Histomorphological structure of the Bursa cloacalis (Bursa of Fabricius) in young Leiothrix lutea: a comparative study using light microscopy and transmission electron microscopy / Estructura histomorfológica de la Bursa cloacalis (Bursa de Fabricius) en jóvenes Leiothrix lutea: un estudio comparativo utilizando microscopía óptica y microscopía electrónica de transmisión

SUMMARY: This study aimed to investigate the microstructure and ultrastructure of the Bursa cloacalis (Bursa of Fabricius) (BC) in young Leiothrix lutea at various days of age (a few days after hatching) using light microscopy and transmission electron microscopy. The bird BC was sampled at 1, 5, 7, and 9 days of age. Immediately after dissection, the structure and integrity of the BC (not degenerative) were retained and the specific temporal features could be visualized precisely. After hematoxylin-eosin staining and uranyl acetate/lead citrate staining, the microstructure and ultrastructure of the BC, respectively, could be observed clearly. The microscopic observations revealed the following: in addition to change in the size of BC or lymphoid follicles, many cavities were found in the BC; the distribution of the lymphoid follicles in Leiothrix lutea was different from that in other birds; and the segregating line between the bursal cortex and medulla became increasingly clear as the age increased. In conclusion, the structural data obtained in this study provides a better understanding of the specific immunological function of the BC in Leiothrix lutea.

RESUMEN: Este estudio tuvo como objetivo investigar la microestructura y ultraestructura de la Bursa cloacalis (BC) en Leiothrix lutea joven unos días después de la eclosión, utilizando microscopía óptica y microscopía electrónica de transmisión. La BC se muestreó a los 1, 5, 7 y 9 días de edad del Leiothrix lutea. Inmediatamente después de la disección, se observó la estructura y la integridad de la CB (no degenerativa) y se pudo visualizar con precisión las características temporales específicas. Después de la tinción con hematoxilina-eosina y con acetato de uranilo /citrato de plomo, pudimos observar claramente la microestructura y ultraestructura de la BC. Las observaciones microscópicas revelaron el cambio en el tamaño de la CB o de los folículos linfoides y además, se encontraron numerosas cavidades en la CB; la distribución de los folículos linfoides en Leiothrix lutea era diferente a la de otras aves; y la línea de segregación entre la corteza bursal y la médula se hizo cada vez más clara a medida que aumentaba la edad. En conclusión, los datos estructurales obtenidos en este estudio proporcionan una mejor comprensión de la función inmunológica específica de la Bursa cloacalis en Leiothrix lutea.

Clonality test by PCR - PARR in real time of canine lymphomas

Lymphoma is a neoplasm of hematopoietic origin that affects canines. The proper establishment of prognosis and rapid institution of treatment are essential for a better quality of life, and immunophenotyping is one of the tools used for this purpose. The objective of this study was to perform a clonality test for immunophenotypic characterization of canine lymphomas using the polymerase chain reaction (PCR) for antigen receptor rearrangements (PARR) technique in real-time from samples fixed in formalin and embedded in paraffin. The 23 analyzed samples were fixed in formalin and embedded in paraffin canine lymphoma from the collection Laboratory of Histopathology of the Animal Pathology Area of the Departament of Veterinary Medicine - Federal Rural University of Pernambuco (UFRPE). Samples were processed, their DNA was extracted, quantified, diluted, and standardized at a concentration of 50 ng/µL. After extraction, all samples were subjected to conventional PCR for endogenous control (detection of the IgM target region), in which the extracted DNA was amplified in a final volume of 25 µL. The 128 bp amplified product was detected by 1.5% agarose gel electrophoresis. Of the 23 samples analyzed for the detection of the conserved region referring to the endogenous gene, 91.30% (21/23) amplified the conserved region Cµ by conventional PCR, and two samples 8.70% (2/23) were negative. Endogenous control positive samples were subjected to real-time PCR-PARR for detection of IgH Major and IgH Minor for B lymphocytes (LB), and TCRy for lymphocytes T (LT) target regions. All reactions were performed in duplicate to reduce the risk of false-positive or false-negative results due to technical errors. Samples previously confirmed by immunohistochemistry were used as positive controls for T cell and B cell lymphoma, and MilliQ water was used as a negative reaction control. After amplification, the melting curve gradually increased the temperature by 1o C/5 s to 95o C during continuous fluorescence monitoring. Of the 21 samples analyzed, 100.00% (21/21) demonstrated clonal amplification. Of these, 57.15% (12/21) were positive for phenotype B, and 42.85% (9/21) were positive for phenotype T. Due to the importance of researching and confirming samples from files fixed and embedded in paraffin samples in laboratories, PCR-PARR is a good tool for this purpose. In the present study, real-time PCR analysis demonstrated greater sensitivity in the characterization of the immunophenotype of lymphomas from old samples fixed in formalin and embedded in paraffin. The temperature of melting curve analysis may vary depending on the amount of DNA and its quality. In the present study, it was found that the average melting temperature in the samples varied between ± 3o C when compared to that in the control sample for LB and LT, 83.5o C and 80o C, respectively: in the literature, there is a relative difference in this temperature, which may vary up to 4o C. Real-time PCR-PARR was satisfactory in the characterization of the immunophenotype of canine lymphomas from formalin-fixed and paraffin-embedded samples; therefore, its use is recommended for both retrospective studies. The use of PCR-PARR associated with histopathological and/or cytopathological examination in cases of canine lymphomas strongly helps pathologists, provide a safe establishment of the immunophenotype, minimize errors, and optimize the diagnosis, thus directly contributing to the establishment of the prognosis.(AU)

