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Damous SHB, Damous LL, Borges VA, Fontella AK, Miranda JDS, Koike MK, Saito OC, Birolini CAV, Utiyama EM. Bilateral inguinal hernia repair and male fertility: a randomized clinical trial comparing Lichtenstein versus laparoscopic transabdominal preperitoneal (TAPP) technique. Surg Endosc 2023; 37:9263-9274. [PMID: 37880447 DOI: 10.1007/s00464-023-10499-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/24/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND The effects of hernia repair on testicular function remain uncertain, regardless of the technique used. Studies that analyze testicular volume and flow after hernia repair or hormonal measurements are scarce and show contradictory results. This study aimed to evaluate the impact of bilateral inguinal hernia repair on male fertility in surgical patients in whom the Lichtenstein and laparoscopic transabdominal preperitoneal (TAPP) techniques were used. METHODS A randomized clinical trial comparing open (Lichtenstein) versus laparoscopic (TAPP) hernia repair using polypropylene mesh was performed in 48 adult patients (20 to 60 years old) with primary bilateral inguinal hernia. Patients were evaluated preoperatively and 90 and 180 postoperative (PO) days. Sex hormones (Testosterone, FSH, LH and SHGB) analysis, testicular ultrasonography, semen quality sexual activity changes and quality of life (QoL) were performed. Postoperative pain was evaluated using the visual analog scale (VAS). RESULTS Thirty-seven patients with aged of 44 ± 11 years were included, 19 operated on Lichtenstein and 18 operated on TAPP. The surgical time was similar between techniques. The pain was greater in the Lichtenstein group on the 7th PO day. The biochemical and hormonal analyses, testicular ultrasonography (Doppler, testicular volume, and morphological findings) and sperm quality were similar between groups. However, the sperm morphology was better in the Lichtenstein group after 180 days (p < 0.05 vs. preoperative) and two patients who underwent Lichtenstein hernia repair had oligospermia after 180 days. The QoL evaluation showed a significant improvement after surgery in the following domains: physical function, role emotional, bodily pain and general health (p < 0.05). On comparison of Lichtenstein vs. TAPP none of the domains showed statistically significant differences. No patient reported sexual changes. CONCLUSION Bilateral inguinal hernia repair with polypropylene mesh, whether using Lichtenstein or TAPP, does not impair male fertility in terms of long-term outcomes. TRIAL REGISTRATION Approved by the Ethics Committee for the Analysis of Research Projects (CAPPesq) of the HC/FMUSP, Number 2.974.457, in June 2015, Registered on Plataforma Brasil in October 2015 under Protocol 45535015.4.0000.0068. Registered on Clinicaltrials.gov, NCT05799742. Enrollment of the first subject in January 2016.
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Affiliation(s)
- Sérgio Henrique Bastos Damous
- Division of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), 255 Dr Enéas de Carvalho Aguiar Av. Cerqueira Cesar, São Paulo, 05402-000, Brazil.
| | - Luciana Lamarão Damous
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
- Postgraduate Program in Health Sciences, Instituto de Assistência Médica do Servidor Público Estadual (IAMSPE), São Paulo, Brazil
| | - Victor André Borges
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | - Jocielle Dos Santos Miranda
- Division of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), 255 Dr Enéas de Carvalho Aguiar Av. Cerqueira Cesar, São Paulo, 05402-000, Brazil
| | - Marcia Kiyomi Koike
- Postgraduate Program in Health Sciences, IAMSPE and Laboratory of Medical Investigation 51 (LIM-51), University of São Paulo, São Paulo, Brazil
| | - Osmar Cássio Saito
- Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), São Paulo, Brazil
| | - Cláudio Augusto Vianna Birolini
- Division of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), 255 Dr Enéas de Carvalho Aguiar Av. Cerqueira Cesar, São Paulo, 05402-000, Brazil
| | - Edivaldo Massazo Utiyama
- Division of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), 255 Dr Enéas de Carvalho Aguiar Av. Cerqueira Cesar, São Paulo, 05402-000, Brazil
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Koike MK, Barbeiro DF, Souza HPD, Machado MCC. Does fasting protect liver from ischemia and reperfusion injury? Acta Cir Bras 2023; 38:e384723. [PMID: 37878985 PMCID: PMC10592748 DOI: 10.1590/acb384723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/13/2023] [Indexed: 10/27/2023] Open
Abstract
PURPOSE To evaluate local and systemic effects of 24-hour fasting in liver ischemia and reperfusion injury. METHODS Twenty-one adult male Wistar rats (330-390 g) were submitted to 60 minutes of hepatic ischemia followed by 24 hours of reperfusion. Before the day of the experiment, the animals fasted, but free access to water was allowed. Two groups were constituted: Control: non-fasted, that is, feeding ad libitum before surgical procedure; Fasting: rats underwent previous fasting of 24 hours. Hepatic ischemia was performed using vascular clamp in hepatic pedicle. At 24 hours after liver reperfusion, blood and tissue samples were collected. To analysis, liver lobes submitted to ischemia was identified as ischemic liver and paracaval non-ischemic lobes as non-ischemic liver. We evaluated: malondialdehyde levels, hepatocellular function (alanine aminotransferase, aspartate aminotransferase activities, and both ratio), cytokines (interleukins-6, -10, and tumor necrosis factor-alpha), hepatic ischemia and reperfusion injury (histology). RESULTS Malondialdehyde measured in non-ischemic and ischemic liver samples, hepatocellular function and cytokines were comparable between groups. Histological findings were distinct in three regions evaluated. Microvesicular steatosis was comparable between 24-hour fasting and non-fasted control groups in periportal region of hepatic lobe. In contrast, steatosis was more pronounced in zones 2 and 3 of ischemic liver samples of fasting compared to control groups. CONCLUSIONS These data indicates that fasting does not protect, but it can be also detrimental to liver submitted to ischemia/reperfusion damage. At that time, using long fasting before liver surgery in the real world may be contraindicated.
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Affiliation(s)
- Marcia Kiyomi Koike
- Universidade de São Paulo - School of Medicine - Department of Clinical Medicine - São Paulo (SP) - Brazil
| | - Denise Frediani Barbeiro
- Universidade de São Paulo - School of Medicine - Department of Clinical Medicine - São Paulo (SP) - Brazil
| | - Heraldo Possolo de Souza
- Universidade de São Paulo - School of Medicine - Department of Clinical Medicine - São Paulo (SP) - Brazil
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da Costa RID, Fischer JMDS, Rasslan R, Koike MK, Utiyama EM, Montero EFDS. Effects of N-acetylcysteine on the inflammatory response and bacterial translocation in a model of intestinal obstruction and ischemia in rats. Acta Cir Bras 2023; 37:e371204. [PMID: 36651429 PMCID: PMC9839184 DOI: 10.1590/acb371204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 11/25/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To evaluate effect of N-acetylcysteine (NAC) associated with Ringer lactate or hypertonic saline in inflammation and bacterial translocation on experimental intestinal obstruction (IO). METHODS Wistar rats was subjected to IO. Six or 24 hours after, rats were subjected to enterectomy and fluid resuscitation: IO, RL (subjected to the same procedures but with fluid resuscitation using Ringer's lactate solution); RLNAC (added NAC to Ringer's solution); and HSNAC (surgical procedure + fluid reposition with 7.5% hypertonic saline and NAC). After 24 h, tissues were collected to cytokines, bacterial translocation, and histological assessments. RESULTS In kidney, interleukin-1beta (IL-1beta) was lower in the groups with fluid resuscitation compared to IO group. The RLNAC showed lower levels compared to the RL. Interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), and (IFN-gamma) were lower in the treatment groups than in IO. In lung, IL-1beta and IL-6 were lower in RLNAC compared to IO. IL-10 was lower in RL, RLNAC and HSNAC compared to IO. TNF-alpha was higher in HSNAC compared to both RL and RLNAC. Bacterial translocation was observed in all animals of IO group. In kidneys, inflammation and congestion degrees were lower in HSNAC compared to RL. In lungs, inflammation levels were higher in RLNAC compared with the sham group. CONCLUSIONS The data indicates that NAC associated with RL can promote a decrease in the inflammatory process in the kidneys and lungs in rats, following intestinal obstruction and ischemia in rats.
