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1.
Adv Rheumatol ; 60: 48, 2020. tab, graf
Article in English | LILACS | ID: biblio-1130784

ABSTRACT

Abstract Background The reproducibility and reliability of the modified Rodnan's Skin Score (mRSS) are debated due to investigator-related subjectivity. Here, we evaluate if durometry correlates with mRSS in patients with diffuse systemic sclerosis (SSc). Methods This cross-sectional study was conducted from December 2018 to June 2019, including 58 diffuse SSc patients. Two certified researchers, blind to each other's scores, performed the mRSS, followed by durometry at 17 predefined skin sites. For durometry and mRSS, individual scores per skin site were registered. Durometry and mRSS results measured by each researcher, as well as scores from different researchers, were compared. Skin thickness measurements from forearm skin biopsies were available in a subset of the patients, for comparisons. Statistical analyses included Cohen's Kappa Coefficient, Intraclass Correlation Coefficient, Kendall's Coefficient and Spearman's test. Results Mean (standard deviation, SD) patient age was 44.8 (12.9) years, and 88% were female. Inter-rater agreement varied from 0.88 to 0.99 (Intraclass correlation coefficient) for durometry, and 0.54 to 0.79 (Cohen's Kappa coefficient) for mRSS, according to the specific evaluated sites. When data were compared with skin thickness assessed in forearm biopsies, durometry correlated better with skin thickness than mRSS. Conclusion Durometry may be considered as an alternative method to quantify skin involvement in patients with diffuse SSc. The strong inter-rater agreement suggests that the method may be useful for the assessment of patients by multiple researchers, as in clinical trials.(AU)


Subject(s)
Humans , Scleroderma, Systemic/physiopathology , Skin Abnormalities , Reproducibility of Results , Cultural Competency
2.
Clinics ; 67(7): 697-703, July 2012. ilus, graf, tab
Article in English | LILACS | ID: lil-645439

ABSTRACT

OBJECTIVES: The objectives of our study were as follows: 1) to analyze the prognostic value of macrophage infiltration in primary IgA nephropathy (IgAN) and 2) to study the relationship between macrophages and other factors associated with the development of renal fibrosis, including mast cells, TGF-β1, α-SMA and NF-kB. METHODS: We analyzed 62 patients who had been diagnosed with IgAN between 1987 and 2003. Immunohistochemical staining was performed with monoclonal antibodies against CD68 and mast cell tryptase and polyclonal antibodies against TGF-β1, α-SMA and NF-kB p65. We also used Southwestern histochemistry for the in situ detection of activated NF-kB. RESULTS: The infiltration of macrophages into the tubulointerstitial compartment correlated with unfavorable clinical and histological parameters, and a worse clinical course of IgAN was significantly associated with the number of tubulointerstitial macrophages. Kaplan-Meier curves demonstrated that increased macrophage infiltration was associated with decreased renal survival. Moreover, the presence of macrophages was associated with mast cells, tubulointerstitial α-SMA expression and NF-kB activation (IH and Southwestern histochemistry). In the multivariate analysis, the two parameters that correlated with macrophage infiltration, proteinuria and tubulointerstitial injury, were independently associated with an unfavorable clinical course. CONCLUSION: An increased number of macrophages in the tubulointerstitial area may serve as a predictive factor for poor prognosis in patients with IgAN, and these cells were also associated with the expression of pro-fibrotic factors.


Subject(s)
Adult , Female , Humans , Male , Actins/metabolism , Glomerulonephritis, IGA/pathology , Macrophages/physiology , NF-kappa B/metabolism , Biopsy , Biomarkers/metabolism , Fibrosis , Glomerulonephritis, IGA/metabolism , Histocytochemistry , Kidney Tubules/pathology , Macrophages/pathology , Proteinuria/pathology , Transforming Growth Factor beta1/metabolism
3.
Rev. Soc. Bras. Med. Trop ; 44(1): 13-17, Jan.-Feb. 2011. graf, tab
Article in English | LILACS | ID: lil-579823

