Avaliação da inervação entérica e análise proteômica do intestino delgado de ratos expostos à dose aguda ou crônica de fluoreto

O trato gastrointestinal (TGI) é a principal rota de exposição ao fluoreto (F) e o seu mais importante sítio de absorção. Acredita-se que a toxicidade do F comprometa a fisiologia do intestino, devido à relevante sintomatologia gastrointestinal relatada em consequência da exposição excessiva ao F. A função intestinal é controlada por uma complexa rede neuronal interligada e incorporada à parede deste órgão, denominada Sistema Nervoso Entérico (SNE). Embora os efeitos tóxicos do F sobre o Sistema Nervoso Central sejam descritos na literatura, não há estudos relacionados à sua toxicidade sobre o SNE. Neste estudo realizado em ratos, foi avaliado o efeito da exposição aguda ou crônica ao F, sobre a população geral de neurônios entéricos e sobre as subpopulações que expressam os principais neurotransmissores entéricos: Acetilcolina (ACh), Óxido Nítrico (NO), Peptídeo Vasoativo Intestinal (VIP), Peptídeo Relacionado ao Gene da Calcitonina (CGRP) e Substância P (SP). Os animais foram divididos em 5 grupos: 3 destinados à exposição crônica (0 ppm, 10 ppm ou 50 ppm de F na água de beber) e 2 à exposição aguda (0 ou 25 mgF/Kg por gavagem gástrica). Foram coletados os 3 segmentos do intestino delgado (duodeno, jejuno e íleo) e processados para a detecção da HuC/D, ChAT, nNOS, VIP, CGRP e SP, através de técnicas de imunofluorescência, no plexo mioentérico. Foram obtidas imagens para a realização da análise quantitativa dos neurônios da população geral (HuC/D) e nitrérgicos (imunorreativos à nNOS); e morfométrica dos neurônios imunorreativos à HuC/D ou nNOS; e das varicosidades imunorreativas à ChAT, VIP, CGRP ou SP. Amostras dos 3 segmentos intestinais foram preparadas e coradas em Hematoxilina e Eosina para análise histológica da morfologia básica. O segmento intestinal considerado mais afetado na análise morfométrica da população geral de neurônios, o duodeno, foi selecionado para a realização da análise proteômica, com o objetivo de oferecer o seu perfil proteico e determinar diferenças na expressão proteica em decorrência da exposição crônica ou aguda ao F. A análise da concentração de F no plasma sanguíneo foi realizada para a confirmação da exposição. Na análise quantitativa, o grupo de 50 ppm F, apresentou uma diminuição significativa na densidade da população geral de neurônios do jejuno e do íleo e na densidade dos neurônios imunorreativos à nNOS no duodeno e no jejuno. Quanto à análise morfométrica, a população geral e as subpopulações neuronais entéricas avaliadas apresentaram alterações morfológicas significativas, tanto após a exposição crônica quanto a aguda. Para a análise proteômica do duodeno, verificou-se que da associação de seus genes a um termo, e assim classificadas de acordo com diferentes processos biológicos. No caso do grupo da dose aguda, o processo biológico com a maior porcentagem de genes associados foi a geração de metabólitos precursores e energia (27% das proteínas); enquanto para os grupos de 10 e 50 ppm F foram o processo metabólico da piridina (41%) e a polimerização proteica (33%), respectivamente.

Controle epigenético do gene imprinted SNRPN durante o desenvolvimento e reprogramação nuclear em equídeos

