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Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet. 大鼠肠切除术后体重减轻和肠黏膜形态计量学研究:谷氨酰胺饮食的影响。
Pub Date : 2004-12-01 Epub Date: 2005-01-11 DOI: 10.1590/s0041-87812004000600007
Sidney Resende Ribeiro, Paulo Engler Pinto, Ariney Costa de Miranda, Sansom Henrique Bromberg, Fábio Pinatel Lopasso, Kiyoshi Irya

Unlabelled: Short-bowel syndrome is responsible for significant metabolic alterations that compromise nutritional status. Glutamine is considered an essential nutrient for enterocytes, so beneficial effects from supplementation of the diet with glutamine are hypothesized.

Purpose: In this study, the effect of a diet enriched with glutamine was evaluated in rats undergoing extensive small bowel resection, with analysis of postoperative weight loss and intestinal morphometrics of villi height, crypt depth, and thickness of the duodenal and remnant jejunal mucosa.

Methods: Three groups of male Wistar rats were established receiving the following diets: with glutamine, without glutamine, and the standard diet of laboratory ration. All animals underwent an extensive small bowel resection, including the ileocecal valve, leaving a remnant jejunum of only 25 cm from the pylorus that was anastomosed lateral-laterally to the ascendant colon. The animals were weighed at the beginning and end of the experiment (20th postoperative day). Then they were killed and the remnant intestine was removed. Fragments of duodenal and jejunal mucosa were collected from the remnant intestine and submitted to histopathologic exam. The morphometric study of the intestinal mucosa was accomplished using a digital system (KS 300) connected to an optic microscope. Morphometrics included villi height, crypt depth, and the total thickness of intestinal mucosa.

Results: The weight loss comparison among the 3 groups showed no significant loss difference. The morphometric studies showed significantly taller duodenal villi in the glutamine group in comparison to the without glutamine group, but not different from the standard diet group. The measurements obtained comparing the 3 groups for villi height, crypt depth, and thickness of the remnant jejunum mucosa were greater in the glutamine-enriched diet group than for the without-glutamine diet group, though not significantly different from with standard-diet group.

Conclusions: In rats with experimentally produced short-bowel syndrome, glutamine-enrichment of an isonitrogenous test diet was associated with an improved adaptation response by the intestinal mucosa but not reduced weight loss. However, the adaptation response in the group receiving the glutamine-enriched diet was not improved over that for the group fed regular chow.

未标示:短肠综合征会导致显著的代谢改变,损害营养状况。谷氨酰胺被认为是肠细胞必需的营养物质,因此从饮食中补充谷氨酰胺的有益作用是假设的。目的:在本研究中,通过分析术后体重减轻和肠道绒毛高度、隐窝深度、十二指肠和残余空肠粘膜厚度的形态计量学,评估了富含谷氨酰胺的饮食对大鼠进行广泛小肠切除术的影响。方法:雄性Wistar大鼠分别饲喂含谷氨酰胺、不含谷氨酰胺和实验室日粮标准日粮。所有动物都进行了广泛的小肠切除术,包括回盲瓣,留下距幽门仅25厘米的残余空肠,与上升结肠侧侧吻合。实验开始和结束时(术后第20天)称重。然后杀死它们,取出残余的肠子。取残肠十二指肠和空肠黏膜切片,行组织病理学检查。使用连接光学显微镜的数字系统(KS 300)完成肠黏膜的形态计量学研究。形态测量包括绒毛高度、隐窝深度和肠黏膜总厚度。结果:3组患者的减重比较无明显差异。形态计量学研究表明,谷氨酰胺组的十二指肠绒毛明显高于没有谷氨酰胺的组,但与标准饮食组没有差异。谷氨酰胺富饲粮组的绒毛高度、隐窝深度和残余空肠黏膜厚度均大于不加谷氨酰胺组,但与标准饲粮组差异不显著。结论:在实验产生的短肠综合征大鼠中,等氮试验饮食中谷氨酰胺的富集与肠黏膜适应反应的改善有关,但与体重减轻无关。然而,接受谷氨酰胺强化饮食组的适应反应并没有比正常饮食组改善。
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引用次数: 23
Endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris: immunoglobulin G heterogeneity detected by indirect immunofluorescence. 地方性叶状天疱疮和寻常型天疱疮:间接免疫荧光检测免疫球蛋白G异质性。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500005
Valéria Aoki, Milian H T Huang, Alexandre M Périgo, Lígia M I Fukumori, Celina W Maruta, Claudia G Santi, Zilda N P Oliveira, Evandro Rivitti

Unlabelled: Pemphigus are autoimmune intraepidermal blistering diseases in which immunoglobulin G (IgG) autoantibodies are directed against desmosomal glycoproteins. The aim of this study was to determine the IgG subclass profile of endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris utilizing indirect immunofluorescence.

Patients and methods: Twenty-five patients with pemphigus vulgaris, 25 with endemic pemphigus foliaceus (fogo selvagem), and 25 healthy controls were analyzed by indirect immunofluorescence for circulating autoantibodies (total IgG and its subclasses).

