each; and group C (10 rats), ischemia and reperfusion interleaved by postconditioning with four alternating cycles of reperfusion and reocclusion of 30 seconds each. Finally, it was resected the upper lung lobe for histological analysis. RESULTS There were mild lung lesions (grade 1) in all samples. There was no statistical difference between groups 1 and 2 (P>0.05). CONCLUSION The mesenteric ischemia and reperfusion in rats for thirty and sixty minutes, respectively, caused mild reperfusion injury in lung. Postconditioning was not able to minimize the remote reperfusion injury and there was no difference comparing two cycles of two minutes with four cycles of 30 seconds.