Novel FGF8 mutations associated with recessive holoprosencephaly, craniofacial defects, and hypothalamo-pituitary dysfunction.

Context: Fibroblast growth factor (FGF) 8 is important for GnRH neuronal development with human mutations resulting in Kallmann syndrome. Murine data suggest a role for Fgf8 in hypothalamo-pituitary development; however, its role in the etiology of wider hypothalamo-pituitary dysfunction in humans is unknown.Objective: The objective of this study was to screen for FGF8 mutations in patients with septo-optic dysplasia (n = 374) or holoprosencephaly (HPE)/midline clefts (n = 47).Methods: FGF8 was analyzed by PCR and direct sequencing. Ethnically matched controls were then screened for mutated alleles (n = 480-686). Localization of Fgf8/FGF8 expression was analyzed by in situ hybridization in developing murine and human embryos. Finally, Fgf8 hypomorphic mice (Fgf8(loxPNeo/-)) were analyzed for the presence of forebrain and hypothalamo-pituitary defects.Results: A homozygous p.R189H mutation was identified in a female patient of consanguineous parentage with semilobar HPE, diabetes insipidus, and TSH and ACTH insufficiency. Second, a heterozygous p.Q216E mutation was identified in a female patient with an absent corpus callosum, hypoplastic optic nerves, and Moebius syndrome. FGF8 was expressed in the ventral diencephalon and anterior commissural plate but not in Rathke's pouch, strongly suggesting early onset hypothalamic and corpus callosal defects in these patients. This was consolidated by significantly reduced vasopressin and oxytocin staining neurons in the hypothalamus of Fgf8 hypomorphic mice compared with controls along with variable hypothalamo-pituitary defects and HPE.Conclusion: We implicate FGF8 in the etiology of recessive HPE and potentially septo-optic dysplasia/Moebius syndrome for the first time to our knowledge. Furthermore, FGF8 is important for the development of the ventral diencephalon, hypothalamus, and pituitary. (J Clin Endocrinol Metab 96: E1709-E1718, 2011)

Stalk and sucrose yield in response to nitrogen fertilization of sugarcane under reduced tillage

The objective of this work was to evaluate the agroindustrial production of sugarcane (millable stalks and sucrose yield) after successive nitrogen fertilizations of plant cane and ratoons in a reduced tillage system. The experiment was carried out at Jaboticabal, SP, Brazil, on a Rhodic Eutrustox soil, during four consecutive crop cycles (March 2005 to July 2009). Plant cane treatments consisted of N-urea levels (control, 40, 80, and 120 kg ha-1 N + 120 kg ha-1 P2O5 and K2O in furrow application). In the first and second ratoons, the plant cane plots were subdivided in N-ammonium nitrate treatments (control, 50, 100, and 150 kg ha-1 N + 150 kg ha-1 K2O as top dressing over rows). In the third ratoon, N fertilization was leveled to 100 kg ha-1 in all plots, including controls, to detect residual effects of previous fertilizations on the last crop's cycle. Sugarcane ratoon was mechanically harvested. A weighing truck was used to evaluate stalk yield (TCH), and samples were collected in the field for analysis of sugar content (TSH). Increasing N doses and meteorological conditions promote significant responses in TCH and TSH in cane plant and ratoons, in the average and accumulated yield of the consecutive crop cycles.

Efeito do ácido indolbutírico e época de coleta no enraizamento de estacas semi-lenhosas do cacaueiro

O objetivo do trabalho foi verificar o efeito do ácido indolbutírico (AIB) no enraizamento de estacas do cacaueiro. O delineamento experimental foi o inteiramente casualizado, em esquema fatorial 3 x 5 x 2, envolvendo 3 clones (Cepec 2008, CCN 51 e TSH 1188), 5 concentrações de ácido indolbutírico AIB (0; 1.000; 3.000; 6.000 e 9.000 mg kg-1), duas épocas do ano (verão e inverno),, cinco repetições e 10 estacas por parcela. A avaliação do experimento foi realizada 120 dias após o plantio e analisadas as seguintes variáveis: percentagem de sobrevivência (SOB), número de brotações (NB), matéria seca das brotações (MSB), percentagem de estacas enraizadas (ENR), número de raízes (NR) e matéria seca de raízes (MSR). Os fatores época do ano e concentração de AIB apresentaram efeito significativo para as variáveis estudadas quando isolados e em interação com os clones. Os dados obtidos possibilitaram concluir que o valor médio da concentração ideal de AIB (CI) foi de 4.169 mg kg-1 e 3.985 mg kg-1 no verão e inverno, respectivamente. Verificou-se que os clones apresentam diferentes respostas em relação à CI de AIB e época do ano. De modo geral, as CIs no verão foram maiores que no inverno. Os resultados mostraram que a época de plantio e a concentração de AIB influenciaram de maneira mais expressiva na sobrevivência e enraizamento das estacas dos clones Cepec 2008 e CCN 51 e em menor intensidade no clone TSH 1188. Existe uma concentração ideal de AIB para cada um dos clones estudados.

