Introdução: A integridade do Sistema Venoso Central é uma condição fundamental para criar ou manter um acesso vascular eficiente para hemodiálise. A cateterização da veia subclávia é a principal responsável pelo desenvolvimento de obstruções nesses vasos. Porém, é preciso reavaliar a distribuição dessas lesões na atual época de priorização da cateterização da veia jugular interna. Objetivo: Avaliar a distribuição anatômica das obstruções no Sistema Venoso Central dos pacientes em hemodiálise com sinais clínicos de hipertensão venosa. Método e Material: foi realizado um estudo prospectivo de casos consecutivos no HC-FMUSP com duração de 2 anos. A amostra foi composta de 30 pacientes que estavam apresentando sinais clínicos de hipertensão venosa no membro superior portador de uma fístula arteriovenosa. Todos os doentes incluídos foram submetidos a uma angiografia do membro superior através da fístula como método diagnóstico. Coleta de dados e Procedimentos: antes da fistulografia, os pacientes encaminhados ao ambulatório de Nefrologia do HC-FMUSP foram submetidos a uma avaliação clínica com preenchimento de um questionário padronizado, aqueles que preencherão os critérios da pesquisa foram agendados para a realização do exame. Após o diagnostico as lesões foram classificadas conforme o tipo e localização. Análise Estatística: os dados foram expressos em proporção, média ou mediana e valores mínimos e máximos conforme apropriado. As variáveis foram apresentadas descritivamente em tabelas contendo freqüências absolutas (n) e relativas (%). As diferenças entre grupos foram testadas inicialmente com uso de análise univariada, com aplicação do teste t de Student ou do teste de Mann- Whitney. Resultados: nos 30 doentes avaliados foram diagnosticadas ao todo 30 lesões, sendo 20 na veia braquiocefálica, 9 na veia subclávia e 1 na veia cava superior. 70% dessas lesões estavam localizadas em veias intratorácicas. O tipo de lesão mais freqüente foi a oclusão, presente em 70% dos casos. 33% dos pacientes que desenvolveram lesões no Sistema Venoso Central tiveram antecedente de cateterização somente da veia jugular interna. Conclusão: Atualmente, no diagnostico das lesões obstrutivas do Sistema Venoso Central nos pacientes em hemodiálise é importante utilizar métodos diagnósticos que possam informar com precisão as condições dos vasos de localização intratorácica. / Introduction: Central Venous System integrity is a fundamental condition in order to create or maintain an efficient vascular access for dialysis. Subclavian vein catheterization is the foremost condition responsible for these vessels\' obstructions development. However, it is necessary to reappraise these wounds distribution as the current priorization is for catheterization of internal jugular vein. Objective: To evaluate anatomical obstructions distribution in the Central Venous System of patients under dialysis who present clinical signs of venous hypertension. Method and material: A prospective study of consecutive cases was carried out at HCFMUSP within a two years period. The sample was composed by 30 patients who showed up clinical signs of venous hypertension and were bearers of an artery-venous fistula in the upper member. All included patients were submitted to an angiography of the upper member through the fistula as a diagnosis approach. Fact-gathering and procedures: Prior to fistulography, patients were directed to the Nephrology outpatient clinic at HC-FMUSP and were submitted to a clinical evaluation, and filled in a pattern questionnaire. Those who fulfilled the research criteria were scheduled for the exam achievement. After diagnosed, all lesions were classified according to category and location. Statistical analysis: Facts were expressed in proportion, medium or average and minimum and maximum values according appropriate needs. Variables were presented descriptively in absolute tables containing frequencies (n) and relative values (%). Differences amid groups were initially quizzed using univariate analysis, with application of test t of Student or test of Mann-Whitney. Results: Among 30 evaluated patients a total 30 wounds were diagnosed, being 20 in brachiocephalic vein, 9 in subclavian vein and 1 in superior cava vein. 70% of these wounds were located within intratoracic veins. The most frequent lesion category was occlusion present in 70% of the cases. 33% of the patients who developed wounds in the Central Venous System had antecedent of catheterization only at internal jugular vein. Conclusion: Nowadays, in order to diagnose obstructive lesions within Central Venous System among patients on dialysis it is important to use diagnoses approaches which can accurately inform the conditions of intratoracic vessels location.

L’autophagie est un processus catabolique lié aux lysosomes. L’autophagie joue un rôle dans la biologie des lymphocytes et dans la réponse immunitaire en générale. Nous avons montré une dérégulation de l’autophagie dans les lymphocytes provenant de souris développant un lupus et de patients atteints d’un lupus érythémateux disséminé. Nous avons ensuite cherché à définir le rôle potentiel de l’autophagie des lymphocytes dans l’activation et le maintien des réponses humorales normales et pathologiques. Ainsi, nous avons généré des souris déficientes en autophagie spécifiquement dans les lymphocytes B. Ces modèles de souris nous ont permis de montrer que l’autophagie ne jouait pas de rôle majeur dans la mise en place de la réponse immunitaire humorale à court terme. Cependant, l’étude du même modèle murin sur fond génétique prédisposant à une auto-immunité systémique a démontré un rôle de l’autophagie dans la production d’auto-anticorps anti-nucléaires et dans le maintien d’un fort nombre de plasmocytes. L’autophagie est donc importante pour l’initiation de l’activation des lymphocytes B et leur survie en contexte d’auto-immunité à long terme. Ce modèle nous a également permis de montrer que l’absence d’autophagie lors de la stimulation du BCR compromet sa polarisation, conjointe à celle des molécules complexe majeur d’histocompatibilité de classe II et des lysosomes. Ce phénomène est important dans la mise en place de la synapse immunologique, structure qui permet la dégradation et l’internalisation d’antigène particulaires. Nous avons pu mettre en évidence que l’inhibition de l’autophagie impacte effectivement la présentation d’antigènes particulaires internalisés via le BCR aux lymphocytes T. Ainsi, la modulation de l’autophagie dans les lymphocytes pourrait permettre à plusieurs niveaux de limiter l’activation et la survie des lymphocytes autoréactifs dans le contexte de maladies auto-immunes. / Macroautophagy, called autophagy, is a catabolic lysosomal process. Macroautophagy was recently shown to regulate the immune response especially by regulating lymphocyte biology. We demonstrated that autophagy is deregulated in T cells from lupus mouse models and patients suffering from systemic lupus erythematosus. We suggest that autophagy could regulate the survival of autoreactive lymphocytes during lupus. We then wanted to better understand the role of autophagy in normal and pathologic humoral responses. We have generated mouse models conditionally deficient for ATG5 in B cells. In accordance with previous studies, we show that autophagy is dispensable for B cell survival and activation under short-term B cell receptor (BCR) activation. We then investigated long-term immunity on a spontaneous model of autoimmunity. In autoimmune-prone mice deficient for autophagy in B cells, we demonstrate that autophagy is important to maintain high levels of anti-nuclear auto-antibodies, and high number of long-lived plasma cells in the bone marrow. With these same mouse models, we show that autophagy contributes to the polarization of internalized BCR after stimulation, together with the recruitment of lysosomes and MHCMII molecules-containing compartments. The polarization of B cells is particularly important for the acquisition of particulate antigens for B cells. We postulate that ATG5 and possibly the autophagic machinery could facilitate the formation of the immune synapse. We indeed demonstrate that presentation of immobilized antigens to T cells is compromised in the absence of ATG5 in B cells. Thus, modulating autophagy in lymphocytes, could limit at several levels the activation and/or survival of autoreactive lymphocytes during autoimmunity.

