Expressão Imuno-histoquímica das proteínas GLUT-1 e HIF-1α em lesões vasculares de mucosa oral

The correct histological diagnosis of vascular lesions in the oral mucosa is critical, especially in defining the treatment and prognosis, as some vascular lesions show spontaneous involution and others do not show such behavior. This study analyzed the expression immunohistochemistry of human glucose transporter protein (GLUT-1), in oral benign vascular tumors and to reclassify such lesions according to with his immunoexpression. In addition, we evaluated the immunohistochemical expression of hypoxia-inducible factor 1 alpha (HIF-1α), the main transcription factor involved in cellular adaptation to hypoxia. We analyzed 60 cases of benign oral vascular tumors: 30 cases with histological diagnosis of HEM and 30 cases of oral pyogenic granuloma (PG). The results of this research showed that of the 30 lesions initially classified as HEM, only 7 showed immuno-positivity for GLUT-1, remaining with the initial diagnosis. The remaining 23 were reclassified as vascular malformation (VM) (13 cases) and PG (10 cases). All cases in the sample with an initial diagnosis of PG were negative for GLUT-1, demonstrating the accuracy of histological diagnosis of these lesions. Concerning to the immunoexpression of HIF-1α, the Mann-Whitney test revealed a statistically significant difference between the cases of GP and MV (p = 0.002), where the median of GP (m=78) was higher than the MV (m=53). Based on these results, this study showed that a histological diagnosis alone is not always sufficient for the correct diagnosis of oral HEM and that HIF-1α participates in the pathogenesis of vascular lesions

Expressão imunoistoquímica de Glut-1 e marcadores de proliferação e apoptose em anomalias vasculares orais

Vascular anomalies constitute a distinct group of lesions, but they may present similar clinical and histopatological characteristics, which can lead to diagnostic mistakes. This study aimed by histopathology and immunohistochemical expression of human glucose transporter protein (GLUT-1), correctly identify and classify oral vascular anomalies, besides analyzing the immunoexpression of markers proliferation and apoptosis (Ki-67 and Bcl-2). All cases diagnosed as "oral hemangiomas" belonging to the archives of the Service of Pathological Anatomy from the subject of Oral Pathology of the Department of Dentistry (DOD), of the Federal University of Rio Grande do Norte (UFRN) were reviewed, totalizing 77 cases. Immunohistochemical analysis for GLUT-1 showed that only 26 (33.8%) of the specimens were true infantile hemangiomas (IHs). The 51 (66.2%%) GLUT-1 negative specimens were then reclassified as pyogenic granulomas (PGs) and vascular malformations (VMs) from their histopathologic characteristics,totalizing 26 (33.8%) cases of IHs, 20 (26.0%) of PGs and 31 (40.2) cases of oral VMs. The cases analyzed by the marker Ki-67 showed different median IH (13,85), PG (33,70) and VM (4.55) with statistically significant differences between them (p <0.001). In relation to the protein Bcl-2, the groups also showed different median of the established scores IH (1.00), PG (1.50), VMs (0.0) demonstrating statistically significant differences between them (p<0,001). No statistically significant correlation between the indexes of positivity for Ki-67 and the scores of immunoexpression of Bcl-2 were observed in any group. Thus, we can conclude that it is necessary a careful and parameterized review of cases of vascular anomalies making use of auxiliary tools such as GLUT-1, since the histopathological findings alone, sometimes, are not sufficient to differentiate some anomalies. Furthermore, analysis of the expressions of markers involved in the levels of proliferation of lesions is important for a better understanding of its biological behavior aspect

Análise fractal da vasculatura retínica: métodos de segmentação e de cálculo dimensional

