O valor da amilase, obtido precocemente nos drenos abdominais, é teste útil em prever a ocorrência de fístula pancreática após duodenopancreatectomia: lições aprendidas de um centro do Sul do Brasil / Early drain fluid amylase is useful to predict pancreatic fistula after pancreatoduodenectomy: lessons learned from a southern brazilian center

ABSTRACT BACKGROUND: Pancreatic fistula represents the most feared complication after pancreatoduodenectomies, being the major responsible for the high morbidity and mortality after this operation. Its incidence remains around 10% to 30%. In recent years, several authors have studied the value of amylase in abdominal drains fluid, measured at an early stage after the surgical procedure, as a useful tool to identify patients at risk of developing pancreatic fistula. OBJECTIVE: To analyze the value of early drain fluid amylase as a method to predict the occurrence and severity of postoperative pancreatic fistula in patients undergoing pancreatoduodenectomies. METHODS: We evaluated 102 prospective patients submitted to pancreatoduodenectomies from January 2013 to June 2017. The mensuration of amylase in abdominal drains was performed on days 1, 3, 5 and 7 in all patients. Patients were divided into three groups according to postoperative day 1 (POD1) results: values <270 U/L (group 1); between 271 and 5.000 U/L (group 2); and values >5.000 U/L (group 3). RESULTS: The incidence of pancreatic fistula was 25.5%, being 3.33%, 27.3% and 41.02% in the three groups, respectively. Compared with group 1, the risk of developing pancreatic fistula increased with increasing amylase values on POD1. Amylase values on POD1 and POD3 of patients with pancreatic fistula were higher than in the other ones without this complication (P<0.001). In addition, in group 3, 37.5% of patients with pancreatic fistula evolved to death (P<0.001). Finally, in this group, patients who died had drain fluid amylase values on POD1 significantly higher than the others in the same group (P<0.001). CONCLUSION: Early drain fluid amylase value is a useful test to stratify patients in relation to the risk of developing pancreatic fistula after pancreatoduodenectomies, in addition to correlate with the severity of this complication.

RESUMO CONTEXTO: A fístula pancreática representa a complicação mais temida após as duodenopancreatectomias, sendo a grande responsável pela elevada morbi-mortalidade após esta operação. Sua incidência permanece em torno de 10% a 30%. Nos últimos anos, diversos trabalhos têm estudado o valor da amilase nos drenos abdominais, medido de forma precoce após o procedimento cirúrgico, como ferramenta útil para a identificação dos pacientes sob risco de desenvolver fístula pancreática. OBJETIVO: Avaliar o valor da amilase no fluido dos drenos abdominais, obtido precocemente no pós-operatório, como método para prever a ocorrência e severidade da fístula pancreática nos pacientes submetidos a duodenopancreatectomias. MÉTODOS: Foram avaliados 102 pacientes prospectivos submetidos a duodenopancreatectomias no período de janeiro de 2013 a junho de 2017. A dosagem da amilase nos drenos abdominais foi realizada nos dias 1, 3, 5 e 7 em todos os pacientes. Os pacientes foram divididos em três grupos conforme os resultados do 1o PO: valores <270 U/L (grupo 1); entre 271 e 5.000 U/L (grupo 2); e valores >5.000 U/L (grupo 3). RESULTADOS: A incidência de fístula pancreática foi de 25,5%, sendo 3,33%, 27,3% e 41,02% nos três grupos, respectivamente. Comparados ao grupo 1, o risco de desenvolver fístula pancreática foi crescente com o aumento da amilase no 1o PO. Os valores das amilases no 1o PO e 3o PO dos pacientes com fístula pancreática foram maiores do que nos pacientes sem essa complicação (P<0,001). Além disso, no grupo 3, 37,5% dos pacientes com fístula pancreática evoluíram para óbito (P<0,001). Por fim, neste grupo, os pacientes que evoluíram para óbito tiveram valores de amilase no 1o PO significativamente maiores do que os demais pacientes (P<0,001). CONCLUSÃO: O valor da amilase, medido de forma precoce nos drenos abdominais no pós-operatório de duodenopancreatectomias, é teste útil para estratificar pacientes em relação ao risco de apresentar fístula pancreática, além de se correlacionar com a severidade dessa complicação.

Utilização dos níveis de amilase no dreno abdominal para diagnóstico de fístulas anastomóticas após o bypass gástrico em Y de Roux / Drain amylase levels may indicate gastrojejunostomy leaks after roux-en-y gastric bypass

