Ventilación colateral: una propuesta para terminologia histologica / Collateral ventilation: a terminologia histologica proposal

La correcta utilización de los términos morfológicos está estandarizada por las terminologías, una de ellas es la Terminologia Histologica (TH). Éstas sugieren la exclusión de los epónimos. Pese a esto, existen estructuras que continúan en esta condición. Específicamente, "Poros de Kohn, Canales de Martin y Canales de Lambert" son términos que componen la ventilación colateral (VC) y son ejemplo de esta situación. Así, el objetivo del presente estudio fue identificar en TH los términos asociados a la VC a fin de proponer denominaciones siguiendo las recomendaciones de la Federación Internacional de Programas de Terminologías Anatómicas (FIPAT). Se buscaron los términos relacionados a la VC en TH, posteriormente, se efectuó el mismo ejercicio en textos de histología, además de esto, en base de datos MedLine a través de su buscador PudMed con el siguiente algoritmo: (lung) AND (alveoli pulmonary) AND (airway) AND (collateral) AND (ventilation). En TH se encontró el término Porus septalis (H3. 05.02.0.00036) para referirse al término Poros de Kohn, en seis textos de histología se menciona el término Poros de Kohn, en 21 artículos revisados se menciona la VC, de estos, en diez se utiliza el epónimo Poro de Kohn, para referirse a los poros septales, el epónimo Canales de Lambert fue utilizado en seis artículos y el epónimo Canales de Martin, apareció en cinco artículos. A partir de la información encontrada, su desarrollo histórico, sumado a los lineamientos de la FIPAT, proponemos complementar e incluir en TH los términos Porus septalis alveolaris para los poros de Kohn, Ductus bronchiolaris alveolaris para los Canales de Lambert y Ductus interbronquiolaris para los canales de Martin, respectivamente.

The correct use of morphological terms is standardized by the Terminologies, one of them is the Histological Terminology (HT) For these Terminologies, the exclusion of eponyms is recommended. Despite this, there are structures that remain as eponyms. Three in particular: Pores of Kohn, Martin Channels and Lambert Channels are terms that make up collateral ventilation (CV) and are an example of this. Thus, the objective of the present study was to identify in the HT the terms associated with the CV in order to propose denominations following the recommendations of the Federative International Programme on Anatomical Terminologies (FIPAT). The terms related to CV in the TH were researched, and subsequently, the same exercise was carried out in histology texts. The MedLine database was also used through its PudMed search engine with the following algorithm: (lung) AND (alveoli pulmonary) AND (airway) AND (collateral) AND (ventilation). In HT the term Porus Septalis" (H3.05.0.0.036) was found to refer to the term "Pores of Kohn, in six histology texts the term Pores of Kohn is mentioned, in 21 reviewed articles the CV is mentioned, of these, in ten the eponymous Pores of Kohn is used, to refer to the Septal Pores, the eponymous Lambert Channels was used in six articles and the eponymous Martin Channels appeared in five articles. From the information found, its historical development, added to the guidelines of the FIPAT, we propose complementing and including in the HT the terms "Porus septalis alveolaris" for pores of Kohn, "Ductus bronchiolaris alveolaris" for the Lambert Channels and "Ductus interbronquiolaris" for the Martin Channels, respectively.

study of histological effects of solder fumes in rat lungs

To determine the potential toxic effects of manual soldering flux cored solder wire on lung of the rat as an experimental model. A total number of 48 adult male rats were divided into experimental [n=30] and control [n=18] groups. Based on exposure time to solder fume, each group was further subdivided into 2, 4 and 6 week subgroups. Rats of experimental groups were exposed to fume in exposure chamber for 1 hour/day [Research Center of Zahedan University of Medical Sciences, 12 Apr 2005 to 14 May 2005]. The amount of fumes were measured daily by standard methods. At the end of experiment, lung specimens were collected from each experimental and control subgroups. Tissue samples were processed routinely and thickness of epithelium in bronchioles and interalveolar septas were measured in stained microscopic slides. Obtained data were analyzed by SPSS. Statistical analysis of data for thickness of epithelium in bronchioles showed that there was only a significant difference between 4 week experimental and control subgroups [P< 0.001]. Analysis of data for thickness of interalveolar septa showed statistically significant differences between experimental and control subgroups of 4 and 6 weeks [P< 0.001]. Histological examination was also revealed an inflammatory process in bronchioles and disorganized architecture in alveoli of lung in experimental subgroups. The result showed that solder fume can change the normal architectures of epithelium in bronchioles and alveoli of the lung and it seems that the severities of changes were dependent on the exposure time

