Patrón génico de fibrosis y apoptosis en nefropatía obstructiva experimental : : modulación por rosuvastatina

La nefropatía obstructiva puede ser un desorden renal complejo de tratar debido al severo cuadro inflamatorio, desbalance oxidativo, apoptosis y fibrosis. Estudios previos sostienen que rosuvastatina (Ros) podría tener utilidad como una opción terapéutica en enfermedades renales que cursarían con apoptosis y fibrosis. Objetivo: Evaluar los posibles efectos antiapoptóticos y antifibróticos de Ros durante la obstrucción ureteral unilateral en ratas neonatas. Materiales y Métodos: Ratas Wistar neonatas de 48 hs. de vida fueron intervenidas quirúrgicamente (grupo experimental) o no (grupo control). Ambos grupos fueron subdivididos en tratadas o no tratadas con Ros (10mg / kg por día) vía oral durante 14 días. Posteriormente se procedió a nefrectomizar y procesar las cortezas renales para determinar por RT-PCR las expresiones de genes: óxido nítrico sintasa inducible (iNOS), factor promotor génico de chaperonas (hsf1), proteína de shock térmico (hsp70), bax, bcL2, wt1, p53, snail, proteína morfogénica del hueso (bmp7), caderina E, factor transformador de crecimiento (tgf-β) y factor de necrosis tumoral (tnf-α). Resultados: La obstrucción ureteral unilateral neonatal indujo una marcada fibrosis y apoptosis, mientras que el tratamiento con Ros moduló el patrón de genes fibróticos y apoptóticos mediante disminución de la expresión de bmp7, caderina E, wt1, p53 y bcl2; además indujo una caída en la expresión de los genes profibróticos y proapoptóticos (bax, tnf-α y tgf-β). El análisis de los resultados presentados, permiten sugerir que la protección renal de rosuvastatina durante nefropatía obstructiva de ratas neonatas estaría asociado a la interacción entre hsp70 y la biodisponibilidad del óxido nítrico con el concomitante descenso en genes pro-apoptóticos.

An Oka principle for equivariant isomorphisms

Let G be a reductive complex Lie group acting holomorphically on normal Stein spaces X and Y, which are locally G-biholomorphic over a common categorical quotient Q. When is there a global G-biholomorphism X → Y? If the actions of G on X and Y are what we, with justification, call generic, we prove that the obstruction to solving this local-to-global problem is topological and provide sufficient conditions for it to vanish. Our main tool is the equivariant version of Grauert's Oka principle due to Heinzner and Kutzschebauch. We prove that X and Y are G-biholomorphic if X is K-contractible, where K is a maximal compact subgroup of G, or if X and Y are smooth and there is a G-diffeomorphism ψ : X → Y over Q, which is holomorphic when restricted to each fibre of the quotient map X → Q. We prove a similar theorem when ψ is only a G-homeomorphism, but with an assumption about its action on G-finite functions. When G is abelian, we obtain stronger theorems. Our results can be interpreted as instances of the Oka principle for sections of the sheaf of G-biholomorphisms from X to Y over Q. This sheaf can be badly singular, even for a low-dimensional representation of SL2(ℂ). Our work is in part motivated by the linearisation problem for actions on ℂn. It follows from one of our main results that a holomorphic G-action on ℂn, which is locally G-biholomorphic over a common quotient to a generic linear action, is linearisable.

Evolution and treatment of vitamin B12 deficiency as a risk factor for (cognitive and functional) neurodegenerative diseases in institutionalized elderly = Evolución y tratamiento de la deficiencia de vitamina B12 como factor de riesgo de enfermedades neurodegenerativas (cognitivas y funcionales) en las personas mayores institucionalizadas.

Prevalence of vitamin B12 deficiency is very common in elderly people and can reach values as high as 40.5% of the population. It can be the result of the interaction among several factors. Vitamin B12 deficiencies have been associated with neurological, cognitive deterioration, haematological abnormalities and cardiovascular diseases that have an important influence on the health of the elderly and their quality of life. It is necessary to approach the problems arisen from the lack of data relative to them. The main objective of this thesis was to analyse the evolution of vitamin B12 status and related parameters, lipid and haematological profiles and their relationship to health risk factors, and to functional and cognitive status over one year and to determine the effect of an oral supplementation of 500 μg of cyanocobalamin for a short period of 28 days. An additional objective was to analyze the possible effects of medicine intakes on vitamin B status. Three studies were performed: a) a one year longitudinal follow-up with four measure points; b) an intervention study providing an oral liquid supplement of 500 μg of cyanocobalamin for a 28 days period; and c) analysis of the possible effect of medication intake on vitamin B status using the ATC classification of medicines. The participants for these studies were recruited from nursing homes for the elderly in the Region of Madrid. Sixty elders (mean age 84 _ 7y, 19 men and 41 women) were recruited for Study I and 64 elders (mean age 82 _ 7y, 24 men and 40 women) for Study II. For Study III, baseline data from the initially recruited participants of the first two studies were used. An informed consent was obtained from all participants or their mentors. The studies were approved by the Ethical Committee of the University of Granada. Blood samples were obtained at each examination date and were analyzed for serum cobalamin, holoTC, serum and RBC folate and total homocysteine according to laboratory standard procedures. The haematological parameters analyzed were haematocrit, haemoglobin and MCV. For the lipid profile TG, total cholesterol, LDL- and HDLcholesterol were analyzed. Anthropometric measures (BMI, skinfolds [triceps and subscapular], waist girth and waist to hip ratio), functional tests (hand grip, arm and leg strength tests, static balance) and MMSE were obtained or administered by trained personal. The vitamin B12 supplement of Study II was administered with breakfast and the medication intake was taken from the residents’ anamnesis. Data were analyzed by parametric and non-parametric statistics depending on the obtained data. Comparisons were done using the appropriate ANOVAs or non-parametric tests. Pearsons’ partial correlations with the variable “time” as control were used to define the association of the analyzed parameters. XIII The results showed that: A) Over one year, in relationship to vitamin B status, serum cobalamin decreased, serum folate and mean corpuscular volumen increased significantly and total homocysteine concentrations were stable. Regarding blood lipid profile, triglycerides increased and HDL-cholesterol decreased significantly. Regarding selected anthropometric measurements, waist circumference increased significantly. No significant changes were observed for the rest of parameters. B) Prevalence of hyperhomocysteinemia was high in the elderly studied, ranging from 60% to 90 % over the year depending on the cut-off used for the classification. LDL-cholesterol values were high, especially among women, and showed a tendency to increase over the year. Results of the balance test showed a deficiency and a tendency to decrease; this indicates that the population studied is at high risk for falls. Lower extremity muscular function was deficient and showed a tendency to decrease. A highly significant relationship was observed between the skinfold of the triceps and blood lipid profile. C) Low cobalamin concentrations correlated significantly with low MMSE scores in the elderly studied. No correlations were observed between vitamin B12 status and functional parameters. D) Regarding vitamin B12 status, holo-transcobalamin seems to be more sensitive for diagnosis; 5-10% of the elderly had a deficiency using serum cobalamin as a criterion, and 45-52% had a deficiency when using serum holotranscobalamin as a criterion. E) 500 μg of cyanocobalamin administered orally during 28 days significantly improved vitamin B12 status and significantly decreased total homocysteine concentrations in institutionalized elderly. No effect of the intervention was observed on functional and cognitive parameters. F) The relative change (%) of improvement of vitamin B12 status was higher when using serum holo-transcobalamin as a criterion than serum cobalamin. G) Antiaenemic drug intake normalized cobalamin, urologic drugs and corticosteroids serum folate, and psychoanaleptics holo-transcobalamin levels. Drugs treating pulmonary obstruction increased total homocysteine concentration significantly. H) The daily mean drug intake was 5.1. Fiftynine percent of the elderly took medication belonging to 5 or more different ATC groups. The most prevalent were psycholeptic (53%), antiacid (53%) and antithrombotic (47%) drugs.

