959 resultados para focal and segmental glomerulosclerosis


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A anastomose arterial término-terminal é demorada, requer tempo prolongado de oclusão vascular e esta associada a necrose focal, infiltração leucocitária e, conseqüentemente, à fibrose e calcificação da parede arterial. A cola de fibrina é uma alternativa para a anastomose microvascular e pode evitar estas alterações com menor aderência aos tecidos vizinhos e melhor coaptação das bordas arteriais. OBJETIVO: Comparar o processo cicatricial de anastomoses convencionais com anastomoses feitas com cola de fibrina em artérias maiores. MÉTODOS: em 22 coelhos, ambas carótidas foram seccionadas transversalmente e reconstruídas por meio de anastomose término-terminal com 4 pontos simples de reparo e cola de fibrina de um lado (G1), e com 8 pontos separados do outro lado (G2). Após 3 e 15 dias, os animais foram destinados aleatoriamente para estudo de força tênsil concentração de hidroxiprolina (8 animais) e avaliação histológica das anastomoses (3 animais). As lâminas histológicas foram coradas pelo HE Masson e Picrossirius polarização (PSP). RESULTADOS: Após 3 e 15 dias a força tênsil aumenta em ambos os grupos, de 280,0± 32,6g para 432,2± 131,2g no Grupo 1 e de 221,4± 72,4g para 452,2± 132,0g no Grupo 2; sem diferença estatística entre os grupos em cada período. A concentração de hidroxiprolina expressa como razão hidroxiprolina/proteína, variou de 0,0816± 0,0651 para 0,0622± 0,0184 no Grupo 1 e de 0,0734± 0,0577 para 0,0460± 0,0271 no Grupo 2; sem diferença estatística entre os períodos e grupos. Os estudos histológicos mostraram discreto aumento das reações de inflamação e reparação no Grupo 2. A técnica PSP mostrou predomínio do colágeno tipo I em relação do colágeno tipo II nas anastomoses de ambos os grupos, sem diferença expressiva entre esses grupos. CONCLUSÃO: A anastomose com a cola de fibrina foi menos lesiva para a parede arterial do que a anastomose convencional. Mesmo usando menos pontos, as características de força tênsil e de cicatrização da anastomose com cola de fibrina foram similares em ambos os grupos. Os tempos de realização das anastomoses foram significativamente maiores do que na anastomose convencional.

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A finalidade deste estudo foi desenvolver reflexão crítica sobre a experiência de enfermeiros plantonistas. Os objetivos foram: apreender como os enfermeiros plantonistas descrevem e interpretam seus conhecimentos e experiências sobre esta realidade; e refletir sobre possíveis caminhos para a superação dos problemas identificados. Este estudo foi qualitativo, utilizando-se a técnica de grupo focal. O grupo foi formado por treze enfermeiros plantonistas. O referencial metodológico foi o do Discurso do Sujeito Coletivo. Foram identificadas importantes dificuldades para a construção do trabalho coletivo e solidário: incompreensões entre o pessoal de enfermagem; entre enfermagem e outros profissionais que atuam no hospital; falta ou inadequação de materiais para a prestação de assistência; e ausência de apoio, dentre outras. Verificou-se a pertinência da criação de espaços comunicativos e de reflexão, visando o fortalecimento do coletivo profissional e a redução das angústias no trabalho do enfermeiro plantonista.

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Quinze pacientes com síndrome de Lennox-Gastaut secundária foram submetidos a exames clínicos e eletrencefalográficos mensais por períodos de tempo que variaram de 1 a 9 anos. Os exames eletrencefalográficos foram realizados durante sono induzido por barbitúrico. Doze pacientes apresentaram atividade epiléptica focal. No presente trabalho descrevemos a localização, morfologia e freqüência dos paroxismos epilépticos focais.

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ObjectiveExplore the presentation, diagnostic criteria and exocrine gland histopathology of paediatric primary Sjogren's syndrome (PPSjS).MethodsA case series of 8 children is reported and American-European Consensus Group (AECG-2002) criteria were examined, as well as minor labial salivary and lachrymal gland biopsies, which were scored by a pathologist blinded to outcome. For all cases, connective tissue diseases and parotid-related infectious disease were excluded.ResultsAge at onset varied from 5-13 years old; 6 were females, all followed from diagnosis up to the last visit (1-10 years). The main features at presentation were recurrent tender parotid swelling and sialectasis imaging, with decreased salivary function assessed by Tc-99 scintigraphy. Mild sicca symptoms were observed in 4/8 cases. Systemic features, including fatigue, myalgia, arthritis, tenosynovitis, joint contractures, transient Raynaud's and high ESR, were recorded at onset. Autoantibody profile was unremarkable for diagnosis, while lymphocytic infiltration of labial salivary glands and sialectasis were observed in all biopsies (8/8). In lachrymal glands, massive lymphocytic infiltration and lymphocytic gastritis were observed during complementary assessment. Flares were treated with low dose steroids and long-term use of hydroxychloroquine (5/8), although only 318 fulfilled AECG-2002 diagnostic criteria, throughout the disease course.ConclusionPPSjS is rare, slowly progressive and its early presentation is variable. Standardised diagnostic algorithms should include recurrent parotid swelling and early diagnosis should rely mostly on salivary and lachrymal gland histopathology in this age group.