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Affiliation(s)
- Rafael Izar Domingues da Costa
- PhD. Universidade de São Paulo – Division of General Surgery and Trauma – Department of Surgery – School of Medicine – São Paulo (SP), and Universidade Federal de São Carlos – São Carlos (SP), Brazil.,Corresponding author:
- (55 16) 3415-3787
| | | | - Roberto Rasslan
- PhD. Universidade de São Paulo – Division of General Surgery and Trauma – Department of Surgery – School of Medicine – São Paulo (SP), Brazil
| | - Marcia Kiyomi Koike
- PhD. Universidade de São Paulo – Department of Clinical Medicine – Laboratory of Emergency Medicine – School of Medicine – São Paulo (SP), Brazil. And Instituto de Assistência Médica do Servidor Publico Estadual (IAMSPE) - Pós-Graduação em Ciencias da Saúde, São Paulo (SP), Brazil
| | - Edvaldo Massazo Utiyama
- PhD, full professor. Universidade de São Paulo – Division of General Surgery and Trauma – Department of Surgery – School of Medicine – São Paulo (SP), Brazil
| | - Edna Frasson de Souza Montero
- PhD, associate professor. Universidade de São Paulo – Division of General Surgery and Trauma – Department of Surgery – School of Medicine – São Paulo (SP), Brazil
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Carvas Junior N, Gomes IC, Valassi JMR, Anunciação L, Freitas-Dias RD, Koike MK. Comparison of the printed and online administration of the Behavioral Regulation in Exercise Questionnaire (BREQ-2). Einstein (Sao Paulo) 2021; 19:eAO6088. [PMID: 34346988 PMCID: PMC8302226 DOI: 10.31744/einstein_journal/2021ao6088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 02/05/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the traditional printed form of the Behavioral Regulation in Exercise Questionnaire with a proposed online form in terms of validity, reliability, and applicability. METHODS A crossover design study was conducted with 157 undergraduate students. Half of the sample answered the printed questionnaire first and then answered the online questionnaire 7 days later, while the other half of the sample did the inverse. Cronbach's alpha was used to analyze the internal consistency of both the online and printed questionnaires. The construct validity was analyzed by confirmatory factor analysis, using a weighted least square mean and adjusted variance estimation and oblique rotation. The quality of the model was tested with fit indices. RESULTS The confirmatory factor analysis showed the 19-item structure with five factors: χ2 of 230.718; degrees of freedom of 142; χ2/degrees of freedom of 1.625; comparative fit index of 0.978 and root mean square error of approximation of 0.073. All items presented factorial loads above 0.5. There was also excellent consistency between the formats of administration in all dimensions, with Cronbach's alpha values above 0.70. The stability between the formats of administration varied between 0.78 (95%CI: 0.69-0.85) and 0.84 (95%CI: 0.77-0.89), suggesting desirable confidence between both formats of administration. CONCLUSION The five-factor model of the online Behavioral Regulation in Exercise Questionnaire shows internal consistency both in terms of the scale dimensions as well as in terms of the total items.
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Affiliation(s)
- Nelson Carvas Junior
- Instituto de Assistência Médica ao Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
| | | | | | - Luís Anunciação
- Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Marcia Kiyomi Koike
- Instituto de Assistência Médica ao Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
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Affiliation(s)
- Marcia Kiyomi Koike
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Akimi Kokanj Kochi
- Programa de Pós-graduação em Ciências da Saúde, Instituto de Assistência ao Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil
| | - Denise Yamada Gomes Pinto
- Programa de Pós-graduação em Ciências da Saúde, Instituto de Assistência ao Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil
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Aikawa L, Yoshizumi AM, Shirassu MM, Koike MK. Rapid acupuncture for musculoskeletal pain in the emergency room of the Hospital Servidor Publico Estadual, Brazil: A quasi-experimental study. J Integr Med 2020; 18:313-318. [PMID: 32553560 DOI: 10.1016/j.joim.2020.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To compare differences in self-reported musculoskeletal pain before and after receiving rapid acupuncture for pain at an outpatient emergency department. METHODS Exactly 102 patients presenting to the emergency room of the Hospital Servidor Publico Estadual in Sao Paulo, Brazil, participated in this before-and-after study. All participants had musculoskeletal pain and were treated with the technique proposed by Marques Filho. This emergency acupuncture involved inserting a needle at a point defined by traditional Chinese medicine and applying intense stimulation for 10 s; no more than two points were used on any individual patient. Pain was measured using a numerical visual scale before and immediately after the procedure. RESULTS Participants in this study were mostly women (78%), had a college degree (47%) and were below the age of 60 (56%). The most common region of pain was the lower back (31%), and the most common type of pain was acute and exacerbated chronic pain. The meridians most commonly involved were the eight extra meridians (40%), and the points most often used for treatment were Houxi (SI3), Shenmai (BL62) and Zulinqi (GB41). Almost all participants reported a decrease in pain intensity, independent of sex, education level, pain site and pain type (acute/chronic; P < 0.05). At the end of the session, only 4% of the participants reported a desire for allopathic medication. CONCLUSION This emergency acupuncture technique for analgesia appears to reduce musculoskeletal pain. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (http://www.ensaiosclinicos.gov.br/) with No. RBR-8dmfjf.
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Affiliation(s)
- Luciana Aikawa
- Programa de Pós-Graduação em Ciências da Saúde, Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), Vila Clementino, São Paulo, SP 04029-000, Brazil
| | | | - Mirian Matsura Shirassu
- Programa de Pós-Graduação em Ciências da Saúde, Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), Vila Clementino, São Paulo, SP 04029-000, Brazil
| | - Marcia Kiyomi Koike
- Programa de Pós-Graduação em Ciências da Saúde, Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), Vila Clementino, São Paulo, SP 04029-000, Brazil.
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Souza PRMD, da Palma RK, Vieira RP, Santos FD, Monteiro-De-Moraes WMA, Medeiros A, Koike MK, Arantes-Costa FM, De Angelis K, Irigoyen MC, Consolim Colombo FM. Early activation of ubiquitin-proteasome system at the diaphragm tissue occurs independently of left ventricular dysfunction in SHR rats. Exp Biol Med (Maywood) 2020; 245:245-253. [PMID: 31986909 DOI: 10.1177/1535370219897883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hypertensive status induces modifications in the respiratory profile. Previous studies have indicated that hypertensive rats show increased respiratory-sympathetic coupling compared to normotensive rats. However, these effects and especially the mechanisms underlying such effects are not well known. Thus, we evaluated the influence of high blood pressure and autonomic dysfunction on a ventilatory pattern associated with lung injury and on the ubiquitin-proteasome system of the diaphragm muscle. Autonomic cardiovascular modulation (systolic BP variance and low-frequency band and pulse interval variance) and arterial blood gases patterns (pH, pO2, HCO3, SpO2), can be changed by hypertension, as well exacerbated chemoreflex pressor response. We observed that the diaphragm muscle of SHR showed increase in type I cross-sectional fiber (16%) and reduction in type II cross-sectional fiber area (41%), increased activity of the ubiquitin-proteasome system and lipid peroxidation, with no differences between groups in the analysis of ubiquitinated proteins and misfolded proteins. Our results showed that hypertension induced functional compensatory/adverse alterations associated with diaphragm fiber type changes and protein degradation as well as changed autonomic control of circulation. In conclusion, we believe there is an adaptation in ventilatory pattern in regarding to prevent the development of fatigue and muscle weakness and improve ventilatory endurance. Impact statement It was well known that hypertension can be driven by increased sympathetic activity and has been documented as a central link between autonomic dysfunction and alterations in the respiratory pattern. Our study demonstrated the impact of hypertension in ventilatory mechanics and their relationship with diaphragm muscle protein degradation. These findings may assist us in future alternative treatments to prevent diaphragm fatigue and weakness in hypertensive patients.
