Hiperautofluorescencia foveal como factor predictor de recuperación visual en pacientes con desprendimiento regmatógeno de retina

Introducción: una de las causas de pobre ganancia visual luego de un tratamiento exitoso de desprendimiento de retina, sin complicaciones, es el daño de los fotoreceptores, reflejada en una disrupción de la capa de la zona elipsoide y membrana limitante externa (MLE). En otras patologías se ha demostrado que la hiperautofluorescencia foveal se correlaciona con la integridad de la zona elipsoide y MLE y una mejor recuperación visual. Objetivos: evaluar la asociación entre la hiperautofluorescencia foveal, la integridad de la capa de la zona elipsoide y recuperación visual luego de desprendimiento de retina regmatógeno (DRR) exitosamente tratado. Evaluar la concordancia inter-evaluador de estos exámenes. Metodología: estudio de corte transversal de autofluorescencia foveal y tomografía óptica coherente macular de dominio espectral en 65 pacientes con DRR evaluados por 3 evaluadores independientes. La concordancia inter-evaluador se estudio mediante Kappa de Cohen y la asociación entre las diferentes variables mediante la prueba chi cuadrado y pruebas Z para comparación de proporciones. Resultados: La concordancia de la autofluorescencia fue razonable y la de la tomografía óptica coherente macular buena a muy buena. Sujetos que presentaron hiperautofluorescencia foveal asociada a integridad de la capa de la zona elipsoide tuvieron 20% más de posibilidad de recuperar agudeza visual final mejor a 20/50 que los que no cumplieron éstas características. Conclusión: Existe una asociación clínicamente importante entre la hiperautofluorescencia foveal, la integridad de la capa de zona elipsoide y la mejor agudeza visual final, sin embargo ésta no fue estadísticamente significativa (p=0.39)

Asociación entre degeneración macular relacionada con la edad y la hipertensión arterial Bogotá 2014

Estudio Casos y Controles 1:1 que busca la relación entre la DMRE e HTA. Se estudian otras variables. Muestra de 400 pacientes, edad promedio 66,9 años +/-9,2 años. HTA y DM OR 2,315 y OR 4,626. Oclusión vascular OR 13,549 (IC 95% 3,023-60,724).

Glucocorticoids in Vivo Induce Both Insulin Hypersecretion and Enhanced Glucose Sensitivity of Stimulus-Secretion Coupling in Isolated Rat Islets

Although glucocorticoids are widely used as antiinflammatory agents in clinical therapies, they may cause serious side effects that include insulin resistance and hyperinsulinemia. To study the potential functional adaptations of the islet of Langerhans to in vivo glucocorticoid treatment, adult Wistar rats received dexamethasone (DEX) for 5 consecutive days, whereas controls (CTL) received only saline. The analysis of insulin release in freshly isolated islets showed an enhanced secretion in response to glucose in DEX-treated rats. The study of Ca(2+) signals by fluorescence microscopy also demonstrated a higher response to glucose in islets from DEX-treated animals. However, no differences in Ca(2+) signals were found between both groups with tolbutamide or KCl, indicating that the alterations were probably related to metabolism. Thus, mitochondrial function was explored by monitoring oxidation of nicotinamide dinucleotide phosphate autofluorescence and mitochondrial membrane potential. Both parameters revealed a higher response to glucose in islets from DEX-treated rats. The mRNA and protein content of glucose transporter-2, glucokinase, and pyruvate kinase was similar in both groups, indicating that changes in these proteins were probably not involved in the increased mitochondrial function. Additionally, we explored the status of Ca(2+)-dependent signaling kinases. Unlike calmodulin kinase II, we found an augmented phosphorylation level of protein kinase C alpha as well as an increased response of the phospholipase C/inositol 1,4,5-triphosphate pathway in DEX-treated rats. Finally, an increased number of docked secretory granules were observed in the beta-cells of DEX animals using transmission electron microscopy. Thus, these results demonstrate that islets from glucocorticoid-treated rats develop several adaptations that lead to an enhanced stimulus-secretion coupling and secretory capacity. (Endocrinology 151: 85-95, 2010)