ABSTRACT BACKGROUND: Although the incidence of leaks after Roux-en-Y gastric bypass (RYGB) significantly decreased over time, their detection still remains challenging. OBJECTIVE: This study aimed to determine the usefulness of drain amylase levels to detect leaks after RYGB. METHODS: This is a population-based study which enrolled 170 individuals who underwent RYGB. Drain amylase levels were determined on the first and fourth postoperative days. Two thresholds were evaluated: three times higher than the serum levels (parameter I) and higher than 250 IU/L (parameter II). The main outcomes evaluated were perioperative morbidity, the occurrence of leaks, 30-day readmissions and reoperations, hospital stay, and mortality. RESULTS: Considering the parameter I, high drain amylase levels were significantly associated with leaks (12.5% vs 0; P<0.00001). Considering the parameter II, high drain amylase levels were significantly associated with longer hospital stay (8±5.7 vs 4.5±1.3 days; P=0.00032), 30-day reoperations (50% vs 3%; P=0.000285), and leaks (50% vs 0; P<0.00001). The parameter I presented a sensitivity of 100% and specificity of 95.9%, whereas the parameter II presented a sensitivity of 100% and a specificity of 99.4%. CONCLUSION: The determination of drain amylase levels after RYGB was a significant indicator of leaks, hospital stay, and 30-day reoperations. This finding reinforces the importance of abdominal drainage in the RYGB within this context.

RESUMO CONTEÚDO: Embora a incidência de fistulas após o bypass gástrico em Y de Roux (BGRY) tenha diminuído significativamente com a evolução da técnica, sua detecção continua desafiadora. OBJETIVO: Determinar a acurácia dos níveis de amilase no dreno abdominal para detector fístulas após o BGYR. MÉTODOS: Este é um estudo populacional que avaliou 170 indivíduos submetidos ao BGYR. Os níveis de amilase no dreno foram determinados no primeiro e quarto dias de pós-operatório. Dois pontos de corte foram avaliados: três vezes maior que os níveis séricos (parâmetro I) e acima de 250 UI/L (parâmetro II). Os principais desfechos estudados foram: morbidade perioperatória, ocorrência de fístulas, reinternações e reoperações nos primeiros 30 dias, permanência hospitalar e mortalidade. RESULTADOS: Considerando o parâmetro I, altos níveis de amilase do dreno foram indicadores significativos de fístulas (12,5% vs 0; P<0,00001). Considerando o parâmetro II, altos níveis de amilse no dreno estiveram significativamente associados a maior permanência hospitalar (8±5,7 vs 4,5±1,3 dias; P=0,00032), frequência de reoperações (50% vs 3%; P=0,000285) e ocorrência de fístulas (50% vs 0; P<0,00001). O parâmetro I apresentou sensibilidade de 100% e especificidade de 95,9%, enquanto o parâmetro II apresentou sensibilidade de 100% e especificidade de 99,4%. CONCLUSÃO: A determinação dos níveis de amilase no dreno após o BGYR foi um indicador significativo de fístulas, permanência hospitalar e reoperações. Este achado reforça a importância da drenagem abdominal no BGYR dentro deste contexto.

Drain amylase on the first postoperative day of whipple surgery: what value is the best predictor for early drain removal? / Amilase do dreno no primeiro dia de pós-operatório de operaçao de whipple: qual valor é melhor preditor para a retirada precoce do dreno?

ABSTRACT Background: The value of drain amylase on the first postoperative day after pancreatic resections has been described as an efficient predictor of pancreatic fistula. In spite of this, the cut-off point below which the drains can be removed early remains controversial. Aim: Validate the use of the amylase on the 1st postoperative day in the correlation with pancreatic fistula and define the value at which early drain removal is safe. Method: Were included patients undergoing Whipple surgery in the period of 2007 to 2016. Group 1 enrolled the ones who did not develop fistula and those who developed biochemical fistula for less than seven days postoperatively and group 2 included patients who developed persistent biochemical fistula between seven and 21 days and those with grade B and C fistula. Results: Sixty-one patients were included, 41 comprised group 1 and 20 group 2. The incidence of abdominal collections, need for reoperation and time of hospitalization were for group 1 and 2, respectively: 17.1%, 17.1% and 9.5 days, and 65%, 40% and 21.1 days. The median of the amylase from the drain at 1st postoperative day was in group 1 and 2, respectively: 175 U/l and 3172.5 U/l (p=0.001). Using a cut-off of 180 to predict the group to which the patient would belong there was obtained sensitivity, specificity, positive predictive value and negative predictive value of 100%, 48.8%, 50% and 100% respectively. Conclusion: It was validated the cut-off value of 180 U/l as appropriate to early drain removal.

RESUMO Racional: O valor da amilase do dreno no primeiro dia pós-operatório após ressecções pancreáticas é descrito como eficiente preditor de fístula pancreática. Entretanto, o valor abaixo do qual os drenos podem ser removidos precocemente permanece controverso. Objetivo: Validar o uso da amilase do primeiro dia pós-operatório na correlação com a fístula pancreática e definir o valor em que seja segura a retirada precoce do dreno. Método: Foram incluídos pacientes submetidos à operação de Whipple no período de 2007 a 2016. No grupo 1 entraram os que não desenvolveram fístula e os que desenvolveram fístula bioquímica por menos de sete dias de pós-operatório e no grupo 2 os que desenvolveram fístula bioquímica persistente entre 7 e 21 dias e aqueles com fístula grau B e C. Resultados: Sessenta e um pacientes foram incluídos, sendo 41 do grupo 1 e 20 do grupo 2. A incidência de coleções abdominais, necessidade de reoperação e tempo de internação foram para o grupo 1 e 2, respectivamente 17,1%, 17,1% e 9,5 dias, e 65%, 40% e 21,1 dias. A mediana da amilase no grupo 1 e 2, respectivamente foi de 175 U/l e 3172,5 U/l (p=0,001). Utilizando o ponto de corte de 180 para predizer o grupo a que o paciente pertenceria, obteve-se sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo de: 100%, 48,8%, 50% e 100% respectivamente. Conclusão: Esta amostra pôde validar o ponto de corte de 180 U/l como adequado para a retirada precoce do dreno.