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Affiliation(s)
- Pamella Ramona Moraes de Souza
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo (FMUSP), Avenida Dr Eneas de Carvalho Aguiar 44, São Paulo/SP, Brazil 05403-000.,Department of Post-graduation in Medicine, Nove de Julho University (UNINOVE), Rua Vergueiro 235/249, São Paulo/SP, Brazil 01504-001
| | - Renata Kelly da Palma
- Department of Post-graduation in Medicine, Nove de Julho University (UNINOVE), Rua Vergueiro 235/249, São Paulo/SP, Brazil 01504-001.,Institute for Bioengineering of Catalonia, Biomimetic systems for cell engineering. Barcelona, Spain (IBEC). C. Baldiri Reixac, 15-21 Barcelona. 08028
| | - Rodolfo Paula Vieira
- Department of Post-graduation in Medicine, Nove de Julho University (UNINOVE), Rua Vergueiro 235/249, São Paulo/SP, Brazil 01504-001.,Institute for Bioengineering of Catalonia, Biomimetic systems for cell engineering. Barcelona, Spain (IBEC). C. Baldiri Reixac, 15-21 Barcelona. 08028
| | - Fernando Dos Santos
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo (FMUSP), Avenida Dr Eneas de Carvalho Aguiar 44, São Paulo/SP, Brazil 05403-000
| | - Wilson Max Almeida Monteiro-De-Moraes
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo (FMUSP), Avenida Dr Eneas de Carvalho Aguiar 44, São Paulo/SP, Brazil 05403-000
| | | | - Marcia Kiyomi Koike
- Department of Medicine, Center of Development of Medical Education, CEDEM, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fernanda Magalhães Arantes-Costa
- Department of Medicine, Center of Development of Medical Education, CEDEM, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Kátia De Angelis
- Federal University of Sao Paulo.Rua Pedro de Toledo, 1800. São Paulo/SP, Brazil 04021-001
| | - Maria Claudia Irigoyen
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo (FMUSP), Avenida Dr Eneas de Carvalho Aguiar 44, São Paulo/SP, Brazil 05403-000
| | - Fernanda Marciano Consolim Colombo
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo (FMUSP), Avenida Dr Eneas de Carvalho Aguiar 44, São Paulo/SP, Brazil 05403-000.,Department of Post-graduation in Medicine, Nove de Julho University (UNINOVE), Rua Vergueiro 235/249, São Paulo/SP, Brazil 01504-001
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Hamasaki MY, Severino P, Puga RD, Koike MK, Hernandes C, Barbeiro HV, Barbeiro DF, Machado MCC, Reis EM, Pinheiro da Silva F. Short-Term Effects of Sepsis and the Impact of Aging on the Transcriptional Profile of Different Brain Regions. Inflammation 2019; 42:1023-1031. [DOI: 10.1007/s10753-019-00964-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Scapini G, Rasslan R, Cayuela NC, Goes MA, Koike MK, Utiyama EM, de Souza Montero EF, Rasslan S. Hypertonic saline and pentoxifylline enhance survival, reducing apoptosis and oxidative stress in a rat model of strangulated closed loop small bowel obstruction. Clinics (Sao Paulo) 2019; 74:e787. [PMID: 31188910 PMCID: PMC6537659 DOI: 10.6061/clinics/2019/e787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 02/25/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Intestinal obstruction has a high mortality rate when therapeutic treatment is delayed. Resuscitation in intestinal obstruction requires a large volume of fluid, and fluid combinations have been studied. Therefore, we evaluated the effects of hypertonic saline solution (HS) with pentoxifylline (PTX) on apoptosis, oxidative stress and survival rate. METHODS Wistar rats were subjected to intestinal obstruction and ischemia through a closed loop ligation of the terminal ileum and its vessels. After 24 hours, the necrotic bowel segment was resected, and the animals were randomized into four groups according to the following resuscitation strategies: Ringer's lactate solution (RL) (RL-32 ml/kg); RL+PTX (25 mg/kg); HS+PTX (HS, 7.5%, 4 ml/kg), and no resuscitation (IO-intestinal obstruction and ischemia). Euthanasia was performed 3 hours after resuscitation to obtain kidney and intestine samples. A malondialdehyde (MDA) assay was performed to evaluate oxidative stress, and histochemical analyses (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling [TUNEL], Bcl-2 and Bax) were conducted to evaluate kidney apoptosis. Survival was analyzed with another series of animals that were observed for 15 days. RESULTS PTX in combination with RL or HS reduced the MDA levels (nmol/mg of protein), as follows: kidney IO=0.42; RL=0.49; RL+PTX=0.31; HS+PTX=0.34 (p<0.05); intestine: IO=0.42; RL=0.48; RL+PTX=0.29; HS+PTX=0.26 (p<0.05). The number of labeled cells for TUNEL and Bax was lower in the HS+PTX group than in the other groups (p<0.05). The Bax/Bcl-2 ratio was lower in the HS+PTX group than in the other groups (p<0.05). The survival rate on the 15th day was higher in the HS+PTX group (77%) than in the RL+PTX group (11%). CONCLUSION PTX in combination with HS enhanced survival and attenuated oxidative stress and apoptosis. However, when combined with RL, PTX did not reduce apoptosis or mortality.
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Affiliation(s)
- Gustavo Scapini
- Disciplina de Cirurgia Geral e Trauma, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Roberto Rasslan
- Disciplina de Cirurgia Geral e Trauma, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Corresponding author. E-mail:
| | - Natalie Chaves Cayuela
- Disciplina de Cirurgia Geral e Trauma, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Miguel Angelo Goes
- Divisao de Nefrologia, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, BR
| | - Marcia Kiyomi Koike
- Disciplina de Emergencias Clinicas, Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Edivaldo Massazo Utiyama
- Disciplina de Cirurgia Geral e Trauma, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Edna Frasson de Souza Montero
- Disciplina de Cirurgia Geral e Trauma, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Samir Rasslan
- Disciplina de Cirurgia Geral e Trauma, Departamento de Cirurgia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Koike MK. Synergy of Rapamycin and Cyanoacrylate in Reducing Intimal Hyperplasia. Arq Bras Cardiol 2019; 112:11. [PMID: 30673011 PMCID: PMC6317633 DOI: 10.5935/abc.20180269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Valassi JMR, Carvas Junior N, Matsura Shirassu M, de Paula KE, Atkinson ER, Koike MK. Factors Associated With Medication Adherence In Elderly Retired Outpatients In São Paulo, Brazil. Patient Prefer Adherence 2019; 13:1619-1628. [PMID: 31686788 PMCID: PMC6777441 DOI: 10.2147/ppa.s208026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 09/01/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To evaluate medication adherence and associated socioeconomic factors in elderly Brazilians. METHODOLOGY This observational study was conducted with 159 elderly retired in an outpatient clinic in the city of São Paulo. Treatment adherence was assessed with the questions from the Morisky Green Levine Medication Adherence Questionnaire, and medications were classified using the Anatomical Therapeutic Chemical system. Statistical tests and adjusted Poisson regression models were used to analyze variables. RESULTS The study population was mostly female (67.5%), had an average age of, and took an average of 6.5 medications per day. The most commonly used drugs were agents acting on the renin-angiotensin system (67.9%), statins (62.3%), antithrombotic agents (48.4%), and biguanides (37.1%) for the treatment of hypertension (76.7%), dyslipidemia (54.1%), and diabetes (47.8%). The rate of adherence was below 60% in the groups of participants that were analyzed except for the high household income category, which had a rate of 75.8%. CONCLUSION Medication adherence among the elderly was low in all categories except for the high household income category, a relevant finding that will help to understand medication adherence patterns in elderly Brazilians.
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Affiliation(s)
| | - Nelson Carvas Junior
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
| | - Mirian Matsura Shirassu
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
| | - Kaleo Eduardo de Paula
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
| | | | - Marcia Kiyomi Koike
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
- Emergency Medicine Department, Medical School, University of São Paulo, São Paulo, Brazil
- Correspondence: Marcia Kiyomi Koike Programa de Pós-Graduação em Ciências da Saúde. Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), Brasil Av. Ibirapuera, 981 - 2º andar, Vila Clementino, São Paulo/SPCEP: 04029-000, BrazilTel +55 11 9 9964-8421 Email
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Cayuela NC, Negreti GP, Rasslan R, Koike MK, Montero EFDS. Oxidative stress on ischemia/reperfusion injury in mice with non-alcoholic hepatic steatosis or steatohepatitis. Acta Cir Bras 2018; 33:753-761. [DOI: 10.1590/s0102-865020180090000003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/13/2018] [Indexed: 12/30/2022] Open
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Machado MSL, Bruno KA, Melo MDO, Koike MK. Fitoterapia brasileira: análise dos efeitos biológicos da sucupira (Bowdichia virgilioides e Pterodon emarginatus). Braz J Nat Sci 2018. [DOI: 10.31415/bjns.v1i2.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
A Sucupira é uma planta nativa utilizada como medicamentos nas tradições populares para a curade feridas, para o tratamento de diabetes, de reumatismo, de artrite, de doenças de pele, de faringites,de amidalites, de bronquites e para dores na coluna. A Sucupira é comumente utilizada em garrafadas,como componente de energéticos, juntamente com plantas como catuaba e muirapuama. Apesar de muitasplantas serem utilizadas comumente no tratamento e prevenção de diversas doenças, não há garantiada segurança e eficácia para a grande maioria dos produtos comercializados produzidos a partir destasplantas que estão sendo utilizados por grande parte da população. O presente artigo teve o objetivo deidentificar as evidências científicas sobre as propriedades químicas presentes na composição de duasespécies de sucupira, a Pterodon emarginatus e a Bowdichia virgilioides, popularmente mais conhecidascomo sucupira branca e sucupira preta, respectivamente, e relacioná-las com os seus efeitos biológicosrelatados na medicina popular. Para assim fazer com que Naturólogos e outros profissionais da área dasaúde tenham maior segurança e eficácia quando forem indicar a sucupira. Foi realizada uma pesquisabaseada nos Princípios da Revisão Sistemática, sobre os efeitos biológicos de duas espécies distintas desucupira. Os artigos científicos mostraram que P. emarginatus possui ação: antimicrobiana, leishmanicidae antinoceptiva e a B. virgilioides possui ação: antiinflamatória, antimicrobiana, ansiolítica, hipoglicemiantee cicatricial. Estes resultados estão de acordo com o que foi encontrado na bibliografia sobre aindicação terapêutica da sucupira na medicina popular, como dores de garganta, bronquite, reumatismo,artrite, feridas e diabetes.
