Tyrosine hydroxylase immunoreactivity as indicator of sympathetic activity: simultaneous evaluation in different tissues of hypertensive rats

Burgi K, Cavalleri MT, Alves AS, Britto LRG, Antunes VR, Michelini LC. Tyrosine hydroxylase immunoreactivity as indicator of sympathetic activity: simultaneous evaluation in different tissues of hypertensive rats. Am J Physiol Regul Integr Comp Physiol 300: R264-R271, 2011. First published December 9, 2010; doi: 10.1152/ajpregu.00687.2009.-Vasomotor control by the sympathetic nervous system presents substantial heterogeneity within different tissues, providing appropriate homeostatic responses to maintain basal/stimulated cardiovascular function both at normal and pathological conditions. The availability of a reproducible technique for simultaneous measurement of sympathetic drive to different tissues is of great interest to uncover regional patterns of sympathetic nerve activity (SNA). We propose the association of tyrosine hydroxylase immunoreactivity (THir) with image analysis to quantify norepinephrine (NE) content within nerve terminals in arteries/arterioles as a good index for regional sympathetic outflow. THir was measured in fixed arterioles of kidney, heart, and skeletal muscle of WistarKyoto rats (WKY) and spontaneously hypertensive rats (SHR) (123 +/- 2 and 181 +/- 4 mmHg, 300 +/- 8 and 352 +/- 8 beats/min, respectively). There was a differential THir distribution in both groups: higher THir was observed in the kidney and skeletal muscle (similar to 3-4-fold vs. heart arterioles) of WKY; in SHR, THir was increased in the kidney and heart (2.4- and 5.3-fold vs. WKY, respectively) with no change in the skeletal muscle arterioles. Observed THir changes were confirmed by either: 1) determination of NE content (high-performance liquid chromatography) in fresh tissues (SHR vs. WKY): +34% and +17% in kidney and heart, respectively, with no change in the skeletal muscle; 2) direct recording of renal (RSNA) and lumbar SNA (LSNA) in anesthetized rats, showing increased RSNA but unchanged LSNA in SHR vs. WKY. THir in skeletal muscle arterioles, NE content in femoral artery, and LSNA were simultaneously reduced by exercise training in the WKY group. Results indicate that THir is a valuable technique to simultaneously evaluate regional patterns of sympathetic activity.

Neurodegeneration and Increased Production of Nitrotyrosine, Nitric Oxide Synthase, IFN-gamma and S100 beta Protein in the Spinal Cord of IL-12p40-Deficient Mice Infected with Trypanosoma cruzi

Background/Aim: Chagas` disease is caused by Trypanosoma cruzi and occurs in most Latin American countries. The protozoan may colonize the central nervous system (CNS) of immune-compromised human hosts, thus causing neuronal disorders. Systemic control of the intracellular forms of the parasite greatly depends on the establishment of a TH1 response and subsequent nitric oxide (NO) release. At the CNS, it is known that low concentrations of NO promote neuronal survival and growth, while high concentrations exert toxic effects and neuron death. Accounting for NO production by astrocytes is the glia-derived factor S100 beta, which is overproduced in some neurodegenerative diseases. In the current work, we studied the expression of NO, interferon (IFN)-gamma and S100 beta in the spinal cord tissue of IL-12p40KO mice infected with T. cruzi, a model of neurodegenerative process. Methods: IL-12p40KO and wild-type (WT) female mice infected with T. cruzi Sylvio X10/4 (10(5) trypomastigotes, intraperitoneally) were euthanized when IL-12p40KO individuals presented limb paralysis. Spinal cord sections were submitted to immunohistochemical procedures for localization of neurofilament, laminin, nitrotyrosine, NO synthases (NOS), IFN-gamma and S100 beta. The total number of neurons was estimated by stereological analysis and the area and intensity of immunoreactivities were assessed by microdensitometric/morphometric image analysis. Results: No lesion was found in the spinal cord sections of WT mice, while morphological disarrangements, many inflammatory foci, enlarged vessels, amastigote nests and dying neurons were seen at various levels of IL-12p40KO spinal cord. Compared to WT mice, IL-12p40KO mice presented a decrement on total number of neurons (46.4%, p<0.05) and showed increased values of immunoreactive area for nitrotyrosine (239%, p<0.01) and NOS (544%, p<0.001). Moreover, the intensity of nitrotyrosine (16%, p<0.01), NOS (38%, p<0.05) and S100 beta (21%, p<0.001) immunoreactivities were also augmented. No IFN-gamma labeled cells were seen in WT spinal cord tissue, contrary to IL-12p40KO tissue that displayed inflammatory infiltrating cells and also some parenchymal cells positively labeled.Conclusion: We suggest that overproduction of NO may account for neuronal death at the spinal cord of T. cruzi-infected IL-12p40KO mice and that IFN-gamma and S100 beta may contribute to NOS activation in the absence of IL-12. Copyright (C) 2009 S. Karger AG, Basel

