Ruy Fernando Kuenzer Caetano da Silva

The protective effect of methylene blue in lungs, small bowel and kidney after intestinal ischemia and reperfusion.

PURPOSE To study the role of methylene blue as an inhibitor of superoxide production by xanthine oxidase. METHODS Thirty-two Wistar rats were divided into 2 groups of 16 animals: the control group and the experimental group. All were submitted to a laparotomy for the occlusion of the cranial mesenteric artery during 60 minutes. The reperfusion was confirmed by the pulsation of the artery after the release of the temporary ligature and color change of the intestines. In the animals of the control group, 2 ml of saline were injected in the peritoneal cavity and in the animals of the experimental group, 2 ml of methylene blue were injected in the peritoneal cavity. After reperfusion for 4 hours, the animals were then sacrificed. The lungs were excised from all 32 rats. Simultaneously, the small intestine and kidneys were ressected in 20 animals (10 from the control group and 10 from the experimental group). Samples of the organs were taken to evaluate the action of xanthine-oxidase, for histopathology studies and for characterization of the edema. RESULTS In the animals of the experimental group, the inflammatory lesion as well as the edema in the lung was greater than in the control group. The intestinal and renal lesions were similar in both groups, but the lung damage was superior to that observed in the intestines and kidneys. . CONCLUSION Despite similar action of the xanthine oxidase in the control and the experimental group, after intestinal ischemia and reperfusion, the protective effect of methylene blue was observed only in the lungs of the experimental group.

Trauma abdominal fechado: análise dos pacientes vítimas de trauma esplênico em um Hospital Universitário de Curitiba

ABSTRACT Background : determining the common characteristics referring to the trauma mechanism and to the anatomic and physiologicallesion of patients victim of splenic trauma. Method: The records of December/1999 to January/2003 were revised, beingselected 524 of those by the Software TNVT Plus (version 2.0.0.213 – year 1996), admitted in the Emergency Service victims ofthoracic-abdominal disease and subsequently interned. Of these records, were excluded those which did not present mechanismof contused trauma, the ones that deceased in the emergency room and the minors of 16 years of age. A sample with N=200patients were studied. The variables of interest in the study were: etiology of the trauma, organ with the lesion, degree andsegment of the lesion, systolic arterial pressure, cardiac frequency in the hospital admission and rib fracture. Results: thesplenic injury isolated had the greater incidence 39%, the hepatic-splenic associated lesion represented 14%. Of the 116patients with diagnosis of splenic lesion, the classified anatomically in Degree IV was the most common (44 patients). Themajority of the lesions had an auto-engine vehicle as the trauma mechanism – 56 patients, among which the lesion Degree IIIhad greater prevalence 33,93%, standard comparable with the lesion Degree IV 32,14%. It was observed that 20% of thepatients with lesion Degree III, IV or V had not described abdominal pain in their records, and in the lesions Degree I or II30,13% did not describe pain. Medium Cardiac Frequency and Systolic Arterial Pressure were shown equivalent amongdifferent lesions. The greater incidence of splenic lesion was related to the absence of rib fracture. When diagnosed fracture,there was predominance of the group with isolated left ribs fractured, in which lesions Degree III, IV or V predominate with62,50%.

Interleukin-6 (IL-6) influence on colonic anastomosis healing in rats

PURPOSE To observe the effect of pro-inflamatory citokin, Interleukin-6 (IL-6), administration on the healing of colonic anastomosis in rats. METHODS Thirty Wistar rats were divided into 2 groups of 15 animals each: a control group and an experiment group. The animals of the experiment group were submitted to injection of 500microg/kg of IL-6 Recombinant (Sandoz Phamarceutical(R)) subcutaneously 24 and 12 hours preceding the surgery, and the control group, were submitted to the injection of saline solution, using the same volume of solution as well as the way of administration. The rats were submitted to an end to end colonic anastomosis, being sacrificed in the 7th post-operative day, the site of the anastomosis was evaluated regarding to the adhesions that was quantified and the presence of complications was observed. The colon containing the anastomosis was submitted to a tensiometric study and a sample were sent for histological studies with HE and Sirius Red dye. RESULTS The macroscopic and the tensiometric study did not demonstrate any significant differences between the control and experiment group. Regarding the histological evaluation, there was a significant reduction of the chronic inflammatory process in the experiment group (p=0,0209) and a lesser granulation area (p=0,0099). The total amount of collagen was similar in both groups, however, the experimental group showed a predominant area of immature collagen (p=0.009). CONCLUSIONS The longer persistence of the acute phase of wound healing in the experiment group, as well as a decreased of the mature collagen type I, demonstrating that the IL-6 was harmful to the colonic healing anastomosis in rats.

