No abstract

Conception, design, intellectual and scientific content of the study, manuscript writing, critical revision. ABSTRACT PURPOSE:To evaluate the relative gene expression (RGE) of cytosolic (MDH1) and mitochondrial (MDH2) malate dehydrogenases enzymes in partially hepatectomized rats after glutamine (GLN) or ornithine alpha-ketoglutarate (OKG) suplementation. METHODS:One-hundred and eight male Wistar rats were randomly distributed into six groups (n=18): CCaL, GLNL and OKGL and fed calcium caseinate (CCa), GLN and OKG, 0.5g/Kg by gavage, 30 minutes before laparotomy. CCaH, GLNH and OKGH groups were likewise fed 30 minutes before 70% partial hepatectomy. Blood and liver samples were collected three, seven and 14 days after laparotomy/hepatectomy for quantification of MDH1/MDH2 enzymes using the real-time polymerase chain reaction (PCR) methodology. Relative enzymes expression was calculated by the 2 -ΔΔC T method using the threshold cycle (C T ) value for normalization.RESULTS: MDH1/MDH2 RGE was not different in hepatectomized rats treated with OKG compared to rats treated with CCa.However, MDH1/MDH2 RGE was greater on days 3 (321:1/26.48:1) and 7 (2.12:1/2.48:1) while MDH2 RGE was greater on day 14 (7.79:1) in hepatectomized rats treated with GLN compared to control animals. CONCLUSION:Glutamine has beneficial effects in liver regeneration in rats by promoting an up-regulation of the MDH1 and MDH2 relative gene expression.

We report the case of a one-year and two-months-old child with a choledochal cyst tYpe I of Alonso-Lej and Todani's classification , diagnosed through abdominal ultrasound. The surgical treatment was cholecistectomy and choledochal cyst excision with Roux-in-Y hepatic-jejunostomy. Minor complications were observed during early postoperative recovery. Long-term flow-up has been uneventiful, with overall improvement.

Mucocele is an unusual lesion of the appendix characterized by accumulation of mucoid substance inside the appendix, which occurs as a sequel of luminal obstruction, usually by fibrous tissue. Diagnosis is intraoperative in most of the cases. We discuss the clinical, anatomicopathological and therapeutics aspects of the disease (Rev. Col. Bras. Cir. 2008; 35(1): 064-065).

The ventriculoperitoneal shunt (VPS) is a solution to relieving symptoms of excess cerebral-ventricle cerebrospinal fluid (CSF); draining this extra fluid to the peritoneum. Other forms of shunts exist though less used in relation to VPS; whose choice is mainly determined by patient’s clinical presentation and regressive history. Though rare, VPS is not devoid of complications. Furthermore, primary abdominal complications are rarer, though most present as peritonitis, abscess or shunt catheter dissociation, each with varying short and long term consequences. Recently, abdominal fluid collections are drawing increasing interest, particularly in relation to: encysted collections (abdominal pseudocysts-APC) and excess cerebrospinal fluid (CSF) accumulation (called CSF ascites). We present a case of an abdominal APC diagnosed in an outpatient treated at our referral centre, and explore the involved clinical and surgical aspects. This patient was successfully treated and evolved well post-operatively and up-to-date. Despite vast evolution in neurosurgery, VPS continues being the prima choice in treating hydrocephalus, a procedure prone to complications just like any surgery, though rare. Non-draining shunts usually warrant revision which usually means at least a reoperation. Mechanisms leading to APC formation remain unknown, although a previous bout of sub-clinical peritonitis continues being the dominant hypothesis.