Results: Our data revealed a significant correlation (P <.05) of disease activity and autoantibody levels in both forms of pemphigus, i.e., negative titers related to clinical remission, whereas positive results related to active disease. Immunoglobulin G subclass analysis in fogo selvagem demonstrated that in patients in remission, 56% showed positive immunoglobulin G4; in active disease, immunoglobulin G4 was the predominant subclass (100% positive in all cases). The IgG subclass profile in pemphigus vulgaris showed that in patients in remission, only 10% were positive for immunoglobulin G4; in active disease, positivity for immunoglobulin G4 was present in 78% to 88% of the cases.

Conclusion: Subclass characterization of immunoglobulin G autoantibodies is a useful tool for pemphigus follow-up, since immunoglobulin G4 (IgG4) is the subclass that is closely related to recognition of pathogenic epitopes, and consequently with disease activity. Careful monitoring should be performed for fogo selvagem in clinical remission with a homogeneous IgG4 response, since this may indicate more frequent relapses.

未标记:天疱疮是一种自身免疫性表皮内疱性疾病,其中免疫球蛋白G (IgG)自身抗体直接针对桥粒糖蛋白。本研究的目的是利用间接免疫荧光测定地方性叶状天疱疮和寻常型天疱疮的IgG亚类谱。患者和方法:采用间接免疫荧光法对25例寻常型天疱疮、25例地方性叶状天疱疮(fogo selvagem)患者和25例健康对照进行循环自身抗体(总IgG及其亚类)检测。结论:免疫球蛋白G自身抗体的亚类特征是天疱疮随访的有用工具,因为免疫球蛋白G4 (IgG4)是与病原性表位识别密切相关的亚类,因此与疾病活性密切相关。对于临床缓解期IgG4均质应答的fogo selvagem,应进行仔细监测,因为这可能表明更频繁的复发。
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引用次数: 23
New method for evaluation of cutaneous sensibility in diabetic feet: preliminary report. 评价糖尿病足皮肤敏感性的新方法:初步报告。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500011
Marcus Castro Ferreira, Leandro Rodrigues, Klaus Fels

Unlabelled: Diabetic neuropathy is an important complication of the disease, responsible for ulceration and amputation of the foot. Prevention of these problems is difficult mainly because there is no method to correctly access sensibility on the skin of the foot. The introduction of the Pressure-Specified Sensory Device (PSSD) in the last decade made possible the measurement of pressure thresholds sensed by the patient, such as touch, both static and in movement, on a continuous scale. This paper is the first in Brazil to report the use of this device to measure cutaneous sensibility in 3 areas of the foot: the hallux pulp, the calcaneus, and the dorsum, which are territories of the tibial and fibular nerves.

Method: Non-diabetic patients were measured as controls, and 2 groups of diabetic patients - with and without ulcers - were compared. The PSSD was used to test the 3 areas described above. The following were evaluated: 1 PS (1-point static), 1 PD (1-point dynamic), 2 PS (2-points static), 2 PD (2-points dynamic).

Results: The diabetic group had poorer sensibility compared to controls and diabetics with ulcers had poorer sensibility when compared to diabetics without ulcers. The differences were statistically significant (P <.001).

Conclusion: Due to the small number of patients compared, the results should be taken as a preliminary report.

未标记:糖尿病神经病变是该疾病的重要并发症,可导致足部溃疡和截肢。预防这些问题是困难的,主要是因为没有办法正确地接触足部皮肤的敏感性。在过去十年中,压力指定传感设备(PSSD)的引入使得测量患者感知的压力阈值成为可能,例如触摸,静态和运动,在连续范围内。这篇论文是巴西首次报道使用该装置测量足部3个区域的皮肤敏感性:拇髓、跟骨和背,这些区域是胫骨和腓骨神经的领地。方法:以非糖尿病患者为对照,比较两组糖尿病患者有无溃疡。PSSD用于测试上述3个区域。评估如下:1 PS(1分静态),1 PD(1分动态),2 PS(2分静态),2 PD(2分动态)。结果:糖尿病组与对照组相比敏感性较差,有溃疡的糖尿病患者与无溃疡的糖尿病患者相比敏感性较差。结论:由于比较的患者数量较少,该结果可作为初步报告。
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引用次数: 32
Renal and urinary findings in 20 patients with Williams-Beuren syndrome diagnosed by fluorescence in situ hybridization (FISH). 荧光原位杂交(FISH)诊断的20例Williams-Beuren综合征患者的肾脏和泌尿系统检查。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500008
Sofia Mizuho Miura Sugayama, Vera Hermina Kalika Koch, Erica Arai Furusawa, Cláudio Leone, Chong Ae Kim

Purpose: Williams-Beuren syndrome is a rare multiple anomalies/mental retardation syndrome caused by deletion of contiguous genes at chromosome region 7q11.23. The aim of this work was to determine the frequency and the types of renal and urinary tract anomalies in 20 patients with Williams-Beuren syndrome.

