Purpose: Quantify the levels of oxidative DNA damage of epithelial colon cells comparing segments with and without fecal stream. Methods: Sixty Wistar rats were subjected to deviation of fecal stream by proximal colostomy and a distal mucosal fistula. Animals were divided into three experimental groups that were sacrificed 6, 12 and 24 weeks after surgery. In each experimental group, five animals underwent laparotomy without intestinal deviation (sham subgroup). The diagnosis of colitis was made by histopathological analysis and the inflammatory activity index by graduated scale. The neutrophil infiltration was determined by myeloperoxidase tissue levels and the intensity of oxidative DNA damage by comet assay. The Mann-Withney and Student t test were used to compare the results among experimental subgroups and the Kruskal-Wallis test for variance analysis, adopting a significance level of 5% (p<0.05). Results: Colon segments without fecal stream was shown higher histological inflammatory score of the colon wall after 12 and 24 weeks (p=0.001) that increased with the time of diversion (p=0.01). The activity of myeloperoxidase in segments without fecal stream decreased with the time (p=0.001). Oxidative DNA damage levels were significantly higher in the segments without fecal stream, (p=0.0001), independent of time of colon diversion, and increase with the time (p=0.0007). Conclusions: Colon segments without fecal stream showed high levels of oxidative DNA damage related to histological alterations observed in diversion colitis. The levels of oxidative DNA damage in segments devoid of the fecal stream increase with the time of intestinal exclusion. Key words: Colitis. Colostomy. DNA Damage. Oxidative Stress. Comet Assay. Fatty Acids, Volatile. Rats. RESUMOObjetivo: Quantificar os níveis de dano oxidativo ao DNA em células epiteliais da mucosa cólica comparando segmentos com e sem trânsito fecal. Métodos: Sessenta ratos Wistar foram submetidos à derivação do trânsito intestinal por colostomia proximal e fístula mucosa distal. Os animais foram divididos em três grupos experimentais segundo terem sido sacrificados 6, 12 e 24 semanas após a cirurgia. Em cada grupo experimental, cinco animais foram submetidos à laparotomia isolada sem derivação fecal (grupo sham). O diagnóstico de colite foi estabelecido por análise histopatológica e o índice de atividade inflamatória por escala graduada. A infiltração neutrofílica foi determinada pelos níveis teciduais da mieloperoxidase e a intensidade do dano oxidativo ao DNA pelo ensaio em cometa. Utilizaram-se os testes de Mann-Withney e o teste t de Student para comparar os resultados encontrados entre os subgrupos experimentais e o teste de Kruskal-Wallis para análise de variância, adotando-se nível de significância de 5% (p<0,05). Resultados: Os segmentos cólicos, sem trânsito fecal apresentaram maior escore histológico de inflamação após 12 e 24 semanas (p=0,001), que aumentou com o tempo de derivação (p=0,01). A atividade da mieloperoxidase nos segmentos sem trânsito...
From statistical analysis we may conclude that human immunodeficiency virus-positive patients have more condylomas, ulcers, tumors, fistulas, and abscesses than human immunodeficiency virus-negative patients, who have more hemorrhoids. Incidence of fissures was similar in the two groups.
High-grade anal intraepithelial neoplasia and late-stage AIDS are risk factors for recurrence of anal condylomata.
Five patients (4 males; mean age, 46.4 years) with painful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.
The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty-nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high-grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re-infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323-327. © 2010 Wiley-Liss, Inc.
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