Caractérisation des ataxies hérédodégénératives par spectroscopie de résonance magnétique nucléaire in vivo

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Caractérisation des ataxies hérédodégénératives par spectroscopie de résonance magnétique nucléaire in vivo

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The subcortical confinement hypothesis: A neurological model for schizotypal hallucinations

Introduction Different types of hallucinations are symptomatic of different conditions. Schizotypal hallucinations are unique in that they follow existing delusional narrative patterns: they are often bizarre, they are generally multimodal, and they are particularly vivid (the experience of a newsreader abusing you personally over the TV is both visual and aural. Patients who feel and hear silicone chips under their skin suffer from haptic hallucinations as well as aural ones, etc.) Although there are a number of hypotheses for hallucinations, few cogently grapple the sheer bizarreness of the ones experienced in schizotypal psychosis. Methods A review-based hypothesis, traversing theory from the molecular level to phenomenological expression as a distinct and recognizable symptomatology. Conclusion Hallucinations appear to be caused by a two-fold dysfunction in the mesofrontal dopamine pathway, which is considered here to mediate attention of different types: in the anterior medial frontal lobe, the receptors (largely D1 type) mediate declarative awareness, whereas the receptors in the striatum (largely D2 type) mediate latent awareness of known schemata. In healthy perception, most of the perceptual load is performed by the latter: by the top-down predictive and mimetic engine, with the bottom-up mechanism being used as a secondary tool to bring conscious deliberation to stimuli that fails to match up against expectations. In schizophrenia, the predictive mode is over-stimulated, while the bottom-up feedback mechanism atrophies. The dysfunctional distribution pattern effectively confines dopamine activity to the striatum, thereby stimulating the structural components of thought and behaviour: well-learned routines, narrative structures, lexica, grammar, schemata, archetypes, and other procedural resources. Meanwhile, the loss of activity in the frontal complex reduces the capacity for declarative awareness and for processing anything that fails to meet expectations.

Avaliação psico-educacional de uma adolescente portadora da síndrome de Sturge-Weber

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Osteotomia sagital da crista alveolar para instalação de implantes Bicon

This case report presents details of a new surgical technique for mandibular ridge sagittal osteotomy and expansion associated to immediate dental implants in atrophic ridges. The bone atrophies represents a challenge for the surgeons that intends to modify this situation. In the past, the only viable option was the onlay bone graft. However, the bone graft requests a second surgical site that certainly increases the postoperative morbidity, without mentioning the longer treatment time required. The sagittal osteotomy of the alveolar crest represents a faster option, because it eliminates the time requested for bone graft integration, providing rehabilitation of edentulous areas with thin alveolar crests that otherwise would need additi onal surgical procedures for a satisfactory result. The authors report a clinical case in which this technique was used with the installation of a Bicon dental implant in the same surgical time, showing all the steps for this single-tooth rehabilitation.

Increased cyclooxygenase-2 and vascular endothelial growth factor protein expression is associated with canine prostatic carcionogenesis process

Background: COX-2 is one of the most important prostaglandin involved in urologic cancer and seems to be associated with tumor progression, invasion, and metastasis. In addition, several effects have been reported for VEGF, including inducing angiogenesis, promoting cell migration, and inhibiting apoptosis. COX2 and VEGF up-regulation have been reported in human prostate cancer. Due to the importance of canine natural model for prostate cancer, the aim of this study was to evaluate COX-2 and VEGF protein expression in canine carcinogenic process. Material and Methods: Seventy-four prostatic tissues from dogs were selected to be evaluated for protein expression by immunohistochemistry (IHC), including: 10 normal prostatic tissues, 20 benign prostatic hyperplasias (BPH), 25 proliferative inflammatory atrophies (PIA) and 20 prostatic carcinomas (PCa). COX-2 and VEGF were detected using the monoclonal antibody CX-294 (1:50 dilution, Dako Cytomation and sc-53463 (1:100 dilution, Santa Cruz), respectively. The immunolabelling was performed by a polymer method (Histofine, Nichirei Biosciences). All reaction included negative controls by omitting the primary antibody. The percentage of C-MYC, E-cadherin, and p63- positive cells per lesion was evaluated according to Prowatke et al. (2007). The samples were scored separately according to staining intensity and graded semi-quantitatively as negative, weakly positive (1), moderately positive, and strongly positive. The score was done in one 400 magnification field, considering only the lesion, since this was done in a TMA core of 1 mm. For statistical analyses, the immunostaining classifications were reduced to two categories: negative and positive. The negative category included negative and weakly positive staining. Chi-square or Fisher exact test was used to determine the association between the categorical variables. Results: The COX-2 protein expression was elevated in the cytoplasm of the canine PCa and PIA compared to normal prostate (p=0.002). VEGF protein expression was increased in 94.75% of the PCa and 100% of the PIA compared with to normal prostate (p = 0.001). No difference was found when compared normal prostate with BPH. Conclusions: This study has demonstrated that the carcinogenesis of canine prostatic tissue may be related to gain of COX-2 and VEGF protein expression.