Caracterização física de substratos à base de serragem e recipientes para crescimento de mudas de cacaueiro

O objetivo deste trabalho foi realizar caracterização física e avaliar o efeito de substratos à base de serragem e dois recipientes no crescimento de mudas de cacaueiro. O delineamento experimental foi em blocos casualizados, em esquema fatorial 2 x 4 x 2. Os tratamentos foram obtidos da combinação de serragens originadas de dois locais: municípios de Una e Camacan, no Estado da Bahia, quatro proporções (v:v) de serragem e areia: 1:0; 8:1; 4:1 e 2:1 e dois recipientes de crescimento (tubetes de 288 cm³ e sacos de polietileno de 840 cm³). Antes do plantio, amostras dos substratos foram retiradas para análises físicas. Foram usadas miniestacas de 4 a 6 cm de comprimento do clone Trinidad Select Hybrid (TSH 1188). Inicialmente, as miniestacas foram tratadas na base com AIB 6.000 mg kg-1, em seguida foram inseridas em tubetes preenchidos com os substratos e mantidas em câmara de nebulização. Após quarenta dias, as miniestacas foram retiradas da câmara e transferidas para crescimento, em casa de vegetação, onde parte foi mantida nos respectivos tubetes e outra transplantada em sacos de polietileno de 840 cm³ preenchidos com os mesmos tratamentos. Após cinco meses, em casa de vegetação, as mudas foram avaliadas quanto à altura da planta, diâmetro do caule, massa da matéria seca da parte aérea e das raízes, número de folhas e área foliar das plantas. Na análise física dos substratos, verificou-se que a distribuição do tamanho de partículas foi diferenciada entre as serragens e a proporção de areia. As densidades seca, úmida e de partícula aumentaram, enquanto o teor de matéria orgânica e a porosidade total foram reduzidos pela adição de areia às serragens. O transplante de miniestacas enraizadas de cacaueiro, clone TSH 1188, para sacos com substrato preparado com serragem coletada no município de Una-BA, nas proporções serragem:areia 4:1 e 2:1, possibilitou maior crescimento das plantas, sendo,portanto, recomendados para produção de mudas.

Subclinical thyroid dysfunction and fracture risk: a meta-analysis.

IMPORTANCE: Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. OBJECTIVE: To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures. DATA SOURCES AND STUDY SELECTION: The databases of MEDLINE and EMBASE (inception to March 26, 2015) were searched without language restrictions for prospective cohort studies with thyroid function data and subsequent fractures. DATA EXTRACTION: Individual participant data were obtained from 13 prospective cohorts in the United States, Europe, Australia, and Japan. Levels of thyroid function were defined as euthyroidism (thyroid-stimulating hormone [TSH], 0.45-4.49 mIU/L), subclinical hyperthyroidism (TSH <0.45 mIU/L), and subclinical hypothyroidism (TSH ≥4.50-19.99 mIU/L) with normal thyroxine concentrations. MAIN OUTCOME AND MEASURES: The primary outcome was hip fracture. Any fractures, nonspine fractures, and clinical spine fractures were secondary outcomes. RESULTS: Among 70,298 participants, 4092 (5.8%) had subclinical hypothyroidism and 2219 (3.2%) had subclinical hyperthyroidism. During 762,401 person-years of follow-up, hip fracture occurred in 2975 participants (4.6%; 12 studies), any fracture in 2528 participants (9.0%; 8 studies), nonspine fracture in 2018 participants (8.4%; 8 studies), and spine fracture in 296 participants (1.3%; 6 studies). In age- and sex-adjusted analyses, the hazard ratio (HR) for subclinical hyperthyroidism vs euthyroidism was 1.36 for hip fracture (95% CI, 1.13-1.64; 146 events in 2082 participants vs 2534 in 56,471); for any fracture, HR was 1.28 (95% CI, 1.06-1.53; 121 events in 888 participants vs 2203 in 25,901); for nonspine fracture, HR was 1.16 (95% CI, 0.95-1.41; 107 events in 946 participants vs 1745 in 21,722); and for spine fracture, HR was 1.51 (95% CI, 0.93-2.45; 17 events in 732 participants vs 255 in 20,328). Lower TSH was associated with higher fracture rates: for TSH of less than 0.10 mIU/L, HR was 1.61 for hip fracture (95% CI, 1.21-2.15; 47 events in 510 participants); for any fracture, HR was 1.98 (95% CI, 1.41-2.78; 44 events in 212 participants); for nonspine fracture, HR was 1.61 (95% CI, 0.96-2.71; 32 events in 185 participants); and for spine fracture, HR was 3.57 (95% CI, 1.88-6.78; 8 events in 162 participants). Risks were similar after adjustment for other fracture risk factors. Endogenous subclinical hyperthyroidism (excluding thyroid medication users) was associated with HRs of 1.52 (95% CI, 1.19-1.93) for hip fracture, 1.42 (95% CI, 1.16-1.74) for any fracture, and 1.74 (95% CI, 1.01-2.99) for spine fracture. No association was found between subclinical hypothyroidism and fracture risk. CONCLUSIONS AND RELEVANCE: Subclinical hyperthyroidism was associated with an increased risk of hip and other fractures, particularly among those with TSH levels of less than 0.10 mIU/L and those with endogenous subclinical hyperthyroidism. Further study is needed to determine whether treating subclinical hyperthyroidism can prevent fractures.

Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis.

OBJECTIVE: The objective was to determine the risk of stroke associated with subclinical hypothyroidism. DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels. DATA EXTRACTION AND SYNTHESIS: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations. CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed.

Thyroid function in the elderly and sex hormones in elderly men: reference intervals and associations with health

Aims: The aims were to create clinically feasible reference intervals for thyroidstimulating hormone (TSH) and free thyroxine (FT4) and to analyze associations between thyroid function and self-rated health, neuropsychiatric symptoms, depression and dementia in the elderly. The second aim was also to establish reference intervals for sex hormones and to analyze associations between sex hormone levels and self-rated health, symptoms, depression and dementia in elderly men. Subjects and methods: The study population comprised 1252 subjects aged 65 years or over, living in the municipality of Lieto, south-western Finland. Self-rated health, life satisfaction, symptoms, depression, and dementia were assessed with specific questions, clinical examination and tools such as the Zung Self-report Depression Scale and the Mini-Mental State Examination. Independent variables were dichotomized, and associations of these variables with TSH, FT4 or sex hormone levels were assessed. Levels of TSH and FT4 in thyroid disease–free women and women treated with thyroxine were also compared. Results: Elevated concentrations of thyroid peroxidase antibodies (TPOAb) or thyroglobulin antibodies (TgAb) were found to have a marked effect on the upper reference limit for TSH among women, who were thyroid antibody positive more higher than suggested in several recent guidelines. After age adjustment, there were no associations between TSH levels and self-rated health, life satisfaction, or most neuropsychiatric symptoms in the thyroid disease-free population. Although women with thyroxine treatment for primary hypothyroidism had far higher TSH levels than thyroid disease-free women, there were no differences between thyroid-disease free women and women with stable thyroxine treatment regarding self-rated health, life satisfaction or symptoms. Age had a significant positive association with luteinizing hormone (LH), follicle 2 practice, one range in men aged 65 years or over can be used for T, E2 and FSH measured with the AutoDelfia method, but two separate reference intervals should be used for fT, LH and SHBG. After adjustment for age, higher levels of T and fT were associated with better self-rated health (SRH) in the reference population. After adjustment for age and body mass index (BMI), there were no associations between sex hormone concentrations and self-rated health, life satisfaction or most symptoms in concentration. Conclusion: Age-specific reference intervals were derived for thyroid function and sex hormones based on comprehensive data from a community-dwelling population with a high participation rate. The results do not support the need to decrease the upper reference limit for TSH or to lower the optimal TSH target in levothyroxine treatment in older adults, as recommended in recent guidelines. Older age or being overweight symptoms among elderly men. The associations of single symptoms with T levels were inconsistent among elderly men, although the association of low T level with diagnosed depression might be clinically significant.

Variation in treatment strategies of Swiss general practitioners for subclinical hypothyroidism in older adults.