Glycogen-rich clear cell carcinoma of the feline mammary gland: case report / Carcinoma de células claras rico em glicogênio da glândula mamária felina: relato de caso

The aim of this report is to describe the first histopathological, immunohistochemical, and clinical characteristics of a feline glycogen-rich clear cell carcinoma (GRCCC). A Persian queen was admitted with mammary gland tumors and underwent radical unilateral mastectomy. Overall survival was considered 33 days and death was due to clinical evolution of the disease. Microscopic evaluation demonstrated epithelial cells arranged in a predominantly solid pattern, tumor cells presented an ample, granular, and foamy clear cytoplasm, and moderate cellular pleomorfism. The presence of cytoplasmatic glycogen was confirmed through diastase digestion followed by PAS staining. Histopathological and histochemical findings lead to the diagnosis of GRCCC with regional metastases.(AU)

O objetivo deste relato de caso é descrever as características clínicas, histopatológicas e imuno-histoquímicas do primeiro carcinoma mamário de células claras rico em glicogênio em felino. Uma gata persa foi atendida com tumores na glândula mamária e foi submetida à mastectomia radical unilateral. A sobrevida livre de doença foi considerada 33 dias, e o óbito foi devido à evolução da doença. A avaliação microscópica demonstrou células epiteliais arranjadas em um padrão predominantemente sólido, as células tumorais apresentaram um citoplasma claro, amplo, granular e espumoso e pleomorfismo celular moderado. A presença do glicogênio citoplasmático foi confirmada pela digestão pela diástase, seguida da coloração de PAS. Achados histopatológicos e histoquímicos levaram ao diagnóstico de carcinoma de células claras rico em glicogênio felino com metástase regional.(AU)

Selección de un hongo filamentoso altamente productor de amilasas para ser usadas en detergentes biodegradables / Selection of filamentous fungus highly producer of amylases to be used in biodegradable detergents

Las amilasas (alfa-amilasa, EC 3.2.1.1 y glucoamilasa, EC 3.2.1.3) son enzimas extracelulares que hidrolizan el almidón en dextrinas hasta glucosa y tienen gran aplicación industrial, especialmente alimentaria; detergentes y en la producción de alcohol a partir de granos. El objetivo del trabajo es seleccionar un hongo filamentoso que presente alta producción de amilasas con características particulares para ser empleadas en biodetergentes. Se estudiaron los siguientes hongos: Penicillium expansum; P. digitatum; P. islandicum; Aspergillus clavatus; A. niger; A. ochraceus; A. fumigatus; A. flavus; A. oryzae; A. nidulans y Geotrichum candidum; Los ensayos se realizaron en un medio de hidrolizado de papa de descarte (variedad Spunta) suplementado con las siguientes sales: KH2 PO4 1,0; NaNO3 3,0; MgSO4 .7H2 O 0,5, a pH 4,0; se inoculó con 2 x106 conidios/mL y se incubaron a 25ºC en un agitador rotatorio a una velocidad de agitación de 250 rpm. Con los extractos enzimáticos parcialmente purificados con (NH4 )2 SO4 al 60 por ciento de saturación, se estudió el efecto del pH (2,5; 3,5; 4,0; 4,5; 5,0; 5,5; 6,0, 7,0 y 8,0) y la temperatura (20; 25; 30; 35 y 40ºC). Los resultados mostraron que la máxima producción de enzima (128 U/L) se obtuvo con Aspergillus niger, en las condiciones ensayadas, a las 48 h de incubación, con alto rendimiento de producto respecto a la biomasa (Yp/x= 18,3 U/g) y productividad volumétrica (Pdv=2,7 U/L). El análisis cualitativo de las enzimas del complejo amilolítico de A. niger mostró que las amilasas implicadas son alfa-amilasa y glucoamilasa y se caracterizaron por hidrolizar en un tiempo de 3 min. manchas mixtas de almidón y grasas de muestras textiles en un rango de pH 4,0 a 8,0 y de 20 a 40 ºC.

