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Finite element analysis (FEA) has been used to analyze the behavior of dental materials, mainly in implantology. However, FEA is a mechanical analysis and few studies have tried to simulate the biological characteristics of the healing process of loaded implants. This study used the rule of mixtures to simulate the biological healing process of immediate implants in an alveolus socket and bone-implant junction interface through FEA. Three-dimensional geometric models of the structures were obtained, and material properties were derived from the literature. The rule of mixtures was used to simulate the healing periods-immediate and early loading, in which the concentration of each cell type, based on in vivo studies, influenced the final elastic moduli. A 100 N occlusal load was simulated in axial and oblique directions. The models were evaluated for maximum and minimum principal strains, and the bone overload was assessed through Frost's mechanostat. There was a higher strain concentration in the healing regions and cortical bone tissue near the cervical portion. The bone overload was higher in the immediate load condition. The method used in this study may help to simulate the biological healing process and could be useful to relate FEA results to clinical practice.
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Implantes Dentários , Módulo de Elasticidade , Análise de Elementos Finitos , Carga Imediata em Implante Dentário , Alvéolo Dental , Cicatrização , Humanos , Alvéolo Dental/fisiologia , Cicatrização/fisiologia , Fenômenos Biomecânicos , Simulação por Computador , Interface Osso-Implante/fisiologia , Estresse Mecânico , Processo Alveolar/fisiologia , Modelos Biológicos , Osseointegração/fisiologia , Força de Mordida , Análise do Estresse Dentário/métodos , Osteoblastos/fisiologia , Osso Cortical/fisiologia , Imageamento Tridimensional/métodosRESUMO
Arsenic and its inorganic compounds affect numerous organs and systemic functions, such as the nervous and hematopoietic systems, liver, kidneys, and skin. Despite a large number of studies on arsenic toxicity, rare reports have investigated the leukopenia incidence in workers exposed to arsenic. In workplaces, the main source of workers' exposure is the contaminated air by the inorganic arsenic in mines, arsenic or copper smelter industries, and chemical factories. Erythropoiesis inhibition is one of the arsenic effects and it is related to regulatory factor GATA-1. This factor is necessary for the normal differentiation of early erythroid progenitors. JAK-STAT is an important intracellular signal transduction pathway responsible for the mediating normal functions of several cytokines related to cell proliferation and hematopoietic systems development and regulation. Arsenic inactivates JAK-STAT by inhibiting JAK tyrosine kinase and using the IFNγ pathway. The intravascular hemolysis starts after the absorption phase when arsenic binds to the globin of hemoglobin in erythrocytes and is transported into the body, which increases the oxidation of sulfhydryl groups in hemoglobin. So, this article intends to highlight the potential leukopenia risk via inhalation for workers exposed to arsenic and suggests a possible mechanism for this leukopenia through the JAK-signal transducer and activator of transcription (STAT) pathway inhibition.
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PURPOSE: There is limited literature on the ocular manifestations in patients with psoriasis. Therefore, this study aimed to identify the prevalence of and factors associated with ocular manifestations in adults with psoriasis. METHODS: This cross-sectional study included Brazilian adults with psoriasis. The dermatological evaluation included diagnosis, clinical form, Psoriasis Area and Severity Index (PASI) measurement, and location of the lesions. Patients underwent a full ophthalmological examination, including the Schirmer I test, Rose Bengala staining, and tear breakup time tests. The results were analyzed using chi-square and Pearson's linear correlation tests. RESULTS: Of the 130 patients assessed, 118 (90.8%) exhibited ocular abnormalities, with meibomian gland dysfunction (MGD) being the most prevalent (59.2%), followed by dry eye disease (DED) (56.2%). A significant correlation was observed between MGD and PASI (p = 0.05), and between MGD and certain treatment modalities. DED was significantly associated with PASI (p < 0.05). Concurrent use of acitretin was identified as an independent predictor of MGD (odds ratio [OR] = 3.5, p < 0.05), whereas PASI was a protective factor against DED (OR = 0.39, p < 0.01). CONCLUSION: Given the high prevalence of eye disease among individuals with psoriasis, routine ophthalmological assessments are recommended to prevent possible ocular complications.