Embora tenha sido proposto que a vasculatura retínica apresenta estrutura fractal, nenhuma padronização do método de segmentação ou do método de cálculo das dimensões fractais foi realizada. Este estudo objetivou determinar se a estimação das dimensões fractais da vasculatura retínica é dependente dos métodos de segmentação vascular e dos métodos de cálculo de dimensão. Métodos: Dez imagens retinográficas foram segmentadas para extrair suas árvores vasculares por quatro métodos computacionais (“multithreshold”, “scale-space”, “pixel classification” e “ridge based detection”). Suas dimensões fractais de “informação”, de “massa-raio” e “por contagem de caixas” foram então calculadas e comparadas com as dimensões das mesmas árvores vasculares, quando obtidas pela segmentação manual (padrão áureo). Resultados: As médias das dimensões fractais variaram através dos grupos de diferentes métodos de segmentação, de 1,39 a 1,47 para a dimensão por contagem de caixas, de 1,47 a 1,52 para a dimensão de informação e de 1,48 a 1,57 para a dimensão de massa-raio. A utilização de diferentes métodos computacionais de segmentação vascular, bem como de diferentes métodos de cálculo de dimensão, introduziu diferença estatisticamente significativa nos valores das dimensões fractais das árvores vasculares. Conclusão: A estimação das dimensões fractais da vasculatura retínica foi dependente tanto dos métodos de segmentação vascular, quanto dos métodos de cálculo de dimensão utilizados

Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária

Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP), as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia), através da mensuração de parâmetros ultra-sonográficos. Método: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS), velocidade de pico diastólico (VPD), índice de pulsatibilidade (IP) e índice de resistência (IR) nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. Resultados: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%), seja isoladamente (25%) ou associada a T4 (62,50%) ou a T2 (8,33%). Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (p<0,05). A VPD da artéria carótida interna diminuiu em ambos os lados (p<0,05). A VPS e a VPD da artéria vertebral direita também aumentaram (p<0,05). Achados assimétricos foram observados, de modo que artérias do lado direito foram as mais freqüentemente afetadas. Conclusões: Alterações hemodinâmicas foram observadas nas artérias vertebral e carótida após simpaticotomia para tratamento de HP. VPS foi o parâmetro mais freqüentemente alterado, principalmente nas artérias do lado direito, representando alterações assimétricas significantes nas artérias carótida e vertebral. Entretanto, são necessárias pesquisas subseqüentes para verificar se essas alterações são definitivas ou temporárias, uma vez que as inferências clínicas somente terão validação se as alterações forem permanentes

Efeitos da microgravidade em plantas de cana-de-açúcar

Sugarcane (Saccharum spp.) is a plant from Poaceae family that has an impressive ability to accumulate sucrose in the stalk, making it a significant component of the economy of many countries. About 100 countries produce sugarcane in an area of 22 million hectares worldwide. For this reason, many studies have been done using sugarcane as a plant model in order to improve production. A change in gravity may be one kind of abiotic stress, since it generates rapid responses after stimulation. In this work we decided to investigate the possible morphophysiological, biochemical and molecular changes resulting from microgravity. Here, we present the contributions of an experiment where sugarcane plants were submitted to microgravity flight using a vehicle VSB-30, a sounding rocket developed by Aeronautics and Space Institute teams, in cooperation with the German Space Agency. Sugarcane plants with 10 days older were submitted to a period of six minutes of microgravity using the VSB-30 rocket. The morphophysiological analyses of roots and leaves showed that plants submitted to the flight showed changes in the conduction tissues, irregular pattern of arrangement of vascular bundles and thickening of the cell walls, among other anatomical changes that indicate that the morphology of the plants was substantially influenced by gravitational stimulation, besides the accumulation of hydrogen peroxide, an important signaling molecule in stress conditions. We carried out RNA extraction and sequencing using Illumina platform. Plants subjected to microgravity also showed changes in enzyme activity. It was observed an increased in superoxide dismutase activity in leaves and a decreased in its activity in roots as well as for ascorbate peroxidase activity. Thus, it was concluded that the changes in gravity were perceived by plants, and that microgravity environment triggered changes associated with a reactive oxygen specie signaling process. This work has helped the understanding of how the gravity affects the structural organization of the plants, by comparing the anatomy of plants subjected to microgravity and plants grown in 1g gravity