The amylases (alpha-amylase, EC 3.2.1.1 and glucoamylase, EC 3.2.1.3) are extracellular enzymes that hydrolyze starch into dextrins to glucose and have great application industrial, especially food, detergents and in the production of alcohol from grains. The objective of the study is to select a filamentous fungus that present high production of amylases showing attractive features to be used in biodetergentes. Were studied following fungus: Penicillium expansum; P. digitatum; P. islandicum; Aspergillus clavatus; A niger; A. ochraceus; A. fumigatus; A. flavus; A. oryzae; A. nidulans and Geotrichum candidum. The tests were conducted in the medium of hydrolyzed potato discard (variety Spunta) supplemented with the following sales: KH2 PO4 , 1.0; NaNO3 , 3.0 and MgSO4 .7H2 O, 0.5, to pH 4.0. Were inoculated with 2 x 106 conidia/ mL and incubated at 25 °C on a rotary Shaker at a speed of 250 rpm. With partially purified enzyme extracts with (NH4 )2 SO4 at 60 percent of saturation, we studied the effect of pH (2.5; 3.5; 4.0; 4.5; 5.0; 5.5; 6.0, 7.0 and 8.0) and temperature (20; 25; 30; 35, and 40 ° C). The results showed that the maximum production of enzyme (128 U/L) was obtained with Aspergillus niger, under the conditions tested, at 48 h of incubation, with high product formation rate with respect to biomass (Yp/x = 18.3 U/g) and volumetric productivity (Pdv = 2,7 U/ hL). The qualitative analysis of the enzymes of the complex amylolític of A. niger showed that involved amylases are α-amylase and glucoamylase and characterized by hydrolyze in 3 min spots mixed starch and fats of textile samples over a range of pH 4.0 to 8.0 and 20 to 40 ° C.

Acute pancreatitis associated with pegylated interferon-alpha-2a therapy in chronic hepatitis C

Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma. Combination therapy of pegylated interferon-alpha (PEG-IFN-α) and ribavirin (RBV) is a current standard treatment for chronic HCV infection in Korea, which has considerable adverse effects. Acute pancreatitis is a rare complication of PEG-IFN-α administration. We report a case of a 62-year-old female who experienced acute pancreatitis after 4 weeks of PEG-IFN-α-2a and RBV combination therapy for chronic HCV infection. The main cause of the acute pancreatitis in this case was probably PEG-IFN-α rather than RBV for several reasons. A few cases have been reported in which acute pancreatitis occurred during treatment with PEG-IFN-α-2b. This is the first report of acute pancreatitis associated with PEG-IFN-α-2a in Korea.

Comparison of salivary levels of mucin and amylase and their relation with clinical parameters obtained from patients with aggressive and chronic periodontal disease

Objective Salivary mucin and amylase levels are increased in patients with chronic periodontitis (CP). Due to the fact that aggressive periodontitis (AgP) not only differs from chronic periodontitis in terms of its clinical manifestation, the aim of this study was to compare salivary mucin and amylase levels and their relation to the clinical parameters of patients with aggressive periodontitis with that of patients with chronic periodontitis. Material and Methods Eighty subjects were divided into two groups: 20 patients with AgP and their 20 matched controls and 20 patients with CP and their 20 matched controls, based on clinical attachment loss (CAL), probing pocket depth (PPD) and bleeding on probing (BOP). Whole unstimulated saliva was obtained and mucin, amylase and protein were determined by colorimetric methods. Pearson's correlation analysis was used to determine the relationship between salivary mucin, amylase and protein levels and the clinical parameters. Results Salivary mucin, amylase and protein levels were increased in patients with AgP and CP but there were no differences between them or between control groups. Pearson's correlation analysis, determined in the entire subjects studied, showed a positive and significant correlation of mucin, amylase and proteins with CAL and PPD and a negative correlation with the flow rate. When Pearson's correlation analysis was carried out in each group separately, Fisher's z transformation showed no significant difference between both groups. Conclusion Comparison of the salivary levels of mucin, amylase and protein and their relationship with clinical parameters of AgP patients with that of CP patients revealed no differences between both groups. .

Chemical salivary composition and its relationship with periodontal disease and dental calculus

Aim: To determine the relationship between the chemical composition of saliva, periodontal disease and dental calculus. Methods: An observational analytical cross-sectional study was conducted with patients over 55 years of age. Ethical principles of autonomy and risk protection were applied according to the international standards. Sociodemographic and diagnosis variables (presence of dental calculus and periodontal status) were considered to measure salivary concentrations of glucose (by the glucose oxidase/peroxidase method, amylase (by the colorimetric test), urea (by the amount of indophenol), total protein (by the Bradford method) and albumin (by the nephelometric method). Patients chewed a sterile rubber band and 3 mL of stimulated saliva were collected. The samples were stored at -5 °C, centrifuged at 2,800 rpm for 10 min, and the supernatant was removed and stored at -20 °C. Data were presented as frequencies and proportions for qualitative variables and measures of central tendency and dispersion for quantitative variables. Data were analyzed by either analysis of variance or Kruskal Wallis test . A p value <0.05 was considered statistically significant. Results: Significant relationships were observed between the concentration of salivary urea and periodontal status (p = 0.03) and the presence of dental calculus and urea (p = 0.04) was demonstrated. Conclusions: A relationship between the salivary urea concentration and the presence of periodontal disease and dental calculus is suggested.

