Composição da matriz extracelular do ligamento cardinal de mulheres na pós-menopausa com e sem prolapso uterino / Composition of extracellular matrix of the cardinal ligament in postmenopausal women with and without uterine prolapse

O prolapso uterino tem sua incidência aumentada na pós-menopausa. O objetivo deste estudo é identificar as alterações na matriz extracelular do ligamento cardinal associadas à menopausa e ao prolapso uterino. Ligamento cardinal de três diferentes grupos de mulheres, pré-menopausa, prolapso uterino e pós-menopausa, foram identificados e biopsiados durante 57 histerectomias abdominais ou vaginais. As amostras foram processadas por métodos bioquímicos para caracterização e quantificação de glicosaminoglicanos sulfatados e colágeno. As concentrações relativas de glicosaminoglicanos foram obtidas por eletroforese. Procedimentos histológicos foram feitos para identificar fibras elásticas (Weigert), distribuição de colágeno (Picro Sirius) e decorin (imunohistoquímica). Nossos resultados mostraram aumento na concentração de GAG de 72,2%, redução na concentração de colágeno de 37% e diminuição de 22% de fibras elásticas no grupo de prolapso uterino quando comparado ao grupo da pós-menopausa (p<0,05, p<0,04 e p<0,05 respectivamente). As concentrações relativas de glicosaminoglicanos sulfatados para condroitin sulfato, heparan sulfato e dermatan sulfato não mostraram diferenças entre os três grupos. A organização do colágeno foi similar entre os três grupos e a marcação do decorin pareceu estar diminuída no grupo de prolapso uterino. Nossos resultados indicam alterações no metabolismo do tecido conjuntivo. O ligamento cardinal da mulher na pós-menopausa possui uma matriz extracelular mais densa. Esta alteração não ocorre na mulher com prolapso uterino.

Uterine prolapse has increase of incidence after menopause. The aim of this study was to identify the changes in extracellular matrix of cardinal ligaments associated to menopause and uterine prolapse. Cardinal ligament of 3 different groups (pre-menopause, menopause and uterine prolapse) are identified and biopsied during 57 women's abdominal or vaginal hysterectomy. Biopsy specimens were assessed by biochemical methods to characterize and quantify sulfated glycosaminoglycans and collagen. Relative concentrations of GAG were obtained by electrophoresis. Histological procedures are made to identify elastic fibers (Weigert) collagen distribution (Picro sirius) and decorin (immunohistochemistry). Our results showed increase in GAG concentration 72.2% in uterine prolapse group compared to menopause group (p<0.05). Collagen concentration was 37% lower in uterine prolapse group compared to menopause group (p<0.04). Relative concentration of GAG: heparan sulfate, chondroitin sulfate and dermatan sulfate showed no differences among three groups. Elastic fibers showed a significant reduction of aproximately 22% uterine prolapse group compared to menopause group (p<0.05). Collagen organization was similar in three groups and the staining pattern of decorin seemed to be decreased in uterine prolapse group. Our results indicate changes in connective tissue metabolism. Cardinal ligament in postmenopausal women has a denser extracellular matrix. This change is not observed in women with uterine prolapse.

Protein expression of VEGF, IGF-1 and FGF in retroocular connective tissues and clinical correlation in Graves' ophthalmopathy / Expressão protéica de VEGF, IGF-1 e FGF no tecido conjuntivo retro-ocular e correlação clínica na oftalmopatia de Graves