Chaotic phase synchronization and desynchronization in an oscillator network for object selection

Object selection refers to the mechanism of extracting objects of interest while ignoring other objects and background in a given visual scene. It is a fundamental issue for many computer vision and image analysis techniques and it is still a challenging task to artificial Visual systems. Chaotic phase synchronization takes place in cases involving almost identical dynamical systems and it means that the phase difference between the systems is kept bounded over the time, while their amplitudes remain chaotic and may be uncorrelated. Instead of complete synchronization, phase synchronization is believed to be a mechanism for neural integration in brain. In this paper, an object selection model is proposed. Oscillators in the network representing the salient object in a given scene are phase synchronized, while no phase synchronization occurs for background objects. In this way, the salient object can be extracted. In this model, a shift mechanism is also introduced to change attention from one object to another. Computer simulations show that the model produces some results similar to those observed in natural vision systems.

Objective Detection and Delineation of Oral Neoplasia Using Autofluorescence Imaging

Although the oral cavity is easily accessible to inspection, patients with oral cancer most often present at a late stage, leading to high morbidity and mortality. Autofluorescence imaging has emerged as a promising technology to aid clinicians in screening for oral neoplasia and as an aid to resection, but current approaches rely on subjective interpretation. We present a new method to objectively delineate neoplastic oral mucosa using autofluorescence imaging. Autofluorescence images were obtained from 56 patients with oral lesions and 11 normal volunteers. From these images, 276 measurements from 159 unique regions of interest (ROI) sites corresponding to normal and confirmed neoplastic areas were identified. Data from ROIs in the first 46 subjects were used to develop a simple classification algorithm based on the ratio of red-to-green fluorescence; performance of this algorithm was then validated using data from the ROIs in the last 21 subjects. This algorithm was applied to patient images to create visual disease probability maps across the field of view. Histologic sections of resected tissue were used to validate the disease probability maps. The best discrimination between neoplastic and nonneoplastic areas was obtained at 405 nm excitation; normal tissue could be discriminated from dysplasia and invasive cancer with a 95.9% sensitivity and 96.2% specificity in the training set, and with a 100% sensitivity and 91.4% specificity in the validation set. Disease probability maps qualitatively agreed with both clinical impression and histology. Autofluorescence imaging coupled with objective image analysis provided a sensitive and noninvasive tool for the detection of oral neoplasia.

Modularity and robustness of bone networks

Cortical bones, essential for mechanical support and structure in many animals, involve a large number of canals organized in intricate fashion. By using state-of-the art image analysis and computer graphics, the 3D reconstruction of a whole bone (phalange) of a young chicken was obtained and represented in terms of a complex network where each canal was associated to an edge and every confluence of three or more canals yielded a respective node. The representation of the bone canal structure as a complex network has allowed several methods to be applied in order to characterize and analyze the canal system organization and the robustness. First, the distribution of the node degrees (i.e. the number of canals connected to each node) confirmed previous indications that bone canal networks follow a power law, and therefore present some highly connected nodes (hubs). The bone network was also found to be partitioned into communities or modules, i.e. groups of nodes which are more intensely connected to one another than with the rest of the network. We verified that each community exhibited distinct topological properties that are possibly linked with their specific function. In order to better understand the organization of the bone network, its resilience to two types of failures (random attack and cascaded failures) was also quantified comparatively to randomized and regular counterparts. The results indicate that the modular structure improves the robustness of the bone network when compared to a regular network with the same average degree and number of nodes. The effects of disease processes (e. g., osteoporosis) and mutations in genes (e.g., BMP4) that occur at the molecular level can now be investigated at the mesoscopic level by using network based approaches.