Amígdalas y adenoides: defensa ante agentes patógenos y su implicancia estomatológica / Tonsils and adenoids: defend to pathogenic agents and their stomatological involvement

La función de las amígdalas siempre ha sido discutida, desde afirmar que no tenían funcionalidad, hasta la actualidad que se plantea un papel inmunológico, con actividad linfocitaria de defensa, debido a la localización de linfocitos en el tejido de las amígdalas. Este artículo de actualización pretende describir desde la embriología, histología, fisiología, patología y estomatología, el rol que desempeñan las mismas en su papel inmunológico ante la acción de agentes patógenos. Se destaca la acción conjunta de las amígdalas palatinas, amígdalas faríngeas o adenoides, amígdalas peritubarias, amígdalas linguales y todo el resto de tejido linfático que conforman el anillo linfático faríngeo o anillo de Waldeyer, ya que cumplen un rol determinante en la defensa del organismo (AU)

The function of the tonsils has always been debated, from stating that they had no functionality, to the present day that an immunological role is proposed, with lymphocyte defense activity, due to the location of lymphocytes in the tissue of the tonsils. This update article aims to describe from embryology, histology, physiology, pathology and stomatology, the role they play in their immunological role against the action of pathogens. The joint action of the palatine tonsils, pharyngeal or adenoid tonsils, peritubal tonsils, lingual tonsils and all the rest of the lymphatic tissue that make up the pharyngeal lymphatic ring or Waldeyer's ring is highlighted, since they play a decisive role in the defense of the organism (AU)

Metástasis solitaria intraparenquimatosa del bazo estudios clínicos patológicos e inmunohistoquímico / Intraparenchymal solitary spleen metastasis pathological and immunohistochemical clinical studies

Las metástasis esplénicas intra-parenquimatosas de tumores sólidos son tumores muy raros, y si se trata de nódulos únicos, son excepcionales. Presentamos dos casos de metástasis intra-parenquimatosas. El primer caso se trató de una mujer de 66 años con antecedentes de un adenocarcinoma endometrial. El segundo caso se trató de un paciente de sexo masculino con antecedente de un adenocarcinoma prostático, quien se presentó con un adenocarcinoma mucinoso en el bazo, como segunda neoplasia. También realizamos una revisión de los registros de biopsias de 14 años, del servicio de anatomía patológica del instituto(AU)

The spleen parenchymal metastasis of the solid tumors, are very rare, but the isolated metastasis to the spleen are considered exceptional. We herein present two cases of the isolated splenic metastases. The first case was a female a 66 year old female with a diagnosis endometrial adenocarcinoma. The second cases was a 71 years old male, with a history of a prostatic adenocarcinoma, and a spleen metastasis of a ucinous adenocarcinoma, as a second malignancy. We also made a review of 14 years, biopsies records from the pathology service, of the institute(AU)

Aspectos patológicos e imuno-histoquímicos da polisserosite em búfalos (Bubalus bubalis) / Histopathological and immunohistochemical study of the polyserositis in buffalo (Bubalus bubalis)

Polisserosites são alterações inflamatórias das serosas viscerais e parietais das cavidades corpóreas. Um tipo especial destas alterações foi identificado em bubalinos abatidos para consumo nos anos 80, sendo associada a infecção por Chlamydia psittaci. Apesar da importância da bubalinocultura no Pará, do caráter zoonótico da C. psittaci e da possibilidade de envolvimento de outros agentes na afecção, são raros trabalhos sobre a enfermidade desde os estudos pioneiros. No presente trabalho casos identificados como polisserosite pelo serviço de inspeção sanitária em búfalos abatidos para consumo foram coletados com objetivo de determinar a frequência e origem dos mesmos e de caracterizar as lesões e pesquisar antígenos de Chlamydia spp. nas mesmas. De um total de 2.887 bubalinos abatidos no período de estudo foram identificados 48 (1,66%) casos. O município de Santa Cruz do Arari na Ilha de Marajó apresentou a maior porcentagem de casos em relação ao número de animais abatidos (6,49%, 5/77). Na macroscopia as lesões se caracterizaram por áreas opacas, branco-amareladas de espessamento das serosas, por vezes com franjas fibrosas na superfície. Os resultados permitem concluir que os casos classificados como polisserosite pelos veterinários da inspeção sanitária nos búfalos abatidos para consumo correspondem na histopatologia a um tipo incomum de polisserosite, caracterizada por infiltrado linfocitário, com ocasionais formações de folículos linfoides terciários ou ectópicos. Foi observado ainda nestas lesões um predomínio de linfócitos T (CD3 positivos) no infiltrado, sendo os linfócitos B (CD79 positivos) presentes em maior número no interior das estruturas foliculares. Não foram demonstrados antígenos de clamídias nas lesões do presente estudo, o que demonstra a necessidade de estudos adicionais relativos a(s) etiologia(s) das lesões.(AU)

