Alterações ultra-estruturais do glomérulo na pré-eclâmpsia

OBJETIVOS: identificar as alterações ultra-estruturais glomerulares em pacientes com pré-eclâmpsia grave, assim como avaliar a evolução destas lesões e sua relação com o momento de realização da biópsia renal. MÉTODOS: dentre as 72 gestantes com síndrome hipertensiva que se submeteram à biópsia renal no puerpério, em 39 o material obtido mostrou-se adequado para exame à microscopia eletrônica de transmissão, assim distribuídas: 25 eram portadoras de pré-eclâmpsia pura e 14 tiveram diagnóstico de pré-eclâmpsia superposta à hipertensão arterial crônica. As apresentações morfológicas estiveram representadas por rim normal, edema das células endoteliais, expansão do mesângio, interposição mesangial, depósitos subendoteliais e fusão dos pés dos podócitos. RESULTADOS: as alterações mais freqüentes nos dois grupos foram os depósitos subendoteliais e a fusão dos pés dos podócitos. O edema da célula endotelial ocorreu em 84% das pacientes com pré-eclâmpsia pura e 92,9% das pacientes com pré-eclâmpsia superposta. Não foi observada associação entre a gravidade da doença e a intensidade do edema da célula endotelial. Verificou-se tendência de interposição mesangial em pacientes biopsiadas após o sétimo dia pós-parto. A fusão dos podócitos apresentou associação significativa com a proteinúria de 24 horas. CONCLUSÕES: as alterações glomerulares citadas representam espectro de lesões complexas e dinâmicas que, em conjunto, constituem as características ultra-estruturais da pré-eclâmpsia, que não deve, pois, ser identificada somente pela presença do edema da célula endotelial.

Fator von Willebrand e disfunção endotelial pulmonar. Implicações prognósticas

OBJETIVO: Avaliar alterações quantitativas e estruturais do fator von Willebrand (fvW) circulante em 40 pacientes com hipertensão pulmonar pré-capilar e verificar possíveis implicações prognósticas dos resultados iniciais, em um ano de seguimento. MÉTODOS: A atividade antigênica plasmática do fator von Willebrand (vWF:Ag) foi analisada por imunoeletroforese. A concentração de multímeros de baixo peso molecular em relação ao total de multímeros do fvW (MBPM%) e o grau de fragmentação de sua subunidade principal foram analisados por Western immunoblotting. RESULTADOS: Em 40 pacientes, observamos aumento significativo de vWF:Ag em relação aos controles (p<0,001). Também foi observado aumento de MBPM% (p<0,001), além de degradação patológica da subunidade do fvW (p<0,05). Em 11 pacientes que evoluíram para óbito no 1º ano, os valores iniciais de vWF:Ag foram 95% superiores em relação aos sobreviventes (p<0,001). Os não sobreviventes tiveram ainda 31% de aumento em MBPM% (p<0,005). A variável MBPM% foi selecionada por regressão logística (p<0,05), como preditor de óbito no primeiro ano de evolução. CONCLUSÃO: As alterações do fvW circulante, consideradas como índices de lesão endotelial, têm valor prognóstico em hipertensão arterial pulmonar, com potencial impacto em decisões terapêuticas, como a indicação de transplante cardiopulmonar.

Aspectos estruturais, farmacológicos e biológicos de fucanas da alga marrom sargassum vulgare