Study of Blood Porphyrin Spectral Profile for Diagnosis of Chronic Renal Failure

The progression to end-stage renal failure is independent of the initial pathogenic mechanism. Metabolic acidosis is a common consequence of chronic renal failure that results from inadequate ammonium excretion and decreased tubular bicarbonate reabsorption. Protoporphyrin IX (PpIX) is the immediate metabolic precursor of the heme molecule. The purpose of this study was to evaluate the levels of erythrocytes protoporphyrin IX at an animal model during progressive renal disease. A total of 36 eight-week-old male Wistar rats were divided into six groups: Normal, 4 and 8 weeks after 5/6 nephrectomy (NX). Renal function was evaluated by creatinine clearance and plasma creatinine levels. The autofluorescence of erythrocytes porphyrin of healthy and NX rats was analyzed using fluorescence spectroscopy. Emission spectra were obtained by exciting the samples at 405 nm. Significant differences between normal and NX rats autofluorescence shape occurred in the 600-700 nm spectral region. A correlation was observed between emission band intensity at 635 nm and progression of renal disease.

Noninvasive Evaluation of Oral Lesions Using Depth-sensitive Optical Spectroscopy

BACKGROUND: Optical spectroscopy is a noninvasive technique with potential applications for diagnosis of oral dysplasia and early cancer. In this study, we evaluated the diagnostic performance of a depth-sensitive optical spectroscopy (DSOS) system for distinguishing dysplasia and carcinoma from non-neoplastic oral mucosa. METHODS: Patients with oral lesions and volunteers without any oral abnormalities were recruited to participate. Autofluorescence and diffuse reflectance spectra of selected oral sites were measured using the DSOS system. A total of 424 oral sites in 124 subjects were measured and analyzed, including 154 sites in 60 patients with oral lesions and 270 sites in 64 normal volunteers. Measured optical spectra were used to develop computer-based algorithms to identify the presence of dysplasia or cancer. Sensitivity and specificity were calculated using a gold standard of histopathology for patient sites and clinical impression for normal volunteer sites. RESULTS: Differences in oral spectra were observed in: (1) neoplastic versus nonneoplastic sites, (2) keratinized versus nonkeratinized tissue, and (3) shallow versus deep depths within oral tissue. Algorithms based on spectra from 310 nonkeratinized anatomic sites (buccal, tongue, floor of mouth, and lip) yielded an area under the receiver operating characteristic curve of 0.96 in the training set and 0.93 in the validation set. CONCLUSIONS: The ability to selectively target epithelial and shallow stromal depth regions appeared to be diagnostically useful. For nonkeratinized oral sites, the sensitivity and specificity of this objective diagnostic technique were comparable to that of clinical diagnosis by expert observers. Thus, DSOS has potential to augment oral cancer screening efforts in community settings. Cancer 2009;115:1669-79. (C) 2009 American Cancer Society.

The applicability of hematoxylin-eosin staining plus fluorescence or confocal laser scanning microscopy to the study of elastic fibers in cartilages

This study focuses on the use of hemotoxylin-eosin staining plus fluorescence microscopy for the investigation of elastic fibers in some elastic cartilages. We have observed that elastic fibers are consistently imaged by the proposed procedure and the resolution attained is similar to that obtained with the classical Weigert's fuchsin-resorcin. The results also demonstrate that elastin autofluorescence gives little or no contribution to the final fluorescence and that the use of the confocal laser scanning microscope adds to the resolution, permits the use of thicker sections and reveals of minute structural features. We conclude that this is a relevant tool in elastin research.

Fluorescence and confocal laser scanning microscopy imaging of elastic fibers in hematoxylin-eosin stained sections

We have studied the possibility of associating fluorescence microscopy and hematoxylin-eosin staining for the identification of elastic fibers in elastin-rich tissues. Elastic fibers and elastic laminae were consistently identified by the proposed procedure, which revealed itself to be easy and useful for the determination of such structures and their distribution. The fluorescence properties of stained elastic fibers are due to eosin staining as revealed by fluorescence analysis of the dye in solution, with no or only minor contribution by the elastin autofluorescence. The main advantage of this technique resides in the possibility of studying the distribution of elastic fibers in file material without further sectioning and staining. The use of the confocal laser scanning microscope greatly improved the resolution and selectivity of imaging elastic fibers in different tissues. The determination of the three-dimensional distribution and structure of elastic fiber and laminae using the confocal laser scanning microscope was evaluated and also produced excellent results.