Polyserositis are inflammatory changes of the visceral and parietal serous of body cavities. A special type of polyserositis was identified in buffaloes in the 80s, being associated with infection by Chlamydia psittaci. Since these pioneering studies, there are no additional works about the condition. Considering the importance of buffalo in Pará, the zoonotic character of C. psittaci and the possibility of involvement of other agents in polyserositis in buffaloes the present study is proposed. We collected cases identified as polyserositis by sanitary inspection service in buffalo slaughtered for consumption in Belem for a complementary characterization of inflammatory cell and the research of Chlamydia spp antigens in lesions. Of 2.887 buffaloes slaughtered in a period of six months, there were 48 (1.66%) cases of polyserositis and 39 analyzed. Santa Cruz do Arari in Marajó Island was the city with the highest frequency of cases, whereas 6.49% of buffaloes had lesions. However, 50% of the present study cases came from Soure municipality in Marajó Island, which provided about 49% of buffaloes slaughtered in the period. In the macroscopy, there were opaque areas with white-yellow thickening of the serous, sometimes with fibrous fringes on the surface. Histopathology showed connective tissue projections partially lined by cuboid or flattened mesothelial cells. Often in projections there were mononuclear infiltrate of variable intensity, consisting mainly of lymphoid cells, with occasional ectopic or tertiary lymphoid follicles.(AU)

Histopathology of murine toxoplasmosis under treatment with dialyzable leukocyte extract

BACKGROUND Dialyzable leukocyte extracts (DLEs) contain molecules smaller than 10 kDa with biological activity in receptor organisms. Primarily, they participate in the regulation of the Th1 immune response, which is essential for the control of several intracellular infections, such as toxoplasmosis. This disease is associated with congenital infection, encephalitis or systemic infections in immunocompromised individuals. The clinical course of this infection fundamentally depends on a well-regulated immune response and timely treatment with the appropriate drugs. OBJECTIVE The aim of this study was to evaluate the effect of treatment with a leukocyte extract, derived from crocodile lymphoid tissue, on the histopathology and brain parasite load in NIH mice that had been infected with cysts of Toxoplasma gondii (ME-49 strain). METHODS The treatment was applied during the acute and chronic stages of the infection. Histopathological changes were evaluated in the ileum, liver and spleen at one, four and eight weeks after infection and in the brain at week 8. The parasite load was evaluated by counting the cysts of T. gondii found in the brain. FINDINGS Compared to the control mouse group, the mice infected with T. gondii and under treatment with DLE showed less tissue damage, mainly at the intestinal, splenic and hepatic levels. In addition, a greater percentage of survival was observed, and there was a considerable reduction in the parasite load in the brain. CONCLUSIONS The results suggest that DLE derived from crocodile is a potential adjunctive therapy in the conventional treatment of toxoplasmosis.

Estudo de linfonodos por espectroscopia Raman confocal / Lymph node study by confocal Raman spectroscopy

Dentre os órgãos linfoides encontram-se os linfonodos. Também conhecidos como nódulos linfáticos, os quais são considerados como filtros da linfa por serem ricos em linfócitos e outras células de defesa. Entre os fatores que contribuem para o seu comprometimento temos a invasão de sua estrutura por células neoplásicas. A citologia constitui o exame padrão ouro no diagnóstico sendo, a PAAF a técnica mais utilizada para a obtenção do material a ser analisado. Entretanto, alguns estudos questionam a sua utilização, devido à perda da arquitetura celular. A espectroscopia Raman confocal por meio da sua capacidade em utilizar as diferenças bioquímicas de tecidos e células vem se destacando cada vez mais neste tipo de diagnóstico. O estudo teve por objetivo identificar as principais características bioquímicas em linfonodos normais, comprometidos e lesão cervical utilizando a espectroscopia Raman confocal. Foram analisadas 12 amostras de linfonodos normais e alterados de pacientes com indicação cirúrgica para linfadenectomia pela espectroscopia seguida pela análise estatística de componentes principais (PCA) e análise de discriminante linear (LDA). Após as análises observou-se que a técnica utilizada conseguiu discriminar os tecidos com valores de especificidade, sensibilidade e acurácia de 83%. Portanto, a espectroscopia Raman confocal se mostrou uma importante ferramenta na caracterização de linfonodos podendo futuramente auxiliar no diagnóstico de lesões linfonodais.

Among the lymphoid organs there are lymph nodes,, which are considered as lymph filters because they are rich in lymphocytes and other defense cells. Among the factors that contribute to their impairment we note the invasion of its structure by neoplastic cells. Cytology is the gold-standard diagnostic test, and FNA is the technique most used to obtain the material to be analyzed. However, some studies question its use, due to the loss of cellular architecture. Confocal Raman spectroscopy, through its ability to utilize biochemical differences in tissues and cells, has been increasingly prominent in this type of diagnosis. The study aimed to identify the main biochemical characteristics in normal and compromised lymph nodes and cervical lesion using confocal Raman spectroscopy. We analyzed 12 normal and altered lymph node samples from patients with medical indications for a lymphadenectomy by spectroscopy, followed by statistical analysis of the main components (PCA) and linear discriminant analysis (LDA). After the analysis, it was observed that this technique was able to discriminate the tissues with values of specificity, sensitivity and accuracy of up to 83%. Therefore, confocal Raman spectroscopy has been shown to be an important tool in the characterization of lymph nodes, and may help in the diagnosis of lymph node lesions in the future.

Efecto de la terapia con probióticos/prebióticos sobre la reconstitución del tejido linfoide asociado a la mucosa gastrointestinal durante la infección por el virus de la inmunodeficiencia humana-1 / Effects of prebiotics and probiotics on gastrointestinal tract lymphoid tissue in hiv infected patients

HIV infection induces alterations in almost all immune cell populations, mainly in CD4+ T cells, leading to the development of opportunistic infections. The gut-associated lymphoid tissue (GALT) constitutes the most important site for viral replication, because the main target cells, memory T-cells, reside in this tissue. It is currently known that alterations in GALT are critical during the course of the infection, as HIV-1 induces loss of tissue integrity and promotes translocation of microbial products from the intestinal lumen to the systemic circulation, leading to a persistent immune activation state and immune exhaustion. Although antiretroviral treatment decreases viral load and substantially improves the prognosis of the infection, the alterations in GALT remains, having a great impact on the ability to establish effective immune responses. This emphasizes the importance of developing new therapeutic alternatives that may promote structural and functional integrity of this tissue. In this regard, therapy with probiotics/prebiotics has beneficial effects in GALT, mainly in syndromes characterized by intestinal dysbiosis, including the HIV-1 infection. In these patients, the consumption of probiotics/prebiotics decreased microbial products in plasma and CD4+ T cell activation, increased CD4+ T cell frequency, in particular Th17, and improved the intestinal flora. In this review, the most important findings on the potential impact of the probiotics/prebiotics therapy are discussed.

