Variantes histológicas da glomeruloesclerose segmentar e focal primária: casuística e evolução clínica

INTRODUÇÃO: O significado clínico das variantes histológicas da glomeruloesclerose segmentar e focal primária (GESF) ainda é pouco claro. Com o objetivo de determinar a frequência das variantes da GESF e sua evolução clínica em uma população hispânica, analisamos nossos casos desta glomerulopatia. MÉTODOS: Neste estudo retrospectivo, biópsias renais com diagnóstico de GESF (de 1998 a 2009) foram analisadas e classificadas acordo com os critérios da classificação de Columbia. Os dados clínico-evolutivos foram analisados e comparados entre as variantes. RESULTADOS: Do total de 291 casos, 224 (77,0%) corresponderam a variante sem especificação (NOS), 40 casos (13,7%) a forma com lesão no polo urinário (TIP), 14 casos (4,8%) a lesão perihiliar (PH), 10 casos (3,4%) ao tipo colapsante (COLL) e três casos (1,0%) a variante celular (CEL). A idade média de apresentação foi de 26 anos (intervalo de 1 a 79), sendo 74 pacientes (25,4%) com idade inferior a 15 anos. Hipertensão arterial e disfunção renal foram os achados mais frequentes nos casos de PH e COLL. A variante PH apresentou-se, frequentemente, com proteinúria não nefrótica. Notou-se menos lesões histológicas de cronicidade em casos TIP. Houve remissão clínica em 57% dos pacientes com TIP, 23,5% dos pacientes com NOS, 22,2% dos pacientes com COLL e em nenhum paciente com PH (p < 0,01). Doença renal crônica (DRC) foi menos frequente no grupo TIP comparativamente as outras variantes (p = 0,03). Não houve diferença estatística na evolução para estágio final da doença renal entre as variantes. CONCLUSÕES: A aparência histológica não parece ser um bom marcador clínico de prognóstico na GESF. A forma COLL é uma doença com muitas diferenças para as outras variantes e pior prognóstico. A variante PH ocorre principalmente de adultos, com evolução frequente para DRC. A lesão do tipo TIP parece ser menos agressiva que as outras variantes, embora sua evolução não seja benigna.

Glomeruloesclerose segmentar e focal (GESF) colapsante associada ao parvovírus B19: relato de caso

Objetivo: Descrever quadro clínico-laboratorial de glomeruloesclerose segmentar e focal (GESF) subtipo colapsante em associação com infecção por parvovírus B19 (PVB19). Relato do caso: Paciente feminino, 37 anos, parda, iniciou quadro de faringoalgia e febre aferida com melhora parcial após penicilina. Com uma semana, observou redução de débito urinário e edema de membros inferiores. Tabagista, com histórico familiar e pessoal negativos para hipertensão, diabetes ou nefropatias. À admissão, apresentava-se com oliguria, hipertensão e edema, associados à anemia microcítica e hipocrômica hipoproliferativa, proteinúria nefrótica, hematúria microscópica e alteração da função renal. A investigação reumatológica e sorologias para hepatites e HIV foram negativas. Ultrassonografia de rins e vias urinárias sem alterações. PCR foi positivo para PVB19 em aspirado de medula óssea e sangue. A biópsia renal conclusiva de GESF subtipo colapsante. Ocorreu remissão espontânea com duas semanas do quadro. Em retorno ambulatorial, o PCR em sangue periférico foi negativo para PVB19, sugerindo associação de GESF colapsante a fase aguda ou reativação da infecção viral. Conclusão : Este relato registra a associação temporal entre GESF colapsante e viremia pelo PVB19, seja por infecção aguda ou reativação de infecção latente. A associação GESF colapsante e PVB19 é descrita na literatura, com demonstração da presença do vírus em tecido renal, porém, a real relação do vírus na patogênese dessa glomerulopatia permanece indefinida.