Enxerto de submucosa porcina no tratamento de lesões duodenais em cães

PURPOSE: To evaluate the biocompatibility and effectiveness of porcine SIS (small intestinal submucosa), when used as a patch to repair a defect on the anterior duodenal wall. METHODS: The experimental study was performed in 8 dogs. A segment of the anterior duodenal wall was removed and the defect was repaired with a patch of porcine intestinal submucosa. On the 120th post operative day the animals were sacrified and the segment of duodenum containing the patch was removed to a macroscopic and microscopic evaluation. RESULTS: There was no infection, suture dehiscence or fistula. The microscopic evaluation showed complete re-epithelization in 75% of the cases, with moderate fibroblastic proliferation in 87, 5% of the cases. CONCLUSION: The porcine SIS used as a patch acts as a tissue substitute for repairing induced lesions in duodenal wall of dogs.

Use of rosiglitazone before and after vascular injury in hypercholesterolemic rabbits: Assessment of neointimal formation

ObjectivesTo analyse the effects of rosiglitazone administered at different times on neointimal formation in hypercholesterolemic rabbits following vascular injury.MethodsThirty-nine rabbits on a hypercholesterolemic diet were included. The animals underwent balloon catheter injury to the right iliac artery on day 14. They were divided into three groups as follows: control group, 13 rabbits without rosiglitazone; group I, 13 rabbits treated with rosiglitazone (3 mg/Kg body weight/day) for 28 days after the vascular injury; and group II, 13 rabbits treated with rosiglitazone (3 mg/Kg body weight/day) during all the experiment (42 days). Histological analysis was done by an experienced pathologist who was unaware of the rosiglitazone treatment. Histomorphometric parameters were performed by calculation of the luminal and intimal layer area, and intima/media layer area ratio (the area of the intimal layer divided by the area of the medial layer).ResultsIntimal area was significantly lower in group II vs. CG (p = 0.024) and group I (p = 0.006). Luminal layer area was higher in group II vs. CG (p < 0.0001) and group I (p < 0.0001). Intima/media layer area ratio was equal between CG and group I. Intima/media layer ratio area was significantly lower in group II vs. control group (p < 0.021) and group I (p < 0.003). There was a significant reduction of 65% and 71% in intima/media layer area ratio in group II vs. control group and group I, respectively.ConclusionPretreatment with rosiglitazone in hypercholesterolemic rabbits submitted to vascular injury significantly reduces neointimal formation.

Rosiglitazona e lesão vascular em coelhos hipercolesterolêmicos: avaliação da formação neointimal

FUNDAMENTO: El uso de rosiglitazona ha estado siendo el objeto de extensas discusiones. OBJETIVO: Evaluar los efectos de la rosiglitazona en las arterias iliacas, en el local de la injuria y en la arteria contralateral, de conejos hipercolesterolemicos sometidos a la lesion por cateter-balon. METODOS: Conejos blancos machos recibieron una dieta hipercolesterolemica a traves de gavage oral por 6 semanas y se los dividieron en 2 grupos: grupo rosiglitazona (GR - 14 conejos tratados con rosiglitazona por 6 semanas) y grupo control (GC - 18 conejos sin rosiglitazona). Los animales se sometieron a lesion por cateter-balon en la arteria iliaca derecha en el 14o dia. RESULTADOS: En la arteria iliaca contralateral, no hubo diferencia significativa en la razon entre las areas intima y media (RIM) entre los grupos GR y GC. La rosiglitazona no redujo la probabilidad de lesiones tipo I, II o III (72,73% vs 92,31%; p=0,30) y lesiones tipo IV o V (27,27% vs 7,69%; p=0,30). En la arteria iliaca homolateral, el area intima era significantemente menor en el GR cuando comparado al GC (p = 0,024). El area luminal era mayor en el GR cuando comparado al GC (p < 0,0001). Hubo una reduccion significante del 65% en la IMR en el GR cuando comparado al GC (p = 0,021). Ningun de los criterios histologicos para lesiones ateroscleroticas tipos I a V (American Heart Association) se encontraron en la arteria iliaca homolateral. CONCLUSION: Estos hallazgos demuestran que la administracion de rosiglitazona por 6 semanas impide la aterogenesis en el local de la lesion, pero no en un vaso distante del sitio de la lesion.BACKGROUND Rosiglitazone has been the focus of extensive discussion. OBJECTIVE To evaluate the effects of rosiglitazone on iliac arteries, both at the injury site and the contralateral artery, of hypercholesterolemic rabbits undergoing balloon catheter injury. METHODS White male rabbits were fed a hypercholesterolemic diet by oral gavage for 6 weeks and divided into two groups as follows: rosiglitazone group (14 rabbits treated with rosiglitazone during 6 weeks) and the control group (18 rabbits without rosiglitazone). Animals underwent balloon catheter injury of the right iliac artery on the 14th day. RESULTS In the contralateral iliac artery, there was no significant difference in the intima/media layer area ratio (IMR) between the control and rosiglitazone groups. Rosiglitazone did not reduce the probability of type I, II, or III lesions (72.73% vs 92.31%; p=0.30) and type IV or V lesions (27.27% vs 7.69%; p=0.30). As for the homolateral iliac artery, the intimal area was significantly lower in the rosiglitazone group, as compared to the control group (p = 0.024). The luminal layer area was higher in the rosiglitazone group vs. the control group (p < 0.0001). There was a significant reduction of 65% in the IMR in the rosiglitazone group vs the control group (p = 0.021). None of the histological criteria for type I-V atherosclerotic lesions (American Heart Association) were found in the homolateral iliac artery. CONCLUSION These findings demonstrate that rosiglitazone given for 6 weeks prevents atherogenesis at the injury site, but not in a vessel distant from the injury site.

