RESUMO
Trypanosoma cruzi infection and nonsteroidal anti-inflammatory drugs inhibit colorectal carcinogenesis by mechanisms not completely known and metallothionein proteins (MTs) may be involved in this process. Sixty-six male Wistar rats weighing 90 to 120 g were randomly divided into seven groups (GI to GVII). GI, GII and GIII animals were subcutaneously infected with 200,000 trypomastigote forms of the Y strain of T. cruzi. After 8 weeks, GI, GII, GIV, and GVI were injected with one weekly subcutaneous dose of 12 mg/kg dimethylhydrazine for 4 weeks. In sequence, GI, GIV and GV were treated with nimesulide (10 mg/kg per dose, five times per week for 8 weeks). Groups I, III, IV, and VI had 12 animals, and each of the other groups had 6 animals. All the animals were euthanized 8 weeks after the last dimethylhydrazine injection. The colons were fixed and processed for MT immunohistochemistry. The index of MT-overexpressing colonic crypts (MTEC) was estimated as the percentage of MT-stained crypts in relation to the total number of crypts scored. Five hundred crypts per animal were scored. Data were analyzed by the Kruskal-Wallis test followed by the Dunn test. There was an increase in MTEC index in the groups either infected with T. cruzi or treated with nimesulide or both infected and treated when compared to control (401, 809, and 1011%, respectively). We suggest that the increased formation of MTEC may be related to the protection against carcinogenesis provided both by T. cruzi infection and nimesulide.
Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Doença de Chagas/complicações , Neoplasias Colorretais/metabolismo , Metalotioneína/metabolismo , Sulfonamidas/farmacologia , Animais , Carcinógenos , Neoplasias Colorretais/complicações , Neoplasias Colorretais/prevenção & controle , Dimetilidrazinas , Modelos Animais de Doenças , Imuno-Histoquímica , Masculino , Metalotioneína/efeitos dos fármacos , Distribuição Aleatória , Ratos , Ratos Wistar , Trypanosoma cruziRESUMO
Trypanosoma cruzi infection and nonsteroidal anti-inflammatory drugs inhibit colorectal carcinogenesis by mechanisms not completely known and metallothionein proteins (MTs) may be involved in this process. Sixty-six male Wistar rats weighing 90 to 120 g were randomly divided into seven groups (GI to GVII). GI, GII and GIII animals were subcutaneously infected with 200,000 trypomastigote forms of the Y strain of T. cruzi. After 8 weeks, GI, GII, GIV, and GVI were injected with one weekly subcutaneous dose of 12 mg/kg dimethylhydrazine for 4 weeks. In sequence, GI, GIV and GV were treated with nimesulide (10 mg/kg per dose, five times per week for 8 weeks). Groups I, III, IV, and VI had 12 animals, and each of the other groups had 6 animals. All the animals were euthanized 8 weeks after the last dimethylhydrazine injection. The colons were fixed and processed for MT immunohistochemistry. The index of MT-overexpressing colonic crypts (MTEC) was estimated as the percentage of MT-stained crypts in relation to the total number of crypts scored. Five hundred crypts per animal were scored. Data were analyzed by the Kruskal-Wallis test followed by the Dunn test. There was an increase in MTEC index in the groups either infected with T. cruzi or treated with nimesulide or both infected and treated when compared to control (401, 809, and 1011 percent, respectively). We suggest that the increased formation of MTEC may be related to the protection against carcinogenesis provided both by T. cruzi infection and nimesulide.
Assuntos
Animais , Masculino , Ratos , Anti-Inflamatórios não Esteroides/farmacologia , Doença de Chagas/congênito , Neoplasias Colorretais/metabolismo , Metalotioneína/metabolismo , Sulfonamidas/farmacologia , Carcinógenos , Neoplasias Colorretais/complicações , Neoplasias Colorretais/prevenção & controle , Dimetilidrazinas , Modelos Animais de Doenças , Imuno-Histoquímica , Metalotioneína/efeitos dos fármacos , Ratos WistarRESUMO
Chronic and recurrent appendicitis are pathologic conditions that differ from acute appendicitis, the most common affection of the vermiform appendix. The purpose of the present study was to describe in detail the clinical features, diagnosis and pathology of those conditions.
