Atualmente os defeitos herniários da parede abdominal são freqüentemente corrigidos com o uso de biomateriais. Embora utilizada com bons resultados há várias décadas, a prótese de Polipropileno (PP) tem implicado graves complicações decorrentes de aderências aos órgãos abdominais. A prótese de Politetrafluoroetileno expandido (PTFEe) tem reconhecidamente menor potencial aderencial; no entanto, dados obtidos de estudos biomecânicos deixam dúvida quanto a sua real eficiência na correção herniária. O objetivo do estudo foi comparar esses dois diferentes tipos de próteses na correção de defeitos ventrais produzidos em ratos Wistar, levando-se em consideração parâmetros histológicos, biomecânicos e da resposta aderencial. Para o estudo histológico um grupo de animais (n=21) foi submetido simultaneamente a implante subperitoneal de fragmentos de próteses de PP e PTFEe. Para o estudo comparativo da resposta biomecânica e aderencial entre as próteses, procedeu-se ao implante protético subperitoneal com PP (n=21) e PTFEe (n=21) para corrigir defeitos ventrais criados cirurgicamente envolvendo toda a espessura da parede abdominal dos animais. Para análise biomecânica, dois outros grupos de animais foram utilizados como controle: um grupo não submetido à cirurgia (n=15) e um grupo com correção de defeitos ventrais por meio de sutura (n=21). Todas as avaliações foram realizadas com 1, 2 e 4 semanas de pós-operatório e constituíram-se de: avaliação da resposta aderencial por meio de pesquisa da área de prótese aderida e incidência de aderência a órgãos, avaliação biomecânica por meio de ensaios de tração de tiras de parede abdominal e avaliação morfométrica do tecido inflamatório e das fibras colagênicas em cortes histológicos corados por Hematoxilina-eosina e pelo método da Picrossírius-polarização, respectivamente. Os resultados mostraram que: a fração de volume de tecido inflamatório no grupo PP na primeira, segunda e quarta semanas foi respectivamente: 20%, 9% e 4% enquanto no grupo PTFEe: 30%, 16% e 16%. Houve diferença estatística na segunda e quarta semanas. A fração de volume de colágeno fibrilar no grupo PP foi respectivamente: 65%, 71% e 77%, na primeira, segunda e quarta semanas. No grupo PTFEe os valores foram: 55%, 66% e 68%, na primeira, segunda e quarta semanas. Da mesma forma, houve diferença estatística na segunda e quarta semanas. Na análise semiquantitativa do grau de agregação de colágeno foi observado diferença estatística apenas primeira semana de pós-operatório a favor do PP (3,24 x 1,40 p=0,022). As próteses induziram valores semelhantes de área aderida na primeira (67,85%-PP x 71,42%- PTFEe), segunda (60,71%-PP x 60,71%-PTFEe) e quarta semanas de pós-operatório (46,42% PP x 42,85% PTFEe). Quanto à presença de aderência a órgãos abdominais houve diferença entre as próteses apenas na primeira semana a favor do PTFEe: enquanto 85,7% dos animais no grupo PP apresentaram aderências à órgãos, esse índice foi de apenas 28,5% no grupo PTFEe. Os valores de força máxima obtidos nos ensaios biomecânicos de tração com a prótese de PP foram na primeira, segunda e quarta semanas: 20,54 N, 21,62 N e 26,23 N. No grupo PTFEe os valores na primeira, segunda e quarta semanas foram: 16,92 N, 23,12 N e 25,41 N. Foi observada diferença estatística na primeira semana de pós-operatório. A comparação entre os implantes protéticos de PP e PTFEe nas condições da presente pesquisa permitiu concluir: 1) A estimativa de área aderida à prótese foi semelhante independentemente do material implantado; 2) Com 1 semana de pós-operatório, o implante de PP demonstrou-se mais resistente aos ensaios biomecânicos de tração o que se correlacionou a um maior grau de agregação das fibras colagênicas nos tecidos implantados; 3) Com 1 semana de pós-operatório, os implantes de PTFEe induziram aderências as órgãos abdominais em um menor número de animais; 4) Com 2 e 4 semanas de pós-operatório o implante de PP induziu a uma menor infiltração de tecido inflamatório e a um maior depósito de colágeno fibrilar / Nowadays, abdominal wall defects are frequently repaired with biomaterials. Although utilized with good results for several decades, polypropylene mesh (PP) has been implicated with serious complications due to adhesion to the abdominal organs. It has been reported that prostheses of expanded polytetrafluoroethylene (ePTFE) mesh exhibit less adhesion formation potential; however, data obtained by biomechanical studies leave doubt as to its real efficiency in hernia repair. The objective of the present study was to compare these two types of mesh in the correction of ventral defects created in Wistar rats, taking into account histological and biomechanical parameters and the adhesion response. For the histological study, a group of animals (n = 21) was submitted simultaneously to subperitoneal implantation of fragments of PP and ePTFE mesh. For the comparative study of the biomechanical and adhesion response between the prostheses, subperitoneal implantation with PP (n = 21) and ePTFE mesh (n = 21) was performed to repair surgically created abdominal defects, involving all layers of the abdominal wall. In the biomechanical analysis, two other groups of animals were used for the control: a group not submitted to surgery (n = 15) and a group with abdominal wall defects repaired with sutures (n = 21). At postoperative weeks 1, 2 and 4, the following evaluations were performed: study of the adhesion response by measuring the incidence of adherence to organs and area of adhered prosthesis; biomechanical test of abdominal wall strips; and morphometric study of the inflammatory tissue and collagenic fibers in sections stained with hematoxylin-eosin and by Picrosiriuspolarization technique. The results showed that: the inflammatory tissue volume in group PP at postoperative weeks 1, 2 and 4, respectively, was 20%, 9% and 4%; while in the group ePTFE the values were 30%, 16% and 16%. The difference was statistically significant in postoperative weeks 1 and 4. The collagen fibril volume in group PP was: 65%, 71% and 77%, in postoperative weeks 1, 2 and 4, respectively. In group ePTFE the values were: 55%, 66% and 68%. Likewise, there was a statistically significant difference in postoperative weeks 2 and 4. In the semi-quantitative analysis of the degree of collagen aggregation, a statistically significant difference was only observed in postoperative week 1, in favor of PP (3.24 x 1.40, p = 0.022). The prostheses induced similar values for adhered area in postoperative week 1 (67.85%-PP vs. 71.42%-ePTFE), week 