RESUMO Racional: A doença hepática gordurosa não alcoólica (DHGNA) é caracterizada por acúmulo de lipídios intra-hepáticos. O uso de microrganismos vivos promove diversos efeitos benéficos; porém, a utilização de simbióticos e sua atuação na DHGNA ainda não está totalmente esclarecida. Objetivo: Verificar se a administração de simbióticos influencia na ocorrência e na progressão da DHGNA em ratos, após a indução de esteatose hepática por dieta hipercalórica. Método: Quarenta e cinco ratos Wistar foram divididos em quatro grupos: G1 (controle); G2 (controle+simbiótico); G3 (hipercalórica+ simbiótico) e G4 (hipercalórica), e eutanasiados após 60 dias de dieta. Coleta de sangue foi realizada para obtenção de análises bioquímicas e dosagem de IL6, e de tecido para análise histológica do fígado. Resultados: O simbiótico não influenciou no ganho de peso e no coeficiente de consumo alimentar nos grupos G3 e G4. Já G2 obteve maior ganho de peso, enquanto G1 apresentou o maior coeficiente de consumo alimentar entre os grupos. G1 apresentou maior expressão de aspartato aminotransferase em relação ao G2 (150±35 mg/dl e 75±5 mg/dl), enquanto G4 teve maior expressão desta enzima em relação ao G3 (141±9,7 mg/dl e 78±4 mg/dl,). A análise histológica hepática mostrou diferentes estágios de evolução da DHGNA entre os grupos. Animais do G4 apresentaram aumento sérico de interleucina-6 quando comparados a G3 (240,58±53,68 mg/dl, e 104,0±15,31 mg/dl). Conclusão: Os simbióticos reduziram aminotransferases hepáticas e a expressão de interleucina-6. No entanto, a histopatologia demonstrou que o simbiótico não foi capaz de prevenir a severidade da DHGNA em ratos.

ABSTRACT Background: Non-alcoholic fatty liver disease (NAFLD) is characterized by accumulation of intrahepatic lipid. The use of live microorganisms promotes beneficial effects; however, the use of symbiotic and its role in NAFLD is not yet fully understood. Aim: Verify if the symbiotic administration influences the occurrence and progression of NAFLD in rats, after induction of hepatic steatosis by high calorie diet. Method: Forty-five rats were divided into four groups: G1 (control); G2 (control+symbiotic); G3 (high calorie+symbiotic) and G4 (high calorie), and euthanized after 60 days of diet. Liver disease was evaluated by biochemical analysis, IL6 measurement and histological assessment. Results: Symbiotic had influence neither on weight gain, nor on coefficient dietary intake in G3 and G4. G2 had the greatest weight gain, while G1 had the highest coefficient dietary intake between groups. G1 showed higher expression of aspartate aminotransferase than those from G2 (150±35 mg/dl, and 75±5 mg/dl) while G4 showed higher expression of the enzyme compared to G3 (141±9.7 mg/dl to 78±4 mg/dl). Liver histology showed different stages of NAFLD between groups. G4 animals showed increased serum interleukin-6 when compared to G3 (240.58±53.68 mg/dl and 104.0±15.31 mg/dl). Conclusion: Symbiotic can reduce hepatic aminotransferases and interleukin-6 expression. However, the histology showed that the symbiotic was not able to prevent the severity of NAFLD in rats.

OBJETIVO: O objetivo do estudo é apresentar as complicações vasculares arteriais e venosas observadas em um serviço de transplante hepático universitário brasileiro. MÉTODOS: Os prontuários de todos os pacientes submetidos a transplante hepático no período de setembro de 1991 a janeiro de 2000 foram analisados para determinar as complicações vasculares e correlacioná-las a dados clínicos e do procedimento cirúrgico. RESULTADOS: Foram realizados 169 transplantes, sendo quatro inter vivos e nove retransplantes. Um total de 24 complicações vasculares (14,3%) foi identificado em 22 pacientes (13,0%). A complicação vascular mais comum foi a trombose da artéria hepática (15 casos), seguido da trombose da veia porta (quatro casos). Complicações da veia cava inferior infra ou supra-hepática foram incomuns, ocorrendo em um total de três casos (1,8%). As complicações vasculares foram mais freqüentes nas crianças (26,06%) do que em adultos (13,14%) (p<0,05). Dos pacientes com trombose da artéria hepática, um foi submetido à angioplastia, um a trombectomia, oito a retransplante e cinco evoluíram para o óbito enquanto aguardavam retransplante. Dos quatro casos de trombose da veia porta, dois foram a óbito, um foi submetido à colocação percutânea de prótese e um a tratamento conservador. Os pacientes com estenose da veia porta e da veia cava inferior infra e supra-hepática foram submetidos a tratamento conservador, com boa evolução clínica. CONCLUSÕES: que as complicações vasculares são freqüentes após o transplante hepático, principalmente em crianças, e são associadas à elevada morbidade, mortalidade e retransplante.

BACKGROUND: The authors present the vascular complications observed in an academic Brazilian hepatic transplantation division. METHODS: Hospital charts of all patients who were submitted to a liver transplantation between of September 1991 and January 2000, were evaluated to determine vascular complications and to correlated them to clinical data and surgical procedures. RESULTS: Of a total of 169 tranplantations performed, four were from living related donors and 9 retransplantations. Twenty-four vascular complications (14,3%) were identified in 22 patients (13,0%), the most common being hepatic artery thrombosis (15 cases) and portal vein thrombosis (4 cases). Complications of the infra and suprahepatic vena cava were observed in three cases (1,8%). Vascular complications were more common in children (26,06%) than in adults (13,14%) (p<0,05). From the patients with hepatic artery thrombosis, one was submitted to an angioplasty, one to a thrombectomy, while eight underwent retransplantation and five died waiting for retransplantation. Of the patients with portal vein thrombosis, two died, one submitted to an endovascular stent placement, and one to conservative treatment. Patients with stenosis of the portal vein and of the infra and suprahepatic inferior vena cava received a conservative treatment, with good clinical recovery. CONCLUSION: Vascular complications are frequent after liver transplantation, mainly with children. They are associated with an elevated rate of morbidity, mortality and retransplantation.

We describe a case of a 22-year-old man that had been submitted to a left herniorraphy 11 years previously to the present admission. He returned to our hospital with another mass in the same side of the groin. At operation, several small cysts linked to the spermatic cord were demonstrated. At this time, an histological exam demonstrated the presence of conective tissue. The final histology report confirmed the diagnosis of lymphangioma of the spermatic cord in the groin region. The patient was discharged from the hospital in a good health, with no complications.

Gastric bezoars are impactations offoreign material in lhe stomach. When they are caused by hail; they are named tricho- bezoars. The complications oftrichobezoars are very rare. In this papel; we describe a case of a 16-year-old girl that had a previous history oftricophagia, and had an acute abdominal pain with a pneumoperitoneum in the abdomen radiography. An operation was performed and a gastric perforation was founded associated with a giant trichobezoa7: The trichobezoar was removed by traction through a gastrostomy which was performed in order to remove lhe trichobezoa7: Some fragments of the ulcer were obtained to histological study. The gastrostomy was treated by a gastrorraphy confection. In lhe post- operative period a left subfrenic abscess was revealed and has been drained by laparatomy 15 days after the fisrt operation. After the second surgical procedure the patient had a good evolution, and left the hospital in good health conditions.