The present study examines the chemical composition and their effects on free radicals, inflammation, angiogenesis, coagulation, VEGF effects and cellular proliferation of a polysaccharides from alga Sargassum vulgare. The sulfated polysaccharide was extracted from brown seaweed by proteolysis with enzymes maxataze. The presence of proteins and sugars were observed in crude polysaccharides. Fractionation of this crude extract was made with growing concentration of acetone (0.3-1.5 v) and produced four groups of polysaccharides. Anionic polysaccharides from brown seaweed Sargassum vulgare, SV1and PSV1 were fractionated (SV1) and purified (PSV1), and displayed with high total sugars and sulfate content and very low level of protein. This fucan SV1 contains low levels of protein and high carbohydrate and sulfate content. This polysaccharides prolonged activated partial thromboplastin time (aPTT) at 50 μg (>240 s). SV1 was found to have no effect on prothrombin time (PT), corresponding to the extrinsic pathway of coagulation. SV1 exhibits high antithrombotic action in vivo, with a concentration ten times higher than heparin. Polysaccharides from S. vulgare promoted direct inhibition enzymatic activity of thrombin and stimulated enzymatic activity of FXa. SV1 showed optimal inhibitory activity of thrombin (50.2±0.28%) at a concentration of 25 μg/mL. Its antioxidant action on scavenging radicals by DPPH was (22%), indicating the polymer has no cytotoxic action (hemolytic) on ABO and Rh blood types in different erythrocyte groups and displays strong anti-inflammatory action on all concentrations tested in the carrageenan-induced paw edema model, demonstrated by reduced edema and cellular infiltration. Angiogenesis is a dynamic process of proliferation and differentiation. It requires endothelial proliferation, migration, and tube formation. In this context, endothelial cells are a preferred target for several studies and therapies. The antiangiogenic efficacy of polysaccharides was examined in vivo in the chick chorioallantoic membrane (CAM) model by using fertilized eggs. Decreases in the density of the capillaries were assessed and scored. The results showed that SV1 and PSV1 have an inhibitory effect on angiogenesis. These results were also confirmed by inhibition tubulogenesis in rabbit aorta endothelial cell (RAEC) in matrigel. These compounds were assessed in Apoptosis assay (Annexin V - FITC / PI) and cell viability by MTT assay of RAEC. These polysaccharides do not affect the viability and do not have apoptotic or necrotic action. RAEC cell when incubated with SV1 and PSV1showed inhibition of VEGF secretion, observed when compounds were incubated at 25, 50 and 100 μg/μL. The VEGF secretion with the RAEC cell line for 24 h, was more effective for PSV1 at 50 μg/μL(71.4%) than SV1 100 μg/μL (75.9%). SV1 and PSV1 had an antiproliferative action (47%) against tumor cell line HeLa. Our results indicate that these sulfated polysaccharides have antiangiogenic and antitumoral actions

Aspectos estruturais, farmacológicos e biológicos de fucanas da alga marrom sargassum vulgare

The present study examines the chemical composition and their effects on free radicals, inflammation, angiogenesis, coagulation, VEGF effects and cellular proliferation of a polysaccharides from alga Sargassum vulgare. The sulfated polysaccharide was extracted from brown seaweed by proteolysis with enzymes maxataze. The presence of proteins and sugars were observed in crude polysaccharides. Fractionation of this crude extract was made with growing concentration of acetone (0.3-1.5 v) and produced four groups of polysaccharides. Anionic polysaccharides from brown seaweed Sargassum vulgare, SV1and PSV1 were fractionated (SV1) and purified (PSV1), and displayed with high total sugars and sulfate content and very low level of protein. This fucan SV1 contains low levels of protein and high carbohydrate and sulfate content. This polysaccharides prolonged activated partial thromboplastin time (aPTT) at 50 μg (>240 s). SV1 was found to have no effect on prothrombin time (PT), corresponding to the extrinsic pathway of coagulation. SV1 exhibits high antithrombotic action in vivo, with a concentration ten times higher than heparin. Polysaccharides from S. vulgare promoted direct inhibition enzymatic activity of thrombin and stimulated enzymatic activity of FXa. SV1 showed optimal inhibitory activity of thrombin (50.2±0.28%) at a concentration of 25 μg/mL. Its antioxidant action on scavenging radicals by DPPH was (22%), indicating the polymer has no cytotoxic action (hemolytic) on ABO and Rh blood types in different erythrocyte groups and displays strong anti-inflammatory action on all concentrations tested in the carrageenan-induced paw edema model, demonstrated by reduced edema and cellular infiltration. Angiogenesis is a dynamic process of proliferation and differentiation. It requires endothelial proliferation, migration, and tube formation. In this context, endothelial cells are a preferred target for several studies and therapies. The antiangiogenic efficacy of polysaccharides was examined in vivo in the chick chorioallantoic membrane (CAM) model by using fertilized eggs. Decreases in the density of the capillaries were assessed and scored. The results showed that SV1 and PSV1 have an inhibitory effect on angiogenesis. These results were also confirmed by inhibition tubulogenesis in rabbit aorta endothelial cell (RAEC) in matrigel. These compounds were assessed in Apoptosis assay (Annexin V - FITC / PI) and cell viability by MTT assay of RAEC. These polysaccharides do not affect the viability and do not have apoptotic or necrotic action. RAEC cell when incubated with SV1 and PSV1showed inhibition of VEGF secretion, observed when compounds were incubated at 25, 50 and 100 μg/μL. The VEGF secretion with the RAEC cell line for 24 h, was more effective for PSV1 at 50 μg/μL(71.4%) than SV1 100 μg/μL (75.9%). SV1 and PSV1 had an antiproliferative action (47%) against tumor cell line HeLa. Our results indicate that these sulfated polysaccharides have antiangiogenic and antitumoral actions