Morphology of ileal and jejunal pouches used as rectal substitutes

PURPOSE: Our aim was to determine whether the mucosa of a canine jejunal pouch used as a rectal substitute after proctocolectomy retains its morphologic features better than the mucosa of a canine ileal pouch so used. METHODS: Among ten dogs that underwent proctocolectomy, five had a jejunal pouch-distal rectal anastomosis and five an ileal pouch-distal rectal anastomosis. After six months, the animals were killed, the intestinal pouches and portions of unaltered distal ileum were removed, and a blinded, mucosal morphometric analysis was performed. RESULTS: The mucosa of the jejunal pouches had an overall thickness (mean ± standard deviation, anterior and posterior walls, 1,300 ± 140 μm), villous height (286 ± 46 μm), and crypt depth (790 ± 77 μm) greater than that of the ileal pouches (920 ± 170, 208 ± 47, and 530 ± 130 μm, respectively; P < 0.05). Moreover, the mucosal thickness of the jejunal pouches was similar to that of the distal ileum proximal to the pouch (1,200 ± 200 μm; P > 0.05), whereas the mucosal thickness of the ileal pouch was thinner (P < 0.05). CONCLUSIONS: The jejunal mucosa retains its major morphometric features when the jejunum is used as a rectal substitute after proctocolectomy. In contrast, the ileal mucosa atrophies when the ileum is so used.

Role of ATM and PTEN in prostatic carcinogenic dog prostate: validation of aCGH results

The canis lupus familiares is the only species besides human that spontaneously develop prostatic carcinoma (PCa). In addition, the metastatic sites are similar to those frequently reported in men. For these reasons, the dog is the best natural model to study the molecular mechanisms in PCa development providing a natural animal model for treatment by molecular targets. Previously, we investigated copy number alterations by arrayCGH (Canine Genome CGH Microarray 4x44K-G2519F, Agilent Technologies) in canine prostatic lesions: 3 benign prostatic hyperplasias (BPH), 4 proliferative inflammatory atrophies (PIA), and 14 PCa. Five histologically normal prostatic tissues were used as reference. Genomic alterations were evaluated using Genomic Workbench Standard Edition 5.0.14. This previous study revealed significant copy number losses of Atm and Pten exclusively in PCa. In the present study, ATM and PTEN immunoexpression were investigated using a tissue microarray (TMA) containing 149 canine prostatic paraffin-embedded lesions (BPH, PIA and PCa) collected from 67 animals. Immunohistochemical reactions were performed using the polyclonal rabbit antibody anti-PTEN (Santa Cruz Biotech, 1:50) and anti-ATM (Abcam, 1:50). The sections were developed with diaminobenzidine (DAB) and peroxidase. The immunohistochemical staining was assessed in each core by the distribution of positive cells for each antibody per lesion (score 1: <25% cells positive, 2: 26% to 50%, 3: being 51% and 75% and 4:> 75%) and intensity (1: weak, 2: moderate, 3: intense). Chi-square or Fisher exact test was used to determine the association between the categorical variables using GraphPad Prism 5 (GraphPad Software Inc., La Jolla, CA). Distribution of positive cells did not differ among lesions. PCa and PIA showed more samples with weak intensity for ATM when compared to normal prostatic tissue and BPH (PCa: p=0,032 and PIA: p=0,025). Benign prostatic hyperplasia and normal samples presented intense PTEN immunostaining than PCa (p=0,021) and PIA (p=0,0013). These results suggest that ATM and PTEN proteins expression in canine prostatic carcinoma are downregulated possibly by copy number losses. These findings are similar from those described in prostate carcinomas from human corroborating for the use of dogs as a natural model to study prostatic disease in men.