Utilization of Agro-industrial Wastes for the Simultaneous Production of Amylase and Xylanase by Thermophilic Actinomycetes

Agro-industrial wastes such as sugarcane bagasse, wheat bran, rice bran, corn cob and wheat straw are cheapest and abundantly available natural carbon sources. The present study was aimed to production of amylase and xylanase simultaneously using agro-industrial waste as the sole carbon source. Seven thermophilic strains of actinomycete were isolated from the mushroom compost. Among of these, strain designated MSC702 having high potential to utilize agro-industrial wastes for the production of amylase and xylanase. Strain MSC702 was identified as novel species of Streptomyces through morphological characterization and 16S rRNA gene sequence. Enzyme production was determined using 1% (w/v) of various agro-industrial waste in production medium containing (g/100mL): K2HPO4(0.1), (NH4)2SO4(0.1), NaCl (0.1), MgSO4(0.1) at pH 7.0 after incubation of 48 h at 50°C. The amylase activity (373.89 IU/mL) and xylanase activity (30.15 IU/mL) was maximum in rice bran. The decreasing order of amylase and xylanase activity in different type of agro-industrial wastes were found rice bran (RB) > corn cob (CC) > wheat bran (WB) > wheat straw (WS) > sugarcane bagasse (SB) and rice bran (RB) > wheat bran (WB) > wheat straw (WS) > sugarcane bagasse (SB) > corn cob (CC), respectively. Mixed effect of different agro-industrial wastes was examined in different ratios. Enzyme yield of amylase and xylanase was ~1.3 and ~2.0 fold higher with RB: WB in 1:2 ratio.

Amylase production by endophytic fungi Cylindrocephalum sp. isolated from medicinal plant Alpinia calcarata (Haw.) Roscoe

Amylases are among the most important enzymes used in modern biotechnology particularly in the process involving starch hydrolysis. Fungal amylase has large applications in food and pharmaceutical industries. Considering these facts, endophytic fungi isolated from the plant Alpinia calcarata (Haw.) Roscoe were screened for amylolytic activity on glucose yeast extract peptone agar (GYP) medium. Among thirty isolates of endophytic fungi, isolate number seven identified as Cylindrocephalum sp. (Ac-7) showed highest amylolytic activity and was taken for further study. Influence of various physical and chemical factors such as pH, temperature, carbon and nitrogen sources on amylase production in liquid media were studied. The maximal amylase production was found to be at 30ºC and at pH 7.0 of the growth medium. Among the various carbon and nitrogen sources tested, maltose at 1.5% and Sodium nitrate at 0.3% respectively gave optimum amylase production.

Growth and enzymatic responses of phytopathogenic fungi to glucose in culture media and soil

The effect of inoculation of Aspergillus flavus, Fusarium verticillioides, and Penicillium sp. in Dystrophic Red Latosol (DRL) and Eutroferric Red Latosol (ERL) soils with or without glucose on the total carbohydrate content and the dehydrogenase and amylase activities was studied. The fungal growth and spore production in culture medium with and without glucose were also evaluated. A completely randomized design with factorial arrangement was used. The addition of glucose in the culture medium increased the growth rate of A. flavus and Penicillium sp. but not of F. verticillioides. The number of spores increased 1.2 for F. verticillioides and 8.2 times for A. flavus in the medium with glucose, but was reduced 3.5 times for Penicillium sp. The total carbohydrates contents reduced significantly according to first and second degree equations. The consumption of total carbohydrates by A. flavus and Penicillium sp. was higher than the control or soil inoculated with F. verticillioides. The addition of glucose to soils benefited the use of carbohydrates, probably due to the stimulation of fungal growth. Dehydrogenase activity increased between 1.5 to 1.8 times (p <0.05) in soils with glucose and inoculated with the fungi (except F. verticillioides), in relation to soil without glucose. Amylase activity increased 1.3 to 1.5 times due to the addition of glucose in the soil. Increased amylase activity was observed in the DRL soil with glucose and inoculated with A. flavus and Penicillium sp. when compared to control.

Amylase production by solid-state fermentation of agro-industrial wastes using Bacillus sp

Solid state fermentation was carried out using various agro- industrial wastes with the best amylase producing strain isolated from soil. Different physicochemical conditions were varied for maximum enzyme production. The strain produced about 5400 units/g of amylase at 1:3 moisture content, 20 percent inoculum, after 72 h of incubation with Mustard Oil seed cake as the substrate. The optimum temperature and pH of the enzyme activity were found to be 50ºC and 6 respectively. The enzyme was found to be thermostable at 70ºC for about 2 h without any salt. It showed stability at pH range 5-7. The metal ions as Na+, Ca++, Mg++ and Co++ enhanced the enzyme activity.