2 (60.71%-PP vs. 60.71%-ePTFE) and week four (46.42% PP vs. 42.85% ePTFE). Regarding the presence of adherence to abdominal organs, there was only a statistically significant difference between the prostheses in week one, in favor of ePTFE. While 85.7% of the animals in group PP presented adherence to organs, this index was only 28.5% in group ePTFE. The maximum force obtained in the biomechanical tests with the PP mesh was 20.54 N, 21.62 N and 26.23 N, in postoperative weeks 1, 2 and 4, respectively. In group ePTFE the values were 16.92 N, 23.12 N and 25.41 N. A statistically significant difference was observed in postoperative week 1. The comparison between PP and ePTFE prosthetic implants in the conditions of the present research enabled the conclusion that: 1) the estimated area adhered to the prostheses was similar, irrespective of the implanted material; 2) at postoperative week 1, the resistance to traction was higher when the repair was done with PP mesh, which was correlated to a higher degree of collagen fiber aggregation in the implanted tissues; 3) at postoperative week 1, fewer visceral adhesions were formed on ePTFE group of animals; and 4) at postoperative weeks 2 and 4, the PP implant induced a smaller infiltration of inflammatory tissue and a larger deposit of collagen fibrils

As características morfológicas da placa aterosclerótica têm sido sugeridas como componentes auxiliares à estenose, na avaliação de risco de acidente vascular cerebral (AVC), em pacientes com doença aterosclerótica carotídea sintomática. O objetivo desse estudo foi comparar as características da placa aterosclerótica de carótida pelo método de tomografia computadorizada com a análise histológica. Foram incluídos 19 pacientes com doença carotídea sintomática submetidos à TC de placa carotídea antes da realização de endarterectomia carotídea. Uma comparação sistemática entre a TC e a histologia foi realizada para determinar a correspondência entre os componentes da placa seguindo a classificação da \"American Heart Association\". Foi considerada placa vulnerável o tipo VI. A histologia foi realizada 5 (±2) dias após a TC. Os laudos (radiologia e patologia) foram comparados pelo investigador principal. Foi dosada a proteína C-Reativa (PCR) sérica e realizada avaliação do desempenho do PCR para detectar placa vulnerável, considerando como padrão-ouro o resultado da avaliação histológica. Foi avaliada a relação entre PCR e o tempo entre o evento e a cirurgia. Para tipo de placa aterosclerótica, foi encontrada uma acurácia de 84,2% (IC 95%: 82,8% a 85,6%), da tomografia em relação à histologia. A concordância para identificar ruptura de capa fibrosa com acurácia 94,7% (IC 95%: 94,2% a 95,3%), e, para calcificação, com acurácia 89.5% (IC 95%: 88,5% a 90,5%), foi considerada alta, e moderada para identificar hemorragia (68% acurácia). A concordância é moderada entre PCR de alto risco e placa vulnerável, e não há relação entre PCR, placa vulnerável e tempo de cirurgia. A tomografia de placa carotídea é um bom método não invasivo para detecção de vulnerabilidade da placa, identificação de ruptura de capa fibrosa e calcificação. Na nossa amostra, a concordância entre PCR alto risco e vulnerabilidade foi moderada, e não observamos relação entre vulnerabilidade, PCR e tempo entre o evento e a endarterectomia / Plaque morphologic characteristics have been suggested as an auxiliary component to luminal narrowing for assessing the risk of stroke associated with carotid atherosclerotic disease (CAD). The purpose of this study was to evaluate the ability of CT angiography (CTA) to categorize carotid artery atherosclerotic plaques (CAP) features in symptomatic patients submitted to endarterectomy according to the AHA histological classification. Nineteen patients with symptomatic CAD who underwent carotid CTA before endarterectomy were enrolled in a prospective study. A systematic comparison of CTA images with histological sections was performed to determine the CT attenuation associated with each component of the CAP. Histologic examination was performed 5 ± 2 days after the CTA. The neuroradiologist\'s reading of these analyses was compared with the histological slides interpretation performed by the same pathologist according to the CAP features following the AHA classification. The type VI plaque was considered as complicated. The two experts were blinded to each other\"s assessments. We performed C reactive Protein (CRP) and the CRP capacity to detect plaque vulnerability, considering histologic features as gold standard and the relation between CRP and time (event-surgery). There was an overall 84.2% (CI 95%: 82.8% a 85.6%), accuracy agreement in CAP classification between CTA and histological analysis. (Tab.1) The agreement between these two methods for the presence of calcification (Tab.2) in the CAP (accuracy 89.5%), and for categorizing the rupture of fibrous cap (accuracy 94,7), was excellent. (Tab. 3). CTA is not a good method to detect hemorrhage (Tab.4). High-risk CRP had moderate power to predict \"complicated plaque\" (Tab. 4) even as high risk CRP + CTA (Tab.5), There are No relation between CRP, complicated plaque and event to surgery delay. (Tab.6) CTA is a non-invasive tool that may help neurologists to categorize CAP features and potentially predict the risk of ischemic stroke in symptomatic CAD patients, and CRP could not be a good marker to complicated carotid plaque

Estudo dos processos linfoproliferativos cutâneos de células B objetivando demonstrar a difícil distinção diagnóstica entre os linfomas cutâneos e pseudolinfomas. Foram avaliados 38 casos de processos linfoproliferativos cutâneos de células B. Foi realizada revisão de prontuários médicos e exames anátomo-patológicos. Foram estudados 25 casos de linfomas cutâneos, 7 de pseudolinfomas e 6 casos onde não foi possível a distinção diagnóstica entre as entidades em estudo. As características clínicas, histológicas e imunoistoquímicas foram descritas para cada grupo. A análise estatística foi realizada demonstrando a similaridade entre os linfomas cutâneos e os pseudolinfomas / Study of cutaneous B-cell lymphoproliferative process with the purpose of demonstrating the difficulty of distinguishing between cutaneous lymphomas and pseudolymphomas. 38 cases of cutaneous B-cell lymphoproliferative processes were evaluated. A review of medical records and histophatologic material was performed. The study comprised 25 cases of cutaneous lymphomas, 7 cases of pseudolymphomas and 6 cases where a diagnosis distinguishing between the entities in study was not possible. It described clinical, histophatologic and immunohistochemical characteristics of each group. A statistical analysis showing the similarity between lymphomas and pseudolymphomas was performed