ABSTRACT

INTRODUCTION: Hepatitis B is common in Brazil, although there are regional differences regarding the degree of endemicity, the most frequent forms of transmission and the presence of different evolutive stages of chronic disease. The present study aimed to determine the clinical, demographic and epidemiological characteristics of patients chronically infected with hepatitis B virus (HBV) residing in the Ribeirão Preto region, southeastern Brazil. METHODS: A total of 529 medical records of individuals with HBV monoinfection were reviewed. RESULTS: More than 60 percent of the subjects were males, with a mean age of 38 years-old. The HBeAg-negative serological pattern was verified in 84.4 percent of the patients, among whom the risk of vertical/intrafamily transmission was 43.2 percent (p = 0.02). The consumption of alcohol in amounts exceeding 20g a day was observed in 21.3 percent of the subjects and was more frequent among men (33 percent) (p < 0.001). Among patients with cirrhosis, 54.1 percent were alcohol abusers (p = 0.04), all of them males. The presence of cirrhosis was more frequent in the HBeAg-positive group (24.4 percent) than in the HBeAg-negative group (10.2 percent) (p < 0.001). CONCLUSIONS: High proportions of HBV-infected subjects with an HBeAg-negative pattern were observed, with a higher risk of vertical/intrafamily transmission. Alcohol abuse was associated with male subjects and with cirrhosis of the liver in this group. A tendency toward an increase in the number of HBeAg-negative cases was observed over time.


INTRODUÇÃO: No Brasil, a hepatite B é comum. No entanto, há diferenças regionais no que diz respeito ao grau de endemicidade, as formas de transmissão mais encontradas e a presença dos diferentes estágios evolutivos da doença crônica. O objetivo deste trabalho foi o de conhecer características clínicas, demográficas e epidemiológicas de pacientes cronicamente infectados pelo vírus da hepatite B (HBV), residentes na região de Ribeirão Preto, no sudeste do Brasil. MÉTODOS: Foi realizada a análise retrospectiva de 529 prontuários de indivíduos com monoinfecção pelo HBV. RESULTADOS: Mais de 60 por cento eram masculinos, a média de idade foi de 38 anos. O padrão sorológico HBeAg negativo foi encontrado em 84,4 por cento dos pacientes, entre os quais o risco para transmissão vertical/intrafamiliar foi de 43,2 por cento (p = 0,02). Verificou-se uso de álcool em quantidades maiores que 20g ao dia em 21,3 por cento dos indivíduos, sendo mais frequente entre os homens (33 por cento) (p < 0,001). Entre os pacientes com cirrose, 54,1 por cento faziam uso abusivo de bebidas alcoólicas (p = 0,04), sendo todos estes do gênero masculino. A presença de cirrose foi maior no grupo HBeAg positivo (24,4 por cento) que no grupo HBeAg negativo (10,2 por cento) (p < 0,001). CONCLUSÕES: Observaram-se elevadas proporções de indivíduos com infecção pelo HBV com padrão sorológico HBeAg negativo, entre os quais houve maior risco para a transmissão vertical/intrafamiliar. O uso abusivo de álcool esteve associado a indivíduos do sexo masculino e, neste grupo, à cirrose hepática. Observou-se tendência ao aumento no número de casos HBeAg negativo ao longo do tempo.


Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Hepatitis B Antibodies/blood , Hepatitis B e Antigens/blood , Hepatitis B virus/immunology , Hepatitis B, Chronic/epidemiology , Alcoholism/complications , Alcoholism/epidemiology , Brazil/epidemiology , DNA, Viral/analysis , Hospitals, University , Hepatitis B virus/genetics , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/transmission , Liver Cirrhosis/epidemiology , Liver Cirrhosis/virology , Retrospective Studies , Risk Factors
4.
Braz. j. infect. dis ; 14(4): 330-334, July-Aug. 2010. tab
Article in English | LILACS | ID: lil-561202

