Perfil eletroforético e concentração de imunoglobulinas G (IgG) do soro sanguíneo de cabras Saanen com mastite experimental induzida por Staphylococcus aureus suplementadas com vitamina E

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Phenolic Derivatives from Fruits of Dipteryx lacunifera DUCKE and Evaluation of Their Antiradical Activities

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of arterial oxygen tension and cardiac output on venous saturation: a mathematical modeling approach

OBJECTIVES: Hemodynamic support is aimed at providing adequate O-2 delivery to the tissues; most interventions target O-2 delivery increase. Mixed venous O-2 saturation is a frequently used parameter to evaluate the adequacy of O-2 delivery. METHODS: We describe a mathematical model to compare the effects of increasing O-2 delivery on venous oxygen saturation through increases in the inspired O-2 fraction versus increases in cardiac output. The model was created based on the lungs, which were divided into shunted and non-shunted areas, and on seven peripheral compartments, each with normal values of perfusion, optimal oxygen consumption, and critical O-2 extraction rate. O-2 delivery was increased by changing the inspired fraction of oxygen from 0.21 to 1.0 in steps of 0.1 under conditions of low (2.0 L.min(-1)) or normal (6.5 L.min(-1)) cardiac output. The same O-2 delivery values were also obtained by maintaining a fixed O-2 inspired fraction value of 0.21 while changing cardiac output. RESULTS: Venous oxygen saturation was higher when produced through increases in inspired O-2 fraction versus increases in cardiac output, even at the same O-2 delivery and consumption values. Specifically, at high inspired O-2 fractions, the measured O-2 saturation values failed to detect conditions of low oxygen supply. CONCLUSIONS: The mode of O-2 delivery optimization, specifically increases in the fraction of inspired oxygen versus increases in cardiac output, can compromise the capability of the "venous O-2 saturation" parameter to measure the adequacy of oxygen supply. Consequently, venous saturation at high inspired O-2 fractions should be interpreted with caution.

Maxillary sinus grafting with Bio-Oss or Straumann Bone Ceramic: histomorphometric results from a randomized controlled multicenter clinical trial

INTRODUCTION: This investigation was designed to compare the histomorphometric results from sinus floor augmentation with anorganic bovine bone (ABB) and a new biphasic calcium phosphate, Straumann Bone Ceramic (BCP). MATERIALS AND METHODS: Forty-eight maxillary sinuses were treated in 37 patients. Residual bone width was > or =6 mm and height was > or =3 mm and <8 mm. Lateral sinus augmentation was used, with grafting using either ABB (control group; 23 sinuses) or BCP (test group; 25 sinuses); sites were randomly assigned to the control or test groups. After 180-240 days of healing, implant sites were created and biopsies taken for histological and histomorphometric analyses. The parameters assessed were (1) area fraction of new bone, soft tissue, and graft substitute material in the grafted region; (2) area fraction of bone and soft tissue components in the residual alveolar ridge compartment; and (3) the percentage of surface contact between the graft substitute material and new bone. RESULTS: Measurable biopsies were available from 56% of the test and 81.8% of the control sites. Histology showed close contact between new bone and graft particles for both groups, with no significant differences in the amount of mineralized bone (21.6+/-10.0% for BCP vs. 19.8+/-7.9% for ABB; P=0.53) in the biopsy treatment compartment of test and control site. The bone-to-graft contact was found to be significantly greater for ABB (48.2+/-12.9% vs. 34.0+/-14.0% for BCP). Significantly less remaining percentage of graft substitute material was found in the BCP group (26.6+/-5.2% vs. 37.7+/-8.5% for ABB; P=0.001), with more soft tissue components (46.4+/-7.7% vs. 40.4+/-7.3% for ABB; P=0.07). However, the amount of soft tissue components for both groups was found not to be greater than in the residual alveolar ridge. DISCUSSION: Both ABB and BCP produced similar amounts of newly formed bone, with similar histologic appearance, indicating that both materials are suitable for sinus augmentation for the placement of dental implants. The potential clinical relevance of more soft tissue components and different resorption characteristics of BCP requires further investigation.