Linfoma en fosa nasal encontrado durante una dacriocistorrinostomía / Lymphoma found in nasal cavity during a dacryocystorhinostomy / Linfoma na fossa nasal encontrado durante una dacriocistorrinostomia

Los tumores de características malignas en áreas sinonasales ocupan el 3% - 5% de todos los tumores malignos, de estos, los linfomas no Hodgkin de células B son los más comúnmente encontrados. Se ha descrito el compromiso de la cavidad nasal entre el 1.5% y 15%, se describe mayor presentación en pacientes entre las séptima y octava décadas de la vida, así como una tendencia de afectación más en mujeres que en hombres y predisposición en pacientes de raza asiática. La histología mayormente hallada es de carácter no epitelial primario. Muchos de los pacientes en series revisadas han tenido diagnóstico subyacente de enfermedad linfoide en otros sitios previo a la presentación de síntomas nasales como obstrucción nasal, epistaxis, edema, cefalea y visión borrosa. Se presenta un caso de paciente de sexo masculino con diagnóstico de leucemia linfoide crónica, residente en la ciudad de Buenos Aires, en quien durante una dacriocistorrinostomía se halla un linfoma en fosa nasal sin previa presentación de síntomas nasales, masa palpable o síntomas sistémicos.

Malignant tumors in sinonasal areas constitute 3% ­ 5% of all malignant tumors, of which non­Hodgkin lymphomas developing from B cells are those most commonly found. Nasal cavity involvement is described between 1.5% and 15% and is usually found in patients who are in their seventies or eighties. It is more commonly found in women than in men and there is predisposition in Asians. Its histology has been found as non-primary epithelial tumors. Many patients in case series had been diagnosed with primary tumor in other places prior to the presentation of nasal symptoms such as nasal obstruction, epistaxis, edema, headache, and blurred vision. This article describes the case report of a male patient diagnosed with chronic lymphoid leukemia residing in Buenos Aires. While the patient was undergoing a dacryocystorhinostomy, a lymphoid tissue was found in the right nostril without previous presentation of nasal symptoms, palpable mass, or systemic symptoms.

Os tumores de características malignas em áreas sinonasais ocupam 3% - 5% de todos os tumores malignos, destes, os linfomas não Hodgkin de células B são os mais comumente encontrados. Se há descrito o compromisso da cavidade nasal entre 1.5% e 15%, se descreve maior apresentação em pacientes entre as sétima e oitava décadas da vida, assim como uma tendência de afetação mais em mulheres do que em homens e pré-disposição em pacientes de raça asiática. A histologia maiormente encontrada é de carácter não epitelial primário. Muitos dos pacientes em séries revisadas têm tido diagnóstico subjacente de doenças linfoide em outros lugares prévio à apresentação de sintomas nasais como obstrução nasal, epistaxe, edema, cefaleia e visão distorcida. Se apresenta um caso de paciente de sexo masculino com diagnóstico de leucemia linfoide crónica, residente na cidade de Buenos Aires, em quem durante uma dacriocistorrinostomia se encontra um linfoma na fossa nasal sem prévia apresentação de sintomas nasais, massa palpável ou sintomas sistémicos.

Epstein-Barr virus load in transplant patients: Early detection of post-transplant lymphoproliferative disorders / Carga de virus Epstein-Barr en pacientes trasplantados: detección temprana de desórdenes linfoproliferativos postrasplante

High levels of circulating EBV load are used as a marker of post-transplant lymphoproliferative disorders (PTLD). There is no consensus regarding the threshold level indicative of an increase in peripheral EBV DNA. The aim of the study was to clinically validate a developed EBV quantification assay for early PTLD detection. Transversal study: paired peripheral blood mononuclear cells (PBMC), plasma and oropharyngeal lymphoid tissue (OLT) from children undergoing a solid organ transplant with (n = 58) and without (n = 47) PTLD. Retrospective follow-up: 71 paired PBMC and plasma from recipients with (n = 6) and without (n = 6) PTLD history. EBV load was determined by real-time PCR. The diagnostic ability to detect all PTLD (categories 1-4), advanced PTLD (categories 2-4) or neoplastic PTLD (categories 3 and 4) was estimated by analyzing the test performance at different cut-off values or with a load variation greater than 0.5 log units. The higher diagnostic performance for identifying all, advanced or neoplastic PTLD, was achieved with cut-off values of 1.08; 1.60 and 2.47 log EBV gEq/10(5) PBMC or 2.30; 2.60; 4.47 log gEq/10(5) OLT cells, respectively. EBV DNA detection in plasma showed high specificity but low (all categories) or high (advanced/neoplastic categories) sensitivity for PTLD identification. Diagnostic performance was greater when: (1) a load variation in PBMC or plasma was identified; (2) combining the measure of EBV load in PBMC and plasma. The best diagnostic ability to identify early PTLD stages was achieved by monitoring EBV load in PBMC and plasma simultaneously; an algorithm was proposed.