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Síndromes do Olho Seco , Psoríase , Humanos , Estudos Transversais , Masculino , Psoríase/epidemiologia , Psoríase/complicações , Feminino , Brasil/epidemiologia , Adulto , Pessoa de Meia-Idade , Prevalência , Síndromes do Olho Seco/epidemiologia , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/diagnóstico , Disfunção da Glândula Tarsal/epidemiologia , Disfunção da Glândula Tarsal/diagnóstico , Disfunção da Glândula Tarsal/etiologia , Índice de Gravidade de Doença , Idoso , Adulto JovemRESUMO
Microbial resistance to drugs is a public health problem; therefore, there is a search for alternatives to replace conventional products with natural agents. One of the potential antimicrobial agents is wood vinegar derived from the carbonization of lignocellulosic raw materials. The objectives of the present work were to evaluate the antibacterial and antifungal action of two kinds of wood vinegar (WV), one of Eucalyptus urograndis wood and another of Bambusa vulgaris biomass, and determine their chemical profile. The antimicrobial effect was assessed against Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella enteritidis, Escherichia coli, Streptococcus agalactiae, and Candida albicans. The minimum inhibitory concentration and the minimum bactericidal and fungicidal concentrations were determined. Micrographs of the microorganisms before and after exposure to both kinds of wood vinegar were obtained by scanning electron microscopy. The chemical profile of the eucalyptus and bamboo vinegar was carried out by gas chromatography and mass spectrometry (GC/MS). Both types of WV presented significant antimicrobial activity, with the bamboo one having a higher efficiency. Both studied pyroligneous extracts seem promising for developing natural antimicrobials due to their efficiency against pathogens. GC/MS analyses demonstrated that the chemical profiles of both kinds of WV were similar but with some significant differences. The major component of the eucalyptus vinegar was furfural (17.2%), while the bamboo WV was phenol (15.3%). Several compounds in both WVs have proven antimicrobial activity, such as acetic acid, furfural, phenol, cresols, guaiacol, and xylenols. Together, they are the major in the chemical composition of the organic fraction of both WVs. Bamboo vinegar had a more expressive content of organic acids. Micrographs of microorganisms taken after exposure to both kinds of wood vinegar displayed several cell modifications. The potential of both types of wood vinegar as a basis for natural antimicrobial products seems feasible due to their proven effect on inhibiting the microorganisms' growth assessed in this experiment.
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Anti-Infecciosos , Bambusa , Eucalyptus , Ácido Acético/farmacologia , Furaldeído , Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Fenóis/análiseRESUMO
BACKGROUND: Primary Central Nervous System Vasculitis (PCNSV) is responsible for 3%-5% of strokes before age 50. It presents with clinical, radiological, and pathological variability. Optimal management is unknown given the absence of randomized clinical trials. AIMS OF THE STUDY: Explore whether tocilizumab, an anti-interleukin-6 monoclonal antibody, is an effective treatment for refractory PCNSV. METHODS: Patients with PCNSV treated with tocilizumab in a single tertiary center were reviewed. RESULTS: Three patients were identified. In two of them, MRI-revealed ischemic lesions. The other presented with a subcortical hemispheric pseudotumoral lesion. Brain biopsy was inconclusive in two patients. Due to a significant number of relapses and clinical deterioration despite other immunosuppressive drugs, tocilizumab was initiated and induced a long remission period up to 44 months. Observed side effects were a fungic infection, neutropenia and thrombocytopenia (both transitory), and a pulmonary embolism in one of the cases. CONCLUSIONS: Tocilizumab might be a therapeutic option for PCNSV (Class IV evidence), given its efficacy and safety. We propose a novel pathway for diagnosis and therapeutics of PCNSV with the purpose of improving the diagnosis, monitoring, and prognosis of this heterogeneous disorder, setting the framework for future use of tocilizumab in this condition.
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Vasculite do Sistema Nervoso Central , Anticorpos Monoclonais Humanizados/uso terapêutico , Biópsia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Vasculite do Sistema Nervoso Central/diagnóstico por imagem , Vasculite do Sistema Nervoso Central/tratamento farmacológicoRESUMO
BACKGROUND: The relationship between indices of mechanical ventilation and pulmonary artery pressures remains ill-defined in ARDS. As our understanding of mechanical ventilation has progressed, there is now a greater appreciation of the impact of high driving pressures and mechanical power in perpetuating lung injury. However, the relationship between the newer derived indices of mechanical ventilation and pulmonary artery pressure is unclear. We performed a post hoc analysis of the Fluid and Catheters Treatment Trial (FACTT) trial to investigate the associations between mechanical ventilation indices in ARDS patients and the prevalence of pulmonary hypertension. This may help elucidate future clinical targets for more, right ventricular protective, mechanical ventilation strategies. METHODS: We performed a post hoc analysis of the FACTT database to identify ARDS patients who had a pulmonary artery catheter (PAC) inserted and pulmonary artery pressure readings recorded. We excluded any patient with a PAC inserted who was spontaneously breathing, as driving pressure and mechanical power are not validated in this cohort. Three independent analyses were performed: a univariate analysis, to assess for associations