RESUMO
An alternative metric to account for particulate matter (PM) composition-based toxicity is the ability of PM-species to generate reactive oxygen species (ROS) and deplete antioxidants, the so-called oxidative potential (OP). Acellular OP assays are the most used worldwide, mainly those based on ascorbic acid (AA) and dithiothreitol (DTT) depletion; OP values are calculated from AA/DTT concentration over time kinetic curves. Since a great variability in OP-DTT and OP-AA values can be found in the literature, the understanding of those factors affecting the kinetic rate of AA and DTT oxidation in the presence of PM-bound species will improve the interpretation of OP values. In this work, a kinetic study of the oxidation rate of AA and DTT driven by species usually found in PM (transition metals and naphthoquinone (NQ)) was carried out. In particular, the influence of the concentration of Cu(II), Fe(II), Fe(III), Mn(II), Mn(III), and 1,4-NQ, and the type of fluid used in the assay (phosphate buffer (PB), phosphate buffer saline (PBS) and artificial lysosomal fluid (ALF)) is analysed and discussed. The reaction orders with respect to the AA/DTT and the active compound, and the kinetic rate constants were also determined. The results show great variability in OP values among the studied species depending on the fluid used; the OP values were mostly higher in PB0.05 M, followed by PBS1x and ALF. Moreover, different species concentration-responses for OP-DTT/OP-AA were obtained. These differences were explained by the different reaction orders and kinetic rate constants obtained for each active compound in each fluid.
Assuntos
Ácido Ascórbico , Cobre , Ditiotreitol , Ferro , Manganês , Naftoquinonas , Oxirredução , Cinética , Ácido Ascórbico/química , Naftoquinonas/química , Ditiotreitol/química , Ferro/química , Cobre/química , Manganês/química , Material Particulado/química , Material Particulado/análise , Antioxidantes/química , Espécies Reativas de Oxigênio/metabolismo , Espécies Reativas de Oxigênio/químicaRESUMO
An evaluation of various operational parameters on the process of sludge ozonation was carried out based on semi-batch experiments. Particular reference has been given to examine the main parameters affecting the solubilisation of organic matter and nitrogenous compounds. Various sets of experiments were undertaken using real sewage sludge to feed a semi-industrial ozonation plant. Applying ozone dosages between 25 and 35 mg O(3)/gTSS, the organic matter solubilisation obtained through ozonation increases proportionally to ozone dosage until a maximum value of 430 mg COD/L. Concerning the nitrogenous compounds, no variation in nitrite concentration and a low increase in nitrate concentration were attained, regardless of the applied ozone dosage. Little increase in ammonia concentration was achieved for low ozone dosages, whilst applying dosages higher than 20 mg O(3)/gTSS, the variation of ammonia increased proportionally with ozone dosage. Experiments using hydraulic retention time (HRT) between 10 and 60 min resulted in a similar COD solubilisation, confirming a rapid rate of cell lysis during ozonation of sludge.
Assuntos
Compostos de Nitrogênio/química , Compostos Orgânicos/química , Ozônio , Esgotos/química , Reatores Biológicos , Solubilidade , Poluentes Químicos da ÁguaRESUMO
The Precision ID Ancestry Panel for the Ion Torrent PGM™ platform is able to genotype 165 autosomal SNPs by massively parallel sequencing (MPS). In the present study, we evaluated the depth of coverage, the locus strand balance and the heterozygote balance of the above panel. The SNPs rs1569175, rs2306040, rs9845457, rs1407434, and rs10007810 showed a low performance, due either to a low coverage, locus strand imbalance or heterozygote imbalance. To further to assess this panel, we analyzed 108 Basques. All loci proved to be in Hardy-Weinberg equilibrium and we did not detect any association between them with the exception of the pair rs3916235-rs4891825 in chromosome 18. The forensic parameters combined match probability and combined power of exclusion were estimated to be 3.13×10-35 and 99.9972%, respectively. In conclusion, the Precision ID Ancestry panel along with this new MPS technology constitute a very promising tool for human identification and biogeographical ancestry inference in routine casework in the forensic field.