Glucocorticoids in vivo induce both insulin hypersecretion and enhanced glucose sensitivity of stimulus-secretion coupling in isolated rat islets

Although glucocorticoids are widely used as antiinflammatory agents in clinical therapies, they may cause serious side effects that include insulin resistance and hyperinsulinemia. To study the potential functional adaptations of the islet of Langerhans to in vivo glucocorticoid treatment, adult Wistar rats received dexamethasone (DEX) for 5 consecutive days, whereas controls (CTL) received only saline. The analysis of insulin release in freshly isolated islets showed an enhanced secretion in response to glucose in DEX-treated rats. The study of Ca2 2+ signals by fluorescence microscopy also demonstrated a higher response to glucose in islets from DEX-treated animals. However, no differences in Ca2 2+signals were found between both groups with tolbutamide or KCl, indicating that the alterations were probably related to metabolism. Thus, mitochondrial function was explored by monitoring oxidation of nicotinamide dinucleotide phosphate autofluorescence and mitochondrial membrane potential. Both parameters revealed a higher response to glucose in islets from DEX-treated rats. The mRNA and protein content of glucose transporter-2, glucokinase, and pyruvate kinase was similar in both groups, indicating that changes in these proteins were probably not involved in the increased mitochondrial function. Additionally,weexplored the status of Ca2 2+-dependent signaling kinases. Unlike calmodulin kinase II, we found an augmented phosphorylation level of protein kinase Cα as well as an increased response of the phospholipase C/inositol 1,4,5-triphosphate pathway in DEX-treated rats. Finally, an increased number of docked secretory granules were observed in the β-cells of DEX animals using transmission electron microscopy. Thus, these results demonstrate that islets from glucocorticoid-treated rats develop several adaptations that lead to an enhanced stimulus-secretion coupling and secretory capacity. Copyright © 2010 by The Endocrine Society.

O tratamento com ácido ascórbico acelera o processo de reparo do tendão calcâneo em modelo de lesão tendínea em ratos

A ruptura do tendão calcâneo acomete uma grande parte da população, principalmente atletas e idosos e seu processo de reparo ainda necessita de maiores esclarecimentos, possibilitando novos tratamentos. O ácido ascórbico (AA) é uma substância conhecida pela participação na hidroxilação de prolina e lisina, importante para síntese da matriz extracelular, bem como eficiência comprovada em diversos tratamentos por suas propriedades antioxidantes. Dessa forma, o presente estudo tem como objetivo avaliar o efeito do tratamento local com AA nos parâmetros de reparo tecidual e funcional no tendão calcâneo de ratos. O trabalho foi aprovado pelo comitê de ética da instituição (CEPAE-UFPA) sob o parecer 161-13. Os animais foram submetidos à ruptura do tendão calcâneo, em três grupos (n=18): Controle; Injúria+AA (30mM); Injúria+veículo (NaCl 0,9%). Todos os tratamentos foram realizados por injeção local, a partir do segundo dia pós-lesão e a cada dois dias até o 14º dia ou 21º dia. Foi avaliado a marcha dos animais pelo Índice funcional de Aquiles (IFA) nos dias 7(n=6), 14(n=6) e 21(n=3) dias pós-lesão, o número de células por marcação com DAPI no 14º(n=9) e 21º(n=9) dia pós –lesão e a estrutura do tecido por marcação com HE, nos mesmos dias. Os animais não diferiram no ganho de massa corporal. O grupo Injúria+AA(-39.51±15.3) apresentou melhora funcional principalmente no 14º dia, se comparado ao grupo Injúria+veículo(-89.22±16.57, p<0,01). A análise histológica demonstrou sob contagem do número de células, que o grupo Injúria+AA(762±29.6) apresentou um menor número de células no 21º dia em relação ao grupo Injúria+veículo(916±57.0, p<0,01). A análise da autofluorescência do colágeno e HE demostrou que o grupo tratado com AA apresentou uma estrutura tecidual mais conservada em 14 e 21 dias pós-lesão em relação ao grupo veículo que, por sua vez, difere bastante do grupo controle. Nossos resultados sugerem que o ácido ascórbico acelera o processo de reparo da lesão tendínea, apresentando melhoras teciduais e funcionais 21 dias após a lesão.

