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Lacchini R, Muniz JJ, Nobre YTDA, Cologna AJ, Martins ACP, Tanus-Santos JE. Influence of arginase polymorphisms and arginase levels/activity on the response to erectile dysfunction therapy with sildenafil. Pharmacogenomics J 2017; 18:238-244. [DOI: 10.1038/tpj.2017.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/16/2016] [Accepted: 01/09/2017] [Indexed: 01/12/2023]
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Lacchini R, Muniz JJ, Nobre YTDA, Cologna AJ, Martins ACP, Tanus-Santos JE. nNOS polymorphisms are associated with responsiveness to sildenafil in clinical and postoperative erectile dysfunction. Pharmacogenomics 2015; 15:775-84. [PMID: 24897285 DOI: 10.2217/pgs.14.30] [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] [Indexed: 12/25/2022] Open
Abstract
AIM Sildenafil potentiates the nitric oxide (NO) signaling pathway. Since neuronal NOS is very important in the penis, we assessed whether NOS1 polymorphisms are associated with altered responsiveness to sildenafil in erectile dysfunction (ED). MATERIALS & METHODS Patients (n = 137) were divided as clinical ED or postoperative ED. They were subdivided as good responders or poor responders to sildenafil, and genotypes for rs41279104 and rs2682826 NOS1 polymorphisms were determined. RESULTS We found that the rs41279104 CT genotype was associated with good responders in postoperative ED patients, while rs2682826 CT genotype was associated with good responders in postoperative ED, and the TT genotype associated with good responders in both groups. Finally, the CT haplotype was associated with good responders in postoperative ED. CONCLUSION NOS1 polymorphisms are associated with responsiveness to sildenafil in ED. Original submitted 20 November 2013; Revision submitted 31 January 2014.
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Affiliation(s)
- Riccardo Lacchini
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Av. Bandeirantes, 3900, 14049-900 Ribeirao Preto, SP, Brazil.
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Cassini MF, da Costa MM, Bagnato VS, Tirapelli LF, Silva GEB, Molina CAF, Martins ACP, Tucci S. Fluorescence spectroscopy in renal ischemia and reperfusion: noninvasive evaluation of organ viability. Transplant Proc 2013; 45:1715-9. [PMID: 23769030 DOI: 10.1016/j.transproceed.2012.10.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 10/30/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Damage provoked by ischemia in renal transplants is difficult to quantify. To determine whether a donated organ is fit for transplantation. We sought to correlate the findings of fluorescence spectroscopy (FS) with histologic evidence of ischemic injury and organ viability. METHODS Kidneys of 33 rats were submitted to FS of the upper and lower poles as well as the middle third. Excitation was generated by the laser's wavelengths of 408, 442, and 532 nm. Rats were randomized into groups with the 30, 60, and 120 minutes warm ischemia before analysis by FS, that was repeated at 5 minutes after reperfusion. RESULTS FS results in the reperfusion phase correlated with ischemia time and degree of histologic injury. After 60 or 120 minutes of ischemia, the excitation lasers of 532 and 442 nm resented a significant negative correlation coefficient with the histological grade (r = -0.61 and r = -0.73, respectively). CONCLUSIONS There was a strong correlation between FS and histologic changes only in the reperfusion phase after renal ischemia. The method was thus unable to assess the viability of organs before transplantation.
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Affiliation(s)
- M F Cassini
- Division of Urology, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil.
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Cassini MF, da Costa MM, Bagnato VS, Tirapelli LF, Silva GEB, Martins ACP, Tuccl S. Evaluation by fluorescence spectroscopy of the most appropriate renal region for obtaining biopsies: a study in the rat. Transplant Proc 2013; 45:1761-5. [PMID: 23769039 DOI: 10.1016/j.transproceed.2013.01.059] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 12/08/2012] [Accepted: 01/15/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Renal puncture biopsies are directed at the lower poles of the organ to decrease the risk of hemorrhage and complications. OBJECTIVES To evaluate by fluorescence spectroscopy (FS) the most appropriate renal region (in terms of metabolic changes) to obtain a biopsy. MATERIALS AND METHODS The kidneys of 33 Rattus norvegicus rats were submitted to FS detection in the upper and lower poles and in the middle third. Excitations were generated with lasers at wavelengths of 408, 442, and 532 nm. Animals were divided at random into groups of warm ischemia (30, 60, and 120 minutes), whose kidneys were again analyzed by FS, as well as after 5 minutes of reperfusion using the same excitation beams in the same renal regions. Then the kidneys underwent histologic preparation and examination. RESULTS The middle third area of the rat's kidneys proved to be significantly more sensitive to ischemic and reperfusion changes than the renal poles, as determined by FS (P < .001). CONCLUSIONS The middle third of the kidney was the most appropriate site for a renal biopsy to monitor a transplanted organ.
