Luiz Roberto Lopes

Rat's age versus human's age: what is the relationship?

BACKGROUND Millions of mice are used annually in research and teaching. The exact relationship between age of the animals compared with the age of humans is still subject to discussion and controversy. OBJECTIVE Literature review analyzing the age of rats in comparison with men age. METHODS Were reviewed the existing publications on the subject contained in Medline / PUBMED, SciELO, The Cochrane Database of Systematic Reviews and Lilacs crossing the headings rats, experimental surgery and physiology. RESULTS Rats rapidly develop during childhood and become sexually mature at about six weeks old, but reach social maturity five to six months later. In adulthood, every month of the animal is approximately equivalent to 2.5 human years. Several authors performed experimental studies in rats and estimated 30 days of human life for every day life of the animal. CONCLUSION The differences in anatomy, physiology, development and biological phenomena must be taken into consideration when analyzing the results of any research in rats when age is a crucial factor. Special care is necessary to be taken when the intention is to produce correlation with human life. For this, special attention is needed to verify the phase in days of the animal and its correlation with age in years of humans.BACKGROUND: Millions of mice are used annually in research and teaching. The exact relationship between age of the animals compared with the age of humans is still subject to discussion and controversy. OBJECTIVE: Literature review analyzing the age of rats in comparison with men age. METHODS: Were reviewed the existing publications on the subject contained in Medline / Pubmed, Scielo, The Cochrane Database of Systematic Reviews and Lilacs crossing the headings rats, experimental surgery and physiology. RESULTS: Rats rapidly develop during childhood and become sexually mature at about six weeks old, but reach social maturity five to six months later. In adulthood, every month of the animal is approximately equivalent to 2.5 human years. Several authors performed experimental studies in rats and estimated 30 days of human life for every day life of the animal. CONCLUSION: The differences in anatomy, physiology, development and biological phenomena must be taken into consideration when analyzing the results of any research in rats when age is a crucial factor. Special care is necessary to be taken when the intention is to produce correlation with human life. For this, special attention is needed to verify the phase in days of the animal and its correlation with age in years of humans

Use of corticosteroids after esophageal dilations on patients with corrosive stenosis: prospective, randomized and double-blind study

OBJECTIVE To determine triancinolone intralesional injections effects in association with esophageal dilations in corrosive stenosis cases, by means of a double-blind and randomized study. METHOD Fourteen adults patients (6 men and 8 women) with severe esophageal corrosive stenosis were randomized in two groups: Group A: treated by esophageal dilations and posterior triancinolone 10 mg/ml intralesional injection; Group B: treated by esophageal injections and posterior saline solution 0,9% injection (placebo). New applications were made based on the patient symptomatology. It had been analysed dilation frequency, obtained diameters and dysphagia before and after the research, for 12 months. RESULTS Eleven patients had ingested sodium hydroxide, two had ingested ammoniac and one had taken muriatic acid. There was no statistic difference (p > 0.05) in dilation frequency and dysphagia between the groups. However, an improvement in obtained diameter was observed in the corticosteroids group in comparison with control group (p < 0.05). By comparing groups before and after steroids, the final results were very favorable in group A CONCLUSION: Multiple intralesional injections of triancinolone hexacetonide 10 mg/ml in association with esophageal dilations increase obtained diameters in succeeding sessions.

Lower expression of p14ARF and p16INK4a correlates with higher DNMT3B expression in human oesophageal squamous cell carcinomas

Oesophageal squamous cell carcinoma (ESCC) is one of the most common malignancies and is the sixth cause of cancer-related death in the world. Inactivation of cell-cycle regulating genes, such as p14ARF and p16INK4a, and cell adhesion genes, such as E-cadherin, is common in cancer, and results from genetic and/or epigenetic alterations. Therefore, we have analysed the mRNA expression of p14ARF, p16INK4a and E-cadherin in 17 matched ESCC and normal mucosal samples obtained from Brazilian patients by semi-quantitative RT-PCR. The expression of p14ARF and p16INK4a was absent or reduced in several ESCC samples. Hypermethylation of CpG islands, caused by the action of DNA methyltransferases (DNMTs), is a major form of epigenetic inactivation of the p14ARF and p16INK4a genes in tumours. Hence, we also investigated the mRNA expression of the human DNA methyltransferases in normal oesophageal mucosa and in the tumour matched samples. All DNMTs were constitutively expressed in the normal oesophageal mucosa but a significantly higher expression of DNMT3B was observed in the tumours. Data analysis by the Spearman rank test showed that the expression of DNMT3B was inversely correlated with that of p14ARF and p16INK4a. Our results suggest that DNMT3B over-expression may be involved in the suppression or lower expression of p14ARF and p16INK4a observed in ESCC.