Rosiglitazone and vascular injury in hypercholesterolemic rabbits: neointimal formation assessment

FUNDAMENTO: El uso de rosiglitazona ha estado siendo el objeto de extensas discusiones. OBJETIVO: Evaluar los efectos de la rosiglitazona en las arterias iliacas, en el local de la injuria y en la arteria contralateral, de conejos hipercolesterolemicos sometidos a la lesion por cateter-balon. METODOS: Conejos blancos machos recibieron una dieta hipercolesterolemica a traves de gavage oral por 6 semanas y se los dividieron en 2 grupos: grupo rosiglitazona (GR - 14 conejos tratados con rosiglitazona por 6 semanas) y grupo control (GC - 18 conejos sin rosiglitazona). Los animales se sometieron a lesion por cateter-balon en la arteria iliaca derecha en el 14o dia. RESULTADOS: En la arteria iliaca contralateral, no hubo diferencia significativa en la razon entre las areas intima y media (RIM) entre los grupos GR y GC. La rosiglitazona no redujo la probabilidad de lesiones tipo I, II o III (72,73% vs 92,31%; p=0,30) y lesiones tipo IV o V (27,27% vs 7,69%; p=0,30). En la arteria iliaca homolateral, el area intima era significantemente menor en el GR cuando comparado al GC (p = 0,024). El area luminal era mayor en el GR cuando comparado al GC (p < 0,0001). Hubo una reduccion significante del 65% en la IMR en el GR cuando comparado al GC (p = 0,021). Ningun de los criterios histologicos para lesiones ateroscleroticas tipos I a V (American Heart Association) se encontraron en la arteria iliaca homolateral. CONCLUSION: Estos hallazgos demuestran que la administracion de rosiglitazona por 6 semanas impide la aterogenesis en el local de la lesion, pero no en un vaso distante del sitio de la lesion.BACKGROUND Rosiglitazone has been the focus of extensive discussion. OBJECTIVE To evaluate the effects of rosiglitazone on iliac arteries, both at the injury site and the contralateral artery, of hypercholesterolemic rabbits undergoing balloon catheter injury. METHODS White male rabbits were fed a hypercholesterolemic diet by oral gavage for 6 weeks and divided into two groups as follows: rosiglitazone group (14 rabbits treated with rosiglitazone during 6 weeks) and the control group (18 rabbits without rosiglitazone). Animals underwent balloon catheter injury of the right iliac artery on the 14th day. RESULTS In the contralateral iliac artery, there was no significant difference in the intima/media layer area ratio (IMR) between the control and rosiglitazone groups. Rosiglitazone did not reduce the probability of type I, II, or III lesions (72.73% vs 92.31%; p=0.30) and type IV or V lesions (27.27% vs 7.69%; p=0.30). As for the homolateral iliac artery, the intimal area was significantly lower in the rosiglitazone group, as compared to the control group (p = 0.024). The luminal layer area was higher in the rosiglitazone group vs. the control group (p < 0.0001). There was a significant reduction of 65% in the IMR in the rosiglitazone group vs the control group (p = 0.021). None of the histological criteria for type I-V atherosclerotic lesions (American Heart Association) were found in the homolateral iliac artery. CONCLUSION These findings demonstrate that rosiglitazone given for 6 weeks prevents atherogenesis at the injury site, but not in a vessel distant from the injury site.