Magnetic fabric and zircon U-Pb geochronology of the Itaoca pluton: Implications for the Brasiliano deformation of the southern Ribeira Belt (SE Brazil)

The Itaoca pluton consists of porphyritic monzogranite that intruded the upper crust into low-grade metasedimentary rocks of the Apiai Dornain (Ribeira Belt). Anisotropy of magnetic susceptibility and zircon U-Pb (Shrimp) geochronology were combined to determine pluton emplacement mechanisms and its chronology relative to the collision structures of the Paranapiacaba (Brasiliano II) orogenic system. Magnetic susceptibility ranges between 4 and 38 x 10(-3) SI, and thermomagnetic measurements indicate multidomain magnetite is the main carrier of anisotropy. The pluton shows an ""onion-skin"" structure roughly elongated to the northeast with its hinge zone including kilometer-wide roof-pendants. Magnetic lineations are variable in orientation in consistency with the dominant oblate symmetry of the magnetic fabric. A distinct NE-trending point-maxima, however, indicates the mean lineation is parallel to the stretching direction of the transpressive deformation that affected the regional host rocks. Prismatic zircon from the monzogranite, both in the core and in the finely-zoned margins, yielded an age of 623 +/- 10 Ma. These results suggest the magmatic fabric recorded the earlier strain increments of the regional shear deformation. It may correspond to the transition from continental arc to collision tectonics of the southern Ribeira Belt. (C) 2008 Elsevier Ltd. All rights reserved.

A non-parametric vessel detection method for complex vascular structures

Modern medical imaging techniques enable the acquisition of in vivo high resolution images of the vascular system. Most common methods for the detection of vessels in these images, such as multiscale Hessian-based operators and matched filters, rely on the assumption that at each voxel there is a single cylinder. Such an assumption is clearly violated at the multitude of branching points that are easily observed in all, but the Most focused vascular image studies. In this paper, we propose a novel method for detecting vessels in medical images that relaxes this single cylinder assumption. We directly exploit local neighborhood intensities and extract characteristics of the local intensity profile (in a spherical polar coordinate system) which we term as the polar neighborhood intensity profile. We present a new method to capture the common properties shared by polar neighborhood intensity profiles for all the types of vascular points belonging to the vascular system. The new method enables us to detect vessels even near complex extreme points, including branching points. Our method demonstrates improved performance over standard methods on both 2D synthetic images and 3D animal and clinical vascular images, particularly close to vessel branching regions. (C) 2008 Elsevier B.V. All rights reserved.

Keratinocyte growth factor: a new mesothelial targeted therapy to reduce postoperative pericardial adhesions

Background: Several methods have been utilized to prevent pericardial and retrosternal adhesions, but none of them evaluated the mesothelial regenerative hypothesis. There are evidences that the mesothelial trauma reduces pericardial fibrinolytic capability and induces an adhesion process. Keratinocyte growth factor (KGF) has proven to improve mesothelial cells proliferation. This study investigated the influence of keratinocyte growth factor in reducing post-surgical adhesions. Methods: Twelve pigs were operated and an adhesion protocol was employed. Following a stratified randomization, the animals received a topical application of KGF or saline. At 8 weeks, intrapericardial adhesions were evaluated and a severity score was established. The time spent to dissect the adhesions and the amount of sharp dissection used, were recorded. Histological sections were stained with sirius red and morphometric analyses were assessed with a computer-assisted image analysis system. Results: The severity score was lower in the KGF group than in the control group (11.5 vs 17, p = 0.005). The dissection time was lower in the KGF group (9.2 +/- 1.4 min vs 33.9 +/- 9.2 min, p = 0.004) and presented a significant correlation with the severity score (r = 0.83, p = 0.001). A significantly less sharp dissection was also required in the KGF group. Also, adhesion area and adhesion collagen were significantly tower in the KGF group than in the control group. Conclusion: The simulation of pericardial cells with KGF reduced the intensity of postoperative adhesions and facilitated the re-operation. This study suggests that the mesothelial regeneration is the new horizon in anti-adhesion therapies. (C) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Synergism Between Keratinocyte Growth Factor and Carboxymethyl Chitosan Reduces Pericardial Adhesions