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Affiliation(s)
- M F Cassini
- Division of Urology, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil.
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Barione DF, Lizarte FSN, Novais PC, de Carvalho CAM, Valeri FCB, Peria FM, de Oliveira HF, Zanette DL, Silva WA, Cologna AJ, Reis RB, Tucci S, Martins ACP, Tirapelli DPC, Tirapelli LF. Gene expression study related with the intrinsic pathway of apoptosis in bladder cancer by real-time PCR technique. Genet Mol Res 2013; 12:878-86. [PMID: 23613234 DOI: 10.4238/2013.april.2.4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We examined the expression of anti-apoptotic genes (XIAP and Bcl-2) and apoptotic genes (cytochrome c, caspase-9, Apaf-1) in tissue samples of patients with superficial bladder cancer. Thirty-two bladder cancer tissue samples (8 papillary urothelial neoplasm of low malignant potential, 10 low-grade, and 14 high-grade) and 8 normal bladder tissue samples from necropsy were used for the study of gene expression by real-time PCR analysis. Analysis of the expression of apoptotic gene constituents of an apoptosome demonstrated an increase in Apaf-1 expression in the three tumor grades when compared with the control (P < 0.01, P < 0.05, and P < 0.01), low expression of caspase-9 in all groups (P < 0.05), and an increase in cytochrome c expression in all tumor grades in relation to the control, although without statistically significant difference. The expression of anti-apoptotic genes revealed an increase in XIAP expression in all tumor grades in relation to the control, although without statistically significant difference, and low expression of Bcl-2 in all tumor grades and the control (P < 0.05). The results proved that there is low evidence of apoptotic activity by the intrinsic pathway, demonstrated by the low expression of caspase-9 and considerable increase in XIAP expression, which may render these genes potential therapeutic targets in bladder cancer treatment.
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Affiliation(s)
- D F Barione
- Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Muniz JJ, Lacchini R, Belo VA, Nobre YTDA, Tucci S, Martins ACP, Tanus-Santos JE. Circulating matrix metalloproteinases and their endogenous inhibitors in patients with erectile dysfunction. Int J Impot Res 2011; 24:38-43. [DOI: 10.1038/ijir.2011.44] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Tirapelli LF, Barione DF, Trazzi BFM, Tirapelli DPC, Novas PC, Silva CS, Martinez M, Costa RS, Tucci S, Suaid HJ, Cologna AJ, Martins ACP. Comparison of two models for evaluation histopathology of experimental renal ischemia. Transplant Proc 2010; 41:4083-7. [PMID: 20005345 DOI: 10.1016/j.transproceed.2009.09.061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 07/01/2009] [Accepted: 09/15/2009] [Indexed: 01/19/2023]
Abstract
Renal ischemia/reperfusion (I/R) injury is one of the frequent causes of acute renal failure (ARF) due to the complex, interrelated sequence of events, that result in damage to and death of kidney cells. Cells of the proximal tubular epithelium are especially susceptible to I/R injury, leading to acute tubular necrosis, which plays a pivotal role in the pathogenesis of ARF. Several models have been explicated to assess morphological changes, including those of Jabonski et al. and Goujon et al. We compared the 2 models for histopathological evaluation of 30- or 120-minute periods of renal ischemia followed by 24-hour reperfusion in rats. Several changes were observed after application of the 2 models: proximal tubular cell necrosis, loss of brush border, vacuolization, denudation of tubular basement membrane as a consequence of flattening of basal cells, and presence of intratubular exfoliated cells in the lumen of proximal convoluted tubules at various stages of degeneration (karyorexis, kariopyknosis and karyolysis). Evaluating tubular lesions after 2 periods of experimental ischemia with light microscopy allowed us to conclude that the Goujon classification better characterized the main changes in cortical renal tubules after ischemia.
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Affiliation(s)
- L F Tirapelli
- Department of Surgery and Anatomy, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900--CEP 14049-900, Ribeirão Preto, São Paulo, Brazil.
