L'endobrachy-oesophage. Etude rétrospective de 258 cas [Barrett esophagus. Retrospective study of 258 cases].

Barrett's esophagus, nearly always an acquired disease, is neither rare nor a curiosity, having been diagnosed in 258 out of 2573 patients with reflux esophagitis. It was associated with esophageal adenocarcinoma in 29 cases (11.2%) and with non-esophageal cancer in 72 cases (27.9%).

A composite stratigraphy for the Neoproterozoic Huqf Supergroup of Oman: integrating new litho-, chemo- and chronostratigraphic data of the Mirbat area, southern Oman

The Huqf Supergroup in Oman contains an exceptionally well-preserved and complete sedimentary record of the Middle to Late Neoproterozoic Era. Outcrops of the Huqf Supergroup in northern and central Oman are now well documented, but their correlation with a key succession in the Mirbat area of southern Oman, containing a sedimentary record of two Neoproterozoic glaciations, is poorly understood. Integration of lithostratigraphic, chemostratigraphic and new U-Pb detrital zircon data suggests that the Mirbat Group is best placed within the Cryogenian (c. 850-635 Ma) part of the Huqf Supergroup. The c. I km thick marine deposits of the Arkahawl and Marsham Formations of the Mirbat Group are thought to represent a stratigraphic interval between older Cryogenian and younger Cryogenian glaciations that is not preserved elsewhere in Oman. The bulk of detrital zircons in the Huqf Supergroup originate from Neoproterozoic parent rocks. However, older Mesoproterozoic, Palaeoproterozoic and even Archaean zircons can be recognized in the detrital population from the upper Mahara Group (Fiq Formation) and Nafun Group, suggesting the tapping of exotic sources, probably from the Arabian-Nubian Shield.

Influence of CD4+/CD25+ regulatory T cells on atherogenesis in patients with end-stage kidney disease.

Atherosclerosis, which is influenced by both traditional and nontraditional cardiovascular risk factors and has been characterized as an inflammatory process, is considered to be the main cause of the elevated cardiovascular risk associated with chronic kidney disease. The inflammatory component of atherosclerosis can be separated into an innate immune response involving monocytes and macrophages that respond to the excessive uptake of lipoproteins and an adaptive immune response that involves antigen-specific T cells. Concurrent with the influx of immune cells to the site of atherosclerotic lesion, the role of the adaptive immune response gradually increases. One of those cells are represented by the CD4+/CD25+ Tregs, which play indispensable roles in the maintenance of natural self-tolerance and negative control of pathological, as well as physiological, immune responses. Altered self-antigens such as oxidized LDLs may induce the development of CD4+/CD25+ Tregs with atheroprotective properties. However, atherosclerosis may be promoted by an imbalance between regulatory and pathogenic immunity that may be represented by the low expression of the forkhead box transcription factor (Foxp3) in CD4+/CD25+ Tregs. Such a defect may break immunologic tolerance and alter both specific and bystander immune suppression, leading to exacerbation of plaque development. Patients with end-stage kidney disease (ESKD) display a cellular immune dysfunction and accelerated atherosclerosis. Uremic solutes that accumulate during ESKD may be involved in these processes. In patients with ESKD and especially in those that are chronically hemodialyzed, oxidative stress induced by oxidized LDLs may increase CD4+/CD25+ Treg sensitivity to Fas-mediated apoptosis as a consequence of specific dysregulation of IL-2 expression. This review will focus on the current state of knowledge regarding the influence of CD4+/CD25+ Tregs on atherogenesis in patients with ESKD, and the potential effect of statins on the circulating number and the functional properties of these cells.

Metabolismo de plantas de cana-de-açúcar cultivadas in vitro sob diferentes concentrações de nitrogênio

Variedades de cana-de-açúcar (RB 732577, RB 83102, RB 75126, CB 45-3, Caiana e Co 997) foram cultivadas in vitro em meio nutritivo básico MS com diferentes concentrações de N (9,83 mM, 7,37 mM, 4,92 mM, 2,46 mM, 0,49 mM e 0,0 mM), com o objetivo de avaliar a eficiência no processo de assimilação desse elemento. Após 45 dias de cultivo, foram determinados os ganhos de biomassa e os teores de amônio, aminoácidos e açúcares solúveis. A variedade Co 997 apresentou maior ganho de biomassa e maior quantidade de N incorporado em aminoácidos livres em relação às demais variedades, sugerindo maior eficiência no processo de assimilação. Os teores mais elevados de amônio foram observados nas variedades RB 83102 e RB 75126, quando cultivadas em meio desprovido de N, mostrando-se menos eficientes no processo de assimilação uma vez que apresentaram os menores valores de aminoácidos livres nas mesmas condições de cultivo.