Hidrocarbonetos alifáticos em sedimentos de fundo do estuário do Rio Potengi, grande Natal (RN): implicações ambientais

The Potengi river estuary is located in the region of Natal (RN, Brazil), comprising a population of approximately 1,000,000 inhabitants. Besides the dominant urban presence, the estuary has fragments of mangrove forest. The objective of this study is to determine the aliphatic hydrocarbons found in the bottom sediments of this estuary, identifying their levels, distribution and their possible origins through the diagnostic rates, indexes and results comparisons with the local anthropic and natural characteristics. The samples were obtained according to a plan that allowed sampling of the estuary up to 12 km upstream from it as mounth. 36 stations were selected, grouped into 12 cross sections through the course of the river and spaced on average by 1 km. Each section consisted of three stations: the right margin, the deepest point and the left margin. The hydrocarbon n-alkanes from C10 to C36, the isoprenoids pristane and phytane, the unresolved complex mixture (UCM) and the total resolved hydrocarbons were analyzed by gas chromatography. N-alkanes, pristane, phytane and UCM were detected only at some stations. In the other, the concentration was below the detection limit defined by the analytical method (0.1 mg / kg), preventing them from being analyzed to determine the origin of the material found. By using different parameters, the results show that the estuary receives both the input of petrogenic hydrocarbons, but also of biogenic hydrocarbons, featuring a mixture of sources and relatively impacted portions. Based on the characteristics and activities found in the region, it is possible to affirm that petrogenic sources related to oil products enter the estuary via urban runoff or boats traffic, boat washing and fueling. Turning to the biogenic source, the predominant origin was terrestrial, characterized by vascular plants, indicating contribution of mangrove vegetation. It was evident the presence of, at specific points in the estuary, hydrocarbon pollution, and, therefore is recommended the adoption of actions aimed at interrupting or, at least, mitigating the sources potentially capable of damp petrogenic hydrocarbons in the estuary studied.

Análise fractal da vasculatura arteriolar e venular da retina em pessoas sem doença ocular

Although it has been suggested that retinal vasculature is a diffusion-limited aggregation (DLA) fractal, no study has been dedicated to standardizing its fractal analysis . The aims of this project was to standardize a method to estimate the fractal dimensions of retinal vasculature and to characterize their normal values; to determine if this estimation is dependent on skeletization and on segmentation and calculation methods; to assess the suitability of the DLA model and to determine the usefulness of log-log graphs in characterizing vasculature fractality . To achieve these aims, the information, mass-radius and box counting dimensions of 20 eyes vasculatures were compared when the vessels were manually or computationally segmented; the fractal dimensions of the vasculatures of 60 eyes of healthy volunteers were compared with those of 40 DLA models and the log-log graphs obtained were compared with those of known fractals and those of non-fractals. The main results were: the fractal dimensions of vascular trees were dependent on segmentation methods and dimension calculation methods, but there was no difference between manual segmentation and scale-space, multithreshold and wavelet computational methods; the means of the information and box dimensions for arteriolar trees were 1.29. against 1.34 and 1.35 for the venular trees; the dimension for the DLA models were higher than that for vessels; the log-log graphs were straight, but with varying local slopes, both for vascular trees and for fractals and non-fractals. This results leads to the following conclusions: the estimation of the fractal dimensions for retinal vasculature is dependent on its skeletization and on the segmentation and calculation methods; log-log graphs are not suitable as a fractality test; the means of the information and box counting dimensions for the normal eyes were 1.47 and 1.43, respectively, and the DLA model with optic disc seeding is not sufficient for retinal vascularization modeling