Starch degradation and nutrition value improvement in corn grits by solid state fermentation technique with Coriolus versicolor

The study was conducted to evaluate effect of Coriolus versicolor mycelia on degrading starch and improving nutrition value in corn grits through solid state fermentation technique. The results showed that using soybean meal as a nitrogen source, á-amylase secreted from C. versicolor expressed 407.25U/g of activity, leading to 45.15 percent of starch degraded. The activity grew with fermentation time until the 15th day, after that the amylase was deactivated rapidly. An orthogonal experiment designed for the study illustrated that degradation rate of starch in corn grits attained to maximum, 50.51 percent, when 100g of corn grits, added 16g of soybean meal, were fermented by C. versicolor for 12 days, in an initial pH 5.5. After fermenting, compared to the nonfermented control, contents of amino acids, total sugar, crude fat and crude protein were increased by 21.00 percent, 38.45 percent, 55.56 percent, 69.15 percent respectively. The significant improvement of nutrition value in corn grits is probably attributed to the intense metabolism of C. versicolor.

Alta frecuencia de pancreatitis aguda asociada a patología biliar en niños chilenos / Elevated frequency of acute pancreatitis associated to biliary illness in Chilean children

Acute Pancreatitis (AP) in children presents significant morbimortality. Most common etiologies in this age group are trauma, systemic illness and idiopathic pancreatitis. This is different from adult AP, where lithiasis and alcohol consumption are the predominant causes. In Chile, where billiary disease is highly prevalent, there is little information regarding AP among children. Objective: To determine the main clinical characteristics of acute pancreatitis in a group of Chilean children. Patients and Methods: A retrospective study (1998-2008) of patients hospitalized with the diagnosis of AP. The diagnosis was confirmed by elevation of pancreatic enzymes and through images. Demographic data, etiology, complications and resolutions, need for parenteral nutrition, and use of antibiotics were examined. Results: Eighteen patients were identified (8,3 +/- 4 y.o.). Etiology of AP was listed as: lithiasis and alterations of biliary duct: 38,8 percent, idiopathic: 22,2 percent, secondary to medications: 22,2 percent and other: 16.8 percent. Two patients presented peripancreatic infected collections; a similar number formed pancreatic pseudocysts. Six patients (33,3 percent) required one type of surgical procedure as part of their treatment. Two-thirds of all patients required treatment in ICU. One half of the patients required parenteral nutrition, and two thirds received IV antibiotics. The median length of hospital stay was 20 days (ave 24,9 +/- 14,3 ds). There was no mortality in this serie. Conclusions: Unlike previously described, biliary AP was the most common cause in this serie. Biliary pathology should be actively studied among Chilean children with AP.

La pancreatitis aguda (PA) en niños presenta una morbimortalidad considerable. Las etiologías más frecuentes en este grupo etario son la PA secundaria a trauma, por enfermedades sistémicas y la PA idiopática, a diferencia de la población adulta en que predomina la litiasis biliar y el consumo de alcohol. En Chile, donde la patología biliar es altamente prevalente, existe escasa información clínica respecto de la PA en niños. Objetivo: Determinar las características clínicas de la pancreatitis aguda en un grupo de niños chilenos. Método: Estudio retrospectivo (1998-2008) de pacientes hospitalizados con PA. Se confirmó el diagnóstico por elevación de enzimas pancreáticas e imágenes; se obtuvieron los datos demográficos y se analizó: etiología, complicaciones y su resolución, necesidad de nutrición parenteral y uso de antibióticos. Resultados: Se identificaron 18 pacientes (8,3 +/- 4 años). Etiología de la PA: litiasis y alteraciones anatómicas de la vía biliar (38,8 por ciento), idiopática (22,2 por ciento), drogas (22,2 por ciento), otras (16.8 por ciento). Dos pacientes presentaron colecciones peripancreáticas infectadas; igual número evolucionó con formación de pseudoquistes pancreáticos. Seis pacientes (33,3 por ciento) requirieron algún tipo de procedimiento quirúrgico como parte de su tratamiento. Dos tercios de los pacientes ingresaron a la Unidad de Pacientes Críticos. La mitad de los pacientes recibió nutrición parenteral y dos tercios antibióticos endovenosos. La mediana de hospitalización fue de 20 días (promedio 24,9 +/- 14,3 días). No hubo mortalidad en la serie. Conclusiones: A diferencia de lo descrito en la literatura, la PA biliar fue la etiología más frecuente en esta serie. La patología biliar debe ser estudiada activamente en niños chilenos con PA.

Thermostable saccharogenic amylase produced under submerged fermentation by filamentous fungus Penicillium purpurogenum

The effect of several nutritional and environmental parameters on Penicillium purpurogenum growth and sacharogenic amylase production was analyzed. High enzyme levels (68.2 U mg-1) were obtained with Khanna medium at initial pH 6.0, incubated at 30ºC for 144 hours. The optimum pH and temperature activities were 5.0 and 65ºC, respectively. The enzyme presented a half-life (t50) of 60 min, at 65ºC. Only glucose was detected after 24 hours of reaction using soluble starch as substrate.