Assuntos
Etnicidade/genética , Genética Populacional , Sequenciamento de Nucleotídeos em Larga Escala/instrumentação , Polimorfismo de Nucleotídeo Único , Análise de Sequência de DNA , Impressões Digitais de DNA , Frequência do Gene , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Reação em Cadeia da Polimerase , EspanhaRESUMO
Specific polysaccharide antibody deficiency (SPAD) is a well reported immunodeficiency characterized by a failure to produce antibodies against polyvalent polysaccharide antigens, expressed by encapsulated microorganisms. The clinical presentation of these patients involves recurrent bacterial infections, being the most frequent agent Streptococcus (S.) pneumoniae. In SPAD patients few reports refer to cells other than B cells. Since the immune response to S. pneumoniae and other encapsulated bacteria was historically considered restricted to B cells, the antibody deficiency seemed enough to justify the repetitive infections in SPAD patients. Our purpose is to determine if the B cell defects reported in SPAD patients are accompanied by defects in other leukocyte subpopulations necessary for the development of a proper adaptive immune response against S. pneumoniae. We here report that age related changes observed in healthy children involving increased percentages of classical monocytes (CD14++ CD16- cells) and decreased intermediate monocytes (CD14++ CD16+ cells), are absent in SPAD patients. Alterations can also be observed in T cells, supporting that the immune deficiency in SPAD patients is more complex than what has been described up to now.
Assuntos
Linfócitos B/imunologia , Síndromes de Imunodeficiência/imunologia , Monócitos/imunologia , Infecções Pneumocócicas/imunologia , Streptococcus pneumoniae/imunologia , Subpopulações de Linfócitos T/imunologia , Linfócitos T/imunologia , Imunidade Adaptativa/genética , Adolescente , Adulto , Anticorpos/sangue , Linfócitos B/microbiologia , Diferenciação Celular , Criança , Feminino , Humanos , Síndromes de Imunodeficiência/genética , Masculino , Infecções Pneumocócicas/genética , Polissacarídeos/imunologia , Adulto JovemRESUMO
Resisting death is a central hallmark of cancer cells. Tumors rely on a number of genetic mechanisms to avoid apoptosis, and alterations in mRNA alternative splicing are increasingly recognized to have a role in tumorigenesis. In this study, we identify the splicing regulator SLU7 as an essential factor for the preservation of hepatocellular carcinoma (HCC) cells viability. Compared with hepatocytes, SLU7 expression is reduced in HCC cells; however, further SLU7 depletion triggered autophagy-related cellular apoptosis in association with the overproduction of reactive oxygen species. Remarkably, these responses were not observed in primary human hepatocytes or in the well-differentiated HepaRG cell line. Mechanistically, we demonstrate that SLU7 binds the C13orf25 primary transcript in which the polycistronic oncomir miR-17-92 cluster is encompassed, and is necessary for its processing and expression. SLU7 knockdown altered the splicing of the C13orf25 primary transcript, and markedly reduced the expression of its miR-17, miR-20 and miR-92a constituents. This led to the upregulation of CDKN1A (P21) and BCL2L11 (BIM) expression, two bona fide targets of the miR-17-92 cluster and recognized mediators of its pro-survival and tumorigenic activity. Interestingly, altered splicing of miR-17-92 and downregulation of miR-17 and miR-20 were not observed upon SLU7 knockdown in non-transformed hepatocytes, but was found in other (HeLa, H358) but not in all (Caco2) non-hepatic tumor cells. The functional relevance of miR-17-92 dysregulation upon SLU7 knockdown was established when oxidative stress, autophagy and apoptosis were reversed by co-transfection of HCC cells with a miR-17 mimic. Together, these findings indicate that SLU7 is co-opted by HCC cells and other tumor cell types to maintain survival, and identify this splicing regulator as a new determinant for the expression of the oncogenic miR-17-92 cluster. This novel mechanism may be exploited for the development of antitumoral strategies in cancers displaying such SLU7-miR-17-92 crosstalk.