ABSTRACT

BACKGROUND AND AIM: The durability of the sustained virologic response (SVR) in patients with chronic hepatitis C after treatment and the ideal follow-up time for these patients remains undefined. The objective of the study was to evaluate the durability of the virologic response in patients with chronic hepatitis C followed up for at least 12 months after SVR at HCFMRP-USP. METHODS: The study was conducted on 174 patients with chronic hepatitis C treated with different antiviral regimens who had achieved SVR. Qualitative serum HCV-RNA was determined by the commercial kit (COBAS AMPLICOR HCV, v2.0). RESULTS: There was predominance of male (73 percent) with a mean age of 45.6 ± 10 years. Liver cirrhosis was present in 16.1 percent of the study subjects. Mean follow-up time after SVR was 47 months (12-156 months). Twenty-two patients received monotherapy with interferon; 94 received interferon plus ribavirin, and 58 received pegylated interferon plus ribavirin. A total of 134 patients (77.0 percent) received one treatment course, 29 (16.7 percent) received two courses, and 11 (6.3 percent) received three courses. The distribution of HCV genotypes was: genotype 1 (40.2 percent), genotype 3 (40.8 percent) and genotype 2 (10.3 percent). Genotype was undetermined in 8.7 percent of cases. None of the 174 patients had recurrence of HCV infection. Two cirrhotic patients developed hepatocellular carcinoma (HCC) during follow-up. CONCLUSIONS: Among patients with SVR there was no recurrence of HCV infection or evidence of liver disease progression in any patient followed up for a mean of 47 months after SVR, except for patients with advanced hepatic disease before treatment, who may develop HCC despite SVR. Therefore, one can assume that SVR is associated with long term good prognosis.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Antiviral Agents/administration & dosage , Hepatitis C, Chronic/drug therapy , Interferons/administration & dosage , Liver Cirrhosis/virology , RNA, Viral/blood , Ribavirin/administration & dosage , Antiviral Agents/therapeutic use , Follow-Up Studies , Genotype , Hepatitis C, Chronic/virology , Interferons/therapeutic use , Polymerase Chain Reaction , Ribavirin/therapeutic use , Severity of Illness Index , Time Factors , Treatment Outcome
5.
Appl. cancer res ; 30(1): 232-235, Jan.-Mar. 2010. ilus
Article in English | LILACS, Inca | ID: lil-547644

ABSTRACT

Wandering spleen is the consequence of excessive splenic mobility due to ineffective peritoneal attachment, rarely associated to splenic cysts. In cases previously reported, splenic cysts are mostly pseudocystic formations from trauma, infarction or parasitic disease. True cysts, epithelial or mesothelial lined, which are considered dysontogenetic formations, are usually not associated to wandering spleen. Angiomyolipoma is a benign triphasic tumor, usually renal. Few cases of wandering spleen associated with mesothelial cyst or angiomyolipoma are described. We present the first case to our knowledge of these three entities together; isolated evidence, once compiled, may lead to the influence of estrogen as a common factor in pathogenesis. Even though a punctual intervention in a benign panorama, we question whether these lesions act as distinct, partially associated or as the manifestation of an underlying silent syndromic disease that could harbor future outcomes to similar patients.


Subject(s)
Angiomyolipoma , Dermoid Cyst , Estrogens , Neoplasms, Mesothelial , Pregnancy , Wandering Spleen
6.
Rev. bras. ortop ; 44(1): 20-25, jan.-fev. 2009. ilus, graf, tab
Article in Portuguese | LILACS | ID: lil-572654

ABSTRACT

OBJETIVO: Avaliar por meio de histomorfometria, a espessura da placa vertebral terminal, a espessura do disco intervertebral e a sua correlação nas diferentes faixas etárias, tentando identificar a sua correlação. MÉTODOS: Foram avaliados os segmentos cervicais C4-C5 e C5-C6 de 50 cadáveres humanos , de ambos os sexos, divididos em 5 grupos com intervalo de faixa etária de 10 anos, a partir dos 21 anos de idade. A avaliação da espessura da PVT e do disco intervertebral foi realizada por meio de avaliação histomorfométrica dos cortes histológicos corados pela hematoxilina e eosina. A espessura da PVT inferior de C4, PVT superior de C5, PVT inferior de C5 e PVT superior de C6 foram comparadas entre si e também com a espessura do disco intervertebral interposto entre as respectivas PVT. RESULTADOS: A espessura das placas vertebrais terminais adjacentes ao mesmo DI não apresentou diferença estatística. No entanto, a comparação da espessura das placas vertebrais superior e inferior da mesma vértebra cervical (C5), apresentou diferença estatística em todas as faixas etárias avaliadas. Foi observado coeficiente de correlação estatística, maior que 80 por cento, entre a espessura daplaca vertebral terminal e o disco intervertebral adjacente, com proporcional redução de espessura de ambas estruturas, nos diferentes níveis cervicais avaliados, e também nas diferentes faixas etárias avaliadas. CONCLUSÃO: A placa vertebral terminal apresenta correlação morfológica com o disco intervertebral ao qual entra em contato, e não apresenta correlação com a placa vertebral terminal da mesma vértebra.