Análises histopatológica e morfométrica no diagnóstico da "nova" displasia broncopulmonar e comparação clinicopatológica com a forma clássica da doença / Histopathological and morphometric analysis in the diagnosis of "new" broncopulmonar dysplasia and clinical and pathological comparison with the classic form of the disease

INTRODUÇÃO: A displasia broncopulmonar (DBP) continua sendo a principal complicação nos recém-nascidos (RN) prematuros. Com o uso de surfactante exógeno e da prevenção de doenças respiratórias no período neonatal a incidência de DBP clássica vem diminuindo, porém uma nova forma de DBP tem surgido, mais branda e associada aos desenvolvimentos pulmonar alveolar e vascular incompletos. Do ponto de vista anatomopatológico a DBP clássica é caracterizada por processos de lesão e reparação, e os achados da "nova" DBP são de hipoplasia alveolar com nenhuma fibrose. OBJETIVOS: Demonstrar as alterações histopatológicas e morfométricas em pulmões de prematuros que foram a óbito, com quadro clínico compatível com "nova" DBP, comparando-as com um grupo controle (sem DBP) e com a forma clássica da doença, além de correlacionar os três grupos com o tempo de uso de oxigênio entre outros fatores de risco da DBP. MATERIAL E MÉTODOS: A população foi composta por 59 amostras de pulmões de prematuros com idade gestacional (IG) menor que 34 semanas e submetidos à oxigenioterapia. Fatores de risco para DBP foram coletados por meio da revisão de prontuários. Amostras pulmonares foram separadas em dois grupos, o com DBP clássica e o sem DBP clássica. O segundo grupo foi então submetido à análise morfométrica para contagem do número de alvéolos, medidas as áreas e os perímetros dos alvéolos. Após esta análise a população estudada ficou dividida em grupo com DBP clássica; com "nova" DBP (casos com mais de sete dias de oxigenioterapia); e grupo controle ou sem DBP clássica ou "nova" (casos com menos de sete dias de oxigenioterapia). RESULTADOS: o primeiro grupo apresentava inflamação e fibrose septal evidentes. Já os segundo e terceiro grupos apresentavam alterações histopatológicas mínimas, sendo então necessária a análise morfométrica para separá-los. O grupo com "nova" DBP apresentou número de alvéolos, sua área e perímetro diminuídos (p < 0,005) quando comparados...

INTRODUCTION: The bronchopulmonary dysplasia (BPD) remains as a major complication in premature infants. The incidence of classic BPD has decreased due to the use of exogenous surfactant and prevention of respiratory diseases in the neonatal period. However, a new and milder form of BPD has appeared, which is associated with incomplete vascular and pulmonary alveolar development. Anatomopathologically, classic BPD is characterized by lesion and repair processeses and "new" BPD findings are alveolar hypoplasia with no fibrosis. OBJECTIVES: To demonstrate the morphometric and histopathological alterations in the lungs of deceased premature infants with clinical course consistent with the new BPD by comparing these changes with a control group (without BPD) and with its classic form. Furthermore, to correlate the three groups with the duration of oxygen therapy and other risk factors. METHODS: The population comprised 59 lungs samples from premature infants of gestational age lower than 34 weeks and that had undergone oxygen therapy. The risk factors for BPD were collected from the review of clinical records. The lungs samples were separated into 2 groups: 1 - with classic BPD and 2 - without classic BPD. Group 2 underwent morphometric analysis for alveoli counting and measurement of alveolar area and perimeter. Subsequently, the studied population was divided into: 1 - with classic BPD, 2 - with new BPD (cases with more than 7 days of oxygen therapy) and 3 - control group or without classic or new BPD (cases with less than 7 days of oxygen therapy). RESULTS: Group 1 (classic BPD) had inflammation and evident septal fibrosis. Groups 2 and 3 (new BPD and control) showed minimal histopathological alterations requiring morphometric analysis to separate them. Group 2 (new BPD) showed reduced number of alveoli, area and perimeter when compared with group 3 (control), p < 0,005. There was no statistically significant difference among the 3 groups...