Assuntos
Processamento Alternativo/genética , Carcinoma Hepatocelular/genética , Neoplasias Hepáticas/genética , MicroRNAs/genética , Fatores de Processamento de RNA/genética , Apoptose/genética , Autofagia/genética , Células CACO-2 , Carcinogênese/genética , Carcinoma Hepatocelular/patologia , Linhagem Celular Tumoral , Sobrevivência Celular/genética , Regulação Neoplásica da Expressão Gênica , Células Hep G2 , Hepatócitos/metabolismo , Hepatócitos/patologia , Humanos , Neoplasias Hepáticas/patologia , RNA Longo não CodificanteRESUMO
The low positive predictive value of mammography results in unnecessary biopsies. We present a prospective evaluation on the contribution of 99mTc-MIBI Scintimammography (SMM) to the diagnosis of breast cancer in 41 patients with non-palpable breast lesions detected by mammography. In all cases mammographical findings were indicative of biopsy and according to the probability of malignancy they were classified into three groups: high probability (17), intermediate (15), and low (9). There were 22 malignant lesions and 19 benign. In the high probability group. MIBI-SMM changed the only false positive into true negative, and showed 2 false negatives. In the intermediate group, MIBI-SMM changed 7 of 11 false positives on mammography into true negatives, and showed 1 false negative. In the low probability group MIBISMM changed 3 of the 7 false positive into true negatives without false negatives. In the 24 patients included in the intermediate and low probability groups, 10 of the 18 false positives were changed into true negatives by MIBI-SMM at the expense of 1 false negative. The addition of SMM may to reduce up to 55% of the number of unnecessary biopsies in non-palpable breast lesions.
Assuntos
Doenças Mamárias/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Mamografia , Tecnécio Tc 99m Sestamibi , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Probabilidade , CintilografiaRESUMO
This study evaluated the relationship between meeting the Nutrition Recommendations and mortality from all causes in a cohort of 1,623 men from the Quebec City area followed from 1985 to 1991. The usual dietary intake was assessed by a self-administered semi-quantitative food frequency questionnaire. Most participants did not meet the Nutrition Recommendations. During the follow-up 69 men died. The mortality was significantly lower among those who did not meet the recommendations for total fat (RR = 0.45, CI: 0.25-0.81) or for carbohydrates (RR = 0.49, CI: 0.26-0.92). This unexpected result could be attributable to an excessive alcohol intake or to dietary changes in the direction of the Nutrition Recommendations, made prior to the dietary assessment often because of illness. It would be interesting to continue the follow-up of this cohort to evaluate the long-term effect of a diet meeting the Nutrition Recommendations on mortality from all causes.
Assuntos
Dieta , Mortalidade , Necessidades Nutricionais , Idoso , Causas de Morte , Estudos de Coortes , Metabolismo Energético , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Quebeque/epidemiologia , Fatores de RiscoRESUMO
Blood samples from 489 unrelated Caucasian Mestizo and 252 individuals of African descent in Colombia were amplified and typed for three short tandem repeat (STR) markers (D12S1090, D3S1744, and D18S849). All markers conformed to Hardy-Weinberg equilibrium expectations in both populations studied. In addition, heterozygosity, mean exclusion chance, polymorphism information content, discrimination power, and the assumption of independence within and between loci were determined. The mean exclusion chance for all three STR markers is 0.9750 in the Caucasian Mestizo population and 0.9731 in the African Colombian Population. The discrimination power is 0.999925 and 0.999911 in the Caucasian Mestizo and African Colombian respectively.