O carcinoma basocelular (CBC) é tumor constituído por diferentes tipos histológicos, que demonstram diverso potencial de agressividade. Sabe-se que a correlação entre os tipos histológicos de CBC encontrados no material de biópsia pré-operatória e no material da peça cirúrgica excisional não é total. Na literatura esta correlação varia de 42,7 a 80,0% quando analisados os tipos histológicos predominantes (THP). No presente estudo foi feita análise retrospectiva de 70 casos de CBC primário submetidos a biópsia préoperatória e cirurgia excisional. A amostra foi analisada estatisticamente quanto ao gênero e idade dos doentes e localização anatômica dos CBC, demonstrando ser comparável aos demais estudos da literatura. Também foram avaliados o tamanho médio tumoral e o tipo de reconstrução utilizado. A média do maior eixo dos CBC foi de 20 mm e 54% dos casos necessitaram reconstrução complexa, como retalhos e enxertos, mostrando ser amostra representativa de tumores de médio a grande porte. A avaliação histológica foi feita de modo padronizado, determinando tanto o THP quanto os tipos histológicos acessórios (THA) encontrados no material das biópsias pré-operatórias e nas peças cirúrgicas excisionais. Houve 78,3% de correlação entre THP da biópsia e peça cirúrgica, 87,0% de correlação entre THP e/ou THA da biópsia e THP da peça cirúrgica e 92,7% de correlação entre tipos agressivos ou não agressivos. Conclui-se que a biópsia préoperatória é útil para predizer o THP de CBC da peça cirúrgica excisional na maioria dos casos. No entanto, é importante ressaltar que, quando descrito apenas o THP encontrado na biópsia, ocorre 21,7% de falha no diagnóstico. Quando descritos THP e THA encontrados na biópsia a falha diagnóstica cai para 13%. Quando a intenção da biópsia for a determinação da presença de tipos de CBC agressivos ou não, a falha no diagnóstico é de apenas 7,3% / Basal cell carcinoma (BCC) is a tumor presenting many histological types, each one possessing a specific aggressivity potential. It\'s known that correlation between histological types found in preoperative biopsy specimens and excisional surgery specimens is not total. When correlation between predominant histological types (PHT) is analyzed, concordance value varies from 42,7 to 80,0% in the literature. In the present study 70 primary BCC submitted to preoperative biopsy and excisional surgery were retrospectively analyzed. The sample was statistically analyzed in terms of patients\' gender and age and anatomical location of the tumour and was found to be similar to other reports in the literature. Average size of tumors and type of surgical reconstruction employed were also evaluated. Average size of the largest tumour axis was 20 mm and 54% of the cases needed complex reconstructions, such as flaps and grafts, demonstrating that the sample was represented by medium to large sized tumors. Histological evaluation was made in a patterned way, determining PHT and accessory histological types (AHT) in both preoperative biopsies and excisional surgery specimens. Results obtained were: 78.3% correlation between biopsy PHT and excisional surgery PHT, 87.0% correlation between biopsy PHT and/or AHT and excisional surgery PHT and 92.7% correlation when BCC were classified as \"aggressive\" or \"non aggressive\" . Conclusion: preoperative biopsy is useful to predict BCC\'s PHT of excisional surgery specimen in most cases. However, it\'s important to note that when biopsy findings are limited to the description of the PHT , there is a 21.7% diagnostic failure. When both PHT and AHT found in biopsy are described, diagnostic failure falls to 13%. When the intention is determining the presence of aggressive or non aggressive types of BCC, diagnostic failure is only 7.3%

Hemangiopericitomas (CHP) assim como schwanomas são neoplasias cutâneas de origem mesenquimal, sendo os hemangiopericitomas freqüentemente relatados em cães, ao contrário dos neurofibromas que são mais raros nos mesmos. Relata-se que o CHP origina-se de pericitos, ou células que se localizam ao redor de vasos sanguíneos. São observadas mais freqüentemente nos membros, como massas, bem circunscritas, firmes e grandes. Os hemangiopericitomas têm características histológicas comuns aos schwanomas (neurofibromas), sugerindo uma possível semelhante histogênese. Na realidade, na experiência deste Serviço de Anatomia Patológica, o diagnóstico diferencial entre hemangiopericitomas e neurofibromas apenas com base na morfologia é bastante difícil. O aspecto histopatológico do hemangiopericitoma e schwanoma correspondem à presença de agrupamentos celulares na forma de espiral pericapilar ou não respectivamente. Na tentativa de melhor caracterizar os hemangiopericitomas e distinguí-los de outros tumores mesenquimais, principalmente dos neurofibromas, propõe-se a caracterização histológica, epidemiológica e imunoistoquímica, dos hemangiopericitomas em animais da espécie canina. Com este, espera-se refinar o diagnóstico diferencial destes tumores, por tratar-se de neoplasias pouco e mal diagnosticadas devido à dificuldade de caracterizá-las morfologicamente. Procura-se estudar também, a proliferação celular nos três subtipos histológicos dos CHP e contagem dos critérios morfológicos de malignidade, correlacionando com o prognóstico clínico. Para isto, o presente estudo propôs realizar um levantamento criterioso dos casos de hemangiopericitomas e neurofibromas e/ou neurofibrossarcomas em cães nos Arquivos do Serviço de Necroscopia do Departamento de Patologia da Faculdade de Medicina veterinária e Zootecnia da Universidade de São Paulo (FMVZ/USP) durante o período de 1990 a 2003, reclassificando histologicamente estas neoplasias e graduando os subtipos dos CHP. Os resultados apontaram um total de 77 casos de CHP dos quais o subtipo perivascular correspondeu (35/77casos); o estoriforme (20/77) e o epitelióide (22/77).As conclusões da imunoistoquímica para tipo perivascular (HPV) revelam positividade de 100% para F8; 60% para S100; 100% para vimentina; 7% para GFAP e 0% para CD34 e citoqueratina. O tipo estoriforme (HES) revelou 70% de positividade para F8; 50% para S100; 100% para vimentina; 0% para citoqueratina e GFAP; 10% para CD34. Destaca-se para o epitelióide (HEP) 70% de positividade para o F8; 40 % para o S100; 