O megaesôfago tratado cirurgicamente: perfil epidemiológico dos pacientes operados no Hospital de Clínicas da Universidade Estadual de Campinas entre 1989 e 2005

Megaesophagus is one of the manifestations of Chagas disease and surgical treatment is the approach that presents the best results. In this retrospective study, the epidemiological profile of patients operated in the Clinical Hospital of University of Campinas between 1989 and 2005 was evaluated with regard to: place of birth, place of residence, probable place of infection, age, degree of megaesophagus, etiology, duration and evolution of dysphagia, other diseases in association and the type of surgery chosen. The method used was to analyze the 390 medical files of these patients, at the hospitals medical archive service. The results made it possible to establish the endemic regions, place of birth and place of residence of the patients with Chagas disease attended at our clinic, and to characterize the group. After detailed analysis, it was found that the mean age was 47 years and the mean duration of dysphagia was 9.47 years. It was observed that: a) in 84.4% of the patients, dysphagia took hold progressively; b) 306 (78.5%) patients presented Chagas disease etiology; c) grade 2 was prevalent in 48%; d) 89.8% of the patients underwent cardiomyotomy; and e) there were frequent associations with gastritis, esophagitis, megacolon, arterial hypertension and cardiopathy.

Studies of distribution and recurrence of Helicobacter spp. gastric mucosa of dogs after triple therapy

Purpose: To analyze the triple antimicrobial therapy in positive Helicobacter spp. dogs and to investigate recurrence. Methods: A total of 20 dogs underwent endoscopy followed by gastric biopsy using the rapid urease test and histopathology stained with Giemsa. Ten animals were treated with triple therapy recommended for humans and divided into control and experimental group. The control group was kept in isolation while the experimental group was placed in contact with positive animals during 60 days. Results: The prevalence of infection in animals in this experiment was 100%, and more frequent in the fundus and the gastric body. Therapy for 7 days using clarithromycin, amoxicillin and lansoprazole was effective in 100% of the animals. Recurrence of the infection in 80% of dogs in the experimental group, while the control group remained eradicated after 60 days. Conclusion: Crowded environments associated with close contact with dogs infected with helicobacter are a determinant for transmission of Helicobacter spp. between canines. Key works: Helicobacter infections. Endoscopy. Gastric Mucosa. Dogs. RESUMO Objetivo: Avaliar a eficacia da terapia triplice em caes naturalmente infectados pelo Helicobacter spp. e investigar a recorrencia da infeccao pelo contato com animais infectados. Metodos: Foram utilizados 20 caes, submetidos a endoscopia digestiva alta seguida de biopsia gastrica usando teste rapido da urease e histopatologia corada pelo Giemsa. Dez animais foram tratados com terapia triplice preconizada para humanos e divididos em grupo controle e experimental. O grupo controle foi mantido em isolamento enquanto que o grupo experimento foi colocado em contato com os animais positivos durante 60 dias. Resultados: A prevalencia da infeccao nos animais deste experimento foi de 100%, e mais frequente no fundo e corpo gastrico. A terapia durante 7 dias empregando claritromicina, amoxicilina e lansoprazol foi eficaz em 100% dos animais. Houve recorrencia da infeccao em 80% dos caes do grupo experimental, enquanto que o grupo controle manteve-se erradicado apos 60 dias. Conclusao: Ambientes aglomerados associado a intimo contato com caes infectados por helicobacterias e fator determinante para transmissao do Helicobacter spp. entre caninos. Descritores: Infeccao por Helicobacter . Endoscopia. Mucosa Gastrica. Caes.PURPOSE To analyze the triple antimicrobial therapy in positive Helicobacter spp. dogs and to investigate recurrence. METHODS A total of 20 dogs underwent endoscopy followed by gastric biopsy using the rapid urease test and histopathology stained with Giemsa. Ten animals were treated with triple therapy recommended for humans and divided into control and experimental group. The control group was kept in isolation while the experimental group was placed in contact with positive animals during 60 days. RESULTS The prevalence of infection in animals in this experiment was 100%, and more frequent in the fundus and the gastric body. Therapy for 7 days using clarithromycin, amoxicillin and lansoprazole was effective in 100% of the animals. Recurrence of the infection in 80% of dogs in the experimental group, while the control group remained eradicated after 60 days. CONCLUSION Crowded environments associated with close contact with dogs infected with helicobacter are a determinant for transmission of Helicobacter spp. between canines.