Assuntos
População Negra/genética , Frequência do Gene , Indígenas Norte-Americanos/genética , Sequências de Repetição em Tandem/genética , Colômbia , Medicina Legal/métodos , Genética Populacional , Humanos , Reação em Cadeia da PolimeraseRESUMO
Hyperparathyroidism (HPT) is one of the most prevalent endocrine diseases, for which the only effective treatment is surgery. The use of imaging techniques in the preoperative localization of the hyperfunctioning glands is the subject of controversy. The purpose of this paper is to assess the use of double-phase scintigraphy with Tc-99m sestamibi in the localization of lesions causing HPT. We used scintigraphy to preoperatively examine 41 patients, 31 of whom had primary HPT and 10 with secondary HPT. We acquired two anterior view planar images of the neck and chest 10 minutes and 3 hours after injection of Tc-99m sestamibi. Final diagnosis, determined with biopsy, was adenoma in 26 patients, 24 of whom had a positive scintigraphic study (sensitivity 92%), with only two false negative results. In the 14 cases of parathyroid hyperplasia, scintigraphy was also positive, and 62% (30/48) of the excised glands were identified by Tc-99m sestamibi. The radioisotope study was of particular interest in the six patients who previously had undergone surgery, since all the studies were positive; in two patients, additional diseased glands were located in the neck, and an ectopic adenoma was found in the remaining four patients. A fifth ectopic lesion was also sestamibi-positive and, in this case, the scintigraphic result was a direct indication for mediastinal surgery. There were no false positive results, even in patients with multinodular goiter. We conclude that, due to its high sensitivity and the ease with which it is performed, double-phase scintigraphy with Tc-99m sestamibi is the preferred technique for the preoperative localization of diseased glands in patients with HPT, especially in cases of parathyroid adenoma, including those with aberrant location. Its use is of particular interest in patients who previously have undergone surgery.
Assuntos
Hiperparatireoidismo/diagnóstico por imagem , Doenças das Paratireoides/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Adenoma/complicações , Adenoma/diagnóstico por imagem , Adenoma/patologia , Adulto , Idoso , Biópsia , Coristoma/diagnóstico por imagem , Reações Falso-Negativas , Feminino , Humanos , Hiperparatireoidismo/etiologia , Hiperparatireoidismo/cirurgia , Hiperparatireoidismo Secundário/diagnóstico por imagem , Hiperparatireoidismo Secundário/etiologia , Hiperparatireoidismo Secundário/cirurgia , Hiperplasia , Masculino , Doenças do Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Doenças das Paratireoides/complicações , Doenças das Paratireoides/cirurgia , Glândulas Paratireoides/diagnóstico por imagem , Glândulas Paratireoides/patologia , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/patologia , Paratireoidectomia , Cintilografia , Sensibilidade e Especificidade , Tórax/diagnóstico por imagem , Fatores de TempoRESUMO
Myocardial infarction is a rare complication that can occur after blunt chest trauma. The authors describe a 30-year-old man who experienced a fatal anterolateral myocardial infarction after chest trauma in a motorcycle accident. The electrocardiogram and creatine phosphokinase-MB isoenzymes levels suggested myocardial necrosis. Tc-99m phosphate myocardial scintigraphy identified an extensive doughnut-shaped uptake over the cardiac area. An echocardiogram revealed severe left ventricular impairment. Coronary angiography confirmed complete occlusion of the proximal left anterior descending coronary artery.
Assuntos
Doença das Coronárias/etiologia , Coração/diagnóstico por imagem , Infarto do Miocárdio/etiologia , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Adulto , Angiografia Coronária , Creatina Quinase/análise , Difosfonatos , Ecocardiografia , Evolução Fatal , Humanos , Isoenzimas , Masculino , Infarto do Miocárdio/diagnóstico , Necrose , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão , Disfunção Ventricular EsquerdaRESUMO
BACKGROUND: We studied the evolution and diagnostic tests performed in patients with dyspepsia aged less than 55 years. PATIENTS AND METHOD: We included 289 patients under age 55 with clinically manifest dyspepsia who were referred for specialized digestive evaluation from the primary care setting. RESULTS: One half of patients consulted again in the course of the study for the same symptoms. In 131 patients (45%), an endoscopy was proposed at some stage during the study. Gastroduodenal pathology was identified in 37% of the patients who underwent an endoscopy. CONCLUSIONS: In these patients, the approach adopted by the gastroenterologist must comprise assessment of the symptoms with endoscopy.