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Federige MAF, Romaldini JH, Miklos ABPP, Koike MK, Takei K, Portes EDS. Serum selenium and selenoprotein-P levels in autoimmune thyroid diseases patients in a select center: a transversal study. Arch Endocrinol Metab 2017; 61:600-607. [PMID: 29412385 PMCID: PMC10522059 DOI: 10.1590/2359-3997000000309] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/31/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Selenium (Se) supplementation has been used to help prevent the progression of Graves' ophthalmopathy (GO) and autoimmune thyroid diseases (AITD) patients. We investigated Se serum and selenoprotein P (SePP) levels in Graves' disease (GD) with and without GO, Hashimoto's thyroiditis (HT) patients and in 27 control individuals (C). SUBJECTS AND METHODS We studied 54 female and 19 male patients: 19 with GD without GO, 21 GD with GO, 14 with HT and 19 with HT+LT4. Se values were measured using graphite furnace atomic absorption spectrophotometry. Serum SePP levels were measured by ELISA. RESULTS Median Se levels were similar among all groups; GD patients: 54.2 (46.5-61.1 μg/L), GO: 53.6 (43.5-60.0 μg/L), HT: 51.9 (44.6-58.5 μg/L), HT+LT4 54.4 (44-63.4) and C group patients: 56.0 (52.4-61.5 μg/L); P = 0.48. However, serum SePP was lower in GO patients: 0.30 (0.15-1.05 μg/mL) and in HT patients: 0.35 (0.2-1.17 μg/mL) compared to C group patients: 1.00 (0.564.21 μg/mL) as well as to GD patients: 1.19 (0.62-2.5 μg/mL) and HT+LT4 patients: 0.7 (0,25-1.95); P = 0.002. Linear regression analysis showed a significant relationship between SePP and TPOAb values (r = 0.445, R2 = 0.293; P < 0.0001). Multiple regression analysis found no independent variables related to Se or SePP. CONCLUSION A serum Se concentration was lower than in some other countries, but not significantly among AITD patients. The low serum SePP levels in GO and HT patients seems to express inflammatory reactions with a subsequent increase in Se-dependent protein consumption remains unclear.
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Affiliation(s)
- Marco Aurélio Ferreira Federige
- Hospital do Servidor Público EstadualSão PauloSPBrasilEndocrinología, Hospital do Servidor Público Estadual (IAMSPE), São Paulo, SP Brasil
| | - João Hamilton Romaldini
- Hospital do Servidor Público EstadualSão PauloSPBrasilEndocrinología, Hospital do Servidor Público Estadual (IAMSPE), São Paulo, SP Brasil
| | - Ana Beatriz Pinotti Pedro Miklos
- Hospital do Servidor Público EstadualSão PauloSPBrasilEndocrinología, Hospital do Servidor Público Estadual (IAMSPE), São Paulo, SP Brasil
| | - Marcia Kiyomi Koike
- Hospital do Servidor Público EstadualSão PauloSPBrasilEndocrinología, Hospital do Servidor Público Estadual (IAMSPE), São Paulo, SP Brasil
| | - Kioko Takei
- Hospital do Servidor Público EstadualSão PauloSPBrasilEndocrinología, Hospital do Servidor Público Estadual (IAMSPE), São Paulo, SP Brasil
| | - Evandro de Souza Portes
- Hospital do Servidor Público EstadualSão PauloSPBrasilEndocrinología, Hospital do Servidor Público Estadual (IAMSPE), São Paulo, SP Brasil
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Costa RIDD, Rasslan R, Koike MK, Utiyama EM, Montero EFDS. Bacterial translocation and mortality on rat model of intestinal ischemia and obstruction. Acta Cir Bras 2017; 32:641-647. [DOI: 10.1590/s0102-865020170080000006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/08/2017] [Indexed: 11/21/2022] Open
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Amaral RC, Barbeiro DF, Koike MK, Mady C, Machado MCC, Pinheiro da Silva F. Cytokine and chemokine levels in the heart tissue of aged rats following severe acute pancreatitis. EUR J INFLAMM 2017. [DOI: 10.1177/1721727x17712398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Severe acute pancreatitis (AP) is a disease associated with high mortality and characterized by overwhelming systemic inflammation. Older people have a prolonged hospital stay and worst prognosis, when affected by this disease. Our group hypothesized, thus, that the systemic inflammatory response in the elderly would promote more organ damage when compared to the young. We sought to investigate the effect of systemic inflammation on the gene expression of cytokines, chemokines, and growth factors in the hearts of older and younger rats in an animal model of AP. AP was induced in all rats by injection of 0.5 mL of 2.5% taurocholate. There were two healthy age-matched control groups. An array of 79 cytokines, chemokines, and growth factors was measured in samples of cardiac tissue taken from the AP rats after 10 h, and from control rats. Older healthy rats had significantly higher levels of interleukin-10 (IL-10) and CCL1 gene expression than younger ones ( P < 0.05), but all other measurements were similar among the study groups. This study indicates the systemic inflammation may show unique features for different organs in the body, but older animals with systemic inflammation are similar to the young regarding the cardiac inflammatory response.
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Affiliation(s)
| | | | | | - Charles Mady
- Heart Institute, University of São Paulo, São Paulo, Brazil
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de Oliveira Andrade R, Kunitake T, Koike MK, Machado MCC, Souza HP. Effects of diazoxide in experimental acute necrotizing pancreatitis. Clinics (Sao Paulo) 2017; 72:125-129. [PMID: 28273237 PMCID: PMC5304406 DOI: 10.6061/clinics/2017(02)10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/10/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE: We aimed to assess the effects of diazoxide on the mortality, pancreatic injury, and inflammatory response in an experimental model of acute pancreatitis. METHODS: Male Wistar rats (200-400 g) were divided randomly into two groups. Fifteen minutes before surgery, animals received physiological (0.9%) saline (3 mL/kg) (control group) or 45 mg/kg diazoxide (treatment group) via the intravenous route. Acute pancreatitis was induced by injection of 2.5% sodium taurocholate via the biliopancreatic duct. Mortality (n=38) was observed for 72 h and analyzed by the Mantel-Cox Log-rank test. To study pancreatic lesions and systemic inflammation, rats (10 from each group) were killed 3 h after acute pancreatitis induction; ascites volume was measured and blood as well as pancreases were collected. Pancreatic injury was assessed according to Schmidt's scale. Cytokine expression in plasma was evaluated by the multiplex method. RESULTS: Mortality at 72 h was 33% in the control group and 60% in the treatment group (p=0.07). Ascites volumes and plasma levels of cytokines between groups were similar. No difference was observed in edema or infiltration of inflammatory cells in pancreatic tissues from either group. However, necrosis of acinar cells was lower in the treatment group compared to the control group (3.5 vs. 3.75, p=0.015). CONCLUSIONS: Treatment with diazoxide can reduce necrosis of acinar cells in an experimental model of acute pancreatitis, but does not affect the inflammatory response or mortality after 72 h.
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Affiliation(s)
- Roberta de Oliveira Andrade
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Emergências Clínicas, São Paulo/SP, Brazil
- *Corresponding author. E-mail:
| | - Tiago Kunitake
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Emergências Clínicas, São Paulo/SP, Brazil
| | - Marcia Kiyomi Koike
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Emergências Clínicas, São Paulo/SP, Brazil
| | - Marcel C C Machado
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Emergências Clínicas, São Paulo/SP, Brazil
| | - Heraldo Possolo Souza
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Emergências Clínicas, São Paulo/SP, Brazil
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Morello RJ, Koike MK, Abrahão MDS, Saad KR, Saad PF, Montero EFDS. Remote ischemic preconditioning and tacrolimus in the fetal small bowel transplant in mice. Acta Cir Bras 2016; 31:675-679. [PMID: 27828601 DOI: 10.1590/s0102-865020160100000006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 09/21/2016] [Indexed: 11/21/2022] Open
Abstract
PURPOSE: To evaluate the effect of remote ischemic preconditioning (IPC-R) in the fetal small bowel transplantation model. METHODS: Two groups were constituted: The Isogenic transplant (ISO, C57BL/6 mice, n=24) and the allogenic transplant (ALO, BALB/c mice, n=24). In each group, the animals were distributed with and without IPC-R. It was obtained the following subgroups: Tx, IPC-R, Fk, IPC-Fk, in both strains. Intestinal grafts were stained with hematoxylin and eosin and immunohistochemically. RESULTS: The graft development evaluation in ISO group showed that IPC-R reduced the development compared with ISO-Tx (5.2±0.4 vs 9.0±0.8) and IPC-R-Fk increased the graft development compared with IPC-R (11.2±0.7 and 10.2±0.8). In ALO group, IPC-Fk increased the development compared with ALO-Tx and ALO with IPC-R (6.0±0.8, 9.0±1.2, 0.0±0.0, 0.5±0.3). The PCNA expression was increased in ISO group treated with Fk and IPC-R compared to other groups (12.2±0.8 vs Tx: 8.8±0.9, IPC-R: 8.0±0.4 and Fk: 9.0±0.6). The graft rejection was lower in groups treated with IPC-R (-18%), Fk (-68%) or both (-61%) compared with ALO-Tx. CONCLUSION: Remote ischemic preconditioning showed benefic effect even associate with Tacrolimus on the development and acute rejection of the fetal small bowel graft in the Isogenic and Allogenic transplants.