Rare Gastric Inflammatory Myofibroblastic Tumor in an Adult Woman: A Case Report with Review of the Literature

Inflammatory myofibroblastic tumor (IMT) of the stomach is extremely rare and its prognosis is unpredictable. We present a 37-year-old woman with a gastric IMT. She presented epigastric pain since 2 months, anemia and weight loss associated. Physical examination showed cutaneous pallor and mild abdominal tenderness in the epigastrium. Abdominal ultrasonography showed a tumor near the pancreas and the CT scan revealed that the lesion was arising from the stomach. Upper endoscopy showed a submucosal lesion of approximately 7.5 cm located in the posterior wall of the gastric body such as a gastrointestinal stromal tumor (GIST). The patient underwent a subtotal gastrectomy and Billroth I reconstruction. The histopathological and immunohistochemical analysis revealed an IMT that originated from the gastric wall.

Complicações pós-operatórias após gastrectomia total no câncer gástrico: análise de 300 doentes

BACKGROUND: A total gastrectomy is considered a procedure with a high level of complexity, has high complication rates, both local and general, because patients are mostly with clinical conditions and nutritional compromised by disease. AIM: To analyse the results and complications of the total gastrectomy in gastric cancer in the period from 1972 to 2007. METHODS: Were reviewed the medical records of 300 patients with gastric adenocarcinoma, divided into two periods: from 1972 to 1992 - comprising 108 patients (36%) and from 1993 to 2007 - comprising 192 patients (64%). They were 67.3% males, 70.7% whites, with ages ranging from 25 to 86 years (mean 63.4 years). The lesions were located in cardia - 40 cases (13.3%), gastric fundus - 83 cases (27.6%), gastric body - 77 cases (25.6%); plastic linitis- 45 cases (15%); gastric stump - 33 cases (11%) and antrum and body gastric - 22 cases (7.3%). A total gastrectomy with extended lymphadenectomy to level D2 was performed in 246 cases (82%). RESULTS: The reconstruction technique used was the esophagus-jejunal anastomosis end-to-side Roux-en-Y in 257 patients (86.7%). The general complications in the period from 1972 to 1992 totalized 47 cases (43.5%), mainly involving the respiratory (28 cases - 25.9%) and urinary tract (10 cases - 9.2%). In the period from 1993 to 2007 amounted to 48 cases (25%), mainly respiratory complications (27 cases - 14%), followed by urinary (12 cases - 6.2%). The local complications from 1972 to 1992 totalized 45 cases (30.8%) and in the period from 1993 to 2007 amounted to 28 cases (14.5%), being the most frequent the digestive fistulas. The operative mortality through 30 days was 18 cases (6%), while in the period from 1972 to 92 a total of 12 cases (11.1%) and in the period from 1993 to 2007 were 7 cases (3.6%). CONCLUSIONS: Total gastrectomy is a procedure that requires a skilled surgeon, his team, using an improved surgical technique to minimize postoperative complications. The postoperative complications requiring care in controlling infections, airway and nutritional care, reducing mortality, increasing survival and contributing to quality of life of patients.

Doença do refluxo gastroesofágico: qual a eficácia dos exames no diagnóstico?