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Neste trabalho apresentamos um caso de hiperplasia nodular focal que foi diagnosticado aos seis anos de idade e que está sendo acompanhado até o momento presente. Para o diagnóstico foram imprescindíveis as técnicas de imagem, tendo importância de realce a cintilografia hepatoesplênica e a tomografia computadorizada. Apresentamos, também, revisão da literatura sobre o assunto.

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Background: Seizures are a common problem in small animal neurology and it may be related to underlying diseases. Porencephaly is an extremely rare disorder, and in Veterinary Medicine it affects more often ruminants, with only few reports in dogs.Case presentation: A one-year-old intact male Shih-Tzu dog was referred to Veterinary University Hospital with history of abnormal gait and generalized tonic-clonic seizures. Signs included hypermetria, abnormal nystagmus and increased myotatic reflexes. At necropsy, during the brain analysis, a cleft was observed in the left parietal and occipital lobes, creating a communication between the subarachnoid space and the left lateral ventricle, consistent with porencephaly; and also a focal atrophy of the caudal paravermal and vermal portions of the cerebellum. Furthermore, the histological examination showed cortical and cerebellar neuronal dysplasia.Conclusions: Reports of seizures due to porencephaly are rare in dogs. In this case, the dog presented a group of brain abnormalities which per se or in assemblage could result in seizure manifestation.

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

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Cimetidine, referred as antiandrogenic agent, has caused alterations in the seminiferous tubules, including alterations in the peritubular tissue and death of myoid cells by apoptosis. Regarding the structural and functional importance of the peritubular tissue for the maintenance of Sertoli cells (SC), we purpose to investigate the SC-basement membrane interface, focusing the morphological features of SC and their interaction with the basement membrane in the affected tubules by cimetidine. Ten animals were distributed into two groups, control (CG) and cimetidine (CmG) which received saline solution and 50 mg of cimetidine per kg of body weight, respectively, for 52 days. The testes were fixed, dehydrated and embedded for analyses under light and transmission electron microscopy. Paraffin sections were submitted to the TUNEL method; sections of testes embedded in glycol methacrylate were submitted to PAS method and stained by H&E for morphological and quantitative analyses of Sertoli Cells. In the CmG, the SC nuclei were positive to the TUNEL method and showed typical morphological alterations of cell death by apoptosis (from early to advanced stages). A significant reduction in the number of Sertoli Cells was probably due to death of these cells by apoptosis. A close relationship between SC nuclear alterations (including a high frequency of dislocated nuclei from the basal portion) and damage in the peritubular tissue was observed. The ultrastructural analysis showed a parallelism between the gradual advancement of apoptotic process in SC and detachment of the anchoring sites (hemidesmosomes) of SC plasma membrane from the lamina densa. The presence of portions of lamina densa underlying the detached hemidesmosomes indicates a continuous deposition of lamina densa, resulting in the thickening of the basal lamina. The results indicate a possible disarrangement of the SC cytoskeleton, including the focal adhesion structure. These alterations are related to SC apoptosis and probably result from disturbs induced by cimetidine on the peritubular tissue.

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Structural features of segmental parts of the aorta of the dog were studied by light microscopy (LM) and scanning electron microscopy (SEM). The variability in the wall architecture composition and vascular thickness of the ascending (T2-3 level), thoracic (T7-8 level) and abdominal (L6-7 infrarenal level) segments of the aorta was analysed. Morphological features such as presence of intimal folds, pattern of the medial myoconnective components with segmental variations in the number of elastic lamellae, whose relative number was higher in the thoracic aorta (ascending and descending parts), compared with the abdominal aorta, and a network of connective (stromal) elements formed by elastic and collagen lamellae and fibres in the adventitia were observed. The results were discussed on a histophysiological basis, because small but significant segmental differences had been characterized in the aortic wall structure of the dog.

