538 resultados para sheath


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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This study was designed to present the feasibility of an in vivo image-guided percutaneous cryoablation of the porcine vertebral body. Methods The institutional animal care committee approved this study. Cone-beam computed tomography (CBCT)-guided vertebral cryoablations (n = 22) were performed in eight pigs with short, 2-min, single or double-freezing protocols. Protective measures to nerves included dioxide carbon (CO2) epidural injections and spinal canal temperature monitoring. Clinical, radiological, and pathological data with light (n = 20) or transmission electron (n = 2) microscopic analyses were evaluated after 6 days of clinical follow-up and euthanasia. Results CBCT/fluoroscopic-guided transpedicular vertebral body cryoprobe positioning and CO2 epidural injection were successful in all procedures. No major complications were observed in seven animals (87.5 %, n = 8). A minor complication was observed in one pig (12.5 %, n = 1). Logistic regression model analysis showed the cryoprobe-spinal canal (Cp-Sc) distance as the most efficient parameter to categorize spinal canal temperatures lower than 19 °C (p<0.004), with a significant Pearson’s correlation test (p < 0.041) between the Cp-Sc distance and the lowest spinal canal temperatures. Ablation zones encompassed pedicles and the posterior wall of the vertebral bodies with an inflammatory rim, although no inflammatory infiltrate was depicted in the surrounding neural structures at light microscopy. Ultrastructural analyses evidenced myelin sheath disruption in some large nerve fibers, although neurological deficits were not observed. Conclusions CBCT-guided vertebral cryoablation of the porcine spine is feasible under a combination of a short freezing protocol and protective measures to the surrounding nerves. Ultrastructural analyses may be helpful assess the early modifications of the nerve fibers.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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A strain of a colorless, filamentous bacterium (tentatively identified as Leucothrix mucor) heavily infests the brine shrimp, Artemia salina. Its ultrastructure, unlike that of some other strains, does not reveal a distinct middle layer between its outer cell wall layer and cytoplasmic membrane, irregular blebs extending from the cell layers, or an external sheath. An entire infestation, represented as a mat of the bacterium with associated debris and microorganisms, sloughs from the shrimp when exposed to a variety of treatments. Primarily because most effective treatments are toxic to the shrimp, 100 ppm terramycin provides the treatment of choice.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Malignant triton tumor (MTT) is an aggressive peripheral nerve sheath tumor with rhabdomyoblastic differentiation. Less than 100 cases have been described, being mostly male children with type 1 neurofibromatosis. We report a 6-year-old female with MTT and no diagnostic criteria for neurofibromatosis type 1. Cytogenetic analysis showed a 46,X,-X[4]/46,XX[16] karyotype. She underwent a transfemoral amputation and chemotherapy and is free of disease 15 months after diagnosis. The few cytogenetic studies of MTT described in the literature have been inconclusive. Further cytogenetic analyses are needed to understand the role of chromosome X monosomy in the pathogenesis of this rare tumor. Pediatr Blood Cancer 2012; 59: 13201323. (C) 2012 Wiley Periodicals, Inc.

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When there is a failure on the external sheath of a flexible pipe, a high value of hydrostatic pressure is transferred to its internal plastic layer and consequently to its interlocked carcass, leading to the possibility of collapse. The design of a flexible pipe must predict the maximum value of external pressure the carcass layer can be subjected to without collapse. This value depends on the initial ovalization due to manufacturing tolerances. To study that problem, two numerical finite element models were developed to simulate the behavior of the carcass subjected to external pressure, including the plastic behavior of the materials. The first one is a full 3D model and the second one is a 3D ring model, both composed by solid elements. An interesting conclusion is that both the models provide the same results. An analytical model using an equivalent thickness approach for the carcass layer was also constructed. A good correlation between analytical and numerical models was achieved for pre-collapse behavior but the collapse pressure value and post-collapse behavior were not well predicted by the analytical model. [DOI: 10.1115/1.4005185]

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Objective. The purposes of this study were to assess clinical, histopathological and immunohistochemical features of 22 oral neurofibromas (NFs) and discuss with previously described literature, addressing the main aspects regarding the differential diagnosis. Materials and methods. Immunohistochemical reactions included S-100, CD34, GLUT-1, EMA, Ki-67, p53 and Collagen IV and histochemical reactions for Alcian blue. Results. Clinically, the preferential location was the maxillary bones, tongue and buccal mucosa. Microscopically, widely spread spindle-shaped cells with scant cytoplasm and elongated nuclei were observed. Immunostaining revealed that the tumor cells weakly expressed GLUT-1, Collagen IV, Ki-67 and p53. They were variably positive for CD34, S-100 protein and membrane epithelial antigen (EMA). Conclusions. The different types of nerve sheath cells observed in the present series reinforce the presence of heterogeneous population in NFs. The strong positivity for S-100 suggests that the lesions were more composed by S-100-positive Schwann cells than other cells. Besides, the high number of CD34-positive cells suggests that this marker can be useful for the differential diagnosis of NFs against PEN, traumatic neuromas and Schwannomas. Finally, the low immunostaining for p53 and Ki-67 may indicate that NFs massively composed by S-100-positive Schwann cells present low potential of aggressiveness and malignant transformation.

