RESUMO
Cirrhosis is a complex process that involves a dynamic modification of liver cell phenotype associated to gene expression changes. This study investigates the reversing capacity of an adenosine derivative compound (IFC305) on a rat model of liver cirrhosis and gene expression changes associated with it. Rats were treated with IFC305 or saline for 5 or 10 weeks after cirrhosis induction (CCl(4) treatment for 10 weeks). Fibrosis score, collagenase activity and amount of hepatic stellate cells (HSC, activated and with a lipid-storing phenotype) were measured in livers. In addition, gene expression analysis was performed using 5K DNA microarrays and quantitative RT-PCR. Treatment of cirrhotic rats with IFC305 for 5 or 10 weeks compared to saline control, induced: (1) reduction of fibrosis (50-70%) and of collagen, of alpha-SMA and desmin proteins, as well as of activated HSCs in liver, (2) increased collagenase activity and cell number of lipid-storing HSC, (3) improved serum parameters of liver function, such as reduced activity of aminotransferases and bilirubin. Expression of 413 differential genes, deregulated in cirrhotic samples, tended to be normalized by IFC305 treatment. Some genes modulated at transcript level by IFC305 were Tgfb1, Fn1, Col1a1, C9, Apoa1, Ass1, Cps1, and Pparg. The present study shows that IFC305 reverses liver fibrosis through modulation of adipogenic and fibrosis-related genes and by ameliorating hepatic function. Thus, understanding of the anti-cirrhotic effect of IFC305 might have therapeutical potential in patients with cirrhosis.
Assuntos
Adenosina/análogos & derivados , Adenosina/farmacologia , Tetracloreto de Carbono/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Cirrose Hepática/induzido quimicamente , Cirrose Hepática/tratamento farmacológico , Adenosina/uso terapêutico , Animais , Ácido Aspártico/análogos & derivados , Perfilação da Expressão Gênica , Células Estreladas do Fígado/efeitos dos fármacos , Células Estreladas do Fígado/metabolismo , Técnicas In Vitro , Cinética , Metabolismo dos Lipídeos/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/enzimologia , Fígado/metabolismo , Fígado/fisiopatologia , Cirrose Hepática/metabolismo , Cirrose Hepática/fisiopatologia , Masculino , Ratos , Ratos Wistar , Recuperação de Função Fisiológica/efeitos dos fármacos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Ureia/metabolismoRESUMO
BACKGROUND: Currently, use of the Bravo capsule is a very common method for evaluating the gastroesophageal reflux because it has the advantage of being an intraesophageal catheter-free system. However, endoscopic removal of the capsule is necessary when technical problems or severe discomfort are present. Most frequently, endoscopists solve this problem by nudging the device with the tip of the endoscope to dislodge it; others have used a cold snare to produce traction on the capsule, and then tear the probe off. These techniques however are not free of complications. We report here the cold and hot snare techniques used in 4 of our patients, which resulted in the successful removal of the capsule without complications. METHODS: The polypectomy cold snare procedure is a typical polypectomy method. The cold snare loops the mucosal pedicle and tightly closes it until sectioning is achieved. In the hot snare technique, a monopolar coagulating current is added to the previous procedure, making the resection more feasible when the cold snare is not sufficient. Finally, in both situations, the probe is removed from the esophagus with the same snare. CONCLUSIONS: The cold and hot snare techniques are safe and simple endoscopic procedures when the removal of the Bravo capsule is required. We recommend the cold snare method as a first option and the hot snare method in case the former fails.
Assuntos
Remoção de Dispositivo/métodos , Monitoramento do pH Esofágico/instrumentação , Adulto , Endoscopia Gastrointestinal/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Masculino neonato de pretérmino, con bajo peso (775 g), conocido a los 78 días de edad, quien desarrolló endocarditis en un corazón estructuralmente sano. Persistió el trombo en el atrio derecho, el cual fue resecado quirúrgicamente. El estudio microbiológico del trombo así como los cortes histopatológicos demostraron la presencia de un alga: Prototheca sp. Después del tratamiento quirúrgico, se le administró Anfotericina B observándose evolución favorable. Este es el primer reporte en la literatura de endocarditis infecciosa por el alga del género Prototheca, saprofito del agua y savia de los arboles
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Anfotericina B/administração & dosagem , Antibacterianos/administração & dosagem , Endocardite/diagnóstico , Endocardite/terapia , Recém-Nascido Prematuro , Infecções/diagnóstico , Infecções/terapia , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/terapia , Prototheca/isolamento & purificação , ÁguaRESUMO
Se presenta a un varón de 20 años de edad que ingresó por alteraciones en el ritmo cardíaco. Se establecieron los diagnósticos de miocardiopatía hipertrófica, síndrome de Wolff-Parkinson-White, hipertensión pulmonar e ICC (insuficiencia cardíaca congestiva). Al mes de su ingreso presentó síndrome ictérico secundario a hepatitis viral A (HVA) y sus niveles de transaminasas persistieron elevadas en forma crónica en un promedio de siete veces su valor normal durante los seis años que precedieron a su muerte por neumonía e insuficiencia cardiaca. Por la posibilidad de otro tipo de hepatopatía por la hipertransaminasemia persistente se realizaron dos biopsias hepáticas que mostraron únicamante daño secundario a hepatopatía por ICC. Este caso ilustra cómo el daño hepático por ICC puede cursar con hipertransaminasemia persistente que semeja hepatopatía crónica de otro tipo
