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BACKGROUND: Previous studies have suggested that the addition of heparin to a preservation solution attenuated the autonomic dysfunction observed in rat jejunum and in addition that hypothermic hyperbaric oxygenation may play a role as a preservation technique. However, these studies did not address the lesion indices of the autonomic enteric neurons. We sought to investigate whether the autonomic enteric neurons are injured during cold ischemic preservation and whether administration of heparin or hyperbaric oxygenation prevents this lesion. METHODS: Jejunal segments (2 cm; n = 20) of Wistar rats (12-16 weeks old) were maintained in lactated Ringer's solution without or with heparin (H- and H+, respectively) at 4 degrees C under normobaric conditions. Other jejunal segments (n = 10) were maintained at 4 degrees C in H- under hyperbaric oxygenation conditions (HBO). After preservation for 12 hours, H-, H+, and HBO preparations fixed in 10% formaldehyde were stained with hematoxylin and eosin. The lesion indices were expressed as the mean number of affected neurons (karyorhexis, nuclear dislocation, cytoplasmic vacuolisation) per 100 neurons present in intramural ganglia. Statistical analysis was performed using the Mann-Whitney test (P < .05). RESULTS: The histologic studies showed that enteric autonomic neurons were damaged in H- jejunal segments. The lesion indices observed were: karyorhexis 90/100, nuclear dislocation 85/100, and cytoplasmic vacuolization 82/100. The autonomic neurons in H+ and HBO segments seemed to be normal and significantly well-preserved (P < .001). CONCLUSION: Hypothermic hyperbaric oxygenation and heparin prevented lesions in cold ischemic preservation of enteric autonomic neurons.

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Previous studies suggest that cold ischemic preservation (CIP) employed in small bowel transplantation promotes loss of intestinal motility due to severe lesions in autonomic enteric nerves. This autonomic dysfunction may be prevented by antioxidant agents. In this work, we investigated whether preservation with heparin prevented autonomic dysfunction of rat jejunum submitted to CIP for a long time. Jejunal segments (2 cm) of Wistar rats (12 to 16 weeks old) were preserved at 4 degrees C in Ringer's lactate solution without (-) or with (+) 100 UI/mL heparin (H). After preservation for 12 hours, H+ and H- preparations were mounted in parallel in isolated organ baths containing 10 mL Tyrode's solution at 37 degrees C for the study of neurogenic contractions evoked by electrical field stimulation (EFS; 10-30 Hz, 1-ms duration, 60 V) or by stimulation of nicotinic (NIC) or muscarinic (carbachol, CCh) cholinoceptors. The effects of NIC (hexamethonium, HEX) and muscarinic (atropine, ATR) antagonists were studied on these contractions. Contractions induced by EFS (30 Hz) were four times greater in H+ (1.02 +/- 0.12 g) versus H- (0.26 +/- 0.07 g), while contractions induced by NIC (1 mmol/L) were also four times higher in H+ (1.07 +/- 0.10 g) than H- (0.25 +/- 0.09 g) preparations. In addition, contractions induced by CCh (1 mmol/L) were two times higher in H+ (1.21 +/- 0.13 g) than in H- (0.65 +/- 0.10 g). EFS, NIC, and CCh contractions were inhibited by pretreatment of jejunum with HEX or ATR (1 mumol/L/30 min), in H+ and H-. These results indicated that addition of heparin to a preservation solution attenuated the autonomic dysfunction of rat jejunum submitted to CIP for a long time.