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Affiliation(s)
- Ricardo José Morello
- PhD, Operative Technique and Experimental Surgery Division, Medical School, Universidade Federal de São Paulo (UNIFESP), Brazil. Technical procedures, acquisition of data, manuscript writing
| | - Marcia Kiyomi Koike
- PhD, Laboratory of Emergency Medicine - LIM-51, Faculty of Medicine (FM), Universidade de São Paulo (USP), Brazil. Interpretation of data, histopathological examinations, statistical analysis, manuscript writing
| | - Marcos de Souza Abrahão
- PhD, Operative Technique and Experimental Surgery Division, Medical School, Universidade Federal de São Paulo (UNIFESP), Brazil. Technical procedures, acquisition of data, manuscript writing
| | - Karen Ruggeri Saad
- Associate Professor, Medical School, Universidade Federal do Vale do São Francisco (UNIVASF), Brazil. Manuscript writing, critical revision
| | - Paulo Fernandes Saad
- Associate Professor, Medical School, Universidade Federal do Vale do São Francisco (UNIVASF), Brazil. Manuscript writing, critical revision
| | - Edna Frasson de Souza Montero
- Associate Professor, Surgical Physiopathology Laboratory (LIM-62), FMUSP. Affiliate Professor, Operative Technique and Experimental Surgery Division, Medical School, UNIFESP, Sao Paulo-SP, Brazil. Conception, intellectual and scientific content of the study; critical revision; final approval
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Afonso MS, Lavrador MSF, Koike MK, Cintra DE, Ferreira FD, Nunes VS, Castilho G, Gioielli LA, Bombo RP, Catanozi S, Caldini EG, Damaceno-Rodrigues NR, Passarelli M, Nakandakare ER, Lottenberg AM. Corrigendum to “Dietary interesterified fat enriched with palmitic acid induces atherosclerosis by impairing macrophage cholesterol efflux and eliciting inflammation” [J Nutr Biochem 32C (2016) 91–100]. J Nutr Biochem 2016; 36:89-90. [DOI: 10.1016/j.jnutbio.2016.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Afonso MS, Lavrador MSF, Koike MK, Cintra DE, Ferreira FD, Nunes VS, Castilho G, Gioielli LA, Paula Bombo R, Catanozi S, Caldini EG, Damaceno-Rodrigues NR, Passarelli M, Nakandakare ER, Lottenberg AM. Dietary interesterified fat enriched with palmitic acid induces atherosclerosis by impairing macrophage cholesterol efflux and eliciting inflammation. J Nutr Biochem 2016; 32:91-100. [DOI: 10.1016/j.jnutbio.2016.01.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 12/08/2015] [Accepted: 01/21/2016] [Indexed: 12/19/2022]
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Maldonado-Menetti JDS, Vitor T, Edelmuth RCL, Ferrante FA, Souza PRDM, Koike MK. Borage oil attenuates progression of cardiac remodeling in rats after myocardial infarction. Acta Cir Bras 2016; 31:190-7. [PMID: 27050790 DOI: 10.1590/s0102-865020160030000007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/15/2016] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To investigate the effects of Borage oil on cardiac remodeling after myocardial infarction (MI). METHODS Male Wistar rats underwent ligation of the left coronary artery and divided into three groups: MI (control), BO-18 (18 mg/kg of borage oil) and BO-180 (180 mg/kg of borage oil). After seven days, heart was arrested in diastole and processed for histological evaluation of: MI size, LV dilation, myocyte hypertrophy, inflammatory infiltration and fibrosis in MI region and in remote region. The relative weight of the lung was used as a marker of heart failure. The MI size was comparable among groups. RESULTS Compared to control, BO treated groups showed lower weight of heart and lungs, reduced LV dilation and myocyte hypertrophy. Hemodynamic measurements were comparable. The treatment attenuated the inflammatory infiltration and fibrosis in remote myocardium. CONCLUSION Borage oil attenuates progression of cardiac remodeling after myocardial infarction and congestive heart failure.
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Affiliation(s)
| | - Taise Vitor
- Hospital Albert Einstein, Sao Paulo, SP, Brazil
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Moreira MA, Irigoyen MC, Saad KR, Saad PF, Koike MK, Montero EFDS, Martins JL. N-acetylcysteine reduces the renal oxidative stress and apoptosis induced by hemorrhagic shock. J Surg Res 2016; 203:113-20. [PMID: 27338542 DOI: 10.1016/j.jss.2016.02.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/05/2016] [Accepted: 02/23/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Renal ischemia/reperfusion injury induced by hemorrhagic shock (HS) and subsequent fluid resuscitation is a common cause of acute renal failure. The objective of this study was to evaluate the effect of combining N-acetylcysteine (NAC) with fluid resuscitation on renal injury in rats that underwent HS. MATERIALS AND METHODS Two groups of male Wistar rats were induced to controlled HS at 35 mm Hg mean arterial pressure for 60 min. After this period, the HS and fluid resuscitation (HS/R) group was resuscitated with lactate containing 50% of the blood that was withdrawn. The HS/R + NAC group was resuscitated with Ringer's lactate combined with 150 mg/kg of NAC and blood. The sham group animals were catheterized but were not subjected to shock. All animals were kept under anesthesia and euthanized after 120 min of fluid resuscitation or observation. RESULTS Animals treated with NAC presented attenuation of histologic lesions, reduced oxidative stress, and apoptosis markers when compared with animals from the HS/R group. The serum creatinine was similar in all the groups. CONCLUSIONS NAC is a promising drug for combining with fluid resuscitation to attenuate the kidney injury associated with HS.
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Affiliation(s)
| | - Maria Claudia Irigoyen
- Hypertension Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Karen Ruggeri Saad
- Medical School, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil
| | - Paulo Fernandes Saad
- Medical School, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil
| | - Marcia Kiyomi Koike
- Department of Internal Medicine, Emergency Medicine Laboratory (LIM-51), University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Edna Frasson de Souza Montero
- Department of Surgery, Laboratory of Surgical Physiopathology (LIM-62), University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
| | - José Luiz Martins
- Department of Surgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil
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Koike MK, Silva V, Romanek FARM, Shirassu MM. Relationship of comorbidities and heart failure mortality in the city of São Paulo, Brazil. Medical Express 2016. [DOI: 10.5935/medicalexpress.2016.02.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hamasaki MY, Barbeiro HV, Barbeiro DF, Cunha DMG, Koike MK, Machado MCC, Pinheiro da Silva F. "Neuropeptides in the brain defense against distant organ damage". J Neuroimmunol 2015; 290:33-5. [PMID: 26711566 DOI: 10.1016/j.jneuroim.2015.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 12/22/2022]
Abstract
Delirium, or acute confusional state, is a common manifestation in diseases that originate outside the central nervous system, affecting 30-40% of elderly hospitalized patients and up to 80% of the critically ill, even though it remains unclear if severe systemic inflammation is able or not to induce cellular disturbances and immune activation in the brain. Neuropeptides are pleotropic molecules heterogeneously distributed throughout the brain and possess a wide spectrum of functions, including regulation of the inflammatory response, so we hypothesized that they would be the major alarm system in the brain before overt microglia activation. In order to investigate this hypothesis, we induced acute pancreatitis in 8-10week old rats and collected brain tissue, 12 and 24h following pancreatic injury, to measure neuropeptide and cytokine tissue levels. We found significantly higher levels of β-endorphin, orexin and oxytocin in the brain of rats submitted to pancreatic injury, when compared to healthy controls. Interestingly, these differences were not associated with increased local cytokine levels, putting in evidence that neuropeptide release occurred independently of microglia activation and may be a pivotal alarm system to initiate neurologic reactions to distant inflammatory non-infectious aggression.
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Oliveira Filho LDD, Saad KR, Saad PF, Koike MK, Silva SMD, Montero EFDS. Effect of N-acetylcysteine in hearts of rats submitted to controlled hemorrhagic shock. Braz J Cardiovasc Surg 2015; 30:173-81. [PMID: 26107448 PMCID: PMC4462962 DOI: 10.5935/1678-9741.20140097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 07/24/2014] [Indexed: 01/24/2023] Open
Abstract
Introduction Pharmacological therapy is a strategy for the prevention of complications
associated with ischemia and reperfusion injury that occurs after volume
replacement in the treatment of hemorrhagic shock. Objective The aim of this study was to evaluate the effect of N-acetylcysteine
associated with fluid resuscitation in cardiac injury in a rat hemorrhagic
shock model. Methods Mice Wister male rats were randomly and subjected to controlled hemorrhagic
shock for 60 min. and then, subjected to resuscitation with Ringer lactate.