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Suaid HJ, Cassini MF, Tucci S, Reis RB, Rodrigues AA, Cologna AJ, Martins ACP. Therapeutic option for infected urinary tract fistulas in renal transplantation. Transplant Proc 2010; 42:479-82. [PMID: 20304170 DOI: 10.1016/j.transproceed.2010.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Approximately 20% of urinary tract fistulas after renal allografting are complicated by urinary tract infection, which presents a therapeutic challenge. OBJECTIVE To evaluate an option for treatment of urinary tract fistulas associated with urinary tract infection and unsuitable for minimally invasive or primary surgical urinary tract repair. PATIENTS AND METHODS The study included 650 recipients who underwent transplantation over 17 years. Urinary leakage was initially treated with indwelling bladder catheterization. Patients with fistulas refractory to treatment underwent surgical intervention to repair the urinary tract. In patients who were not candidates for primary repair of the urinary tract, temporary urinary diversion was performed, rather than classic percutaneous or open nephrostomy, using a ureteral stent (ie, a 6F or 8F Foley catheter with the balloon placed inside the renal pelvis). RESULTS Overall, urinary leakage occurred in 36 patients (5.5%). Conservative management was successful in 14 vesical fistulas (42.4%) and no ureteral fistulas (0%). Three patients died of sepsis during conservative treatment, before the new surgical approach. Five of 36 urinary leaks (13.9%) were managed using ureteral intubation with an 8F Foley catheter, with a success rate of 80%. CONCLUSION Ureteral catheterization with an 8F Foley catheter is a feasible therapeutic option to treat complicated urinary tract fistulas unsuitable for primary surgical repair of the urinary tract.
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Affiliation(s)
- H J Suaid
- Divisions of Urology, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
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Domingos ALA, Tucci S, Garcia SB, de Bessa J, Cologna AJ, Martins ACP. Use of a latex biomembrane for bladder augmentation in a rabbit model: biocompatibility, clinical and histological outcomes. Int Braz J Urol 2010; 35:217-24; author reply 225-6. [PMID: 19409126 DOI: 10.1590/s1677-55382009000200012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2009] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To investigate histological features and biocompatibility of a latex biomembrane for bladder augmentation using a rabbit model. MATERIAL AND METHODS After a partial cystectomy, a patch of a non-vulcanized latex biomembrane (2x4 cm) was sewn to the bladder with 5/0 monofilament polydioxanone sulfate in a watertight manner. Groups of 5 animals were sacrificed at 15, 45 and 90 days after surgery and the bladder was removed. The 5-mum preparations obtained from grafted area and normal bladder were stained with hematoxylin-eosin. Immunohistochemical staining was performed with a primary antibody against alpha-actin to assess muscle regeneration. RESULTS No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. Macroscopically, after 90 days, the latex biomembrane was not identifiable and the patch was indistinguishable from normal bladder. A bladder stone was found in one animal (6.6%). On the 90th day, histology revealed continuity of transitional epithelium of host bladder tissue on the patch area. At this time, the muscle layers were well organized in a similar fashion to native bladder muscle layers. The inflammatory process was higher on grafted areas when compared to controls: 15 days--p < 0.0001, 45 days--p < 0.001, and 90 days--p < 0.01. The anti alpha-actin immunoexpression peaked at 45 days, when the graft was observed covered by muscle cells. CONCLUSION The latex biomembrane is biocompatible and can be used in models for bladder augmentation in rabbits. It promotes epithelium and muscle regeneration without urinary leakage.
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Affiliation(s)
- Andre L A Domingos
- Department of Surgery, Division of Urology, Ribeirao Preto Medical School, University of Sao Paulo, USP, Ribeirao Preto, SP, Brazil.
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Lizarte FS, Morgueti M, Tirapelli CR, Claudino MA, Evora PRB, Novais PC, Tirapelli DPC, Celotto AC, Capellini VK, Celini FPM, Tucci Jr S, Cologna AJ, Antunes E, Martins ACP, Tirapelli LF. Chronic alcoholism associated with diabetes impairs erectile function in rats. BJU Int 2010; 105:1592-7. [DOI: 10.1111/j.1464-410x.2009.09084.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lizarte FS, Claudino MA, Tirapelli CR, Morgueti M, Tirapelli DPC, Batalhão ME, Carnio EC, Queiroz RH, Evora PRB, Tucci S, Cologna A, Antunes E, Martins ACP, Tirapelli LF. Chronic ethanol consumption induces cavernosal smooth muscle dysfunction in rats. Urology 2009; 74:1250-6. [PMID: 19615717 DOI: 10.1016/j.urology.2009.04.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 04/08/2009] [Accepted: 04/14/2009] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To investigate the effects of chronic ethanol consumption on nitric oxide (NO)-mediated relaxation in rat cavernosal smooth muscle (CSM). METHODS Male wistar rats were divided into 2 groups: control and ethanol. CSM obtained from both groups were mounted in organ chambers for measurement of isometric tension. Contraction of the strips was induced by electrical field stimulation (EFS, 1-32 Hertz) and phenylephrine. We also evaluated the effect of ethanol consumption on the relaxation induced by acetylcholine (0.01-1000 micromol L(-1)), sodium nitroprusside (SNP, 0.01-1000 micromol L(-1)), or EFS (1-32 Hz) in strips precontracted with phenylephrine (10 micromol L(-1)). Blood ethanol, serum testosterone levels, and basal nitrate generation were determined. Immunoexpression of endothelial NO synthase (eNOS) and inducible NO synthase (iNOS) was also accessed. RESULTS Ethanol intake for 4 weeks significantly increased noradrenergic nerve-mediated contractions of CSM in response to EFS. The endothelium-dependent relaxation induced by acetylcholine decreased after the ethanol treatment. Ethanol consumption decreased serum testosterone levels but did not affect the nitrate levels on rat CSM. The mRNA and protein levels for eNOS and iNOS receptors were increased in CSM from ethanol-treated rats. CONCLUSIONS Ethanol consumption reduces endothelium-dependent relaxation induced by acetylcholine, but does not affect SNP or EFS-induced relaxation, suggesting that ethanol disrupts the endothelial function. Despite the overexpression of eNOS and iNOS in ethanol-treated rats, the impaired relaxation induced by acetylcholine may suggest that chronic ethanol consumption induces endothelial dysfunction.