La carga alta del virus Epstein-Barr se utiliza como un marcador de desórdenes linfoproliferativos postrasplante (post-transplant lymphoproliferative disorders [PTLD]). El objetivo de este estudio fue validar clínicamente un ensayo de cuantificación del virus Epstein-Barr para la detección temprana de PTLD. Se efectuó un estudio transversal en el que se analizaron muestras pareadas de células mononucleares periféricas (CMP), de plasma y de tejido linfoide orofaríngeo de niños con trasplante de órgano sólido, con PTLD (n = 58) y sin PTLD (n = 47). En el seguimiento retrospectivo se incluyeron 71 muestras pareadas de CMP y de plasma de trasplantados, con PTLD (n = 6) y sin PTLD (n = 6). La carga viral se determinó por PCR en tiempo real. Se estimó la capacidad diagnóstica para detectar PTLD (categorías: todas vs. avanzadas vs. neoplásicas) analizando diferentes valores de corte o una variación de carga mayor de 0,5 logaritmos. El mayor desempeño diagnóstico para identificar todos los PTLD, los avanzados y los neoplásicos, se obtuvo con valores de corte de 1,08; 1,60 y 2,47 log copias/10(5) en CMP y de 2,30; 2,60 y 4,48 log copias/10(5) en células de tejido linfoide orofaríngeo, respectivamente. La detección del ADN del virus Epstein-Barr en el plasma mostró una especificidad alta, pero una sensibilidad baja (todas las categorías) o alta (categorías avanzadas o neoplásicas) para identificar PTLD. Se observó el desempeño diagnóstico más alto en las siguientes condiciones: 1) al identificar una variación de carga en CMP o en plasma; 2) combinando la medición de la carga viral en CMP y en plasma. La mejor capacidad diagnóstica para identificar las etapas tempranas de los PTLD se logró mediante el seguimiento simultáneo de la carga viral en CMP y en plasma; se propone un algoritmo.

Tratamento intralesional de malformações linfáticas com ênfase na escleroterapia com picibanil (OK-432): revisão sistemática / Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review

INTRODUÇÃO: Conduziu-se revisão sistemática retrospectiva da literatura incluindo estudos relatando o uso de picibanil para tratar malformações linfáticas (ML). MÉTODOS: A pesquisa foi realizada com estudos publicados no PubMed de janeiro de 1990 a 14 de abril de 2013. Na estratégia de busca, usou-se os descritores "OK-432" ou "Picibanil" e "lymphatic malformation". Os seguintes elementos foram comparados aos de outras modalidades relatadas e, então, compilados: mecanismo de ação, indicações, contraindicações, eficácia, administração, efeitos colaterais, complicações, vantagens e desvantagens. RESULTADOS: Foram encontrados 44 estudos, 27 dos quais atenderam aos critérios de inclusão. O picibanil é uma preparação liofilizada de uma cepa de baixa virulência de Streptococcus pyogenes inativada pela penicilina G. Seu mecanismo de ação ainda não definido claramente, mas especula-se que provoque uma resposta inflamatória controlada com adesão das paredes dos cistos. O picibanil é indicado quase que unanimemente para o tratamento da ML macrocística, cuja resposta é mais efetiva do que em lesões microcísticas ou mistas. Em geral, o picibanil é administrado por meio de punção com visualização direta ou guiada por ultrassonografia, com o paciente sob anestesia geral. A preparação comumente utilizada consiste em 0,1 mg de picibanil em 10 ml de soro fisiológico. Os efeitos colaterais são, em geral, leves; sendo dor, inchaço e febre os mais frequentemente relatados. CONCLUSÃO: Os estudos apresentam pouca evidência científica. A revisão sistemática identificou que o picibanil é útil no tratamento da ML de qualquer tipo, mas tem resultados melhores em lesões macrocísticas. A eficácia foi comparável à de outras terapias. Não foi apresentada nenhuma contraindicação específica. Embora o mecanismo de ação ainda não tenha sido determinado, o picibanil trata-se de opção de tratamento.

INTRODUCTION: We performed a retrospective systematic review of studies reporting the use of Picibanil for treatment of lymphatic malformations (LMs). METHODS: We searched the PubMed database for available studies, including those published between January 1990 and April 14, 2013. The search strategy involved the use of the keywords "OK-432" or "Picibanil" and "lymphatic malformation." Information was compiled regarding the reported mechanism of action, indications, contraindications, efficacy, administration, side effects, complications, and advantages and disadvantages compared to those of other modalities. RESULTS: Forty-four studies were found, of which 27 fulfilled the inclusion criteria. Picibanil is a lyophilized preparation of a low-virulence strain of Streptococcus pyogenes inactivated with penicillin G. Its mechanism of action is unclear, but it has been speculated that it causes a controlled inflammatory response with adhesion of cyst walls. Picibanil is almost unanimously indicated for the treatment of macrocystic LMs, which show a greater effectiveness response compared to that shown by microcystic or mixed LMs. Picibanil is usually administered by puncturing, either with direct visualization or guided by ultrasound, with the patient under general anesthesia. The most widely used preparation comprises 0.1 mg of Picibanil in 10 mL of saline. Side effects are mostly mild, with pain, swelling, and fever being the most frequently reported. CONCLUSION: The studies had low scientific evidence. A systematic review found that Picibanil is useful against any LM, with better results in macrocystic lesions. Efficacy was comparable to that of other therapies. No specific contraindication was presented. Although the mechanism of action has not been established, the inclusion of Picibanil as a treatment option is warranted.