Produtos agrícolas e florestais como alimento suplementar de tambaqui em policultivo com jaraqui

O objetivo deste trabalho foi avaliar o desempenho de tambaqui (Colossoma macropomum), em policultivo com jaraqui (Semaprochilodus insignis), alimentado com produtos agrícolas e florestais como suplemento. Dois viveiros, medindo 644 m² (Viveiro A, consorciado com suínos) e 1.075 m² (Viveiro B, não-consorciado), foram utilizados com 0,5 tambaqui/m² e 0,1 jaraqui/m². Após 371 dias, os tambaquis apresentaram crescimento de 18,6±4,5 g para 997,1±195,08 g no Viveiro A e de 81,4±18,8 g para 519,9±191,7 g no Viveiro B. O manejo alimentar do Viveiro A pode ser uma alternativa sustentável de produção de tambaqui em substituição às rações comerciais.

Atividade enzimática em variedades de cana-de-açúcar cultivadas in vitro sob diferentes níveis de nitrogênio

O nitrogênio é considerado o elemento mineral mais abundante nas plantas, sendo componente essencial de biomoléculas e inúmeras enzimas. O objetivo deste trabalho foi avaliar a eficiência no processo de assimilação do nitrogênio e encontrar parâmetros indicativos do potencial de fixação biológica em variedades de cana-de-açúcar (Saccharum officinarum) cultivadas in vitro. Foram utilizadas as variedades de cana-de-açúcar RB 842021, RB 83102, RB 75126, RB 882980 e Co 997, além da Brachiaria arrecta (testemunha), cultivadas in vitro em diferentes níveis de nitrogênio [M1 (9,83 mM), M2 (2,46 mM), M3 (0,49 mM), M4 (0,0 mM)]. Todas as variedades e a cultura testemunha (Brachiaria arrecta) apresentaram atividade da nitrato redutase (NR) constitutiva e também da glutamina sintetase (GS), mesmo na ausência de amônio e nitrato no meio de cultura. A variedade RB 842021 apresentou a maior atividade da nitrato redutase e o maior conteúdo de clorofilas a e b, e a variedade RB 882980 a maior atividade da glutamina sintetase nas mesmas condições de cultivo, o que pode representar maior potencial de assimilação do nitrogênio.

Exposure to radio-frequency electromagnetic fields from broadcast transmitters and risk of childhood cancer: a census-based cohort study.

We investigated the association between exposure to radio-frequency electromagnetic fields (RF-EMFs) from broadcast transmitters and childhood cancer. First, we conducted a time-to-event analysis including children under age 16 years living in Switzerland on December 5, 2000. Follow-up lasted until December 31, 2008. Second, all children living in Switzerland for some time between 1985 and 2008 were included in an incidence density cohort. RF-EMF exposure from broadcast transmitters was modeled. Based on 997 cancer cases, adjusted hazard ratios in the time-to-event analysis for the highest exposure category (>0.2 V/m) as compared with the reference category (<0.05 V/m) were 1.03 (95% confidence interval (CI): 0.74, 1.43) for all cancers, 0.55 (95% CI: 0.26, 1.19) for childhood leukemia, and 1.68 (95% CI: 0.98, 2.91) for childhood central nervous system (CNS) tumors. Results of the incidence density analysis, based on 4,246 cancer cases, were similar for all types of cancer and leukemia but did not indicate a CNS tumor risk (incidence rate ratio = 1.03, 95% CI: 0.73, 1.46). This large census-based cohort study did not suggest an association between predicted RF-EMF exposure from broadcasting and childhood leukemia. Results for CNS tumors were less consistent, but the most comprehensive analysis did not suggest an association.

Surface-functionalized ultrasmall superparamagnetic nanoparticles as magnetic delivery vectors for camptothecin.