90% para vimentina; 0% para citoqueratina; GFAP e CD34. A contagem estatística dos critérios de malignidade como PCNA (CL3); índice mitótico (CL1); índice apoptótico (CL4); células multinucleadas (CL0) revelaram nos subseqüentes (HPV, HE, HEP) subtipos de CHP, respectivamente: CL0 (6.135±4.038; 5.067±3.019; 11.217±5.729); CL1 (6.155±2.380; 7.545±1.941; 12.540±8.629); CL3 (30.042±10.824; 39.1.22±11.158; 41.945±9.705); CL4 (1.153±1.1443; 1.888±1.988; 2.400±1.648). O prognóstico clínico revelou 59% de taxa de recidiva para o tipo epitelióide. Assim, o presente estudo mostrou que os hemangiopericitomas devem ser graduados histologicamente por três subtipos dos quais o epitelióide parece ser o mais agressivo e o perivascular o mais incidente (45,5%) (35/77 casos) e que a imunoistoquímica pode ter papel importante na diferenciação entre os hemangiopericitomas e neurofibromas, devido à positividade e negatividade do Fator 8 respectivamente; no entanto não auxilia para distinção entre os subtipos dos CHP. Contudo o estabelecimento de critérios para diferenciar, graduar e caracterizar os CHP poderão ter implicações epidemiológicas, terapêuticas e prognósticas importantes como mostra o presente estudo / Haemangiopericytomas CHP like Schwanomas are cutaneous neoplasms of mesenchymal origin, frequently appearing in dogs, unlike neurofibromas, which are rare on the species. There are cases reported that CHP originates from pericytes, or cells located around blood vessels. They are observed more in limbs such as tissues, they are well defined, big and firm. Haemangiopericytomas have histologic characteristics common to schwanomas (neurofibromas), suggesting a possible similarity in histogenesis. In fact, at this service of Animal Pathology experience, the distinguishing final diagnosis between Haemangiopericytomas and neurofibromas, based only on morphology offers great difficulty. The hispathological aspects of the haemangiopericytons and of the schwanomas correspond to the presence or not (respectively) of spiral pericilar shape cell forms. Attempting to better identify and distinguish the haemangiopericytons from other mesenquimal tumors, mainly neurofiberns, the study indicates the histological, epidemiological and immunohistochemical characterization of Haemangiopericytomas in canine species. With this, it is expected to refine the distinguishing diagnosis of such tumors, for they are known to be neoplasms rarely and wrongly diagnosed due to difficulties to identify them morphologically. The work also studies cell proliferation at the three histological subtypes of CHP and the count for morphological malignity, correlating with the clinic prospect. In order to accomplish it, the work proposes a thoroughly case study of Haemangiopericytomas and neurofibromas and/or neurobrosarcomas in dogs; investigating on the archives of the Necrology Department of Pathology at the Veterinary Medical and Zoology at São Paulo University; from 1990 to 2003, to reclassify histologically these neoplasms and scale the subtypes of CHP. The results indicated a sum of 77 cases of CHP from which the subtype perivascular accounted for (35/77) cases; the storiform (20/77) and the epithelioid (22/77). The conclusions of immunohistochemical to perivascular type (HPV) reveal positiveness of 100% to F8; 60% to S100; 100% to vimentin; 7% to GFAP and 0% to CD34 and cytokeratin. The type estoriform (HES) revealed 70% positiveness to F8; 50% to S100; 100% to vimentin; 0% to cytokeratin and GFAP; 10% to CD34. Note that to epithelioid (HEP) 70% positiveness to F8; 40% to S100; 90% to vimentin; 0% to cytokeratin; GFAP and CD34. Statistical count of malignity criteria such as PCNA (CL3); miotic level (CL1); apoptotic level (CL4); multinucleous cells (CLO) reveal on subsequent (HPV, HE, HEP) subtypes of CHP, respectively: CLO (6.135 (6.135±4.038; 5.067±3.019; 11.217±5.729); CL1 (6.155±2.380; 7.545±1.941; 12.540±8.629); CL3 (30.042±10.824; 39.1.22±11.158; 41.945±9.705); CL4 (1.153±1.1443; 1.888±1.988; 2.400±1.648). The clinical prognostic revealed 59% receding rate to epithelioid. Therefore the study showed that Haemangiopericytomas must be histologically scaled by three subtypes of which the epithelioid appears to be the most AGGRESSIVE =INVASIVE) and perivascular the most incidental (45,5%) (35/77cases); immunohistochemical may have an important role on distinguishing between Haemangiopericytomas and neurofibrossarcomas due to positiveness and negativeness of Factor 8 respectively; notwithstanding it does not aid to distinguish between subtypes from CHP. Nevertheless, a criteria definition that enables to distinguish, scale and define CHP may have relevant epidemiologic, therapeutical and prognostical connotations as shown by the present study

<p>Инфективна болест бурзе (Гамборо болест) је контагиозна вирусна болест младих пилића. Узрочник је РНК вирус који припада фамилији Birnaviridae. Испољава тропизам према Фабрицијусовој бурзи доводећи до оштећења лимфоцита и атрофије. Болест се контролише вакцинацијом родитељских јединки и пријемчивих пилића. Употреба атенуираних вакцина може довести до смањења неких технолошких параметара. Циљ овог рада је био да се докаже које од примењених атенуираних вакцина, интермедијарних Гумбокал, Гумбокал D78 и интермедијарне-плус Гумбокал 228Е, индукује најбољи развитак имнунолошког одговора и доводе до најмањих оштећења у ткиву Фабрицијусове бурзе и слезене. Пратили смо да ли делују имуносупресивно на вакцину против Њукастл болести и да ли утичу на смањење телесне масе бројлерских пилића. Основне огледне групе су вакцинисане четрнаестог дана старости против Гамборо болести, а затим су од основних огледних група оформљене подгрупе које су вакцинисане против Њукастл болести у различитим временским периодима: О1-1, О2-2, О3-1 после седам дана, О1-2, О2-2, О3-2 после четрнаест дана, О1-3, О2-3, О3-3 после двадесетједан дан од вакцинације против Гамборo болести .Од првог до четрдесетдругог дана експеримента сваких седам дана је вађена крв пилићима, мерена њихова телесна маса и узорковане бурзе и слезене. Крвни серуми су испитивани на висину титра антитела ЕЛИСА тестом за Гамборо болест, а методом инхибиције хемагутинације за Њукастл болест. Највишу висину титра на Гамборо болест је показала огледна група О1, затим група О2 и најнижи О3. У огледним подгрупама О3-1, О3-2 и О3-3 се испољио имуносупресивни ефекат на имунолошки одговор према Њукастл болести. Фабрицијусовим бурзама је одређивана релативна маса и бурзални индекс да би се установило да ли је дошло до атрофије након примене вакцина. Најнижи бурзални индекс је установљен у огледној групи О3, затим у О2 и у О1. Таквим редоследом су устновљене и патохистолошке промене у бурзи. Добијени резултати указују да употреба интермедијане-плус вакцине индукује најбољи имунолошки одговор, али и најнижу релативну масу и вредност бурзалног индекса, као и нижу телесну масу у односу на инермедијарне вакцине. Примењене вакцине нису утицале на релативну масу слезене и нису довеле до појаве патохистолошких промена у њој.