A tranferência nuclear de células somáticas (TNCS) está sendo utilizada para produzir cavalos de elite. No entanto, durante este procedimento pode ocorrer a perfuração da zona pelúcida, levando, ocasionalmente, à secção da massa celular interna, e conseqüente derivação de gêmeos monozigóticos. Além de serem relatadas alterações no processo de imprinting genômico, que conduzem ao desenvolvimento de doenças. Com a descoberta da possibilidade de reprogramar as células somáticas a um estado de pluripotência (iPSCs), estas células passaram a ser muito utilizadas em pesquisas de neurociência. Contudo, também ocorrem modificações epigenéticas durante esta reprogramação celular. Portanto, nossas hipóteses são que os gêmeos eqüinos gerados pela TNCS podem levar às irregularidades no desenvolvimento do sistema nervoso. O padrão de metilação do SNRPN nas estruturas dos fetos muares clonados, e as células iPSCs são diferentes dos padrões encontrados nos muares analisados. A expressão dos genes SNRPN, Necdin e UBE3A são maiores no cérebro, enquanto a expressão do H19 é maior nas membranas extra-embrionárias. Em nosso estudo, obtivemos duas gestações gemelares equinas derivadas da TNCS, que foram interrompidas com 40 e 60 dias de gestação, e comparados com gestações eqüinas únicas de idade similar. Diferenças no comprimento entre os embriões gêmeos foram observadas aos 40 (2.0 e 2.2 cm 10%) e aos 60 (6,5 e 8,5 cm 24%) dias de gestação. Somente o plexo coróide do quarto ventrículo apresentou-se mais desenvolvido nos fetos com maior comprimento. Ao analisarmos fetos muares clonados em diferentes idades gestacionais e compará-los com muares, nos períodos embrionário, fetal e adulto, não foi observada diferença no padrão de metilação do gene SNRPN. No entanto, na décima passagem das células iPSC o padrão de metilação alterou, em relação aos muares estudados e ao padrão observado nos fibroblastos. Ao analisarmos os fetos clonados nas diferentes idades gestacionais observou-se no cérebro menor expressão dos gene H19 e UBE3A, e maior expressão do gene SNRPN. Contudo, a expressão do gene Necdin variou entre as estruturas estudadas. Em conclusão, apesar dos gêmeos eqüinos provenientes de TNCS diferirem quanto ao tamanho, morfologicamente são iguais. Dentre as estruturas cerebrais o plexo coróide se apresentou mais desenvolvido nos fetos de maior comprimento. Os fetos muares clonados não apresentaram diferença no padrão de metilação do gene SNRPN. No entanto, as iPSCs apresentaram alteração no padrão de metilação deste gene na décima passagem. Embora os genes SNRPN, Necdin e UBE3A sejam expressos no cérebro, o SNRPN apresentou-se prevalente nessa estrutura

Avaliação da acurácia da ressonância magnética no diagnóstico das lesões traumáticas do plexo braquial

A lesão do plexo braquial é considerada a alteração neural mais grave das extremidades. A principal causa é o trauma de alta energia, especialmente acidentes envolvendo veículos a motor. Por este motivo, as lesões traumáticas do plexo braquial são cada vez mais frequentes. O presente estudo avaliou a acurácia da ressonância magnética (RM) no diagnóstico das lesões traumáticas do plexo braquial no adulto, utilizando o achado intraoperatório como padrão-ouro. Também foi avaliada a acurácia da neurografia pesada em difusão (neurografia DW) em relação à RM convencional e a capacidade de diferenciação dos três tipos de lesão: avulsão, ruptura e lesão em continuidade. Trinta e três pacientes com história e diagnóstico clínico de lesão traumática do plexo braquial foram prospectivamente estudados por RM. Os achados obtidos pela RM sem e com o uso da neurografia DW, e os achados de exame clínico foram comparados com os achados intraoperatórios. A análise estatística foi feita com associação de significância de 5%. Observou-se alta correlação entre a RM com neurografia DW e a cirurgia (rs=0,79), e baixa correlação entre a RM convencional e a cirurgia (rs=0,41). A correlação interobservador foi maior para a RM com neurografia DW (rs = 0,94) do que para a RM sem neurografia DW (rs = 0,75). Os resultados de sensibilidade, acurácia e valor preditivo positivo foram acima de 95% para as RM com e sem neurografia DW no estudo de todo o plexo. As especificidades foram, em geral, maiores para a neurografia DW (p < 0,05). Em relação à diferenciação dos tipos de lesão, a RM com neurografia DW apresentou altas acurácias e sensibilidades no diagnóstico da avulsão/rotura, e alta especificidade no diagnóstico da lesão em continuidade. A acurácia da RM (93,9%) foi significativamente maior que a do exame clínico (76,5%) no diagnóstico das lesões de todo o plexo braquial (p < 0,05).