OBJECTIVE: To evaluate, by means of histomorphometry, terminal vertebral plate thickness, intervertebral disc thickness and its correlation on different age groups, seeking to identify its correlation. METHODS: C4-C5 and C5-C6 cervical segments removed from human cadavers of both genders were assessed and divided into five groups of 10-year age intervals, from 21 years old. TVP and intervertebral disc thickness evaluation was made by means of histomorphometry of histological slides stained with hematoxylin and eosyn. Lower C4 TVP, upper C5 TVP, and upper C6 TVP de were compared between each other and to the interposed intervertebral disc thickness between relevant TVP. RESULTS: The thickness of terminal vertebral plates adjacent to the same ID did not show statistic differences. However, the comparison of upper and lower vertebral plates thickness on the same cervical vertebra (C5), showed statistical difference on all age groups studied. We found a statistical correlation coefficient above 80 percent between terminal vertebral plate and adjacent intervertebral disc, witha proportional thickness reduction of both structures on the different cervical levels studied, and also on the different age groups assessed. CONCLUSION: Terminal vertebral plate shows a morphologic correlation with the intervertebral disc next to it, and does not show correlation with the terminal vertebral plate on the same vertebra.


Subject(s)
Cadaver , Intervertebral Disc , Spine
7.
Braz. j. infect. dis ; 12(3): 180-185, June 2008. tab
Article in English | LILACS | ID: lil-493644

ABSTRACT

Liver histological improvement after treatment for chronic hepatitis C in patients co-infected with human immunodeficiency virus-1 (HIV-1) has been described. Paired liver biopsies in twenty six HCV/HIV co-infected patients were compared to determine factors possibly associated with histological improvement. The patients were submitted to a liver biopsy before treatment for hepatitis C and 25 months after the end of treatment. Fragments of the liver biopsy obtained before and after treatment were compared regarding the following parameters: histological activity index (HAI) and degree of fibrosis (Knodell); intensity of collagen deposits (Sirius Red staining) and degree of stellate cell activation (alpha-smooth muscle actin labeling). The ratios of the post and pre-treatment variables were related through logistic regression to body mass index (BMI), alcohol ingestion, HCV genotype, HCV viremia, presence of hepatic iron and pre-treatment hepatic steatosis. A negative RNA test in the 24th week of treatment was associated with improvement in fibrosis, collagen deposits and stellate cell numbers. The other variables analyzed did not correlate to an improvement in hepatic histology after hepatitis C treatment. Reduction in HCV viremia during treatment may result in reduced hepatic fibrosis even in patients without a sustained virological response.


Subject(s)
Adult , Female , Humans , Male , Antiviral Agents/therapeutic use , HIV Infections/complications , Hepacivirus/drug effects , Hepatitis C, Chronic/drug therapy , Liver/drug effects , Biopsy , Genotype , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/pathology , Hepatitis C, Chronic/virology , Interferon-alpha , Interferon-alpha/therapeutic use , Liver/pathology , Liver/virology , Polyethylene Glycols/therapeutic use , RNA, Viral , Ribavirin/therapeutic use , Treatment Outcome , Viral Load
8.
Acta cir. bras ; 23(supl.1): 17-23, 2008. graf, tab
Article in English | LILACS | ID: lil-483118

ABSTRACT

PURPOSE: Thalidomide, because of its anti-inflammatory properties, as re-emerged as an option for the treatment of Crohn's disease refractory to standard therapy. We studied the effect of thalidomide on the healing of colonic anastomosis. METHODS: Sixty male rats (Rattus norvegicus), were divided into 3 groups of 20 animals each, respectively receiving 0.5 or 1.0 mg/kg thalidomide by the oral route for 7 days, or saline solution (control). All animals were submitted to continuous end-to-end anastomosis with 6-0 Prolene sutures. After sacrifice the anastomoses were analyzed macroscopically and submitted to determination of hydroxyproline, to histology and to immunohistochemistry for metalloproteinase 1, metalloproteinase 1 inhibitor and vascular endothelial growth factor (VEGF). RESULTS: Statistical analysis of the data showed no significant difference in macroscopic aspect or hydroxyproline determination (p= 0.5403). In the immunohistochemical analysis, the following p values were obtained: p = 0.5817 for VEGF, p = 0.1854 for metalloproteinase 1, and p = 0.0023 for metalloproteinase 1 inhibitor, with this last value being considered statistically significant. CONCLUSION: We conclude that thalidomide influenced collagen maturation. There was a stronger action of metalloproteinases, possibly indicating a negative tendency for the healing process.