Specific features of endothelial cells in primary tumors

RESUMO: As células endoteliais definem e delineiam todo o sistema vascular...Nesta tese procurámos explorar o papel que o ambiente tumoral exerce sobre as células endoteliais. ... Avaliamos também a capacidade anti-angiogénica de alguns derivados do estrogénio... Em suma os nossos resultados mostram a importância de um controlo rigoroso da regulação transcricional...

Efeitos da exposição perinatal ao chumbo sobre a pressão arterial e a rea tividade vascular de ratos recém-desmamados e adultos, tratados ou não com DMSA, L-Arginina e/ou Enalapril: Andréia Fresneda Gaspar. -

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Hipertensión y edema pulmonar de altura. Rol de la disfunción endotelial y de la programación fetal [Pulmonary hypertension and lung edema at high altitude. Role of endothelial dysfunction and fetal programming].

High altitude constitutes an exciting natural laboratory for medical research. While initially, the aim of high-altitude research was to understand the adaptation of the organism to hypoxia and find treatments for altitude-related diseases, over the past decade or so, the scope of this research has broadened considerably. Two important observations led to the foundation for the broadening of the scientific scope of high-altitude research. First, high-altitude pulmonary edema (HAPE) represents a unique model which allows studying fundamental mechanisms of pulmonary hypertension and lung edema in humans. Secondly, the ambient hypoxia associated with high-altitude exposure facilitates the detection of pulmonary and systemic vascular dysfunction at an early stage. Here, we review studies that, by capitalizing on these observations, have led to the description of novel mechanisms underpinning lung edema and pulmonary hypertension and to the first direct demonstration of fetal programming of vascular dysfunction in humans.

Estudo sôbre a célula leprosa do rato

Onze ratos com lepra murina em periodo muito adiantado, foram inoculados várias vezes com litio carmin e azul pirrol. Foi possível evidenciar nestes onze ratos que as células que englobam as partículs do corante, na coloração vital, eram as mesmas que continham os bacilos. Vêem-se mesmo num únoco elemento celular os grãos de corante e os bacilos. Em cortes da pele é possível observar-se a transformação dos histiocitos do tecido cojuntivo frouxo em células leprosas. Em órgãos internos examinados, sempre se verificou que a célula leprosa provinha de um elemento do sistema retículo endotelial e grânulos de corante juntamente com bacilos foram encontrados nas células do retículo-endotélio do baço, medula óssea gânglios linfáticos, células de Kupffer e histiocitos do pulmão.