Indocyanine green angiography findings in patients with long-standing Vogt-Koyanagi-Harada disease: a cross-sectional study

Background: To investigate indocyanine green angiography (ICGA) findings in patients with long-standing Vogt-Koyanagi-Harada (VKH) disease and their correlation with disease activity on clinical examination as well as with systemic corticosteroid therapy. Methods: Twenty-eight patients (51 eyes) with long-standing (>= 6 months from disease onset) VKH disease whose treatment was tapered based only in clinical features were prospectively included at a single center in Brazil. All patients underwent standardized clinical evaluation, which included fundus photography, fluorescein angiography and ICGA. Clinical disease activity was determined based in the Standardization in Uveitis Nomenclature Working Group. Fisher exact test and logistic regression models were used for statistical analysis. Results: Disease-related choroidal inflammation on ICGA was observed in 72.5% (31 of 51 eyes). Angiographic findings suggestive of (choroidal and/or retinal) disease activity were not observed on FA. Clinically active disease based on clinical evaluation was observed in 41.2% (21 of 51 eyes). In these 21 eyes, disease-related choroidal inflammation on ICGA was observed in 76.2% (16 of 21 eyes); in the remaining eyes (without clinical active disease) disease-related choroidal inflammation on ICGA was observed in 70.0% (21 of 30 eyes). In respect to systemic corticosteroid therapy, 10 patients (18 of 51 eyes) were under treatment with prednisone. In these 10 (18 of 51 eyes) patients, disease-related choroidal inflammation on ICGA was observed in 83.3% (15 of 18 eyes); in the remaining patients (33 of 51 eyes) disease-related choroidal inflammation on ICGA was observed in 66.7% (22 of 33 eyes). Conclusion: ICGA findings suggestive of disease-related choroidal inflammation were observed in a considerable proportion of patients with long-standing VKH disease, independent of the inflammatory status of the disease on clinical examination or current use of systemic corticosteroid. Therefore, the current study reinforces the crucial role of ICGA to assist the management and treatment of patients with long-standing VKH disease.

Fluorescence spectroscopy as a tool to detect and evaluate glucocorticoid-induced skin atrophy

Topical glucocorticoid (GC) therapy has been successfully used in the treatment of several common cutaneous diseases in clinical practice for a long time, and skin atrophy is one of the most typical cutaneous side effects of this therapy. The aim of this study was to evaluate the potential of noninvasive fluorescence spectroscopy (FS) technique in the detection and classification of GC-induced skin atrophy. A total of 20 male Wistar rats were used in the experimental protocol under controlled environmental conditions and with free access to food. One group received topical application of clobetasol propionate 0.05% for 14 days to induce cutaneous atrophy (atrophic group) and the other (control) group received only vehicle application following the same protocol and schedule. Histological analyses and FS measurements with laser excitation at both 532 nm and 408 nm were obtained on days 1 and 15. The FS results were classified as "normal" or "atrophic" according by histological analysis. Fluorescence spectra obtained with excitation at 408 nm allowed a clear distinction between the control and atrophic groups, and were more informative than the those obtained at 532 nm. Our results reveal that, if correctly applied, FS allows noninvasive evaluation of corticosteroid-induced skin atrophy, and thus represents an important step towards better monitoring of undesirable side effects of cutaneous therapy.