Mitochondrial neurogastrointestinal encephalomyopathy in three siblings: clinical, genetic and neuroradiological features

Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive disorder in which a nuclear mutation of the thymidine phosphorylase (TP) gene causes mitochondrial genomic dysfunction. Patients suffer from gastrointestinal dysmotility, cachexia, ptosis, external ophthalmoparesis, myopathy and polyneuropathy. Magnetic resonance imaging (MRI) shows leukoencephalopathy. We describe clinical, genetic and neuroradiological features of three brothers affected with MNGIE. Clinical examination, laboratory analyses, MRI and magnetic resonance spectroscopy (MRS) of the brain, and genetic analysis have been performed in all six members of the family with the three patients with MNGIE. Two of them are monozygous twins. They all suffered from gastrointestinal dysmotility, cachexia, ophthalmoplegia, muscular atrophies, and polyneuropathy. Urinary thymidine was elevated in the patients related to the severity of clinical disease, and urinary thymidine (normally not detectable) was also found in a heterozygous carrier. Brain MRI showed leukoencephalopathy in all patients; however, their cognitive functioning was normal. Brain MRS demonstrated reduced N-acetylaspartate and choline in severely affected areas. MRI of heterozygous carriers was normal. A new mutation (T92N) in the TP gene was identified. Urinary thymidine is for the first time reported to be detectable in a heterozygous carrier. MRS findings indicate loss of neurons, axons, and glial cells in patients with MNGIE, but not in heterozygous carriers.

Functional and anatomical outcomes of vitreoretinal surgery for posterior segment complications after elective cataract surgery

PURPOSE: To assess the outcomes in patients who required 1 or more vitreoretinal interventions for posterior segment complications arising from elective uneventful cataract surgery. SETTING: Tertiary referral center, single-center study. METHODS: A retrospective interventional case series included 56 consecutive patients who were referred for surgical correction of posterior segment complications within 6 months of cataract surgery. The study period was between 1996 and 2003, and the minimum follow-up was 5 months. RESULTS: Posterior segment complications were resolved with a single surgical intervention in 40 cases (71.4%). Within 5 months of primary surgical correction, persisting or newly arising posterior segment complications were noted in 16 cases (28.6%). After a mean of 2.1 +/- 1.4 (SD) additional surgeries, the number of eyes with posterior segment problems decreased to 7 (12.5%) (P = .035). Posterior segment complications requiring more than 1 vitreoretinal intervention included retinal detachment, endophthalmitis, and choroidal hemorrhages. After primary correction surgery, the mean best corrected visual acuity increased from 0.15 +/- 0.24 to 0.37 +/- 0.33 (P = .001) after a single intervention and to 0.39 +/- 0.32 (P>.05) after additional interventions. Although the intraocular pressure (IOP) decreased from 21.8 +/- 16.6 mm Hg to 14.9 +/- 3.4 mm Hg (P = .008), 4 (7.1%) consecutive vascular optic atrophies occurred. A reduction in corneal transparency was observed in 46.4% of patients before primary surgical correction and 12.5% after primary surgical correction (P<.001). CONCLUSIONS: In many cases, posterior segment complications arising from cataract surgery could be repaired with favorable functional and anatomical outcomes by a single vitreoretinal intervention. Additional surgery, if requested, provided stabilization of the anatomical and functional outcomes.

Neuroradiological findings expand the phenotype of OPA1-related mitochondrial dysfunction

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