Assuntos
Dispepsia/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
The presence of IBS was studied in 289 patients under 55 years of age with dyspeptic syndrome. The subjects were divided into two groups: group I (240 patients with DS) and group II (49 patients with DS and IBS). The mean duration of follow%shy;up was 10.8 years (130 months). IBS was diagnosed in 49 patients (17%). Females accounted for 64% and 77% of groups I and II, respectively (p < 0.05). There were no differences in mean age or the type of FDS. The patients in group II consulted more often and earlier (92% returned for consultation, and took 27 months in doing so) than those in group I (52% and 40 months)(p < 0.05). The number of diagnostic tests requested was greater in group II. Psychiatric pathology was in turn more common in group II than in group I (20 versus 7%)(p < 0.05).
Assuntos
Doenças Funcionais do Colo/complicações , Dispepsia/complicações , Adulto , Estudos de Casos e Controles , Doenças Funcionais do Colo/diagnóstico , Doenças Funcionais do Colo/epidemiologia , Dispepsia/diagnóstico , Dispepsia/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Encaminhamento e Consulta/estatística & dados numéricosRESUMO
A heart transplant patient treated with OKT3 developed a severe headache which worsened and was accompanied by a sudden decrease in the patient's consciousness level and aphasia when the treatment course was completed. CT was performed and was normal. SPET imaging with 99mTc-HMPAO of cerebral blood flow done 16 hours later revealed multiple and clear focal defects in the blood flow. Analysis of cerebral spinal fluid revealed aseptic pleocytosis. Five days after the completion of treatment, the symptoms remitted and a new control SPET 3 weeks later was completely normal. A diagnosis of neurotoxicity secondary to OKT3 administration was established.
Assuntos
Edema Encefálico/diagnóstico por imagem , Circulação Cerebrovascular/efeitos dos fármacos , Transplante de Coração , Imunossupressores/efeitos adversos , Meningoencefalite/diagnóstico por imagem , Muromonab-CD3/efeitos adversos , Complicações Pós-Operatórias/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Afasia/induzido quimicamente , Afasia/diagnóstico por imagem , Abscesso Encefálico/diagnóstico , Edema Encefálico/induzido quimicamente , Cardiomiopatia Dilatada/cirurgia , Hemorragia Cerebral/diagnóstico , Líquido Cefalorraquidiano/citologia , Confusão/induzido quimicamente , Confusão/diagnóstico por imagem , Diagnóstico Diferencial , Cefaleia/induzido quimicamente , Cefaleia/diagnóstico por imagem , Humanos , Imunossupressores/farmacologia , Leucocitose/induzido quimicamente , Leucocitose/diagnóstico por imagem , Ativação Linfocitária/efeitos dos fármacos , Masculino , Meningoencefalite/líquido cefalorraquidiano , Meningoencefalite/induzido quimicamente , Muromonab-CD3/farmacologia , Complicações Pós-Operatórias/induzido quimicamente , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologiaRESUMO
Surgical alterations after median sternotomy can difficult the interpretation of scintigraphic images with Ga67. To analize the use of Ga67 scintigraphy in this patology, we wanted to know the Ga67 distribution in patients who had suffered median sternotomy. We studied 8 patients in the first month after median sternotomy without infection complication and performed planar images and SPECT. Ga67 showed uptake in liver, spleen and bone. Sternal uptake was greater or lesser than liver uptake but always showed an homogeneous distribution. No mediastinum uptake was observed. Surgical wound showed Ga67 uptake during the first week after sternotomy. To know the <
Assuntos
Osso e Ossos/diagnóstico por imagem , Radioisótopos de Gálio , Fígado/diagnóstico por imagem , Baço/diagnóstico por imagem , Esterno/diagnóstico por imagem , Esterno/cirurgia , Tomografia Computadorizada de Emissão de Fóton Único , Humanos , Período Pós-Operatório , Fatores de TempoRESUMO
The prognosis of infections complications after median sternotomy depends of precocious diagnoses and depth extension of infection. We wanted to analyze the use of 67Ga scintigraphy in this pathology, comparing planar studies an SPECT. We studied 22 patients with suspect of infection complication after median sternotomy, the final diagnoses were 5 mediastinitis, 10 osteomyelitis and 7 patients with other pathology. 67Ga scintigraphy diagnosed correctly the 5 mediastinitis, 9 of 10 osteomyelitis and descarted both pathology in the other 7 patients. Planar studies only were able to diagnose correctly 3 of 5 mediastinitis and the another 2 were correctly diagnosed by SPECT. 67Ga scintigraphy is useful in the diagnosis of infection complication after median sternotomy and SPECT is better than planar studies in the diagnosis of mediastinitis.