Microscopic and spectroscopic analysis of biogenic aerosols

Aerosol particles are important actors in the Earth’s atmosphere and climate system. They scatter and absorb sunlight, serve as nuclei for water droplets and ice crystals in clouds and precipitation, and are a subject of concern for public health. Atmospheric aerosols originate from both natural and anthropogenic sources, and emissions resulting from human activities have the potential to influence the hydrological cycle and climate. An assessment of the extent and impacts of this human force requires a sound understanding of the natural aerosol background. This dissertation addresses the composition, properties, and atmospheric cycling of biogenic aerosol particles, which represent a major fraction of the natural aerosol burden. The main focal points are: (i) Studies of the autofluo-rescence of primary biological aerosol particles (PBAP) and its application in ambient measure-ments, and (ii) X-ray microscopic and spectroscopic investigations of biogenic secondary organic aerosols (SOA) from the Amazonian rainforest.rnAutofluorescence of biological material has received increasing attention in atmospheric science because it allows real-time monitoring of PBAP in ambient air, however it is associated with high uncertainty. This work aims at reducing the uncertainty through a comprehensive characterization of the autofluorescence properties of relevant biological materials. Fluorescence spectroscopy and microscopy were applied to analyze the fluorescence signatures of pure biological fluorophores, potential non-biological interferences, and various types of reference PBAP. Characteristic features and fingerprint patterns were found and provide support for the operation, interpretation, and further development of PBAP autofluorescence measurements. Online fluorescence detection and offline fluorescence microscopy were jointly applied in a comprehensive bioaerosol field measurement campaign that provided unprecedented insights into PBAP-linked biosphere-atmosphere interactions in a North-American semi-arid forest environment. Rain showers were found to trigger massive bursts of PBAP, including high concentrations of biological ice nucleators that may promote further precipitation and can be regarded as part of a bioprecipitation feedback cycle in the climate system. rnIn the pristine tropical rainforest air of the Amazon, most cloud and fog droplets form on bio-genic SOA particles, but the composition, morphology, mixing state and origin of these particles is hardly known. X-ray microscopy and spectroscopy (STXM-NEXAFS) revealed distinctly different types of secondary organic matter (carboxyl- vs. hydroxy-rich) with internal structures that indicate a strong influence of phase segregation, cloud and fog processing on SOA formation, and aging. In addition, nanometer-sized potassium-rich particles emitted by microorganisms and vegetation were found to act as seeds for the condensation of SOA. Thus, the influence of forest biota on the atmospheric abundance of cloud condensation nuclei appears to be more direct than previously assumed. Overall, the results of this dissertation suggest that biogenic aerosols, clouds and precipitation are indeed tightly coupled through a bioprecipitation cycle, and that advanced microscopic and spectroscopic techniques can provide detailed insights into these mechanisms.rn

Etablierung transgener BY-2-Zelllinien zur In-vivo-Lokalisierung pflanzlicher Cytoskelettproteine