INTRODUÇÃO: O transplante hepático é o único tratamento efetivo para uma variedade de doenças hepáticas irreversíveis. No entanto, o número limitado de doadores pediátricos leva ao uso de enxertos hepáticos de doadores adultos, com necessidade de anastomoses vasculares mais complexas. Essas anastomoses tornam-se complicadas pela diferença no calibre dos vasos entre o doador e o receptor, resultando em alterações do fluxo sanguíneo, estenose da anastomose venosa ou arterial e trombose. Os efeitos para regeneração hepática decorrentes da privação do fluxo sanguíneo pela veia porta ou pela artéria hepática não estão completamente elucidados. Experimentalmente, quando um lobo do fígado não recebe o fluxo venoso portal, é observada atrofia deste segmento e hipertrofia do restante do órgão perfundido. Embora existam vários modelos experimentais para estudo da regeneração hepática, poucos são focados em animais em crescimento. Além disso, os efeitos regenerativos de drogas como o tacrolimus e a insulina precisam ser pesquisados, com o objetivo de encontrar um tratamento ideal para a insuficiência hepática ou um método de estimular a regeneração do fígado após ressecções ou transplantes parciais. O objetivo do presente estudo é descrever modelos de regeneração hepática em ratos em crescimento com: 1) ausência de fluxo hepático arterial e 2) redução do fluxo portal. Adicionalmente, o estudo avalia o efeito pró-regenerativo do tacrolimus e da insulina nesses modelos descritos. MÉTODOS: cento e vinte ratos (entre 50 e 100g de peso) foram divididos em 6 grupos, de acordo com o tipo de intervenção cirúrgica: Grupo 1, incisão abdominal sem intervenção hepática; Grupo 2, hepatectomia a 70%; Grupo 3, hepatectomia a 70% + estenose de veia porta; Grupo 4, hepatectomia a 70% + ligadura da artéria hepática; Grupo 5, hepatectomia a 70% + estenose de veia porta + insulina; Grupo 6, hepatectomia a 70% + estenose de veia porta + tacrolimus. Os animais dos grupos 1 ao 4 foram subdivididos em 5 subgrupos de acordo com o momento da morte: 1, 2, 3, 5 e 10 dias após a intervenção cirúrgica. Os animais dos grupos 5 e 6 foram subdividos em 2 subgrupos de acordo com o momento da morte: 2 e 10 dias após a intervenção cirúrgica. Os lobos hepáticos remanescentes foram submetidos à análise histomorfométrica, imuno-histoquímica e molecular. RESULTADOS: Verificou-se que no grupo com hepatectomia a 70% houve recuperação do peso do fígado no terceiro dia com aumento da atividade mitótica, enquanto que no grupo com estenose portal não se observou esse fenômeno (p < 0,001). A insulina e o tacrolimus promoveram aumento do peso do fígado e do índice mitótico. A atividade mitótica foi considerada aumentada nos animais dos grupos hepatectomia, hepatectomia + ligadura da artéria, insulina e tacrolimus; e esse parâmetro estava reduzido no grupo submetido à hepatectomia + estenose portal (p < 0,001). A expressão de interleucina 6 estava presente em todos os animais, sendo significativamente maior nos grupos hepatectomia, hepatectomia + ligadura da artéria e significativamente menor no grupo hepatectomia + estenose portal. Entretanto, a administração de tacrolimus ou insulina recuperou os níveis teciduais de interleucina 6 no grupo com estenose portal. CONCLUSÕES: No presente estudo foi padronizado um modelo simples e facilmente reprodutível para estudar a regeneração hepática em ratos em crescimento com redução do fluxo arterial ou venoso para o fígado. Foi demonstrado que a administração de insulina ou tacrolimus é capaz de reverter os efeitos deletérios da estenose portal na regeneração hepática. A obstrução do fluxo arterial não afetou a capacidade regenerativa hepática / BACKGROUND/PURPOSE: Liver transplantation is an effective treatment for a variety of irreversible liver diseases. However, the limited number of pediatric donor livers leads to the use of adult livers, which usually require more complex vascular anastomoses. These anastomoses are complicated by differences in vessel caliber between donors and recipients, resulting in vascular flow anomalies, stenosis of the venous or arterial anastomosis and thrombosis . The effects of portal vein or hepatic arterial flow privation in hepatic regeneration have not been completely elucidated. Experimentally, when a liver lobe is deprived of portal vein flow, atrophy is observed with hypertrophy of the other perfused parts of the organ, and interleukin-6 (IL-6) is required for normal liver regeneration. Although several experimental models are currently used to study the liver regeneration mechanisms, few studies have focused on the growing animal. In addition, the regenerative effects of drugs (e.g., tacrolimus and insulin) have been experimentally studied, aiming to find an ideal treatment for hepatic failure or a method of stimulating liver regeneration after extensive resection or partial transplants. The aim of the present investigation was to describe the new models of liver regeneration in growing rats with: 1) absence of arterial blood hepatic inflow and 2) reduced portal flow. Additionally, it was studied whether tacrolimus or insulin could have any pro-regenerative effect under such conditions. METHODS/MATERIALS: one hundred and twenty rats (50-100 g body weight) were divided into 6 groups based on the intervention type: Group 1 (sham), abdominal incision without intervention; Group 2, 70% hepatectomy; Group 3, 70% hepatectomy + portal vein stenosis; Group 4, 70% hepatectomy + ligation of the hepatic artery; Group 5, 70% hepatectomy + portal vein stenosis + insulin; and Group 6, 70% hepatectomy + portal vein stenosis + tacrolimus. Animals in groups 1 to 4 were subdivided into 5 groups according to the moment of death: 1, 2, 3, 5 and 10 days after surgical intervention. The animals in groups 5 and 6 were subdivided into 2 other groups according to the moment of death: 2 and 10 days