Scrapie diagnosis in a goat and four Santa Inês sheep from the same herd in Brazil / Diagnóstico de scrapie em um caprino e quatro ovinos Santa Inês de um mesmo rebanho no Brasil

Scrapie is a fatal and progressive transmissible spongiform encephalopathy (TSE) of natural occurrence in sheep and goats. The suspicion of scrapie may be based on clinical signs; however, the detection of pathological features of the prionic protein (PrP) in target tissues is necessary to diagnose the disease. The presence of an abnormal protein form (PrPSc) in lymphoreticular and nervous tissues is an important characteristic in diagnosis. This paper reports a case of scrapie in a flock of 55 Suffolk crossbred sheep, 19 Santa Inês sheep and 21 goats in the Mato Grosso state, midwestern Brazil. The animals were euthanized after the confirmation of a scrapie case with clinical signs in a Suffolk sheep in the same farm...

Scrapie é uma encefalopatia espongiforme transmissível (EET) progressiva e fatal de ocorrência natural em ovinos e caprinos. A suspeita de scrapie é baseada nos sinais clínicos, porém a manifestação patológica da proteína priônica (PrP) nos tecidos-alvo é necessária para a confirmação da doença. A presença de uma forma anormal da proteína (PrPSc) em tecido linforreticular e tecido nervoso constitui uma característica importante para o diagnóstico. Este trabalho é o relato de um foco de scrapie ocorrido em rebanho com 55 ovinos mistos Suffolk, 21 caprinos e 19 ovinos Santa Inês, na região Centro-Oeste do Brasil. Os animais foram eutanasiados após a confirmação de um caso de scrapie com sinais clínicos em um ovino Suffolk nessa propriedade...

Caracterización clínico-epidemiológica de los linfomas en un período de cinco años en Villa Clara / Clinical and epidemiological characterization of lymphomas in a five year-period in Villa Clara

INTRODUCCIÓN: Los linfomas de Hodgkin y no Hodgkin son neoplasias malignas derivadas de los componentes celulares del sistema inmune, en particular, de los linfocitos y de sus precursores. Constituyen un grupo muy heterogéneo con amplias diferencias clinicobiológicas, pronósticas y terapéuticas. OBJETIVO: Caracterizar algunas variables clínico - epidemiológicas en los linfomas. MÉTODOS: Se realizó un estudio descriptivo y longitudinal entre enero de 2006 y diciembre de 2010 que incluyó a todos los pacientes adultos atendidos en los hospitales Celestino Hernández Robau y Arnaldo Milián Castro, en Santa Clara, Villa Clara. RESULTADOS: Se evaluaron 388 pacientes, con un predominio de edades mayores de 40 años, del sexo masculino y color de la piel blanca. El linfoma no Hodgkin tuvo mayor frecuencia; los factores de riesgo que predominaron fueron pertenecer al sexo masculino y la presencia del virus de Epstein-Barr. En las tres cuartas partes de los pacientes, la localización principal fue ganglionar. De las variedades histológicas del linfoma de Hodgkin la más frecuente fue la esclerosis nodular, mientras que para los linfomas no Hodgkin, fue el folicular. El estadio con mayor número de pacientes fue el III-b para ambos tipos de linfomas. La tercera parte de los pacientes fallecieron; el mayor número correspondió a los linfomas no Hodgkin. CONCLUSIÓN: Los linfomas tienen una alta morbilidad y mortalidad en los adultos de la provincia de Villa Clara.

IINTRODUCTION: Hodgkin and non-Hodgkin lymphomas are considered malignant neoplasms derived from cellular components of the immune system, in particular, of the lymphocytes and their precursors. They constitute a very heterogeneous group with broad clinical and biological, prognostic and therapeutic differences. OBJECTIVE: To characterize some clinical and epidemiological variables in lymphomas. METHODS: A descriptive and longitudinal study was carried out from January, 2006 to December, 2010, which included all adult patients who were attended at «Dr. Celestino Hernández Robau¼ and «Arnaldo Milián Castro¼ Hospitals, in Santa Clara, Villa Clara. RESULTS: A number of 388 patients were evaluated, with a predominance of white male, aged over 40. Non-Hodgkin lymphoma was the most frequent; male sex and the presence of Epstein-Barr virus were identified as predominant risk factors. The main localization of lymphomas was ganglionated in the three- quarter parts of patients. Nodular sclerosing was the most frequent histological variety of Hodgkin lymphomas, while for non-Hodgkin lymphomas it was follicular. The higher number of patients had III-b stage for both types of lymphomas. The third part of patients died; the higher number corresponded to non-Hodgkin lymphomas. CONCLUSION: Lymphomas has a high morbidity and mortality in adults from Villa Clara province.

Linfoma esplénico de la zona marginal / Splenic marginal zone lymphoma

Los linfomas no Hodgkin son un grupo de neoplasias que afectan los ganglios linfáticos y/o el tejido linfoide extraganglionar. Su frecuencia ha ido en ascenso en los últimos años. Según la clasificación de la OMS para los linfomas no Hodgkin, los linfomas esplénicos de la zona marginal (LEZM) son neoplasias de las células B maduras que constituyen menos de 2% de todos estos tipos de linfomas. Se presenta el caso de un paciente de 58 años, quien consultó por presentar fiebre prolongada, asociado a pérdida de peso, pancitopenia y esplenomegalia masiva no dolorosa. Después de realizar múltiples estudios, los cuales resultaron negativos, se decide realizar esplenectomía diagnóstica y terapéutica. Se obtiene en resultado de histología resultado compatible con linfoma esplénico de la zona marginal. Posteriormente, paciente presenta mejoría exitosa de todos sus síntomas y es dado de alta del hospital. (Acta Med Colomb 2015; 40: 62-65).