Clinical outcomes and revascularization strategies in patients with low-flow, low-gradient severe aortic valve stenosis according to the assigned treatment modality

OBJECTIVES This study compared clinical outcomes and revascularization strategies among patients presenting with low ejection fraction, low-gradient (LEF-LG) severe aortic stenosis (AS) according to the assigned treatment modality. BACKGROUND The optimal treatment modality for patients with LEF-LG severe AS and concomitant coronary artery disease (CAD) requiring revascularization is unknown. METHODS Of 1,551 patients, 204 with LEF-LG severe AS (aortic valve area <1.0 cm(2), ejection fraction <50%, and mean gradient <40 mm Hg) were allocated to medical therapy (MT) (n = 44), surgical aortic valve replacement (SAVR) (n = 52), or transcatheter aortic valve replacement (TAVR) (n = 108). CAD complexity was assessed using the SYNTAX score (SS) in 187 of 204 patients (92%). The primary endpoint was mortality at 1 year. RESULTS LEF-LG severe AS patients undergoing SAVR were more likely to undergo complete revascularization (17 of 52, 35%) compared with TAVR (8 of 108, 8%) and MT (0 of 44, 0%) patients (p < 0.001). Compared with MT, both SAVR (adjusted hazard ratio [adj HR]: 0.16; 95% confidence interval [CI]: 0.07 to 0.38; p < 0.001) and TAVR (adj HR: 0.30; 95% CI: 0.18 to 0.52; p < 0.001) improved survival at 1 year. In TAVR and SAVR patients, CAD severity was associated with higher rates of cardiovascular death (no CAD: 12.2% vs. low SS [0 to 22], 15.3% vs. high SS [>22], 31.5%; p = 0.037) at 1 year. Compared with no CAD/complete revascularization, TAVR and SAVR patients undergoing incomplete revascularization had significantly higher 1-year cardiovascular death rates (adj HR: 2.80; 95% CI: 1.07 to 7.36; p = 0.037). CONCLUSIONS Among LEF-LG severe AS patients, SAVR and TAVR improved survival compared with MT. CAD severity was associated with worse outcomes and incomplete revascularization predicted 1-year cardiovascular mortality among TAVR and SAVR patients.

Dose-painting intensity-modulated proton therapy for intermediate- and high-risk meningioma.

BACKGROUND Newly diagnosed WHO grade II-III or any WHO grade recurrent meningioma exhibit an aggressive behavior and thus are considered as high- or intermediate risk tumors. Given the unsatisfactory rates of disease control and survival after primary or adjuvant radiation therapy, optimization of treatment strategies is needed. We investigated the potential of dose-painting intensity-modulated proton beam-therapy (IMPT) for intermediate- and high-risk meningioma. MATERIAL AND METHODS Imaging data from five patients undergoing proton beam-therapy were used. The dose-painting target was defined using [68]Ga-[1,4,7,10-tetraazacyclododecane tetraacetic acid]- d-Phe(1),Tyr(3)-octreotate ([68]Ga-DOTATATE)-positron emission tomography (PET) in target delineation. IMPT and photon intensity-modulated radiation therapy (IMRT) treatment plans were generated for each patient using an in-house developed treatment planning system (TPS) supporting spot-scanning technology and a commercial TPS, respectively. Doses of 66 Gy (2.2 Gy/fraction) and 54 Gy (1.8 Gy/fraction) were prescribed to the PET-based planning target volume (PTVPET) and the union of PET- and anatomical imaging-based PTV, respectively, in 30 fractions, using simultaneous integrated boost. RESULTS Dose coverage of the PTVsPET was equally good or slightly better in IMPT plans: dose inhomogeneity was 10 ± 3% in the IMPT plans vs. 13 ± 1% in the IMRT plans (p = 0.33). The brain Dmean and brainstem D50 were small in the IMPT plans: 26.5 ± 1.5 Gy(RBE) and 0.002 ± 0.0 Gy(RBE), respectively, vs. 29.5 ± 1.5 Gy (p = 0.001) and 7.5 ± 11.1 Gy (p = 0.02) for the IMRT plans, respectively. The doses delivered to the optic structures were also decreased with IMPT. CONCLUSIONS Dose-painting IMPT is technically feasible using currently available planning tools and resulted in dose conformity of the dose-painted target comparable to IMRT with a significant reduction of radiation dose delivered to the brain, brainstem and optic apparatus. Dose escalation with IMPT may improve tumor control and decrease radiation-induced toxicity.