Hydrologisen tilanteen ja tuulivoimatuotannon muutosten vaikutus vesiarvoihin pohjoismaisilla sähkön spot-markkinoilla

Vesivoimalla on merkittävä rooli pohjoismaisessa sähköntuotantojärjestelmässä. Spot-markkinoille tarjottavan vesivoiman hinta riippuu vaihtoehtoisen tuotannon hinnasta ja odotetusta vesivoimantuottajien käytettävissä olevasta veteen sitoutuneen potentiaalienergian määrästä. Hydrologisella tilanteella tarkoitetaan tässä tämän potentiaalienergian poikkeamaa normaalitasostaan. Viime vuosina tuulivoimatuotanto pohjoismaisella sähkömarkkina-alueella on kasvanut voimakkaasti, ja on tullut aiheelliseksi tarkastella, millaisia vaikutuksia tällä on vesivoimantuottajien toimintaan. Työssä määritellään vesivoimalle vaihtoehtoisen sähköntuotannon tuotantokustannus, joka pitkällä aikavälillä toimii vertailutasona, jonka perusteella vesivoimantuottajat määrittävät markkinoilla tarjontahinnan tuotannolleen. Tarkastellaan, kuinka hydrologisen tilanteen ja vaihtoehtoisen tuotannon tuotantokustannusten muutokset vaikuttavat vesiarvoon, joka on hinta, jolla hintariippuvaista eli säätyvää vesivoimaa tarjotaan spot-markkinoille. Todetaan, että hydrologisen tilanteen vahvistuminen ja vaihtoehtoisen tuotantokustannuksen aleneminen alentavat vesiarvoja. Todetaan lisäksi, että tuulivoima vaikuttaa sähkön hinnanmuodostukseen markkinoilla samankaltaisesti kuin hintariippumaton vesivoimatuotanto. Esitetään aikasarjamalli vesivoimatuotannon hintariippuvuuden mallintamiseksi. Vertaillaan vesivoimatuottajien toimintaa kahdella vesivoimatuotantoa sisältävällä hinta-alueella, joista toisella tuulivoimatuotanto on kasvanut voimakkaammin kuin toisella. Havaitaan, että molemmilla hinta-alueilla hydrologisen tilanteen vahvistuminen on alentanut ja heikkeneminen nostanut vesiarvoja. Lisäksi havaitaan, että alueella, jonka tuulivoimatuotanto on kasvanut enemmän, vesiarvot ovat laskeneet suhteessa alueen, jolla tuulivoimatuotanto on kasvanut vähemmän, vesiarvoihin. Tuulivoiman voidaan todeta syrjäyttäneen markkinoilta tuotantokustannuksiltaan kalliimpaa tuotantoa.

Doença de lesões mínimas e glomeruloesclerose segmentar e focal em adultos: resposta a corticoide e risco de insuficiência renal

Resumo Introdução: O perfil clínico de pacientes brasileiros adultos com síndrome nefrótica por doença de lesões mínimas (LM) e glomeruloesclerose segmentar e focal (GESF) é pouco conhecido. Objetivo: Avaliamos as características clínico-laboratoriais e resposta a tratamento em pacientes adultos com síndrome nefrótica e diagnósticos histológicos de LM ou GESF. Métodos: Fez-se a análise retrospectiva de 50 pacientes adultos com LM e 120 com GESF. Todos os pacientes foram inicialmente tratados com corticosteroide. Os desfechos do estudo foram: resposta a corticosteroide, prevalência de remissão total, progressão para doença renal crônica estágio 5 (DRC5) e necessidade de terapia de substituição renal por DRC5. Resultados: Níveis iniciais de creatinina sérica foram 24% mais elevados entre pacientes com GESF (p = 0,02) e os de proteinúria foram 36% mais altos em LM (p < 0,001). Pacientes com LM foram córtico-sensíveis em 80% dos casos, com remissão total em 74%, e os pacientes com GESF em 58% (p = 0,01), com remissão total em 30% (p = 0,002). A prevalência de insuficiência renal aguda em pacientes com GESF foi de 39% (vs. 12%, p = 0,013) e DRC5 de 10% (vs. 0%, p < 0,001). Remissão completa ou parcial com o uso de corticosteroide reduziu em 83% o risco de DRC5 (p < 0,001) e remissão total associou-se a redução no risco de DRC5 de 89% (p < 0,001). Conclusão: A resposta positiva à corticoterapia foi o fator mais importante relacionado à preservação da função renal ao longo de mais de uma década de seguimento, e GESF relacionou-se a menor índice de resposta a corticosteroide.