after surgical intervention. The remnant liver lobes were harvested for morphological, histological histomorphometric, immunohistochemical and molecular analyses. RESULTS: it was verified that the hepatectomy group regained liver weight on the third day and had increased mitotic activity, and the portal vein stenosis prevented these phenomena, as well as the increased mitotic index (P < 0.001). In addition, insulin and tacrolimus promoted a significant increase of liver weight. Mitotic activity was considerably increased in the hepatectomy, hepatectomy + arterial ligature, insulin and tacrolimus groups and this parameter was reduced by portal vein stenosis. The expression of the interleukin-6 (IL-6) gene was present in all the animal groups. Tissue levels of IL- 6 were significantly increased by hepatectomy and hepatectomy + hepatic artery ligature; portal vein stenosis prevented this change. However, the administration of tacrolimus or insulin could recuperate the tissue levels of IL-6. CONCLUSION: In the present study a simple and highly reproducible model was standardized to study liver regeneration with portal vein or hepatic artery blood inflow reduction in growing rats. It was demonstrated that insulin or tacrolimus administration may partially reverse the harmful effects of portal vein stenosis. The obstruction of the arterial flow did not affect liver regeneration

Made available in DSpace on 2014-07-29T15:25:22Z (GMT). No. of bitstreams: 1 tese joao arraes ciencias saude.pdf: 3252483 bytes, checksum: be116024cf6d2b2b6cef094fc736420d (MD5) Previous issue date: 2009-06-19 / Antiangiogenesis therapy has become a first-line treatment for neovascular age-related macular degeneration (AMD). Bevacizumab has proven to be efficient and cost effective, however its use in AMD is still off-label. PURPOSES: Evaluating the histological toxicity of bevacizumab on the neurosensorial retina (NSR) and the retinal pigmented epithelium (RPE) in pigmented rabbit eyes; evaluating if a fast increase in vitreous volume after a 0.1 ml balanced saline solution (BSS) intravitreal injection (IVI) in a rabbit eye will lead to histological damages in the NSR and RPE; and evaluating postoperative clinical complications after an IVI in rabbits eyes. METHODS: Eighteen pigmented rabbits (36 eyes) were divided into 4 groups a Control Group (3 rabbits - 6 eyes), which did not receive any IVI; the rabbits were sacrificed at the beginning of the study. Thirty eyes of the fifteen remaining rabbits were distributed to three groups: a sham group (S), that received a 0.1 ml balanced saline solution (BSS) IVI (ten eyes); group 1, that received a 1.25 mg (0.1 ml) bevacizumab IVI (ten eyes); and group 2, that received a 2.5 mg (0.1 ml) bevacizumab IVI (ten eyes). Postoperative clinical evaluation included inspection of the anterior segment and indirect binocular ophthalmoscopy. The rabbits were sacrificed 90 days after the procedure and both eyes of all the rabbits were enucleated. Histological examination of the NSR and RPE were performed and their morphological features and layer thickness were analyzed. RESULTS: No significant postoperative clinical complications were observed either in the neurossensorial retina or in the RPE. Histological morphology and thickness of the NSR and RPE layers did not differ significantly between BBS-injected eyes and bevacizumab-injected eyes. CONCLUSIONS: A rapid increase in vitreous volume, after 0.1 ml BSS IVI did not lead to any histological damage in the NSR and RPE in rabbit eyes. After a 90-day follow-up period, a single Bevacizumab 1.25 and 2.5 mg intravitreal injection did not lead any toxic damage in the NSR and RPE. No important postoperative complications in pigmented rabbit eyes were observed and it appears to be a safe procedure for the treatment of retinal neovascular diseases / A terapia anti-angiogênica tornou-se o tratamento de primeira linha para a forma neovascular da degeneração macular relacionada à idade. O Bevacizumabe é uma droga com boa eficácia e custo-efetividade, porém seu uso nesta doença ainda é considerado off-label. OBJETIVOS: Avaliar a toxicidade sobre a retina neurossensorial (RNS) e epitélio pigmentado da retina (EPR) da injeção intra-vítrea (IV) de bevacizumabe em olhos de coelhos não albinos; avaliar se o aumento súbito do volume vítreo após a injeção IV de 0,1ml de solução salina balanceada (SSB) no olho do coelho leva a danos histológicos na RNS e EPR; e avaliar as complicações clínicas pós-operatórias após a injeção IV em olhos de coelhos. MÉTODOS: 18 coelhos não albinos (36 olhos) foram distribuídos em 4 grupos. O grupo controle (3 coelhos 6 olhos), o qual não recebeu injeção IV, foi sacrificado no início do estudo. Os trinta olhos dos 15 coelhos restantes foram distribuídos em 3 grupos (1:1:1): Grupo Placebo (injeção IV de 0,1ml de SSB); Grupo 1 (injeção IV de 1,25mg/0,1ml de bevacizumabe); e Grupo 2 (injeção IV de 2,5mg/0,1ml de bevacizumabe). Os coelhos foram acompanhados por um período de 90 dias após o procedimento, quando então foram submetidos a eutanásia. Todos os coelhos tiveram seus olhos enucleados e avaliados histologicamente. Foram realizadas avaliação clínica pós-operatória (inspeção do segmento anterior e oftalmoscopia binocular indireta) e avaliação histológica da morfologia e da espessura das camadas da RNS e EPR. RESULTADOS: Não foram observadas complicações clínicas pós-operatórias significantes. A morfologia histológica e espessura das camadas da RNS e EPR não apresentou diferença significante entre os grupos controle e placebo, grupo placebo e grupo 1 e grupo placebo e grupo 2. CONCLUSÕES: A injeção IV de 1,25mg/0,1ml e 2,5mg/0,1ml bevacizumabe não leva a alterações histológicas tóxicas na RNS e EPR, nem a complicações clínicas pós-operatórias importantes em olhos de coelhos não albinos. A injeção IV de 0,1ml de SSB não leva a danos histológicos ao RNS e ao EPR em olhos de coelhos não albinos