Background. Mesothelial injury is the pivot in the development of adhesions. An increase in the proliferation of mesothelial cells was verified by in vitro studies with the use of keratinocyte growth factor (KGF). This study investigated the influence of KGF associated with thermo-sterilized carboxymethyl chitosan (NOCCts) in the reduction of pericardial adhesions. Methods. An induction model of pericardial adhesion was carried out in 24 pigs. Animals were randomly allocated to receive topical application of KGF, KGF + NOCCts, NOCCts, or saline (control). At 8 weeks, intra-pericardial adhesions were evaluated and a severity score was established. The time spent to dissect the adhesions and the amount of sharp dissection used, were recorded. Histologic sections were stained with sirius red for a morphometric evaluation using a computer-assisted image analysis system. Cytokeratin AE1/AE3 immunostaining were employed to identify mesothelial cells. Results. The severity score expressed in median (minimum to maximum), in relation to the control group (17 [15 to 18]), was lower in the KGF + NOCCts group (7 [6 to 9], p < 0.01) followed by the KGF group (11.5 [9 to 12], 0.01 < p < 0.05) and the NOCCts group (12 [9 to 14], p > 0.05). The dissection time was significantly lower in the KGF + NOCCts group (7.1 +/- 0.6 vs 33.9 +/- 9.2 minutes, p < 0.001). A significantly less sharp dissection was also required in the KGF + NOCCts group. In the adhesion segment, a decreased collagen proportion was found in the KGF + NOCCts group (p < 0.05). Mesothelial cells were present more extensively in groups in which KGF was delivered (p = 0.01). Conclusions. The use of KGF associated with NOCCts resulted in a synergic action that decreases postoperative pericardial adhesions in a highly significant way. (Ann Thorac Surg 2010; 90: 566-72) (C) 2010 by The Society of Thoracic Surgeons

Road and Traffic Signs Recognition using Vector Machines

Intelligent Transportation System (ITS) is a system that builds a safe, effective and integrated transportation environment based on advanced technologies. Road signs detection and recognition is an important part of ITS, which offer ways to collect the real time traffic data for processing at a central facility.This project is to implement a road sign recognition model based on AI and image analysis technologies, which applies a machine learning method, Support Vector Machines, to recognize road signs. We focus on recognizing seven categories of road sign shapes and five categories of speed limit signs. Two kinds of features, binary image and Zernike moments, are used for representing the data to the SVM for training and test. We compared and analyzed the performances of SVM recognition model using different features and different kernels. Moreover, the performances using different recognition models, SVM and Fuzzy ARTMAP, are observed.