Structural Polymorphism in Tau Filaments: An Implication for Neurodegenerative Diseases

Tau filaments are the pathological hallmark of >20 neurodegenerative diseases including Alzheimer's disease, Pick's disease, and progressive supranuclear palsy. In the adult human brain, six isoforms of tau are expressed that differ by presence or absence of the second of the four semiconserved repeats. As a consequence, half of the tau isoforms have three repeats (3R tau), whereas the other half has four repeats (4R tau). Site-directed spin labeling of recombinant tau in conjunction with electron paramagnetic resonance spectroscopy was used to obtain structural insights into tau filaments. The studies showed that the filaments of 4R tau and 3R tau share a highly ordered core structure in the third repeat with parallel, in-register arrangement of beta-strands. This structure in 3R and 4R is conserved regardless of whether full-length isoforms (htau40 and htau23) or truncated constructs (K18 and K19) are used. When mixed, 3R tau and 4R tau coassembled into heterogeneous filaments. Hence, these findings indicate that there are at least three compositionally distinct types of filaments: homogeneous 3R tau, homogeneous 4R tau, and heterogeneous 3R/4R tau. In vitro experiments show that the seeded filament growth, a prerequisite for tau spreading in tissue culture and brain, is crucially dependent on the isoform composition of individual seeds. Seeds of 3R tau and 3R/4R tau recruit both types of isoforms whereas seeds of 4R tau can recruit 4R tau, but not 3R tau, establishing an asymmetric barrier. Conformational templating of 4R tau onto 3R tau seeds eliminates this barrier, giving rise to a new type of tau filament. Conformational studies at the molecular level of tau filaments were done using Double electron-electron resonance spectroscopy, which allows the determination of distances between pairs of spin labels. These studies revealed structural differences between filaments of 3R tau and 4R tau. Furthermore, they indicated that 4R tau assumed the conformation of 3R tau when templated on 3R tau seeds. Our measurements have also provided insights into the heterogeneity of tau filament structure. Conformational differences due to variation in filament composition and seeding properties of tau filaments have shown that they are structurally polymorphic in nature. This structural polymorphism of tau filaments has widespread implications in understanding and treatment of neurodegenerative diseases.

Rotenone induces degeneration of photoreceptors and impairs the dopaminergic system in the rat retina

Rotenone is a widely used pesticide and a potent inhibitor of mitochondrial complex I (NADH-quinone reductase) that elicits the degeneration of dopaminergic neurons and thereby the appearance of a parkinsonian syndrome. Here we have addressed the alterations induced by rotenone at the functional, morphological and molecular levels in the retina, including those involving both dopaminergic and non-dopaminergic retinal neurons. Rotenone-treated rats showed abnormalities in equilibrium, postural instability and involuntary movements. In their outer retina we observed a loss of photoreceptors, and a reduced synaptic connectivity between those remaining and their postsynaptic neurons. A dramatic loss of mitochondria was observed in the inner segments, as well as in the axon terminals of photoreceptors. In the inner retina we observed a decrease in the expression of dopaminergic cell molecular markers, including loss of tyrosine hydroxylase immunoreactivity, associated with a reduction of the dopaminergic plexus and cell bodies. An increase in immunoreactivity of AII amacrine cells for parvalbumin, a Ca2+-scavenging protein, was also detected. These abnormalities were accompanied by a decrease in the amplitude of scotopic and photopic a- and b-waves and an increase in the b-wave implicit time, as well as by a lower amplitude and greater latency in oscillatory potentials. These results indicate that rotenone induces loss of vision by promoting photoreceptor cell death and impairment of the dopaminergic retinal system.

Phosphorylated α-synuclein-immunoreactive retinal neuronal elements in Parkinson's disease subjects

Visual symptoms are relatively common in Parkinson's disease (PD) and optical coherence tomography has indicated possible retinal thinning. Accumulation of aggregated α-synuclein is thought to be a central pathogenic event in the PD brain but there have not as yet been reports of retinal synucleinopathy. Retinal wholemounts were prepared from subjects with a primary clinicopathological diagnosis of PD (N = 9), dementia with Lewy bodies (DLB; N = 3), Alzheimer's disease (N = 3), progressive supranuclear palsy (N = 2) as well as elderly normal control subjects (N = 4). These were immunohistochemically stained with an antibody against α-synuclein phosphorylated at serine 129, which is a specific molecular marker of synucleinopathy. Phosphorylated α-synuclein-immunoreactive (p-syn IR) nerve fibers were present in 7/9 PD subjects and in 1/3 DLB subjects; these were sparsely distributed and superficially located near or at the inner retinal surface. The fibers were either long and straight or branching, often with multiple en-passant varicosities along their length. The straight fibers most often had an orientation that was radial with respect to the optic disk. Together, these features are suggestive of either retinopetal/centrifugal fibers or of ganglion cell axons. In one PD subject there were sparse p-syn IR neuronal cell bodies with dendritic morphology suggestive of G19 retinal ganglion cells or intrinsically photosensitive ganglion cells. There were no stained nerve fibers or other specific staining in any of the non-PD or non-DLB subjects. It is possible that at least some of the observed visual function impairments in PD subjects might be due to α-synucleinopathy.