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Affiliation(s)
- Fermino S Lizarte
- Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Tirapelli LF, Bagnato VS, Tirapelli DPC, Kurachi C, Barione DF, Tucci S, Suaid HJ, Cologna AJ, Martins ACP. Renal ischemia in rats: mitochondria function and laser autofluorescence. Transplant Proc 2008; 40:1679-84. [PMID: 18589172 DOI: 10.1016/j.transproceed.2008.02.081] [Citation(s) in RCA: 7] [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: 11/09/2007] [Accepted: 02/26/2008] [Indexed: 10/21/2022]
Abstract
Ischemia-reperfusion injury is the major cause of organ dysfunction or even nonfunction following transplantation. It can attenuate the long-term survival of transplanted organs. To evaluate the severity of renal ischemia injury determined by histology, we applied laser- (442 nm and 532 nm) induced fluorescence (LIF), mitochondria respiration, and membrane swelling to evaluate 28 Wistar rats that underwent left kidney warm ischemia for 20, 40, 60, or 80 minutes. LIF performed before ischemia (control) was repeated at 20, 40, 60, and 80 minutes thereafter. We harvested left kidney tissue samples immediately after LIF determination for histology and mitochondrial analyses: state 3 and 4 respiration, respiration control rate (RCR), and membrane swelling. The association of optic spectroscopy with histological damage showed: LIF, 442 nm (r2 = 0.39, P < .001) and 532 nm, (r2 = 0.18, P = .003); reflecting laser/fluorescence-induced, 442 nm (r2 = 0.20, P = .002) and 532 nm (r2 = 0.004, P = .67). The associations between mitochondria function and tissue damage were: state 3 respiration (r2 = 0.43, P = .0004), state 4 respiration (r2 = 0.03, P = 0.38), RCR (r2 = 0.28, P = .007), and membrane swelling (r2 = 0.02, P = .43). The intensity of fluorescence emitted by tissue excited by laser, especially at a wave length of 442 nm, was determined in real time. Mitochondrial state 3 respiration and respiratory control ratio also exhibited good correlations with the grade of ischemic tissue damage.
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Affiliation(s)
- L F Tirapelli
- Department of Surgery and Anatomy, Medical School of Ribeirão Preto, São Paulo, Brazil.
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Abstract
PURPOSE We evaluated treatment outcomes in children with adrenocortical carcinoma. MATERIALS AND METHODS We studied 34 children with a median age of 3 years. In 27 of 28 patients without intracaval extension complete surgical excision was accomplished, while tumor resection combined with thrombectomy was carried out in 5 of 6 children with vascular invasion. In 2 children with cavoatrial thrombus the thrombectomy required cardiopulmonary bypass with deep hypothermia and circulatory arrest. Children with incomplete excision of the tumor and/or stage IV disease received adjuvant chemotherapy. RESULTS Ultrasonography, computerized tomography and magnetic resonance imaging exhibited specificity of 100% in the diagnosis of vascular invasion, and sensitivity of 50%, 66% and 100%, respectively. Patient age, tumor stage or size and vascular invasion were associated with survival in univariate analysis. Tumor stage was the only independent factor associated with survival in multivariate analysis. The overall 5-year survival rates according to tumor stage were 100% in stage I, 85% in stage II, 40% in stage III and 0% in stage IV. Of 11 children with local recurrence only 2 were alive without disease at 96 and 204 months after reoperation with complete tumor excision. Only 2 of 6 patients with vascular invasion were disease-free at 17 and 50 months. A total of 10 children with stage IV disease treated with chemotherapy died within a median of 6 months. CONCLUSIONS Tumor stage was the most relevant prognostic factor for children with adrenocortical carcinoma. Reoperation for local tumor recurrence and thrombectomy for inferior vena caval tumor invasion should be attempted whenever possible.