Assuntos
Radioisótopos de Gálio , Mediastinite/diagnóstico por imagem , Osteomielite/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Esterno/cirurgia , Tomografia Computadorizada de Emissão de Fóton Único , Diagnóstico Diferencial , Humanos , Pneumonia/diagnóstico por imagem , Síndrome Pós-Pericardiotomia/diagnóstico por imagem , Esterno/diagnóstico por imagem , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Tuberculose Pulmonar/diagnóstico por imagemRESUMO
OBJECTIVE: This study aimed to assess if activation with acetazolamide increases the diagnostic capacity of baseline SPECT with (99m)Tc-HMPAO in the study of brain perfusion in type I diabetic patients with no history of neurological symptoms. MATERIAL AND METHODS: A baseline SPECT was carried out in 11 diabetes mellitus type I patients with no neurological symptoms with 555 MBq of (99m)Tc-HMPAO; 1 g of acetazolamide was administered during the examination and a second SPECT was obtained 20' later with the same methodology used in the baseline SPECT. The images were visually analyzed. The post-acetazolamide studies were analyzed with (CBS) and without (WBS) baseline image subtraction and both methods were compared. RESULTS: The baseline SPECT showed 48 hypoperfused cortical areas. The post-acetazolamide SPECT analyzed without baseline image subtraction detected 14 new hypoperfused areas and those analyzed with it detected 26 areas. 69% of the baseline hypoperfused areas were hyporeactive in the WBS analysis and 54% in the CBS analysis. CONCLUSION: The perfusion SPECT with acetazolamide improves the diagnostic capacity of the baseline perfusion (99m)Tc-HMPAO SPECT, and makes it possible to classify the abnormalities as metabolic or vascular, with a preference for the post-acetazolamide CBS imaging analysis.
Assuntos
Acetazolamida/farmacologia , Encefalopatias Metabólicas/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Circulação Cerebrovascular , Diabetes Mellitus Tipo 1/diagnóstico por imagem , Angiopatias Diabéticas/diagnóstico por imagem , Neuropatias Diabéticas/diagnóstico por imagem , Pré-Medicação , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Vasodilatadores/farmacologia , Adulto , Encéfalo/irrigação sanguínea , Encefalopatias Metabólicas/etiologia , Diabetes Mellitus Tipo 1/complicações , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/etiologia , Neuropatias Diabéticas/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Perfusão , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/farmacocinética , Técnica de Subtração , Tecnécio Tc 99m Exametazima/administração & dosagem , Tecnécio Tc 99m Exametazima/farmacocinéticaRESUMO
INTRODUCTION: Acute rejection is the most common complication in lung transplantation. OBJECTIVE: This work aimed to assess the contribution of pulmonary clearance of radioaerosols and relative pulmonary perfusion to diagnose acute rejection in lung transplantation. MATERIAL AND METHOD: We have designed a prospective study and present the results obtained for the preliminary phase. This work includes 5 patients who have received a lung transplantation and in whom 28 studies of pulmonary clearance of 99mTc-DTPA and relative pulmonary perfusion with 99mTc microspheres were performed. The pulmonary biopsy diagnosed 9 rejection episodes, 2 associated to CMV infection. RESULTS: The mean radioaerosol clearance time increased when the follow-up was favorable and decreased in 6 of the 9 rejection episodes, including 2 associated to CMV infection. There was only one case with decreased mean clearance time that was not associated to rejection. CONCLUSIONS: Calculating relative pulmonary perfusion can be useful in the follow-up of single lung transplantation but not in bipulmonary ones. Our results suggest that measuring 99mTc-DTPA clearance is useful to suspect a rejection episode.