OBJETIVO: Sabe-se que agentes farmacológicos podem influenciar no processo de cicatrização. A talidomida, devido às suas propriedades antiinflamatórias, tem ressurgido como uma opção no tratamento da doença de Crõhn refratária à terapêutica convencional. Neste trabalho, estudamos o efeito da talidomida na cicatrização de anastomoses colônicas no rato. MÉTODOS: Foram utilizados 60 animais Rattus norvegius, com peso médio de 300g. Organizou-se 3 grupos de 20 animais, sendo um grupo controle (AC), um grupo (BD), com administração de talidomida 0,5 mg/kg por 7 dias e um grupo (AD) com administração de talidomida 1,0 mg/kg por 7 dias. Foi realizada anastomose término-terminal contínua de prolene 6-0. O sacrifício foi no 7º. dia pós operatório e as anastomoses foram analisadas quanto a aspecto macroscópico, dosagem de hidroxiprolina, histologia em hematoxilina-eosina e imuno-histoquímica para metaloproteinase 1, inibidor de metaloproteinase 1 e VEGF. RESULTADOS: Não houve diferença estatisticamente significante para a observação macroscópica e para dosagem de hidroxiprolina (p=0,5403). Na análise imunohistoquímica, para VEGF houve p=0,5817, para metaloproteinase 1, p=0,1854 e para inibidor de metaloproteinase, p=0,0023, considerado estatisticamente significante. CONCLUSÃO: Concluímos que a talidomida influenciou na maturação do colágeno. Notou-se maior ação das metaloproteinases, que pode significar uma tendência negativa para o processo cicatricial.


Subject(s)
Animals , Male , Rats , Angiogenesis Inhibitors/pharmacology , Colon/surgery , Thalidomide/pharmacology , Wound Healing/drug effects , Anastomosis, Surgical , Biomarkers/analysis , Collagen/biosynthesis , Disease Models, Animal , Hydroxyproline/analysis , Matrix Metalloproteinase 1/analysis , Random Allocation , Rats, Wistar , Surgical Wound Dehiscence , Vascular Endothelial Growth Factor A/analysis
9.
Acta cir. bras ; 23(supl.1): 24-30, 2008. graf
Article in English | LILACS | ID: lil-483119

ABSTRACT

PURPOSE: Colorectal anastomosis is a constant worry-issue among surgeons because of high rates of complications, specially the dehiscence. The preoperative irradiation on cancer surgeries might interfere in the healing process, leading to an unfavorable outcome. METHODS: In the present study, two groups of rats were irradiated previously to a colorectal anastomosis surgery, with intervals of 4 and 8 weeks between the procedures. Seven days after the surgery, healing process was evaluated for dehiscence presence and histologic inflammatory characteristics. Also, levels of hydroxyproline, metalloproteinases and vascular endothelial growth factor were measured. RESULTS: Our results showed a higher incidence of dehiscences on the animals submitted to irradiation, compared to controls, with a reduced inflammatory activity in the healing tissue. DISCUSSION: Comparing both irradiated groups, those irradiated 8 weeks before surgery showed higher levels of hydroxyproline and metalloproteinases, indicating higher efficiency of the healing process. In conclusion, preoperative irradiation interferes with intestinal anastomosis healing and a larger time interval between both procedures is safer in terms of the healing quality.


INTRODUÇÃO: As anastomoses colorretais são motivos constante de preocupação por parte dos cirurgiões, em virtude do alto índice de complicações, principalmente as deiscências. O uso da radioterapia previamente à cirurgia, nos casos de doença neoplásica, pode interferir no processo cicatricial das anastomoses, e levar a uma evolução desfavorável. MÉTODOS: Os autores estudaram dois grupos de ratos, submetidos a radioterapia e à confecção de uma anastomose no cólon, com intervalo de 04 e de 08 semanas entre os dois procedimentos, comparando com um grupo controle. Após 07 dias da cirurgia, estudaram-se vários aspectos do processo cicatricial: presença de deiscência, características inflamatórias do tecido, dosagem de hidroxiprolina, de mateloproteinase e de VEGF. RESULTADOS: Os autores detectaram maior índice de deiscência nos animais submetidos à radioterapia, com prejuízo da atividade inflamatória característica de um tecido em cicatrização. DISCUSSÃO: Dentre os dois grupos irradiados, aquele com intervalo de oito semanas entre a radioterapia e a confecção da anastomose teve dosagem mais alta de hidroxiprolina e metaloproteinase, demonstrando maior eficiência do processo cicatricial. CONCLUSÃO: A radioterapia prévia interfere no processo de cicatrização das anastomoses intestinais, e que um maior intervalo de tempo entre os dois procedimentos é melhor para garantia de uma cicatrização satisfatória.


