PURPOSE:To investigate if expression of genes encoding pro and anti-apoptotic proteins in the rat enteric endothelial cells stimulated by intestinal ischemia followed by reperfusion (IR) can be modified by treatment with heparin (HP).METHODS:Eighteen adult Wistar rats were divided in three groups: sham group submitted to laparotomy only (SG), ischemia followed by reperfusion group (IRG); ischemia followed by reperfusion plus pretreatment with HP 100 mg.kg-1 (IRG+HP). Ischemia was performed by clamping of the superior mesenteric artery. After 60 min of ischemia, metal clamps were removed for reperfusion for 120 min. Gene expression of encoding pro (Casp1, Casp6, Casp3, Cflar, Fas and Pgl) and anti-apoptotic (Bcl2, Bcl2l1 and Naip2) proteins in rat enteric endothelial cells was evaluated by PCR microarray method.RESULTS:Compared to rat endothelial cells of SG, the expression of pro-apoptotic genes was up-regulated in IRG while anti-apoptotic genes were down-regulated. In contrast, the expression of anti-apoptotic genes in IRG+HP was up-regulated while pro-apoptotic genes was down-regulated compared to SG.CONCLUSION:The attenuation by heparin of intestinal ischemia-reperfusion previously demonstrated in rodents could be related with ability of this drug to stimulate and reduce gene expression of encoding anti and pro-apoptotic proteins, respectively.

PURPOSE: To investigate the effects of ischemic preconditioning (IPC) on the expression of pro and anti-apoptotic genes in rat endothelial cells undergoing enteric ischemia (I) and reperfusion (R). METHODS: Thirty rats underwent clamping of the superior mesenteric vessels. Sham group (GS) laparotomy only; Ischemia (GI): intestinal ischemia (60 min); Ischemia and Reperfusion (GIR): ischemia (60 min) and reperfusion (120 min); Ischemia and intestinal ischemic preconditioning (GI + IPC) : 5 minutes of ischemia followed by 10 min of reperfusion before sustained ischemia (60 min) ischemia and reperfusion and IPC (GIR + IPC): 5 min ischemia followed by 10 min of reperfusion before sustained ischemia (60min) and reperfusion (120 min). Rat Endothelial Cell Biology (PCR array) to determine the expression of genes related to endothelial cell biology. RESULTS: Gene expression of pro-apoptotic markers (Casp1, Casp6, Cflar, Fas, and Pgl) was down regulated in GI+IPC and in GIR + IPC. In contrast, the expression of anti-apoptotic genes (Bcl2 and Naip2), was up-regulated in GI + IPC and in GIR + IPC. CONCLUSION: Ischemic preconditioning may protect against cell death caused by ischemia and reperfusion.

Objetivo: avaliar os resultados anatomopatológicos das peças operatórias de pacientes submetidas a cirurgia com alça de alta freqüência e sua relação com a localização colposcópica da atipia. Métodos: estudo retrospectivo de 134 pacientes que apresentavam neoplasia intra-epitelial ao exame citológico e/ou anatomopatológico e que foram submetidas a cirurgia com alça de alta freqüência. As pacientes foram separadas em três grupos, de acordo com a localização das atipias: Grupo I (n = 36): pacientes com atipia localizada na ectocérvice e junção escamo-colunar visível; Grupo II (n = 50): pacientes com atipia ecto-endocervical, e Grupo III (n = 48): pacientes com colposcopia insatisfatória. Resultados: o Grupo I apresentou média de idade de 33, o Grupo II média de 39 e o Grupo III, 48 anos. O comprometimento das margens cirúrgicas por neoplasia ocorreu respectivamente em 8,3, 36 e 29,2% dos casos quando avaliados por grupo. No acompanhamento das pacientes verificou-se que a porcentagem de doença residual foi de 4,2% no Grupo I, 31,6% no Grupo II e 35,5% no Grupo III. Conclusão: pacientes com lesões localizadas no canal endocervical apresentaram maior taxa de margens comprometidas. Pacientes com neoplasia intra-epitelial de alto grau localizadas no canal endocervical e idade superior a 40 anos têm maior chance de apresentar margens comprometidas e doença residual, necessitando de controles citológicos e colposcópicos rigorosos.