A modified nominal stress method for fatigue assessment of steel plates with thermally cut edges

Thermal cutting methods, are commonly used in the manufacture of metal parts. Thermal cutting processes separate materials by using heat. The process can be done with or without a stream of cutting oxygen. Common processes are Oxygen, plasma and laser cutting. It depends on the application and material which cutting method is used. Numerically-controlled thermal cutting is a cost-effective way of prefabricating components. One design aim is to minimize the number of work steps in order to increase competitiveness. This has resulted in the holes and openings in plate parts manufactured today being made using thermal cutting methods. This is a problem from the fatigue life perspective because there is local detail in the as-welded state that causes a rise in stress in a local area of the plate. In a case where the static utilization of a net section is full used, the calculated linear local stresses and stress ranges are often over 2 times the material yield strength. The shakedown criteria are exceeded. Fatigue life assessment of flame-cut details is commonly based on the nominal stress method. For welded details, design standards and instructions provide more accurate and flexible methods, e.g. a hot-spot method, but these methods are not universally applied to flame cut edges. Some of the fatigue tests of flame cut edges in the laboratory indicated that fatigue life estimations based on the standard nominal stress method can give quite a conservative fatigue life estimate in cases where a high notch factor was present. This is an undesirable phenomenon and it limits the potential for minimizing structure size and total costs. A new calculation method is introduced to improve the accuracy of the theoretical fatigue life prediction method of a flame cut edge with a high stress concentration factor. Simple equations were derived by using laboratory fatigue test results, which are published in this work. The proposed method is called the modified FAT method (FATmod). The method takes into account the residual stress state, surface quality, material strength class and true stress ratio in the critical place.

Using Tomato Analyzer software to determine embryo size in x-rayed seeds

A primary interest of image analysis of X-rayed seeds is to identify whether the extent of fill in the embryo cavity is associated with to seed physiological quality. The objective of this research was to verify the accuracy of the freely available Tomato Analyzer (TA) software developed at The Ohio State University to determine the ratio of embryo size over total seed area. Seeds of pumpkin, watermelon, cucumber and cotton were X-rayed and analyzed by the software which defines seed and embryo boundaries and automatically generates numerical values to quantify that ratio. Results showed that the TA has the sensitivity to evaluate the extent of embryo growth within the cucurbits and cotton seeds and is a promising alternative for this assessment in other seed species.

Effect of loading type on the fatigue strength of symmetric and asymmetric welded joints made of ultra high strength steel

In this study, finite element analyses and experimental tests are carried out in order to investigate the effect of loading type and symmetry on the fatigue strength of three different non-load carrying welded joints. The current codes and recommendations do not give explicit instructions how to consider degree of bending in loading and the effect of symmetry in the fatigue assessment of welded joints. The fatigue assessment is done by using effective notch stress method and linear elastic fracture mechanics. Transverse attachment and cover plate joints are analyzed by using 2D plane strain element models in FEMAP/NxNastran and Franc2D software and longitudinal gusset case is analyzed by using solid element models in Abaqus and Abaqus/XFEM software. By means of the evaluated effective notch stress range and stress intensity factor range, the nominal fatigue strength is assessed. Experimental tests consist of the fatigue tests of transverse attachment joints with total amount of 12 specimens. In the tests, the effect of both loading type and symmetry on the fatigue strength is studied. Finite element analyses showed that the fatigue strength of asymmetric joint is higher in tensile loading and the fatigue strength of symmetric joint is higher in bending loading in terms of nominal and hot spot stress methods. Linear elastic fracture mechanics indicated that bending reduces stress intensity factors when the crack size is relatively large since the normal stress decreases at the crack tip due to the stress gradient. Under tensile loading, experimental tests corresponded with finite element analyzes. Still, the fatigue tested joints subjected to bending showed the bending increased the fatigue strength of non-load carrying welded joints and the fatigue test results did not fully agree with the fatigue assessment. According to the results, it can be concluded that in tensile loading, the symmetry of joint distinctly affects on the fatigue strength. The fatigue life assessment of bending loaded joints is challenging since it depends on whether the crack initiation or propagation is predominant.