Utveckling av metod för att bedöma behovet av ogräsbekämpning i spår

A system for weed management on railway embankments that is both adapted to the environment and efficient in terms of resources requires knowledge and understanding about the growing conditions of vegetation so that methods to control its growth can be adapted accordingly. Automated records could complement present-day manual inspections and over time come to replace these. One challenge is to devise a method that will result in a reasonable breakdown of gathered information that can be managed rationally by affected parties and, at the same time, serve as a basis for decisions with sufficient precision. The project examined two automated methods that may be useful for the Swedish Transport Administration in the future: 1) A machine vision method, which makes use of camera sensors as a way of sensing the environment in the visible and near infrared spectrum; and 2) An N-Sensor method, which transmits light within an area that is reflected by the chlorophyll in the plants. The amount of chlorophyll provides a value that can be correlated with the biomass. The choice of technique depends on how the information is to be used. If the purpose is to form a general picture of the growth of vegetation on railway embankments as a way to plan for maintenance measures, then the N-Sensor technique may be the right choice. If the plan is to form a general picture as well as monitor and survey current and exact vegetation status on the surface over time as a way to fight specific vegetation with the correct means, then the machine vision method is the better of the two. Both techniques involve registering data using GPS positioning. In the future, it will be possible to store this information in databases that are directly accessible to stakeholders online during or in conjunction with measures to deal with the vegetation. The two techniques were compared with manual (visual) estimations as to the levels of vegetation growth. The observers (raters) visual estimation of weed coverage (%) differed statistically from person to person. In terms of estimating the frequency (number) of woody plants (trees and bushes) in the test areas, the observers were generally in agreement. The same person is often consistent in his or her estimation: it is the comparison with the estimations of others that can lead to misleading results. The system for using the information about vegetation growth requires development. The threshold for the amount of weeds that can be tolerated in different track types is an important component in such a system. The classification system must be capable of dealing with the demands placed on it so as to ensure the quality of the track and other pre-conditions such as traffic levels, conditions pertaining to track location, and the characteristics of the vegetation. The project recommends that the Swedish Transport Administration: Discusses how threshold values for the growth of vegetation on railway embankments can be determined Carries out registration of the growth of vegetation over longer and a larger number of railway sections using one or more of the methods studied in the project Introduces a system that effectively matches the information about vegetation to its position Includes information about the growth of vegetation in the records that are currently maintained of the track’s technical quality, and link the data material to other maintenance-related databases Establishes a number of representative surfaces in which weed inventories (by measuring) are regularly conducted, as a means of developing an overview of the long-term development that can serve as a basis for more precise prognoses in terms of vegetation growth Ensures that necessary opportunities for education are put in place