Assuntos
Transplante de Pulmão/diagnóstico por imagem , Compostos Radiofarmacêuticos , Mucosa Respiratória/metabolismo , Pentetato de Tecnécio Tc 99m , Adulto , Aerossóis/farmacocinética , Feminino , Seguimentos , Humanos , Masculino , Microesferas , Pessoa de Meia-Idade , Perfusão , Permeabilidade , Estudos Prospectivos , CintilografiaRESUMO
The combined use of bone SPET and CT was a good approach for diagnosing an osteoid osteoma of spine in a 16-year-old young woman with a history of several months of back pain. Pain was increased at night and relieved by aspirin intake. Plain films of the spine only revealed a scoliosis. Bone SPET demonstrated a focal increased activity in the left posterior elements of T12 vertebra. CT of this vertebra discovered a lytic lesion in the left lamina. An osteoid osteoma was removed by laminectomy.
Assuntos
Osteoma Osteoide/diagnóstico por imagem , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Adolescente , Dor nas Costas/etiologia , Difosfonatos , Feminino , Humanos , Laminectomia , Compostos de Organotecnécio , Osteólise/etiologia , Osteoma Osteoide/complicações , Osteoma Osteoide/cirurgia , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The preoperative use of imaging techniques to localize the diseased glands in primary hyperparathyroidism is still the subject of controversy. This paper assess the use of double-phase 99mTc-MIBI scintigraphy with that purpose. We examined 37 patients with primary hyperparathyroidism before surgical intervention. Two planar images 10 minutes and 3 hours after injection of 99mTc-MIBI were acquired. Final diagnosis was adenoma in 32 patients, 30 of whom had a positive scintigraphy (sensitivity 94%), with only two false negative results. In the other five patients, four with hyperplasia and one carcinoma, scintigraphy was also positive. Radioisotopic study was of particular interest in 5 patients who had undergone previous surgery; in one case, other diseased gland was located in the neck, and an ectopic adenoma was found in the remaining four cases. Two other ectopic lesions were also MIBI positive and, in these cases, scintigraphy was a direct indication for mediastinal surgery. There was no false positive results. We conclude that the high sensitivity and easy performance make double-phase 99mTc-MIBI scintigraphy the technique of choice for the preoperative localization of diseased glands in primary hyperparathyroidism, especially in cases of adenoma. Its use is of particular interest in adenomas with aberrant location and in patients who have undergone previous surgery.
Assuntos
Adenoma/diagnóstico por imagem , Hiperparatireoidismo/diagnóstico por imagem , Glândulas Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Adenoma/cirurgia , Adulto , Idoso , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/cirurgia , Cuidados Pré-Operatórios , Cintilografia , Sensibilidade e EspecificidadeRESUMO
The shortage of organ availability in recent years has made it necessary to use grafts from advanced-aged donors to maintain the rate of renal transplantation in our country. The objective of this study was to evaluate the graft function and patient survival using kidneys from deceased donors of over 65 year of age. From 2005 until 2010, we compared the outcomes of patients who received grafts from donors over 65 years old vs less than 65 years. We observed no significant difference in sex, time on dialysis, or cold ischemia time between the groups. As expected the recipient age was significantly different. For the analysis of survival, we used the Tablecloth-Haenzel test and the Kaplan-Meier survival estimator. Actuarial survivals at 3 years after transplantation showed 84.8% among patients transplanted with kidneys from donors over 65 years old versus 97.5% in the control group. The graft survival was 78.8% among expanded criteria versus 86.85% in the control group. When we analyzed graft survival using an "exitus-censured" analysis, we obtained graft survivals of 89.1% in the expanded criteria kidney group versus 88.6% among the controls. We concluded that the use of kidney from donors over 65 years of age allows us to increase the rate of renal transplantation to about 15 to 20 per million population, with good graft and patient survivals provided that the protocol for expanded criteria organs ensured proper macroscopic and microscopic evaluation of the organ for transplantation.