Drug-nanoparticle conjugates: The anticancer drug camptothecin (CPT) was covalently linked at the surface of ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) via a linker, allowing drug release by cellular esterases. Nanoparticles were hierarchically built to achieve magnetically-enhanced drug delivery to human cancer cells and antiproliferative activity.The linking of therapeutic drugs to ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) allowing intracellular release of the active drug via cell-specific mechanisms would achieve tumor-selective magnetically-enhanced drug delivery. To validate this concept, we covalently attached the anticancer drug camptothecin (CPT) to biocompatible USPIOs (iron oxide core, 9-10 nm; hydrodynamic diameter, 52 nm) coated with polyvinylalcohol/polyvinylamine (PVA/aminoPVA). A bifunctional, end-differentiated dicarboxylic acid linker allowed the attachment of CPT to the aminoPVA as a biologically labile ester substrate for cellular esterases at one end, and as an amide at the other end. These CPT-USPIO conjugates exhibited antiproliferative activity in vitro against human melanoma cells. The intracellular localization of CPT-USPIOs was confirmed by transmission electron microscopy (iron oxide core), suggesting localization in lipid vesicles, and by fluorescence microscopy (CPT). An external static magnetic field applied during exposure increased melanoma cell uptake of the CPT-USPIOs.

Total and segmental liver volume variations: implications for liver surgery.

BACKGROUND: Liver remnant volumes after major hepatic resection and graft volumes for liver transplantation correlate with surgical outcome. The relative contributions of the hepatic segments to total liver volume (TLV) are not well established. METHODS: TLV and hepatic segment volumes were measured with computed tomography (CT) in 102 patients without liver disease who underwent CT for conditions unrelated to the liver or biliary tree. RESULTS: TLV ranged from 911 to 2729 cm(3). On average, the right liver (segments V, VI, VII, and VIII) contributed approximately two thirds of TLV (997+/-279 cm(3)), and the left liver (segments II, III and IV) contributed approximately one third of TLV (493+/-127 cm(3)). Bisegment II+III (left lateral section) contributed about half the volume of the left liver (242+/-79 cm(3)), or 16% of TLV. Liver volumes varied significantly between patients--the right liver varied from 49% to 82% of TLV, the left liver, 17% to 49% of TLV, and bisegment II+III (left lateral section) 5% to 27% of TLV. Bisegment II+III contributed less than 20% of TLV in more than 75% of patients and the left liver contributed 25% or less of TLV in more than 10% of patients. DISCUSSION: There is clinically significant interpatient variation in hepatic volumes. Therefore, in the absence of appreciable hypertrophy, we recommend routine measurement of the future liver remnant before extended right hepatectomy (right trisectionectomy) and in selected patients before right hepatectomy if a small left liver is anticipated.

Monitoring of noninvasive ventilation by built-in software of home bilevel ventilators: a bench study.

BACKGROUND: Current bilevel positive-pressure ventilators for home noninvasive ventilation (NIV) provide physicians with software that records items important for patient monitoring, such as compliance, tidal volume (Vt), and leaks. However, to our knowledge, the validity of this information has not yet been independently assessed. METHODS: Testing was done for seven home ventilators on a bench model adapted to simulate NIV and generate unintentional leaks (ie, other than of the mask exhalation valve). Five levels of leaks were simulated using a computer-driven solenoid valve (0-60 L/min) at different levels of inspiratory pressure (15 and 25 cm H(2)O) and at a fixed expiratory pressure (5 cm H(2)O), for a total of 10 conditions. Bench data were compared with results retrieved from ventilator software for leaks and Vt. RESULTS: For assessing leaks, three of the devices tested were highly reliable, with a small bias (0.3-0.9 L/min), narrow limits of agreement (LA), and high correlations (R(2), 0.993-0.997) when comparing ventilator software and bench results; conversely, for four ventilators, bias ranged from -6.0 L/min to -25.9 L/min, exceeding -10 L/min for two devices, with wide LA and lower correlations (R(2), 0.70-0.98). Bias for leaks increased markedly with the importance of leaks in three devices. Vt was underestimated by all devices, and bias (range, 66-236 mL) increased with higher insufflation pressures. Only two devices had a bias < 100 mL, with all testing conditions considered. CONCLUSIONS: Physicians monitoring patients who use home ventilation must be aware of differences in the estimation of leaks and Vt by ventilator software. Also, leaks are reported in different ways according to the device used.

Tipología selvícola para los abetales españoles de Abies alba Mill.