Long time remodeling during retinal degeneration evaluated by optical coherence tomography, immunocytochemistry and fundus autofluorescence

Purpose: To characterize the relationship between fundus autofluorescence (FAF), Optical Coherence Tomography (OCT) and immunohistochemistry (IHC) over the course of chronic retinal degeneration in the P23H rat. Methods: Homozygous albino P23H rats, Sprague–Dawley (SD) rats as controls and pigmented Long Evans (LE) rats were used. A Spectralis HRA OCT system was used for scanning laser ophthalmoscopy (SLO) imaging OCT and angiography. To determine FAF, fluorescence was excited using diode laser at 488 nm. A fast retina map OCT was performed using the optic nerve as a landmark. IHC was performed to correlate with the findings of OCT and FAF changes. Results: During the course of retinal degeneration, the FAF pattern evolved from some spotting at 2 months old to a mosaic of hyperfluorescent dots in rats 6 months and older. Retinal thicknesses progressively diminished over the course of the disease. At later stages of degeneration, OCT documented changes in the retinal layers, however, IHC better identified the cell loss and remodeling changes. Angiography revealed attenuation of the retinal vascular plexus with time. Conclusion: We provide for the first time a detailed long-term analysis of the course of retinal degeneration in P23H rats using a combination of SLO and OCT imaging, angiography, FAF and IHC. Although, the application of noninvasive methods enables longitudinal studies and will decrease the number of animals needed for a study, IHC is still an essential tool to identify retinal changes at the cellular level.

Diary of Elias Mann, 1796-1800

Elias Mann kept this diary during his undergraduate years at Harvard College. The diary begins August 17, 1796 and ends in August of 1800 and also includes several undated sheets filled with excerpts of poems. The daily entries describe many aspects of Mann's life, including not only his experiences at Harvard but also his involvement in the larger community. Entries related to life at Harvard describe club meetings (coffee club, Hasty Pudding Club and Phi Beta Kappa); trips to the theater; dinners at taverns; games and recreation, including a card game called "Loo," cribbage, backgammon, bowling, playing ball, fishing, skating and going for sleigh rides; gathering, and sometimes taking from others' gardens, food (most often plums, peaches, nuts and apples); what he ate (including one breakfast of three raw eggs and two glasses of wine); what he read (including Tristram Shandy and one of "Mrs. Ratcliffe's novels"); his friends, often mentioned by name; and academic work and formalities. In one entry he mentions the theft of several possessions from his room, and there are several entries about trips to Fresh Pond.

Odell, Richard, 2 autographed letters signed to John Winthrop; Southampton, Long Island, 1652 November 16-1653

Correspondence concerning an illness, which Odell believed was palsy or the King's evil (scrofula), that afflicted his five-year-old daughter. Odell writes that her symptoms included loss of speech and feeling in her right side, and a throat blockage, and he requests advice from Winthrop on the course of treatment the family should pursue. Odell writes again in 1653 thanking Winthrop for the ointment and electuary he had prescribed for the child. Her symptoms had persisted, however, and he requested further advice. Odell adds several lines regarding rumors of an insurrection of a Native American tribe, inquiring if Winthrop has any information regarding "how matters stand & between the Dutch & the English."