Mémoire sur la ville d'Yvice size dans l'isle de même nom sur la Mediterranée à l'occident de Majorque

Ancien possesseur : Argenson, Antoine-René de Voyer (1722-1787 ; marquis de Paulmy d')

Lifespan, body size and oxygen : aerobic metabolism and oxidative stress in cultured fibroblasts /

The allometric scaling relationship observed between metabolic rate (MR) and species body mass can be partially explained by differences in cellular MR (Porter & Brand, 1995). Here, I studied cultured cell lines derived from ten mammalian species to determine whether cells propagated in an identical environment exhibited MR scaling. Oxidative and anaerobic metabolic parameters did not scale significantly with donor body mass in cultured cells, indicating the absence of an intrinsic MR setpoint. The rate of oxygen delivery has been proposed to limit cellular metabolic rates in larger organisms (West et al., 2002). As such cells were cultured under a variety of physiologically relevant oxygen tensions to investigate the effect of oxygen on cellular metabolic rates. Exposure to higher medium oxygen tensions resulted in increased metabolic rates in all cells. Higher MRs have the potential to produce more reactive oxygen species (ROS) which could cause genomic instability and thus reduced lifespan. Longer-lived species are more resistant to oxidative stress (Kapahi et al, 1999), which may be due to greater antioxidant and/or DNA repair capacities. This hypothesis was addressed by culturing primary dermal fibroblasts from eight mammalian species ranging in maximum lifespan from 5 to 120 years. Only the antioxidant manganese superoxide dismutases (MnSOD) positively scaled with species lifespan (p<0.01). Oxidative damage to DNA is primarily repaired by the base excision repair (BER) pathway. BER enzyme activities showed either no correlation or as in the case of polymerase p correlated, negatively with donor species (p<0.01 ). Typically, mammalian cells are cultured in a 20% O2 (atmospheric) environment, which is several-fold higher than cells experience in vivo. Therefore, the secondary aim of this study was to determine the effect of culturing mammalian cells at a more physiological oxygen tension (3%) on BER, and antioxidant, enzyme activities. Consistently, standard culture conditions induce higher antioxidant and DNA ba.se excision repair activities than are present under a more physiological oxygen concentration. Therefore, standard culture conditions are inappropriate for studies of oxidative stress-induced activities and species differences in fibroblast DNA BER repair capacities may represent differences in ability to respond to oxidative stress. An interesting outcome firom this study was that some inherent cellular properties are maintained in culture (i.e. stress responses) while others are not (i.e. MR).

Pollen and grain size records in abyssal sediments of the northwest Pacific Ocean as proxies of Plio-Pleistocene climate change /

A distinctive period of global change occurred during the PUocene between the warm Miocene and subsequent Quaternary cooling. Samples from Ocean Drilling Project Site 11 79 (-5586 mbsl, 41°4'N, 159°57'E), Site 881 (-5765 mbsl, 47°6.133'N, 161°29.490'E) and Site 882 (-3255 mbsl, 50°22'N, 167°36'E) were studied to determine the magnitude and composition ofterrigenous flux to the western mid-latitude North Pacific and its relation to climate change in East Asia since the mid-Pliocene. Dust-sized particles (including pollen), sourced from the arid regions and loess plateaus in East Asia are entrained by prevailing westerly winds and transported to the midlatitude northwest North Pacific Ocean. This is recorded by peaks in the total concentration of pollen and spores, as well as the mean grain size of allochthonous and autochthonous silicate material in abyssal marine sediments. Aridification of the Asian interior due to the phased uplift of the Himalayan-Tibetan Plateau created the modem East Asian Monsoon system dominated by a strengthening of the winter monsoon. The winter monsoon is further enhanced during glacials due to the expansion of desert and steppe environments at the expense ofwoodlands and forests recorded by the composition of palynological assemblages. The late Pliocene-Pleistocene glacials at ODP Sites 1 179, 881, and 882 are characterized by increases in grain size, magnetic susceptibility, pollen and spore concentrations around 3.5-3.3, 2.6-2.4, 1.7-1.6, and 0.9-0.7 Ma (ages based on magnetostratigraphic and biostratigraphic datums). The peaks during these times are relatively rich in pollen taxa derived primarily from steppe and boreal vegetation zones, recording cool, dry climates. The overall size increase of sediment and abundance of terrestrial palynomorphs record enhanced wind strength. The increase in magnitude of pollen and spore concentrations as well as grain size record global cooling and Northern Hemisphere glaciation. The peaks in grain size as well as pollen and spore abundance in marine sediments correlate with the mean grain size of loess in East Asia, consistent with the deflation of unarmoured surfaces during glacials. The transport of limiting nutrients to marine environments enhanced sea surface productivity and increased the rate of sediment accumulation.