A novel methodology for planning reliable wireless sensor networks

Wireless sensor networks (WSNs) have shown their potentials in various applications, which bring a lot of benefits to users from both research and industrial areas. For many setups, it is envisioned thatWSNs will consist of tens to hundreds of nodes that operate on small batteries. However due to the diversity of the deployed environments and resource constraints on radio communication, sensing ability and energy supply, it is a very challenging issue to plan optimized WSN topology and predict its performance before real deployment. During the network planning phase, the connectivity, coverage, cost, network longevity and service quality should all be considered. Therefore it requires designers coping with comprehensive and interdisciplinary knowledge, including networking, radio engineering, embedded system and so on, in order to efficiently construct a reliable WSN for any specific types of environment. Nowadays there is still a lack of the analysis and experiences to guide WSN designers to efficiently construct WSN topology successfully without many trials. Therefore, simulation is a feasible approach to the quantitative analysis of the performance of wireless sensor networks. However the existing planning algorithms and tools, to some extent, have serious limitations to practically design reliable WSN topology: Only a few of them tackle the 3D deployment issue, and an overwhelming number of works are proposed to place devices in 2D scheme. Without considering the full dimension, the impacts of environment to the performance of WSN are not completely studied, thus the values of evaluated metrics such as connectivity and sensing coverage are not sufficiently accurate to make proper decision. Even fewer planning methods model the sensing coverage and radio propagation by considering the realistic scenario where obstacles exist. Radio signals propagate with multi-path phenomenon in the real world, in which direct paths, reflected paths and diffracted paths contribute to the received signal strength. Besides, obstacles between the path of sensor and objects might block the sensing signals, thus create coverage hole in the application. None of the existing planning algorithms model the network longevity and packet delivery capability properly and practically. They often employ unilateral and unrealistic formulations. The optimization targets are often one-sided in the current works. Without comprehensive evaluation on the important metrics, the performance of planned WSNs can not be reliable and entirely optimized. Modeling of environment is usually time consuming and the cost is very high, while none of the current works figure out any method to model the 3D deployment environment efficiently and accurately. Therefore many researchers are trapped by this issue, and their algorithms can only be evaluated in the same scenario, without the possibility to test the robustness and feasibility for implementations in different environments. In this thesis, we propose a novel planning methodology and an intelligent WSN planning tool to assist WSN designers efficiently planning reliable WSNs. First of all, a new method is proposed to efficiently and automatically model the 3D indoor and outdoor environments. To the best of our knowledge, this is the first time that the advantages of image understanding algorithm are applied to automatically reconstruct 3D outdoor and indoor scenarios for signal propagation and network planning purpose. The experimental results indicate that the proposed methodology is able to accurately recognize different objects from the satellite images of the outdoor target regions and from the scanned floor plan of indoor area. Its mechanism offers users a flexibility to reconstruct different types of environment without any human interaction. Thereby it significantly reduces human efforts, cost and time spent on reconstructing a 3D geographic database and allows WSN designers concentrating on the planning issues. Secondly, an efficient ray-tracing engine is developed to accurately and practically model the radio propagation and sensing signal on the constructed 3D map. The engine contributes on efficiency and accuracy to the estimated results. By using image processing concepts, including the kd-tree space division algorithm and modified polar sweep algorithm, the rays are traced efficiently without detecting all the primitives in the scene. The radio propagation model iv is proposed, which emphasizes not only the materials of obstacles but also their locations along the signal path. The sensing signal of sensor nodes, which is sensitive to the obstacles, is benefit from the ray-tracing algorithm via obstacle detection. The performance of this modelling method is robust and accurate compared with conventional methods, and experimental results imply that this methodology is suitable for both outdoor urban scenes and indoor environments. Moreover, it can be applied to either GSM communication or ZigBee protocol by varying frequency parameter of the radio propagation model. Thirdly, WSN planning method is proposed to tackle the above mentioned challenges and efficiently deploy reliable WSNs. More metrics (connectivity, coverage, cost, lifetime, packet latency and packet drop rate) are modeled more practically compared with other works. Especially 3D ray tracing method is used to model the radio link and sensing signal which are sensitive to the obstruction of obstacles; network routing is constructed by using AODV protocol; the network longevity, packet delay and packet drop rate are obtained via simulating practical events in WSNet simulator, which to the best of our knowledge, is the first time that network simulator is involved in a planning algorithm. Moreover, a multi-objective optimization algorithm is developed to cater for the characteristics of WSNs. The capability of providing multiple optimized solutions simultaneously allows users making their own decisions accordingly, and the results are more comprehensively optimized compared with other state-of-the-art algorithms. iMOST is developed by integrating the introduced algorithms, to assist WSN designers efficiently planning reliable WSNs for different configurations. The abbreviated name iMOST stands for an Intelligent Multi-objective Optimization Sensor network planning Tool. iMOST contributes on: (1) Convenient operation with a user-friendly vision system; (2) Efficient and automatic 3D database reconstruction and fast 3D objects design for both indoor and outdoor environments; (3) It provides multiple multi-objective optimized 3D deployment solutions and allows users to configure the network properties, hence it can adapt to various WSN applications; (4) Deployment solutions in the 3D space and the corresponding evaluated performance are visually presented to users; and (5) The Node Placement Module of iMOST is available online as well as the source code of the other two rebuilt heuristics. Therefore WSN designers will be benefit from v this tool on efficiently constructing environment database, practically and efficiently planning reliable WSNs for both outdoor and indoor applications. With the open source codes, they are also able to compare their developed algorithms with ours to contribute to this academic field. Finally, solid real results are obtained for both indoor and outdoor WSN planning. Deployments have been realized for both indoor and outdoor environments based on the provided planning solutions. The measured results coincide well with the estimated results. The proposed planning algorithm is adaptable according to the WSN designer’s desirability and configuration, and it offers flexibility to plan small and large scale, indoor and outdoor 3D deployments. The thesis is organized in 7 chapters. In Chapter 1, WSN applications and motivations of this work are introduced, the state-of-the-art planning algorithms and tools are reviewed, challenges are stated out and the proposed methodology is briefly introduced. In Chapter 2, the proposed 3D environment reconstruction methodology is introduced and its performance is evaluated for both outdoor and indoor environment. The developed ray-tracing engine and proposed radio propagation modelling method are described in details in Chapter 3, their performances are evaluated in terms of computation efficiency and accuracy. Chapter 4 presents the modelling of important metrics of WSNs and the proposed multi-objective optimization planning algorithm, the performance is compared with the other state-of-the-art planning algorithms. The intelligent WSN planning tool iMOST is described in Chapter 5. RealWSN deployments are prosecuted based on the planned solutions for both indoor and outdoor scenarios, important data are measured and results are analysed in Chapter 6. Chapter 7 concludes the thesis and discusses about future works. vi Resumen en Castellano Las redes de sensores inalámbricas (en inglés Wireless Sensor Networks, WSNs) han demostrado su potencial en diversas aplicaciones que aportan una gran cantidad de beneficios para el campo de la investigación y de la industria. Para muchas configuraciones se prevé que las WSNs consistirán en decenas o cientos de nodos que funcionarán con baterías pequeñas. Sin embargo, debido a la diversidad de los ambientes para desplegar las redes y a las limitaciones de recursos en materia de comunicación de radio, capacidad de detección y suministro de energía, la planificación de la topología de la red y la predicción de su rendimiento es un tema muy difícil de tratar antes de la implementación real. Durante la fase de planificación del despliegue de la red se deben considerar aspectos como la conectividad, la cobertura, el coste, la longevidad de la red y la calidad del servicio. Por lo tanto, requiere de diseñadores con un amplio e interdisciplinario nivel de conocimiento que incluye la creación de redes, la ingeniería de radio y los sistemas embebidos entre otros, con el fin de construir de manera eficiente una WSN confiable para cualquier tipo de entorno. Hoy en día todavía hay una falta de análisis y experiencias que orienten a los diseñadores de WSN para construir las topologías WSN de manera eficiente sin realizar muchas pruebas. Por lo tanto, la simulación es un enfoque viable para el análisis cuantitativo del rendimiento de las redes de sensores inalámbricos. Sin embargo, los algoritmos y herramientas de planificación existentes tienen, en cierta medida, serias limitaciones para diseñar en la práctica una topología fiable de WSN: Sólo unos pocos abordan la cuestión del despliegue 3D mientras que existe una gran cantidad de trabajos que colocan los dispositivos en 2D. Si no se analiza la dimensión completa (3D), los efectos del entorno en el desempeño de WSN no se estudian por completo, por lo que los valores de los parámetros evaluados, como la conectividad y la cobertura de detección, no son lo suficientemente precisos para tomar la decisión correcta. Aún en menor medida los métodos de planificación modelan la cobertura de los sensores y la propagación de la señal de radio teniendo en cuenta un escenario realista donde existan obstáculos. Las señales de radio en el mundo real siguen una propagación multicamino, en la que los caminos directos, los caminos reflejados y los caminos difractados contribuyen a la intensidad de la señal recibida. Además, los obstáculos entre el recorrido del sensor y los objetos pueden bloquear las señales de detección y por lo tanto crear áreas sin cobertura en la aplicación. Ninguno de los algoritmos de planificación existentes modelan el tiempo de vida de la red y la capacidad de entrega de paquetes correctamente y prácticamente. A menudo se emplean formulaciones unilaterales y poco realistas. Los objetivos de optimización son a menudo tratados unilateralmente en los trabajos actuales. Sin una evaluación exhaustiva de los parámetros importantes, el rendimiento previsto de las redes inalámbricas de sensores no puede ser fiable y totalmente optimizado. Por lo general, el modelado del entorno conlleva mucho tiempo y tiene un coste muy alto, pero ninguno de los trabajos actuales propone algún método para modelar el entorno de despliegue 3D con eficiencia y precisión. Por lo tanto, muchos investigadores están limitados por este problema y sus algoritmos sólo se pueden evaluar en el mismo escenario, sin la posibilidad de probar la solidez y viabilidad para las implementaciones en diferentes entornos. En esta tesis, se propone una nueva metodología de planificación así como una herramienta inteligente de planificación de redes de sensores inalámbricas para ayudar a los diseñadores a planificar WSNs fiables de una manera eficiente. En primer lugar, se propone un nuevo método para modelar demanera eficiente y automática los ambientes interiores y exteriores en 3D. Según nuestros conocimientos hasta la fecha, esta es la primera vez que las ventajas del algoritmo de _image understanding_se aplican para reconstruir automáticamente los escenarios exteriores e interiores en 3D para analizar la propagación de la señal y viii la planificación