Methods: The fluorescence in situ hybridization test using a LSI Williams syndrome region DNA probe was performed for all 20 patients to confirm the diagnosis of Williams-Beuren syndrome. A prospective study was performed in order to investigate renal and urinary aspects using laboratory assays to check renal function, ultrasonography of the kidneys and urinary tract, voiding cystourethrogram and urodynamics.

Results: Deletion of the elastin gene (positive fluorescence in situ hybridization test) was found in 17 out of 20 patients. Renal alterations were diagnosed in 5 of 17 (29%) the patients with the deletion and in 1 of 3 patients without the deletion. Fourteen patients with the deletion presented dysfunctional voiding. Arterial hypertension was diagnosed in 3 patients with deletions and 1 of these presented bilateral stenosis of the renal arteries.

Conclusions: Due to the high incidence of renal and urinary abnormalities in Williams-Beuren syndrome, performing a systematic laboratory and sonographic evaluation of the patients is recommended.

目的:Williams-Beuren综合征是一种罕见的由染色体7q11.23区域连续基因缺失引起的多发性异常/智力低下综合征。本研究的目的是确定20例Williams-Beuren综合征患者肾脏和尿路异常的频率和类型。方法:采用LSI Williams综合征区DNA探针对20例患者进行荧光原位杂交检测,确认Williams- beuren综合征的诊断。为了调查肾脏和泌尿方面的前瞻性研究进行了实验室检查肾功能,超声检查肾脏和尿路,排尿膀胱尿道造影和尿动力学。结果:弹性蛋白基因缺失(荧光原位杂交试验阳性)17例。17例缺失患者中有5例(29%)诊断出肾脏改变,3例未缺失患者中有1例诊断出肾脏改变。14例缺失患者出现排尿功能障碍。3例缺失患者被诊断为动脉高血压,其中1例表现为双侧肾动脉狭窄。结论:由于Williams-Beuren综合征中肾脏和泌尿系统异常的高发,建议对患者进行系统的实验室和超声检查。
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引用次数: 22
Oropharyngeal colonization by Haemophilus influenzae in healthy children from Taubaté (São Paulo), prior to the Haemophilus influenzae type B vaccination program in Brazil. 在巴西实施B型流感嗜血杆菌疫苗接种计划之前,taubat<e:1>(圣保罗)健康儿童的流感嗜血杆菌口咽定植。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500003
Lucia Ferro Bricks, Caio Márcio Figueredo Mendes, Bianca Rezende Lucarevschi, Carmem Paz Oplustil, Rosemeire C Zanella, Adriana Bori, Ciro João Bertoli

Unlabelled: Haemophilus influenzae is one of the most important bacterial agents of otitis and sinusitis. H. influenzae type b (Hib) is one of the main causes of meningitis, pneumonia, and septicemia in nonvaccinated children under 6 years of age. The aims of this study were to determine the prevalence of H. influenzae and Hib oropharyngeal colonization prior to the onset of the Hib vaccination program in Brazil in previously healthy children and to assess the susceptibility profile of this microorganism to a selected group of antimicrobials that are used to treat acute respiratory infections.

Method: Cultures of Haemophilus influenzae were made from oropharynx swabs from 987 children under 6 years of age who were enrolled in 29 day-care centers in Taubaté (a city of São Paulo state, Brazil) between July and December 1998.

Results: The prevalence of H. influenzae carriers was 17.4%, and only 5.5% of the strains were beta-lactamase producers. The prevalence of Hib carriers was high, 7.3% on average (range, 0.0 - 33.3%).

Conclusions: The low prevalence of colonization by penicillin-resistant strains indicates that it is not necessary to substitute ampicilin or amoxicilin to effectively treat otitis and sinusitis caused by H. influenzae in Taubaté.