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Affiliation(s)
- Silvio Tucci
- Division of Urology, Department of Surgery, Medical School of Ribeirão Preto, University of São Paulo, Av. Bandeirantes #3900, Ribeirão Preto, São Paulo, Brazil 14048-900
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Tucci S, Borelli-Bovo TJ, Cologna AJ, Tiraboschi RB, Martins ACP, Roselino JES. Calcium channel blocker and renal mitochondrial function in warm renal ischemia. Int Braz J Urol 2005; 31:384-9. [PMID: 16137409 DOI: 10.1590/s1677-55382005000400014] [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: 02/24/2005] [Accepted: 06/15/2005] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE Ions, particularly calcium ions, play an important role in ischemia-reperfusion cell injury. In this study, we investigated the action of verapamil on the mitochondrial function of kidneys submitted to ischemia without blood reperfusion in order to study isolated early and late ischemic effects. MATERIALS AND METHODS 44 rats were submitted to bilateral warm renal ischemia for 30 minutes. The kidneys were then immediately reperfused with saline or Euro-Collins (EC) solution, with and without previous administration of 0.35 mg/kg of verapamil. Mitochondrial function was assessed at the end of renal perfusion and after 24 hours of cold preservation. RESULTS In kidneys perfused with saline, verapamil allowed a significant early preservation of state III mitochondrial respiration, a result that was no longer evident after 24 hours. In kidneys perfused with EC solution, verapamil did not change state III for either early or late evaluations. Comparison of the groups showed that the results obtained for kidneys perfused with EC were always superior to those obtained for the saline group, except for the initial analysis of kidneys treated with saline and verapamil, which showed results similar to those obtained with EC perfusion alone. CONCLUSION Administration of verapamil before warm ischemia provides partial and short-lasting functional protection of the mitochondrial function in kidneys perfused with sodium rich saline. With Euro-Collins solution, verapamil did not show any additional beneficial effect. This fact permits us to conclude that protective action is effective only under conditions that facilitate increased sodium uptake and/or potassium loss.
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Affiliation(s)
- Silvio Tucci
- Laboratory of Experimental Surgery, Department of Surgery and Anatomy, Ribeirao Preto School of Medicine, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
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Martins ACP, Cologna AJ, Tucci S, Suaid HJ, Falconi RAR. CLINICAL FEATURES AND IMMUNOEXPRESSION OF p53, MIB-1 AND PROLIFERATING CELL NUCLEAR ANTIGEN IN ADRENAL NEOPLASMS. J Urol 2005; 173:2138-42. [PMID: 15879867 DOI: 10.1097/01.ju.0000157683.55748.41] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/26/2022]
Abstract
PURPOSE We evaluated the clinical features and immunoreactivity of p53 protein, MIB-1 antigen and proliferating cell nuclear antigen (PCNA) in adrenal neoplasms. MATERIALS AND METHODS A total of 26 patients with adrenocortical adenoma and 24 patients with carcinoma were treated with adrenalectomy. Clinical features and immunohistochemical reactions were compared in adult vs pediatric tumors. RESULTS There was a bimodal age distribution of carcinomas and adenomas, with a first peak occurring before age 5 years. The proportion of carcinomas in children (18 of 29) was higher than in adults (6 of 21). Carcinoma and adenoma occurring in children presented more commonly as the virilizing syndrome, while in adults Cushing's syndrome was more common. All adenomas in adults were p53 negative, while in children 4 of 11 adenomas (36%) were p53 positive. Histological Weiss criteria were the most reliable pathological features to distinguish adenoma from carcinoma. Other pathological features, including tumor weight, rate of mitotic figures and immunoexpression of p53 protein, MIB-1 antigen and PCNA, exhibited a striking difference in adenomas and carcinomas but none demonstrated sensitivity or specificity of 100%. Of all the computerized tomographic characteristics analyzed, including tumor size, shape, necrosis/hemorrhage, attenuation and contrast enhancement, only tumor size (greater than 5 cm) showed sensitivity and specificity of 100% in the differential diagnosis. Children and adults with carcinoma had similar curves of survival (p = 0.76). Carcinoma stage and PCNA immunoexpression displayed an association with outcome. CONCLUSIONS Endocrine syndromes differed in adults and children but other clinical features were similar in both groups. The role of p53 protein, MIB-1 antigen and proliferating cell nuclear antigen in discrimination of adenomas from carcinomas is unclear.
