Invasive enteritis by Strongyloides stercoralis presenting as acute abdominal distress under corticosteroid therapy

Overwhelming helminthiasis is still a problem in endemic areas, especially in immunocompromised patients. We report a case of invasive intestinal strongyloidiasis that was clinically expressed as acute abdominal distress in a 73-year-old man from São Paulo who had been receiving methylprednisone, 20 mg/day, for one year for osteoarthritis. A surgical specimen from the ileum revealed invasive enteritis with severe infestation by Strongyloides stercoralis. The patient died of sepsis 6 days after surgery. The possibility of invasive strongyloidiasis should be considered in the differential diagnosis of acute abdominal distress in patients undergoing immunosuppressive therapy.

Three-dimensional technology facilitates surgical performance of novice laparoscopy surgeons: a quantitative assessment on a porcine kidney model

Objective To determine whether the use of 3-dimensional (3D) imaging translates into a better surgical performance of naïve urologic laparoscopic surgeons during pyeloplasty (PY) and partial nephrectomy (PN) procedures. Materials and Methods Eighteen surgeons without any previous laparoscopic experience were randomly assigned to perform PY and PN in a porcine model using initially 2-dimensional (2D) and 3D laparoscopy. A surgical performance score was rated by an "expert" tutor through a modified 5-item global rating scale contemplating operative field view, bimanual dexterity, efficiency, tissue handling, and autonomy. Overall surgical time, complications, subjective perception of participating surgeons, and inconveniences related to the 3D vision were recorded. Results No difference in terms if operative time was found between 2D or 3D laparoscopy for both the PY (P =.51) and the PN (P =.28) procedures. A better rate in terms of surgical performance score was noted by the tutors when the study participants were using 3D vs 2D, for both PY (3.6 [0.8] vs 3.0 [0.4]; P =.034) and PN (3.6 [0.51] vs 3.15 [0.63]; P =.001). No complications occurred in any of the procedures. Most (77.2%) of the participating na??ve laparoscopic surgeons had the perception that 3D laparoscopy was overall easier than 2D. Headache (18.1%), nausea (18.1%), and visual disturbance (18.1%) were the most common issues reported by the surgeons during 3D procedures. Conclusion Despite the absence of translation in a shorter operative time, the use of 3D technology seems to facilitate the surgical performance of naive surgeons during laparoscopic kidney procedures on a porcine model.

Tecnología de igy anti-escherichia coli aplicada mediante nanotubos sobre cultivos de enterocitos porcinos. Anti- escherichia coli igy technology applied through nanotubes on porcine enterocyte cultures.