QUESTIONS UNDER STUDY: As the best management of subclinical hypothyroidism is controversial, we aimed to assess variations in treatment strategies depending on different Swiss regions, physician and patient characteristics. METHODS: We performed a case-based survey among general practitioners (GPs) in different Swiss regions, which consisted of eight hypothetical cases presenting a female patient with subclinical hypothyroidism and nonspecific complaints differing by age, vitality status and thyroid-stimulating hormone (TSH) concentration. RESULTS: A total of 262 GPs participated in the survey. There was considerable variation in the levothyroxine starting dose chosen by GPs, ranging from 25 µg to 100 µg. Across the Swiss regions, GPs in the Bern region were significantly more inclined to treat, with a higher probability of initiating treatment (60%, p = 0.01) and higher mean starting doses (45 µg, p <0.01) compared with the French-speaking region (44%, 36 µg); the Zurich region had intermediate values (52%, 39 µg). We found no association between treatment rate and other physician characteristics. GPs were more reluctant to initiate treatment in 85-year-old than in 70-year-old women (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.63-0.94), and more likely to treat women with a TSH of 15 mU/l than those with a TSH of 6mU/l (OR 8.71, 95% CI 6.21-12.20). CONCLUSIONS: There are strong variations in treatment strategies for elderly patients with subclinical hypothyroidism across different Swiss regions, including use of higher starting doses than the recommended 25 µg in the Swiss guidelines, which recommend a starting dose of 25 µg. These variations likely reflect the current uncertainty about the benefits of treatment, which arise from the current lack of evidence from adequately powered clinical trials.

Highly functional binding surface for miniaturised solid-phase immunoassays. - A spot story -

Several bioaffinity assays are based on the detection of an analyte which is bound on a solid substrate via biochemical interaction. These so called solid phase assays are based on the adhesion of the primary binding partner on a solid surface, which then binds the analyte to be detected. In this thesis work a novel solid phase based assay technology, known as spot technology, was developed. The spot technology is based on combination of high-capacity solid phases, concentrated in a spot format, utilising modified streptavidin molecules and recombinant antibody fragments. The reduction of the solid phase binding surface to a size of a spot enabled denser binding of the target molecules, providing improved signal intensities and signal-to-background ratio when applied in different solid phase immunoassays. Streptavidin-biotin interactions are commonly utilised in numerous different bioaffinity assays and the ultimate nature of streptavidin to bind biotin is among the strongest non-covalent interaction reported between two biomolecules. In this study native core streptavidin was chemically modified to provide polymerised streptavidin molecules with altered adsorption properties. These streptavidin conjugates, when coated onto polystyrene surface, provided enhanced biotin binding capacity and surface stability when compared to a reference coating constructed with native streptavidin. Furthermore, the combination of chemically modified streptavidin, sitespecifically biotinylated antibody fragments and the spot coating technology provided highly dense solid phase coating with improved binding properties. The performance of the spot assay technology was further demonstrated in different immunoassay configurations. Human thyroid stimulating hormone (TSH) and human cardiac troponin I (cTnI) were used as model analytes to show the applicability of the highly sensitive spot-based solid-phase immunoassay for detection of very low levels of analytes. It was demonstrated that the spot technology provided an assay concept with enhanced sensitivity and short turn-around times, characteristics that are highly suitable for point-of-care applications.

Componentes fenólicos e enzimas oxidativas em clones de Theobroma cacao resistentes e suscetíveis a Crinipellis perniciosa

Os níveis de fenóis solúveis totais e a atividade das enzimas oxidativas polifenoloxidases e peroxidases foram estudados em tecidos foliares sadios dos clones de cacaueiro (Theobroma cacao) SCA 6, TSH 1188, TSH 565, TSH 516, EET 397, EET 62, TSA 641, SIAL 505, RIM 106, RIM 52, SIC 24 e UF 613, com o objetivo de estudar possível(is) mecanismo(s) de resistência de cacaueiro a Crinipellis perniciosa. Os níveis de fenóis solúveis totais foram mais elevados em clones de cacaueiro com resistência a C. perniciosa, e podem estar contribuindo na resposta de defesa contra o patógeno. A atividade de polifenoloxidases foi menor nos clones resistentes do que nos clones suscetíveis. A atividade de peroxidases em folhas maduras foi menor nos clones resistentes, mas em folhas jovens não foi possível estabelecer uma relação da atividade de peroxidase com os clones resistentes. Os níveis de fenóis e a atividade das enzimas oxidativas correlacionaram-se de forma inversa na maioria dos clones estudados, o que pode indicar uma inibição das enzimas peroxidases e polifenoloxidases pelos compostos fenólicos.