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This study evaluated the functional and quantitative differences between the early and delayed use of phototherapy in crushed median nerves. After a crush injury, low-level laser therapy (GaAs) was applied transcutaneously at the injury site, 3 min daily, with a frequency of five treatments per week for 2 weeks. In the early group, the first laser treatment started immediately after surgery, and in the delayed group, after 7 days. The grasping test was used for functional evaluation of the median nerve, before, 10, and 21 days after surgery, when the rats were killed. Three segments of the median nerve were analyzed histomorphometrically by light microscopy and computer analysis. The following features were observed: myelinated fiber and axon diameters, myelin sheath area, g-ratio, density and number of myelinated fibers, and area and number of capillaries. In the proximal segment (site of crush), the nerves of animals submitted to early and delayed treatment showed myelinated fiber diameter and myelin sheath area significantly larger compared to the untreated group. In the distal segment, the myelin sheath area was significantly smaller in the untreated animals compared to the delayed group. The untreated, early, and delayed groups presented a 50, 57, and 81% degree of functional recovery, respectively, at 21 days after injury, with a significant difference between the untreated and delayed groups. The results suggest that the nerves irradiated with low-power laser exhibit myelinated fibers of greater diameter and a better recovery of function.

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Topoisomerase 2 alpha (), HER-2/ and are genes that lie on chromosome 17 and correlate with the prognosis and prediction of target-driven therapy against tumors. In a previous study, we showed that TOP2A transcripts levels were significantly higher in soft tissue sarcomas (STS) than in benign tumors and desmoid-type fibromatoses (FM). Because these genes have been insufficiently examined in STS, we aimed to identify alterations in TOP2A and HER-2 expression by fluorescent in situ hybridization and immunohistochemistry, as well as that of survivin, and correlate them with clinicopathologic findings to assess their prognostic value. Eighteen FM and 244 STS were included. Fluorescent in situ hybridization and immunohistochemistry were performed on a tissue microarray. TOP2A and survivin were more highly expressed in sarcomas than in FM. TOP2A was an independent predictor of an unfavorable prognosis; it was combined with formerly established prognostic factors (primarily histologic grade and tumor size at diagnosis) to create a prognostic index that evaluated overall survival. Gene amplification/polysomy (13%) did not correlate with protein overexpression. Survivin and HER-2 expression were not associated with patient outcomes. These findings might become valuable in the management of patients with STS and possibly in the prospective evaluation of responses to new target-driven therapies.