PURPOSE: To investigate the immunohistochemical expression (IGF-1, EGFr, EGF, c-erbB-2/HER-2/neu, PDGF-A, PDGF-B, FGF and VEGF) in patients with Graves' ophthalmopathy. METHODS: Twenty-four samples (Graves' ophthalmopathy patients) underwent lateral rectus muscle and surrounding fibrous and adipose tissue biopsy. The control group was obtained by strabismus surgery. Correlation between clinical- ophthalmologic, endocrinological, ultrasonographic findings, and immunohistochemical expression was performed. RESULTS: IGF-1: There were 7 positive cases (29.2 percent). There was a direct relation with higher CAS (clinical activity score) in all of them and if only CAS equal or higher than 5 was considered, this was 54.5 percent. FGF: There was expression in 5 cases (20.8 percent) with a direct relation in all those with higher CAS (>5) (45.4 percent). VEGF: There were two positive cases (8.3 percent) for VEGF in endothelial cells, in these cases the patients also presented CAS higher than 5. There was no expressions of all growth factors in the control group. CONCLUSIONS: All patients, except one, with positive expression of FGF, IGF-1 and VEGF showed CAS greater than 5, suggesting in this way an important role of these growth factors in the pathogenesis and severity of Graves' ophthalmopathy. However, statistical analysis revealed only significant association between IGF-1 and male sex (P=0.034). Low ultrasound reflectivity and endocrine status may not correlate directly with disease activity or with immunoexpression of growth factors and c-erbB-2/HER-2/neu.

OBJETIVO: Investigar a expressão imuno-histoquímica de IGF-1, EGFr, EGF, c-erbB-2/HER-2/neu, PDGF-A, PDGF-B, FGF e VEGF na oftalmopatia de Graves. MÉTODOS: Vinte e dois pacientes (oftalmopatia de Graves) foram submetidos à biópsia do músculo reto lateral e tecido fibroso e adiposo adjacente. O grupo controle foi de pacientes de cirurgia de estrabismo. Foi feita correlação entre achados clínico-oftalmológicos, endocrinológicos, ultra-sonográficos e da expressão imuno-histoquímica dos fatores de crescimento. RESULTADOS: IGF-1: Houve 7 casos positivos (29,2 por cento). Houve correlação direta com o CAS (clinical activity score) elevado em todos os casos e em que consideramos CAS apenas acima de 5, em 54,5 por cento. FGF: Houve expressão em 5 casos (20,8 por cento) com relação direta com CAS elevado em todos os casos e em que consideramos CAS maior que 5 (45,4 por cento). VEGF: Houve dois casos positivos (8,3 por cento) para VEGF nas células endoteliais e estes casos também apresentavam CAS maior que 5. A imunorreatividade foi negativa em todo grupo controle. CONCLUSÃO: Todos os pacientes, com exceção de um, com expressão positiva para FGF, IGF-1 e VEGF mostraram CAS maior que 5, sugerindo importante papel destes fatores de crescimento na patogênese e gravidade da oftalmopatia de Graves. Entretanto, a análise estatística demonstrou associação significativa entre IGF-1 e o sexo masculino (P=0,034). Baixa refletividade ao ultra-som e condição endócrina não estiveram correlacionadas.

Transconjunctival penetration of mitomycin C.

AIMS: The study was performed to estimate transconjunctival penetration of mitomycin C (MMC) to Tenon's tissue following application over the intact conjunctiva before routine trabeculectomy. SETTINGS AND DESIGN: Institution-based case series. MATERIALS AND METHODS: In 41 eyes of 41 patients, MMC (0.4 mg/ml for 3 min) was applied over the intact conjunctiva before beginning trabeculectomy. Tenon's capsule directly beneath the site of application was excised during trabeculectomy and was homogenized, centrifuged and MMC concentrations were analyzed using high-performance liquid chromatography (HPLC). Statistical Analysis Used: Statistical analysis was performed using STATA 8.0 version software (STATA Corporation, Houston, TX, USA). In this study, P -values less than 0.05 were considered as statistically significant. RESULTS: The average weight of the sample of Tenon's tissue excised was 5.51+/-4.42 mg (range: 0.9-17.1) and the average estimated MMC concentration found to be present in Tenon's tissue using HPLC was 18.67+/-32.36 x 10(-6) moles/kg of the tissue (range: 0.38-197.05 x 10(-6)). In 36 of the 41 patients (87.80%), the MMC concentration reached above 2 x 10(-6) moles/kg of the tissue concentration required to inhibit human conjunctival fibroblasts. CONCLUSIONS: Mitomycin C does permeate into the subconjunctival tissue after supraconjunctival application for 3 min. Application of MMC over the conjunctiva may be a useful alternative to subconjunctival or subscleral application during routine trabeculectomy and as an adjunct for failing blebs.