Efeito do sildenafil na lesão renal por isquemia-reperfusão em ratos

A lesão renal causada pelo processo isquemia-reperfusão ocorre em várias intervenções cirúrgicas, como transplantes de rins, cirurgias vasculares renais e na nefrectomia parcial. Devido ao processo isquêmico, ocorre disfunção do órgão e morte celular. Com o objetivo de avaliar o efeito do sildenafil, em ratos, administrado previamente à isquemia renal e reperfusão, em avaliações cintilográficas e histopatológicas, foram utilizados vinte e quatro ratos Wistar, aleatoriamente distribuídos em dois grupos. Os animais receberam 0,1 ml IV 99mTecnécio-Etilenodicisteína, realizando-se a cintilografia renal inicial e, em seguida, foram submetidos à laparotomia, provocando-se isquemia no rim esquerdo, com oclusão da artéria renal, durante 1 hora, com posterior reperfusão. Os animais do grupo sildenafil receberam previamente 1mg/kg de sildenafil via oral, 60 minutos antes da isquemia. O grupo controle recebeu somente solução salina. Após a isquemia e reperfusão, metade dos animais de cada grupo foi avaliada com 24 horas e a outra metade, com sete dias, com nova cintilografia renal. Após eutanásia, com superdose de anestésico, os rins foram retirados e submetidos a exame histopatológico. Empregou-se avaliação estatística com o teste t de Student e com teste não-paramétrico de Mann-Whitney. Foi observado no rim esquerdo do grupo controle um déficit funcional nas imagens cintilográficas, após sete dias, comparativamente ao respectivo estudo cintilográfico inicial (p<0,05). Nos rins esquerdos dos animais do grupo controle (24 horas pós-isquemia), ocorreu um maior grau de necrose celular quando comparados ao grupo tratado com o sildenafil (p<0,05). A cintilografia e a histopatologia demonstraram que o sildenafil exerceu ação protetora dos rins, após episódio de isquemia-reperfusão renal normotérmica. Deve ressaltar-se o x caráter interdisciplinar desta tese, que contou com a participação ativa de profissionais das áreas de cirurgia, medicina nuclear, urologia, patologia e estatística

Análise do óxido nítrico, perfil lipídico, resistência arterial e capacidade funcional de idosas submetidas a um treinamento aquático

A prática regular de exercício físico possibilita redução dos efeitos das disfunções hormonais e envelhecimento biológico natural que promovem desajustes hemodinâmicos, vasculares e músculo-esqueléticos, principalmente na população feminina no período pós-menopausa. Nesta fase da vida, o exercício aquático representa mais do que uma forma de ajuste funcional, é uma forma de manutenção de independência para as atividades da vida diária (AVD s) e melhoria na qualidade de vida. Este estudo teve como objetivo avaliar as modificações adquiridas pela prática regular de um programa de exercício aquático concorrente de intensidade moderada no nível de óxido nítrico (ON), no índice de resistividade arterial (IR), no perfil lipídico, na capacidade funcional e na qualidade de vida de idosas. A amostra foi formada por idosas (60 a 80 anos) selecionadas por randomização, por sorteio simples divididas em grupo controle e grupo de intervenção as quais foram submetidas a um programa de exercícios aquáticos proposto inicialmente em projeto piloto, por 12 semanas (n=34) e o ensaio clínico teve duração de 16 semanas (n=40). Foi coletada amostra sanguínea das idosas e avaliado o perfil lipídico pelo método enzimático com kit Labtest e o ON por medida indireta a partir da concentração de nitrito no sobrenadante das células em cultura em leitor de ELISA. A avaliação das artérias carótidas e vertebrais foi feita utilizando o método de ultra-som Doopler. A capacidade funcional foi avaliada por quatro testes que simulam atividades da vida diária que são: caminhar 10 metros (C10m), levantar da posição sentada (LPS), levantar da cadeira e locomover-se pela casa (LCLC) e o de levantar-se da posição decúbito ventral (LPDV). No estudo piloto foi avaliado o índice geral de autonomia funcional (IG) e a qualidade de vida através do questionário WHOQOL-100. Empregou-se a análise de variância (ANOVA) com medidas repetidas nos fatores grupo (GH e GC) e tempo (pré e pós-teste) para as comparações intra e intergrupos nas variáveis seguida do post hoc de Scheffé. Utilizou-se o teste de correlação de Pearson e adotado o valor de p<0,05 para a significância estatística. Houve aumento do ON circulante, redução nos índices de resistividade arterial, melhoria significativa nos níveis de colesterol e triglicérides e ganho na capacidade funcional das idosas após a intervenção. Existiu correlação inversa entre a resistividade da artéria vertebral direita (VERTD) e níveis de ON e entre a VERTD e os níveis plasmáticos de HDL, assim como entre estes e o teste C10m nas idosas em estudo. Não houve modificações significativas na qualidade de vida das idosas. Em conclusão, o programa de exercício proposto foi capaz de oferecer melhorias funcionais, aumentar o nível de óxido nítrico circulante, diminuindo a resistência arterial promovendo modificações no perfil lipídico de idosas