Bei den Pflanzen sind viele Fragen bezüglich der Organisation und Regulation des bei der Zellteilung und differenzierung wichtigen Auf-, Ab- und Umbaus des Mikrotubuli-Netzwerkes noch immer offen, insbesondere was die Rolle des γ-Tubulins betrifft. Ziel der vorliegenden Arbeit war die Etablierung von BY-2 Modell-Zelllinien (Nicotiana), die verschiedene mit fluoreszierenden Proteinen (FP) markierte Elemente des Cytoskeletts exprimieren, um eine fluoreszenzmikroskopische Detektion in vivo zu ermöglichen.rnAls Grundlage für alle weiteren Versuche wurde eine zuverlässige Methode zur A. tumefaciens vermittelten stabilen Transfektion von BY-2 Zellen erarbeitet. Für die Expression von FP-markierten Cytoskelettproteinen, wurden entsprechende Fusionskonstrukte kloniert und via A. tumefaciens in BY-2 Zellen transferiert. So gelang zunächst die Herstellung transgener Zelllinien, die GFP-markiertes α- bzw. γ-Tubulin exprimierten. Diese sollten später als Basis für die Untersuchung des dynamischen Mikrotubuli-Netzwerkes bzw. dessen Regulation dienen. In beiden Zelllinien standen die Konstrukte zunächst unter Kontrolle eines doppelten 35S-Promotors, was zu einer starken, konstitutiven Expression der Transgene führte. Fluoreszenzmikroskopisch konnten Strukturen, an deren Aufbau Mikrotubuli beteiligt sind, detektiert werden. Aufgrund einer starken Hintergrundfluoreszenz, vermutlich bedingt durch die konstitutive Überexpression, war die Darstellung feinerer Bereiche, wie sie im Cytoskelett häufig auftreten, jedoch äußerst schwierig. Deshalb wurde eine schwächere bzw. adäquate Expressionsrate angestrebt. rnPhysiologische Expressionsraten sollten vor allem durch den endogenen γ-Tubulin-Promotor ermöglicht werden. Da die entsprechende Sequenz noch unbekannt war, wurde sie zunächst bestimmt und in ein passendes Konstrukt integriert. Fluoreszenzmikroskopische Untersuchungen der resultierenden Zelllinie ließen auf eine stark reduzierte Expressionsrate schließen. Tatsächlich war die Detektion von Cytoskelettstrukturen, wenn überhaupt, erst bei deutlich längeren Belichtungszeiten möglich. Bedingt durch die langen Belichtungszeiten wurde die Dokumentation durch eine latente pflanzentypische Autofluoreszenz der Zellen erschwert. Auch wenn hier keine detailreicheren Aufnahmen der Cytoskelettstrukturen möglich waren, ist die Zellkultur für weiterführende Untersuchungen, z.B. in Studien bezüglich des zeitlichen Expressionsmusters des γ-Tubulins, potentiell geeignet. Der Einsatz eines sensibleren Mikroskopsystems ist allerdings erforderlich. rnUm klären zu können, inwieweit γ-Tubulin mit den Mikrotubuli co-lokalisiert, wurden Zelllinien benötigt, bei denen die entsprechenden Elemente unterschiedlich markiert waren. Zu diesem Zweck wurde der Einsatz von RFP-markiertem Tubulin getestet. Eine deutliche Überexpression von RFP alleine war möglich. Trotz mehrfacher Wiederholung der Versuche war aber keine Expression von RFP-markiertem α-Tubulin in BY-2 Zellen zur Visualisierung der Mikrotubuli detektierbar. Die DNA-Sequenzen waren im Genom nachweisbar, eine Transkription jedoch nicht. Möglicherweise spielten hier gene silencing Effekte eine Rolle. Das verwendete RFP (TagRFP) und GFP stammten aus unterschiedlichen Organismen, aus einer Seeanemone bzw. einer Qualle. Eine Lösung könnte der Austausch des TagRFP durch ein Quallen-Derivat, das in einer von grün unterscheidbaren Farbe fluoresziert, bringen. Da bereits BY-2 Zelllinien vorliegen, die GFP-markiertes α- bzw. γ-Tubulin exprimieren, sollte es, nach Klonieren eines entsprechenden Konstruktes, zeitnah möglich sein, eine doppelt transfizierte Zelllinie herzustellen.

Selective retina therapy (SRT) in patients with geographic atrophy due to age-related macular degeneration

For geographic atrophy (GA) due to age-related macular degeneration (AMD) there is so far no approved treatment option. Usually, increased autofluorescence (AF) levels of different patterns adjacent to the atrophic area indicate lipofuscin-laden retinal pigment epithelium (RPE) cells at a high risk for apoptosis. Herein, SRT was used to selectively treat these cells to stimulate RPE proliferation, in order to reduce or ideally stop further growth of the atrophic area.

Simple and objective method for routine detection of the macular pigment xanthophyll

A new simple method for two-dimensional determination of optical density of macular pigment xanthophyll (ODx) in clinical routine is based on a single blue-reflection fundus image. Individual different vignetting is corrected by a shading function. For its construction, nodes are automatically found in structureless image regions. The influence of stray light in elderly crystalline lenses is compensated by a correction function that depends on age. The reproducibility of parameters in a one-wavelength reflection method determined for three subjects (47, 61, and 78 years old) was: maxODx = 6.3%, meanODx = 4.6%, volume = 6%, and area = 6% already before stray-light correction. ODx was comparable in pseudophakic and in an eye with a crystalline lens of the same 11 subjects after stray-light correction. Significant correlation in ODx was found between the one-wavelength reflection method and the two-wavelength autofluorescence method for pseudophakic and cataract eyes of 19 patients suffering from dry age-related macular degeneration (AMD) (R(2) = 0.855). In pseudophakic eyes, maxODx was significantly lower for dry AMD (n = 45) (ODx = 0.491±0.102 ODU) than in eyes with healthy fundus (n = 22) (ODx = 0.615±0.103 ODU) (p = 0.000033). Also in eyes with crystalline lens, maxODx was lower in AMD (n = 125) (ODx = 0.610±0.093 ODU) than in healthy subjects (n = 45) (ODx = 0.674±0.098 ODU) (p = 0.00019). No dependence on age was found in the pseudophakic eyes both of healthy subjects and AMD patients.