In a group of six animals, 150mg/kg of N-acetylcysteine were added to fluid
volume replacement. The animals were observed for 120 min and after this
period, were euthanized and cardiac tissue was collected for
histopathological analysis and measurement of thiobarbituric acid reactive
substances and pro-and anti-inflammatory interleukin. Results Cardiac tissue of the group treated with N-acetylcysteine showed lower
concentrations of thiobarbituric acid reactive substances (0.20±0.05
vs. 0.27±0.05, P=0.014) and reduced
histopathological damage and edema when compared to the group whose volume
replacement occurred only with Ringer lactate. There was no difference in
the expression of cytokines interleukin 6 (2,138.29±316.89 vs.
1,870.16±303.68, P=0.091) and interleukin 10
(1.019,83±262,50 vs. 848.60±106.5, P=0.169)
between the treated groups. Conclusion The association of N-acetylcysteine on volume replacement attenuates
oxidative stress in the heart, as well myocardial damage and edema, but does
not modify the expression of inflammatory cytokines.
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Koike MK, Cardoso R. Meditation can produce beneficial effects to prevent cardiovascular disease. Horm Mol Biol Clin Investig 2015; 18:137-43. [PMID: 25390009 DOI: 10.1515/hmbci-2013-0056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 04/17/2014] [Indexed: 11/15/2022]
Abstract
Coronary heart disease is the major cause of global cardiovascular mortality and morbidity. Lifestyle behaviour contributes as a risk factor: unhealthy diet, sedentary lifestyle, tobacco, alcohol, hypertension, diabetes, dyslipidemia and psychosocial stress. Atherosclerosis pathologic mechanisms involving oxidative stress, dyslipidemia, inflammation and senescence are associated with arterial wall damage and plaque formation. Stress reduction was observed in several types of meditation. After meditation, hormonal orchestration modulates effects in the central nervous system and in the body. All types of meditation are associated with blood pressure control, enhancement in insulin resistance, reduction of lipid peroxidation and cellular senescence, independent of type of meditation. This review presents scientific evidence to explain how meditation can produce beneficial effects on the cardiovascular system, and particularly regarding vascular aspects.
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Miott MS, Koike MK. Bariatric surgery. Analysis of hospital admissions for obesity in the Brazilian Public Health System (SUS) in Sao Paulo. Acta Cir Bras 2014; 29:759-64. [DOI: 10.1590/s0102-86502014001800011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/22/2014] [Indexed: 11/22/2022] Open
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Saurim R, Koike MK, Bonservizi WGS, Felix GAA, Silva SM, Taha MO, Montero EFS. Cardiac effect of ischemic preconditioning and heparin following intestinal ischemia and reperfusion in rats. Transplant Proc 2014; 46:1852-6. [PMID: 25131053 DOI: 10.1016/j.transproceed.2014.05.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To study the role of heparin and ischemic preconditioning (IPC) in cardiac injury after intestinal ischemia (I) and reperfusion (R), 54 rats underwent 60 minutes of I, which was produced by occlusion of the superior mesenteric artery, and/or 120 minutes of R. The IPC group had the I procedure stimulation for 5 minutes and R for 10 minutes. The control group was subjected to sham surgery only, and the other groups were injected with saline solution (SS; 0.1 mL) or heparin (100 IU/kg) via the inferior cava vein 5 minutes before I and 5 minutes before R and 55 minutes after the R begins in I-R groups. In all animals, cardiac samples were stained with hematoxylin and eosin for optical microscopy analysis, and other sample was processed for lipid peroxidation determination. In I-R groups, both heparin and IPC showed significant protection compared to the SS group; conversely, in animals subjected only to I, no protection was observed. Moreover, when heparin was associated with IPC, I-R protection was compromised and the ischemic injury increased. Data showed that IPC and heparin attenuated cardiac dysfunction caused by intestinal I and I-R, but when used in association did not show beneficial effects.
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Affiliation(s)
- R Saurim
- Escola Paulista de Medicina, Federal University of São Paulo, Brazil
| | - M K Koike
- Laboratory of Clinical Emergencies (LIM 51), Brazil
| | - W G S Bonservizi
- Escola Paulista de Medicina, Federal University of São Paulo, Brazil
| | - G A A Felix
- Escola Paulista de Medicina, Federal University of São Paulo, Brazil
| | - S M Silva
- Escola Paulista de Medicina, Federal University of São Paulo, Brazil
| | - M O Taha
- Operative Technique and Experimental Surgery Division, Escola Paulista de Medicina, Federal University of São Paulo, Brazil
| | - E F S Montero
- Operative Technique and Experimental Surgery Division, Escola Paulista de Medicina, Federal University of São Paulo, Brazil; Laboratory of Surgical Physiopathology (LIM 62), Department of Surgery, University of São Paulo, Federal University of São Paulo, Brazil.
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Thomaz Neto FJ, Koike MK, Abrahão MDS, Carillo Neto F, Pereira RKH, Machado JLM, Montero EFDS. Ischemic preconditioning attenuates remote pulmonary inflammatory infiltration of diabetic rats with an intestinal and hepatic ischemia-reperfusion injury. Acta Cir Bras 2014; 28:174-8. [PMID: 23503857 DOI: 10.1590/s0102-86502013000300003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 01/16/2013] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To assess ischemic preconditioning (IPC) effects in pulmonary lesion in intestinal and hepatic ischemia-reperfusion (IR) injury models using diabetic rats. METHODS Diabetes (DM) was induced in 28 male Wistar rats by alloxan (42 mg/kg, IV). After 28 days, severe DM rats were submitted to intestinal or hepatic IR injury with or without IPC. Intestinal IR (30 min of mesenteric artery occlusion and 30 min of reperfusion; n=6) and IPC groups (10 min ischemia, 10 min reperfusion, followed by intestinal IR; n=6), and Hepatic IR (30 min of hepatic pedicle occlusion and 30 min of reperfusion; n=5) and IPC groups (10 min ischemia, 10 min reperfusion, followed by hepatic IR; n=5), were compared to DM rats group (n=6). Plasmatic lactate, glycemia were measured before and after IR injury. Histomorphology of lung was performed counting inflammatory cells. Data was expressed in mean± SE. P<0.05. RESULTS Glycemia and lactate were similar among groups. IPC did not interfere in these parameters. On histological evaluation, IR increased inflammatory cells infiltration in pulmonary parenchyma compared to control in both IR injury models. IPC attenuated inflammatory infiltration in lungs. CONCLUSION Ischemic preconditioning protects against remote ischemia-reperfusion injury in lung on intestinal or hepatic ischemia-reperfusion model with acute diabetes.
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Risso PS, Koike MK, Abrahão MDS, Ferreira NC, Montero EFDS. The effect of n-acetylcysteine on hepatic histomorphology during hypothermic preservation. Acta Cir Bras 2014; 29 Suppl 3:28-32. [DOI: 10.1590/s0102-86502014001700006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Amorim EMGD, Damous LL, Durando MCS, Saraiva MVA, Koike MK, Montero EFDS. N-acetylcysteine improves morphologic and functional aspects of ovarian grafts in rats. Acta Cir Bras 2014; 29 Suppl 3:22-7. [DOI: 10.1590/s0102-86502014001700005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Montero MF, Saurim R, Bonservizi WGS, Koike MK, Taha MO. Heart injury following intestinal ischemia reperfusion in rats is attenuated by association of ischemic preconditioning and adenosine. Acta Cir Bras 2014; 29 Suppl 2:67-71. [DOI: 10.1590/s0102-8650201400140013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Machado RM, Koike MK. Circadian rhythm, sleep pattern, and metabolic consequences: an overview on cardiovascular risk factors. Horm Mol Biol Clin Investig 2014; 18:47-52. [DOI: 10.1515/hmbci-2013-0057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/24/2014] [Indexed: 01/20/2023]
Abstract
AbstractSleep duration is a risk factor for cardiovascular disease. Alteration in sleep pattern can induce the loss of circadian rhythmicity. Chronically, this desynchronization between endogenous rhythm and behavioral cycles can lead to an adverse metabolic profile, a proinflammatory condition and can increase the risk of cardiovascular disease. The circadian cycle can vary due to environmental cues. The circadian pacemaker is located in the suprachiasmatic nuclei; this central clock coordinates the circadian rhythm in the central nervous system and peripheral tissues. The mechanisms involved in sleep disturbance, circadian misalignment and adverse metabolic effects have yet to be fully elucidated. This review looks over the association among sleep alteration, circadian rhythm and the development of risk factors implicated in cardiovascular disease.