Subject(s)
Animals , Male , Rats , Colon/surgery , Preoperative Care/methods , Rectum/surgery , Surgical Wound Dehiscence/etiology , Wound Healing/radiation effects , Anastomosis, Surgical , Collagen/radiation effects , Disease Models, Animal , Hydroxyproline/analysis , Hydroxyproline/radiation effects , Matrix Metalloproteinase 1/analysis , Matrix Metalloproteinase 1/radiation effects , Pelvis , Radiotherapy Dosage , Rats, Wistar , Time Factors , Tissue Inhibitor of Metalloproteinase-1/analysis , Tissue Inhibitor of Metalloproteinase-1/radiation effects , Vascular Endothelial Growth Factor A/analysis , Vascular Endothelial Growth Factor A/radiation effects
10.
Acta cir. bras ; 21(supl.1): 54-57, 2006.
Article in English, Portuguese | LILACS | ID: lil-438807

ABSTRACT

The cirrhosis represents the final stage of several chronic hepatic diseases and it is characterized by the presence of fibrosis and morphologic conversion from the normal hepatic architecture into structurally abnormal nodules. In the evolution of the disease there is loss of the normal vascular relationship and portal hypertension. There are also regenerative hepatocelular alterations that become more prominent with the progression of the disease. The liver transplantation continues to be the only therapeutic option in cases of disease in terminal phase. The hepatic stellate cells (HSC) are perisinusoidal cells that store vitamin A and produce growth factors, citocins, prostaglandins and other bioactive substances. They can suffer an activation process that convert them to cells with a phenotype similar to myofibroblasts. When activated, they present increased capacity of proliferation, mobility, contractility and synthesis of collagen and other components of extracelular matrix. They possess cytoplasmic processes adhered to sinusoids and can affect the sinusoidal blood flow. HSC are important in pathogenesis of fibrosis and portal hypertension.


A cirrose representa o estágio final de diversas doenças hepáticas crônicas e é caracterizada pela presença de fibrose e conversão da arquitetura hepática normal em nódulos estruturalmente anormais. Na evolução da doença ocorre perda da relação vascular normal e hipertensão portal. Há também alterações regenerativas hepatocelulares que se tornam mais proeminentes com a progressão da doença. O transplante hepático permanece como a única opção terapêutica nos casos de doença em fase terminal. As células estreladas hepáticas (CEH) são células perisinusoidais que armazenam vitamina A e produzem fatores de crescimento, citocinas, prostaglandinas e outras substâncias bioativas. Podem sofrer um processo de ativação para um fenótipo semelhante a miofibroblastos. Quando ativadas apresentam maior capacidade de proliferação, motilidade, contractilidade, síntese de colágeno e componentes da matriz extracelular. Possuem processos citoplasmáticos aderidos aos sinusóides e podem afetar o fluxo sangüíneo sinusoidal. As CEH são importantes na patogênese da fibrose e hipertensão portal.


Subject(s)
Humans , Adult , Hepatocytes/metabolism , Kupffer Cells/metabolism , Liver Cirrhosis/physiopathology , Liver/metabolism , Cell Proliferation , Disease Progression , Extracellular Matrix/metabolism , Hepatocyte Growth Factor/metabolism , Hepatocytes/cytology , Hypertension, Portal/complications , Kupffer Cells/cytology , Liver Cirrhosis/etiology , Liver Cirrhosis/metabolism , Liver Failure/complications , Liver/cytology , Myocytes, Smooth Muscle/metabolism , Paracrine Communication/physiology , Platelet-Derived Growth Factor/metabolism
11.
Acta cir. bras ; 21(supl.1): 58-62, 2006. ilus
Article in English, Portuguese | LILACS | ID: lil-438808

ABSTRACT

The purpose of this review was to carry out an analysis of the liver regenerative process focusing on the molecular interactions involved in this process. The authors undertook a review of scientific publications with a focus on the liver regeneration.The cellular processes involved in liver regeneration require multiple systematic actions related to cytokines and growth factors. These interactions result in the initiation of mitogenic potential of the hepatocytes. The action of these modulators in the regenerative process require a processing in the extra-cellular matrix. Serines and metal proteins are responsible for the bio availability of cytokines and growth factors so that they can interact as receptors in the cellular membrane generating signaling events for the beginning and end of the liver regenerative process. The exact mechanism of interaction between cells, cytokines and growth factors is not well established yet. A series of ordered events that result in the hepatic tissue regeneration has been described. The better understanding of these interactions should provide a new approach of the treatment for liver diseases, aiming at inducing the regenerative process.