INTRODUÇÃO: O transplante hepático é o único tratamento efetivo para uma variedade de doenças hepáticas irreversíveis. No entanto, o número limitado de doadores pediátricos leva ao uso de enxertos hepáticos de doadores adultos, com necessidade de anastomoses vasculares mais complexas. Essas anastomoses tornam-se complicadas pela diferença no calibre dos vasos entre o doador e o receptor, resultando em alterações do fluxo sanguíneo, estenose da anastomose venosa ou arterial e trombose. Os efeitos para regeneração hepática decorrentes da privação do fluxo sanguíneo pela veia porta ou pela artéria hepática não estão completamente elucidados. Experimentalmente, quando um lobo do fígado não recebe o fluxo venoso portal, é observada atrofia deste segmento e hipertrofia do restante do órgão perfundido. Embora existam vários modelos experimentais para estudo da regeneração hepática, poucos são focados em animais em crescimento. Além disso, os efeitos regenerativos de drogas como o tacrolimus e a insulina precisam ser pesquisados, com o objetivo de encontrar um tratamento ideal para a insuficiência hepática ou um método de estimular a regeneração do fígado após ressecções ou transplantes parciais. O objetivo do presente estudo é descrever modelos de regeneração hepática em ratos em crescimento com: 1) ausência de fluxo hepático arterial e 2) redução do fluxo portal. Adicionalmente, o estudo avalia o efeito pró-regenerativo do tacrolimus e da insulina nesses modelos descritos. MÉTODOS: cento e vinte ratos (entre 50 e 100g de peso) foram divididos em 6 grupos, de acordo com o tipo de intervenção cirúrgica: Grupo 1, incisão abdominal sem intervenção hepática; Grupo 2, hepatectomia a 70%; Grupo 3, hepatectomia a 70% + estenose de veia porta; Grupo 4, hepatectomia a 70% + ligadura da artéria hepática; Grupo 5, hepatectomia a 70% + estenose de veia porta + insulina; Grupo 6, hepatectomia a 70% + estenose de veia porta + tacrolimus. Os animais dos grupos 1 ao 4 foram subdivididos em 5 subgrupos de acordo com o momento da morte: 1, 2, 3, 5 e 10 dias após a intervenção cirúrgica. Os animais dos grupos 5 e 6 foram subdividos em 2 subgrupos de acordo com o momento da morte: 2 e 10 dias após a intervenção cirúrgica. Os lobos hepáticos remanescentes foram submetidos à análise histomorfométrica, imuno-histoquímica e molecular. RESULTADOS: Verificou-se que no grupo com hepatectomia a 70% houve recuperação do peso do fígado no terceiro dia com aumento da atividade mitótica, enquanto que no grupo com estenose portal não se observou esse fenômeno (p < 0,001). A insulina e o tacrolimus promoveram aumento do peso do fígado e do índice mitótico. A atividade mitótica foi considerada aumentada nos animais dos grupos hepatectomia, hepatectomia + ligadura da artéria, insulina e tacrolimus; e esse parâmetro estava reduzido no grupo submetido à hepatectomia + estenose portal (p < 0,001). A expressão de interleucina 6 estava presente em todos os animais, sendo significativamente maior nos grupos hepatectomia, hepatectomia + ligadura da artéria e significativamente menor no grupo hepatectomia + estenose portal. Entretanto, a administração de tacrolimus ou insulina recuperou os níveis teciduais de interleucina 6 no grupo com estenose portal. CONCLUSÕES: No presente estudo foi padronizado um modelo simples e facilmente reprodutível para estudar a regeneração hepática em ratos em crescimento com redução do fluxo arterial ou venoso para o fígado. Foi demonstrado que a administração de insulina ou tacrolimus é capaz de reverter os efeitos deletérios da estenose portal na regeneração hepática. A obstrução do fluxo arterial não afetou a capacidade regenerativa hepática / BACKGROUND/PURPOSE: Liver transplantation is an effective treatment for a variety of irreversible liver diseases. However, the limited number of pediatric donor livers leads to the use of adult livers, which usually require more complex vascular anastomoses. These anastomoses are complicated by differences in vessel caliber between donors and recipients, resulting in vascular flow anomalies, stenosis of the venous or arterial anastomosis and thrombosis . The effects of portal vein or hepatic arterial flow privation in hepatic regeneration have not been completely elucidated. Experimentally, when a liver lobe is deprived of portal vein flow, atrophy is observed with hypertrophy of the other perfused parts of the organ, and interleukin-6 (IL-6) is required for normal liver regeneration. Although several experimental models are currently used to study the liver regeneration mechanisms, few studies have focused on the growing animal. In addition, the regenerative effects of drugs (e.g., tacrolimus and insulin) have been experimentally studied, aiming to find an ideal treatment for hepatic failure or a method of stimulating liver regeneration after extensive resection or partial transplants. The aim of the present investigation was to describe the new models of liver regeneration in growing rats with: 1) absence of arterial blood hepatic inflow and 2) reduced portal flow. Additionally, it was studied whether tacrolimus or insulin could have any pro-regenerative effect under such conditions. METHODS/MATERIALS: one hundred and twenty rats (50-100 g body weight) were divided into 6 groups based on the intervention type: Group 1 (sham), abdominal incision without intervention; Group 2, 70% hepatectomy; Group 3, 70% hepatectomy + portal vein stenosis; Group 4, 70% hepatectomy + ligation of the hepatic artery; Group 5, 70% hepatectomy + portal vein stenosis + insulin; and Group 6, 70% hepatectomy + portal vein stenosis + tacrolimus. Animals in groups 1 to 4 were subdivided into 5 groups according to the moment of death: 1, 2, 3, 5 and 10 days after surgical intervention. The animals in groups 5 and 6 were subdivided into 2 