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Paschoalin EL, Martins ACP, Pastorello M, Sândis KA, Maciel LMZ, Silva WA, Zago MA, Bessa J. Racial influence on the prevalence of prostate carcinoma in Brazilian volunteers. Int Braz J Urol 2005; 29:300-5. [PMID: 15745552 DOI: 10.1590/s1677-55382003000400003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2003] [Accepted: 05/20/2003] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To investigate the prevalence of prostate carcinoma in a sample of volunteers known to have a large proportion of Bantu African ancestors, and the performance of total PSA (tPSA), PSA density (PSAD) and free-to-total PSA ratio (f/tPSA) on the diagnosis. MATERIALS AND METHODS A total of 473 volunteers (range: 40 - 79 years) were screened for prostate carcinoma. Those with tPSA >2 ng/ml and/or abnormal digital rectal examination were submitted to a transrectal ultrasound-directed biopsy (10 cores). The volunteers were classified as White, Mulatto or Black according to physical characteristics and to ancestors race reference. The following variable number of tandem repeats (VNTR) were analyzed in the blood of 120 volunteers without cancer and in 27 patients with prostate cancer: D4S43, PAH, F13A1, APOB and vW-1. RESULTS The biopsies performed in 121 volunteers revealed cancer in 27 (5.7% of 473). The proportions of cancer in White, Mulatto and Black were respectively: 0.6% (1/148), 6.7% (6/90) and 8.5% (20/235) (p = 0.006). The VNTRs analysis revealed heterogeneity in White, Mulatto and Black anthropologic phenotypes with the following admixture of Caucasian, African and Amerindian gene lineages: 67.5 +/- 8%, 20.8 +/- 8%, 11.7 +/- 7%; 54.8 +/- 9%, 36.3 +/- 5%, 8.9 +/- 7%; and, 45.3 +/- 3%, 45.9 +/- 4%, 8.8 +/-7%. Such a mixture was 50.5 +/- 9%, 49 +/- 8% and 0.5 +/- 4% in volunteers bearing cancer, and 59.1 +/- 7%, 31.7 +/- 8% and 9.2 +/- 5% in those without cancer. The sensitivity and specificity of tPSA at cut-off levels of 2, 2.5 and 4 ng/ml for volunteers with tPSA </= 10 ng/ml were respectively: 100% and 6,6%, 100% and 36,6%, 69,2% and 62,2%. PSAD at a cut-off level of 0.08 or 0.10, and f/tPSA at a cut-off level of 20% were able to increase significantly tPSA specificity without loss on sensitivity. CONCLUSIONS The tumor prevalence was higher in Non-White than in White phenotype. The association of tPSA at a cut-off level of 2.5 ng/ml with a PSAD of 0.08 or a f/tPSA of 20% for biopsy indication deserves further investigations as an alternative to tPSA cut-off level of 4 ng/ml.
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Affiliation(s)
- Edson L Paschoalin
- Ribeirão Preto General Hospital, School of Medicine, USP, São Paulo, Brazil
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Suaid HJ, Gonçalves MA, Rodrigues AA, Cunha JP, Cologna AJ, Martins ACP. Estimated costs of treatment of benign prostate hyperplasia in Brazil. Int Braz J Urol 2003; 29:234-7. [PMID: 15745527 DOI: 10.1590/s1677-55382003000300007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2002] [Accepted: 04/11/2003] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The treatment of benign prostate hyperplasia (BPH) presents 2 options: medical or surgical, and there are doubts about what is the best treatment since 80% of patients who undergo surgery become asymptomatic and 10 to 40% of those under medical regimen undergo surgery within a 5 years period. It is difficult to assess the actual costs of treating BPH in Brazil due to several factors, among them regional particularities and the scarcity of current statistical data. PATIENTS AND METHODS Recently, in the Ribeirao Preto area, Sao Paulo, Brazil, the IPSS (International Prostatic Symptoms Score) and quality of life were verified in 934 volunteers. It was determined the percentage of individuals with ages ranging from 40 to 79 years with moderate symptoms (score 8-19) and with severe symptoms (score 20-35), values for which are indicated medical and surgical treatment, respectively, according to the Brazilian Society of Urology consensus on BPH. Data on Brazilian population in that age range were obtained from the Brazilian Institute of Geography and Statistics referent to the year of 2000. It was determined the number of patients, according to the criteria above, subjected to either one of the treatments mentioned. Surgical costs of prostate transurethral resection were researched according to Unified Health System - SUS tables (173 US dollars) and of Brazilian Medical Society - AMB with a mean cost in 3 hospitals of 933 US dollars. Drug costs were calculated by the annual mean price (355 US dollars) of 4 alpha-blockers (tamsulosin, alfuzosin, doxazosin and terazosin). RESULTS The estimated population for medical treatment was 5,397,321 individuals, with a cost corresponding to 1,916,489,055.00 US dollars. The estimated population for surgical treatment was 2,040,299 men, what would represent a cost of 353,291,204.00 US dollars based on the SUS table and of 1,904,279,066.00 US dollars based on AMB with hospital expenses included. CONCLUSION All theses facts induce us to predict that the treatment of BPH in a not-so-far future can become a public health problem for Brazilian society, since the current estimate would be, approximately, costs around 2.26 - 3.83 billion dollars, added by the yearly increase in the risk population (24.99%) for the group under medical treatment and over the non-operated amount of the surgical group.