La diarrea neonatal representa uno de los problemas sanitarios de mayor relevancia en las primeras semanas de vida del cerdo. Provoca importantes pérdidas económicas por morbilidad y mortalidad. El cultivo de enterocitos primarios representa una herramienta valiosa para el estudio de patologías causadas por agentes infecciosos que afectan la integridad del epitelio intestinal. La producción de anticuerpos extraídos a partir de la yema de huevo de gallinas inmunizadas (IgY), es una tecnología innovadora, que ha mostrado ser protectiva contra diarreas causadas por agentes víricos y bacterianos. La nanotecnología permite mejorar la eficiencia en la administración de distintas drogas. Los nanotubos de carbono han ganado una enorme popularidad por sus propiedades y aplicaciones únicas. La investigación sobre los aspectos toxicológicos de estas nanopartículas es escasa. Una vez dentro de la célula, las nanopartículas pueden inducir estrés oxidativo intracelular por perturbar el equilibrio oxidativo. Las hipótesis de trabajo es: La administración de IgY anti-Escherichia coli a través de nanotubos protegerá in vitro e in vivo a los enterocitos de una infección por E. coli previniendo la diarrea neonatal porcina. Los objetivos del trabajo son: Evaluar la protección por un anticuerpo aviario IgY anti-E. coli aplicado mediante nanotubos de carbono a cultivo de enterocitos porcinos primarios sometidos a una post-infección con E. coli; Analizar los efectos secundarios de los nanotubos con IgY anti-E coli en la citotoxicidad, el balance oxidativo y la apoptosis de los enterocitos porcinos cultivados in vitro y Evaluar la acción terapeútica de la IgY anti-E coli aplicada a porcinos y efectos secundarios de la administración con nanotubos. Se implementará un diseño experimental in vitro con diferentes grupos de cultivos con nanotubos, con IgY anti-E. coli e inespecifica y con exposición a E. coli. Se realizará cultivo de enterocitos porcinos primarios con una técnica de disgregación enzimática con colagenasa según protocolo de Bader et al. (2000). Se evaluará la viabilidad por la prueba de azul tripan. Para la obtención del anticuerpo anti-E. coli aviario se aplicarán un total de 3 dosis de E. coli (109 UFC/ml de adyuvante) a gallinas Legorhn en condiciones fisiológicas. Se recolectarán los huevos diariamente. Se purificará la IgY según método de Polson et al. (1985) utilizando PEG 6000. La concentración de IgY se medirá por ELISA de alta sensibilidad. La IgY será incorporada a nanotubos según protocolo de Acevedo et al. 2006. Para analizar los posibles efectos secundarios de los nanotubos se evaluará: 1. Citotoxicidad por técnica de MTT 2. Estrés oxidativo por técnica de TBARS y 3. Apoptosis por técnica de TUNEL.Además, se implementará un diseño experimental in vivo para probar la acción terapeútica de este nutraceútico aplicados a lechones destetados y los efectos secundarios de la administración con nanotubos. Se realizará un cultivo de enterocitos de lechones que previamente fueron tratados con la IgY anti-E. coli administrada mediante nanotubos y efectuarán las técnicas descriptas anteriormente. Los resultados esperados son: Elaboración de un Ac aviario IgY anti-E. coli para prevenir infección de enterocitos, Profundización en el conocimiento acerca de los efectos citotóxicos de los nanotubos de carbono multilamelares, Generación de tratamiento alternativo para enfermedades entéricas porcinas.

Detección de circovirus pocino tipo II en cerdos que presentan diarrea en criaderos intensivos. Detection of porcine circovirus type II in pigs that present diarrhea in intensive hatcheries.

Se propone detectar la presencia del agente etiológico circovirus porcino (CVP) en cerdos con diarrea. El cual se considera un patógeno emergente importante asociado a diferentes sindromes y enfermedades porcinas. Se comunicó a nivel internacional en 1997 y en Argentina fue descripto en el 2003 en animales de cria extensiva, aunque se encuentra en los diferentes sistemas de producción. Su presencia causa grandes pérdidas económicas, ya que muchas veces no tiene una sintomatología clínica, sino que se manifiesta subclinicamente. En la provincia de Córdoba no se han realizado estudios sistemáticos para determinar la presencia de circovirus. Además, en animales que presentan diarrea no se ha realizado un relevamiento de la presencia del CVP y su asociación con el cuadro clínico. Diversos investigadores estan viendo la necesidad de incluir al CVP a la hora de pensar en los diagnósticos etiológicos, en aquellos que no solo presentan índices productivos ineficientes sino también que no responden a la terapia antimicrobiana. Es agente causal del Sindrome de Desmedro Posdestete y podria favorecer la acción de otros agentes patógenos que actuarían tanto en Sistema Respirastorio como en Sistema Digestivo. La complejidad del trabajo radica en demostrar lo antes mencionado a traves de las lesiones a observar en los tejidos y la determinación de la presencia del agente. La ejecución de este estudio sería un importante aporte a la producción porcina, en donde este agente produce importantes pérdidas económicas. La metodología, así como los resultados obtenidos serán útiles en la formación de recursos humanos aplicados a la investigación y transferidos directamente a la docencia. Hipotesis: Establecer la presencia del CVP en cerdos con signos clinicos de enteropatías Objetivos: Determinar en cortes histopatológicos de intestino y ganglio mesentério, lesiones compatibles con CVP; Determinar por inmunohistoquímica la presencia del antígeno CVP en las muestras. Identificar las células en las que se encuentre el antígeno. Materiales y método: Muestreo a campo y toma de muestra. En diferentes establecimientos porcinos, de aquellos animales que presenten el cuadro clínico de diarrea, serán elegidos 3 animales aleatoriamente para sacrificio y realización de la técnica de necropsia. Se tomarán muestras de intestino delgado y ganglio mesentérico que serán fijadas en formol; la técnica histopatológica y su lectura tendrán fin de encontrar lesiones compatibles con circovirus porcino tipo II; Realización de la técnica de inmunohistoquímica con anticuerpo monoclonal, para la detección del CVP en los tejidos; Interpretación de resultados; Publicación de los resultados.