RACIONAL: A doenca do refluxo gastroesofagico (DRGE) e muito frequente na populacao e os exames empregados para o seu diagnostico sao a endoscopia digestiva alta, exames radiologicos contrastados, a cintilografia com tecnecio99m Tc, a manometria e a phmetria de 24 h. OBJETIVO: Analisar a eficacia destes exames em doentes portadores de DRGE submetidos a tratamento cirurgico por video-laparoscopia. METODOS: Estudo retrospectivo de 126 doentes com diagnostico de DRGE, que realizaram no pre-operatorio endoscopia digestiva alta, exame radiologico do esofago, estomago e duodeno, cintilografia e manometria do esofago. A phmetria de 24 h foi realizada em numero pequeno de doentes. RESULTADOS: A endoscopia digestiva diagnosticou esofagite de refluxo em 91,7% dos casos e hernia hiatal em 88,6%. Os exames radiologicos demonstraram a presenca de refluxo gastroesofagico em 80,2% dos casos e hernia hiatal em 91,5%. A cintilografia demonstrou refluxo gastroesofagico em 85,1% dos casos. A manometria esofagica foi normal em 6,45% dos casos. CONCLUSAO: O exame subsidiario que apresentou elevada sensibilidade para o diagnostico da esofagite de refluxo foi a endoscopia digestiva alta; o estudo cintilografico foi o e que mais demonstrou refluxo gastroesofagico; o exame radiologico contrastado foi o de melhor eficacia em demonstrar o refluxo.

Results of the surgical treatment of non-advanced megaesophagus using Heller-Pinotti's surgery: Laparotomy vs. Laparoscopy

INTRODUCTION: Dysphagia is the important symptom in achalasia, and surgery is the most common treatment. The Heller–Pinotti technique is the method preferred by Brazilian surgeons. For many years, this technique was performed by laparotomy, and now the laparoscopic method has been introduced. The objective was to evaluate the immediate and long‐term results of patients submitted to surgery by either laparotomy or laparoscopy. MATERIALS AND METHODS: A total of 67 patients submitted to surgery between 1994 and 2001 with at least 5 years of follow‐up were evaluated retrospectively and divided into two groups: laparotomy (41 patients) and laparoscopy (26 patients). Chagas was the etiology in 76.12% of cases. Dysphagia was evaluated according to the classification defined by Saeed et al. RESULTS: There were no cases of conversion to open surgery. The mean duration of hospitalization was 3.32 days for laparotomy and 2.54 days for laparoscopy (p<0.05). An improvement in dysphagia occurred with both groups reporting good or excellent results (laparotomy: 73.17% and laparoscopy: 73.08%). Mean duration of follow‐up was 8 years. CONCLUSIONS: There was no difference between the two groups with respect to relief from dysphagia, thereby confirming the safety and effectiveness of the Heller–Pinotti technique, which can be performed by laparotomy or laparoscopy, depending on the surgeons experience.

Role of the vitamin C in diethylnitrosamine-induced esophageal cancer in Wistar rats.

PURPOSE To evaluate the inhibitory effect of vitamin C on the experimental esophageal carcinogenesis induced by diethylnitrosamine (NDEA). METHODS Sixty Wistar male rats aged three months, with mean weight of 210 g were employed in the study and were divided into four different groups according to the drinking drugs: group I--controls: only water, seven days a week; group II--only vitamin C, seven days a week; group III--NDEA, three days a week and water during the other four days; group IV--NDEA, three days a week and vitamin C during the other four days; group V--NDEA together with vitamin C three days a week, and only water during the other four days and group VI--NDEA together with vitamin C three days a week and vitamin C during the other four days. The dosages of NDEA were: --10 mg./Kg/day and vitamin C--200 mg/animal/day, dissolved in drinking water. The animals were observed during 180 days and after that each one was sacrificed and its esophagus and the stomach were removed together and macro and microscopically analyzed to identify any tumors. RESULTS The largest number of tumors was observed in the group III: 48 macroscopic lesions (4.8 lesions per animal) and 23 microscopic lesions (2.3 lesions per animal). The groups that received vitamin C (groups IV, V and VI) showed smaller number of tumors: group V--0.5 macroscopic lesions and 0.3 microscopic lesions per animal and group VI--0.1 macroscopic lesions and 0.1 microscopic lesions per animal. The incidence of tumors in the groups V and VI showed statistical significance (p<0.05), when compared to the other groups. CONCLUSION The vitamin C administered together with diethylnitrosamine showed an inhibitory effect on the experimental esophageal carcinogenesis in Wistar rats.