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Affiliation(s)
- Haylton J Suaid
- Division of Urology, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil
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Suaid HJ, Rocha JN, Martins ACP, Cologna AJ, Tucci SJ. Modulation of urethral alpha-sympathetic by parasympathetic before and following bethanechol chloride injection. Int Braz J Urol 2003; 29:162-5. [PMID: 15745502 DOI: 10.1590/s1677-55382003000200013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2002] [Accepted: 02/17/2003] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Chagas' disease causes specific parasympathetic denervation and in its digestive clinic form promotes also functional alterations in bladder. Thus, the aim was to investigate the existence of balance between sympathetic and parasympathetic systems in lower urinary tract, as occurs in other organs. We verified the urethral closing pressure before and following parasympathetic stimulus. PATIENTS AND METHODS For that, the urethral closure pressure was studied before and after the injection of 5 mg of bethanechol chloride subcutaneously in 28 voluntary female patients, divided into 4 groups. The constitution of theses groups was: A) normal control = 6 patients; B) Chagas' disease with positive serology only = 5 patients; C) Chagas' disease with cardiac disease = 6 patients, and D) Chagas' disease with digestive disease and vesical hyporeflexia = 11 patients. Urethral profilometry was performed through perfusion urethral catheter with a 6.5 ml/minute flow and a traction rate of 5 mm/minute. RESULTS Means and standard deviations for urethral closure pressure before bethanechol chloride were respectively: group A = 67.3 +/- 7.1; group B = 69.2 +/- 7.4; group C = 95.8 +/- 5.1; group D = 82.1 +/- 8.4. After bethanechol chloride they were: group A = 66.0 +/- 6.6; group B = 77.0 +/- 7.6; group C = 98.3 +/- 8.8; group D = 45.9 +/- 6.2. The Kruskal Wallis statistical test did not show statistically significance difference between groups A, B, C. However, it was statistically significant between groups C and D with p = 0.003. Wilcoxon test showed p = 0.001, only for values in group D before and following bethanechol chloride. CONCLUSIONS Chagas' disease in its intestinal form seems to alter urethral function as well. Parasympathetic stimulation decreased urethral pressure, indicating potential modulation by the parasympathetic system over the sympathetic system.
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Affiliation(s)
- Haylton J Suaid
- Section of Urodynamics, Division of Urology, Department of Surgery and Anatomy, HCFMRP-USP, São Paulo, SP, Brazil
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Abstract
PURPOSE We examined p53 protein and proliferating cell nuclear antigen immunoexpression as prognostic factors to the outcome of squamous cell carcinoma of the penis in 50 patients. MATERIALS AND METHODS Penectomy and lymphadenectomy were performed in 14 patients with clinically positive nodes while 36 with cN0 disease were treated with penectomy and kept under surveillance that resulted in subsequent lymphadenectomy due to nodal relapse in 8. Of 21 patients with confirmed nodal metastases 18 died of disease. Immunohistochemical reactions were performed via the avidin-biotin-immunoperoxidase method and the results were compared with tumor pT stage, grade, nodal status and cause specific death. RESULTS In univariate analysis proliferating cell nuclear antigen staining showed association only with nodal metastasis (p = 0.04) while p53 staining exhibited correlation with tumor pT stage (p = 0.0005), grade (p = 0.02), lymphatic spread (p = 0.02) and cause specific survival (p = 0.003). Multivariate analysis showed that p53 immunoreactivity was the only factor with prognostic significance for disease progression and cause specific survival. Tumor pT stage, grade and proliferating cell nuclear antigen staining had no significance for nodal metastases and cause specific death. CONCLUSIONS Proliferating cell nuclear antigen staining had no prognostic value for disease progression. Since p53 over expression was associated with tumor progression and cause specific death, perhaps it should be evaluated in staging and therapeutic planning for patients with squamous cell carcinoma of the penis.