Celularidade endotelial na ceraoplastia penetrante em coelhos

Pós-graduação em Cirurgia Veterinária - FCAV

O fator de crescimento do nervo inibe o edema citotóxico de células de Müller e células bipolares da retina de rato por meio da liberação de citocinas gliais: participação do sistema glutamatérgico e purinérgico

O fator de crescimento do nervo (NGF) pode retardar a degeneração celular na retina de ratos em diferentes injúrias retinianas. O acúmulo de água em células da retina contribui para o desenvolvimento de edema retiniano e degeneração neuronal. Em atribuição ao seu efeito protetor, este trabalho teve por objetivo avaliar se o NGF influencia o edema celular osmótico em células de Müller e células bipolares. Assim, montagens planas, fatias de retina e células isoladas da retina de ratos foram superfundidas com solução hipo-osmótica na presença de BaCl₂. Secções retinianas foram utilizadas para imunomarcações, e a liberação de adenosina foi medida por cromatografia líquida de alta eficácia, em montagens planas. A área de secção transversal celular foi medida antes e após a superfusão em meio hipo-osmótico, em fatias de retina e suspensões celulares. Tanto células de Müller quanto células bipolares foram imunopositivas para TrkA, mas somente células de Müller foram marcadas contra p75^NTR e NGF. A hipo-osmolaridade induziu um rápido e significativo aumento da liberação de adenosina endógena em retinas controle, mas não em retinas perfundidas com BaCl₂. O NGF inibiu o edema citotóxico em células de Müller e em células bipolares em fatias de retina controle e retinas pós-isquêmicas submetidas a condições hipo-osmóticas. Por outro lado, NGF impediu o edema citotóxico da célula de Müller isolada, mas não da célula bipolar isolada (em meio hipo-osmótico contendo íons Ba²⁺). Isto sugere que NGF induz a liberação de fatores por células de Müller, os quais inibem o edema citotóxico de células bipolares em fatias de retina. O efeito inibitório do NGF sobre o edema citotóxico de células de Müller foi mediado pela ativação do receptor TrkA, mas não de p75^NTR, e foi anulado por bloqueadores de receptores metabotrópicos de glutamato, receptores de adenosina A₁, e receptores do fator de crescimento de fibroblasto (FGF). O bFGF evitou o edema citotóxico de células de Müller isoladas, mas inibiu somente em parte o edema citotóxico de células bipolares isoladas. O bloqueio de FGFR impediu o efeito inibidor de edema celular da adenosina, sugerindo que a liberação de bFGF ocorre após à ativação autócrina/parácrina de receptores A_l. Além de bFGF, GDNF e TGF431 reduziram em parte o edema citotóxico da célula bipolar. Estes dados sugerem que o efeito neuroprotetor do NGF é em parte mediado pela prevenção de edema citotóxico de células gliais e bipolares da retina.

Edema pulmonar neurogênico: relato de dois casos

Neurogenic pulmonary edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures. Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic pulmonary edema, one with head injury and other with intracerebral hemorrhage. Diagnosis was made by rapid onset of pulmonary edema, severe hypoxemia, decrease of pulmonary complacence and diffuse pulmonary infiltrations, without previous history of tracheal aspiration or any other risk factor for developement of adult respiratory distress syndrom. In the first case, with severe head trauma, neurogenic pulmonary edema was diagnosed at admission one hour after trauma, associated with severe systemic inflammatory reaction, and good outcome in three days. The second case, with hemorragic vascular insult, developed neurogenic pulmonary edema the fourth day after drenage of intracerebral hematom and died.

Efeito dos dióxidos de enxofre e de nitrogênio no desempenho de uma célula a combustível de membrana de intercâmbio de prótons

There is presently much interest in the clean and efficient generation of energy by proton exchange membrane fuel cells (PEMFC), using hydrogen as fuel. The generation of hydrogen by the reforming of other fuels, anaerobic fermentation of residual waters and other methods, often produce contaminants that affect the performance of the cell. In this work, the effect of gaseous SO2 and NO2 on the performance of a H2/O2 single PEMFC is studied. The results show that SO2 decreases irreversibly the performance of the cell under operating conditions, while NO2 has a milder effect that allows the recovery of the system.