Reflujo pancreáticobiliar en pacientes con colelitiasis y sin colelitiasis: estudio comparativo / Pancreaticobiliary reflux in patients with cholelithiasis and without cholelithiasis: a comparative study

Background. Pancreaticobiliary reflux is a pathologic phenomenon occurring in patients with gallstones. However, the occurrence of pancreaticobiliary reflux has not been studied in patients without gallstones. The objective of this study was to measure the bile levels of amylase and lipase in patients without gallstones submitted to cholecystectomy as part of another surgical procedure, and to compare these values with patients submitted to cholecystectomy for gallstone disease. Patients and Methods. A prospective observational comparative study was designed. A sample of 136 consecutive patients was included. Amylase and lipase levels were measured in bile. Normal serum amylase levels at our institution are 28-100 U/L and for lipase are 13-60 U/L. There are no established normal levels for pancreatic enzymes in bile. However, we considered elevated the bile amylase and lipase levels whenever they were higher than normal plasma levels. Results. One-hundred three patients (76 percent) had gallstones and 33 (24 percent) liad healthy gallbladders without gallstones. According to normal plasma levels for amylase and lipase, these enzymes in bile were elevated in 83.5 percent patients with gallstones, compared to elevated levels of amylase in 6 percent patients and lipase in 3 percent patients without gallstones. Conclusions. Pancreaticobiliary reflux is a common phenomenon in patients with gallstones and occurs sporadically in patients without gallstones.

Introducción. El reflujo pancreáticobiliar es un fenómeno patológico que ocurre en pacientes con colelitiasis. La ocurrencia de este fenómeno no ha sido estudiada en pacientes sin colelitiasis. El presente estudio tiene por objetivo medir los niveles de amilasa y lipasa en la bilis de pacientes sin colelitiasis, colecistectomizados como parte de otro procedimiento quirúrgico y comparar estos valores con pacientes colecistectomizados por colelitiasis. Pacientes y Métodos. Se diseñó un estudio observacional y comparativo. Una muestra de 136 pacientes consecutivos fue incluida. Se midieron los niveles de amilasa y lipasa en la bilis. En nuestra institución los valores normales para amilasa son 28-100 U/L y para lipasa 13-60 U/L. No se han establecido valores normales de enzimas pancreáticas en la bilis. Para efectos del presente estudio, se consideró como elevados los niveles biliares de amilasa y lipasa cuando fueron mayores a los valores plasmáticos normales. Resultados. 103 pacientes (76 por ciento) tenían colelitiasis y 33 (24 por ciento) tenían vesículas normales sin cálculos. De acuerdo a los valores plasmáticos normales de amilasa y lipasa, estas enzimas se encontraron elevadas en 83,5 por ciento de los pacientes con colelitiasis comparados con valores elevados de amilasa en 6 por ciento en pacientes sin colelitiasis y de lipasa en 3 por ciento de estos pacientes. Conclusiones. El reflujo pancreaticobiliar es un fenómeno común en pacientes con colelitiasis y ocurre esporádicamente en pacientes sin colelitiasis.

Evaluación de actividades enzimáticas de Fusarium spp., aislados de lesiones en humanos, animales y plantas / Avaliação das atividades enzimáticas de Fusarium spp. Isolados a partir de lesões em humanos, animais e plantas / Assessment of enzymatic characterization of Fusarium spp. isolated from human, animal, and plant rounds

Objetivo. Determinar actividades amilolíticas, celulolíticas, lipolíticas, pectinolíticas y proteolíticas en 32 aislamientos de Fusarium spp. de origen humano, animal y vegetal. Materiales y métodos. Las actividades enzimáticas se determinaron a nivel cualitativo, por medio de la medición de halos de hidrólisis en placas de agar con el respectivo sustrato, y a nivel cuantitativo se realizó un cultivo líquido para determinar la degradación del respectivo sustrato por medio de técnicas colorimétricas. Resultados. Todos los aislamientos presentaron actividades enzimáticas a nivel cualitativo, excepto las amilolíticas y lipolíticas. La determinación a nivel cuantitativo fue posible para las enzimas evaluadas, a excepción de las lipasas. Conclusión. La determinación de los perfiles enzimáticos amilolíticos, celulolíticos, pectinolíticos y proteolíticos de cada uno de los aislamientos evaluados pertenecientes al género Fusarium sugirió su capacidad, indistintamente de su procedencia, de degradar estos sustratos...

Assessment of enzymatic characterization of Fusarium spp. isolated from human, animal, and plant wounds. Objective. To determine amylolytic, cellulolytic, lipolytic, pectinolytic and proteolytic activities in 32 Fusarium spp. isolates from humans, animals and plants. Materials and methods. Qualitative determination of enzymatic activities was done by measuring hydrolysis halos in agar plates with their corresponding substrate. Quantitative determination was done by colorimetric techniques, using liquid culture supernatants to determine the respective substrate degradation. Results. All isolates showed enzymatic activities from a qualitative point of view, except amylolytic and lipolytic. Quantitative determination was possible for all the evaluated enzymes except lipases. Conclusion. The determination of amylolytic, cellulolytic, pectinolytic and proteolytic enzymatic profiles of each of the Fusarium isolates assessed suggests their capacity to degrade these substrates, irrespectively of their origin...