Producción de inmunosueros para diagnóstico de Enteritis Proliferativa Porcina

La observación de lesiones macro y microscópicas es una de las herramientas más utilizadas en el diagnóstico en Medicina Veterinaria. Sin embargo, esta observación no es suficiente, ya que no permite identificar la causa del trastorno. Esto dio lugar a las técnicas inmunológicas que permiten la detección de antígenos específicos. Estas técnicas inmunohistoquímicas permiten, utilizando un anticuerpo, evidenciar el antígeno específico y determinar en que estructura del tejido se encuentra. Los anticuerpos que éstas reacciones requieren pueden ser obtenidos experimentalmente, inoculando animales de laboratorio con los antígenos correspondientes y obteniendo así los antisueros específicos. Nuestro laboratorio de diagnóstico, investigación y docencia requiere, desde hace años, de inmunosueros para el diagnóstico de varias enfermedades que producen diarrea como signo clínico principal. La Enteritis Proliferativa Porcina (EPP), debe ser vista fundamentalmente como una enfermedad económicas, en la que el impacto esta dado principalmente por la disminución de ganancia diaria de peso de los animales, desigualdad en los lotes de terminación y retardo en llegar al peso de faena. Las técnicas inmunológicas de detección in situ entre las que se puede mencionar la inmunohistoquímica, aparece como una alternativa viable, porque solo se requeriría de un Ac mono o policlonal específico que permita la identificación del agente. Actualmente se utilizan Ac policlonales producidos en gran escala por laboratorios internacionales. Pero bajo las condiciones económicas actuales se hace muy difícil el aprovisionamiento de estos reactivos. La hipótesis de esta propuesta es produccir estos inmunosueros de calidad, a un costo que nos permita continuar con el servicio de diagnóstico, con nuestra línea de investigación y con la formación de recursos humanos El objetivo general es obtener un inmunosuero específico contra Lawsonia intracellularis. Para la obtención de estos antisueros policlonales se utilizará el biomodelo conejo con varias inoculaciones subcutáneas periódicas para lograr mayor cantidad de anticuerpos y mayor afinidad. La Li es una bacteria que presenta escasa variabilidad por lo que la producción de inmunosueros no requiere mayores procesamientos para eliminar inmunoglobulinas inespecíficas que puedan desarrollar reacciones cruzadas con otros agentes. Los antisueros obtenidos serán titulados por inmunofluorescencia. Se realizarán muestreos en frigoríficos de cerdos del Dpto. Río Cuarto a fin de determinar, con el antisuero obtenido la presencia de EPP en granjas de cerdos establecidas en el área de influencia de la U.N.R.C. Se espera obtener antisueros contra Li a un costo razonable y accesible, de manera de poder continuar con el servicio de diagnóstico, con nuestra línea de investigación y con la formación de recursos humanos Los muestreos en frigoríficos de cerdos del Dpto. Río Cuarto, permitirán conocer el impacto de la EPP en granjas porcinas del área de influencia de la U.N.R.C., transfiriendo esta tecnología a las necesidades de la comunidad de productores de cerdos. Una vez estandarizada la producción del antisuero, el producto resultante podrá ser ofrecido a laboratorios oficiales o privados que requieran del mismo. La importancia potencial está dada por la posibilidad de producir en los laboratorios de la U.N.R.C. un anticuerpo policlonal contra Li que actualmente solo se consigue a nivel internacional, con las limitaciones de importación que ello conlleva y a precios inaccesibles para nuestros presupuestos, permitiendo continuar la línea de investigación referida a diarreas subclínicas del ganado porcino. Se propone desarrollar, una Beca de Ayudantía de Investigación para la alumna Daniela Ramello. Existen vinculaciones de cooperación con el laboratorio de diagnóstico del Área de Patología de la Fac. de Cs. Veterinarias de la U. N. de La Plata en la temática específica de desarrollo de protocolos de diagnóstico inmunohistoquímico