Regarding "Edema and leg volume: Methods of assessment" (Letters to the Editor)

I noted with interest the article by Drs Perrin and Guex, entitled &dquo;Edema and leg volume: Methods of assessment,&dquo; published in Angiology 51:9-12, 2000. This was a timely and comprehensive review of the various methods in clinical use for the assessment of peripheral edema, notably in the leg. I would like to take this opportunity to alert readers to a further technique useful for this purpose, namely, bioelectrical impedance analysis. An early reportl described its use for the measurement of edema in the leg, but other than its successful use for the assessment of edema in the arm following masteCtoMy,2,1 the potential of the method remains to be fully realized. This is unfortunate since the method directly and quantifiably measures edema.

Combined Laser and Intravitreal Triamcinolone for Proliferative Diabetic Retinopathy and Macular Edema: One-year Results of a Randomized Clinical Trial

PURPOSE: To evaluate laser combined with intravitreal triamcinolone acetonide (IVTA) for the management of patients with proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME). DESIGN: Randomized clinical trial. METHODS: SETTINGS: Single center. STUDY POPULATION: Twenty-two patients with bilateral treatment,naive moderate PDR and CSME. INTERVENTION: Laser (panretinal and macular) photocoagulation was performed in each eye, followed by IVTA in one randomly assigned eye. Best,corrected visual acuity (BCVA), fundus photography, and optical coherence tomography were performed at baseline and at months 1, 3, 6, 9, and 12. MAIN OUTCOME MEASURES:. Changes in BCVA, central macular thickness (CMT), and total macular volume (TMV). RESULTS: The mean logarithm of the minimal angle of resolution (logMAR) BCVA improved significantly, and mean CMT and TMV were significantly reduced in the IVTA group compared with the laser,only group (controls) at all study follow-up visits (P < .001). The mean logMAR BCVA (Snellen equivalent) was 0.44 (20/50(-2)) for the IVTA group and 0.38 (20/50(+1)) for the controls at baseline, and 0.12 (20/25(-1)) for the IVTA group and 0.32 (20/40(-1)) for the controls at 12 months (P < .001.). The mean CMT and TMV were, respectively, 360 mu m and 8.59 mm(3) for the IVTA group and 331 mu m and 8.44 mm(3) for the controls at baseline, and 236 mu m and 7.32 mm(3) for the IVTA group and 266 mu m and 7.78 mm(3) for the controls at 12 months (P < .001). CONCLUSIONS: The combination of laser photocoagulation with IVTA was associated with improved BCVA and decreased CMT and TMV when compared with laser photocoagulation alone for the treatment of moderate PDR with CSME. (Am J Ophthalmol 2009;147:291-297. (C) 2009 by Elsevier Inc. All rights reserved.)

Peritumoral brain edema in benign meningiomas: correlation with clinical, radiologic, and surgical factors and possible role on recurrence

Background: Approximately 60% of meningiomas are associated with peritumoral edema. Various causative factors have been discussed in the literature. The objective of this study was to investigate the correlation of PTBE with clinical, radiologic, and surgical aspects and recurrence of meningiomas. Methods: Sixty-one patients with benign meningiomas were chosen for surgical treatment by the Group of Brain Tumors and Metastasis of the Department of Neurosurgery. All patients underwent complete surgical resection (Simpson grades I and 2), and those with atypical and malignant histopathologic grades were excluded. Tumors located in the cavernous sinus, tuberculum sellae, foramen magnum, ventricles, and petroclival region were excluded. Results: Edema extension had a positive correlation with the higher recurrence rates (P=.042) and with the presence of irregular margins (P<.011) on bivariate analysis. Meningiomas with larger edema sizes also showed correlation with large meningiomas (P=.035), and the ones with smaller edema sizes correlated with the tentorial location (P=.032). Multivariate analysis showed an association between PTBE and the presence of seizures (odds ratio, 3.469), large meningiomas (odds ratio, 15.977), and for each cubic centimeter added to its size, the risk of edema increased 1.082 times (odds ratio). Conclusion: Peritumoral brain edema may be related to the invading potential of meningiomas and may play a role in the recurrence potential of the tumor. As a consequence, it is reasonable to consider the presence of edema as an additional factor to be taken into account when mapping out strategies for the treatment of meningiomas. (C) 2008 Elsevier Inc. All rights reserved.