Hemorragia alveolar fatal: estudo histológico detalhado de necropsias / Fatal alveolar hemorrhage: detailed histological analysis of necropsies

A hemorragia alveolar é uma síndrome que pode ocorrer como manifestação de uma série de doenças, cada uma com eventos fisiopatológicos diferentes resultando em sangramento pulmonar. A análise histológica detalhada destes pacientes pode auxiliar no entendimento desta síndrome. Neste estudo nós fizemos a revisão e descrição dos achados das lâminas de tecido pulmonar e do prontuário médico de 48 pacientes falecidos por hemorragia alveolar nos anos de 1999 a 2004. A maioria apresentou hemorragia de característica difusa (87,5%), predominantemente alveolar (79,2%), sem sinais de recorrência (79,2%) e com presença de fibrina (81,3%). As outras características avaliadas foram: vasculite (8,3%), trombose intravascular (27,1%),esclerose arterial (31,3%), capilarite (41,7%), acometimento intersticial (35,4%), acometimento venoso (41,7%), presença de sinais de infecção (50%), membrana hialina (25%). Com os registros médicos, classificamos os pacientes nas seguintes síndromes clínicas: congestão pulmonar (29,17%), coagulopatia (25%), sepse (27,08%) e inflamação (18,75%). Após as análises clínica e histológica, fizemos a correlação entre estes dados e encontramos que os pacientes com diagnóstico de congestão apresentaram menor presença de fibrina e de acometimento intersticial e maior presença de sangramento focal. O sangramento por coagulopatia se caracterizou por menor presença de fibrina e ausência de sinais de sangramento recorrente. Os pacientes com infecção clínica, histologicamente apresentaram fibrina e sinais de infecção no tecido pulmonar, já os pacientes com diagnóstico de inflamação se caracterizaram pela presença de fibrina, esclerose arterial e sangramento focal. Concluindo, nosso estudo sugere que alguns padrões histológicos são mais comuns em determinadas síndromes clínicas, e podem ser úteis no diagnóstico causal da hemorragia alveolar.

Alveolar haemorrhage is a syndrome presented by many diseases each one with its particular physiopathologic mechanism resulting in pulmonary bleeding. The detailed histological analysis of these patients can help understanding this syndrome. In this study we reviewed and described histological findings of lung slides and medical records from patients whose cause of death was alveolar haemorrhage between 1999 and 2004. Most patients presented diffuse (87,5%), mainly alveolar (79,2%) rather than interstitial and recent bleeding with no signs of recurrence (79,2%). We also observed the presence of: fibrin (81,3%), vasculitis (8,3%), intravascular thrombosis (27,1%), arterial sclerosis (31,3%), capillarity (41,7%), interstitial involvement (35,4%), venous involvement (41,7%), signs of infection on lung tissue (50%) and hyaline membrane (25%). Clinically we classified the patients as having one of the following syndromes: pulmonary oedema due to congestive heart failure (CHF- 29,17%), coagulation disorders (25%), sepsis (27,08%) and systemic inflammation (18,75%). After correlating clinical and histological data we found CHF to have lower presence of fibrin and interstitial involvement and a greater presence of focal bleeding. Coagulation disorders were characterized by no signs of recurrent bleeding and a lower presence of fibrin than infection and inflammation. Patients with clinical diagnosis of systemic inflammation had a greater presence of fibrin and arterial sclerosis than other clinical syndrome and patients with clinical diagnosis of sepsis showed presence of signs of infection in lung tissue no matter the clinical site of infection. In conclusion, our study suggests that some histological patterns happens more commonly in determined clinical syndromes and can help diagnosing the cause of bleeding.

Morphological analysis of neonates of rats treated with dexamethasone in the initial phase of pregnancy / Análisis morfológico de neonatos de ratas tratadas con dexametasona en fase inicial de la preñez

The glucocorticoid dexamethasone has been largely used due to its anti-inflammatory effect. However, several authors report that the excessive exposition to it during pregnancy may cause a retard in the development in several tissues, mainly: liver, lungs and kidneys. But, the majority of the works are done with the application of dexamethasone in the late periods of pregnancy. Because of the lack of researches that evaluate the effects in the beginning of gestation, this paper aimed at evaluating the effect of dexamethasone administered in the initial phase of pregnancy, over the morphology of neonates rat. It was used 10 albino rats (Rattus norvegicus albinus) aged 90 days from the lineage Wistar. The female were coupled and divided in two groups: Group I - rats not submitted to the dexamethasone application (control); Group II - rats submitted to the dexamethasone application in the first 5 days of pregnancy. The results show that the treatment with dexamethasone in a dosage of 0.8mg/Kg during the 5 first days of pregnancy does not produces a weight and height reduction or malformation in the offspring, it does not cause changes in the development of the liver and kidneys of neonate rats, but it leads to a reduction in the denseness of the interalveolar septa causing a higher distension of the alveoli.