Reação do tecido conjuntivo subcutâneo de rato ao MTA e ao hidróxido de cálcio / Reaction of rat connective tissue to implanted Mineral Trioxide Aggregate (MTA) and to calcium hydroxide

Foram analisadas as reações que ocorrem no tecido conjuntivo de ratos em contato com tubos de polietileno, contendo agregado de trióxido mineral (MTA) e uma pasta de hidróxido de cálcio (Calen). Os animais foram sacrificados nos períodos de 7, 14 e 30 dias. A maioria dos espécimes foram corados com hematoxilina e eosina, os demais com a técnica de Von Kossa para tecidos mineralizados. Próximo às aberturas do tubo foi constatada a presença de insenso infiltrado inflamatório, que no período de 30 dias de apresentou leve. Foi observada tanto junto ao agregado de trióxido mineral como junto à pasta de hidróxido de cálcio (Calen), a formação de uma cápsula fibrosa fina. Nos espécimes tratados pela técnica de Von Kossa somente foram encontradas áreas positivas nos que continham hidróxido de cálcio (Calen)

Myelopoietic competence of stroma composed of hepatic granuloma-derived connective tissue cells or skin fibroblasts

1. Connective tissue cells isolated form hepatic granulomas (GR cells), induced in mouse liver tissue by schistosomal infection, are able to sustain myelopoiesis, while other connective tissue cells such as skin fibroblasts (SF) are not. 2. We compared the ability of SF and GR cells sustain in vitro proliferation of the FDC-P1 myeloid cell line, dependent upon IL-3 or GM-CSF. 3. Only the GR stroma susteined the proliferation of co-cultured FDC-P1 cells. RT-PCR analysis showed that both cell lines expressed the message for GM-CSF, but not for IL-3. We showed that GM-CSF was produced by, and remained bound to the cell layer through heparan sulfate; this growth factor could be released by high-salt treatment in a biologically active form from both cell types. The same activity could be restored to NaCl-treated GR cells, but not to SF, by incubation with recombinant murine GM-CSF. 4. These results indicate that the ability of connective tissue cells to sustain myelopoiesis depends directly upon the capapcity of their heparan sulfate-bearing molecules to bind and present the GM-CSF to the target cells in a biologically active form. Alternatively, a yet unidentified set of cell layer-associated molecules may be required for the positive or negative control of the membrane-bound GM-CSF

Proteoglycans and glycosaminoglycans synthesized by the hepatic granulomas isolated from schistosome-infected mice and by a granuloma-derived connective tissue cell line

1. This paper summarizes our studies on proteglycans and glycosaminoglycans in the hepatic fibrosis occurring in schistosomiasis. 2. We have compared proteglycans and glycosaminoglycans isolated from schistosomal fibrotic granulomas with those obtained from the cellular and extracellular compartments of a murine cell line derived from schistosome-induced granulomas, primary cell line "GR". 3. Our results have shown some biochemical and structural similarities between proteglycans and glycosaminoglycans extracted from granulomas and those synthesized and secreted by GR cells, suggesting that cells may be the major cell population involved in synthesis and accumulation of these molecules in the schistosomal periovular granulomas in liver. Furthermore, we have shown that GR cells can function as an extramedullary myelopoietic stroma that mediates a long-term myeloid proliferation through an autocrine mechanism where the interaction between myelopoietic growth factors and cell-surface heparan sulfate proteoglycans was characterized

Biomateriais na substituiçäo de tecidos moles / Biomaterials in soft tissue substitution

Os autores apresentam revisäo da literatura sobre o uso de biomateriais na reparaçäo de tecidos moles. Säo descritos os principais aspectos relacionados ao silicone, poliamida, polietileno e politetrafluoretileno, quando utilizados como inclusöes. Destaques säo dados à resposta inflamatória local, formaçäo de cápsula, fenômenos de sensibilizaçäo. Säo ainda salientadas a interferência das propriedades físico-químicas e superfície na evocaçäo de resposta inflamatória, além da fixaçäo das inclusöes em relaçäo à porosidade das mesmas