Functional studies of β-arresting and αB-crystallin as interaction partners of PAR-1 and PAR-2 and their involvement in protective and proliferative signaling pathways in astrocytes

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2014

Gastric supply manipulation to modulate ghrelin production and enhance vascularization to the cardia: proof of the concept in a porcine model.

Introduction. Selective embolization of the left-gastric artery (LGA) reduces levels of ghrelin and achieves significant short-term weight loss. However, embolization of the LGA would prevent the performance of bariatric procedures because the high-risk leakage area (gastroesophageal junction [GEJ]) would be devascularized. Aim. To assess an alternative vascular approach to the modulation of ghrelin levels and generate a blood flow manipulation, consequently increasing the vascular supply to the GEJ. Materials and methods. A total of 6 pigs underwent a laparoscopic clipping of the left gastroepiploic artery. Preoperative and postoperative CT angiographies were performed. Ghrelin levels were assessed perioperatively and then once per week for 3 weeks. Reactive oxygen species (ROS; expressed as ROS/mg of dry weight [DW]), mitochondria respiratory rate, and capillary lactates were assessed before and 1 hour after clipping (T0 and T1) and after 3 weeks of survival (T2), on seromuscular biopsies. A celiac trunk angiography was performed at 3 weeks. Results. Mean (±standard deviation) ghrelin levels were significantly reduced 1 hour after clipping (1902 ± 307.8 pg/mL vs 1084 ± 680.0; P = .04) and at 3 weeks (954.5 ± 473.2 pg/mL; P = .01). Mean ROS levels were statistically significantly decreased at the cardia at T2 when compared with T0 (0.018 ± 0.006 mg/DW vs 0.02957 ± 0.0096 mg/DW; P = .01) and T1 (0.0376 ± 0.008mg/DW; P = .007). Capillary lactates were significantly decreased after 3 weeks, and the mitochondria respiratory rate remained constant over time at the cardia and pylorus, showing significant regional differences. Conclusions. Manipulation of the gastric flow targeting the gastroepiploic arcade induces ghrelin reduction. An endovascular approach is currently under evaluation.

Cell mediated immunity in Chagas' disease: Trypanosoma cruzi antigens induce suppression of the in vitro proliferative response of mononuclear cells

The partial suppression of the cell-mediated immune response by Trypanosoma cruzi antigens in patients with Chagas' disease is demonstrated in a costimulation assay with T. cruzi antigens and Mycobacterium tuberculosis purified protein derivative (PPD) or Tetanus toxoid (TT). ononuclear cells from 13 patients with chagasic infection without evidence of heart disease, 10 patients with chagasic cardiomyopathy and 7 healthy blood donors were stimulated with antigen A (autoclaved epimastigotes), PPD, TT, PPD + A, PPD + TT and TT + A. The average percentage of suppression induced by costimulation of mononuclear cells with PPD and antigen A was 47.1% in patients with chagasic infection without heart disease (INF), 38.8% in patients with chagasic cardiomyopathy (CDM) and 23.3% in healthy controls. Similar values were observed when living trypomastigotes were used. A costimulatory study with PPD and TT, PPD and A and TT and A was carried out in 8 patients with chagasic infection, in order to evaluate the possibility that this difference could be due to a nonspecific inhibitory effect. The mean suppression induced by TT + PPD was -8.9, with TT + A was 52.7 and with PPD + A was 50.1. The data reported show that T. cruzi antigens induce a specific suppression of the proliferative responseof mononuclear cells, that might be relevant to the persistence of the parasite in the host.