A apendicite crônica e a apendicite recorrente são condições patológicas que diferem da apendicite aguda, a afecção mais comum do apêndice vermiforme. O propósito desse artigo é decifrar com critério os aspectos clínicos, o diagnóstico e a histopatologia da apendicite crônica e da apendicite recorrente. Os dados da literatura e as experiências clínica e cirúrgica dos autores, demonstradas por 10 pacientes com idade média entre 40 e 45 anos, com distribuição similar quanto ao sexo, sendo 6 pacientes com apendicite recorrente e 4 com apendicite crônica, permitem concluir que a apendicite crônica e a recorrente já não devem ser mais uma controvérsia ou dúvida, mas um fato inequívoco de importâncias clínica e acadêmica. Portanto, seus conceitos merecem difusão na literatura científica e nas escolas médicas.
RESUMO
The most used surgical technic for treatment of rectal prolapse is the rectal promontofixation by laparotomy. In the last years, the perineal rectossigmoidectomy has been widely performed again, as alternative for old pacients, particulary for these who have other severe diseases. We've studied 14 pacients operated on perineal rectosigmoidectomy (Altemeier procedure ), 13 women and only 01 man. There were 50% constipated ,also 14,2% had chronic diarrhoea and 64,2% were incontinent. The medium age was of 72,2 years, 64,2% had manual anastomosis and 35,8% mechanic and 42,9% had posterior anal repair (Parks) at the same surgical time. The pacients were hospitalized for 3,8 days (mean time), there were no imediate or recent complications and just 01 recurrence (7,1%). As wehad good results, low morbimortality and acceptable recurrence, we have performed that technique more usually, specially for old patients.
A técnica cirúrgica mais utilizada no tratamento do prolapso retal é a sacropromontofixação do reto por via abdominal, porém nos últimos anos a proctossigmoidectomia via perineal tem sido retomada como alternativa para pacientes idosos com comorbidades. Revisamos 14 casos operados pela proctossigmoidectomia via perineal (cirurgia de Altemeier), sendo 13 mulheres e 1 homem. Destes pacientes havia 50% de obstipados, 14,2% tinham diarréia crônica e 64,2% eram previamente incontinentes. Idade média de 72,2 anos, 64,2 % com anastomose manual e 35,8% mecânica, além de 42,9% com reparo anal posterior no mesmo tempo operatório. O tempo médio de internação foi de 3,8 dias, não houve complicações imediatas ou precoces e apenas ocorreu recidiva em 01 paciente, 7,1%. Pelos bons resultados, baixa morbi-mortalidade e recidiva aceitável e de acordo com a literatura nos encorajamos à utilização desta técnica para correção do prolapso retal .
RESUMO
The most used surgical technic for treatment of rectal prolapse is the rectal promontofixation by laparotomy. In the last years, the perineal rectossigmoidectomy has been widely performed again, as alternative for old pacients, particulary for these who have other severe diseases. We've studied 14 pacients operated on perineal rectosigmoidectomy (Altemeier procedure ), 13 women and only 01 man. There were 50% constipated ,also 14,2% had chronic diarrhoea and 64,2% were incontinent. The medium age was of 72,2 years, 64,2% had manual anastomosis and 35,8% mechanic and 42,9% had posterior anal repair (Parks) at the same surgical time. The pacients were hospitalized for 3,8 days (mean time), there were no imediate or recent complications and just 01 recurrence (7,1%). As wehad good results, low morbimortality and acceptable recurrence, we have performed that technique more usually, specially for old patients.