other groups according to the moment of death: 2 and 10 days after surgical intervention. The remnant liver lobes were harvested for morphological, histological histomorphometric, immunohistochemical and molecular analyses. RESULTS: it was verified that the hepatectomy group regained liver weight on the third day and had increased mitotic activity, and the portal vein stenosis prevented these phenomena, as well as the increased mitotic index (P < 0.001). In addition, insulin and tacrolimus promoted a significant increase of liver weight. Mitotic activity was considerably increased in the hepatectomy, hepatectomy + arterial ligature, insulin and tacrolimus groups and this parameter was reduced by portal vein stenosis. The expression of the interleukin-6 (IL-6) gene was present in all the animal groups. Tissue levels of IL- 6 were significantly increased by hepatectomy and hepatectomy + hepatic artery ligature; portal vein stenosis prevented this change. However, the administration of tacrolimus or insulin could recuperate the tissue levels of IL-6. CONCLUSION: In the present study a simple and highly reproducible model was standardized to study liver regeneration with portal vein or hepatic artery blood inflow reduction in growing rats. It was demonstrated that insulin or tacrolimus administration may partially reverse the harmful effects of portal vein stenosis. The obstruction of the arterial flow did not affect liver regeneration

Contexte: La grande majorité des mutations délétères identifiées sur le gène BRCA1 sont des mutations « privées ». Cependant, certaines d’entre elles proviennent d’un ancêtre commun, à l’origine d’un effet fondateur. Ainsi, la mutation BRCA1-3600del11 (c.3481_3491del11, p.Glu1161Phefs*3) est localisée en France pour 82% des familles porteuses et 85% d’entre elles sont originaires du quart Nord-Est. En 2006, cette mutation représentait respectivement 51,5% et 42,0% de toutes les mutations du gène BRCA1 identifiées dans les familles lorraines et alsaciennes atteintes d’un cancer du sein et/ou de l’ovaire. En 2004, parmi les 27 cas-index ayant consulté en Alsace et présentant une mutation de BRCA1, 37% sont porteurs de cette mutation, tous issus de familles originaires des Vosges, suggérant l’existence d’un effet fondateur. L’identification d’un haplotype commun est venue confirmer l’existence de cette hypothèse. Une équipe alsacienne a mentionné dans deux publications en 2000 et 2004 sur la mise en évidence de la mutation 3600del11 que les caractéristiques des cancers associés à cette mutation, ne plaidaient pas en faveur d’une relation génotype-phénotype. Or, les caractéristiques anatomo-pathologiques des cancers associés à cette mutation n’ont pas été abordées par ces deux publications. Nous nous sommes alors posés la question de caractéristiques anatomo-pathologiques particulières des cancers du sein et des cancers de l’ovaire diagnostiqués chez les femmes porteuses de cette mutation dans notre région. Nous nous sommes également posés la question de l’existence d’un phénomène d’anticipation génétique dans ces familles. L’anticipation génétique est la survenue plus précoce d’une pathologie et/ou l’aggravation de ses signes cliniques lors de la transmission d’une mutation d’une génération à la suivante au sein d’une même famille. Très peu d’études ont cherché à mettre en évidence ce phénomène d’anticipation dans des cohortes issues de familles de syndrome sein-ovaire associées à une mutation de BRCA1 ou BRCA2. Les études publiées présentaient des biais de sélection du fait de l’inclusion de patients non testés dans leur analyse. Les études publiées sur des cohortes issues de familles présentant une mutation sur le gène BRCA1/2 suggéraient que le dépistage ciblé et l’excès de surveillance pourraient avoir une influence sur l’âge au diagnostic d’un cancer du sein chez les jeunes femmes incluses.Les améliorations majeures au niveau de la mammographie et du traitement du cancer du sein, de même que le programme de dépistage organisé pour les femmes de 50 ans et plus sont apparues en France, après 1980. A notre connaissance, à ce jour, aucune étude n’a été réalisée en France visant à identifier un phénomène d’anticipation génétique dans les familles associées à une mutation sur BRCA1ou BRCA2 et à analyser ce phénomène.Objectif: Notre premier objectif est de constituer une première cohorte lorraine de patientes porteuses de la mutation 3600del11 et d’analyser les caractéristiques anatomo-pathologiques des cancers du sein et de l’ovaire liés à cette mutation. Notre deuxième objectif rechercher l’existence d’une anticipation génétique dans des familles présentant la mutation fondatrice BRCA1-3600del11.Patientes: Quatre cent quatre patientes sont porteuses d’une mutation BRCA1 à l’Institut de Cancérologie de Lorraine (ICL) sur la période s’étendant de 1994 à 2012, parmi elles, nous avons identifié les patientes porteuses de la mutation BRCA1-3600del11. Nous avons identifié à l’Institut de Cancérologie de Lorraine, 38 paires mères-filles atteintes d’un cancer du sein ou de l’ovaire issues de 37 familles présentant le syndrome sein-ovaire associé à cette mutation dont 25 paires mères-filles atteintes d’un cancer du sein et 13 paires mères-filles atteintes d’un cancer de l’ovaire [...] / Introduction: Over 1000 alterations in the BRCA1 gene have been documented. Most of these are frameshifts and ~10% are missense mutations that generate stop codons leading to a truncated and therefore inactive BRCA1 protein. In the French population, prevalence of BRCA1 mutations has been reported in few studies; In a preliminary study of 14 breast and/or ovarian cancer families, a frequent BRCA1 mutation was detected in five unrelated families; the c.3481_3491del11 mutation (BIC: 3600del11), an 11 base-pair deletion in exon 11 leading to a premature stop codon at 1165. In a second study carried out