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Saad PF, Saad KR, Oliveira Filho LDD, Ferreira SG, Koike MK, Montero EFDS. Effect of N-acetylcysteine on pulmonary cell death in a controlled hemorrhagic shock model in rats. Acta Cir Bras 2013; 27:561-5. [PMID: 22850708 DOI: 10.1590/s0102-86502012000800008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 06/21/2012] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To evaluate the effect of N-acetylcysteine (NAC) combined with fluid resuscitation on pulmonary cell death in rats induced with controlled hemorrhagic shock (HS). METHODS Two arteries (MAP calculation and exsanguination) and one vein (treatments) were catheterized in 22 anesthetized rats. Two groups of male albino rats were induced with controlled HS at 35mmHg MAP for 60 min. After this period, the RL group was resuscitated with Ringer's lactate and the RL+NAC group was resuscitated with Ringer's lactate combined with 150mg/Kg NAC. The control group animals were cannulated only. The animals were euthanized after 120 min of fluid resuscitation. Lung tissue samples were collected to evaluate the following: histopathology, TUNEL and imunohistochemical expression of caspase 3. RESULTS RL showed a greater number of cells stained by TUNEL than RL + NAC, but there was no change in caspase 3 expression in any group. CONCLUSION N-acetylcysteine associate to fluid resuscitation, after hemorrhagic shock, decreased cell death attenuating lung injury.
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Guimarães CA, Pellizzon RDF, Koike MK. Brazilian Scientific Journals in Surgery: quality control in the abstract structure of non-experimental articles. Acta Cir Bras 2013; 28:84-7. [PMID: 23338119 DOI: 10.1590/s0102-86502013000100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 11/11/2012] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the quality of abstracts of original non-experimental research articles in Brazilian Journals in Surgery. METHODS Convenience sample of 471 abstracts of original research articles from six Brazilian surgical journals indexed in Thomson Reuters (ISI) Web of Knowledge. The quality of abstracts was measured against a checklist of eight evaluation criteria, which were divided into 32 categories. The total score for each abstract was obtained by summing the score of all criteria present. The overall mean score was also determined. RESULTS The overall mean score of abstract quality was that of a good abstract. Most of the abstracts contained some information from each of the eight basic categories of an abstract. All abstracts were structured ones. CONCLUSION The overall quality, for abstracts of original articles of six Brazilian non-experimental journals in surgery, was classified as good.
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Saad KR, Saad PF, Dantas Filho L, Brito JMD, Koike MK, Zanoni FL, Dolhnikoff M, Montero EFDS. Pulmonary impact of N-acetylcysteine in a controlled hemorrhagic shock model in rats. J Surg Res 2012; 182:108-15. [PMID: 22883437 DOI: 10.1016/j.jss.2012.07.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 06/28/2012] [Accepted: 07/13/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND Experimental hemorrhagic shock (HS) is based on controlling bleeding and the treatment of fluid resuscitation to restore tissue oxygenation and perfusion. The HS could promote ischemia/reperfusion injury, which induces a general exacerbation of the inflammatory process, initially compromising the lungs. N-acetylcysteine (NAC), an antioxidant, may attenuate ischemia/reperfusion injury. This study evaluated the effect of NAC in association with fluid resuscitation on pulmonary injury in a controlled HS model in rats. METHODS Male Wistar rats were submitted to controlled HS (mean arterial pressure of 35 mm Hg for 60 min). Two groups were constituted according to resuscitation solution administered: RLG (Ringer's lactate solution) and RLG+NAC (Ringer's lactate in association with 150 mg/kg NAC. A control group was submitted to catheterization only. After 120 min of resuscitation, bronchoalveolar lavage was performed to assess intra-alveolar cell infiltration and pulmonary tissue was collected for assessment of malondialdehyde, interleukin 6, and interleukin 10 and histopathology. RESULTS Compared with the RLG group, the RLG+NAC group showed lower bronchoalveolar lavage inflammatory cell numbers, lower interstitial inflammatory infiltration in pulmonary parenchyma, and lower malondialdehyde concentration. However, tissue cytokine (interleukin 6 and interleukin 10) expression levels were similar. CONCLUSION N-acetylcysteine was associated with fluid resuscitation-attenuated oxidative stress and inflammatory cell infiltration in pulmonary parenchyma. N-acetylcysteine did not modify cytokine expression.
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Affiliation(s)
- Karen Ruggeri Saad
- Department of Surgery, Medical School, Federal University of São Paulo, São Paulo, Brazil
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Pontieri V, Neto AS, de França Camargo AF, Koike MK, Velasco IT. The herbal drug Catuama reverts and prevents ventricular fibrillation in the isolated rabbit heart. J Electrocardiol 2007; 40:534.e1-8. [PMID: 17888942 DOI: 10.1016/j.jelectrocard.2007.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 06/11/2007] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Catuama, an herbal drug very popular in Brazil, was tested on the reversion and prevention of ventricular fibrillation (VF) in the isolated rabbit heart. MATERIALS AND METHODS Catuama (a mixture of Trichilia catigua, Paullinia cupana, Ptychopetalum olacoides, and Zinziber officinalis) was perfused in the isolated perfused rabbit heart. Its effects on intraventricular conduction, heart rate, and monophasic action potential (MAP) duration were evaluated, and sustained VF was induced. The effects on reversion and reinduction of arrhythmia were observed, and new measures were taken in the hearts that reverted. RESULTS Catuama and T catigua reverted VF in all hearts, prevented reinduction, and prolonged intraventricular conduction. Catuama prolonged MAP phase 2. On the other hand, P cupana reverted VF in 3 of 5 hearts, but depressed automatism, prolonged MAP phase 3, and did not prevent reinduction. DISCUSSION Catuama reverted and prevented VF in this model. T catigua extract is probably the main agent responsible for the beneficial actions observed. Further studies are now in progress to clarify these actions.
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Affiliation(s)
- Vera Pontieri
- Emergency Medicine Research Laboratory, Medical School of University of São Paulo, São Paulo, Brazil
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De Pinho Pessoa BBG, Menezes Cavalcante BB, Maia MP, Ribeiro Filho HH, Koike MK, De Pinho Pessoa SG, Porto Pinheiro LG, Montero EFDS. Effect of tamoxifen on arterial microvascular anastomosis. Microsurgery 2007; 27:286-8. [PMID: 17477413 DOI: 10.1002/micr.20357] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Breast reconstruction after cancer treatment is based on the circulation of pedicle and microvascular flaps. This article aimed to verify the effect of tamoxifen (TMX) pretreatment in arterial anastomosis in rats. Twenty female Wistar rats were equally divided into two groups. TMX (0.3 mg/kg) was administered to the experimental group for 2 weeks orally. After this period, the right femoral artery was sectioned and a terminoterminal anastomosis performed. The same procedure was done in the control group, except that the animals received the vehicle without TMX. One week later, the femoral arteries were inspected for flow through the anastomosis, and the vessel near it was sent to light microscopic examination. It was observed mild vasculite in both groups. The intimal thickness and total vessel wall in the TMX-treated group was significantly higher. A real thrombotic effect upon the arterial vascular anastomosis was not observed, eventhough, TMX induced intimal hyperplasia.
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Koike MK, Frimm CDC, Cúri M. Low coronary driving pressure early in the course of myocardial infarction is associated with subendocardial remodelling and left ventricular dysfunction. Int J Exp Pathol 2007; 88:279-90. [PMID: 17696909 PMCID: PMC2517313 DOI: 10.1111/j.1365-2613.2007.00540.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Subendocardial remodelling of the left ventricular (LV) non-infarcted myocardium has been poorly investigated. Previously, we have demonstrated that low coronary driving pressure (CDP) early postinfarction was associated with the subsequent development of remote subendocardial fibrosis. The present study aimed at examining the role of CDP in LV remodelling and function following infarction. Haemodynamics were performed in Wistar rats immediately after myocardial infarction (MI group) or sham surgery (SH group) and at days 1, 3, 7 and 28. Heart tissue sections were stained with HE, Sirius red and immunostained for alpha-actin. Two distinct LV regions remote to infarction were examined: subendocardium (SE) and interstitium (INT). Myocyte necrosis, leucocyte infiltration, myofibroblasts and collagen volume fraction were determined. Compared with SH, MI showed lower CDP and LV systolic and diastolic dysfunction. Necrosis was evident in SE at day 1. Inflammation and fibroplasia predominated in SE as far as day 7. Fibrosis was restricted to SE from day 3 on. Inflammation occurred in INT at days 1 and 3, but at a lower grade than in SE. CDP correlated inversely with SE necrosis (r = -0.65, P = 0.003, at day 1), inflammation (r = -0.76, P < 0.001, at day 1), fibroplasia (r = -0.47, P = 0.04, at day 7) and fibrosis (r = -0.83, P < 0.001, at day 28). Low CDP produced progressive LV expansion. Necrosis at day 1, inflammation at days 3 and 7, and fibroplasia at day 7 correlated inversely with LV function. CDP is a key factor to SE integrity and affects LV remodelling and function following infarction.