O objetivo desta revisão foi desenvolver uma análise do processo regenerativo do fígado, focando as interações moleculares envolvidas neste processo.Os processos celulares envolvidos na regeneração hepática requerem múltiplas ações sistemáticas relacionadas com citoquinas e fatores de crescimento. Estas interações resultam na iniciação do potencial mitogênico dos hepatócitos. A ação destes moduladores do processo regenerativo necessita de processamento no meio extra celular. As serinas e metaloproteínas são responsáveis pela biodisponibilização de citoquinas e fatores de crescimento, para que então possam interagir com receptores na membrana celular gerando os eventos sinalizadores para o inicio e o término do processo regenerativo hepático.O exato mecanismo de interação entre células, citoquinas e fatores de crescimento não está bem estabelecido. Tem-se descrito uma série de eventos ordenados que resulta na regeneração do tecido hepático. O melhor entendimento destas interações leva a uma nova abordagem de tratamento para doenças hepáticas, objetivando a indução do processo regenerativo.


Subject(s)
Humans , Cell Proliferation , Hepatocyte Growth Factor/metabolism , Hepatocytes/metabolism , Liver Regeneration/physiology , Liver/metabolism , Extracellular Matrix/metabolism , Hepatocytes/cytology , Kupffer Cells/cytology , Kupffer Cells/metabolism , Liver/cytology , NF-kappa B/metabolism , Tumor Necrosis Factor-alpha/metabolism , Vascular Endothelial Growth Factors/metabolism
12.
Acta cir. bras ; 21(supl.1): 63-66, 2006.
Article in English, Portuguese | LILACS | ID: lil-438809

ABSTRACT

This paper has the objective to analyze the cellular aspects of liver regeneration (LR). Upon damage in this organ, the regenerative capacity of hepatocyte is sufficiently able to reestablish the parenchyma as a whole. Taking into account the regenerative capacity of hepatocyte, the need of a progenitor or a liver trunk cell was not obvious. Nowadays it is well-established that precursor cells take part in the liver regenerative process. The liver trunk cell, oval cell, acts as a bypotential precursor, contributing for the liver restoration, mainly when the hepatocytes are unable to proliferate. Another precursor, trunk cell of hematopoetic origin (HSC), takes part in the regenerative process, originating cells of the hepatocitic lineage and colangiocytes, as well as the oval cell. The way the trans-differentiation takes place is not established yet. A number of studies must be undertaken in order to clarify questions, such as the possible occurrence of cellular fusion process between the HSC and the hepatic cells and the possibility of application as a new therapeutic procedure in the treatment of diseases associated with insufficiency of this noble organ.


Este artigo tem como objetivo analisar aspectos da regeneração hepática (RH) sob a óptica celular. Em vigência de uma lesão neste órgão a capacidade regenerativa do hepatócito é suficientemente capaz de restabelecer o parênquima como um todo. Levando em conta a elevada capacidade regenerativa do hepatócito, a necessidade de um progenitor ou uma célula tronco hepática não era óbvia. Hoje esta bem estabelecido que células precursoras participam do processo regenerativo hepático. A célula tronco hepática, célula oval, atua como um precursor bipotencial, contribuindo para o restauro do fígado principalmente quando os hepatócitos se encontram impossibilitados de proliferar. Um outro precursor, a célula tronco de origem hematopoética (HSC), participa do processo regenerativo, originando células da linhagem hepatocítica e colangiócitos, assim como a células oval. Ainda não está estabelecido o meio como ocorre o fenômeno de transdiferenciação.Muitos estudos devem ser realizados no intuito de esclarecer questões, tais como a possível ocorrência de processo de fusão celular entre a HSC e as células hepáticas e a possibilidade de ser aplicado como uma nova terapêutica no tratamento de doenças associadas à insuficiência deste nobre órgão.


