RESUMO
BACKGROUND: Surgery on varicose veins (crossectomy and stripping) may lead to recurrence, with clinical and socioeconomic repercussions. The etiopathogenesis of varicose veins has yet to be fully understood. OBJECTIVE: Study the expression of endoglin and other molecules involved in the neovascularisation process in patients suffering from this disease. METHODS: Total of 43 patients that have undergone surgery for varicose veins (24 primary and 19 recurrent). Endoglin and other molecules were identified on the venous wall (proximal -saphenofemoral junction- and distal), via real-time RT-PCR, and in serum, via ELISA: endoglin (Eng), vascular endothelial growth factor (VEGF-A), its receptors 1 and 2 (VEGFR1 or FLT1), (VEGFR2 or FLK), and the hypoxia-inducible factor (HIF-1A). All the patients signed a consent form. RESULTS: The recurrent group recorded a higher expression of Eng, VEGF-A, VEGFR1, and VEGFR2 at the level of proximal venous wall compared to the primary group. HIF-1A did not record any differences. As regards the determination of the distal venous wall, no markers recorded differences between the groups. Among the serum determinations, only sFLT1 recorded a significant drop among the patients with recurrent varicose veins. CONCLUSIONS: Patients with recurrent varicose veins record a higher expression of endoglin and other markers of angiogenesis in proximal veins. Endoglin in the blood (sEng) serves no apparent purpose in recurrent varicose veins.
RESUMO
In 1888, Rudolph Matas described and performed a procedure (endoaneurysmorrhaphy) that revolutionized the treatment of aneurysms, which for centuries had been untreatable or simply involved treatment by ligation and other marginal techniques. In 1940, during the annual meeting of the American Surgical Association, Matas presented the excellent results he had obtained with 98 endoaneurysmorrhaphies, although none of these cases involved an aortic aneurysm. On November 4, 1904, a Spanish surgeon called Ricardo Lozano Monzón was the first person in the world to perform an endoaneurysmorrhaphy on a patient suffering from an abdominal aortic aneurysm. The case was reported in a local journal called La Clínica Moderna in 1905. Despite the journal's limited circulation, Matas and others acknowledged that Lozano was the practitioner of the first, although admittedly unsuccessful, endoaneurysmorrhaphy on an abdominal aorta. Lozano's attempt was followed by other equally unsuccessful ones until Isaac A. Bigger performed the first successful procedure in 1938. The different kinds of endoaneurysmorrhaphy that Matas used, which proved to be effective in the treatment of peripheral aneurysms, did not perform in the same way in aortic aneurysms. Nonetheless, the procedure paved the way for new ideas and contributions (Creech technique).
RESUMO
Renal ischemia/reperfusion (I/R) is characterized by severe inflammatory damage. We assessed the effect of administrating recently developed nitrosothiol compounds acting as nitric oxide (NO) donors on the production of cytokines and other markers of acute inflammatory reaction in an experimental model of warm (I/R), and in a model of cold ischemia and transplant in rats. Warm ischemia was achieved by ligation of left renal pedicle for 60 min, followed by contralateral nephrectomy. NO-donors LA-803, LA-807, LA-810 were administered i.v. (1.8 micromol/kg) during 30 min before reperfusion. Cold ischemia was achieved by preservating the kidney for 24 h in Euro Collins and grafting it in consanguineous Fisher 344/Ico rats. LA-803 was administered in the preservation fluid and in the recipient rat. Reperfusion time was 4 h in warm ischemia and 3 h in cold ischemia + transplantation. Administration of LA-803, LA-807 and, in a lower proportion, LA-810 prevented from the enhanced production of tumor necrosis factor (TNF), interferon-gamma (IFN-gamma), and interleukin-1beta (IL-1beta), the decrease in interleukin-6 (IL-6) and interleukin-10 (IL-10), the increase in tissue level of superoxide anion (SOA) and superoxide dismutase (SOD), and the increase in neutrophil infiltration induced by warm I/R. Treatment with LA-803 in animals with renal transplantation after cold ischemia was also associated with reduced plasma levels of TNF, IFN-gamma, and IL-1beta, increased plasma levels of IL-6 and IL-10, reduced renal levels of SOA and SOD, and reduced neutrophil infiltration. These data demonstrate that systemic administration of new NO-donors with nitrosothiol structure diminished inflammatory responses in a kidney subjected to warm I/R or cold ischemia and transplantation.