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This was a study on the oxidative stress due to ischaemia (I) and reperfusion (R) in skeletal muscle tissue. Using a tourniquet, groups of rats were submitted to ischaemia for 4 h, followed by different reperfusion periods. The animals were divided in four groups: control; 4 h of ischaemia (IR); 4 h of ischaemia plus 1 h reperfusion (IR-1 h); 4 h of ischaemia plus 24 h reperfusion (IR-24 h); and 4 h of ischaemia plus 72 h reperfusion (IR-72 h). At the end of the procedures, samples of soleus muscle were collected and frozen in n-hexane at -70 degrees C. Cryostat sections were submitted to haematoxylin-eosin, succinate dehydrogenase (SDH) and nicotinamide adenine dinucleotide-tetrazolium reductase (NADH-TR) stains. An additional muscle sample was processed for electron microscopy. No alterations were found in control animals. IR group showed fibres had normal aspect besides some round, acidophilic and hypertrophic fibres. There were several fibres with angular outlines and smaller diameters in this group compared with control group. NADH-TR/SDH reaction was moderately intense in most fibres. In some fibres, cytoplasm showed areas without activity and other fibres had very intense reactivity. IR-1 h group showed oedema hypercontracted fibres with disorganized myofibrils, mitochondria with focal lesions and dilated sarcoplasmic reticulum. NADH-TR/SDH reaction was moderate to weak. IR-24 h showed intense inflammatory infiltrate in the endomysium and perimysium. NADH-TR/SDH reaction was similar to IR-1 h. IR-72 h showed necrotic fibres, areas with inflammatory infiltrate, reduced muscle fibres at different stages of necrosis and phagocytosis, and many small round and basophilic fibres characterizing a regeneration process. NADH-TR/SDH reaction was weak to negative. Our results suggest that ischaemia and the subsequent 1-, 24- and 72-h reperfusions induced progressive histological damage. Although progressive, it may be reversible because there were ultrastructural signs of recovery after 72-h reperfusion. This recovery could in part be due to the low oxidative stress identified by the morphological and histochemical analysis.

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Dehiscent fruits of Euphorbiaceae usually have two stages of seed dispersal, autochory followed by myrmecochory. Two stages of Margaritaria nobilis seed dispersal were described, the first stage autochoric followed by ornithocoric. Their dehiscent fruits are green and after they detached from the tree crown and fall on the ground, they open and expose blue metallic cocas. We studied the seed dispersal system of Margaritaria nobilis in a semi-deciduous forest in Brazil. In 80 h of focal observations, we recorded only 12 visits of frugivores, however the thrush Turdus leucomelas was the only frugivore that swallowed the fruits on the tree crown. Pitylus fuliginosus (Fringilidae) and Pionus maximiliani (Psittacidae) were mainly pulp eaters, dropping the seeds below the tree. on the forest floor, after fruits dehiscence, jays (Cyanocorax chrysops), guans (Penelope superciliaris), doves (Geotrygon montana) and collared-peccaries (Pecari tajacu) were observed eating the blue diaspores of M. nobilis. Experiments in captivity showed that scaly-headed parrots (Pionus maximiliani), toco toucans (Ramphastos toco), jays (Cyanochorax chrysops), and guans (Penelope superciliaris) consumed the fruits and did not prey on the seeds before consumption. The seeds collected from the feces did not germinate in spite of the high viability. The two stages of seed dispersal in M. nobilis resembles the dispersal strategies of some mimetic species. However M. nobilis seeds are associated with an endocarp, it showed low investment in nutrients, and consistent with this hypothesis, M. nobilis shared important characteristics with mimetic fruits, such as bright color display, long seed dormancy and protection by secondary compounds.

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

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

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Epstein-Barr virus (EBV) has been associated with 10% of gastric carcinomas. The aim of this study was to determine the frequency of EBV in gastric carcinomas in Brazil assessed by in situ hybridization (ISH) and PCR, which would contribute to the characterization of the clinical and pathological aspects of EBV-associated gastric carcinomas. One hundred and ninety-two gastric carcinoma cases were collected at hospitals in two Brazilian states. Seventy-three out of 151 cases were PCR(+), while 11/160 cases were ISH(+). Nine out of eleven ISH(+) cases displayed a diffuse staining pattern and 2 out of 11 a focal pattern. Both techniques showed that the EBV(+) cases were characterized by their association with males, older patients, lower gastric region, intestinal type, advanced stage and poorly to moderately differentiated tumors. The concordance between the two techniques was 55.8% (Cohen's kappa index = 0.034). Four cases were ISH(+)/PCR(-), while 49 cases were PCR(+)/ISH(-). Only two cases showed stained lymphocytes by ISH and one of them was PCR(-). The observed discrepancy between the two techniques could not be explained just by the elevated accuracy of PCR. ISH(+)/PCR(-) carcinomas may be encountered if EBV is not present in the whole tumor tissue or if there are polymorphisms in the sequences of the viral genome amplified. on the other hand, the high frequency of PCR(+) results associated with the absence of ISH staining in lymphocytes and/or tumors cells suggests that the virus may be present in tumor cells or other cell types without expressing EBER1, the target of the ISH technique.