Avaliação de efeitos toxicológicos e comportamentais de ginseng panax em ratos

Panax ginseng CA Meyer (Araliaceae) is a herbaceous plant widely used in China, South Korea, Japan and other Asian countries for the treatment of various diseases micro circulatory, cerebrovascular, among others, representing one of the drugs used by older man. It has over 30 biologically active ginsenosides with different pharmacological and behavioral effects and inhibitory effect on the NMDA receptor. The amino acid glycine is a co-agonist of the NMDA receptor, activating this receptor. At the cellular level, ketamine is widely known to be NMDA receptor antagonist. The aim of this study was to evaluate the general activity in the open field, and anxiety in elevated plus maze, mice treated with P. ginseng compared with the action of ketamine and glycine, to better understand the action of this herbal medicine at the NMDA receptor. We used 66 adult male rats were divided into six groups: a positive control, treated for 30 days with water by gavage, who received glycine (500mg/kg; po) on days 7, 14, 21 and 28 of treatment, one hour before of behavioral assessment, a negative control was treated for 30 days with water by gavage received ketamine (5mg/kg, ip) on days 7, 14, 21 and 28 of treatment, one hour prior to behavioral evaluation, three experimental groups, receiving 100, 200 or 300 mg / kg P. ginseng by gavage for 30 days and one group treated solely with white water, and is also administered 1 ml of water by gavage one hour prior to behavioral evaluation. Animal behavior in these three groups was also examined on days 7, 14, 21 and 28 of treatment. On day 30 of treatment, the animals were anesthetized with thiopental (70mg/kg) for blood collection and after euthanasia, withdrawal of various organs. There were no changes in weight and body weight gain and weight reasons in organ / body weight. However the consumption of water and food values showed a significant increase. Serum levels of AST was increased in a dose-dependently in the animals treated with doses of P. ginseng, glycine and ketamine as compared to the blank group. Unlike creatinine levels proved to be decreased in all treated groups when compared with white. However, the level of urea in these groups was reduced and no changes were observed in the ALT parameter. Histopathological examination revealed no changes in cell morphology in different tissues. There were no behavioral changes in the elevated plus maze and few changes were observed in the open field, animals treated with P. ginseng, glycine and ketamine when compared to white. These data suggest that the doses of P. ginseng employed were unable to induce general toxicity in rats treated for 30 days and also shows that the general behavior of mice treated with P. ginseng was slightly different from that observed in animals treated with ketamine and glycine. Finally, the study on the elevated plus maze showed that the extract of P. ginseng showed no anxiolytic or anxiogenic action

Análise imunoistoquímica após terapia fotodinâmica com cloro-alumínio ftalocianina em tecidos gengivais de humanos