未标示:流感嗜血杆菌是引起中耳炎和鼻窦炎最重要的细菌之一。b型流感嗜血杆菌(Hib)是未接种疫苗的6岁以下儿童脑膜炎、肺炎和败血症的主要病因之一。本研究的目的是在巴西开展Hib疫苗接种计划之前确定流感嗜血杆菌和Hib口咽定植的流行情况,并评估这种微生物对用于治疗急性呼吸道感染的选定抗微生物药物的敏感性。方法:对1998年7月至12月在taubat(巴西圣保罗州市)29个日托中心登记的987名6岁以下儿童的口咽拭子进行流感嗜血杆菌培养。结果:流感嗜血杆菌携带者的感染率为17.4%,产生β -内酰胺酶的菌株仅占5.5%。Hib带菌者患病率高,平均7.3%(范围:0.0 ~ 33.3%)。结论:流感嗜血杆菌引起的中耳炎和鼻窦炎,由于耐青霉素菌株的定植率较低,没有必要替代氨苄西林或阿莫西林。
{"title":"Oropharyngeal colonization by Haemophilus influenzae in healthy children from Taubaté (São Paulo), prior to the Haemophilus influenzae type B vaccination program in Brazil.","authors":"Lucia Ferro Bricks,&nbsp;Caio Márcio Figueredo Mendes,&nbsp;Bianca Rezende Lucarevschi,&nbsp;Carmem Paz Oplustil,&nbsp;Rosemeire C Zanella,&nbsp;Adriana Bori,&nbsp;Ciro João Bertoli","doi":"10.1590/s0041-87812004000500003","DOIUrl":"https://doi.org/10.1590/s0041-87812004000500003","url":null,"abstract":"<p><strong>Unlabelled: </strong>Haemophilus influenzae is one of the most important bacterial agents of otitis and sinusitis. H. influenzae type b (Hib) is one of the main causes of meningitis, pneumonia, and septicemia in nonvaccinated children under 6 years of age. The aims of this study were to determine the prevalence of H. influenzae and Hib oropharyngeal colonization prior to the onset of the Hib vaccination program in Brazil in previously healthy children and to assess the susceptibility profile of this microorganism to a selected group of antimicrobials that are used to treat acute respiratory infections.</p><p><strong>Method: </strong>Cultures of Haemophilus influenzae were made from oropharynx swabs from 987 children under 6 years of age who were enrolled in 29 day-care centers in Taubaté (a city of São Paulo state, Brazil) between July and December 1998.</p><p><strong>Results: </strong>The prevalence of H. influenzae carriers was 17.4%, and only 5.5% of the strains were beta-lactamase producers. The prevalence of Hib carriers was high, 7.3% on average (range, 0.0 - 33.3%).</p><p><strong>Conclusions: </strong>The low prevalence of colonization by penicillin-resistant strains indicates that it is not necessary to substitute ampicilin or amoxicilin to effectively treat otitis and sinusitis caused by H. influenzae in Taubaté.</p>","PeriodicalId":76453,"journal":{"name":"Revista do Hospital das Clinicas","volume":"59 5","pages":"236-43"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24812203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Comparison of catheter-related infection risk in two different long-term venous devices in adult hematology-oncology patients. 两种不同的长期静脉装置在成人血液肿瘤患者导管相关感染风险的比较。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500012
Luís Fernando Pracchia, Lúcia Cristina Santos Dias, Pedro Enrique Dorlhiac-Llacer, Dalton de Alencar Fisher Chamone

Purpose: Infection is the leading complication of long-term central venous catheters, and its incidence may vary according to catheter type. The objective of this study was to compare the frequency and probability of infection between two types of long-term intravenous devices.

Methods: Retrospective study in 96 onco-hematology patients with partially implanted catheters (n = 55) or completely implanted ones (n = 42). Demographic data and catheter care were similar in both groups. Infection incidence and infection-free survival were used for the comparison of the two devices.

Results: In a median follow-up time of 210 days, the catheter-related infection incidence was 0.2102/100 catheter-days for the partially implanted devices and 0.0045/100 catheter-days for the completely implanted devices; the infection incidence rate was 46.7 (CI 95% = 6.2 to 348.8). The 1-year first infection-free survival ratio was 45% versus 97%, and the 1-year removal due to infection-free survival ratio was 42% versus 97% for partially and totally implanted catheters, respectively (P <.001 for both comparisons).

Conclusion: In the present study, the infection risk was lower in completely implanted devices than in partially implanted ones.

目的:感染是长期中心静脉置管的主要并发症,其发生率随置管类型的不同而不同。本研究的目的是比较两种类型的长期静脉注射设备感染的频率和概率。方法:回顾性分析96例部分植入导管或完全植入导管的肿瘤血液病患者。两组的人口学数据和导管护理相似。比较两种装置的感染发生率和无感染生存率。结果:中位随访时间为210 d,部分植入器导管相关感染发生率为0.2102/100导管-d,完全植入器导管相关感染发生率为0.0045/100导管-d;感染发生率为46.7 (CI 95% = 6.2 ~ 348.8)。1年首次无感染生存率分别为45%和97%,1年无感染清除生存率分别为42%和97% (P结论:本研究中,完全植入的导管感染风险低于部分植入的导管。
{"title":"Comparison of catheter-related infection risk in two different long-term venous devices in adult hematology-oncology patients.","authors":"Luís Fernando Pracchia,&nbsp;Lúcia Cristina Santos Dias,&nbsp;Pedro Enrique Dorlhiac-Llacer,&nbsp;Dalton de Alencar Fisher Chamone","doi":"10.1590/s0041-87812004000500012","DOIUrl":"https://doi.org/10.1590/s0041-87812004000500012","url":null,"abstract":"<p><strong>Purpose: </strong>Infection is the leading complication of long-term central venous catheters, and its incidence may vary according to catheter type. The objective of this study was to compare the frequency and probability of infection between two types of long-term intravenous devices.</p><p><strong>Methods: </strong>Retrospective study in 96 onco-hematology patients with partially implanted catheters (n = 55) or completely implanted ones (n = 42). Demographic data and catheter care were similar in both groups. Infection incidence and infection-free survival were used for the comparison of the two devices.</p><p><strong>Results: </strong>In a median follow-up time of 210 days, the catheter-related infection incidence was 0.2102/100 catheter-days for the partially implanted devices and 0.0045/100 catheter-days for the completely implanted devices; the infection incidence rate was 46.7 (CI 95% = 6.2 to 348.8). The 1-year first infection-free survival ratio was 45% versus 97%, and the 1-year removal due to infection-free survival ratio was 42% versus 97% for partially and totally implanted catheters, respectively (P <.001 for both comparisons).</p><p><strong>Conclusion: </strong>In the present study, the infection risk was lower in completely implanted devices than in partially implanted ones.</p>","PeriodicalId":76453,"journal":{"name":"Revista do Hospital das Clinicas","volume":"59 5","pages":"291-5"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24812639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Microsatellite instability in solitary and sporadic gastric cancer. 孤立和散发性胃癌的微卫星不稳定性。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500010
Rodrigo Oliva Perez, Carlos Eduardo Jacob, Fabricio L'ofreddo D'Ottaviano, Conrado Alvarenga, Adriana Safatle Ribeiro, Ulysses Ribeiro, Cláudio José Caldas Bresciani, Bruno Zilberstein, José Eduardo Krieger, Angelita Habr-Gama, Joaquim José Gama-Rodrigues