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Introduction Lower pole kidney stones represent at time a challenge for the urologist. The gold standard treatment for intrarenal stones <2 cm is Extracorporeal Shock Wave Lithotripsy (ESWL) while for those >2 cm is Percutaneous Nephrolithotomy (PCNL). The success rate of ESWL, however, decreases when it is employed for lower pole stones, and this is particularly true in the presence of narrow calices or acute infundibular angles. Studies have proved that ureteroscopy (URS) is an efficacious alternative to ESWL for lower pole stones <2 cm, but this is not reflected by either the European or the American guidelines. The aim of this study is to present the results of a large series of flexible ureteroscopies and PCNLs for lower pole kidney stones from high-volume centers, in order to provide more evidences on the potential indications of the flexible ureteroscopy for the treatment of kidney stones. Materials and Methods A database was created and the participating centres retrospectively entered their data relating to the percutaneous and flexible ureteroscopic management of lower pole kidney stones. Patients included were treated between January 2005 and January 2010. Variables analyzed included case load number, preoperative and postoperative imaging, stone burden, anaesthesia (general vs. spinal), type of lithotripter, access location and size, access dilation type, ureteral access sheath use, visual clarity, operative time, stone-free rate, complication rate, hospital stay, analgesic requirement and follow-up time. Stone-free rate was defined as absence of residual fragments or presence of a single fragment <2 mm in size at follow-up imaging. Primary end-point was to test the efficacy and safety of flexible URS for the treatment of lower pole stones; the same descriptive analysis was conducted for the PCNL approach, as considered the gold standard for the treatment of lower pole kidney stones. In this setting, no statistical analysis was conducted owing to the different selection criteria of the patients. Secondary end-point consisted in matching the results of stone-free rates, operative time and complications rate of flexible URS and PCNL in the subgroup of patients harbouring lower pole kidney stones between 1 and 2 cm in the higher diameter. Results A total 246 patients met the criteria for inclusion. There were 117 PCNLs (group 1) and 129 flexible URS (group 2). Ninety-six percent of cases were diagnosed by CT KUB scan. Mean stone burden was 175±160 and 50±62 mm2 for groups 1 and 2, respectively. General anaesthesia was induced in 100 % and 80% of groups 1 and 2, respectively. Pneumo-ultrasonic energy was used in 84% of cases in the PCNL group, and holmium laser in 95% of the cases in the flexible URS group. The mean operative time was 76.9±44 and 63±37 minutes for groups 1 and 2 respectively. There were 12 major complications (11%) in group 1 (mainly Grade II complications according to Clavidien classification) and no major complications in group 2. Mean hospital stay was 5.7 and 2.6 days for groups 1 and 2, respectively. Ninety-five percent of group 1 and 52% of group 2 required analgesia for a period longer than 24 hours. Intraoperative stone-free rate after a single treatment was 88.9% for group 1 and 79.1% for group 2. Overall, 6% of group 1 and 14.7% of group 2 required a second look procedure. At 3 months, stone-free rates were 90.6% and 92.2% for groups 1 and 2, respectively, as documented by follow-up CT KUB (22%) or combination of intra-venous pyelogram, regular KUB and/or kidney ultrasound (78%). In the subanalysis conducted comparing 82 vs 65 patients who underwent PCNL and flexible URS for lower pole stones between 1 and 2 cm, intreoperative stone-free rates were 88% vs 68% (p= 0.03), respectively; anyway, after an auxiliary procedure which was necessary in 6% of the cases in group 1 and 23% in group 2 (p=0.03), stone-free rates at 3 months were not statistically significant (91.5% vs 89.2%; p=0.6). Conversely, the patients undergoing PCNL maintained a higher risk of complications during the procedure, with 9 cases observed in this group versus 0 in the group of patients treated with URS (p=0.01) Conclusions These data highlight the value of flexible URS as a very effective and safe option for the treatment of kidney stones; thanks to the latest generation of flexible devices, this new technical approach seems to be a valid alternative in particular for the treatment of lower pole kidney stones less than 2 cm. In high-volume centres and in the hands of skilled surgeons, this technique can approach the stone-free rates achievable through PCNL in lower pole stones between 1 and 2 cm, with a very low risk of complications. Furthermore, the results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, with no difference detectable between the prone and supine position.