Student notes from medical lectures by Benjamin Rush, undated

The volumes contain student notes on a course of medical lectures given by Dr. Benjamin Rush (1746-1813) while he was Professor of the Institutes of Medicine and Clinical Practice at the University of Pennsylvania Medical School, likely in circa 1800-1813. The notes indicate Rush often referenced the works or teachings of contemporaries such as Scottish physicians William Cullen, John Brown, John Gregory, and Robert Whytt, and Dutch physician Herman Boerhaave. He frequently included anecdotes and case histories of his own patients, as well as those of other doctors, to illustrate his lecture topics. He also advised students to take notes on the lectures after they ended to allow them to focus on what they were hearing. Volume 1 includes notes on: physician conduct during visits to patients; human and animal physiology; voice and speech; the nervous system; the five senses; and faculties of the mind. Volume 2 includes notes on: food, the sources of appetite and thirst, and digestion; the lymphatic system; secretions; excretions; theories of nutrition; differences in the minds and bodies of women and men; reproduction; pathology; a table outlining the stages of disease production; “disease and the origin of moral and natural evil”; contagions; the role of food, drink, and clothing in producing disease; worms; hereditary diseases; predisposition to diseases; proximate causes of diseases; and pulmonary conditions. Volume 3 includes notes on: the pulse; therapeutics, such as emetics, sedatives, and digitalis, and treatment of various illnesses like pulmonary consumption, kidney disease, palsy, and rheumatism; diagnosis and prognosis of fever; treatment of intermitting fever; and epidemics including plague, smallpox, and yellow fever, with an emphasis on the yellow fever outbreaks in Philadelphia in 1793 and 1797.

Kernicterus e icterícia neonatal : revisão teórica a propósito de um caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Síndrome de Melkersson-Rosenthal : um diagnóstico a ponderar numa doente com edema do lábio

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

L'oxygénothérapie hyperbare dans le traitement de la paralysie cérébrale : arnaque ou traitement approprié?

L'oxygénothérapie hyperbare (OTH) consiste à soumettre un patient à des taux de pression plus élevés que la pression atmosphérique normale et de lui faire respirer 100 % d'oxygène. Cette approche a été mise à l'essai pour le traitement de nombreuses conditions médicales avec succès dans certains cas alors pour d'autres sa validité reste encore à démontrer. Dans le cas de la paralysie cérébrale son utilisation a soulevé de nombreuses controverses et les études conduites jusqu'alors n'ont pas encore convaincu tous les membres de la communauté scientifique et ce, malgré certains effets positifs mis en évidence. Une récente étude qui a montré des améliorations notables chez des enfants atteints de paralysie cérébrale (PC) traités avec de l'air légèrement pressurisé, de même que chez ceux traités avec un protocole standard pour l'oxygénothérapie hyperbare (l'OTH), est invoquée pour nier l'efficacité de l'OTH. Des considérations politiques et économiques, plutôt que purement scientifiques, jouent un rôle important dans cette controverse. Des recherches systématiques supplémentaires sont requises, mais entre-temps, comme les effets thérapeutiques de cette approche semblent plus importants que ceux des thérapies actuellement acceptées dans le traitement de la paralysie cérébrale, les enfants atteints de cette condition ne devraient pas se faire refuser l'accès à l'OTH.

Quantitative silicoflagellate data from the southern Indic Ocean from ODP Holes 188-1165B, 120-748B and 120-751A

In the modern marine environment the silicoflagellate genus Dictyocha is rare, or absent, south of the Antarctic polar front (APF); the genus Distephanus, in contrast, is dominant. In sediments recovered from ODP Site 1165, 1600 km south of the front, however, three intervals where Dictyocha is abundant are interpreted to represent Pliocene warm events. Comparison of our data with Ciesielski and Weaver's [1974] modern core top silicoflagellate relationship with sea surface temperature (SST) indicates that at Site 1165 mean annual SST was approximately 5°C at 3.7 Ma (event I), and approximately 4°C at 4.3-4.4 Ma (event II) and 4.55-4.8 Ma (event III). Event I represents a 5.5°C warming, and events II and III represents a 4.5°C warming relative to modern mean annual SST. Dictyocha is absent from other Site 1165 Pliocene intervals, which suggests that cooler SST (<2°C) prevailed. The warm events detected at Site 1165 may represent times when North Atlantic Deep Water production and ocean heat transport into the Southern Ocean exerted maximum influence.

The chirurgical works of Percivall Pott, with his last corrections. : to which are added, a short account of the life of the author, a method of curing the hydrocele by injection, and occasional notes and observations /

Published in London in 1771 and 1808.