Unlabelled: Recently, the presence of microsatellite instability (MSI) has been reported in gastric cancer and associated with older age of presentation, distal tumor location, early disease staging, and better overall prognosis. Different characteristics in presentation and in tumor behavior may be explained by different genetic alterations during carcinogenesis of gastric cancer. Identification of specific genetic pathways in gastric cancer may have direct impact on prognosis and selection of treatment strategies.

Patients and methods: All 24 patients were treated by radical surgery. Fragments of normal and tumor tissues were extracted from the specimen and stored at -80 degrees C before DNA purification and extraction. PCR amplification utilizing microsatellite markers was performed. Tumors presenting PCR products of abnormal sizes were considered positive for microsatellite instability (MSI+).

Results: Five patients (21%) had tumors that were MSI+ in at least 1 marker. In the group of patients with Lauren's intestinal-type gastric carcinoma, 3 had tumors that were MSI+ (23%), while in the group of diffuse-type gastric cancer, 2 patients had tumors that were MSI+ (19%). The mean age of presentation and the male:female ratio was similar in both groups. Tumors that were MSI+ were more frequently located in proximal portion of the stomach compared to microsatellite-stable (MSS) tumors (40% vs. 16%). Although there was a trend of patients with MSI+ tumors towards a proximal gastric tumor location, early staging, and negative lymph node metastasis, there was no statistical significance compared to those with MSS tumors (P >.1). Comparison of overall and disease-free survival between gastric tumors that were MSI+ and those that were MSS found no statistically significant differences (P >.1).

Conclusions: Microsatellite instability is a frequent event in gastric carcinogenesis and shows a trend towards distinct clinical and pathological characteristics of gastric cancer.