between mPAP and mechanical ventilation parameters using Pearson correlation coefficients, a multivariate analysis, to assess for independent associations with mPAP using a multiple regression model according to Akaike's information criteria and finally an analysis for nonlinearity, using the best-fitting model according to the Bayesian information criterion (BIC) from linear, quadratic, fractional polynomial and restricted cubic spline models. RESULTS: All the ventilation parameters demonstrated a significant correlation with mPAP, except tidal volume (once adjusted for respiratory rate) in the univariate analysis. The multivariate analysis demonstrated that the blood pH level, P/F ratio, PaCO2 level, mean airway pressure and the mechanical power indexed to compliance were independently associated with mPAP. In the final nonlinear analysis, associations did not differ from linearity except for 4 variables for which the fractional polynomial was the best-fitting model. These were mechanical power (p = 0.01 compared to the linear model), respiratory rate (p = 0.04), peak pressure (p = 0.03) and mean airway pressure (p = 0.01). Two nonlinear variables associated with mPAP were assessed in more detail, respiratory rate and mechanical power. Inflexion points at a respiratory rate of 16.8 cycles per minute and a mechanical power of 8.8 J/min were demonstrated. CONCLUSIONS: The associations identified between mPAP and mechanical ventilation variables in this analysis would suggest that classical ARDS lung protective strategies, including low tidal volume ventilation and permissive hypercapnia, may negatively impact the management of the subset of ARDS patients with associated right ventricular dysfunction or ACP. Additionally, respiratory rates above 17 cycles per minute show an incremental increase in mPAP. Therefore, increases in tidal volume (within the limitation of driving pressure < 18 cmH20) may represent a more right ventricular protective way to control CO2 and pH.
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Respiração Artificial , Síndrome do Desconforto Respiratório , Humanos , Teorema de Bayes , Artéria Pulmonar , Síndrome do Desconforto Respiratório/terapia , Pulmão , Volume de Ventilação PulmonarRESUMO
Computer vision techniques can monitor the rotational speed of rotating equipment or machines to understand their working conditions and prevent failures. Such techniques are highly precise, contactless, and potentially suitable for applications without massive setup changes. However, traditional vision sensors collect a significant amount of data to process and measure the rotation of high-speed systems, and they are susceptible to motion blur. This work proposes a new method for measuring rotational speed processing event-based data applied to high-speed systems using a neuromorphic sensor. This sensor produces event-based data and is designed to work with high temporal resolution and high dynamic range. The main advantages of the Event-based Angular Speed Measurement (EB-ASM) method are the high dynamic range, the absence of motion blurring, and the possibility of measuring multiple rotations simultaneously with a single device. The proposed method uses the time difference between spikes in a Kernel or Window selected in the sensor frame range. It is evaluated in two experimental scenarios by measuring a fan rotational speed and a Router Computer Numerical Control (CNC) spindle. The results compare measurements with a calibrated digital photo-tachometer. Based on the performed tests, the EB-ASM can measure the rotational speed with a mean absolute error of less than 0.2% for both scenarios.
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Movimento , Movimento (Física) , Monitorização FisiológicaRESUMO
The X-ray free-electron lasers that became available during the last decade, like the European XFEL (EuXFEL), place high demands on their instrumentation. Especially at low photon energies below 1â keV, detectors with high sensitivity, and consequently low noise and high quantum efficiency, are required to enable facility users to fully exploit the scientific potential of the photon source. A 1-Megapixel pnCCD detector with a 1024â ×â 1024 pixel format has been installed and commissioned for imaging applications at the Nano-Sized Quantum System (NQS) station of the Small Quantum System (SQS) instrument at EuXFEL. The instrument is currently operating in the energy range between 0.5 and 3â keV and the NQS station is designed for investigations of the interaction of intense FEL pulses with clusters, nano-particles and small bio-molecules, by combining photo-ion and photo-electron spectroscopy with coherent diffraction imaging techniques. The core of the imaging detector is a pn-type charge coupled device (pnCCD) with a pixel pitch of 75â µmâ ×â 75â µm. Depending on the experimental scenario, the pnCCD enables imaging of single photons thanks to its very low electronic noise of 3â e- and high quantum efficiency. Here an overview on the EuXFEL pnCCD detector and the results from the commissioning and first user operation at the SQS experiment in June 2019 are presented. The detailed descriptions of the detector design and capabilities, its implementation at EuXFEL both mechanically and from the controls side as well as important data correction steps aim to provide useful background for users planning and analyzing experiments at EuXFEL and may serve as a benchmark for comparing and planning future endstations at other FELs.
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Glycidyl methacrylate (GMA; CAS no. 106-91-2) is a chemical monomer used in the manufacture of dental resins, can coatings and polymers. GMA has demonstrated toxicity to the ocular, digestive, respiratory and dermal systems. Human exposure occurs mainly in the workplace, but it can also happen through food. