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RESUMO - RACIONAL: O estresse oxidativo é um dos principais mecanismos associados à ruptura dos mecanismos de defesa que formam a barreira epitelial cólica e reduz o conteúdo tecidual das proteínas claudina-3 e ocludina principais... more
RESUMO - RACIONAL: O estresse oxidativo é um dos principais mecanismos associados à ruptura dos mecanismos de defesa que formam a barreira epitelial cólica e reduz o conteúdo tecidual das proteínas claudina-3 e ocludina principais constituintes das junções de oclusão intercelulares. O sucralfato, possui atividade antioxidante e tem sido usado para tratar diferentes formas de colite. OBJETIVO: Mensurar o conteúdo tecidual de claudina-3 e ocludina da mucosa do cólon sem trânsito fecal, submetido à intervenção com sucralfato. MÉTODO: Trinta e seis ratos foram submetidos à colostomia do cólon esquerdo e fístula mucosa distal. Os animais foram divididos em dois grupos de acordo com a eutanásia ser realizada duas ou quatro semanas após a intervenção. Cada grupo foi dividido em três subgrupos de acordo com o tipo de intervenção realizada diariamente: solução salina isolada; sucralfato a 1 g/kg/dia ou sucralfato a 2g/kg/dia. A colite foi diagnosticada por análise histológica adotando escala...
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The restoration of intestinal transit after the Hartmann procedure (HP) has high rates of complications.1 Anastomotic leakage is the most feared due to its high morbidity and mortality rates.1 Several hypotheses have been proposed to... more
The restoration of intestinal transit after the Hartmann procedure (HP) has high rates of complications.1 Anastomotic leakage is the most feared due to its high morbidity and mortality rates.1 Several hypotheses have been proposed to explain the high incidence of leakage. Among them, the reduction of collagen content in colorectal segments without fecal stream (WTFS) has been given special attention.2,3 A reduction in collagen content in segments WTFS is related to a lack of supply of short-chain fatty acids (SCFAs) and its degradation by overproduction of collagenases due to inflammation.2,3 Strategies that reduce inflammation in segments WTFS may reduce collagen degradation, increasing its content. Studies in a diversion proctitis (DP) model have shown that infliximab reduces inflammation and the production of collagenases in segments WTFS.3,4 However, its effects on the content of type-I and type-III collagen have not yet been studied. Method
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Diversion colitis (DC) is an inflammatory disease that occurs in colonic segments without fecal stream (WFS). 1 The lack of supply of short-chain fatty acids (SCFAs) to the cells of mucosa WFS causes changes in energy metabolism with the... more
Diversion colitis (DC) is an inflammatory disease that occurs in colonic segments without fecal stream (WFS). 1 The lack of supply of short-chain fatty acids (SCFAs) to the cells of mucosa WFS causes changes in energy metabolism with the overproduction of reactive oxygen species (ROS). ROS leads to oxidative tissue damage with the development of mucosal inflammatory process. 2 Infliximab has anti-inflammatory and antioxidant activities and represents one of the most effective strategies for the treatment of inflammatory bowel disease, but little is known about its use in DC. Method
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Research Interests: Surgery, Gastroenterology, Medicine, Mucin, Clinical Sciences, and 6 moreColitis, Rats, Mucins, Mesalamine, ENEMA, and Mesalazine
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Perianal Paget's disease (PPD) is a rare intraepithelial adenocarcinoma of the anal margin. Primary PPD likely represents intra-epithelial neoplasm from an apocrine source, whereas secondary disease may represent "pagetoid"... more
Perianal Paget's disease (PPD) is a rare intraepithelial adenocarcinoma of the anal margin. Primary PPD likely represents intra-epithelial neoplasm from an apocrine source, whereas secondary disease may represent "pagetoid" spread from an anorectal malignancy. Histologic CDX-2 and CK20 are hallmark markers for colorectal-derived Paget's cells. Interestingly, our primary PPD patient presented both positive and no internal malignancy was identified. In addition, a negative CK7 marker was observed in our case in contrast with previously reported. Surgical excision is the standard treatment; however, previous studies have demonstrated good response with Imiquimod 5% cream in patients with vulval extramammary Paget disease (EMPD). The efficiency of Imiquimod treatment for PPD has not been well described. Our PPD patient was successfully treated using Imiquimod 5% cream. This study describes a primary cutaneous PPD patient CDX-2+/CK20+/CK7- without invasion of the dermis...
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In addition to the presence of neoplasia in the colon and rectum, patients with familial adenomatous polyposis (FAP) may develop numerous polyps and carcinoma within the upper gastrointestinal tract. The aim of the present paper was to... more
In addition to the presence of neoplasia in the colon and rectum, patients with familial adenomatous polyposis (FAP) may develop numerous polyps and carcinoma within the upper gastrointestinal tract. The aim of the present paper was to review the incidence advanced duodenal polyposis or cancer and their surgical outcomes. A retrospective review of patients' records from our department was performed. Information was retrieved from a prospective collected data, including clinical (gender, age, family history), endoscopic [association with colorectal cancer (CRC), polyposis severity, age at diagnosis] and surgical management (age, time from the index surgery, type of procedure, morbidity). Duodenal adenomatosis at the time of surgery was classified according to Spigelman stages. In a group of 145 FAP patients, 8 (5.5%) had been surgically treated for duodenal advanced neoplasia [3] or cancer [5]. There were included 2 women and 6 men whose first endoscopic examination and diagnosis...
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Purpose To verify if the application of enemas containing oily extracts of curcumin preserves the tissue content of mucins in the glands of the colonic mucosa without fecal stream. Method Thirty-six Wistar rats were submitted to diversion... more
Purpose To verify if the application of enemas containing oily extracts of curcumin preserves the tissue content of mucins in the glands of the colonic mucosa without fecal stream. Method Thirty-six Wistar rats were submitted to diversion of the fecal stream by proximal colostomy and distal mucous fistula. The animals were subdivided into three groups, and accordingly received enemas with saline and oily extract of curcumin at concentrations of 50 mg/kg/day or 200 mg/kg/day. After two or four weeks of intervention, the irrigated colic segments were removed. Neutral and acidic mucins were identified by Periodic-acid Schiff and Alcian-Blue techniques, respectively. The content of both mucin subtypes was measured by computerized morphometry. Mann–Whitney test was used to analyze the results, adopting a significance level of 5% (p ≤ 0.05). Results There was an increase in the tissue content of neutral mucins in animals treated with curcumin at a concentration of 50 mg/kg/day for four we...
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Background: MTUYH and OGG1 genes have importance in the base excision repair systems of oxidized DNA bases. Modification of the tissue expression of these genes is related to the increased risk of developing colorectal cancer. Aim: To... more
Background: MTUYH and OGG1 genes have importance in the base excision repair systems of oxidized DNA bases. Modification of the tissue expression of these genes is related to the increased risk of developing colorectal cancer. Aim: To evaluate the tissue expression of MUTYH and OGG1 comparing normal and neoplastic tissues of patients with sporadic colorectal cancer and to correlate it with clinical and histopathological variables. Method: MUTYH and OGG1 tissue expression was quantified by RT-PCR in patients with colorectal cancer and the values were compared in normal and neoplastic tissues. MUTYH and OGG1 expression was measured and normalized to the constitutive 18S gene. The level of expression of both genes was correlated with the variables: age, gender, tumor location, size of the tumor, histological type, degree of cell differentiation, invasion depth in the intestinal wall, angiolymphatic infiltration, lymph node involvement and TNM staging. Results: Was found downregulation ...
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To investigate the relationship between beta-catenin and E-cadherin tissue quantitative expression (content) in tumors and clinical prognostic factors in patients with left colon cancer. Twenty nine patients with colon adenocarcinoma... more
To investigate the relationship between beta-catenin and E-cadherin tissue quantitative expression (content) in tumors and clinical prognostic factors in patients with left colon cancer. Twenty nine patients with colon adenocarcinoma located distal to the splenic flexure were studied. Diagnosis and histological variables related to adenocarcinoma prognosis were evaluated using hematoxylin-eosin. Beta-catenin and E-cadherin were analysed by immunohistochemistry with specific anti-beta-catenin and anti-E-cadherin monoclonal antibodies. Tissue quantitative expression (content) was determined by computer assisted image analysis method. Results were analysed with statistical tests, adopting a significance level of 5%. There are correlations between beta-catenin and TNM stage (p< 0.01). There are progressively greater amounts of beta-catenin in patients with deeper invasion of the tumor in colon layers (p=0.03), progressive lymph node involvement (p=0.05), as well as in patients with d...