El glucocorticoide dexametasona ha sido ampliamente utilizado en virtud de su potencial antiinflamatorio. Sin embargo, varios autores relatan que la exposición excesiva a la dexametasona durante la preñez puede causar el retardo del desarrollo de varios tejidos, principalmente hígado, pulmones y riñones. La mayoría de los trabajos son llevados a cabo con la aplicación de dexametasona en los períodos tardíos de la gestación. El objetivo del trabajo fue evaluar el efecto de la dexametasona, sobre la morfología de ratones neonatos, administrada en la fase inicial de la preñez. Fueron utilizadas 10 ratas Wistar albinas (Rattus norvegicus albinus) con 90 días de edad. Las hembras fueron apareadas y divididas en dos grupos: Grupo I- ratas no sometidas a la dexametasona (grupo control) y Grupo II - ratas sometidas a la aplicación de dexametasona durante los cinco primeros días de preñez. Los resultados mostraron que el tratamiento con dexametasona en dosis de 0,8mg/Kg, a lo largo de los cinco primeros días de la preñez, no produce reducción de peso, longitud o malformación en la prole, tampoco causa alteraciones en el desarrollo del hígado y riñones en los ratones neonatos, pero sí reduce el grosor de los septos interalveolares, causando de esta manera, mayor distensión de los alvéolos.

effect of an antioxidant [vitamin C] on the endotoxaemic lung alveoli of male albino rats. Histological, histochemical and electron microscopical study

The present study was carried out to clarify the role of an antioxidant compound, vitamin C, in counteracting oxidative changes induced in albino rat lung alveoli due to endotoxaemia. Single dose of endotoxin [LPS] [5mg/kg] caused diffuse alveolar damage with interstitial and alveolar infiltration with leucocytes, increase interstitial collagen fibers with thickening of interalveolar septa and decrease PAS positive material and protein contents. Electron microscope examination reflected disconfiguration of pneuomocytes type II, thickening of blood air barrier and increase collagen fibers. On the other hand, pretreatment with vitamin C [18mg/kg] daily for two weeks prior to endotoxin injection modulated the toxic effects of endotoxin on the lung alveoli. It is to be concluded that, administration of vitamin C has pronounced prophylactic effect against endotoxaemia induced lung oxidative damage in rats. Therefore, drug or food containing this antioxidant affords an effective role in protection against endotoxaemia

Pulmonary Alveoli and Macrophages of Rats: A Study of Aging Changes by Electron Microscopy

Lung tissues of rats from two different age groups (2-12 and 16-26 months of age) were studied by both light and electron microscopy. Proliferation of granular pneumocytes in pulmonary alveolar lining was a frequent occurrence in older rats. Lungs of older rats showed not only an increase in number of granular pneumocytes, but also a remarkable increase of lamellar bodies and other forms of lipid vacuoles in individual granular pneumocytes. Spontaneously-occurring nodular lesions characterized by the accumulation of macrophages in the alveolar spaces were accompanied by desquamation and proliferation of granular pneumocytes. These lesions developed only in the lungs of rats older than l7 months of age. Such lessions in lungs of old rats were similar in many respects to desquamative interstitial pneumonitis of human lungs. Atrophy of alveolar walls and emphysematous areas seen in senile rats was characterized by irregular cytoplasmic breakdown of Type I alveolar lining epithelial cells. Obliteration of capillaries by spontaneously-occurring thrombus formation or a herniated cytoplasm of the septal cell and collagen fibers was considered to be a cause of atrophy of alveolar walk. Degeneration and actual breakdown of endothe1ial cytoplasm of puImonary capillaries enhanced herniation of the septal tissue. Vacuolar degeneration of epithelial cytoplasm was occasionally observed, but only in rats older than 20 months of age. The basement membrane of pulmonary alveolar walls was often thicker in old rats than in younger rats. Hyperplasia of granular pneumocytes invariably accompanied large septal cells, some of which contained many of the organelles found in granular pneumocytes.