An ultrasound and histomorphological analysis of experimental liver cirrhosis in rats

We investigated whether liver injury by dual exposure to ethanol and carbon tetrachloride (EtOH + CCl4) for 15 weeks would persist after hepatotoxic agents were removed (EtOH + CCl4/8wR). After 15 weeks of hepatic injury with ethanol (5.5 percent, m/v) and carbon tetrachloride (0.05, mL/kg, ip), 5 of 11 female Wistar rats were sacrificed. The other 6 rats were maintained for an additional 8 weeks without hepatotoxic agents. Ultrasonography showed increased liver echogenicity and dilation of portal vein caliber in both groups (EtOH + CCl4: 0.22 ± 0.01 cm, P < 0.001; EtOH + CCl4/8wR: 0.21 ± 0.02 cm, P < 0.01) vs control (0.16 ± 0.02 cm). Histopathology showed regenerative nodules in both experimental groups. Histomorphometry revealed increased fibrosis content in both groups (EtOH + CCl4: 12.6 ± 2.64 percent, P < 0.001; EtOH + CCl4/8wR: 10.4 ± 1.36 percent, P < 0.05) vs control (2.2 ± 1.21 percent). Collagen types I and III were increased in groups EtOH + CCl4 (collagen I: 2.5 ± 1.3 percent, P < 0.01; collagen III: 1.3 ± 0.2 percent, P < 0.05) and EtOH + CCl4/8wR (collagen I: 1.8 ± 0.06 percent, P < 0.05; collagen III: 1.5 ± 0.8 percent, P < 0.01) vs control (collagen I: 0.38 ± 0.11 percent; collagen III: 0.25 ± 0.06 percent). Tissue transglutaminase increased in both groups (EtOH + CCl4: 66.4 ± 8 percent, P < 0.01; EtOH + CCl4/8wR: 58.8 ± 21 percent, P < 0.01) vs control (7.9 ± 0.8 percent). Cirrhosis caused by the association of CCl4-EtOH remained for at least 8 weeks after removal of these hepatotoxic agents. Ultrasound images can be a useful tool to evaluate advanced hepatic alterations.

Prevalence of low trauma fractures in long-term kidney transplant patients with preserved renal function

We evaluated the prevalence of low bone mineral density (BMD) and osteoporotic fractures in kidney transplantation (KT) patients and determined risk factors associated with osteoporotic fractures. The study was conducted on 191 patients (94 men and 97 women) with first KT for 3 years or more presenting stable and preserved renal function (serum creatinine levels lower than 2.5 mg/dl). KT patients were on immunosuppressive therapy and the cumulative doses of these drugs were also evaluated. BMD was determined by dual-energy X-ray absorptiometry at multiple sites (spine, femur and total body). Quantitative ultrasound of the calcaneus (broadband ultrasound attenuation, speed of sound, and stiffness index, SI) was also performed. Twenty-four percent (46) of all patients had either vertebral (29/46) or appendicular (17/46) fractures. We found osteoporosis and osteopenia in 8.5-13.4 and 30.9-35.1 percent of KT patients, respectively. Women had more fractures than men. In women, prevalent fractures were associated with diabetes mellitus [OR = 11.5, 95 percent CI (2.4-55.7)], time since menopause [OR = 3.7, 95 percent CI (1.2-11.9)], femoral neck BMD [OR = 1.99, 95 percent CI (1.4-2.8)], cumulative dose of steroids [OR = 1.1, 95 percent CI (1.02-1.12)] and low SI [OR = 1.1, 95 percent CI (1.0-1.2)]. In men, fractures were associated with lower lumbar spine BMD [OR = 1.75, 95 percent CI (1.1-2.7)], lower SI [OR = 1.1, 95 percent CI (1.03-1.13)], duration of dialysis [OR = 1.3, 95 percent CI (1.13-2.7)], and lower body mass index [OR = 1.24, 95 percent CI (1.1-1.4). Our results demonstrate high prevalence of low BMD and osteoporotic fractures in patients receiving a successful kidney transplant and indicate the need for specific intervention to prevent osteoporosis in this population.

Usefulness of a rapid immunometric assay for intraoperative parathyroid hormone measurements

Intraoperative parathyroid hormone (IO-PTH) measurements have been proposed to improve operative success rates in primary, secondary and tertiary hyperparathyroidism (PHP, SHP and THP). Thirty-one patients requiring parathyroidectomy were evaluated retrospectively from June 2000 to January 2002. Sixteen had PHP, 7 SHP and 8 THP. Serum samples were taken at times 0 (before resection), 10, 20 and 30 min after resection of each abnormal parathyroid gland. Samples from 28 patients were frozen at -70ºC for subsequent tests, whereas samples from three patients were tested while surgery was being performed. IO-PTH was measured using the Elecsys immunochemiluminometric assay (Roche, Mannheim, Germany). The time necessary to perform the assay was 9 min. All samples had a second measurement taken by a conventional immunofluorimetric method. We considered as cured patients who presented normocalcemia in PHP and THP, and normal levels of PTH in SHP one month after surgery and who remained in this condition throughout the follow-up of 1 to 20 months. When rapid PTH assay was compared with a routine immunofluorimetric assay, excellent correlation was observed (r = 0.959, P < 0.0001). IO-PTH measurement showed a rapid average decline of 78.8 percent in PTH 10 min after adenoma resection in PHP and all patients were cured. SHP patients had an average IO-PTH decrease of 89 percent 30 min after total parathyroidectomy and cure was observed in 85.7 percent. THP showed an average IO-PTH decrease of 91.9 percent, and cure was obtained in 87.5 percent of patients. IO-PTH can be a useful tool that might improve the rate of successful treatment of PHP, SHP and THP