A técnica cirúrgica mais utilizada no tratamento do prolapso retal é a sacropromontofixação do reto por via abdominal, porém nos últimos anos a proctossigmoidectomia via perineal tem sido retomada como alternativa para pacientes idosos com comorbidades. Revisamos 14 casos operados pela proctossigmoidectomia via perineal (cirurgia de Altemeier), sendo 13 mulheres e 1 homem. Destes pacientes havia 50% de obstipados, 14,2% tinham diarréia crônica e 64,2% eram previamente incontinentes. Idade média de 72,2 anos, 64,2 % com anastomose manual e 35,8% mecânica, além de 42,9% com reparo anal posterior no mesmo tempo operatório. O tempo médio de internação foi de 3,8 dias, não houve complicações imediatas ou precoces e apenas ocorreu recidiva em 01 paciente, 7,1%. Pelos bons resultados, baixa morbi-mortalidade e recidiva aceitável e de acordo com a literatura nos encorajamos à utilização desta técnica para correção do prolapso retal .
RESUMO
Chronic and recurrent appendicitis are pathologic conditions that differ from acute appendicitis, the most common affection of the vermiform appendix. The purpose of the present study was to describe in detail the clinical features, diagnosis and pathology of those conditions.
A apendicite crônica e a apendicite recorrente são condições patológicas que diferem da apendicite aguda, a afecção mais comum do apêndice vermiforme. O propósito desse artigo é decifrar com critério os aspectos clínicos, o diagnóstico e a histopatologia da apendicite crônica e da apendicite recorrente. Os dados da literatura e as experiências clínica e cirúrgica dos autores, demonstradas por 10 pacientes com idade média entre 40 e 45 anos, com distribuição similar quanto ao sexo, sendo 6 pacientes com apendicite recorrente e 4 com apendicite crônica, permitem concluir que a apendicite crônica e a recorrente já não devem ser mais uma controvérsia ou dúvida, mas um fato inequívoco de importâncias clínica e acadêmica. Portanto, seus conceitos merecem difusão na literatura científica e nas escolas médicas.
RESUMO
A apendicite crônica e a apendicite recorrente säo condiçöes patológicas que diferem da apendicite aguda, a afecçäo mais comum do apêndice vermiforme. O propósito desse artigo é decifrar com critério os aspectos clínicos, o diagnóstico e a histopatologia da apendicite crônica e da apendicite recorrente. Os dados da literatura e as experiências clínica e cirúrgica dos autores, demonstradas por 10 pacientes com idade média entre 40 e 45 anos, com distribuiçäo similar quanto ao sexo, sendo 6 pacientes com apendicite recorrente e 4 com apendicite crônica, permitem concluir que a apendicite crônica e a recorrente já näo devem ser mais uma controvérsia ou dúvida, mas um fato inequívoco de importâncias clínica e acadêmica. Portanto, seus conceitos merecem difusäo na literatura científica e nas escolas médicas.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Apendicite , Apendicectomia , Apendicite , Doença CrônicaRESUMO
PURPOSE: This study was designed to examine the influence of misoprostol, a synthetic prostaglandin E1 analog, on the healing of colonic anastomoses in rats, with particular regard to changes in collagen levels at the site of the anastomoses and their histopathologic aspects. METHODS: Sixty rats were submitted to resection and anastomosis of the colon, and divided at random into two groups. The test group received misoprostol intragastrically (200 micrograms/kg body weight), twice daily, from the day of operation until sacrifice. Controls received 0.9 percent NaCl. The animals were sacrificed on the third, seventh, or fourteenth postoperative day, and the results of the histopathologic analyses and hydroxyproline concentrations were compared. RESULTS: Our results show that misoprostol administration increased the hydroxyproline concentration on the fourteenth postoperative day without interfering in the inflammatory response (P < 0.05). CONCLUSION: Misoprostol interferes with the balance between the synthesis and degradation of collagen, resulting in an elevation of collagen levels by the fourteenth postoperative day without influencing the inflammatory response.