Non-Hodgkin lymphomas are a group of neoplasms that affect the lymph nodes and / or extranodal lymphoid tissue. Its frequency has been increasing in recent years. According to the WHO classification of non-Hodgkin lymphoma, splenic marginal zone lymphomas (SMZL) are neoplasms of mature B cells that constitute less than 2% of all these types of lymphomas. The case of a 58 year old patient who consulted by presenting prolonged fever associated with weight loss, pancytopenia and painless massive splenomegaly, is presented. After conducting multiple studies, which were negative, it was decided to perform diagnostic and therapeutic splenectomy. Histology result is obtained is consistent with splenic marginal zone lymphoma. Subsequently, the patient presents successful improvement of all symptoms and is discharged from the hospital. (Acta Med, Colomb 2015; 40: 62-65).

Oral bacillus Calmette-Guérin vaccine against tuberculosis: why not?

The bacillus Calmette-Guérin (BCG) vaccine is the only licensed vaccine for human use against tuberculosis (TB). Although controversy exists about its efficacy, the BCG vaccine is able to protect newborns and children against disseminated forms of TB, but fails to protect adults against active forms of TB. In the last few years, interest in the mucosal delivery route for the vaccine has been increasing owing to its increased capacity to induce protective immune responses both in the mucosal and the systemic immune compartments. Here, we show the importance of this route of vaccination in newly developed vaccines, especially for vaccines against TB.

Human testis-expressed sequence 101 is limitedly distributed in germinal epithelium of testis and disappears in seminoma

BACKGROUND: Testis-expressed sequence 101 (TEX101) was found to be highly expressed in testis and involved in acrosome reaction in previous studies. Recently, the metastasis suppressor function of TEX101 in cancer was disclosed, but the comprehensive investigation of its expression has rarely been reported. In this study, the expression features of TEX101 in normal human organs and seminoma were systematically analyzed. RESULTS: Immunohistochemistry demonstrated intense staining of TEX101 in human testis tissues; however, its expression in 27 other types of normal human organs, including the ovary, was negligible. Higher expression of TEX101 was observed in the spermatocytes and spermatids of the testis, but relatively lower staining was detected in spermatogonia. Western blotting showed a single TEX101 band of 38 kDa in human testis, but it did not correspond to the predicted molecular weight of its mature form at 21 KDa. Furthermore, we examined seminoma tissues by immunohistochemistry and found that none of the 36 samples expressed TEX101. CONCLUSIONS: Our data confirmed TEX101 to be a testis protein that could be related to the maturation process of male germ cells. The lack of TEX101 in seminoma indicated its potential role in tumor progression. This characteristic expression of TEX101 could provide a valuable reference for understanding its biological functions.

Tejido linfático asociado a mucosas: Células presentadoras de antígenos / Mucose associated lymphoid tissue: Antigen presenting cells

Se estudiaron al microscopio electrónico biopsias de mucosas normales y patológicas (cavidad bucal y cuello uterino), con especial atención a los sistemas de defensa existentes en las células epiteliales (CE) y en las células dendríticas (CD). Las CE, cuando están activadas, muestran su capacidad de fagocitar y procesar antígenos con la finalidad de presentarlos luego a las CD; los elementos implicados en esta función son vesículas de micropinocitosis, cuerpos multivesiculares, lisosomas, fagosomas, vesículas recubiertas por clatrina, gránulos de contenido denso recubiertos por una unidad de membrana, gránulos en cuyo interior se aprecian láminas que simulan hojas de cebolla, microcuerpos y gránulos con actividad de fosfatasa ácida. Las CD que recién han ingresado al interior del epitelio son de baja densidad electrónica y poseen grandes prolongaciones citoplasmáticas, que luego se reducen de tamaño, a la vez que aumenta la densidad de su citoplasma. Muestran vesículas de micropinocitosis, algunas recubiertas por clatrina, lisosomas y corpúsculos de Birberk. En este momento son reconocidas como células de Langerhans. Tanto en las CE como en las CD existen abundantes “pliegues marginales o de superficie“ (surface folds), conteniendo numerosas vesículas de micropinocitosis. Entre la CE y la CD se establecen íntimos contactos a través de los cuales las primeras presentan los antígenos fagocitados y tratados a las CD donde son terminados de procesar y se unen a las moléculas del complejo principal de histocompatibilidad y/o a moléculas con función similar (CD1). Las CD migran a los ganglios linfáticos donde presentan los antígenos a los linfocitos T y empieza el proceso de activación de estos, que conduce a la defensa frente a las noxas que han ingresado al organismo. De esta manera tanto las CD como las CE son un lazo de unión entre los sistemas de defensa innata y la adquirida.