in 2004 involving 27 index cases, the c.3481_3491del11 mutation accounted for 37%. The haplotype analysis of the families carrying the mutation c.3481_3491del11, all originating from Alsace-Lorraine (North-East of France), revealed the presence of a common allele, indicating a founder effect. Purpose: To an attempt to better define the clinical and pathologic characteristics of breast and ovarian cancer related with the 3600del11 BRCA1 mutation, we report our experience with breast and ovarian cancer patients carrying the 3600del11 mutation at the Lorraine Oncology Institute in France. The aim of the current analysis is also to evaluate any differences of breast or ovarian cancer age at diagnosis between mothers and daughters carrying the c.3481_3491del11 mutation in the BRCA1 gene.Patients: Within the population who were referred between 1994 and 2012 to our oncogenetic clinic at the Lorraine oncology institute and who underwent genetic testing for BRCA1 and BRCA2, we identified 404 women carrying a BRCA1 mutation. Interestingly, 45% (180 of 404) of women with detected BRCA1 mutation had the germline 3600del11 mutation. These women were members of 89 different families with breast and or ovarian cancer cases. A study cohort of 38 women carrying the c.3481_3491del11 mutation and affected by first breast or ovarian cancer who reported a first breast or ovarian cancer in their mother carrying the c.3481_3491del11 mutation, was identified in 37 different families including members with breast and/or ovarian cancer at the Oncology Institute of Lorraine. Twelve mothers underwent genetic testing. Twenty five pairs of the 38 mothers-daughters pairs with c.3481_3491del11 mutation were affected by breast cancer and 13 pairs by ovarian cancer.Methods: Clinical and genetic data were collected from medical files and family pedigrees. Analyses were conducted for each cancer type. We investigated an early breast cancer detection effect due to early screening programs and also an increased breast tumor aggression. Since major improvements in breast cancer clinical management and imaging techniques appeared after 1980, we compared the age at breast cancer diagnosis and the age at death in mothers and daughters before and after 1980, first, in the group of women including mothers and daughters taken together and then in mothers and daughters separately. Genetic data were retrieved from familial files and clinical and pathological data from medical files. Descriptive statistics for the study population were calculated using the SPSS software (version 20.0). Results: Ninety one patients (71, 7%) were affected by first breast cancer and 31 (24,4%) by ovarian cancer. Breast tumors were identified in 37.4% of cases aged <40 years. Estrogen receptor status and progesterone receptor status were reported to 67 patients. Hormonal receptors status was positive in 31.4% of breast tumors. A triple-negative subtype was found in 21 cases, which accounts for 65.6% of the 32 patients with 3600del11 mutation for whom HER2 status was available. Ovarian tumors of the serous type, which constitute about 71 percent of all epithelial ovarian carcinomas, predominate among patients with 3600del11 mutation. Eighty six per cent of carriers were diagnosed at advanced stages III/IV [...]

Ocular neovascularization (NV) associated with corneal NV, ischemic retinopathies and age-related macular degeneration is a leading cause of severe vision loss. While numerous contributing factors have been identified, the potential role of the CD36 scavenger receptor has been largely overlooked notwithstanding its crucial involvement in normal retinal function. Accordingly, the central aim of this work was to elucidate the contribution and regulation of CD36 during ocular NV using the cornea as a model. / Initial work investigating the role of CD36 10 maintaining corneal avascularity, an important feature of the normal cornea, revealed that genetic ablation of CD36 elicits age-related corneal NV. Subsequent studies using a pathophysiologically relevant model of inflammatory corneal NV showed constitutive expression of CD36 in the normal cornea with marked induction in the neovascularized cornea. Importantly, activation of CD36 suppressed and induced regression of corneal NV, effects that proceeded via concerted inhibition of VEGFA, JNK-1, and cJun. / Because hypoxia is a fundamental stimulus for angiogenesis, it was pertinent to explore the role and regulation of CD36 during hypoxia. We demonstrate that CD36 expression was significantly elevated in hypoxia-exposed corneal and retinal tissue and in hypoxic retinal pigment epithelial cells. Essential contributions of hypoxia-inducible factor (HIF)-1 and reactive oxygen species were also established. Functional consequences were depicted by augmentations in CD36 phagocytic and anti-angiogenic activities. / Collectively, data disclose CD36 as an important modulator of corneal avascularity and inflammatory corneal NV; this imparts several interesting avenues for future research on the involvement of CD36 in neovascular diseases of the eye. Novel data further identify CD36 as a hypoxia and HIF-1 regulated gene thus creating a framework for future elucidation of the regulatory aspects of this receptor.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-06-05T21:22:13Z No. of bitstreams: 1 Caroline Brandi Schlaaepfer Sales Expressao de componentes da via de sinalizacao....pdf: 1798926 bytes, checksum: d4bb00f0a9c879a36a9a0c59bc3a1be8 (MD5) / Made available in DSpace on 2012-06-05T21:22:13Z (GMT). No. of bitstreams: 1 Caroline Brandi Schlaaepfer Sales Expressao de componentes da via de sinalizacao....pdf: 1798926 bytes, checksum: d4bb00f0a9c879a36a9a0c59bc3a1be8 (MD5) Previous issue date: 2012 / Universidade Federal da Bahia. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / Os mecanismos moleculares envolvidos no desenvolvimento do carcinoma escamocelular oral (CECO) ainda são pouco conhecidos. Vias de sinalização que participam do desenvolvimento embrionário, como a via Sonic Hedgehog (SHH), podem estar associadas ao desenvolvimento de tumores e ainda participar da progressão tumoral através do estímulo a angiogênese. Este trabalho teve como objetivo avaliar o perfil de expressão gênica de componentes da via de sinalização SHH, Sonic Hedegehog (SHH), Patched 1 (PTCH1) e Hedgehog interacting protein (HHIP), que possam estar relacionados a angiogênese em CECO, bem como os níveis de expressão do vascular endothelial growth factor (VEGF-A) e a microdensidade vascular (MDV) nestes tumores. Após aprovação do CEP (Parecer 229/10), a casuística foi composta por 66 casos de CECO no total. Para as reações de PCR quantitativo (qPCR) foram utilizadas amostras criopreservadas de 50 casos de CECOs, 8 casos de Mucosa Adjacente ao Tumor (MAT) e 2 casos de Mucosa Não Neoplásica de paciente saudável (MNN). Após extração de RNA, o DNA complementar foi obtido com o auxílio de High-Capacity cDNA Reverse-Transcription. As reações de qPCR foram conduzidas no aparelho ABI Prism 7900 utilizando o sistema Taqman, sendo a quantificação relativa avaliada pelo método comparativo de Cq (ΔΔCQ). Foram utilizados 56 blocos parafinizados para a confecção do tissue microarray (TMA) e análise da expressão de proteínas VEGF-A e CD34 (MDV), utilizando sistema EnVision AdvancedTM . Foi detectada expressão de HHIP e PTCH1 em CECO e MAT indicando ativação da via SHH nestas lesões. Dezessete (34%) casos de CECO não apresentaram expressão de SHH, os outros 33 (66%) tumores expressaram tal gene, indicando que a ativação desta via de sinalização pode ser através ou não do ligante. Correlação positiva foi observada entre a expressão de SHH e HHIP (rs=0.29; p=0.044, Teste de Spearman) e SHH e PTCH1 (rs=0.49; p=0.0003, Teste de Spearman) em CECO. A correlação positiva entre SHH e VEGF-A (rs=0.37; p=0.0086; Teste de Spearman) sugere uma participação da via SHH na angiogênese em CECOs, ao mesmo tempo maiores níveis de expressão de VEGFA, parecem favorecer um aumento da densidade de vasos sanguíneos (rs=0.55;p=0.0050; Teste de Sperman). Maiores níveis de transcritos e da proteína VEGF-A estavam relacionados a CECOs com invasão perineural e moderadamente diferenciados. Por último, maior expressão de VEGF-A foi detectada em MAT (p=0.034, Teste de Mann Whitney). Assim, a correlação positiva entre a expressão gênica de SHH e VEGF-A indica esta via pode participar da angiogênese tumoral. Além disso, isoladamente, a expressão do gene VEGF-A foi o fator que mais contribui para uma maior MDV e uma maior expressão deste, em nível de transcrito e de proteína, esteve relacionado a CECO de comportamentos mais agressivos. A expressão de HHIP, PTCH1 e VEGF-A em MAT indica que via SHH pode estar ativada nas margens tumorais e, corrobora para a existência de um campo de cancerização que envolve tecidos fenotipicamente normais. Além disso, maior expressão de VEGF-A nesta localização, sugere que a margem tumoral pode participar na secreção de fatores de crescimento para o tumor. / Sonic Hedgehog (SHH) signaling has been implicated in tumor development and progression by stimulating angiogenesis, and its molecular mechanisms involving these events are little known in oral squamous cell carcinomas (OSCC). The aim of this study was to characterize the transcripts expression involved in the SHH pathway (SHH, PTCH1, HHIP, VEGF-A) and microvessel density in these neoplasms. In this study, a total of 50 CECOs, eight non-tumor epithelium adjacent to oral cancer (NTEA), and two oral mucosa obtained from healthy individuals were included. After RNA extraction, complementary DNA was obtained using the High-Capacity cDNA Reverse-Transcriptio. qPCR reactions were conducted in the ABI Prism 7900 using Taqman Gene Expression System. Cq (ΔΔCQ) relative quantification method was perfomed for gene expression analysis. Fifty six paraffin-embedded specimens of OSCC were used for tissue microarray (TMA) and by immunohistochemistry, VEGF and CD34 using EnVision System Advanced TM were used. HHIP and PTCH1 transcripts were detected in OSCC and NTEA indicating their SHH pathway activation. Seventeen (34%) OSCC cases were negative for SHH gene expression. This results indicate that activation of SHH pathway may be either through SHH ligand or not. Our results showed a positive correlation between SHH and HHIP (rs=0.29; p=0.044, Spearman test) and SHH and PTCH1 (rs=0.49; p=0.0003, Spearman test) gene expression in OSCC. The positive correlation between the expression of SHH and VEGF-A (rs=0.37; p=0.0086; Spearman test) suggests an involvement of the SHH pathway on angiogenesis of OSCC, whereas higher levels of VEGF-A expression seems to increase the microvessel density of OSCC (rs=0.55;p=0.0050; Sperman test). Higher levels of transcripts and VEGF-A protein were related to OSCC with perineural invasion and those moderately differentiated. Finally, increased expression of VEGF-A was detected in NTEA (p = 0.034, Mann Whitney test). Thus, the positive correlation between the gene expression of SHH and VEGF-A indicates that pathway could participate in tumor angiogenesis. Moreover, VEGF-A gene expression was the only factor that contributed to a greater MVD in our series. In addition, increased expression of this gene and protein was related to more aggressive behavior of OSCC. The expression of HHIP, PTCH1 and VEGF-A in NTEA also indicates that SHH pathway can be activated in the tumor margins and might suggest existence of a field cancerization involving phenotypically normal cells. At the same time, increased gene expression of VEGF-A in this location suggests that adjacent cells to oral cancer could actively participate in the secretion of important growth factors to the tumor developing.