未标记:最近,微卫星不稳定性(MSI)在胃癌中的存在被报道,并与年龄较大、肿瘤远端位置、早期疾病分期和更好的整体预后相关。胃癌发生过程中不同的基因改变可能解释其表现和肿瘤行为的不同特征。胃癌特异性遗传通路的确定可能直接影响预后和治疗策略的选择。患者及方法:24例患者均行根治性手术治疗。从标本中提取正常组织和肿瘤组织片段,在-80℃保存,然后进行DNA纯化和提取。利用微卫星标记进行PCR扩增。出现异常大小PCR产物的肿瘤被认为是微卫星不稳定性(MSI+)阳性。结果:5例患者(21%)的肿瘤在至少1项标志物上为MSI+。Lauren氏肠型胃癌组3例肿瘤为MSI+(23%),弥漫性胃癌组2例肿瘤为MSI+(19%)。两组患者的平均发病年龄和男女比例相似。与微卫星稳定(MSS)肿瘤相比,MSI+肿瘤更常位于胃近端(40%对16%)。虽然MSI+肿瘤患者有向胃近端肿瘤位置、早期分期、淋巴结转移阴性的趋势,但与MSS肿瘤患者相比,差异无统计学意义(P > 1)。MSI+组与MSS组的总生存期和无病生存期比较,差异无统计学意义(P > 1)。结论:微卫星不稳定性是胃癌发生过程中常见的事件,具有胃癌独特的临床和病理特征。
{"title":"Microsatellite instability in solitary and sporadic gastric cancer.","authors":"Rodrigo Oliva Perez,&nbsp;Carlos Eduardo Jacob,&nbsp;Fabricio L'ofreddo D'Ottaviano,&nbsp;Conrado Alvarenga,&nbsp;Adriana Safatle Ribeiro,&nbsp;Ulysses Ribeiro,&nbsp;Cláudio José Caldas Bresciani,&nbsp;Bruno Zilberstein,&nbsp;José Eduardo Krieger,&nbsp;Angelita Habr-Gama,&nbsp;Joaquim José Gama-Rodrigues","doi":"10.1590/s0041-87812004000500010","DOIUrl":"https://doi.org/10.1590/s0041-87812004000500010","url":null,"abstract":"<p><strong>Unlabelled: </strong>Recently, the presence of microsatellite instability (MSI) has been reported in gastric cancer and associated with older age of presentation, distal tumor location, early disease staging, and better overall prognosis. Different characteristics in presentation and in tumor behavior may be explained by different genetic alterations during carcinogenesis of gastric cancer. Identification of specific genetic pathways in gastric cancer may have direct impact on prognosis and selection of treatment strategies.</p><p><strong>Patients and methods: </strong>All 24 patients were treated by radical surgery. Fragments of normal and tumor tissues were extracted from the specimen and stored at -80 degrees C before DNA purification and extraction. PCR amplification utilizing microsatellite markers was performed. Tumors presenting PCR products of abnormal sizes were considered positive for microsatellite instability (MSI+).</p><p><strong>Results: </strong>Five patients (21%) had tumors that were MSI+ in at least 1 marker. In the group of patients with Lauren's intestinal-type gastric carcinoma, 3 had tumors that were MSI+ (23%), while in the group of diffuse-type gastric cancer, 2 patients had tumors that were MSI+ (19%). The mean age of presentation and the male:female ratio was similar in both groups. Tumors that were MSI+ were more frequently located in proximal portion of the stomach compared to microsatellite-stable (MSS) tumors (40% vs. 16%). Although there was a trend of patients with MSI+ tumors towards a proximal gastric tumor location, early staging, and negative lymph node metastasis, there was no statistical significance compared to those with MSS tumors (P >.1). Comparison of overall and disease-free survival between gastric tumors that were MSI+ and those that were MSS found no statistically significant differences (P >.1).</p><p><strong>Conclusions: </strong>Microsatellite instability is a frequent event in gastric carcinogenesis and shows a trend towards distinct clinical and pathological characteristics of gastric cancer.</p>","PeriodicalId":76453,"journal":{"name":"Revista do Hospital das Clinicas","volume":"59 5","pages":"279-85"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24812133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study. 根治性耻骨后前列腺切除术后7或14天拔除导尿管:一项随机研究的临床意义和并发症
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500007
Carlos Ary Vargas Souto, Ernani Luis Rhoden, Rafael De Conti, Mário Chammas, Sandro Eduardo Laste, Alexandre Fornari, Eduardo Porto Ribeiro, Liana Scholl, Claudio Teloken, José Carlos Stumpf Souto

Purpose: To evaluate the hypothesis that a 7-day period of indwelling catheter after radical retropubic prostatectomy is effective and safe without the need of performing cystography.

Methods: In the period from January of 2000 to July of 2002, 73 patients underwent radical retropubic prostatectomy, and these patients were prospectively randomized in 2 groups: Group 1-37 patients who had the urethral catheter removed 7 days after the procedure, and Group 2-36 patients who had the catheter removed 14 days after the surgery. The 2 groups were similar, the surgeons and the technique were the same, and no cystography was performed to evaluate the presence of leaks.

Results: Two patients in Group 1 had bleeding and clot retention after having the catheter taken out in the seventh postoperative day and were managed by putting the catheter back in for 7 more days. Two patients in Group 2 developed bladder neck stricture and were treated by bladder neck incision with success. The continence rate was the same, with 2 cases of incontinence in each group. About 2 pads a day were used by the patients with incontinence. The average follow-up was 17.5 months (12-36 months). No urinary fistula, urinoma, or pelvic abscesses developed after catheter removal. Two patients were excluded from the analysis of this series: 1 died with a pulmonary embolus in the third postoperative day, and 1 developed a urinary suprapubic fistula before catheter withdrawal, which was maintained for 16 days.

Conclusion: Withdrawal of the urethral catheter 7 days after radical retropubic prostatectomy, without performing cystography, has a low rate of short-term complications that are equivalent to withdrawal 14 days after the surgery.