Purpose: to evaluate the histopathologic results of cone specimens of patients undergoing loop electrosurgical excision procedure (LEEP) and their relationship with the localization of the lesion. Methods: in a retrospective study, 134 clinical reports of patients with abnormal findings of cervical cytology and/or biopsy undergoing LEEP were reviewed. The colposcopic findings were divided into three groups according to the localization of the lesion. Group I (n = 36): patients with ectocervical lesions and fully visible squamocolumnar junction; Group II (n = 50): patients with lesions at the ectocervix and endocervix, and Group III (n = 48): patients with unsatisfactory colposcopy. Results: the mean age in Group I was 33 years and there were 8.3% positive margins. In Group II the mean age was 39 years, with 36% positive margins. Group III had a mean age of 48 years and presented 29.2% positive margins. The percentage of residual disease was 4.2% in Group I, 31.6% in Group II and 35.5% in Group III. Conclusion: patients with lesions at the endocervical canal showed a higher rate of positive margins. Patients with high-grade cervical intraepithelial neoplasia at the endocervical canal and older than 40 years have a greater chance of showing positive margins and residual disease, therefore requiring stricter cytologic and colposcopic follow-up.

Objetivo: estudar a ocorrência de dano térmico tissular nos espécimes excisados por cirurgia de alta freqüência e avaliar qualitativa e quantitativamente o dano térmico sobre o epitélio ectocervical e o endocervical e a provável influência do estado menstrual sobre sua gênese. Método: estudo prospectivo de 100 pacientes com lesão cervical intra-epitelial de alto grau. O dano térmico encontrado foi subdividido em três graus, leve, moderado e grave, de acordo com os critérios de Messing et al.¹ Resultado: a análise estatística permitiu avaliar que o dano térmico ocorreu em todos os casos, porém em 91% das vezes ele foi insignificante, permitindo a correta avaliação histopatológica. A extensão da alteração térmica tecidual sobre o epitélio endocervical foi de 271,6 mi, ao passo que a extensão no epitélio ectocervical foi de 254,8 mi, mostrando desta forma que a extensão do dano térmico é significantemente maior no epitélio endocervical. Das 100 pacientes avaliadas, 80 estavam no menacme e 20 na menopausa. O grau e a extensão do dano térmico tissular não variaram com o estado menstrual. Conclusão: não se observou qualquer diferença significativa na avaliação tanto do ponto de vista qualitativo quanto quantitativo. Por outro lado, evidenciou-se que na prática cotidiana não há necessidade de se fazer a mensuração do dano térmico.

Purpose: to evaluate the incidence of thermal damage to the specimens excised through large loop excision of the transformation zone (LLETZ) and to determine qualitatively and quantitatively the thermal injury to the ectocervical and endocervical epithelia as well as the influence of the menstrual phase on such process. Methods: we performed a prospective study of 100 patients with high-grade squamous intraepithelial lesions (HGSIL). Thermal damage was subdivided into three grades according to Messing et al¹. Results: thermal injury occurred in all the cases, however, through statistical analysis we found that in 91% of the cases it was insignificant, thus leading to a precise histological evaluation, hence to measure the thermal injury was unnecessary. The grade and extent of thermal damage in excised specimens using LLETZ had no relation to the menstrual phase. The extension of thermal tissue alteration in the endocervical epithelia was 271,6 mu while the extension in ectocervical epithelia was 254,8 mu, showing that the extension of thermal damage is significantly higher in endocervical epithelia. Of the one hundred patients, 80 were in menacme and 20 in menopause correlating the grade and extension of thermal damage with the menstrual state. Conclusion: there was no significant difference in both qualitative and quantitative evaluations. There is no need to measure the thermal damage.