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Affiliation(s)
- Marcia Kiyomi Koike
- LIM 51 - Laboratory of Emergency Medicine, University of São Paulo Medical School, São Paulo, SP, Brazil.
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Koike MK, de Carvalho Frimm C, de Lourdes Higuchi M. Bradykinin B2receptor antagonism attenuates inflammation, mast cell infiltration and fibrosis in remote myocardium after infarction in rats. Clin Exp Pharmacol Physiol 2006; 32:1131-6. [PMID: 16445581 DOI: 10.1111/j.1440-1681.2005.04309.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Bradykinin may interfere with myocardial remodelling by promoting inflammation and mast cell activation or, alternatively, by counteracting angiotensin II-dependent collagen accumulation. The aim of the present study was to investigate the role of bradykinin B2 receptor antagonism in inflammatory and mast cell infiltration, fibroplasia and fibrosis accumulation following myocardial infarction (MI). Myocardial infarction was produced by the ligature of the left coronary artery in male Wistar rats that were 10 weeks of age. Immediately after MI, rats received the B2 receptor antagonist Hoe140 (0.5 microg/kg per min, s.c.) or saline over a period of 3 days, 1 week or 4 weeks, constituting three separate groups and their respective controls. Coronal myocardial tissue sections underwent haematoxylin and eosin, Giemsa and picrosirius red staining, as well as immunohistochemistry for alpha-smooth muscle actin (SMA). Morphometric studies were undertaken in three different myocardial regions: MI, remote non-infarcted subendocardium (non-MI SE) and remote non-infarcted interventricular septum (non-MI IVS). The MI size was comparable between Hoe140-treated groups and their respective controls (day 3: 42 +/- 4%, n = 8, vs 43 +/- 3%, n = 6; week 1: 37 +/- 5%, n = 5, vs 39 +/- 2%, n = 5; week 4: 35 +/- 3%, n = 9, vs 36 +/- 3%, n = 7). At day 3, Hoe140 treatment reduced inflammatory cell reaction within the MI (585 +/- 59 vs 995 +/- 170 cells/mm2; P = 0.02), non-MI SE (77 +/- 12 vs 214 +/- 57 cells/mm2; P = 0.02) and non-MI IVS (93 +/- 16 vs 135 +/- 14 cells/mm2; P = 0.03) regions. Mast cells were reduced within the non-MI IVS region (0.8 +/- 0.1 vs 2.5 +/- 0.4 cells/mm2; P = 0.006), but not within the MI region. In non-MI SE, mast cells were rarely found. At week 1, Hoe140 treatment reduced alpha-SMA-positive myofibroblast infiltration within the MI (2535 +/- 383 vs 5636 +/- 968 cells/mm2; P = 0.01) and non-MI SE (222 +/- 33 vs 597 +/- 162 cells/mm2; P = 0.03) regions. In the non-MI IVS region, alpha-SMA-positive myofibroblasts were rarely found. At week 4, Hoe140 treatment reduced collagen volume fraction within the MI (37 +/- 4 vs 53 +/- 4%; P = 0.03), non-MI SE (1.3 +/- 0.2 vs 2.6 +/- 0.3%; P = 0.001) and non-MI IVS (1.1 +/- 0.2 vs 1.8 +/- 0.2%; P = 0.01) regions. Bradykinin promotes inflammation, fibroplasia and fibrosis after MI. Mast cells may have a role in fibrosis deposition through a bradykinin-related mechanism.
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Affiliation(s)
- Marcia Kiyomi Koike
- LIM-51, Emergências Clínicas, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
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Abstract
The prognosis of dilated cardiomyopathy due to hypertension (HT-DCM) is surprisingly unknown, particularly in the absence of coronary disease and diabetes. We aimed at investigating the long-term outcome and the predictors of mortality in patients with left ventricular systolic dysfunction exclusively due to hypertension. From October 1995 to May 2001, 90 consecutive patients with echocardiographic fractional shortening (FS) < 30% and 29 control patients with FS > or = 30% were included. Obstructive coronary disease was excluded by dipyridamole myocardial perfusion imaging in all patients and coronary angiography in 60. After a mean follow-up of 4.3+/-1.6 years, the total mortality rate of HT-DCM was twice as much higher than that of patients without left ventricular systolic dysfunction (P = 0.01). In HT-DCM, the 5-year mortality rate was 26%. Univariate analyses selected age and creatinine for being positively related to mortality, and body mass index, FS and blood pressure during follow-up for being negatively related to mortality. Neither the improvement of left ventricular FS nor the decrease in left ventricular mass index was related to survival. Multivariate analysis identified (hazard ratio; 95% confidence interval) age (1.08; 1.02-1.13), body mass index (0.86; 0.75-0.98), and baseline FS (0.88; 0.78-0.98) as independent predictors of mortality. In conclusion, poor survival in HT-DCM can be anticipated by the severity of left ventricular systolic dysfunction and advanced age. Instead of ominous signs, high blood pressure and body mass may predict a more favourable prognosis.
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Affiliation(s)
- C de Carvalho Frimm
- Clínica Médica-Emergências Clínicas, Hospital das Clínicas-Faculdade de Medicina da USP, São Paulo, SP, Brazil.
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Frimm CDC, Koike MK, Cúri M. Subendocardial fibrosis in remote myocardium results from reduction of coronary driving pressure during acute infarction in rats. Arq Bras Cardiol 2003. [DOI: 10.1590/s0066-782x2003000500004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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de Carvalho Frimm C, Koike MK, Cúri M. Subendocardial fibrosis in remote myocardium results from reduction of coronary driving pressure during acute infarction in rats. Arq Bras Cardiol 2003; 80:509-20. [PMID: 12792716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVE To investigate the role of hemodynamic changes occurring during acute MI in subsequent fibrosis deposition within non-MI. METHODS By using the rat model of MI, 3 groups of 7 rats each [sham, SMI (MI <30%), and LMI (MI >30%)] were compared. Systemic and left ventricular (LV) hemodynamics were recorded 10 minutes before and after coronary artery ligature. Collagen volume fraction (CVF) was calculated in picrosirius red-stained heart tissue sections 4 weeks later. RESULTS Before surgery, all hemodynamic variables were comparable among groups. After surgery, LV end-diastolic pressure increased and coronary driving pressure decreased significantly in the LMI compared with the sham group. LV dP/dt max and dP/dt min of both the SMI and LMI groups were statistically different from those of the sham group. CVF within non-MI interventricular septum and right ventricle did not differ between each MI group and the sham group. Otherwise, subendocardial (SE) CVF was statistically greater in the LMI group. SE CVF correlated negatively with post-MI systemic blood pressure and coronary driving pressure, and positively with post-MI LV dP/dt min. Stepwise regression analysis identified post-MI coronary driving pressure as an independent predictor of SE CVF. CONCLUSION LV remodeling in rats with MI is characterized by predominant SE collagen deposition in non-MI and results from a reduction in myocardial perfusion pressure occurring early on in the setting of MI.
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Jatene MB, Monteiro R, Guimarães MH, Veronezi SC, Koike MK, Jatene FB, Jatene AD. Aortic valve assessment. Anatomical study of 100 healthy human hearts. Arq Bras Cardiol 1999; 73:75-86. [PMID: 10684143 DOI: 10.1590/s0066-782x1999000700007] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To assess anatomical characteristics of the aortic valve, so that they may be useful in diagnostic situations and surgical treatment. METHODS The study analyzed 100 healthy fixed human hearts; 84% of them obtained from males, 61% of them from Caucasian individuals. The ages of the individuals ranged from 9 to 86 years (mean 30 +/- 15.5 years). The characteristics assessed related to age, sex, and race were the following: number and height of the cusps, size of the lunulae, internal and external intercommissural distance, position of the coronary ostium in relation to the aortic valve, position of the ventricular septum in relation to the aortic valve, thickness of the cusps. RESULTS All hearts assessed had a tricuspidal aortic valve. In regard to the height of the cusps and size of the lunula, the left coronary cusp was larger, followed by the right coronary cusp and the noncoronary cusp. The internal and external intercommissural distances had mean values of 24.6 +/- 5.7 mm and 19.7 +/- 7 mm, respectively. In regard to the position of the coronary ostia, in one heart two ostia emerged from the left coronary sinus, and in another, the ostium was supracommissural. The mean diameter of the aorta was 21.8 +/- 3.6 mm, and there were no significant sexual or racial differences, but the diameter increased progressively with the increase in age. The thickness of the cusps did not show any significant difference in the 3 points assessed. CONCLUSION The aortic valve annulus did not show a perfect circumference, with some variations in the measurements of the annulus, in the cusps and in the relation with the ventricular septum.
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Affiliation(s)
- M B Jatene
- Instituto do Coração do Hospital das Clínicas, FMUSP, Brazil
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