de la red. Los resultados experimentales indican que la metodología propuesta es capaz de reconocer con precisión los diferentes objetos presentes en las imágenes satelitales de las regiones objetivo en el exterior y de la planta escaneada en el interior. Su mecanismo ofrece a los usuarios la flexibilidad para reconstruir los diferentes tipos de entornos sin ninguna interacción humana. De este modo se reduce considerablemente el esfuerzo humano, el coste y el tiempo invertido en la reconstrucción de una base de datos geográfica con información 3D, permitiendo así que los diseñadores se concentren en los temas de planificación. En segundo lugar, se ha desarrollado un motor de trazado de rayos (en inglés ray tracing) eficiente para modelar con precisión la propagación de la señal de radio y la señal de los sensores en el mapa 3D construido. El motor contribuye a la eficiencia y la precisión de los resultados estimados. Mediante el uso de los conceptos de procesamiento de imágenes, incluyendo el algoritmo del árbol kd para la división del espacio y el algoritmo _polar sweep_modificado, los rayos se trazan de manera eficiente sin la detección de todas las primitivas en la escena. El modelo de propagación de radio que se propone no sólo considera los materiales de los obstáculos, sino también su ubicación a lo largo de la ruta de señal. La señal de los sensores de los nodos, que es sensible a los obstáculos, se ve beneficiada por la detección de objetos llevada a cabo por el algoritmo de trazado de rayos. El rendimiento de este método de modelado es robusto y preciso en comparación con los métodos convencionales, y los resultados experimentales indican que esta metodología es adecuada tanto para escenas urbanas al aire libre como para ambientes interiores. Por otra parte, se puede aplicar a cualquier comunicación GSM o protocolo ZigBee mediante la variación de la frecuencia del modelo de propagación de radio. En tercer lugar, se propone un método de planificación de WSNs para hacer frente a los desafíos mencionados anteriormente y desplegar redes de sensores fiables de manera eficiente. Se modelan más parámetros (conectividad, cobertura, coste, tiempo de vida, la latencia de paquetes y tasa de caída de paquetes) en comparación con otros trabajos. Especialmente el método de trazado de rayos 3D se utiliza para modelar el enlace de radio y señal de los sensores que son sensibles a la obstrucción de obstáculos; el enrutamiento de la red se construye utilizando el protocolo AODV; la longevidad de la red, retardo de paquetes ix y tasa de abandono de paquetes se obtienen a través de la simulación de eventos prácticos en el simulador WSNet, y según nuestros conocimientos hasta la fecha, es la primera vez que simulador de red está implicado en un algoritmo de planificación. Por otra parte, se ha desarrollado un algoritmo de optimización multi-objetivo para satisfacer las características de las redes inalámbricas de sensores. La capacidad de proporcionar múltiples soluciones optimizadas de forma simultánea permite a los usuarios tomar sus propias decisiones en consecuencia, obteniendo mejores resultados en comparación con otros algoritmos del estado del arte. iMOST se desarrolla mediante la integración de los algoritmos presentados, para ayudar de forma eficiente a los diseñadores en la planificación de WSNs fiables para diferentes configuraciones. El nombre abreviado iMOST (Intelligent Multi-objective Optimization Sensor network planning Tool) representa una herramienta inteligente de planificación de redes de sensores con optimización multi-objetivo. iMOST contribuye en: (1) Operación conveniente con una interfaz de fácil uso, (2) Reconstrucción eficiente y automática de una base de datos con información 3D y diseño rápido de objetos 3D para ambientes interiores y exteriores, (3) Proporciona varias soluciones de despliegue optimizadas para los multi-objetivo en 3D y permite a los usuarios configurar las propiedades de red, por lo que puede adaptarse a diversas aplicaciones de WSN, (4) las soluciones de implementación en el espacio 3D y el correspondiente rendimiento evaluado se presentan visualmente a los usuarios, y (5) El _Node Placement Module_de iMOST está disponible en línea, así como el código fuente de las otras dos heurísticas de planificación. Por lo tanto los diseñadores WSN se beneficiarán de esta herramienta para la construcción eficiente de la base de datos con información del entorno, la planificación práctica y eficiente de WSNs fiables tanto para aplicaciones interiores y exteriores. Con los códigos fuente abiertos, son capaces de comparar sus algoritmos desarrollados con los nuestros para contribuir a este campo académico. Por último, se obtienen resultados reales sólidos tanto para la planificación de WSN en interiores y exteriores. Los despliegues se han realizado tanto para ambientes de interior y como para ambientes de exterior utilizando las soluciones de planificación propuestas. Los resultados medidos coinciden en gran medida con los resultados estimados. El algoritmo de planificación x propuesto se adapta convenientemente al deiseño de redes de sensores inalámbricas, y ofrece flexibilidad para planificar los despliegues 3D a pequeña y gran escala tanto en interiores como en exteriores. La tesis se estructura en 7 capítulos. En el Capítulo 1, se presentan las aplicaciones de WSN y motivaciones de este trabajo, se revisan los algoritmos y herramientas de planificación del estado del arte, se presentan los retos y se describe brevemente la metodología propuesta. En el Capítulo 2, se presenta la metodología de reconstrucción de entornos 3D propuesta y su rendimiento es evaluado tanto para espacios exteriores como para espacios interiores. El motor de trazado de rayos desarrollado y el método de modelado de propagación de radio propuesto se describen en detalle en el Capítulo 3, evaluándose en términos de eficiencia computacional y precisión. En el Capítulo 4 se presenta el modelado de los parámetros importantes de las WSNs y el algoritmo de planificación de optimización multi-objetivo propuesto, el rendimiento se compara con los otros algoritmos de planificación descritos en el estado del arte. La herramienta inteligente de planificación de redes de sensores inalámbricas, iMOST, se describe en el Capítulo 5. En el Capítulo 6 se llevan a cabo despliegues reales de acuerdo a las soluciones previstas para los escenarios interiores y exteriores, se miden los datos importantes y se analizan los resultados. En el Capítulo 7 se concluye la tesis y se discute acerca de los trabajos futuros.