Se ofrece una tipología de naturaleza silvogenética para los abetales del Pirineo español, elaborada a partir de la información suministrada por el Segundo Inventario Forestal Nacional. Se han derivado nueve tipos, cuya diferenciación se articula en base al área basimétrica, la densidad, la distribución diamétrica de los pies presentes y el carácter puro o mixto de la masa. Se ha analizado comparativamente la estructura que conforman sus distribuciones diamétricas y el rol que las especies acompañantes del abeto desempeñan en aquélla, destacando cómo el carácter de irregularidad preside, aunque en grados diversos, la totalidad de las formas tipificadas. La tipología resulta de sencilla aplicación por parte del gestor forestal puesto que se maneja con tan sólo los diámetros inventariados de los pies existentes, y contempla los distintos estadios secuenciales y evolutivos de los abetales españoles que abarcan, desde la fase de instalación del abeto bajo la cubierta de otras especies, hasta las estructuras más capitalizadas y envejecidas.

Reprodutibilidade do volume de membros fetais pela ultrassonografia tridimensional utilizando o método XI VOCAL

OBJETIVO: Avaliar a reprodutibilidade do volume do braço e coxa fetais aferido pela ultrassonografia tridimensional utilizando o método eXtended Imaging Virtual Organ Computer-aided AnaLysis (XI VOCAL). MATERIAIS E MÉTODOS: Realizou-se estudo de reprodutibilidade com 43 fetos normais entre 20 e 37 semanas. Para o cálculo do volume do braço e coxa fetais utilizou-se o método XI VOCAL com delimitação de 10 planos consecutivos. Para o cálculo da variabilidade interobservador, um examinador realizou uma medida do volume do braço e coxa dos 43 fetos, enquanto um segundo examinador, sem o conhecimento prévio dos resultados do primeiro examinador, realizou uma segunda medida dos mesmos volumes. Utilizaram-se, para os cálculos estatísticos, o coeficiente de correlação intraclasse (ricc), gráficos de Bland-Altman e teste t-Student pareado (p). RESULTADOS: Observou-se alta reprodutibilidade interobservador. Para o volume do braço, obtiveram-se ricc = 0,996 (intervalo de confiança [IC] 95%: 0,992; 0,998) e média das diferenças = 0,13 ± 1,29% (95% limites de concordância: -2,54; +2,54%). Para o volume da coxa, obtiveram-se ricc = 0,997 (IC 95%: 0,995; 0,999) e média das diferenças = 0,24 ± 7,60% (95% limites de concordância: -7,6; +7,6%). CONCLUSÃO: O volume do braço e coxa fetais aferido pela ultrassonografia tridimensional utilizando o método XI VOCAL apresentou elevada reprodutibilidade interobservador.

Análise da reprodutibilidade do Doppler de amplitude tridimensional na avaliação da circulação do cérebro fetal

OBJETIVO: Avaliar a reprodutibilidade intra e interobservador do Doppler de amplitude tridimensional (3D power Doppler) na avaliação do fluxo sanguíneo cerebral do território da artéria cerebral média. MATERIAIS E MÉTODOS: Foi realizado estudo transversal com 20 gestantes normais entre 26 e 34 semanas. O território da artéria cerebral média mais próximo ao transdutor foi selecionado e o volume foi calculado utilizando-se o método Virtual Organ Computer-aided AnaLysis. Posteriormente, obtiveram-se os índices do 3D power Doppler: índice de vascularização (VI), índice de fluxo (FI) e índice de vascularização-fluxo (VFI). Utilizaram-se, para os cálculos, o coeficiente de correlação intraclasse (CCI) e gráficos de Bland-Altman. RESULTADOS: Foi observada boa concordância intra e interobservador, com CCI > 0,90 para todos os índices do 3D power Doppler: VI [CCI = 0,992 (IC 95%: 0,981-0,997)], FI [CCI = 0,999 (IC 95%: 0,998-0,999)], VFI [CCI = 0,995 (IC 95%: 0,987-0,998)]. Reprodutibilidade interobservador: VI [CCI = 0,988 (IC 95%: 0,970-0,995)], FI [CCI = 0,999 (IC 95%: 0,997-1,000)], VFI [CCI = 0,994 (IC 95%: 0,994-0,998)]. CONCLUSÃO: O 3D power Doppler mostrou-se um método prático, fácil e com boa reprodutibilidade intra e interobservador, com o IF evidenciando a melhor concordância intra e interobservador