Made available in DSpace on 2016-06-02T20:09:08Z (GMT). No. of bitstreams: 1 1675.pdf: 3472865 bytes, checksum: cdd740eb5820a30c37b4efc5f281f779 (MD5) Previous issue date: 2007-01-30 / Several factors have been demanding from the building enterprises to search for better quality in their gerencial organization, methods and construtive techniques have been used, like the cost reductions for their permanency in the market, trough the rationalize of their process and the legal aspects of the Consumer Defense Code, among others. For that a building execute the requisits related to the aspects of performance from their functions during their utilization, is necessary during their life, to use a pre-determinated plan of maintenance, that must be seen as another stage of the constructions process, as well as the conception stage, project and building execution. The construction building patology study, is a fundamental instrument to be possible to identify and to understand the falilure incident on performance during the utilization of the buildings components.The present production tryed to show the performance requirements in two medium to high standard entrerprise buildings, that has norms and procedure of quality control. Information were utilized from the project stage until the execution and post-occupancy stage of the enterprise, with purpose to localize possibles pathologies in fase of utilization, and track them with their history of projects or with sistem and construtive procedure. Based on information obtained in this study, the results were realized with the purpose of systemaze the information to elaborate the grafics and other tools to enable a better comprehension of problems detected.Through the results obtained, together with the project studied and construtives methods adopted trought the building enterprise, were realized the Identification and the caracterization of the main pathology . The objective of this production is to provide information to searches in this pathologies in the Hydraulics and Sanitary buildings Systems and buildings enterprises to aim to aid on control and syatematizing the necessaries maintenance, to prevent the same problems in future buildings executed by the enterprises and the executer of theses systems. / Diversos fatores têm exigido das empresas construtoras a busca por melhorias de qualidade em sua organização gerencial, métodos e técnicas construtivas adotadas, tais como a redução de custos para sua permanência no mercado, através da racionalização dos seus processos, e os aspectos legais do Código de Defesa do Consumidor, entre outros. Para que uma edificação cumpra os requisitos relativos aos aspectos de desempenho de suas funções durante sua utilização, é preciso que, durante sua vida útil, seja utilizado um plano de manutenção pré-determinado, que deve ser encarado como uma outra etapa do processo de construção, além das etapas de concepção, projeto e execução do empreendimento. O estudo das patologias da construção civil é a ferramenta fundamental para que sejam possíveis a identificação e compreensão das incidências de falhas de desempenho durante a utilização dos componentes da edificação. O presente trabalho buscou avaliar os requisitos de desempenho em dois edifícios residenciais em altura de médio a alto padrão, de empresa construtora que possui normas e procedimentos de controle da qualidade. Foram utilizadas informações desde a fase de projeto até a execução e pós-ocupação do empreendimento, a fim de mapear as possíveis patologias na fase de utilização e rastreá-las com base em seu histórico de projetos ou sistemas e procedimentos construtivos. Com os dados obtidos no estudo de caso foram realizadas as análises dos resultados, com o objetivo de sistematizar as informações para, então, elaborar os gráficos e outras ferramentas que possibilitem a melhor compreensão dos problemas detectados. Por meio dos resultados alcançados, juntamente com o estudo dos projetos e métodos construtivos adotados pela empresa construtora, foram realizadas a identificação e caracterização das principais patologias detectadas. O objetivo do trabalho é o de fornecer dados para os pesquisadores da área de patologias nos Sistema Prediais Hidráulicos e Sanitários e empresas construtoras, visando auxiliá-las no controle e sistematização das manutenções necessárias, de forma a prevenir os mesmos problemas em futuras obras realizadas pela empresa e projetistas desses sistemas.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A pesquisa para o desenvolvimento de novas drogas quimioterápicas, tem se baseado nas propriedades dos produtos de origem natural. Estudos experimentais em animais indicam que o álcool perílico (AP), um monoterpeno originalmente isolado dos óleos essenciais de várias plantas é capaz de causar a regressão de diferentes tipos de tumores. O tratamento clássico preconizado para os astrocitomas anaplásicos e glioblastoma multiforme consiste de: ressecção cirúrgica, radioterapia e/ou quimioterapia e raramente apresentam efeito curativo. O presente trabalho teve como objetivo analisar o efeito do AP na proliferação, na alteração da morfologia, na síntese de proteínas e migração celular de diferentes linhagens de glioblastoma murino e humano. Foram utilizados modelos in vitro de cultivo de células e ensaios in vivo de migração celular. O tratamento in vitro com o AP nas concentrações v/v de 0,003%, 0,02%, 0,03%, 0,3%, 3% e 30% nas linhagens de glioblastoma C6 de murinos e linhagens A172 e U87MG de glioblastoma humano, mostrou que mesmo nas concentrações (v/v) mais baixas (0,03% e 0,3%) o AP promove a inibição da proliferação celular e da síntese de proteínas. O tratamento in vitro com o AP a 0,3% v/v causou após 15 minutos perda da permeabilidade celular e mais tardiamente, 50 minutos, alterações acentuadas na citoarquitetura das linhagens C6, U87MG e A172. Nos ensaios in vivo com ovos embrionados, o tratamento com o AP nas concentrações v/v 0,3% e 0,03% causou efeito inibitório na migração celular da linhagem C6. Os resultados sugerem uma eficácia quimioterápica do AP na citotoxidade e na inibição da migração celular de linhagens de glioblastoma murino e humano. / The search for new chemotherapeutic drugs has increased, especially for those that have a natural origin. Perillyl alcohol (POH), is a naturally occurring monoterpene, found in the essential oils of citrus fruits and other plants, with pronounced chemotherapeutic activity and minimal toxicity in preclinical studies. Standard treatment of anaplastic gliomas and glioblastoma multiforme consisting of surgical resection, radiation therapy and/or chemotherapy is rarely curative. This work aimed to evaluate in vitro and in vivo effects of POH treatment, cell proliferation, changes in morphology, protein synthesis, and migration of distinct lineage of glioblastoma cells. It was chosen in vitro culture systems and in vivo assays for assessing cellular migration. In vitro treatment of POH at concentrations of (v/v) 0.003%, 0.02%, 0.03%, 0.3%, 3% and 30%, consistently inhibited proliferation of murine C6 and human A172 and U87MG of glioblastoma cells. In vitro treatment of POH at low concentrations 0.03% v/v and 0.3% v/v also produced marked changes in cell morphology and inhibited protein synthesis. Likewise in vitro assays with 0.3% v/v POH treatment for 15 minutes, initially caused marked alteration in membrane permeability and later (50 minutes) drastic changes in the cytoarchitecture of C6, U87MG and A172 cells. Furthermore, previous in vitro treatment of glioblastoma cells with 0.3% v/v and 0.03% v/v POH showed inhibition of cell migration and anti-metastatic activity in the in vivo model of the chick embryo with C6 cell line. Such results indicate the chemotherapeutic action of POH by promoting cytotoxicity and arresting migration of murine and human glioblastoma cell lines