AVALIAÇÃO DA INFLUÊNCIA DO TIPO FACIAL NOS TAMANHOS DOS ESPAÇOS AÉREOS NASO E BUCOFARÍNGE

A variação nos tamanhos dos espaços aéreos naso e bucofaríngeo ocorre devido a fatores genéticos e/ou ambientais. A diminuição no tamanho do espaço aéreo nasofaríngeo, causada pela hipertrofia da tonsila faríngea, tem sido associada a alterações no padrão normal de crescimento craniofacial e a efeitos deletérios na oclusão. O objetivo do presente trabalho é avaliar se há variação nos tamanhos dos espaços aéreos naso e bucofaríngeo de acordo com o padrão de crescimento craniofacial, assim como avaliar a correlação entre os tamanhos dos espaços e o índice VERT, além de verificar um possível dimorfismo sexual. Na mensuração dos espaços, utilizou-se telerradiografias laterais de 90 pacientes, divididos em três grupos de acordo com o padrão de crescimento craniofacial, determinado por meio do índice VERT de Ricketts. Os pacientes da amostra, com idades entre 9 e 16 anos, apresentavam padrão respiratório nasal, sem qualquer tipo de obstrução. Não foi observada variação estatisticamente significante nos tamanhos dos espaços aéreos naso e bucofaríngeo, quando comparados os três tipos faciais. Também não foi encontrada correlação entre os tamanhos dos espaços aéreos e os valores do índice VERT de Ricketts dos pacientes e não foi observado dimorfismo sexual. XII

AVALIAÇÃO DA INFLUÊNCIA DO TIPO FACIAL NOS TAMANHOS DOS ESPAÇOS AÉREOS NASO E BUCOFARÍNGE

A variação nos tamanhos dos espaços aéreos naso e bucofaríngeo ocorre devido a fatores genéticos e/ou ambientais. A diminuição no tamanho do espaço aéreo nasofaríngeo, causada pela hipertrofia da tonsila faríngea, tem sido associada a alterações no padrão normal de crescimento craniofacial e a efeitos deletérios na oclusão. O objetivo do presente trabalho é avaliar se há variação nos tamanhos dos espaços aéreos naso e bucofaríngeo de acordo com o padrão de crescimento craniofacial, assim como avaliar a correlação entre os tamanhos dos espaços e o índice VERT, além de verificar um possível dimorfismo sexual. Na mensuração dos espaços, utilizou-se telerradiografias laterais de 90 pacientes, divididos em três grupos de acordo com o padrão de crescimento craniofacial, determinado por meio do índice VERT de Ricketts. Os pacientes da amostra, com idades entre 9 e 16 anos, apresentavam padrão respiratório nasal, sem qualquer tipo de obstrução. Não foi observada variação estatisticamente significante nos tamanhos dos espaços aéreos naso e bucofaríngeo, quando comparados os três tipos faciais. Também não foi encontrada correlação entre os tamanhos dos espaços aéreos e os valores do índice VERT de Ricketts dos pacientes e não foi observado dimorfismo sexual. XII

Primary structure and tissue distribution of two novel proline-rich γ-carboxyglutamic acid proteins

Two human cDNAs that encode novel vitamin K-dependent proteins have been cloned and sequenced. The predicted amino acid sequences suggest that both are single-pass transmembrane proteins with amino-terminal γ-carboxyglutamic acid-containing domains preceded by the typical propeptide sequences required for posttranslational γ-carboxylation of glutamic acid residues. The polypeptides, with deduced molecular masses of 23 and 17 kDa, are proline-rich within their putative cytoplasmic domains and contain several copies of the sequences PPXY and PXXP, motifs found in a variety of signaling and cytoskeletal proteins. Accordingly, these two proteins have been called proline-rich Gla proteins (PRGP1 and PRGP2). Unlike the γ-carboxyglutamic acid domain-containing proteins of the blood coagulation cascade, the two PRGPs are expressed in a variety of extrahepatic tissues, with PRGP1 and PRGP2 most abundantly expressed in the spinal cord and thyroid, respectively, among those tissues tested. Thus, these observations suggest a novel physiological role for these two new members of the vitamin K-dependent family of proteins.

Nonmuscle myosin II-B is required for normal development of the mouse heart

We used targeted gene disruption in mice to ablate nonmuscle myosin heavy chain B (NMHC-B), one of the two isoforms of nonmuscle myosin II present in all vertebrate cells. Approximately 65% of the NMHC-B−/− embryos died prior to birth, and those that were born suffered from congestive heart failure and died during the first day. No abnormalities were detected in NMHC-B+/− mice. The absence of NMHC-B resulted in a significant increase in the transverse diameters of the cardiac myocytes from 7.8 ± 1.8 μm (right ventricle) and 7.8 ± 1.3 μm (left ventricle) in NMHC-B+/+ and B+/− mice to 14.7 ± 1.1 μm and 13.8 ± 2.3 μm, respectively, in NMHC-B−/− mice (in both cases, P < 0.001). The increase in size of the cardiac myocytes was seen as early as embryonic day 12.5 (4.5 ± 0.2 μm for NMHC-B+/+ and B+/− vs. 7.2 ± 0.6 μm for NMHC-B−/− mice (P < 0.01)). Six of seven NMHC-B−/− newborn mice analyzed by serial sectioning also showed structural cardiac defects, including a ventricular septal defect, an aortic root that either straddled the defect or originated from the right ventricle, and muscular obstruction to right ventricular outflow. Some of the hearts of NMHC-B−/− mice showed evidence for up-regulation of NMHC-A protein. These studies suggest that nonmuscle myosin II-B is required for normal cardiac myocyte development and that its absence results in structural defects resembling, in part, two common human congenital heart diseases, tetralogy of Fallot and double outlet right ventricle.