Insoluble residues of the fine-grained sediments from DSDP Leg 67 Holes

Insoluble residues of Late Cretaceous to Quaternary deep-sea samples from slope, trench, and oceanic plate sites south of Guatemala were examined, specifically for the distribution of clay minerals in the <2-µm fraction and of silt grains in the 20-63-µm fraction. Widespread "oceanic" particles (biogenic opal, rhyolitic glass) and their diagenetic products (smectite, clinoptilolite, heulandite) were distinguished from terrigenous material - illite, kaolinite, chlorite, plagioclase, quartz, and heavy minerals. The main results of this investigation are: (1) At Site 494 on the slope immediately adjacent to the trench, terrigenous supplies testify to a slope position of the whole sequence back to the Late Cretaceous. (2) At Site 495 on the Pacific Cocos Plate, "oceanic" and terrigenous sedimentation are clearly separated. Whereas the pelagic sedimentation prevailed in the early Miocene, terrigenous minerals appeared in the middle Miocene in the clay fraction, and in the early Pliocene in the coarse silt fraction. These terrigenous supplies are interpreted as having been transported by suspension clouds crossing the slope and even the trench. The alternative, however, an eolian transport, cannot be excluded.

(Table 1) Composition of clay minerals in DSDP Hole 75-532

An investigation of the quantitative composition of the coarse (> 40 µm) and clay (< 2 µm) fraction of HPC 532, DSDP Leg 75, in 1300 m water depth on the eastern Walvis Ridge off Southwest Africa yielded the following results: (1) The sediments reflect a complete Latest Miocene to Recent depositional history. Sedimentation rates vary between 2.3 and 7.8 cm/ka. (2) Preservation of calcium carbonate is subject to strong variations: short-term (< 100,000 years) and long-term (about 1 m.y.) cycles in carbonate dissolution have been observed, with strongest dissolution occurring during periods of lowered sea level. (3) Upwelling influence from the near-coastal upwelling centre has been detected by means of the opal content: interglacial periods show high opal contents, because the Benguela Current turned westward at about 20°S and carried opal-laden upwelled water to the west. Sediments from glacial periods, however, show opal minima. Besides these short-term cyclic variations in opal content, long-term cycles have been found, with maximum upwelling influence in the latest Pliocene/early Quaternary. (4) Each CaCO3 dissolution minimum (maximum) is correlated with an opal maximum (minimum) throughout the sediment sequence. (5) The oceanographic system off southwest Africa remained essentially unchanged since the latest Miocene: sea level rose and fell periodically on a small and on a large scale, and the Benguela Current flowed southeast-northwest and turned to the west at the latitude of Site 532 during interglacial periods, when sea level was high. (6) The climate in the near-coastal area of southwest Africa in the latitude of Site 532 has probably been arid throughout the investigated period.

Mineralogy and geochemistry of sediments of the Cretaceous/Tertiary boundary at DSDP Holes 62-465 and 62-465A

The complete Paleocene section begins with the basal Tertiary Globigerina eugubina Zone. This zone occurs at 465A-3-3, 4 cm to 465A-3-3, 144 cm and belongs to Lithologic Unit I (Site 465 report, this volume), a homogeneous, white, moderately to highly disturbed nannofossil ooze.