Body size in the field cricket Gryllus integer (Orthoptera : Gryllidae) :heritability and male mating success

The influence of male body weight on the aggressive and mating behaviour of male Gryllus integer was studied under laboratory conditions. The relationship between adult age and weight was first determined; female weight increased and male weight decreased with age. Virgin males that had been isolated since the adult molt were paired for similar age and a difference in weight of greater than 200 mg. Paired males and a virgin female were observed in a glass arena for 24 minutes or until a mating occurred. Larger males mated significantly more often than smaller males. Larger males attacked more often, were more successful in aggressive encounters and had more contact with the female. Males that did not mate had lower rates of courtship and mounts than males that mated. Females in trials that did not result in a mating were signifcantly heavier than females in trials that resulted in a mating. Larger males that mated were significantly closer in weight to the weight of the female than larger males in trials that did not result in a mating. Larger males in trials that did not result in a mating had higher rates of aggressive stridulation than larger males that mated. Male weight is therefore important in mating success; fitness traits should theoretically show low genetic variability. However, significant heritability values were found for live weight, dry weight, head width, pronotum width and length, hind femur length and forewing length when estimated from the regression of offspring on mid-parent values, offspring and female and male values separately and full-sib correlations. The heritability of hind femur width was significant when estimated from the regression of offspring on male parent and from full-sib correlations. Heritability estimates of forewing length were significantly higher when estimated from the regression of offspring on female parent than when estimated from the regression of offspring on male parent. High phenotypic, genetic and environmental correlations were found between all pairs of traits. Data on male mating success and the heritability of fitness traits were discussed in terms of the maintenance of genetic variability.

Size regulation of double and half embryos in the mice musculus

Genetic chimeras made by aggregating early mouse embryos have many uses in developmental biology and have also provided insights into embryonic growth regulation. There is an indication that the embryo can regulate for an increase in size because although aggregation chimeras are twice as big as normal embryos when made, they are born of normal size. Upward regula..... tion of size reduced embryos is also possible. Half embryos made by the isolation or destruction of one of the blastomeres of a 2-cell embryo are also born of normal size. Little is known about the timing or the mechanism of this size regulation. In this study, the timing of size regulation in double and half embryos was clearly established by comparison of cell numbers derived from serial reconstruction of light microscope sections of control and experimental embryos. It was shown that size regulation in double embryos occurred around 6dl6h and in half embryos by 7dOh. Size regulation occurred in all tissues at the same time indicating a single control mechanism for the entire embryo. More detailed examination of the growth of double embryos revealed that size regulation occurred by alteration in cell cycle length~ No excessive cell death was found in double embryos compared to the controls and continuous labelling with [3H] thymidine showed no large non-dividing cell population in double embryos. However, a comparison of the mitotic index of double and control embryos after colcemid treatment, revealed a large difference between the two around 5dl6h to 6d16h. During this period, control embryos underwent a proliferative burst not shown by the double embryos. The mechanism for cell cycle control is not clear; it may be intrinsic to the embryo or determined by the uterine environment. Evidence was found suggesting that differentiation in the postimplantation embryo was cell number dependent. The timing of differentiative events was examined in half, double and control embryos. Proamnion formation, which occurs prior to size regulation, occurs at the same cell number but at different times in the three groups of embryos. However mesoderm which appears after size regulation was seen at the same time in all grollps of embryos.

Planeación punto focal de la auditoría financiera por Manuel Coello Ríos

Tesis [Maestría en Contaduría Pública con Especialidad en Auditoría) U.A.N.L.

Development of a Chinese version WHO Self-Assessment Tool for Evaluating Health Promotion in Hospital

[Support Institutions:] Department of Administration of Health, University of Montreal, Canada Public Health School of Fudan University, Shanghai, China