Cytochrome P450 CYP1B1 determines susceptibility to 7,12-dimethylbenz[a]anthracene-induced lymphomas

CYP1B1-null mice, created by targeted gene disruption in embryonic stem cells, were born at the expected frequency from heterozygous matings with no observable phenotype, thus establishing that CYP1B1 is not required for mouse development. CYP1B1 was not detectable in cultured embryonic fibroblast (EF) or in different tissues, such as lung, of the CYP1B1-null mouse treated with the aryl hydrocarbon receptor agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin whereas the equivalent wild-type EF cells express basal and substantial inducible CYP1B1 and lung expresses inducible CYP1B1. CYP1A1 is induced to far higher levels than CYP1B1 in liver, kidney, and lung in wild-type mice and is induced to a similar extent in CYP1B1-null mice. 7,12-dimethylbenz[a]anthracene (DMBA) was toxic in wild-type EFs that express CYP1B1 but not CYP1A1. These cells effectively metabolized DMBA, consistent with CYP1B1 involvement in producing the procarcinogenic 3,4-dihydrodiol as a major metabolite, whereas CYP1B1-null EF showed no significant metabolism and were resistant to DMBA-mediated toxicity. When wild-type mice were administered high levels of DMBA intragastrically, 70% developed highly malignant lymphomas whereas only 7.5% of CYP1B1-null mice had lymphomas. Skin hyperplasia and tumors were also more frequent in wild-type mice. These results establish that CYP1B1, located exclusively at extrahepatic sites, mediates the carcinogenicity of DMBA. Surprisingly, CYP1A1, which has a high rate of DMBA metabolism in vitro, is not sufficient for this carcinogenesis, which demonstrates the importance of extrahepatic P450s in determining susceptibility to chemical carcinogens and validates the search for associations between P450 expression and cancer risk in humans.

Methionine adenosyltransferase 1A knockout mice are predisposed to liver injury and exhibit increased expression of genes involved in proliferation

Liver-specific and nonliver-specific methionine adenosyltransferases (MATs) are products of two genes, MAT1A and MAT2A, respectively, that catalyze the formation of S-adenosylmethionine (AdoMet), the principal biological methyl donor. Mature liver expresses MAT1A, whereas MAT2A is expressed in extrahepatic tissues and is induced during liver growth and dedifferentiation. To examine the influence of MAT1A on hepatic growth, we studied the effects of a targeted disruption of the murine MAT1A gene. MAT1A mRNA and protein levels were absent in homozygous knockout mice. At 3 months, plasma methionine level increased 776% in knockouts. Hepatic AdoMet and glutathione levels were reduced by 74 and 40%, respectively, whereas S-adenosylhomocysteine, methylthioadenosine, and global DNA methylation were unchanged. The body weight of 3-month-old knockout mice was unchanged from wild-type littermates, but the liver weight was increased 40%. The Affymetrix genechip system and Northern and Western blot analyses were used to analyze differential expression of genes. The expression of many acute phase-response and inflammatory markers, including orosomucoid, amyloid, metallothionein, Fas antigen, and growth-related genes, including early growth response 1 and proliferating cell nuclear antigen, is increased in the knockout animal. At 3 months, knockout mice are more susceptible to choline-deficient diet-induced fatty liver. At 8 months, knockout mice developed spontaneous macrovesicular steatosis and predominantly periportal mononuclear cell infiltration. Thus, absence of MAT1A resulted in a liver that is more susceptible to injury, expresses markers of an acute phase response, and displays increased proliferation.

Apolipoprotein E competitively inhibits receptor-dependent low density lipoprotein uptake by the liver but has no effect on cholesterol absorption or synthesis in the mouse.

This study examines the question of whether apolipoprotein E (apoE) alters steady-state concentrations of plasma cholesterol carried in low density lipoproteins (LDL-C) by acting as a competitive inhibitor of hepatic LDL uptake or by altering the rate of net cholesterol delivery from the intestinal lumen to the liver. To differentiate between these two possibilities, rates of cholesterol absorption and synthesis and the kinetics of hepatic LDL-C transport were measured in vivo in mice with either normal (apoE+/+) or zero (apoE-/-) levels of circulating apoE. Rates of cholesterol absorption were essentially identical in both genotypes and equaled approximately 44% of the daily dietary load of cholesterol. This finding was consistent with the further observation that the rates of cholesterol synthesis in the liver (approximately 2,000 nmol/h) and extrahepatic tissues (approximately 3,000 nmol/h) were also essentially identical in the two groups of mice. However, the apparent Michaelis constant for receptor-dependent hepatic LDL-C uptake was markedly lower in the apoE-/- mice (44 +/- 4 mg/dl) than in the apoE+/+ animals (329 +/- 77 mg/dl) even though the maximal transport velocity for this uptake process was essentially the same (approximately 400 micrograms/h per g) in the two groups of mice. These studies, therefore, demonstrate that apoE-containing lipoproteins can act as potent competitive inhibitors of hepatic LDL-C transport and so can significantly increase steady-state plasma LDL-C levels. This apolipoprotein plays no role, however, in the regulation of cholesterol absorption, sterol biosynthesis, or hepatic LDL receptor number, at least in the mouse.

Hepatic expression of mature transforming growth factor beta 1 in transgenic mice results in multiple tissue lesions.