</p> / <p>Infektivna bolest burze (Gamboro bolest) je kontagiozna virusna bolest mladih pilića. Uzročnik je RNK virus koji pripada familiji Birnaviridae. Ispoljava tropizam prema Fabricijusovoj burzi dovodeći do oštećenja limfocita i atrofije. Bolest se kontroliše vakcinacijom roditeljskih jedinki i prijemčivih pilića. Upotreba atenuiranih vakcina može dovesti do smanjenja nekih tehnoloških parametara. Cilj ovog rada je bio da se dokaže koje od primenjenih atenuiranih vakcina, intermedijarnih Gumbokal, Gumbokal D78 i intermedijarne-plus Gumbokal 228E, indukuje najbolji razvitak imnunološkog odgovora i dovode do najmanjih oštećenja u tkivu Fabricijusove burze i slezene. Pratili smo da li deluju imunosupresivno na vakcinu protiv NJukastl bolesti i da li utiču na smanjenje telesne mase brojlerskih pilića. Osnovne ogledne grupe su vakcinisane četrnaestog dana starosti protiv Gamboro bolesti, a zatim su od osnovnih oglednih grupa oformljene podgrupe koje su vakcinisane protiv NJukastl bolesti u različitim vremenskim periodima: O1-1, O2-2, O3-1 posle sedam dana, O1-2, O2-2, O3-2 posle četrnaest dana, O1-3, O2-3, O3-3 posle dvadesetjedan dan od vakcinacije protiv Gamboro bolesti .Od prvog do četrdesetdrugog dana eksperimenta svakih sedam dana je vađena krv pilićima, merena njihova telesna masa i uzorkovane burze i slezene. Krvni serumi su ispitivani na visinu titra antitela ELISA testom za Gamboro bolest, a metodom inhibicije hemagutinacije za NJukastl bolest. Najvišu visinu titra na Gamboro bolest je pokazala ogledna grupa O1, zatim grupa O2 i najniži O3. U oglednim podgrupama O3-1, O3-2 i O3-3 se ispoljio imunosupresivni efekat na imunološki odgovor prema NJukastl bolesti. Fabricijusovim burzama je određivana relativna masa i burzalni indeks da bi se ustanovilo da li je došlo do atrofije nakon primene vakcina. Najniži burzalni indeks je ustanovljen u oglednoj grupi O3, zatim u O2 i u O1. Takvim redosledom su ustnovljene i patohistološke promene u burzi. Dobijeni rezultati ukazuju da upotreba intermedijane-plus vakcine indukuje najbolji imunološki odgovor, ali i najnižu relativnu masu i vrednost burzalnog indeksa, kao i nižu telesnu masu u odnosu na inermedijarne vakcine. Primenjene vakcine nisu uticale na relativnu masu slezene i nisu dovele do pojave patohistoloških promena u njoj.</p> / <p>Infectious bursal disease (Gumboro disease) is a contagious viral disease of young chickens. The causative agent is an RNA virus that belongs to the family Birnaviridae. It exhibits tropism toward bursa of Fabricius causing damage to cells and atrophy. The disease is controlled by vaccination of susceptible broiler breeders and chickens. The use of attenuated vaccines may lead to the reduction of certain production parameters. The aim of this study was to prove which of the applied attenuated vaccines, intermediate Gumbokal, Gumbokal D78 and intermediate-plus Gumbokal 228E, induces the best immunological response and leads to fewest damages to burza of Fabricijus tissue and spleen. We tracked whether it influences on immunosuppressive vaccine against Newcastle disease and if it leads to reduce of body mass of broiler chickens. Basic experimental groups were vaccinated on the fourteenth day of age against Gamboro diseases, and sub-groups were formed of the basic experimental groups which have been vaccinated against Newcastle disease in different time periods: O1-1, O2-2, O3-1 after seven days, O1-2 , O2-2, O3-2 after fourteen days, O1-3, O2-3, O3-3 after twenty-one days of vaccination against Gumboro disease. From the first to the fourty second day of the experiment, blood was extracted form the chicks every seven days, their body weight was measured and burza and spleen were sampled. Blood serum were assayed for the amount of the antibody titer by enzyme-linked immunosorbent assay test (ELISA) for Gumboro disease, and with Hemagglutination-inhibition test (HI) for Newcastle disease. The biggest titer for Gamboro disease were showed by experimental group O1, then O2 and group O3 the lowest. In the experimental subgroups O3-1, O3-2 and O3-3 immunosuppressive effect was exhibited on the immune response to Newcastle disease. Relative weight and bursal index were determined for burza of Fabricius to determine whether there was atrophy after administration of the vaccine. The lowest bursal index was established in the experimental group O3, followed by O2 and O1. Such sequence was establilshed also for histopathological changes in the burza. The obtained results indicate that the use of the intermediate-plus vaccine induces the best immune response, but also the lowest relative value of the mass and burzal index, as well as a lower body weight compared to the inermediate vaccine. Applied vaccines did not affect the relative weight of the spleen and have not led to the appearance of histopathological changes in it.</p>

<p>Uvod: Implementacija brojnih neuroradiolo&scaron;kih modaliteta je značajno uticala na način i efikasnost sprovođenja dijagnostike tumora mozga. Na osnovu neinvazivno dobijenih podataka može se postaviti diferencijalna dijagnoza, ali do sada nije potvrđena nijedna neuroradiolo&scaron;ka metoda koja može samostalno i konačno da postavi definitivnu patohistolo&scaron;ku (PH) dijagnozu. Stereotaksična biopsija je neurohirur&scaron;ka procedura kojom se, bez bitnog naru&scaron;avanja integriteta i funkcije moždanog tkiva, može obezbediti reprezentativni uzorak intrakranijalne tumorske promene radi sprovođenja PH i drugih specifičnih analiza, u cilju postavljanja tačne dijagnoze i potom primene adekvatnog lečenja. Cilj: Cilj ove studije je da se utvrditi mogućnost uzorkovanja reprezentativnog tkiva za postavljanje PH dijagnoze uz pomoć stereotaksične biopsije kod pacijenata sa tumorom mozga, kao i da se utvrdi vrsta i učestalost eventualnih komplikacija same procedure i postojanje korelacije između PH nalaza dobijenog stereotaksičnom biopsijom i rezultata sprovedenih neuroradiolo&scaron;kih ispitivanja. Materijal i metode: Sprovedeno istraživanje je bilo kliničko, prospektivno, a uzorak je činilo