Although photodynamic therapy have been used as a useful tool over the past 30 years in oncology, few clinical trials have been conducted in dentistry. Photodynamic therapy (PDT) uses non - toxic photosensitizers and selective which are administered in target cells followed by local application of visible light, producing reactive oxygen species capable of causing cell death by apoptosis or necrosis, injured the local vasculature, and exert important effects on the im mune system. New generations of photosensitizing agents, such as nanoparticulate phthalocyanines, has shown excellent results in antitumor and antibacterial activity . In this context, the present work constitutes the first clinical protocol of local appli cation of nanoemulsion chloro - aluminum phthalocyanine (AlClFc) followed by irradiation in human gingiva, and analyzed descriptively and comparatively , by means of immunohistochemistry , the expression of RANK , RANKL , OPG and VEGF in a split - mouth model . Eight healthy volunteers with clinical indication for extraction were included in the study . Seven days before the extraction, was injected in the gingiva of participants, 5 μ M of nanoemulsion AlClFc followed by irra diation with diode laser (660nm , 7 J/cm2 ), the contralateral side was used as control. Tissue specimens were removed seven days after the TFD is performed. Tissues sample were divided into two groups (test and con trol groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy. Vascular alterations were seen in gingival samples that received PDT. Areas of edema and vascular con gestion, and intense vascularization were viewed . Additionally, dystrophic calcification in subepithelial region were observed in the test group. The results showed a similar pattern of immunostaining scores of RANK, RANKL and VEGF between the test and co ntrol groups, with no statistically significant difference (p = 0.317, p = 0.777, p = 0 .814, respectively). RANK and RANKL exhibited weak or absent immunostaining in most specimens analyzed. There was n o immunostaining for OPG. VEGF showed moderate to stro ng immunostaining in specimens from the test group. In addition, the clinical study showed that therapy was well tolerated by all patients. Adverse effects were short - time and completely reversible. Taken together, the results presented in this study showe d that PDT mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that a strong immunostaining for VEGF after therapy .

Validação do conteúdo do diagnóstico de enfermagem proteção ineficaz para pacientes submetidos à hemodiálise

Methodological study, in order to validate the content of the nursing diagnosis protection ineffective in patients undergoing hemodialysis. The research took place in two stages, namely: concept analysis and content analysis of the instrument by experts. T he first step was operationalized through an integrative review of the databaes LILACS, CINAHL, PubMed, Scopus and Cochrane, with the key words protection and hemodialysis, in October and November 2013. The sample consisted of 32 articles, which were analyz ed by a c areful reading to identify the sections that correspond ed to the defining attributes , antecedents and consequences of protection in patients undergoing hemodialysis. T he interpretation for the diagnosis of effective protection was made by transpos ing the components of the diagnosis (definition, defining characteristics and related factors) to the denial form . In the second stage, we elaborated an instrument with the components of the nursing diagnostic s studied and proceeded to the analysis conduct ed in April 2014 by 22 specialists in nephrology and in the terminology of the NANDA International, selected by means of th e Lattes Platform . We used the binomial test to assess the proportion of experts who rated each item as appropriate, considering a si gnificance level of 5%. The project was approved by the Ethics Committee of the institution responsible for the research, an opinion on num b er 387 837 and CAAE 18486413.0.0000.5537. The results show that the proposal for the nursing diagnosis of ineffectiv e protection in patients undergoing hemodialysis is: definition - the same as that presented in the NANDA International Taxonomy II, location - domain safety / protection and class injury. Related factors are: Absence of routine vaccines; Non - adherence to care related to vascular access; Non - adherence to infection control measures; Non - adherence to prescribed diet; Non - adherence to drug therapy; Presence of comorbidities; Drug abuse; Immune disorders; Extremes of age; Abnormal blood profiles; Drugs that red uce immunity; and side effects and adverse treatment - related. The defining characteristics are: Presence of invading the bloodstream; Nutritional disorders; Increase in the number of hospitalizations; Uncontrolled dry weight; Infected vascular access; Vasc ular inadequate access; Increased blood pressure; fever; Bleeding disorder; Disability immunity; fatigue; weakness; itching; and maladaptive response to stress. It follows that the identification of the defining attributes, antecedents and consequences inc reased the wealth of vocabulary, allowing the construction of theoretical and empirical definitions for a broader understanding of the concept protection. Furthermore, the study contributed to the enrichment of nursing specific body of knowledge, as well a s in the direction of nursing care for patients undergoing hemodialysis.