Subject(s)
Humans , Animals , Rats , Cell Differentiation/physiology , Hematopoietic Stem Cells/cytology , Hepatocytes/cytology , Liver Regeneration/physiology , Antigens, Surface/metabolism , Bile Ducts/cytology , Biomarkers/metabolism , Cell Proliferation
14.
Acta cir. bras ; 17(supl.3): 92-95, 2002. ilus, graf
Article in English | LILACS | ID: lil-335026

ABSTRACT

Recently, the LED (light emitting diode) developed by the Optics Group of IFSC-USP has been used instead of laser for the treatment of skin tumors by the PDT (Photodinamic Therapy) because of its low operational cost compared to the use of a laser. In this paper we investigate the effect of LED light on oxidative phosphorylation during liver regeneration after partial hepatectomy. Twenty-four male Wistar rats (250 g) were kept in identical housing units on a 12-hour light/12 hour dark cycle. The LED 10 group was exposed to LED at 638 nm (10 J/cm for 3 minutes). Seventy percent partial hepatectomy was performed in the LED 10 and HPC (Pardal Hepatectomy-Control). A sham-operated group (C) was used for control. Twenty four hours after the procedure, LED 10, HPC and control animals were sacrificed. Samples of liver tissue were used for the mitochondrial respiration assay. Statistical comparisons of the groups were performed by analysis of variance (ANOVA), followed by the Bonferroni post-test. Probability values less than 0.05 were considered to be statistically significant. the phosphorylation index (FI) for the LED 10 group was higher than that for the HPC group and for the sham group (p<005). The FI for the HPC group was higher than that for the sham group (p<005). The values of the ADRO ratio for the three groups, which did not differ significantly from one another (p > 0.05). In the present study we noted and affective interaction beetween LED light and hepatic mitochondria, with an increased phosphorylation rate for the latter.


Subject(s)
Animals , Male , Rats , Hepatectomy , Mitochondria , Oxidative Phosphorylation , Liver Regeneration/physiology , Photochemotherapy , Rats, Wistar
15.
Acta cir. bras ; 15(supl.2): 21-2, 2000. graf
Article in Portuguese | LILACS | ID: lil-282423

ABSTRACT

O presente estudo relata os efeitos da aplicação de LASER sobre fígados cirróticos de ratos Wistar. A cirrose hepática foi induzida através da ligadura do ducto biliar. Aproximadamente vinte e cinco dias após a cirurgia inicial, os animais foram submetidos à irradiação LASER com exposição hepática direta. O experimento compôs-se da análise morfométrica dos constituintes do fígado após 24 horas da irradiação. Os resultados revelaram maior proliferação vascular nos animais irradiados sem alteração dos demais componentes.


Subject(s)
Animals , Rats , Liver Cirrhosis/pathology , Lasers/adverse effects , Common Bile Duct/surgery , Liver/pathology , Lasers/therapeutic use , Ligation , Rats, Wistar
16.
Arq. gastroenterol ; 31(1): 24-9, jan.-mar. 1994. tab
Article in Portuguese | LILACS | ID: lil-139526

ABSTRACT

Os efeitos do cloreto de benzalcônio (CB) sobre o número de neurônios, a espessura da musculatura própria e o perímetro intestinal externo foram determinados após desenervaçäo aguda (até 10 dias pós-aplicaçäo do CB) e crônica (30 e 60 dias pós-aplicaçäo do CB) do jejuno proximal de ratos. Houve reduçäo significativa no número de neurônios mioentéricos em todos os segmentos tratados. A extensäo da desnervaçäo variou em funçäo do tempo decorrido após o tratamento: nos segmentos desnervados cronicamente o número de neurônios era superior àquele nos segmentos desnervados agudamente. Este achado pode ser resultado de fenômenos de neuroplasticidade ocorrendo durante a fase crônica. A desenervaçäo mioentérica induziu aumento da espessura da musculatura própria, especialmente da camada muscular longitudinal, sugerindo maior sensibilidade desta camada à desnervaçäo mioentérica


Subject(s)
Animals , Male , Rats , Benzalkonium Compounds/pharmacology , Jejunum/drug effects , Muscle Denervation , Myenteric Plexus , Case-Control Studies , Rats, Wistar , Time Factors
17.
Acta cir. bras ; 8(4): 177-89, out.-dez. 1993.
Article in Portuguese | LILACS | ID: lil-127392

ABSTRACT

No presente estudo, os autores elaboraram uma extensa abordagem acêrca da regeneraçäo hepática. Aspectos básicos, tais como cinética da resposta regenerativa, fases do processo replicativo e fatores que interferem na magnitude da síntese hepatocelular de DNA foram considerados. Considerou-se ainda as principais alteraçöes na expressäo gênica relacionadas à regeneraçäo hepática e, por fim, um minucioso relato dos principais fatores de crescimento hepático, com suas interaçöes e possíveis mecanismos de açäo


Subject(s)
Humans , Animals , Rats , Liver Regeneration/physiology , Growth Inhibitors/physiology , Growth Substances/physiology
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