目的:评价根治性耻骨后前列腺切除术后留置导尿管7天不需膀胱造影的有效性和安全性。方法:对2000年1月~ 2002年7月行根治性耻骨后前列腺切除术的73例患者进行前瞻性随机分组,1 ~ 37组患者术后7天拔除导尿管,2 ~ 36组患者术后14天拔除导尿管。两组相似,外科医生和技术相同,均未进行膀胱造影以评估是否存在渗漏。结果:1组2例患者术后第7天拔管后出现出血、血块潴留,术后7天继续拔管。第二组2例患者膀胱颈狭窄,均行膀胱颈切开治疗,均成功。两组尿失禁发生率相同,均为2例。尿失禁患者每天约使用2个尿垫。平均随访17.5个月(12 ~ 36个月)。拔管后无尿瘘、尿瘤或盆腔脓肿。2例患者被排除在本系列分析之外:1例在术后第3天因肺栓塞死亡,1例在拔管前出现尿耻骨上瘘,并维持了16天。结论:根治性耻骨后前列腺切除术后7天不行膀胱造影,撤置导尿管短期并发症发生率低,与术后14天撤置导尿管发生率相当。
{"title":"Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study.","authors":"Carlos Ary Vargas Souto,&nbsp;Ernani Luis Rhoden,&nbsp;Rafael De Conti,&nbsp;Mário Chammas,&nbsp;Sandro Eduardo Laste,&nbsp;Alexandre Fornari,&nbsp;Eduardo Porto Ribeiro,&nbsp;Liana Scholl,&nbsp;Claudio Teloken,&nbsp;José Carlos Stumpf Souto","doi":"10.1590/s0041-87812004000500007","DOIUrl":"https://doi.org/10.1590/s0041-87812004000500007","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the hypothesis that a 7-day period of indwelling catheter after radical retropubic prostatectomy is effective and safe without the need of performing cystography.</p><p><strong>Methods: </strong>In the period from January of 2000 to July of 2002, 73 patients underwent radical retropubic prostatectomy, and these patients were prospectively randomized in 2 groups: Group 1-37 patients who had the urethral catheter removed 7 days after the procedure, and Group 2-36 patients who had the catheter removed 14 days after the surgery. The 2 groups were similar, the surgeons and the technique were the same, and no cystography was performed to evaluate the presence of leaks.</p><p><strong>Results: </strong>Two patients in Group 1 had bleeding and clot retention after having the catheter taken out in the seventh postoperative day and were managed by putting the catheter back in for 7 more days. Two patients in Group 2 developed bladder neck stricture and were treated by bladder neck incision with success. The continence rate was the same, with 2 cases of incontinence in each group. About 2 pads a day were used by the patients with incontinence. The average follow-up was 17.5 months (12-36 months). No urinary fistula, urinoma, or pelvic abscesses developed after catheter removal. Two patients were excluded from the analysis of this series: 1 died with a pulmonary embolus in the third postoperative day, and 1 developed a urinary suprapubic fistula before catheter withdrawal, which was maintained for 16 days.</p><p><strong>Conclusion: </strong>Withdrawal of the urethral catheter 7 days after radical retropubic prostatectomy, without performing cystography, has a low rate of short-term complications that are equivalent to withdrawal 14 days after the surgery.</p>","PeriodicalId":76453,"journal":{"name":"Revista do Hospital das Clinicas","volume":"59 5","pages":"262-5"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/s0041-87812004000500007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24812127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Influence of nephrotic state on the infectious profile in childhood idiopathic nephrotic syndrome. 肾病状态对儿童特发性肾病综合征感染谱的影响。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500009
Emilia Maria Dantas Soeiro, Vera Hermina Koch, Maria Danisi Fujimura, Yassuhiko Okay

Unlabelled: Patients with idiopathic nephrotic syndrome present alterations in their cellular and humoral immune reactions that predispose them to the development of infectious processes.

Purpose: To characterize the infectious processes in patients with idiopathic nephrotic syndrome.

Patients and methods: Ninety-two children and adolescents with idiopathic nephrotic syndrome were assessed retrospectively. The types of infection were grouped as follows: upper respiratory tract infections; pneumonia; skin infections; peritonitis; diarrhea; urinary tract infection ; herpes virus; and others. The patients were divided into 2 groups: Group I (steroid-responsive) n = 75, with 4 subgroups-IA (single episode) n = 10, IB (infrequent relapsers) n = 5, IC (frequent relapsers) n = 14, and ID (steroid-dependent) n = 46; and Group II (steroid-resistant) n = 17. The incidence-density of infection among the patients was assessed throughout the follow-up period. Comparisons for each group and subgroup were done during the periods of negative and nephrotic proteinuria.

Results: The analysis revealed a greater incidence-density of infections during the period of nephrotic proteinuria in all the groups and subgroups, with the exception of subgroup IA. During the period of nephrotic proteinuria, subgroups IC, ID, and Group II presented a greater incidence-density of infections as compared to subgroup IA. For the period of negative proteinuria, there was no difference in the incidence-density of infections between the groups and subgroups. Upper respiratory tract infections were the most frequent infectious processes.

Conclusion: The nephrotic condition, whether as part of a course of frequent relapses, steroid dependence, or steroid resistance, conferred greater susceptibility to infection among the patients with idiopathic nephrotic syndrome. The results of this study suggest that the best preventive action against infection in this disease is to control the nephrotic state.