ukupno 50 pacijenata koji su bili hospitalizovani na Klinici za neurohirurgiju KCV zbog dijagnostikovane tumorske promene mozga i postavljene indikacije za stereotaksičnu biopsiju, u periodu od septembra 2016. godine do januara 2018. godine. Svi pacijenti koji su uključeni u studiju su u sklopu sprovedene dijagnostičke obrade imali načinjen magnetno rezonanantni (MRI) pregled glave na osnovu kojeg su se određivale morfolo&scaron;ke karakteristike tumora i vr&scaron;ila procena prirode tumorske promene mozga, a kod ukupno 25 pacijenata je dodatno načinjena MR spektroskopija (MRS) dijagnostikovane tumorske promene sa ciljem određivanja biohemijskog profila i dodatne procene i karakterizacije tkiva. Nakon sprovedene detaljne onkolo&scaron;ke obrade i adekvatne pripreme, se sprovodila kompjuterizovanom tomografijom (CT) navođena stereotaksična biopsija sa ramom u cilju uzorkovanja adekvatnog tkiva za PH analizu. U toku istraživanja procena uspe&scaron;nosti uzorkovanja reprezentativnog tkiva se vr&scaron;ila pregledom bioptata od strane patologa, a nakon procedure se kliničkim pregledom i kontrolnim CT pregledom glave utvrđivao stepen komplikacija. Rezultati: Dobijeni rezultati su pokazali da su fokalni neurolo&scaron;ki deficit i moždani sindrom bili najče&scaron;ći klinički simptomi i znaci kod pacijenata kod kojih je indikovana stereotaksična biopsija tumora mozga. Prema MRI nalazu najzastupljenije su bile difuzne tumorske promene sa 36% udela u uzorku, zatim solitarne sa 34% i multifokalne sa 20%, a potom multicentrične tumorske promene koje su predstavljale 10% uzorka. Takođe, na osnovu MRI i MRS nalaza je oko 80% tumora procenjeno kao najverovatnije glijalnog porekla. U 95,9% slučaja je postavljena precizna PH dijagnoza. Nepromenjeno stanje svesti i neurolo&scaron;ki nalaz su imali 92% pacijenata nakon biopsije, a kod 3 pacijenta (6%) je do&scaron;lo do razvoja prolaznog neurolo&scaron;kog deficita, dok je jedan pacijent (2%) razvio trajan neurolo&scaron;ki deficit. Ukupan morbiditet vezan za proceduru je stoga 2%, a nije zabeležen ni jedan smrtni slučaj (mortalitet 0%) tokom sprovođenja studije. Zaključak: Stereotaksična biopsija je dokazana i veoma pouzdana procedura sa malim brojem komplikacija i niskom stopom morbiditeta i mortaliteta, kojom se omogućava dobijanje reprezentativnog uzorka tumorskog tkiva za postavljanje sigurne patohistolo&scaron;ke dijagnoze. Intraoperativna PH analiza dela uzorka tkiva dodatno pobolj&scaron;ava uspe&scaron;nost pri uzorkovanju i postavljanju definitivne PH dijagnoze. Savremene neuroradiolo&scaron;ke metode imaju visoku specifičnost u razlikovanju biolo&scaron;ke prirode tumorskih promena, ali se ne mogu koristi nezavisno od PH analize uzorka tkiva</p> / <p><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> <w:SplitPgBreakAndParaMark/> <w:DontVertAlignCellWithSp/> <w:DontBreakConstrainedForcedTables/> <w:DontVertAlignInTxbx/> <w:Word11KerningPairs/> <w:CachedColBalance/> 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5.4pt;mso-para-margin-top:0in;mso-para-margin-right:0in;mso-para-margin-bottom:10.0pt;mso-para-margin-left:0in;line-height:115%;mso-pagination:widow-orphan;font-size:11.0pt;font-family:"Calibri","sans-serif";mso-ascii-font-family:Calibri;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:"Times New Roman";mso-fareast-theme-font:minor-fareast;mso-hansi-font-family:Calibri;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:"Times New Roman";mso-bidi-theme-font:minor-bidi;}</style><![endif]-->Introduction: The implementation of numerous neuroradiological techniques has significantly influenced the way and the efficiency in which the diagnosis of brain tumor is established. Based on non-invasive imaging data, a differential diagnosis can be made, but no neuroradiological method has been established so far, which can finally make a definitive diagnosis. Stereotactic biopsy is a neurosurgical procedure that can provide a representative sample of any intracranial tumor in order to performe histopathological and other specific examinations, and to set the exact diagnosis and then apply adequate treatment, but without significantly impairing the integrity and function of brain tissue. Objective: The aim of this study is to determine the diagnostic value of stereotactic biopsy and ability of providing the representative tissue in order to establish a pathohistological diagnosis in patients with brain tumors. Also, the aim is to determine the type and frequency of possible complications of the procedure itself and the correlation between the pathohistological findings obtained and the results of the conducted neuroradiological examinations. Materials and methods: This research was clinical, prospective and included a total of 50 patients who were hospitalized at the Clinical Center of Vojvodina, from September 2016 to January 2018, due to diagnosed brain tumor for which the stereotactic biopsy is indicated. In all patients magnetic resonance (MRI) examination of the head was used to determine morphological characteristics and assesse the nature of the brain tumor tissue, and in a total of 25 patients MR spectroscopy was additionally made with the goal of determining the biochemical profile and additional tissue assessment and characterization. After detailed oncological assessment, completed laboratory and radiological diagnostics, a CT guided framebased stereotactic biopsy was performed for the purpose of sampling tumor tissue for pathohistological analysis. During the research, the success rate of biopsy in providing the representative tissue and establishing the diagnosis was performed by a pathologist, and after the procedure, a clinical and a control head CT examination was used to review the rate of complications. Results: The results obtained showed that focal neurological deficit and psychoorganic syndrome were the most common clinical symptoms and signs in this study. According to MRI, the most common were diffuse brain tumors with 36% of the sample, then solitary with 34% and multifocal with 20%, followed by multicentric tumors representing 10% of the study sample. Also, based on MRI and MRS findings, approximately 80% of tumors are estimated to be most likely of glial origin. In 95.9% of cases, a complete pathohistological (PH) diagnosis was established. The unchanged neurological status was observed in 92% of patients after biopsy, and 3 patients (6%) developed a transient neurological deficit, while only one patient (2%) developed a permanent neurological deficit. The total morbidity associated with the procedure is therefore 2%, and no deaths (mortality 0%) related to the procedure during the study is recorded. Conclusion: Stereotactic biopsy is highly reliable procedure with a small number of complications and a low morbidity and mortality rate, which allows us to acquire the representative sample of brain tumor tissue and to establish a pathohistological diagnosis. Intraoperative PH analysis of acquired tissue samples further enhances the sampling performance and the setting of definitive PH diagnosis. Modern neuroradiological modalities have a high specificity in distinguishing the biological nature of brain tumors, but they still can not be used independently of the pathohistological analysis of the tissue sample.</p>