We studied samples of normal and abnormal human mucosae, including oral tissue and uterine cervix, using electron microscopy. Special attention was given to the functions and mechanisms of defense carried out by the epithelial (EC) and dendritic cells (DC). Activated epithelial cells posses the capacity to uptake and process antigens, in order to present them, subsequently, to the dendritic cells. The structures and elements of the cells intervening on this function are: micropinocytic vesicles, multivesicular bodies, lysosomes, phagosomes, clathrin-covered vesicles, dense granules covered by a unit membrane, granules with onion likes leaves, microbodies, and dense granules with acid phosphatase activity. When they first arrive within the epithelial layers, the DC are clear with long cytoplasmic projections, which later become short, and the density of their cytoplasm increases. They possess mycropinocytic vesicles, some clathrine-covered vesicles, lysososmes and Birbeck granules. At this moment, they are known as Langerhans cells. EC and DC present many surface folds rich in micropynocytic vesicles. Between EC and DC there are many contacts (close junctions or tight junctions), through which antigens, phagocitized and processed by the EC, are given to the DC. These cells join them to major histocompatibility complex molecules or to other molecules with similar functions (CD1). Then the Langerhans cells travel to the lymphatic node to activate T cells and continue the immunologic task. So, in this way, both the EC and the DC are a link between the natural and the acquired immunological mechanisms.

Alterações venosas e linfáticas em mulheres com linfedema após linfadenectomia axilar no tratamento do câncer de mama / Venous and lymphatic alterations in women with lymphedema after axillary lymphadenectomy in breast cancer treatment

OBJETIVO: Avaliar as alterações do sistema venoso axilo-subclávio e do sistema linfático em mulheres com linfedema após linfadenectomia axilar para o tratamento do câncer de mama. MÉTODOS: Trata-se de um estudo de série de casos, envolvendo 11 mulheres com linfedema unilateral de membro superior após linfadenectomia axilar para o tratamento do câncer de mama. O estudo foi realizado em hospital universitário do Brasil Central no período compreendido entre os meses de março de 2010 e março de 2011. Avaliou-se a presença de alterações venosas nas veias subclávia e axilar, por meio do exame de ultrassonografia com dopplervelocimetria, e de alterações linfáticas, pela linfocintilografia, em ambos os membros superiores. O teste Exato de Fisher foi utilizado na comparação entre os membros. RESULTADOS: No membro superior com linfedema, detectou-se diferença significativa na veia subclávia, em relação ao membro contralateral, quanto ao volume do fluxo (p<0,001), sendo que 54,6% das mulheres apresentaram fluxo aumentado. Já, na veia axilar, 45,4% apresentaram fluxo aumentado e 45,4% reduzido, com diferença significante (p<0,01) na comparação entre os membros. Também foram observadas alterações linfáticas significativas (p<0,05), em relação ao membro contralateral, representadas pelo trajeto do vaso (não visibilizado), número de vasos linfáticos (nenhum), linfonodos axilares (ausentes) e refluxo dérmico (presente). No membro superior contralateral sem linfedema, não foram encontradas alterações venosas ou linfáticas. CONCLUSÃO: As mulheres submetidas à linfadenectomia axilar para o tratamento do câncer de mama apresentam tanto alterações venosas quanto linfáticas no membro superior com linfedema.

PURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered. CONCLUSION: The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.

Polimorfismo do gene da proteína prion celular (PrPC) e imunohistoquímica de tecido linfóide em ovinos / Polymorphism of cellular prion protein (PrPC) and immunohistochemistry of lymphoid tissue of sheep

O objetivo deste trabalho foi avaliar o polimorfismo do gene da proteína prion celular (PRPN) de ovinos introduzidos numa propriedade onde ocorreu um surto de scrapie, e relacionar com a suscetibilidade à doença por meio da análise da presença da proteína prion celular alterada (PrPSc), utilizando imunohistoquímica (IHQ) de tecido linfóide associado à mucosa reto-anal. Foram avaliados 42 ovinos, mestiços Texel. Eram fêmeas entre um e oito anos de idade, sendo que sete (16,67%) ovelhas foram introduzidas adultas na propriedade em 2006. As demais, 83,33%, eram nascidas na fazenda. A genotipagem do PRPN foi feita pela análise do polimorfismo de comprimento de fragmento de restrição - RFLP ("Restriction Fragment Lenght Polimorphism"). O genótipo ARQ/ARQ foi o mais freqüente, encontrado em 73,81% dos animais, seguido do genótipo ARR/ARQ, com 16,67% e do ARQ/VRQ, com 9,52%. Os alelos ARH e AHQ não foram encontrados nestes animais. O resultado da IHQ foi negativo em todas as amostras. Não foi possível, portanto, estabelecer uma relação entre genótipo e maior susceptibilidade ao scrapie, devido à ausência de PrPSc na amostras examinadas. No Brasil, há poucos dados de genotipagem do gene da proteína prion celular (PRNP) em ovinos e, até o momento, nenhum tipo de controle baseado em cruzamentos direcionados foi implementado.

The aim of this work was to study the polymorphism of the prion protein gene (PRNP) of a sheep flock raised in a farm where a scrapie outbreak had occurred, and to relate to disease susceptibility of possible animals infected with altered prion protein (PrPSc), by immunohistochemical analysis of recto-anal mucosa-associated lymphoid tissue (RAMALT). Forty two sheep, crossbred with Texel, Ile de France, Dorper and Suffolk were used. Females were between one and eight years old, and seven (16.67%) were adult ewes when they entered the flock in 2006. The rest, 83.33% were born in the farm. The PRNP genotyping was performed by RFLP ("restriction fragment length polymorphism") analysis. The most frequent genotype was ARQ/ARQ, found in 73.81% of the animals, followed by ARR/ARQ, with 16.67% and ARQ/VRQ, with 9.52%. The ARH and AHQ alleles were not found. All RAMALT samples were negative in immunohistochemical analysis. It was not possible to establish a relation between PRNP polymorphisms and susceptibility to scrapie, due to the lack of positive samples to PrPSc. In Brazil, there is little available PRNP genotyping data of sheep and, so far, no type of controlled breeding scheme for scrapie has been implemented.