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Nach Homogenisation ejakulierter Eberspermien und Zentrifugation des Homogenates blieben mehr als 60% der Aktivität des glykolytischen Enzyms Pyruvatkinase (PK) an Zellfragmenten im Sediment gebunden. Diese strukturgebundene PK wurde als PK-S bezeichnet. Das Detergenz Triton X-100 führte nicht zur Ablösung der PK-S; mit Trypsin konnten jedoch rund 80% der PK-S ohne Verlust an Aktivität von den Strukturen gelöst und durch kombinierte Kationenaustausch- und Hydrophobizitätschromatographie gereinigt werden (spezifische Aktivität: 116,7 U/mg Protein). Die lösliche PK aus Eberspermien konnte ebenfalls durch ein ähnliches Verfahren angereichert werden. Im Gel (SDS-PAGE) zeigten die Untereinheiten der PK-S mit 64.400 eine geringfügig größere relative Molekülmasse als die der PK-M1 aus Kaninchenmuskel (62.000). Die kinetischen Eigenschaften der abgelösten PK-S als auch der noch an Spermienstrukturen gebundenen PK-S und der löslichen PK aus Eberspermien waren sehr ähnlich und entsprachen der M1-Isoform der PK. Antikörper gegen Kaninchenmuskel-PK (Anti-PK-M1) reagierten auch mit der löslichen PK und der PK-S aus Eberspermien. Edman-Abbau der ersten 19 Aminosäuren zeigte, dass die tryptisch abgelöste PK-S am N-Terminus um 5 Aminosäuren gegenüber nativer PK-M1 verlängert ist, während der C-Terminus der erhaltenen PK-S-Sequenz mit einem meist nahe dem N-Terminus gelegenen Sequenzabschnitt der PK-M1 und -M2 übereinstimmt. Die N-terminale Verlängerung der nativen PK-S enthält sicherlich mehr als die nach tryptischer Lyse nachgewiesenen 5 Aminosäuren. Vergleiche der Aminosäure- und übersetzten Nukleotidsequenzen sowie die kinetischen Eigenschaften lassen vermuten, dass die PK-S, wie die PK-M1 und PK-M2, vom PKM-Gen codiert wird. Gegen die gereinigte PK-S wurden Antikörper in Kaninchen produziert. Da das Antiserum nicht ausreichend spezifisch für PK-S war, wurden aus ihm affinitätschromatographisch Antikörper (Anti-PK-S) isoliert, die hohe Affinität zu einem synthetisierten PK-S-Peptid (13 N-terminale Aminosäuren der tryptisch abgelösten PK-S) hatten. Dieses Anti-PK-S-Präparat war spezifisch für PK-S; es reagierte weder mit Kaninchenmuskel-PK noch mit löslicher PK oder anderen Proteinen aus Eberspermien. Anti-PK-S und Anti-PK-M1 wurden zur Lokalisierung von PK-S und löslicher PK in Spermien von Eber, Bulle und Mensch sowie in Schnitten von Eberhoden eingesetzt. Mit Anti-PK-S wurden der Bereich des Akrosoms und das lange flagellare Hauptstück sowie der Übergangsbereich zwischen Kopf und Mittelstück von Eberspermien fluoreszenzmarkiert, wogegen das kurze, die Mitochondrien enthaltende Mittelstück des Flagellums und der postakrosomale Kopfbereich nur mit Anti-PK-M1 markiert wurden. Immunogoldmarkierung in elektronenmikroskopischen Bildern bestätigte die Lokalisierung von PK-S im Akrosombereich. Im Hauptstück banden Anti-PK-M1 und Anti-PK-S an die fibröse Scheide. Glyzerinaldehyd-3-phosphat Dehydrogenase (GAPDH) konnte von mir ebenfalls im Akrosombereich, im Übergangsbereich zwischen Kopf und Mittelstück und an der fibrösen Scheide detektiert werden. Auch an Bullen- und Humanspermien konnte über Immunogoldmarkierung PK und vermutlich GAPDH an der fibrösen Scheide gezeigt werden. Im Akrosombereich dieser Spermien waren die Nachweise von PK und GAPDH jedoch nicht sicher. In Eberhodenschnitten war die PK-S erstmals, oder zumindest vermehrt, in den elongierenden Spermatiden über Fluoreszenzmarkierung nachweisbar, während andere, vermutlich somatische PK vermehrt in den früheren Stadien (Spermatogonien, aber auch in den Spermatozyten und runden Spermatiden) auftrat. Für die GAPDH zeigte sich ein ähnlicher Entwicklungsverlauf. Die Ergebnisse zeigen, dass in Eberspermien zwei Isoformen der PK auftreten: eine N-terminal verlängerte, strukturgebundene Form, die PK-S, und eine lösliche Form, die beide der PK-M1 ähneln. Der ungewöhnliche N-Terminus der PK-S dient vermutlich der spezifischen räumlichen Anordnung der PK-S im Akrosombereich und an der fibrösen Scheide, nicht aber der Modulation kinetischer Eigenschaften. Meine Untersuchungen stützen die Hypothese, dass in bestimmten Kompartimenten von Säugerspermien die Glykolyse durch Verankerung einiger ihrer Enzyme strukturell hochgeordnet ist. Dadurch wird vermutlich die Versorgung der Mitochondrien-freien Regionen mit ATP sichergestellt. Man kann diese Organisation als Anpassung des Stoffwechsels von Spermien deuten, bei denen die Mitochondrien in einem kleinen Bereich (Mittelstück) hinter dem Spermienkopf kompartimentiert sind. Im Hauptstück des Flagellums könnte die Glykolyse ATP für die Spermienmotilität liefern, im Akrosombereich für die Verhinderung einer vorzeitigen Akrosomreaktion. Somit käme der strukturierten Glykolyse eine essentielle Bedeutung für die Befruchtungsfähigkeit von Säugerspermien zu.