未标记:特发性肾病综合征患者在细胞和体液免疫反应中表现出改变,使他们易患感染过程。目的:探讨特发性肾病综合征患者的感染过程。患者和方法:回顾性分析92例特发性肾病综合征的儿童和青少年。感染类型分为:上呼吸道感染;肺炎;皮肤感染;腹膜炎;腹泻;尿路感染;疱疹病毒;和其他人。将患者分为2组:I组(类固醇反应)75例,4个亚组:ia(单次发作)10例,IB(罕见复发)5例,IC(频繁复发)14例,ID(类固醇依赖)46例;II组(类固醇耐药)n = 17。在整个随访期间评估患者感染的发生率-密度。在蛋白尿阴性和肾病期间对各组和亚组进行比较。结果:分析显示,除IA亚组外,所有组和亚组在肾病蛋白尿期间感染的发生率密度均较大。在肾病蛋白尿期间,与IA亚组相比,IC、ID和II亚组的感染发生率-密度更高。在蛋白尿阴性期间,各组和亚组之间感染的发生率密度没有差异。上呼吸道感染是最常见的感染过程。结论:肾病状况,无论是作为频繁复发,类固醇依赖或类固醇抵抗过程的一部分,赋予特发性肾病综合征患者更大的感染易感性。本研究结果提示,预防本病感染的最佳措施是控制肾病状态。
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引用次数: 36
Low coronary perfusion pressure is associated with endocardial fibrosis in a rat model of volume overload cardiac hypertrophy. 在容量过负荷心肌肥厚大鼠模型中,低冠状动脉灌注压与心内膜纤维化有关。
Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI: 10.1590/s0041-87812004000500002
Maria Carolina Guido, Márcia Kiyomi Koike, Clovis de Carvalho Frimm

Unlabelled: Left ventricular hypertrophy following volume overload is regarded as an example of cardiac remodeling without increased fibrosis accumulation. However, infarction is associated with increased fibrosis within the noninfarcted, hypertrophied myocardium, particularly in the subendocardial regions. It is conceivable to suppose that, as also occurs postinfarction, low coronary driving pressure may also interfere with accumulation of myocardial fibrosis following aortocaval fistula.

Purpose: To investigate the role of acute hemodynamic changes in subsequent deposition of cardiac fibrosis in response to aortocaval fistula.

Method: Aortocaval fistula were created in 4 groups of Wistar rats that were followed over 4 and 8 weeks: aortocaval fistula 4 and aortocaval fistula 8 (10 rats each) and their respective controls (sham-operated controls - Sh), Sh4 and Sh8 (8 rats each). Hemodynamic measurements were performed 1 week after surgery. Hypertrophy and fibrosis were quantified by myocyte diameter and collagen volume fraction at the end of follow up.

Result: Compared with Sh4 and Sh8, pulse pressure, left ventricular end-diastolic pressure, and +dP/dt were higher in aortocaval fistula 4 and aortocaval fistula 8, but -dP/dt was similar. Coronary driving pressure (mm Hg), used as an estimate of perfusion pressure, was lower in aortocaval fistula 8 (52.6 +/- 4.1) than in Sh8 (100.8 +/- 1.3), but comparable between aortocaval fistula 4 (50.0 +/- 8.9) and Sh4 (84.8 +/- 2.3). Myocyte diameter was greater in aortocaval fistula 8, whereas interstitial and subendocardial fibrosis were greater in aortocaval fistula 4 and aortocaval fistula 8. Coronary driving pressure correlated inversely and independently with subendocardial fibrosis (r(2) = .86, P <.001), whereas left ventricular systolic pressure (r(2) = 0.73, P = .004) and end-diastolic pressure (r(2) = 0.55, P = 012) correlated positively and independently with interstitial fibrosis.

Conclusion: Coronary driving pressure falls and ventricular pressures increase early after aortocaval fistula and are associated with subsequent myocardial fibrosis deposition.

未标记:容量超载后左心室肥厚被认为是心脏重构的一个例子,但没有增加纤维化积累。然而,梗死与非梗死肥厚心肌纤维化增加有关,特别是在心内膜下区域。可以想象,正如梗死后发生的那样,低冠状动脉驱动压也可能干扰主动脉腔瘘后心肌纤维化的积累。目的:探讨急性血流动力学改变在主动脉下腔瘘后心肌纤维化沉积中的作用。方法:取Wistar大鼠造腹主动脉瘘4组、腹主动脉瘘8组(每组10只)及其对照(假手术对照Sh)、Sh4、Sh8组(每组8只),随访4、8周。术后1周进行血流动力学测量。随访结束时,用心肌细胞直径和胶原体积分数量化肥大和纤维化。结果:与Sh4、Sh8组相比,4、8组的脉压、左室舒张末压、+dP/dt均高于Sh4、Sh8组,但-dP/dt相差不大。冠状动脉驱动压(mm Hg),作为灌注压力的估计,主动脉腔瘘8组(52.6 +/- 4.1)低于Sh8组(100.8 +/- 1.3),但主动脉腔瘘4组(50.0 +/- 8.9)和Sh4组(84.8 +/- 2.3)之间具有可比性。主动脉腔瘘8的心肌细胞直径更大,而主动脉腔瘘4和主动脉腔瘘8的间质和心内膜下纤维化更大。冠状动脉驱动压与心内膜下纤维化呈负相关且独立相关(r(2) = 0.86, P)。结论:主动脉腔瘘后早期冠状动脉驱动压下降,心室压升高,并与随后的心肌纤维化沉积有关。
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引用次数: 6
期刊
Revista do Hospital das Clinicas
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