Comparison of porcine and human coagulation by thrombelastometry.

Introduction: Although the pig is a standard model for the evaluation of various diseases in humans, including coagulopathy, it is not clear whether results in animals can be extrapolated to man.Materials and methods: In 75 anesthetized pigs, we assessed reagent-supported thrombelastometry (ExTEM (R)), platelet-blocked thrombelastometry (FibTEM (R)), and aprotinin thrombelastometry (ApTEM (R)). Results were compared to values from 13 anesthetized humans.Results (median, 95% CI): ExTEM (R) : While clot strength was comparable in pigs (66 mm, 65-67 mm) and in humans (64 mm, 60-68 mm; NS), clotting time in animals was longer (pigs 64 s, 62-66 s; humans 55 s, 49-71 s; P<0.05) and clot formation time shorter (pigs 52 s, 49-54 s; humans 83 s, 67-98 s, P<0.001). The clot lysis index at 30 minutes was lower in animals (96.9%, 95.1-97.3%) than in humans (99.5%, 98.6-99.9%; P<0.001). ApTEM (R) showed no hyperfibrinolysis in animals. Modification of the anesthesia protocol in animals resulted in significant ExTEM (R) changes. FibTEM (R) : Complete platelet inhibition yielded significantly higher platelet contribution to clot strength in pigs (79%, 76-81%) than in humans (73%, 71-77%; P<0.05), whereas fibrinogen contribution to clot strength was higher in humans (27%, 24-29%) than in animals (21%, 19-24%; P<0.05).Conclusions: Maximum clot firmness is comparable in human and porcine blood. However, clot lysis, platelet and fibrinogen contribution to clot strength, as well as initiation and propagation of clotting, are considerably different between pigs and humans. In addition, anesthesic drugs seem to influence thrombelastometry in animals. Accordingly, coagulation abnormalities in pigs subjected to diseases may not necessarily represent the coagulation profile in sick patients. (C) 2011 Elsevier Ltd. All rights reserved.

Synthetic Plasmodium falciparum circumsporozoite peptides elicit heterogenous L3T4+ T cell proliferative responses in H-2b mice.

The ability of synthetic P. falciparum (NANP)n circumsporozoite peptides to elicit murine T cell proliferative responses was studied. When C57BL/6, C3H, and DBA/2 mice were injected with (NANP)40, only C57BL/6 (H-2b)-immune lymph node cells proliferated on restimulation in vitro with the same peptide. By using anti-I-A monoclonal antibodies or spleen cells from congenic H-2b mice as a source of antigen-presenting cells, the T cell proliferative response was shown to be restricted to the I-Ab region of the C57BL/6 haplotype. These results are in agreement with previous experiments which demonstrated that the anti-(NANP)40 antibody response was uniquely restricted to C57BL/6 (H-2b) mice. Several C57BL/6 long-term (NANP)n-specific T cell lines and clones were derived. All of the clones exhibited the L3T4 helper T cell phenotype. A considerable heterogeneity of T cell responses was observed when the lines and clones were stimulated with different concentrations of the various peptides studied. The results, together with the observed genetic restriction for both antibody and T cell responses, suggest that perhaps not all individuals who receive a similar repetitive tetrapeptide sporozoite malaria vaccine will develop T cell and or antibody responses.