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Während der Myelinbildung im zentralen Nervensystem (ZNS) umwinden Oligodendrozyten mit Ausläufern ihrer Plasmamembran mehrfach das Axon. Myelin ermöglicht die saltatorische Erregungsweiterleitung entlang der Axone und ist zudem für die Aufrechterhaltung der axonalen Integrität erforderlich (Edgar and Garbern, 2004). Ein Oligodendrozyt myelinisiert bis zu 40 Axonsegmente gleichzeitig, wodurch er in seiner aktivsten Myelinisierungsphase 5 bis 50 x 103 µm2 Membranfläche pro Tag produziert (Pfeiffer et al., 1993). Die vollständig ausgebildete Myelinscheide besteht aus Subdomänen mit charakteristischen Protein- und Lipidzusammensetzungen. Die Entwicklung und der Erhalt der komplexen Myelinmembran erfordert die kontinuierliche Kommunikation zwischen Neuronen und Glia-Zellen, die Koordination der Protein- und Lipidsynthese sowie angepasste intrazelluläre Sortier- und Transportwege der Myelinkomponenten. Über die molekularen Mechanismen, die zur Ausbildung des Myelins und seiner Domänen führen, ist bisher nicht sehr viel bekannt. Im Rahmen dieser Arbeit wurden Endo- und Exozytosemechanismen von Myelinproteinen analysiert. Dabei wurden drei Proteine untersucht, die in unterschiedlichen Subdomänen der Myelinmembran des ZNS lokalisiert sind. Das Hauptmyelinprotein Proteolipid Protein (PLP), das Myelin-assoziierte Glykoprotein (MAG) und das Myelin Oligodendrozyten Glykoprotein (MOG). Die Exozytose des Hauptmyelinproteins PLP erfolgt möglicherweise durch sekretorische Lysosomen (Trajkovic et al., 2006) und ist Ca2+-abhängig. Interessanterweise konnte gezeigt werden, dass PLP, MAG und MOG unterschiedlichen endosomalen Transportwegen und Sortierprozessen unterliegen. PLP wird über einen Clathrin-unabhängigen, MAG und MOG hingegen über einen Clathrin-abhängigen Mechanismus endozytiert. Zudem gelangen die Proteine zu unterschiedlichen endosomalen Zielkompartimenten und recyceln zu verschiedenen oligodendroglialen Membrandomänen. Diese Ergebnisse legen nahe, dass die endosomale Sortierung und das Recycling der Myelinproteine, die für die Bildung der Subdomänen erforderliche Umgestaltung der oligodendroglialen Plasmamembran unterstützen.

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During central nervous system myelination, oligodendrocytes extend membrane processes towards an axonal contact site which is followed by ensheathment resulting in a compacted multilamellar myelin sheath. The formation of this axon-glial unit facilitates rapid saltatory propagation of action potentials along the axon and requires the synthesis and transport of copious amounts of lipids and proteins to the axon-glial contact site. Fyn is a member of the Src family of non receptor tyrosine kinases and inserted into the inner leaflet of the oligodendrocyte membrane by acylation. Fyn activity plays a pivotal role in the maturation of oligodendrocytes and the myelination process. It was suggested previously that Fyn kinase can be stimulated by binding of a neuronal ligand to oligodendroglial F3/ contactin, a glycosyl-phosphatidyl-inositol anchored immunoglobulin superfamily (IgSF) member protein. It could be shown here, that neuronal cell adhesion molecule L1 binds to oligodendrocytes in an F3-dependent manner and activates glial Fyn. In the search for downstream participants of this novel axon-glial signalling cascade, heterogeneous nuclear ribonucleoprotein (hnRNP) A2 was identified as a novel Fyn target in oligodendrocytes. HnRNP A2 was known to be involved in the localisation of translationally repressed myelin basic protein (MBP) mRNA by binding to a cis acting A2 response element (A2RE) present in the 3’ untranslated region. Transport of MBP mRNAs occurs in RNA-protein complexes termed RNA granules and translational repression during transport is achieved by hnRNP A2-mediated recruitment of hnRNP E1 to the granules. It could be shown here, that Fyn activity leads to enhanced translation of reporter mRNA containing a part of the 3’ UTR of MBP including the A2RE. Furthermore hnRNP E1 seems to dissociate from RNA granules in response to Fyn activity and L1 binding. These findings suggest a novel form of neuron- glial communication: Axonal L1 binding to oligodendroglial F3 activates Fyn kinase. Activated Fyn phosphorylates hnRNP A2 leading to removal of hnRNP E1 from RNA granules initiating the translation of MBP mRNA. MBP is the second most abundant myelin protein and mice lacking this protein show a severe hypomyelination phenotype. Moreover, the brains of Fyn knock out mice contain reduced MBP levels and are hypomyelinated. Hence, L1-mediated MBP synthesis via Fyn as a central molecule could be part of a regulatory mechanism required for myelinogenesis in the central nervous system.