Mastocitose na infância : estudo anátomo-patológico e imuno-histoquímico

Introdução A mastocitose abrange um grupo heterogêneo de condições crônicas caracterizado pela proliferação excessiva de mastócitos nos tecidos. Os sinais e sintomas clínicos são decorrentes da distribuição anatômica dos mastócitos e do efeito funcional dos mediadores produzidos e liberados por estas células. Na infância, a doença é considerada uma condição benigna na maioria dos casos, cujo comprometimento característico é o cutâneo. As mais freqüentes manifestações na pele são os mastocitomas e a urticária pigmentosa. Lesões cutâneas bolhosas podem manifestar-se e acompanhar todas as formas de mastocitose e quando esta apresentação é a predominante, é denominada de mastocitose bolhosa. O diagnóstico de mastocitose é suspeitado clinicamente e confirmado pela histologia. A demonstração do aumento do número de mastócitos nas lesões cutâneas características se constitui no principal critério diagnóstico. Contudo, este método tem dificuldades técnicas que impedem a adequada reprodutibilidade dos achados, dificultando a elucidação de casos duvidosos e retardando seu tratamento. Considerando as propriedades imunológicas e a importância clínica dos mastócitos reveste-se de maior importância compreender o papel destas células nas doenças, sendo indispensável identificá-las e enumerá-las com acurácia nos tecidos. Objetivos Quantificar o número de mastócitos marcados com anticorpo monoclonal antitriptase, através de técnica imuno-histoquímica e análise de imagem, em biópsias cutâneas de crianças, com diagnóstico clínico de mastocitose. Descrever os achados histológicos; quantificar o número de mastócitos marcados com o anticorpo antitriptase entre as diferentes expressões clínicas da mastocitose cutânea; comparar o número de mastócitos entre os casos de mastocitose cutânea e mastocitose associada à sintomas sistêmicos e correlacionar as contagens de mastócitos entre os dois diferentes métodos (coloração por Giemsa com contagem manual e marcação com anticorpo antitriptase e análise digital). Material e Método Foram incluídas no estudo biópsias cutâneas de crianças de 0 a 14 anos, com diagnóstico clínico e histológico de mastocitose. Os casos foram classificados de acordo com a apresentação clínica cutânea em mastocitoma, urticária pigmentosa ou mastocitose bolhosa e assinalada a presença de sintomas sistêmicos associados. Os fragmentos de pele fixados em formalina e emblocados em parafina foram cortados e utilizados para diagnóstico histopatológico convencional, corados com hematoxilina-eosina e Giemsa, e para análise imuno-histoquímica com estreptavidina peroxidase marcados com anticorpo antitriptase. A densidade de mastócitos (número de células por área) foi realizada por um único observador na técnica histológica e através de um sistema de análise de imagem de vídeo no método imuno-histoquímico. Resultados Foram avaliados 33 casos de mastocitose, sendo 21 do sexo masculino. Dez casos (30,3%) apresentavam mastocitoma, 21 (63,6%) urticária pigmentosa e 2 (6,1%) mastocitose bolhosa. Todos os casos da amostra foram classificados como tendo mastocitose incipiente e em 6 (18,8%) pacientes pôde ser identificada a associação com sintomas sistêmicos. Prurido foi o sintoma mais freqüente, sendo relatado em 21 casos. Em 21 dos 33 casos foi identificada a infiltração de mastócitos na derme havendo predominância pela região perivascular (p=0,001, teste exato de Fisher). Não houve diferenças significativas entre a presença de infiltrado mastocitário e as várias formas cutâneas de mastocitose ou a mastocitose sistêmica. A presença de eosinófilos foi identificada em 15 casos (45,5%) e em 10 casos associadamente ao infiltrado perivascular de mastócitos. A densidade de mastócitos na técnica histológica, incluindo-se todos os casos, foi 50,00 células/mm2. Não houve diferença significativa das contagens entre os pacientes com mastocitoma e aqueles com urticária pigmentosa, assim como entre os pacientes com e sem sintomas sistêmicos associados aos cutâneos. A densidade de mastócitos encontrada com a técnica imuno-histoquímica e contagem por análise de imagem foi 158,85 células/mm2. Não houve diferença significativa das contagens entre os pacientes com mastocitoma e aqueles com urticária pigmentosa, assim como entre aqueles com e sem sintomas sistêmicos. Comparando-se a contagem dos mastócitos por área (densidade) entre a histologia e a imuno-histoquímica houve uma diferença significativa (p=0,0001 teste não-paramétrico de Wilcoxon). A média da diferença entre as contagens foi 199,98 células/mm2 (±365,31 DP). Também não houve semelhança, entre os dois métodos, nos grupos mastocitoma e urticária pigmentosa (p=0,005 e p=0,01, respectivamente, teste não-paramétrico de Wilcoxon). Puderam ser identificados 518% a mais de mastócitos com a técnica imunohistoquímica quando comparada com a histológica. Conclusões O presente estudo permite concluir que: 1) a localização preferencial da infiltração de mastócitos é dérmica e perivascular, não sendo possível identificar diferenças histológicas entre casos de urticária pigmentosa e mastocitoma; 2) o número de mastócitos marcados com o anticorpo monoclonal antitriptase e contados com análise digital de imagem, em biópsia de pele de crianças com diagnóstico clínico de mastocitose, foi 159 células por milímetro quadrado; 3) a densidade de mastócitos, foi semelhante entre os casos de urticária pigmentosa e mastocitoma e entre os casos com e sem sintomas sistêmicos associados nas duas diferentes técnicas empregadas; 4) o número de mastócitos por milímetro quadrado com a técnica imuno-histoquímica e a contagem através de análise de imagem foi significativamente maior quando comparada com a coloração através de Giemsa e a contagem manual, com uma diferença média entre os dois métodos de 200 células por milímetro quadrado; 5) a densidade de mastócitos com a técnica imunohistoquímica foi significativamente maior tanto nos casos com urticária pigmentosa quanto nos com mastocitoma, quando comparada com a técnica empregada rotineiramente e 6) com a técnica imuno-histoquímica e a contagem através de análise de imagem foi possível identificar 518% a mais de mastócitos quando comparada com a técnica histológica.