Avaliação das atividades enzimáticas de Fusarium spp. Isolados a partir de lesões em humanos, animais e plantas. Objetivo. Determinar as atividades amilolíticas, celulolíticas, lipolítica, pectinolíticas e proteolíticas em 32 isolamentos de Fusarium spp. de origem humana, animal e vegetal. Materiais e métodos. As atividades enzimáticas foram determinadas a nível qualitativo medindo os halos de hidrólise em placas de agar com o substrato respectivo e a nível quantitativo realizou-se uma cultura líquida para determinar a degradação do substrato respectivos por meio de técnicas colorimétricas. Resultados. Todos os isolados apresentaram uma atividade enzimática a nível qualitativo, exceto as amilolíticas e lipolíticas. A determinação a nível quantitativo foi possível para as enzimas testadas, exceto para as lipases. Conclusão. A determinação de perfis enzimáticos amilolíticos, celulolíticos, pectinolíticos e proteolíticos de cada um dos isolados testados pertencentes ao gênero Fusarium, sugeriu sua capacidade, independentemente da sua origem, para degradar estes substratos...

Estimation of salivary amylase and total proteins in leukemia patients and its correlation with clinical feature and radiographic finding.

Background: Leukemia is a fatal disease. The oral manifestations of the leukemias occur early in the course of the disease and these oral features can at times act as a diagnostic indicator. Saliva has been used as a diagnostic aid in a number of systemic diseases. Materials and Methods: In our study, samples of unstimulated saliva of 30 leukemia patients who were not on chemotherapy were collected and analyzed for salivary amylase and total protein. The oral manifestations and radiographic changes (OPG) were recorded. The correlation between the oral manifestations and the salivary components (salivary amylase and total protein) was assessed for prognostic significance. Results: In the present study when the mean values of salivary amylase (1280±754 U/ml) and total protein (647.2±320.7 mg%) were compared with that in control subjects. There was a statistically significant difference for amylase levels (P<.05). On intraoral examination the study subjects showed pallor, gingivitis, gingival enlargement, petechiae, and ecchymosis. On the OPG, the radiographic features included generalized rarefaction of bone (20%), thinning of lamina dura (3.4%), generalized alveolar crest bone resorption (30%), thinning of walls of alveolar crypts (6.7%), besides others, e.g., periapical abscess (10%). Conclusions: The saliva of leukemic patients demonstrated obvious changes in composition. A rise in salivary amylase and total protein levels was evident, with the increase in amylase levels being statistically significant.

Management of a parotid sialocelein a young patient: case report and literature review

Sialocele is a subcutaneous cavity containing saliva, caused by trauma or infection in the parotid gland parenchyma, laceration of the parotid duct or ductal stenosis with subsequent dilatation. It is characterized by an asymptomatic soft and mobile swelling on the parotid region. Imaging studies are useful and help establishing the diagnosis, such as sialography, ultrasonography, computed tomography and magnetic resonance imaging. This paper describes a recurrent case of a parotid sialocele in a young female patient. She presented a 6 cm x 5 cm swelling on the left parotid region. The ultrasonographic scan of the area revealed a hypoechoic ovoid well defined image suggesting a cyst. A sialography of the left parotid showed a cavitary sialectasia in a panoramic and anteroposterior view. A conservative management was adopted by percutaneous needle aspiration of the swelling, which was useful to provide material for analysis and helped healing. Dentists should be aware of this pathology and the importance in adopting a conservative treatment whenever it is possible.

Influência do pH e temperatura sobre a atividade amilolítica de rizóbios isolados de solos da Amazônia / Influence of pH and temperature on amylolytic activity of rhizobia isolated from Amazonian soils

Poucas são as informações referentes ao perfil enzimático de bactérias rizobiais. Em meio de cultura solidificado, foi conduzido um experimento em fatorial 7 x 3 x 3 para avaliar o efeito do pH (5,0; 6,5 e 8,0) e da temperatura (25, 35 e 42 ºC) sobre a atividade amilolítica de sete isolados de rizóbio. As maiores atividades amilolíticas foram observadas em ambientes ácidos, com algumas bactérias também produzindo níveis significativos em pH 8,0. Entre as interações significativas (P<0,01), os isolados INPA R-110 e R-822 apresentaram máximas atividades em pH 5,0 e 25 ºC, com o R-822 também sendo um bom produtor de amilase nas temperaturas de 35 e 42 ºC. Em termos gerais, os isolados INPA R-110 e R-822 foram os melhores produtores de amilases, com atividades enzimáticas maiores do que 2,0.

Information is scarce regarding the enzymatic profiles of rhizobia bacteria. On solid medium, a 7 x 3 x 3 factorial experiment was conducted to evaluate the effect of pH (5.0, 6.5 and 8.0) and temperature (25, 35 and 42 ºC) on amylase activities of seven rhizobia strains. The highest enzymatic activities were found in acid environments, with some bacteria also producing significant levels at pH 8.0. Among the significant interactions (P<0.01), INPA strains R-110 and R-822 exhibited maximum activities at pH 5.0 and 25 ºC, with the R-822 being also a good amylase producer at 35 and 42 ºC. In general terms, INPA strains R-110 and R-822 were the best enzyme producers, with amylolytic enzymatic activities higher than 2.0.