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Thesis submitted in fulfillment of the requirements for the Doctor of Technology: Biomedical Technology In the Faculty of Health and Wellness At the CAPE PENINSULA UNIVERSITY OF TECHNOLOGY 2014 / Diabetes mellitus (DM) results in severe metabolic imbalances and pathological changes in many tissues. Chronic inflammation and oxidative stress have been implicated in the pathophysiology of diabetes mellitus. Garcinia kola (Family: Guttiferae) is a plant well known for its ample medicinal values. The seed of the plant also known as ‘bitter kola’ due to its bitter taste is used as a masticatory agent in traditional hospitality, cultural and social ceremonies in Africa. Kolaviron (KV) is a defatted ethanol extract from the seeds of Garcinia kola (GK). Kolaviron has been shown in experimental models of diseases to have numerous beneficial effects due to the presence of flavonoids (mainly Garcinia biflavonoid (GB)-1, GB-2 and kolaflavanone). However, there is paucity of information regarding the possible effect of kolaviron on inflammatory mediators and oxidative stress in diabetes mellitus. Therefore, this study was carried out to investigate the potential beneficial effects of kolaviron on antioxidant status, inflammatory mediators and apoptosis. Other biochemical and histological alterations in the blood, liver and kidney of streptozotocin-induced diabetic rats were also evaluated. A single intraperitoneal injection of freshly prepared solution of streptozotocin (50 mg/kg.b.wt.) in citrate buffer (0.1M, pH 4.5) was administered to overnight fasted rats for diabetes induction. Diabetes was confirmed by stable hyperglycemia (>18 mmol/l) in the tail blood glucose after 5 days of streptozotocin injection. Kolaviron (100 mg/kg b.wt.) was administered to diabetic rats (by gastric gavage) on the 6th day after the induction of diabetes and treatment continued for 6 weeks (5 times weekly). The effects on blood glucose, body weight, organ (liver and kidney) weight, serum biochemical parameters, oxidative status, inflammatory mediators and histology of the liver, kidney and pancreas were assessed. Kolaviron (KV) treatment lowered blood glucose in diabetic and normoglycemic rats and reduced glycated haemoglobin [HbA1C (%)]. Plasma insulin level was raised in diabetic rats treated with KV. Histomorphometric analysis of the pancreas revealed increased β-cell area of pancreatic islets of kolaviron-treated diabetic group. The indices of organ (liver and kidney) damage were increased in diabetic rats. However, KV treatment protected against liver and kidney damage. The characteristic features of diabetic dyslipidemia such as elevated serum triglyceride and cholesterol concentration which are major risk factors for cardiovascular disease were also significantly reduced in KV-treated diabetic rats. Alteration in antioxidant enzymes status was observed in the liver, kidney and blood (erythrocyte, plasma and serum) of diabetic rats. Lowered catalase (CAT) activity was observed in the liver and kidney of diabetic rats while KV treatment significantly (p < 0.05) elevated catalase activity in the liver and kidney. There was no significant change (p > 0.05) in erythrocyte catalase activity among all treatment groups. Erythrocyte of diabetic rats showed a marked reduction in the activity of superoxide dismutase (SOD) with no significant changes in liver and kidney SOD activity of diabetic rats compared to control whereas KV administration to rats markedly increased SOD activity. Glutathione peroxidase (GPX) activity was elevated in the erythrocyte and kidney of STZ-induced diabetic rats with no significant effect on liver GPX activity. KV treatment reversed the alteration in GPX activity in the kidney and erythrocyte. Level of reduced glutathione (GSH), a non-enzymatic antioxidant was decreased in the both liver and kidney of diabetic rats and treatment of diabetic rats with KV elevated GSH concentration in both tissues. Also, malondialdehyde (MDA), a marker of lipid peroxidation was elevated in the liver, kidney and plasma of diabetic rats and significantly (p < 0.05) lowered following KV treatment. Diabetes induction reduced the capacity of liver and kidney to absorb oxygen radicals as demonstrated by lowered oxygen radical absorbance capacity (ORAC) values. KV administration to normal and diabetic rats significantly increased ORAC values. Increased rate of apoptosis, a major cellular response to high glucose induced stress was observed in the renal and hepatic tissues of diabetic control rats. Kolaviron treatment of diabetic rats protected the liver and kidney against hyperglycemia-induced apoptosis and decreased the number of TUNEL positive cells A significant (p < 0.05) elevation of pro-inflammatory cytokines; monocyte chemoattractant protein (MCP-1), Interleukin-1β (IL-1β), IL-6 and tumor necrosis factor (TNF)-𝛂 was observed in the liver of diabetes rats. KV treatment lowered these inflammatory biomarkers. On the other hand, the kidney of diabetic rats showed elevated concentration of pro-inflammatory IL-1β with no significant effect on kidney TNF-𝛂. An increase in the serum concentration of MCP-1 and IL-1β was observed in the untreated diabetic rats while kolaviron treatment normalized the alteration in serum concentration of MCP-1, IL-1β and vascular endothelial growth factor (VEGF). In conclusion, persistent and chronic hyperglycemia promotes the generation of free radicals and inflammatory molecules which contributes to progressive development of micro- and macro vascular complications and multi-organ damage. Kolaviron demonstrated beneficial effects on markers of oxidative stress and inflammation in the diabetic rats and also promoted the survival and functional integrity of the liver and kidney.