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In vitro studies have demonstrated that cold ischemic preservation (CIP) employed in small bowel transplantation produces loss of intestinal motility due to severe lesions of autonomic enteric nerves and that this autonomic dysfunction is attenuated by antioxidant agents. In this work, we investigated whether preservation with atenolol attenuated autonomic dysfunction of rat jejunum submitted to long-term CIP. Jejunal segments (2 cm) of Wistar rats (12 to 16 weeks old) were surgically isolated and preserved at 4 degrees C in Ringer's lactate solution without (-) or with (+) 1 mumol/L atenolol (AT). After preservation for 12 hours, AT+ and AT- preparations were mounted in parallel in isolated organ baths containing 10 mL Tyrode's solution at 37 degrees C for the study of neurogenic contractions evoked by electrical field stimulation (EFS; 10 to 30 Hz, 1-ms duration, 60 V) or by stimulation with nicotinic (nicotine, NIC) or muscarinic (carbachol, CCh) cholinoceptor agents as well as nicotine (hexamethonium, HEX) and muscarinic (atropine, ATR) antagonists. Contractions induced by EFS (30 Hz) were 46% higher in AT+ (0.38 +/- 0.02 g) than AT- (0.26 +/- 0.01 g), while contractions induced by NIC (1 mmol/L) were 84% higher in AT+ (0.46 +/- 0.03 g) than in AT- (0.25 +/- 0.02 g). In addition, contractions induced by CCh (1 mmol/L) were 34% higher in AT+ (0.87 +/- 0.06 g) than in AT- (0.65 +/- 0.08 g). EFS-, NIC-, and CCh-induced contractions were inhibited by pretreatment of jejunum with HEX or ATR (1 mumol/30 min), in AT+ and AT-. These results suggest that addition of atenolol in the preservation solution attenuated autonomic dysfunction of rat jejunum submitted to long-term CIP.

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INTRODUCTION: The aim of this work was to study the effects of hyperbaric oxygenation as a preservation technique for small bowel transplantation. METHODS: Twenty 2-month-old male Wistar rats weighting 250 g were divided into two groups: group A (n = 10) in which the small bowel was preserved for 12 hours, and group B (n = 10) in which the small bowel was preserved for 24 hours. After vascular and intraluminal perfusion, 3-cm segments were maintained in Ringer's solution at temperatures between 2 degrees C to 4 degrees C and in normobaric O2 conditions (groups A1, B1) or conditioned in an hyperbaric O2 metal chamber (100% oxygen at 5.5 absolute atmospheres) (groups A2, B2). After this preservation time, we studied intestinal tissue injury and morphometric analysis of the villi. RESULTS: Mucosal injury was significantly greater among group A1 compared to group A2 animals. The grade of the lesions was greater among group B1 compared to group B2 animals. Group A1 showed no difference from Group B1. For lesion grade, the range was smaller in group A2 and group B2 animals. The villi height was significantly smaller in groups A1 and B1 compared to the other groups; whereas it was higher in group A2 as compared with B2. CONCLUSION: Hyperbaric oxygenation may play a role as a preservation technique. Further research is necessary.

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UNLABELLED: This study was conducted to assess apoptosis and nuclear proliferation in rat small bowel submitted to hypothermic hyperbaric oxygenation for preservation. METHODS: Twenty two-month-old, male Wistar rats, weighing 250 g were divided into two groups: group I (n = 10), in which the small bowel was preserved for 12 hours, and group II (n = 10) in which the small bowel was preserved for 24 hours. After vascular and intraluminal perfusion, 3-cm segments were maintained in Ringer's solution at 2 degrees to 4 degrees C under normobaric conditions (groups Ia and IIa) or conditioned in a small hyperbaric metal chamber with 100% oxygen at 5.5 absolute atmospheres (groups Ib and IIb). After 12 or 24 hours, apoptotic and mitotic indices were evaluated by immunohistochemical methods. RESULTS: The apoptotic index was significantly higher in small bowel segments in groups Ia and IIa compared with groups Ib and IIb. The mitotic index was significantly higher among group IIb. CONCLUSION: Hypothermic hyperbaric oxygenation reduced intestinal epithelial apoptosis and increased nuclear proliferation during rat small bowel preservation.

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UNLABELLED: This study was designed to investigate the feasibility of building a simple and inexpensive device to preserve organs or tissues in hyperbaric and hypothermic conditions. METHODS: The device was built on a 40-cm wide, 28-cm long, and 23-cm deep stainless steel chassis. The pressure vessel was built by a 7.8-cm bore stainless steel cylinder put inside another 12-cm cylinder welded together and closed by a steel plate on the top and bottom. The inferior plate was welded, and the superior one was fixed by manual clasp nut. The cooling system is made up of air compressor, condenser, expansion area, and cooling worm that is located between the cylinders. The temperature-controlling device is a computer processor contained in an integrated-circuit chip, with a on-off system to maintain the chamber temperature between 2 degrees to 4 degrees C. The compression of the chamber is performed by lateral coupling with the oxygen cylinder and is maintained at 5.5 absolute atmospheres and controlled by air pressure gauge. The maximal work pressure was evaluated by spreadsheet. Temperature or pressure changes were evaluated by 12- and 24-hour assays. RESULTS: The maximal work pressure permitted was 6.5 absolute atmospheres. Thus, the container was free from danger. The temperature inside the chamber was kept between 2 degrees and 4 degrees C. The production costs of the prototype was US$1000. DISCUSSION: The manufacture of the refrigerating hyperbaric chamber is viable, simple, and inexpensive.