The in vitro cytopathology of a porcine and the simian (SA-11) strains of rotavirus

Rotaviruses have been implicated as the major causal agents of acute diarrhoea in mammals and fowls. Experimental rotavirus infection have been associated to a series of sub-cellular pathologic alterations leading to cell lysis which may represent key functions in the pathogenesis of the diarrhoeic disease. The current work describes the cytopathic changes in cultured MA-104 cells infected by a simian (SA-11) and a porcine (1154) rotavirus strains. Trypan blue exclusion staining showed increased cell permeability after infection by both strains, as demonstrated by cell viability. This effect was confirmed by the leakage of infected cells evaluated by chromium release. Nuclear fragmentation was observed by acridine orange and Wright staining but specific DNA cleavage was not detected. Ultrastructural changes, such as chromatin condensation, cytoplasm vacuolisation, and loss of intercellular contact were shown in infected cells for both strains. In situ terminal deoxynucleotidyl transferase (Tunel) assay did not show positive result. In conclusion, we demonstrated that both strains of rotavirus induced necrosis as the major degenerative effect.

Cytostatic lung perfusion results in heterogeneous spatial regional blood flow and drug distribution: evaluation of different cytostatic lung perfusion techniques in a porcine model.

OBJECTIVES: Comparison of doxorubicin uptake, leakage and spatial regional blood flow, and drug distribution was made for antegrade, retrograde, combined antegrade and retrograde isolated lung perfusion, and pulmonary artery infusion by endovascular inflow occlusion (blood flow occlusion), as opposed to intravenous administration in a porcine model. METHODS: White pigs underwent single-pass lung perfusion with doxorubicin (320 mug/mL), labeled 99mTc-microspheres, and Indian ink. Visual assessment of the ink distribution and perfusion scintigraphy of the perfused lung was performed. 99mTc activity and doxorubicin levels were measured by gamma counting and high-performance liquid chromatography on 15 tissue samples from each perfused lung at predetermined localizations. RESULTS: Overall doxorubicin uptake in the perfused lung was significantly higher (P = .001) and the plasma concentration was significantly lower (P < .0001) after all isolated lung perfusion techniques, compared with intravenous administration, without differences between them. Pulmonary artery infusion (blood flow occlusion) showed an equally high doxorubicin uptake in the perfused lung but a higher systemic leakage than surgical isolated lung perfusion (P < .0001). The geometric coefficients of variation of the doxorubicin lung tissue levels were 175%, 279%, 226%, and 151% for antegrade, retrograde, combined antegrade and retrograde isolated lung perfusion, and pulmonary artery infusion by endovascular inflow occlusion (blood flow occlusion), respectively, compared with 51% for intravenous administration (P = .09). 99mTc activity measurements of the samples paralleled the doxorubicin level measurements, indicating a trend to a more heterogeneous spatial regional blood flow and drug distribution after isolated lung perfusion and blood flow occlusion compared with intravenous administration. CONCLUSIONS: Cytostatic lung perfusion results in a high overall doxorubicin uptake, which is, however, heterogeneously distributed within the perfused lung.

Telomerase activity and human telomerase reverse transcriptase mRNA expression in soft tissue tumors: correlation with grade, histology, and proliferative activity.

Telomerase activity (TA) is detected in most human cancers but, with few exceptions, not in normal somatic cells. Little is known about TA in soft tissue tumors. We have examined a series of benign and malignant soft tissue tumors for TA using the telomerase repeat amplification protocol assay. Analysis of the expression of the human telomerase reverse transcriptase was also carried out using RT-PCR. TA was undetectable in benign lesions (15 of 15) and low-grade sarcomas (6 of 6) and was detectable in 50% (19 of 38) of intermediate-/high-grade sarcomas. Although the presence of TA in soft tissue tumors is synonymous with malignancy, it is neither a reliable method in making the distinction between reactive/benign and malignant (especially low-grade) lesions nor a reliable marker of tumor aggressiveness. Leiomyosarcomas and storiform/pleomorphic malignant fibrous histiocytomas rarely showed TA, irrespective of their grade. A strong correlation between human telomerase reverse transcriptase mRNA expression and TA was observed, supporting the close relationship between both parameters. No significant relationship was observed between proliferative activity (as assessed by MIB-1 immunolabeling) and TA. We verified that the absence of telomerase expression was not due to the presence of telomerase inhibitors and therefore alternative mechanism(s) for cell immortalization, yet to be determined, seem to be involved in the development and/or maintenance of some soft tissue sarcomas.