Ensino da ultrassonografia diagnóstica a partir do ciclo básico do curso de medicina utilizando livro digital multimídia

Currently, the diagnostic ultrasound is inserted in various areas of medical action and carried out by many medical professionals, from which militate directly in the image area, such as radiologists and sonographers, but also by gynecologists, pediatricians, neurologists, general practitioners, endocrinologists, angiologists, orthopedists, rheumatologists, urologists, general and vascular surgeons. It is well known that the medical professional, for the exercise of its mission, requires a broad set of skills, competencies and attitudes developed and exercised during their training period. Living with medical students over nearly 20 years in hospital environment, I noticed gaps in the learning process by the students about what is diagnostic ultrasound and its applications, demonstrating failures as understanding the basic acoustic ultrasound, difficulties in identifying of anatomical structures in ultrasound images and inability in requests examinations and interpretations of images and reports. Based on these findings, it was developed in this Professional Masters a multimedia digital book that exposes what the ultrasound as a diagnostic modality imaging, dealing with its historiography and its physical/acoustic concepts, relating the process of formation of the ultrasound image, discussing about the features of sonographic equipments and their embedded technologies and highlighting its diagnostic applications , the latter presented through videos which will be described aspects of captured ultrasound images. This book will be available for access in digital format, serving as a teaching tool in medical education since the beginning of the course, so that can be used in conjunction with the discipline of Gross Anatomy, offered in the basic cycle of the Medicine Undergraduate Course of the Federal University of Rio Grande do Norte (UFRN).

Análise fractal da vasculatura retínica: métodos de segmentação e de cálculo dimensional

Embora tenha sido proposto que a vasculatura retínica apresenta estrutura fractal, nenhuma padronização do método de segmentação ou do método de cálculo das dimensões fractais foi realizada. Este estudo objetivou determinar se a estimação das dimensões fractais da vasculatura retínica é dependente dos métodos de segmentação vascular e dos métodos de cálculo de dimensão. Métodos: Dez imagens retinográficas foram segmentadas para extrair suas árvores vasculares por quatro métodos computacionais (“multithreshold”, “scale-space”, “pixel classification” e “ridge based detection”). Suas dimensões fractais de “informação”, de “massa-raio” e “por contagem de caixas” foram então calculadas e comparadas com as dimensões das mesmas árvores vasculares, quando obtidas pela segmentação manual (padrão áureo). Resultados: As médias das dimensões fractais variaram através dos grupos de diferentes métodos de segmentação, de 1,39 a 1,47 para a dimensão por contagem de caixas, de 1,47 a 1,52 para a dimensão de informação e de 1,48 a 1,57 para a dimensão de massa-raio. A utilização de diferentes métodos computacionais de segmentação vascular, bem como de diferentes métodos de cálculo de dimensão, introduziu diferença estatisticamente significativa nos valores das dimensões fractais das árvores vasculares. Conclusão: A estimação das dimensões fractais da vasculatura retínica foi dependente tanto dos métodos de segmentação vascular, quanto dos métodos de cálculo de dimensão utilizados

Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária

Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP), as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia), através da mensuração de parâmetros ultra-sonográficos. Método: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS), velocidade de pico diastólico (VPD), índice de pulsatibilidade (IP) e índice de resistência (IR) nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. Resultados: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%), seja isoladamente (25%) ou associada a T4 (62,50%) ou a T2 (8,33%). Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (p<0,05). A VPD da artéria carótida interna diminuiu em ambos os lados (p<0,05). A VPS e a VPD da artéria vertebral direita também aumentaram (p<0,05). Achados assimétricos foram observados, de modo que artérias do lado direito foram as mais freqüentemente afetadas. Conclusões: Alterações hemodinâmicas foram observadas nas artérias vertebral e carótida após simpaticotomia para tratamento de HP. VPS foi o parâmetro mais freqüentemente alterado, principalmente nas artérias do lado direito, representando alterações assimétricas significantes nas artérias carótida e vertebral. Entretanto, são necessárias pesquisas subseqüentes para verificar se essas alterações são definitivas ou temporárias, uma vez que as inferências clínicas somente terão validação se as alterações forem permanentes