Mineralogy and geochemistry at DSDP Leg 80 Holes

Cenozoic sediments recovered from Sites 548, 549, and 550 were the objects of mineralogical (bulk sample and <2 - µm fraction) and geochemical (HCl extract) studies. Thin sections of rock pebbles embedded in sediments (upper levels at Site 548, particularly) were examined on a polarizing microscope. This study outlines the vertical and lateral variation and evolution of the sedimentation. In the Paleocene and lower Eocene, the clay fraction is abundant and smectite is practically the sole existing clay mineral. High Mn, Al, Fe, Mg, and K contents were measured in HCl extracts. Through the middle Eocene, carbonates become more abundant - highly dominant at Site 548. Metal contents in HCl extracts are very low. The clay fraction, although dominated at all sites by smectites, becomes richer in illite and poorly crystallized chlorite. At the middle/upper Miocene boundary, a significant decrease in the smectite/(illite + chlorite) ratio occurs at all sites, and this decrease continues into the middle Pliocene. This decrease is marked by an abrupt increase of quartz at Site 548. At the two other sites, carbonates remain highly predominant; HCl extracts reflect the relative abundance of the clay and carbonate fractions. After a brief recurrence of smectite in a high-metal-content interval, illite and chlorite become the dominant clay minerals in the upper Pliocene and the Pleistocene, where numerous variations in mineralogical composition occur in the clay fraction (Sites 548 and 549) or in non-clay components (Site 548). Several pebbles of various nature and origin, encountered in different levels of this interval at Site 548, appear to have an ice-rafting origin. This study points out three main breaks in the general evolution of the sedimentation: the first, corresponding to the lower/middle Eocene boundary, is marked by the increase of carbonates and associated elements; the second, corresponding to the middle/upper Miocene boundary, is marked by a major decrease of the smectite/(illite + chlorite) ratio at all sites and by a massive appearance of quartz at Site 548; and the third, which occurred toward the late Pliocene, is marked by the dominance of primary clay minerals and the arrival of ice-rafted pebbles. Our interpretation of results considers paleohydrological and paleoclimatic phenomena. It is suggested that the major middle/late Miocene break was associated with an increase of the deep bottom-water circulation between the Norwegian Sea and the North Atlantic Ocean, and/or a climatic evolution: humidification and cooling of climate. The changes toward the late Pliocene appear to have been the first effects of the glaciations at the end of Cenozoic.

Late Quaternary sediment accumulation in the Baffin Bay

Piston cores from fiords, shelf troughs, and the deep-sea off eastern Baffin Island, N.W.T., Canada, have been sampled for texture and detrital carbonate in the <2 mm fraction. The sediments consist primarily of silty clays usually containing <5% sand. Estimates are made for sediment accumulation (kg/m**2/ka) over the last ca. 10 ka. Three sets, of two cores each, lie on a fiord-shelf transect and thus define variations in sediment accumulation gradients. These continental margin data are compared with cruder estimates of Holocene sediment accumulation at three sites farther offshore in Baffin Bay, Davis Strait and the northern Labrador Sea. Minimum accumulation in a 2 ka interval was 200 kg/m2 with a maximum estimate of 8,800 kg/m2. Detrital carbonate accumulation varies between 0 and 1,300 kg/m**2. Median accumulation for a typical fiord-shelf-deep-sea transect over the last 10 ka have been 10,340, 3493 and 820 kg/m**2. At DSDP Leg, site 645 in central Baffin Bay, the sedimentation rate ranged between 40 and 130 m/Ma (ca. 400 and 1200 kg/m**2/2ka); that is, comparable with the Late Quaternary input into Baffin Bay.

Coarse-sand ice-rafted debris components and mass accumulation rates of ODP Site 152-918

To understand the late Cenozoic glacial history of the Northern Hemisphere, continuous long-term proxy records from climatically sensitive regions must be examined. Ice-rafted debris (IRD) from Ocean Drilling Program (ODP) Site 918, located in the Irminger Basin, is one such record. IRD in marine sediments is a direct indicator of the presence of glacial ice extending to sea level on adjacent landmasses, and, therefore, is an important paleoclimatic signal from the mid- to high latitudes. The IRD record at Site 918 is the first long-term ice-rafting record available for southeast Greenland, a region that may have been a key nucleation area for widespread glaciation during the late Cenozoic (Larsen et al, 1994, doi:10.2973/odp.proc.ir.152.1994). This data report presents the results of coarse sand-size IRD mass accumulation rate (MAR) analyses for Site 918 from the late Miocene through the Pleistocene. In addition, a preliminary analysis of IRD compositions is included. Detailed discussions of the local, regional, and global paleoclimatic implications of this data, and of the companion Site 919 Pleistocene IRD MAR data (Krissek, 1999, doi:10.2973/odp.proc.sr.163.118.1999), are in preparation. Such future work will include comparisons of these IRD MAR data sets to the Site 919 oxygen isotope stratigraphy developed by Flower (1998, doi:10.2973/odp.proc.sr.152.219.1998).