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Affiliation(s)
- Antonio C P Martins
- Division of Urology, Department of Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes #3900, Ribeirão Preto, São Paulo, Brazil, CEP:14048-900
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Netto JMB, Tucci Jr S, Cologna AJ, Suaid HJ, Martins ACP, Molina CAF, Roselino JES. CLORORPROMAZINA E FUNÇÃO MITOCONDRIAL NA ISQUEMIA-REPERFUSÃO RENAL. Acta Cir Bras 2001. [DOI: 10.1590/s0102-86502001000500012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introdução e objetivo - em transplante renal com doador cadáver, a função do enxerto depende da manutenção da integridade celular e subcelular, principalmente mitocondrial. Neste estudo o objetivo foi analisar a função mitocondrial do rins submetidos a período prolongado de isquemia fria, seguido de reperfusão por uma hora, empregando-se, ou não, a clorpromazina previamente à isquemia. Métodos - utilizando autotransplante renal em cães, subdivididos em dois grupos, foram extraidas mitocôndrias de rins submetidos à isquemia fria de 48 horas, seguida de 1 hora de reperfusão pós-transplante. Um grupo recebeu clorpromazina antes da nefrectomia. A análise da fosforilação oxidativa e do intumescimento osmótico ("swelling") mitocôndrial foi comparada com dados obtidos de rins normais, sem isquemia. Resultados - Os dados obtidos para o estado III e IV da respiração não mostraram diferença significativa entre os grupos experimentais. A primeira fase do "swelling" ocorreu em tempo semelhante em todos os grupos experimentais. Durante a reversão, os grupos I e II se comportaram de maneira estatisticamente semelhante, com frações de reversão de 57%, e 68%, respectivamente, valores significativamente menores que os obtidos para o grupo normal (99%) (grupo I: p = 0,0374 e grupo II: p = 0,0221). Discussão - é conhecida a ação protetora da clorpromazina na isquemia renal normotérmica. Entretanto, os dados aqui obtidos mostram que após 48 horas de isquemia fria, o grupo II (clorpromazina) comportou-se de maneira semelhante ao grupo I (hipotermia isolada) tanto no estudo da fosforilação oxidativa, quanto no "swelling", embora os valores apresentem tendência a serem maiores no grupo II. Isto pode ser devido a alguns fatores, como: 1) a clorpromazina possui efeito protetor mínimo quando o tempo de isquemia é prolongado; 2) seu efeito pode ser afetado ou sua ação protetora sobreposta àquela imposta pela hipotermia; 3) tempo de reperfusão curto para manifestação de seus efeitos.
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Paschoalin EL, Costa RS, Maciel LMZ, Bessa Jr. J, Martins ACP, Dias-Neto JA, Souza RVS. RASTREAMENTO DO ADENOCARCINOMA PROSTÁTICO EM VOLUNTÁRIOS DE UMA REGIÃO DA BAHIA: RESULTADOS PRELIMINARES. Acta Cir Bras 2001. [DOI: 10.1590/s0102-86502001000500017] [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: 11/22/2022] Open
Abstract
O estudo teve como objetivo a determinação da prevalência do adenocarcinoma prostático em uma amostra de voluntários entre 40 e 80 anos de idade de uma região nordestina. Os voluntários foram recrutados da comunidade e submetidos ao toque retal e à dosagem do PSA total. Compareceram 499 homens para essa avaliação inicial. Aqueles com PSA maior que 2ng/ml e/ou toque retal suspeito tiveram a biópsia indicada. De 135 homens com indicação de biópsia, 120 compareceram para o exame. A biópsia guiada por ultra-som consistiu da retirada de 10 fragmentos (5/lobo). O adenocarcinoma prostático foi encontrado em 24 voluntários, o que corresponde a 5,1% dos casos. Essa prevalência parece mais elevada que a observada em voluntários da região sudeste do país. A diferença pode ser conseqüência de fatores genéticos ou ambientais, mas não se pode descartar outros fatores como variações metodológicas.
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Martins ACP. Ensino, pesquisa e extensão em medicina. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Falconi RAR, Martins ACP, Velludo MAL, Tucci Jr S, Cologna AJ, Suaid HJ, Carlotti Jr CG. Tumores da córtex da supra-renal: o uso do p53 na diferenciação entre carcinomas e adenomas. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Iwakura R, Martins ACP, Tucci Jr S, Pastorello MT, Suaid HJ. Nefroblastomas e antígeno p53. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Mendes Leal D, Tucci Jr S, Martins ACP, Cologna AJ, Suaid HJ, Roselino JES. Efeito protetor da lovastatina na função renal e mitocondrial de rins submetidos à isquemia normotécnica. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Falconi RA, Martins ACP, Velludo MAL, Suaid HJ, Tucci Jr S S, Cologna AJ, Serafini LN. Antígeno nuclear de proliferação celular em tumores de adrenal. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Martins ACP, Iwakura R, Tucci Jr S, Pastorello MT, Cologna AJ. Antígeno MIB-1 em nefroblastomas. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Martins ACP, Falconi RAR, Maggioni Jr GS, Suaid HJ, Cologna AJ, Tucci Jr S. Papel do MIB-1 no prognóstico dos carcinomas da córtex de supra-renal. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Muglia VF, Tucci Jr S, Elias Jr. J, Suaid HJ, Cologna AJ, Martins ACP. Contribuição da ressonância magnética no diagnóstico e abordagem das lesões escrotais. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Moriya T, Martins ACP, Piccinato CE, Cherri J, Iwakura R. Influência de diversos tipos de hidratação sobre o equilíbrio ácido base de pacientes cirúrgicos. Acta Cir Bras 2000. [DOI: 10.1590/s0102-86502000000600043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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