Tamoxifen decreases the myofibroblast count in the healing bile duct tissue of pigs

OBJECTIVE: The aim of this study was to evaluate the effect of oral tamoxifen treatment on the number of myofibroblasts present during the healing process after experimental bile duct injury. METHODS: The sample consisted of 16 pigs that were divided into two groups (the control and study groups). Incisions and suturing of the bile ducts were performed in the two groups. Tamoxifen (20 mg/day) was administered only to the study group. The animals were sacrificed after 30 days. Quantification of myofibroblasts in the biliary ducts was made through immunohistochemistry analysis using anti-alpha smooth muscle actin of the smooth muscle antibody. Immunohistochemical quantification was performed using a digital image system. RESULTS: In the animals treated with tamoxifen (20 mg/day), there was a significant reduction in immunostaining for alpha smooth muscle actin compared with the control group (0.1155 vs. 0.2021, p = 0.046). CONCLUSION: Tamoxifen reduced the expression of alpha smooth muscle actin in the healing tissue after bile duct injury, suggesting a decrease in myofibroblasts in the scarred area of the pig biliary tract. These data suggest that tamoxifen could be used in the prevention of biliary tract stenosis after bile duct surgeries

Resposta linfóide em biópsias gástricas de crianças do Hospital Universitário Antonio Pedro: associação com Helicobacter pylori e com vírus Epstein-Barr

The infection by Helicobacter pylori (H.pylori) can be related to the occurrence of carcinomas and MALT lymphomas, while the latent infection by Epstein-Barr virus (EBV) is associated both to gastric epithelial malignant neoplasias as to lymphomatous gastric epithelial neoplasias. The purpose of this study was to perform a systematic and global histopathological analysis of gastric biopsies from children submitted to upper digestive endoscopy, with recurrent abdominal pain, in Antonio Pedro University Hospital/UFF and to study the association between lymphoid proliferation and H.pylori and EBV. The gastric biopsies (n=142) from children up to 12 years old (n=129; 52% male; age 8±3 years) from January 2002 to December 2004 were reviewed and the slides were stained with Giemsa and Whartin-Starry for identification of H.pylori and immunostains for EBV (anti-LMP1) and T-lymphocytes CD8+ were used. Under light microscopy, 63% presented chronic gastritis and 30% infection by H.pylori. Forty-eight percent of children with chronic gastritis had lymphoid proliferation, but 15 among these were negative for H.pylori. None of the children was positive for EBV and 83% of them presented up to five T CD8+ lymphocytes per 100 superficial epithelial cells. H.pylori positive children were older than the negative ones (9.1±2.8 vs. 7.1±3.3 years; P<0,001) and the presence of lymphoid response was more frequently found in children with H.pylori (80% vs. 15%; P <0,001). In conclusion, EBV is not related to lymphoid response in children gastric biopsies. However, this lymphoid proliferation is associated with H.pylori infection in 48% of children with chronic gastritis. Five out of 15 children with lymphoid proliferation but negative for H.pylori, had been previously treated for this bacteria, suggesting that this response could be post-treatment sequelae. The remaining 10 biopsies could represent post-treatment sequelae from other systemic infections.A infecção gástrica pelo Helicobacter pylori (H.pylori) pode estar relacionada ao aparecimento de carcinomas e de linfomas MALT e a infecção latente pelo vírus Epstein-Barr (EBV) está associada tanto ao desenvolvimento de neoplasias malignas epiteliais gástricas usuais, quanto a neoplasias epiteliais com estroma linfomatoso. O objetivo deste trabalho foi realizar uma análise histopatológica sistemática e global das biópsias gástricas de crianças submetidas a endoscopia digestiva alta, com queixas de dor abdominal recorrente, no Hospital Universitário Antônio Pedro/UFF e estudar a possível associação da resposta linfóide com Helicobacter pylori e com vírus Epstein-Barr. Foram revistas as biopsias gástricas (n=142) realizadas entre janeiro de 2002 a dezembro de 2004 de crianças com até 12 anos (n=129; 52% masculino; idade 8±3 anos) e os fragmentos foram submetidos às colorações de Giemsa e Whartin-Starry para pesquisa de H.pylori, à imuno-histoquímica para pesquisa de EBV (anti-LMP1) e pesquisa de linfócitos T CD8+. À microscopia, 63% apresentaram gastrite crônica e 30% infecção pelo H.pylori. Dentre as crianças com gastrite crônica, 48% apresentaram resposta linfóide, sendo que apenas 15 dessas não tinham positividade para H.pylori. Nenhuma das crianças apresentou positividade para EBV e 83% delas exibiu até 5 linfócitos T CD8+ por 100 células epiteliais superficiais. A idade das crianças positivas para H.pylori foi maior do que as negativas (9,1±2,8 vs. 7,1±3,3 anos; P<0,001) e a presença de resposta linfóide foi mais freqüente nas crianças com H.pylori (80% vs. 15%; P <0,001). Em conclusão, o EBV não está relacionado a resposta linfóide em biopsias gástricas de crianças, entretanto este afluxo linfóide está associado a positividade do H. pylori em 48% das crianças com gastrite crônica. De quinze crianças com reposta linfóide e H.pylori negativo, cinco foram tratadas para erradicação do bacilo, podendo ser esta resposta uma seqüela pós-tratamento. As dez biopsias restantes sugerem tratar-se também de resolução/seqüela pós-tratamento para outras infecções sistêmicas

Posterior Cord Syndrome and Trace Elements Deficiency as an Uncommon Presentation of Common Variable Immunodeficiency

Diarrhea is one of the most common symptoms in common variable immunodeficiency, but neurologic manifestations are rare. We presented a 50-year-old woman with recurrent diarrhea and severe weight loss that developed a posterior cord syndrome. Endoscopy found a duodenal villous blunting, intraepithelial lymphocytosis, and lack of plasma cells and magnetic resonance imaging of the spine was normal. Laboratory assays confirmed common variable immunodeficiency syndrome and showed low levels of trace elements (copper and zinc). Treatment was initiated with parenteral replacement of trace elements and intravenous human immunoglobulin and the patient improved clinically. In conclusion, physicians must be aware that gastrointestinal and neurologic disorders may be related to each other and remember to request trace elements laboratory assessment