Estudo da precocidade diagnóstica dos melanomas cutâneos primários em Porto Alegre por análise de imagem computadorizada

Fundamentos: A literatura tem demonstrado que a detecção precoce e a remoção cirúrgica em fases iniciais reduz a mortalidade do melanoma e que, em conseqüência, a identificação do melanoma em fases curáveis deve ser encorajada. Objetivos: O interesse principal do estudo foi conhecer se os melanomas cutâneos, no meio, estão sendo diagnosticados em fases iniciais, através de método reprodutível e armazenável. Metodologia: Foi realizado um estudo transversal com os casos de melanomas cutâneos primários, analisados nos laboratórios de patologia de Porto Alegre, de 1° de janeiro de 1994 a 30 de junho de 1995, a fim de avaliar se os diagnósticos foram realizados em estágios precoces. Os casos foram revisados por três dermatopatologistas, que classificaram quanto ao tipo histológico e quanto ao nível de invasão de Clark. Foi realizado um consenso com pelo menos duas concordâncias. A espessura de Breslow foi considerada fator prognóstico determinante e foi medida através de um sistema de análise de imagem computadorizada, por dois membros da equipe. Resultados: Do total de 279 casos que preencheram os critérios de inclusão, 2,15% eram intraepiteliais. Dos melanomas invasivos, 52% tinham espessura ≤ 1,5 mm. Quando agrupado por sexo e procedência, as mulheres de Porto Alegre, capital do estado do Rio Grande do Sul, tiveram a mais alta taxa de diagnóstico precoce (75% ≤ 1,5 mm). O tronco foi o sítio predominante no homem e freqüente na mulher. O melanoma de espalhamento superficial foi o tipo histológico mais freqüente (80,9%), seguido pelo nodular (10,1%). Para definir os determinantes do diagnóstico precoce, foram realizados cruzamentos simples, dos melanomas intraepiteliais somados aos de espessura <0,76 mm, com o sexo, a idade, a procedência, a situação previdenciária, a região anatômica e o tipo histológico. A análise de variáveis múltiplas demonstrou que apenas o sexo (feminino), o sítio anatômico (outras regiões exceto membros inferiores) e a procedência (Porto Alegre) mostraram-se variáveis independentes para determinar um diagnóstico precoce. A idade ≥ 40 anos apresentou significância próxima ao limite. O tipo histológico foi excluído do modelo, uma vez que gerou instabilidade estatística. Conclusão: Embora o número de casos fosse pequeno, o diagnóstico do melanoma ainda é tardio (52% com até 1,5 mm de espessura). Entretanto, existe um subgrupo de diagnóstico precoce que são mulheres, sobretudo de Porto Alegre, possivelmente por estarem mais atentas e informadas sobre os riscos do melanoma. As mudanças no estilo de vida, nas últimas décadas, provavelmente são responsáveis pela maior incidência no tronco e pela alta freqüência de melanoma de espalhamento superficial encontrada. A análise da espessura tumoral por projeção em tela de computador mostrou-se um recurso auxiliar vantajoso.

Enxertos ósseos liofilizados e impactados humano e bovino em revisão de artroplastia total de quadril

O presente estudo é uma coorte não concorrente em 63 pacientes (66 quadris) submetidos à revisão de artroplastia total de quadril (RATQ), com enxerto ósseo liofilizado moído e impactado. Foi realizado no Serviço de Ortopedia e Traumatologia do Hospital de Clínicas de Porto Alegre (HCPA), no período de maio de 1997 a setembro de 2003. O objetivo do estudo foi comparar clínica, radiográfica e cintilograficamente a capacidade de osteointegração dos enxertos ósseos liofilizados humano e bovino impactados em RATQs cimentadas e não-cimentadas. Os pacientes foram divididos em dois grupos: o Grupo 1 (n=35) foi composto pelos que receberam enxerto ósseo liofilizado de origem humana e o Grupo 2 (n=31) por aqueles que receberam enxerto de origem bovina. O tempo médio de seguimento foi de 33 meses. Os enxertos ósseos purificados e liofilizados foram produzidos pelo Banco de Tecidos do HCPA. A análise clínica baseou-se no escore de Merle, d’Aubigné e Postel; a radiográfica, nos critérios de radioluscência, densidade, formação de trabeculado ósseo, migração dos componentes e floculação, formulando-se um escore radiográfico de osteointegração (EROI). Foram escolhidos, aleatoriamente, como forma complementar de análise por imagem, 35 (53%) pacientes assintomáticos para realizarem cintilografia óssea com Tecnécio, sendo 17 (48,5%) do Grupo 1 e 18 (51,5%) do Grupo 2. Não foram encontradas diferenças clínicas, radiográficas ou cintilográficas relevantes entre os grupos, obtendo-se em torno de 85% de integração do enxerto, tanto no componente acetabular quanto femoral. Estes resultados são comparáveis aos relatados na literatura com o uso de enxerto alogênico congelado e confirmam a adequacidade do uso de enxertos liofilizados de origem bovina e humana em RATQ.