Aberrant expression of transforming growth factor beta 1 (TGF-beta 1) has been implicated in a number of disease processes, particularly those involving fibrotic and inflammatory lesions. To determine the in vivo effects of overexpression of TGF-beta 1 on the function and structure of hepatic as well as extrahepatic tissues, transgenic mice were generated containing a fusion gene (Alb/TGF-beta 1) consisting of modified porcine TGF-beta 1 cDNA under the control of the regulatory elements of the mouse albumin gene. Five transgenic lines were developed, all of which expressed the Alb/TGF-beta 1 transgene selectively in hepatocytes. The transgenic line 25 expressing the highest level of the transgene in the liver also had high (> 10-fold over control) plasma levels of TGF-beta 1. Hepatic fibrosis and apoptotic death of hepatocytes developed in all the transgenic lines but was more pronounced in line 25. The fibrotic process was characterized by deposition of collagen around individual hepatocytes and within the space of Disse in a radiating linear pattern. Several extrahepatic lesions developed in line 25, including glomerulonephritis and renal failure, arteritis and myocarditis, as well as atrophic changes in pancreas and testis. The results from this transgenic model strongly support the proposed etiological role for TGF-beta 1 in a variety of fibrotic and inflammatory disorders. The transgenic model may also provide an appropriate paradigm for testing therapeutic interventions aimed at neutralizing the detrimental effects of this important cytokine.

Ultrassonografia vascular comparada à intravascular no diagnóstico das obstruções venosas ilíacas em portadores de insuficiência venosa crônica

Introdução: O tratamento da Insuficiência Venosa Crônica (IVC) é baseado na correção dos refluxos e obstruções ao fluxo sanguíneo venoso. A detecção, a gravidade e o tratamento dessas obstruções venosas, responsáveis pelos sinais e sintomas da IVC, têm sido recentemente estudados e melhor compreendidos. Estes estudos não definem qual o grau de obstrução significativa nem os critérios ultrassonográficos para sua detecção. O objetivo deste estudo foi determinar critérios ultrassonográficos para o diagnóstico das obstruções venosas ilíacas, avaliando a concordância deste método com o ultrassom intravascular (UI) em pacientes portadores de IVC avançada. Métodos: Foram avaliados 15 pacientes (30 membros; 49,4 ± 10,7 anos; 1 homem) com IVC inicial (Classificação Clínica-Etiológica-Anatômica-Physiopatológica - CEAP C1-2) no grupo I (GI) e 51 pacientes (102 membros; 50,53 ± 14,5 anos; 6 homens) com IVC avançada (CEAP C3-6) no grupo II (GII) pareados por sexo, idade e etnia. Todos pacientes foram submetidos à entrevista clínica e à ultrassonografia vascular com Doppler (UV-D), sendo obtidas as medidas de fasicidade de fluxo, os índices de fluxo e velocidades venosas femorais, e as relações de velocidade e de diâmetro da obstrução ilíaca. Foi analisado o escore de refluxo multisegmentar. Os indivíduos do GI foram avaliados por 3 examinadores independentes. Os pacientes do GII foram submetidos ao UI, sendo obtidos a área dos segmentos venosos comprometidos e comparados com os resultados obtidos pelo UV-D, agrupados em 3 categorias: obstruções < 50%; obstruções entre 50-79% e obstruções >= 80%. Resultados: A classe de severidade clinica CEAP predominante no GI foi C1 em 24/30 (80%) membros, e C3 em 54/102 (52,9%) membros no GII. O refluxo foi severo (escore de refluxo multisegmentar >= 3) em 3/30 (10%) membros no grupo I, e em 45/102 (44,1%) membros no grupo II (p<0,001). Houve uma concordância moderadamente elevada entre o UV-D e o UI, quando agrupadas em 3 categorias (K=0,598; p<0,001), e uma concordância elevada quando agrupadas em 2 categorias (obstruções <50% e >= 50%) (K= 0,784; p<0,001). Os melhores pontos de corte e sua correlação com o UI foram: índice de velocidade (0,9; r=-0,634; p<0,001); índice de fluxo (0,7; r=-0,623; p<0,001); relação de obstrução (0,5; r=0,750; p<0,001); relação de velocidade (2,5; r= 0,790; p<0,001); A ausência de fasicidade de fluxo esteve presente em 88,2% dos pacientes com obstrução >=80% ao UV-D. Foi construído um algoritmo ultrassonográfico vascular, utilizando as medidas e os pontos de corte descritos obtendo-se uma acurácia de 79,6% para 3 categorias (K=0,655; p<0,001) e de 86,7% para 2 categorias (k=0,730; p<0,001). Conclusões: O UV-D apresentou uma concordância elevada com o UI na detecção de obstruções >= 50%. A relação de velocidade na obstrução >= 2,5 é o melhor critério para detecção de obstruções venosas significativas em veias ilíacas.

Avaliação dos biomarcadores urinários no controle do tratamento de estenose de junção ureteropélvica em adultos