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OBJECTIVE: The kidney of the child, mainly the newborn, is specially susceptible to ischemic and/or toxic injuries, which can affect the renal tubular function. Therefore, reliable and precocious markers of tubular dysfunction would be useful in Pediatrics. The urinary levels of retinol binding-protein (RBPu) has been used in this way. Our goal was to evaluate the RBPu behavior in childhood to establish a reference interval and verify possible differences according to the age. METHODS: We studied healthy children aged 1 month to 8 years and healthy term and preterm babies; in the last group we only included babies without hemodynamic repercussion. We collected isolated urine samples once for children above 1 month and periodically for those below this age. In this urine, besides the dipsticks test (Combur 9(R), Boehringer), RBPu and creatinine were measured. RESULTS: We observed that the RBPu levels in childhood do not have a normal distribution; after logarithm data transformation we were able to establish an interval of reference for children above one month of age: 3 to 269 micro g/L, mean of 27 micro g/ L. In newborns, we found a large variation of RBPu excretion. However, we noticed that the excretion decreases significantly, reaching the healthy adult levels at the end of the 1st month, for term as well as for preterm newborns. CONCLUSIONS: We suggest that RBPu can be used as a marker of proximal tubular dysfunction, since we could establish an interval of reference, and it can be repeated whenever necessary in the follow-up of this kind of injury, because it is not an invasive exam. Moreover, this study contributes to the knowledge of the tubular function development for showing that at the end of the 1st month of life the newborn's kidney is able to reabsorb RBPu as the healthy adult kidney is.

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Realizamos um teste simples em aspirado gástrico (Teste de Estabilidade das Bolhas - TEB), em 102 recém-nascidos (RN), com o intuito de avaliar a maturidade pulmonar ao nascimento, divididos de acordo com a idade gestacional em dois grupos. O primeiro, composto por 44 RN pré-termo (IG<38 semanas) e um grupo controle de 58 RN a termo (IG>=38 semanas). Comparamos os resultados do teste com a evoluçäo respitória e obtivemos que, no grupo pré-termo entre os 44 RN, 8 apresentaram teste negativo para presença de surfactante e, destes, cinco desenvolveram síndrome de desconforto respiratório (SDR). Os cinco RN que desenvolveram SDR apresentaram o teste negativo para a presença de surfactante, o que representa uma sensibilidade de 100%. Todos os RN, tanto o grupo de termo quanto do grupo pré-termo, que apresentaram o teste positivo para presença de surfactante, tiveram evoluçäo respiratória normal. Estes resultados valorizam a importância do teste de maturidade pulmonar através do suco gástrico como método de diagnóstico precoce de imaturidade pulmonar

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Em familias de propositos com psicose maniaco-depressiva (PMD) existe grande ocorrencia de alcoolatras e suicidas, mas nao encontramos na literatura determinacoes da frequencia, entre alcoolatras dos que pertencem a familias com PMD. Estamos investigando os sinais associados com PMD nas familias de tres amostras de propositos alcoolatras internados: a. homens, classe baixa; b. homens, classe media-alta; c.mulheres. Os pacientes ou suas familias foram entrevistados para determinar-se a percentagem dos que pertencem a familias com sinais sugestivos de PMD, seguindo um criterio operacional uniforme. Ate agora, o levantamento mostra uma frequencia dos que tem familias sugestivas de PMD de 15% na amostra e a 40% na b. Na literatura existe tres pesquisas controladas (com placebo e teste cego) que mostram eficacia significante da litioterapia em amostras de alcoolatras nao selecionados. A proxima etapa de presente pesquisa e repetir essas investigacoes com alcoolatras selecionados por pertencerem a familias com PMD

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