Assuntos
Anastomose Cirúrgica , Colo/cirurgia , Hidroxiprolina/efeitos dos fármacos , Misoprostol/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Colo/metabolismo , Masculino , Misoprostol/metabolismo , Período Pós-Operatório , Ratos , Ratos Wistar , Fatores de TempoRESUMO
To study the possible effects of diclofenac sodium on intestinal anastomoses, 48 rabbits were submitted to surgery consisting of two single-layer ileal anastomoses performed with separate propylene 5-0 sutures. The animals were divided at random into two groups (test and control). The animals in the test group were given intramuscular injections of diclofenac sodium at the dose of 3 mg/kg body weight at 24-hour intervals, and the control animals were given injections of an identical amount of 0.9 percent saline. The animals were sacrificed on the 3rd, 7th, and 14th postoperative days for macroscopic evaluation of the peritoneal cavity and of the anastomoses, tensile strength measurement, hydroxyproline determination, and histopathologic examination. The following results were observed: anastomotic dehiscence followed by peritonitis and death in five test animals (20.83 percent) and no control animals; decreased anastomotic tensile strength on the 7th day in test animals (P less than 0.05); delayed acute inflammatory response and onset of fibroblast proliferation in the test group; and similar hydroxyproline levels in both groups. On the basis of the results obtained, we conclude that diclofenac sodium had a negative effect on intestinal anastomotic healing.
Assuntos
Diclofenaco/toxicidade , Intestino Delgado/cirurgia , Cicatrização/efeitos dos fármacos , Anastomose Cirúrgica , Animais , Feminino , Hidroxiprolina/efeitos dos fármacos , Intestino Delgado/patologia , Intestino Delgado/fisiopatologia , Masculino , Coelhos , Distribuição Aleatória , Deiscência da Ferida Operatória/etiologia , Resistência à Tração/efeitos dos fármacosRESUMO
Two types of single-layer sutures in intestinal anastomoses were compared in female dogs regarding safety, time of execution of anastomoses, amount of thread used, histopathology, impermeability and resistance to tension. Two colon anastomoses were carried out in each animal with either continuous or separate-stitch suture (monofilament nylon 4-0 thread). Before surgery the animals underwent intestinal cleaning and they were sacrificed on day 28 after the operation. Impermeability and resistance to tension by gaseous insufflation were tested, in five animals, immediately after surgery. Regarding safety, impermeability, border coaptation, inflammatory reaction and cicatrization in both types of suture presented similar results. Time of execution of the anastomosis was shorter for continuous suture and amount of thread used was smaller than for separate-stitch suture, representing lower cost for this type of anastomosis.
Assuntos
Animais , Feminino , Cães , Anastomose Cirúrgica/métodos , Colo/cirurgia , Técnicas de Sutura , Permeabilidade , Resistência à TraçãoRESUMO
Of 34 patients with massive lower intestinal bleeding, 17 (11 men and 6 women, age range 33-85 years; mean 64.8 years) were diagnosed as having angiodysplasia of the colon. The diagnosis was made by colonoscopy and the lesions were treated successfully by fulguration in 13 (86.6 per cent) of 15 patients. Two of the 17 patients underwent surgical resection of the involved intestinal segment. One patient still has sporadic intestinal haemorrhage, and another patient died from bleeding of the left colon after blind right colectomy. The remaining 13 patients have had no further bleeding in the 1-7 years following colonoscopic fulguration. Colonoscopy is a useful method of diagnosing angiodysplasia of the colon and affords the possibility of treatment.
Assuntos
Colo/irrigação sanguínea , Doenças do Colo/diagnóstico , Hemorragia Gastrointestinal/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Vasos Sanguíneos/anormalidades , Doenças do Colo/etiologia , Doenças do Colo/cirurgia , Colonoscopia , Eletrocoagulação , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Oito casos de diverticulo solitario inflamado do ceco sao apresentados, com comentarios a respeito do quadro clinico, diagnostico diferencial, tratamento e estudo anatomopatologico