Evolution of Bioaffinity Reagents by Phage Display

Antibodies are natural binding proteins produced in vertebrates as a response to invading pathogens and foreign substances. Because of their capability for tight and specific binding, antibodies have found use as binding reagents in research and diagnostics. Properties of cloned recombinant antibodies can be further improved by means of in vitro evolution, combining mutagenesis with subsequent phage display selection. It is also possible to isolate entirely new antibodies from vast naïve or synthetic antibody libraries by phage display. In this study, library techniques and phage display selection were applied in order to optimise binding scaffolds and antigen recognition of antibodies, and to evolve new and improved bioaffinity reagents. Antibody libraries were generated by random and targeted mutagenesis. Expression and stability were mainly optimised by the random methods whereas targeted randomisation of the binding site residues was used for optimising the binding properties. Trinucleotide mutagenesis allowed design of defined randomisation patterns for a synthetic antibody library. Improved clones were selected by phage display. Capture by a specific anti- DHPS antibody was exploited in the selection of improved phage display of DHPS. Efficient selection for stability was established by combining phage display selection with denaturation under reducing conditions. Broad-specific binding of a generic anti-sulfonamide antibody was improved by selection with one of the weakest binding sulfonamides. In addition, p9 based phage display was studied in affinity selection from the synthetic library. A TIM barrel protein DHPS was engineered for efficient phage display by combining cysteinereplacement with random mutagenesis. The resulting clone allows use of phage display in further engineering of DHPS and possibly use as an alternative-binding scaffold. An anti-TSH scFv fragment, cloned from a monoclonal antibody, was engineered for improved stability to better suite an immunoassay. The improved scFv tolerates 8 – 9 °C higher temperature than the parental scFv and should have sufficient stability to be used in an immunoanalyser with incubation at 36 °C. The anti-TSH scFv fragment was compared with the corresponding Fab fragment and the parental monoclonal antibody as a capturing reagent in a rapid 5-min immunoassay for TSH. The scFv fragment provided some benefits over the conventionally used Mab in anayte-binding capacity and assay kinetics. However, the recombinant Fab fragment, which had similar kinetics to the scFv, provided a more sensitive and reliable assay than the scFv. Another cloned scFv fragment was engineered in order to improve broad-specific recognition of sulfonamides. The improved antibody detects different sulfonamides at concentrations below the maximum residue limit (100 μg/kg in EU and USA) and allows simultaneous screening of different sulfonamide drug residues. Finally, a synthetic antibody library was constructed and new antibodies were generated and affinity matured entirely in vitro. These results illuminate the possibilities of phage display and antibody engineering for generation and optimisation of binding reagents in vitro and indicate the potential of recombinant antibodies as affinity reagents in immunoassays.

Superoxide dismutase 3-mediated cell survival and proliferation

This dissertation studies the signaling events mediated by the extracellular superoxide dismutase (SOD3). SOD3 is an antioxidant enzyme which converts the harmful superoxide into hydrogen peroxide. Overproduction of these reactive oxygen species (ROS) in the cellular environment as a result of tissue injury or impaired antioxidant defense system has detrimental effects on tissue integrity and function. However, especially hydrogen peroxide is also an important signaling agent. Ischemic injury in muscle causes acute oxidative stress and inflammation. We investigated the ability of SOD3 to attenuate ischemia induced inflammation and to promote recovery of skeletal muscle tissue. We found that SOD3 can downregulate the expression of several inflammatory cytokines and cell adhesion molecules thus preventing the accumulation of oxidant-producing inflammatory cells. Secondly, SOD3 was able to promote long-term activation of the mitogenic Erk pathway, but increased only briefly the activity of pro-survival Akt pathway at an early stage of ischemic inflammation, thus reducing apoptosis. SOD3 is a prominent antioxidant in the thyroid gland where oxidative stress is constantly present. We investigated the role of SOD3 in normal thyroid follicular cells and the changes in its expression in various hyperproliferative disorders. We first showed that SOD3 is TSH-responsive which indicated its participation in thyroid function. Its principal function seems to be in follicular cell proliferation since knockdown cells were deficient in proliferation. Additionally, it was overexpressed in goiter tissue. However, SOD3 was consistently downregulated in thyroid cancer cell lines and tissues. In conclusion, SOD3 is involved in tissue maintenance, cell proliferation and inflammatory cell migration. Its mechanisms of action are the activation of known proliferation/survival pathways, inhibition of apoptosis and regulation of adhesion molecule expression.