Nutritional status of hemodialysis patients with secondary hyperparathyroidism

The repercussions of secondary hyperparathyroidism on the nutritional status of chronic renal failure patients have not been well established. Therefore, the aim of this study was to compare the nutritional indices of hemodialysis patients with and without secondary hyperparathyroidism. Sixteen hemodialysis patients with serum parathyroid hormone (PTH) levels higher than 420 pg/ml (hyperparathyroidism group) were matched for gender, age and length of dialysis treatment to 16 patients with serum PTH between 64 and 290 pg/ml (control group). The following parameters were assessed: anthropometric indices (body mass index, skinfold thickness, midarm muscle circumference and body fat), 4-day food diaries, protein catabolic rate, biochemical indices (blood urea nitrogen, serum creatinine, albumin, ionized calcium, inorganic phosphorus, serum alkaline phosphatase, PTH, pH and HCO3) and dialysis efficiency. We did not observe differences in the anthropometric indices between the two groups. Only calcium intake was significantly different between groups (307.9 mg/day for the hyperparathyroidism group vs 475.8 mg/day for the control group). Protein catabolic rate tended to be higher in the hyperparathyroidism group compared to the control group (1.3 vs 0.9 g kg-1 day-1; P = 0.08). Except for blood urea nitrogen (86.4 vs 75.7 mg/dl), alkaline phosphatase (175 vs 65 U/l) and PTH (898 vs 155 pg/ml), no other differences were found between groups in the biochemical indices studied. PTH was directly correlated with protein catabolic rate (r = 0.61; P<0.05) and length of dialysis (r = 0.53; P<0.05) only in the hyperparathyroidism group. Considering the indices used, we could not demonstrate the deleterious effect of high PTH levels on the nutritional status of hemodialysis patients. Indirect evidence, however, suggests an action of PTH on protein metabolism

Efeitos de imunopotenciadores nao especificos na infeccao experimental pelo Schistosoma mansoni. I. Levamisole / Effects of non-specific immunopotentiators in experimental Schistosoma mansoni infection. I. Levamisole

Os efeitos do levamisole nas alteracoes histopatologicas, resistencia do hospedeiro e quimiotaxia "in vitro" foram estudados na infeccao experimental pelo Schistosoma mansoni em camundongos da linhagem C57B1/10. O tratamento profilatico resultou em um aumento no numero de vermes adultos obtidos pela perfusao e tambem em uma taxa de mortalidade maior (p<0,05). As alteracoes histopatologicas (figado e intestino) foram similares em todos os grupos. Uma reducao significante da quimiotaxia "in vitro" ocorreu em camundongos controles infectados, assim como naqueles submetidos a tratamento profilatico com levamisole. A atividade quimiotatica atingiu os mesmos niveis dos camundongos controles normais (nao-infectados e nao-tratados com levamisole), quando o esquema curativo foi usado. O levamisole parece aumentar a susceptibilidade de camundongos da linhagem C57B1/10 a infeccao pelo S. mansoni quando administrado antes da infeccao e normaliza a atividade quimiotatica, quando dado apos a infeccao.

Natural lectin activity in the haemolymph of Panstrogylus megistus (Heteroptera: Reduvidae)

A hemolinfa de Panstrongylus megistus mostrou uma atividade lectínica natural para eritrócitos de vários vertebrados e näo mostrou especificidade para os diversos tipos de eritrócitos testados (humano ABO, pato, coelho,c amundongo,carneiro, galinha e boi). Com relaçäo aos eritrócitos humanos a atividade lectínica foi similar nos tipos A+, B+ e AB+ enquanto a atividade mais alta foi observada no tipo O+. O título de aglutinaçäo entre eritrócitos animais näo mostrou diferença apreciável, excluindo eritrócitos de boi, que apresentaram o título mmais baixo. A determinaçäo da concentraçäo mínima de inibiçäo foi realizada com eritrócitos humanos O+. A aglutinaçäo foi inibida por vários carboidratos (ramnose, D-dalactose, rafinose, D-lactose e D-fucose). A ramnose foi o inibidor mais potente (0,78 mM). Os resultados sugerem a presença de mais de uma lectina na hemolinfa de P. megistus

In vivo leukocyte chemotaxis during the development of acute experimental Trypanosoma cruzi infection

Five and 15 days after T. cruzi infection, staphylococcal protein A was injected into a connective tissue air pouch of mice and the migration of polymorphonuclear leukocyrtes into the area was monitored. The PMN leukocyte response of 15-day infected mice was lower than of uninfected mice (P < 0.001): The 15 - day infected mice also showed a lower leukocyte response when compared to 5 - day infected mice (P < 0.001). These data suggest that chemotaxis defect development gradually during the acute phase of infection

Afeccoes desmielinizantes do sistema nervoso - Estudo imunologico - Nota previa. / Demyelinating diseases of the nervous system - Immunological study - Previous note

Sao relatados os resultados obtidos de uma pesquisa de anticorpos anti-mielina nos soros e liquidos cefalorraquianos de 11 pacientes com doencas neurologicas supostamente desmielizantes. A tecnica utilizada foi de imunofluorescencia indireta usando-se como marcadores soro de cabra anti-imunoglobulina (IgG, IgA e IgM) e de coelho anti-IgM humano