Effects of rosiglitazone on contralateral iliac artery after vascular injury in hypercholesterolemic rabbits

BackgroundThe objective was to evaluate the effects of rosiglitazone on iliac arteries of hypercholesterolemic rabbits undergoing balloon catheter injury in the contralateral iliac arteries.MethodsWhite male rabbits were fed a hypercholesterolemic diet for 6 weeks and divided into two groups as follows: rosiglitazone group, 14 rabbits treated with rosiglitazone (3 mg/Kg body weight/day) during 6 weeks; and control group, 18 rabbits without rosiglitazone treatment. All animals underwent balloon catheter injury of the right iliac artery on the fourteenth day of the experiment.ResultsThere was no significant difference in intima/media layer area ratio between the control group and the rosiglitazone group. Rosiglitazone did not reduce the probability of lesions types I, II, or III (72.73% vs. 92.31%; p = 0.30) and types IV or V (27.27% vs. 7.69%; p = 0.30). There were no differences in the extent of collagen type I and III deposition or in the percentage of animals with macrophages in the intima layer. The percentage of rabbits with smooth muscle cells in the intima layer was higher in rosiglitazone group (p = 0.011).ConclusionThese findings demonstrate that rosiglitazone given for 6 weeks did not prevent atherogenesis at a vessel distant from the injury site.

EFEITO DA L-ARGININA NA NEOPROLIFERAÇÃO INTIMAL E NO REMODELAMENTO ARTERIAL APÓS LESÃO POR BALÃO EM ILÍACAS DE COELHOS HIPERCOLESTEROLÊMICOS

OBJECTIVE It has been implied that neointimal proliferation and remodeling are the major causes of restenosis. The objective of this study is to assess the effect of orally administered L-arginine on these two factors in hypercholesterolemic rabbits that had suffered an injury to their iliac arteries caused by a catheter balloon. METHODS The study included nineteen rabbits that were divided in two groups: control (CG) and arginine (AG). There were 19 arteries studied from the control group and 17 in the arginine group. The animals were placed on a 2% hypercholesterolemic diet for 15 days and then submitted to a balloon angioplasty in order to produce a lesion in their iliac arteries. Next, the AG animals were given a 1g/kg/day oral dose of a L-arginine solution. The animals were sacrificed 15 days after the angioplasty procedure and histological artery sections were prepared, stained and fixed. The ratio between the neointimal area (in mm(2)) and the media layer (in mm(2)) was used to represent lesion development. In order to determine remodeling, the ratio between the total area of the medial portion of the vessel (greater balloon contact) and the total area of the reference segment of the vessel (less balloon contact) was used. RESULTS Mean neointimal thickness (NI/M) was 0.8151+/-0.2201 in CG and 0.3296+/-0.1133 in AG. Remodeling patterns for the two groups studied were similar. CONCLUSION In the experimental model used, L-arginine was able to reduce intimal tissue thickness in hypercholesterolemic rabbits but did not act on artery remodeling.

Perfil da atividade de pesquisa encaminhada ao Congresso Brasileiro de Cirurgia Torácica - Tórax 2009

OBJECTIVE To increase the knowledge of research activity in Thoracic Surgery in Brazil. METHODS We carried out a prospective observational study of the abstracts published in the Annals of the Brazilian Congress of Thoracic Surgery - Thorax 2009, to quantitatively and qualitatively assess the geographic distribution and type of home institutions of abstracts, the types of studies and themes addressed. RESULTS We published 182 abstracts, 174 (95.60%) of interventionist nature. There were three foreign abstracts, all from a single Italian institution. As for the types of studies, we observed 108 trials, 67 case reports and seven experimental studies. Pulmonary resection (14.29%) was the most frequent theme, followed by lung cancer, hyperhidrosis and tracheal disorders (10.44%), trauma (7.14%) and mediastinum (6.04%). Public institutions participated with 68.16% of the abstracts, private institutions with 11.17% and the philanthropic entities with 20.67%; the Pontifical Catholic Universities (11.00%) and the Santas Casas--Holy Homes (7.70 %)--had a significant involvement in Thoracic Surgery research in Brazil. CONCLUSION Public institutions are mainly responsible for research activity in Thoracic Surgery in Brazil, which is more concentrated in the state of São Paulo (34.07%). One third of this activity is represented by case reports and, although there is wide variation in topics covered, pulmonary resection is the most frequent theme.