INTRODUÇÃO E OBJETIVO: A estenose de junção ureteropélvica (EJUP) é importante causa de obstrução do trato urinário e pode levar a deterioração progressiva da função renal. Há espaço para o aprimoramento de novos métodos diagnósticos capazes de discriminar hidronefrose e uropatia obstrutiva. Acredita-se que os biomarcadores urinários podem fornecer indícios de lesão renal precoce na obstrução urinária. Neste contexto, KIM-1 pode elevar-se na urina por lesão tubular proximal, NGAL por lesão no túbulo proximal, distal ou alça de Henle, CA19-9 por produção excessiva no túbulo obstruído e ?2-microglobulina (beta2M) por injúria ao glomérulo ou ao túbulo proximal. O objetivo do presente estudo foi avaliar as propriedades diagnósticas dos biomarcadores urinários citados em adultos com EJUP, sendo o primeiro estudo na literatura a avaliar tais moléculas nesta população. MÉTODOS: Foram estudados de modo prospectivo pacientes consecutivos acima de 18 anos com diagnóstico de EJUP submetidos a pieloplastia videolaparoscópica de dezembro de 2013 a fevereiro de 2015. Foram excluídos do estudo pacientes com EJUP bilateral, rim contralateral patológico, EJUP em rim único, antecedentes de tratamento cirúrgico para estenose de JUP ou taxa de filtração glomerular inferior a 60 ml/min/1,73m2. Cada paciente forneceu quatro amostras de urina para medição de biomarcadores, uma no pré-operatório e outras com 1, 3 e 6 meses de seguimento pós-operatório. O grupo controle foi constituído por voluntários saudáveis sem hidronefrose à ultrassonografia. RESULTADOS: Foram incluídos 47 pacientes com idade média de 38,6 ± 12,7 anos (intervalo 19 a 64 anos), sendo 17 (36,2%) do sexo masculino e 30 (62,8%) do sexo feminino. O grupo controle foi composto por 40 indivíduos semelhantes ao grupo com EJUP no que concerne idade (p = 0,95) e sexo (p = 0,82). KIM-1 foi o marcador com melhores propriedades diagnósticas, apresentando área sob a curva (AUC) de 0,79 (95% CI 0,70 a 0,89). O NGAL, por sua vez, teve AUC de 0,71 (95% CI 0,61 a 0,83), CA19- 9 teve AUC de 0,70 (95% CI 0,60 a 0,81) e (beta2M) apresentou AUC de 0,61 (95% CI 0,50 a 0,73), sendo o único biomarcador com propriedades inadequadas neste cenário. O KIM-1 foi o marcador mais sensível com o ponto de corte 170,4 pg/mg de creatinina (sensibilidade 91,4%, especificidade 59,1%) e o CA 19-9 o mais específico para o ponto de corte de 51,3 U/mg de creatinina (sensibilidade 48,9%, especificidade 88,0%), enquanto o NGAL foi o que apresentou maior queda após desobstrução, com 90,0% dos pacientes apresentando clareamento superior a 50%. CONCLUSÕES: A avaliação dos biomarcadores urinários é útil no diagnóstico de obstrução em adultos com EJUP submetidos a pieloplastia videolaparoscópica. O KIM-1 foi o marcador mais sensível e o CA 19-9 o mais específico, enquanto o NGAL foi o que apresentou maior que com a desobstrução. Houve queda das concentrações dos marcadores após pieloplastia no período estudado. O papel exato dos biomarcadores urinários no cenário de obstrução em adultos deve ser mais amplamente investigado

Oxidação eletroquímica de etanol em temperatura ambiente e intermediária: estudo quantitativo das vias reacionais por espectrometria de massas on-line

Na primeira parte do trabalho, foram investigados materiais ativos para eletro-oxidar etanol e acetaldeído seletivos para a rota C2 (Carbono 2) e, também, ativos para eletro-oxidar hidrogênio molecular, visando a aplicação em células a combustível de hidrogênio indireto. Neste tipo de célula, um processador de combustível externo desidrogena o etanol e os produtos desta reação, contendo H2, acetaldeído e, possivelmente, etanol residual, são direcionados para alimentar o ânodo. Neste sentido, o eletrocatalisador anódico pode ser ativo para a eletro-oxidação de etanol residual, bem como acetaldeído, mas este deve catalisar a reação via C2 com o objetivo de evitar a formação de espécies que envenenam a superfície catalítica (CO ou CHx), ou seja, a ligação C-C deve permanecer intacta. Os eletrocatalisadores bimetálicos foram formados por M/Pt/C (onde M = W, Ru ou Sn) e os produtos reacionais foram analisados por DEMS On-line. Os resultados mostraram que Ru/Pt/C e Sn/Pt/C apresentaram maiores taxas de reação global, no entanto, eles não foram seletivos. Por outro lado, W2/Pt3/C foi mais seletivo para a rota C2, dada a não formação de CH4 e CO2. Além disso, este material também foi ativo e estável para a eletro-oxidação de H2, mesmo na presença de acetaldeído, o que o torna um potencial catalisador para aplicação no ânodo de células a combustível de hidrogênio indireto. Na segunda parte do trabalho, o objetivo foi relacionado com o estudo de eletrocatalisadores seletivos para a rota C1 (Carbono 1). A oxidação eletroquímica do etanol e de seus produtos reacionais foram investigados por DEMS on-line em temperatura ambiente e intermediária (245oC). Para temperatura ambiente, utilizou-se solução aquosa de ácido sulfúrico (H2SO4) e, para temperatura intermediária, utilizou-se ácido sólido (CsH2PO4) como eletrólito. Os eletrocatalisadores investigados foram formados por SnOxRuOx-Pt/C e Pt/C. Em temperatura ambiente, os resultados de polarização potenciodinâmica mostraram uma maior atividade eletrocatalítica para o material SnOxRuOx-Pt/C, com eficiência de corrente para formação de CO2 de 15,6% contra 15,2% para Pt/C, sob condições estagnantes, sem controle por transporte de massa. O stripping de resíduos reacionais, após a eletro-oxidação de etanol bulk, sob condições de fluxo, mostraram o acúmulo de espécies com 1 átomo de carbono (CO e CHx) que causam o bloqueio dos sítios ativos e são oxidadas eletroquimicamente somente em mais altos potenciais (ca. 1,0 V). Por outro lado, as curvas de polarização a 245oC mostraram maiores valores de eficiências de correntes para formação de CO2 (45% para Pt/C em ambos potenciais 0,5 V e 0,8 V contra 36% e 50% para SnOxRuOx-Pt/C em 0,5 V e 0,8 V respectivamente) quando comparado com os valores obtidos em temperatura ambiente, mas com atividades similares para SnOxRuOx-Pt/C e Pt/C. Para ambos os eletrocatalisadores, os estudos de espectrometria de massas a 245oC evidenciaram que as rotas eletroquímicas ocorrem em paralelo com rotas puramente químicas, envolvendo catálise heterogênea, de decomposição do etanol, produzindo H2 e CO2 como produtos majoritários.