Modalities for soil preparation and gypsum application in ultisol: stem productivity of sugarcane

The study was conducted in an area of expansion of sugarcane at Vale do Paraná factory in Suzanápolis city - São Paulo (SP), in Brazil, in the northwestern region of the State of São Paulo. It was used the sugarcane variety RB92-5345, 1.5m of spacing between rows, in an Ultisol. The study aimed to evaluate the productivity of sugarcane and first ratoon and some soil chemical attributes in function of soil tillage and application or not of gypsum. The experimental design was randomized blocks with six treatments, in a factorial 3x2 and six replicates, the main treatments were soil tillage with three equipments, moldboard plow, chisel plow, and heavy harrow, and two secondary treatments with application of 1 t ha-1of gypsum and no gypsum. After each harvest of cane, the soil was characterized as to its fertility indicators in layers of 0.0-0.15; 0.15-0.30 and 0.30-0.45m. Differences in values of soil chemical attributes due to the methods of preparation occurred in the sugarcane did not last until the harvest of the 1st ratoon cane, and also did not influence the crop productivity. The gypsum application resulted in higher values ​​of total recoverable sugar (TRS) and the productivity of tons of stems per hectare (TSH) to sugarcane and 1st ratoon cane, respectively, confirming the initial hypothesis.

Aspectos morfológicos dos autotransplantes de tireóide da rata

Foram operadas cinqüenta ratas Wistar, adultas, separadas em seis grupos: 1, 2, 3, grupos isotado 1 e 2 e um grupo piloto. O lobo esquerdo da tireóide da rata foi dividido em três fragmentos similares e implantados no músculo esternoclidomastóideo, na raiz do mesentério e no ovário. Os tecidos implantados foram examinados histologicamente após dez, vinte e trinta dias. No grupo isolado I, depois de trinta dias a porção restante da tireóide in situ foi removida, passando a viver somente com os implantes. Para verificar aspectos funcionais, foram implantados três fragmentos da tireóide em um grupo isolado na raiz do mesentério. T3 T4 e TSH foram dosados no soro antes e após a retirada da tireóide. O exame histológico mostrou que o tecido tireóideo implantado sofria inicialmente discreta hipotrofia, retomando em seguida para os limites da normalidade. Os melhores resultados foram obtidos com o implante no mesentério. Os valores de T 3 e T 4 eram baixos e os de TSH altos. Apoiado nos resultados histológicos e hormonais, concluiu-se que no período estudado, a tireóide autotransplantada manteve sua arquitetura folicular, cumprindo a função de produzir os hormônios.

Valor da dosagem da tireoglobulina no seguimento de pacientes com carcinoma diferenciado da tireóide submetidos à tireoidectomia parcial

OBJETIVO: Estudar o valor da dosagem da tireoglobulina (Tg) plasmática na detecção de recidivas, nos pacientes com carcinoma diferenciado da tireóide, submetidos à tireoidectomia parcial. MÉTODOS: São analisados, retrospectivamente, 48 pacientes portadores de carcinoma diferenciado e submetidos à tireoidectomia parcial que foram acompanhados no pós-operatório com dosagens de Tg plasmática. O exame foi realizado no paciente com TSH suprimido (< 0,6mU/cc) e o valor da Tg de 10ng/cc considerado como limite entre os casos com e sem suspeita de recidiva. O tempo médio de seguimento foi de 8,1 anos. RESULTADOS: Onze pacientes apresentaram Tg elevada (> 10ng/cc) e quatro eram portadores de doença benigna capaz de elevar a Tg como hipertireoidismo (dois casos) e doença de Hashimoto (dois casos). Estes quatro pacientes não foram considerados na análise estatística. Os sete restantes foram considerados suspeitos de recidiva tumoral que foi confirmada em seis (verdadeiro positivo) e não confirmada em um (falso positivo). Nos 37 pacientes com Tg baixa (< 10ng/cc) apenas um apresentou recidiva (verdadeiro negativo: 36 e falso negativo: 1). A análise estatística da capacidade da Tg em detectar recidivas mostrou: sensibilidade 85%; especificidade 94%; valor preditivo positivo 85%; valor preditivo negativo 84% e acurácia 95%. CONCLUSÕES: Os resultados obtidos neste trabalho mostraram que a dosagem da Tg é de valor na detecção de possibilidade de recidivas no seguimento de pacientes operados por carcinoma diferenciado mesmo quando submetidos à cirurgia parcial.