Análise digital de imagem e estereologia da angiogênese em adenomas e no adenocarcinoma colorretal invasivo de submucosa

A angiogênese é essencial no desenvolvimento neoplásico, associando-se às metástases à distância e recorrência em diversas neoplasias malignas. Em carcinomas colorretais, os parâmetros da análise digital de imagem e estereologia da angiogênese foram pouco estudados. Objetivo: avaliar parâmetros tridimensionais e a quantificação microvascular bidimensional nas diferentes apresentações morfológicas dos adenomas colorretais e no adenocarcinoma colorretal restrito à submucosa, a fim de determinar o papel da angiogênese nas diferentes etapas da seqüência adenoma-carcinoma e sua relação com as diferentes apresentações das lesões precursoras do carcinoma colorretal. Material e métodos: foi realizado estudo histórico de delineamento transversal, incluindo 115 lesões neoplásicas colorretais, ressecadas endoscópica ou cirurgicamente no período de 1997 a 2001, obtidas de pacientes do Hospital de Clínicas de Porto Alegre e da Fundação Universitária de Gastroenterologia (FUGAST). Para análise da angiogênese foram utilizadas as técnicas de imuno-histoquímica, análise digital de imagem, quantificação microvascular e estereologia. Os resultados foram apresentados como mediana e intervalos interquartis. Resultados: a quantificação microvascular foi progressivamente mais elevada nas lesões polipóides com displasia de alto grau comparadas às de baixo grau. Quanto maior o grau de atipia observado, maior foi o número de microvasos (regressão linear, P < 0,05). O volume e extensão microvascular foram diferentes entre as fases evolutivas da neoplasia colorretal, resultando em aumento no volume 728 (416 - 1408) versus 178 (93 - 601) e extensão microvascular 242,4 (131,1 - 936,8) vs 24,0 (6,5 - 142,2) (P < 0,001) nas lesões polipóides com displasia de alto grau comparadas às de baixo grau, respectivamente. A quantificação microvascular foi progressivamente mais elevada, acompanhando a progressão neoplásica polipóide: displasia de baixo grau 41,8 (15,8 - 71,9), displasia de alto grau 60,0 (23,0 - 95,6) e carcinoma de submucosa 76,0 (37,5 - 132,6) (P < 0,001). Concomitante, o volume 956 (436 - 2188) vs 178 (93 - 601) e a extensão microvascular 534,6 (146,7 - 1262) vs 24,0 (6,5 - 142,2) foram mais elevados nos adenocarcinomas colorretais restritos à submucosa em relação às lesões polipóides com displasia de baixo grau, respectivamente (P < 0,001). Não foi encontrada diferença estatisticamente significativa na angiogênese entre os adenomas polipóides e não-polipóides através da quantificação 41,8 (15,8 - 71,9) vs 22 (16 - 40) e estimativa da extensão microvascular 24 (6,5-142,2) vs 17,5 (4,4-54,7), respectivamente. Conclusão: a utilização da análise digital de imagem e estereologia acrescentou maior objetividade e eficácia na metodologia de avaliação angiogênica, pois permitiu a precisa segmentação das áreas hipervasculares, a representação da morfologia tridimensional característica do suprimento vascular e a identificação de diferenças na microvascularização nas etapas evolutivas do câncer colorretal.