Made available in DSpace on 2014-12-17T15:32:18Z (GMT). No. of bitstreams: 1 CyntiaCPC.pdf: 2470782 bytes, checksum: 4619c7ffcab85bffa54a732d30786d99 (MD5) Previous issue date: 2010-02-24 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Currently, bone morphogenetic proteins (BMPs) have effective participation in the growth of malignancies. Knowing that there are few studies involving BMPs and oral squamous cell carcinoma, this work constitutes an immunohistochemical study of BMP-2, BMPR IA and BMPR II in squamous cell carcinomas (SCC) of the lower lip relating to the clinical and pathological aspects of this lesion. The sample consisted of 40 cases of SCC of the lower lip, being 20 cases of SCC of the lower lip with regional metastasis and 20 cases without metastasis. We evaluated the intensity of expression (score 1 to mark absent / weak, score 2 for high ) and was found the percentage of labeled cells, where the score was 1 cases with 0 to 50% of positive cells, score 2 with 51 to 75% of positive cells, and score 3 more than 75% of positive cells. The sample comprised 72.5% of men with a mean age of 65.8 years, there was a predominance of stage II and 52.5% of the carcinomas were classified as low grade, being carcinoma with metastasis presenting most cases (70%) as carcinomas of high malignancy grade (p = 0.004). The largest number of cases of SCC of the lower lip that were in stages I / II (61, 9%) were classified as carcinomas of low grade malignancy and carcinomas in stages III / IV were classified as high-grade tumors (p = 0, 024). The BMP-2 showed strong intensity of immunostaining in 82.5%, BMPR-IA showed 55% of cases with an intensity of immunostaining absent / weak and BMPR-II showed 85% of cases with an intensity of immunostaining absent / weak. Only the protein BMPR-IA were significantly associated with all clinic-pathological parameters studied, metastasis (p <0.001), TNM (p <0.001) and histological grade of malignancy with (p = 0.028). The percentage of positive cells, all markers showed the highest number of cases with more than 75% of positive cells (score 3) and only BMPR-II showed statistical difference when related to the presence and absence of metastasis (p = 0.049 ). We conclude that there is disturbance in the BMP signaling pathway in EC-mediated lower lip and that high expression of BMP-2 associated with the expression of BMPR-IA and BMPR-II are associated with metastasis in carcinoma / Atualmente as prote?nas morfogen?ticas do osso (BMPs) t?m efetiva participa??o no crescimento de neoplasias malignas. Sabendo que s?o escassos os trabalhos envolvendo BMPs e o carcinoma epiderm?ide oral, este trabalho realizou um estudo imunoistoqu?mico da BMP-2, BMPR IA e BMPR II em carcinomas epiderm?ides (CE) de l?bio inferior relacionando com os aspectos clinico-patol?gicos desta les?o. A amostra constou de 40 casos de CE de l?bio inferior, sendo 20 casos de CE de l?bio inferior com met?stase linfonodal regional e 20 casos sem met?stase. A grada??o histol?gica de malignidade foi realizada no front invasivo da les?o. Foi avaliada a intensidade de express?o (escore 1 para marca??o ausente/ fraca e escore 2 para marca??o forte), bem como foi verificado a porcentagem de c?lulas positivas, onde o escore 1 era os casos com 0 a 50% das c?lulas positivas; escore 2 com 51 a 75% das c?lulas positivas; e escore 3 com mais de 75% das c?lulas positivas. A amostra foi composta por 72,5% de homens com a m?dia de idade de 65,8 anos, houve um predom?nio do est?gio II e 52,5% dos carcinomas foram classificados como de baixo grau, sendo os carcinomas com met?stase regional apresentando a maioria dos casos (70%) como carcinomas de alto grau de malignidade (p =0,004). O maior n?mero de casos de CE de l?bio inferior que estavam nos est?gios I/ II (61, 9%) foi classificado em carcinomas de baixo grau de malignidade e os carcinomas nos est?gios III/ IV foram classificados em alto grau de malignidade (p =0, 024). A BMP-2 apresentou intensidade da imunomarca??o forte em 82,5%, BMPR-IA observou-se 55% dos casos com intensidade de imunomarca??o ausente/ fraca e a BMPR-II revelou 85% dos casos com intensidade de imunomarca??o ausente/ fraca. Apenas a prote?na BMPR-IA apresentou associa??o estatisticamente significante com todos os par?metros clinico-patol?gicos estudados, met?stase (p<0,001), TNM (p<0,001) e grada??o histol?gica de malignidade com ( p=0,028). Quanto ? porcentagem de c?lulas positivas, todos os marcadores apresentaram o maior n?mero de casos com mais de 75% das c?lulas positivas (escore 3) e apenas a BMPR-II apresentou diferen?a estat?stica quando relacionada com a presen?a e aus?ncia de met?stase (p=0,049). Conclui-se que existe dist?rbio na via de sinaliza??o BMP-mediada no CE de l?bio inferior e que a alta express?o da BMP-2 associada com a express?o da BMPR-IA e BMPR-II est?o relacionadas com a met?stase neste carcinoma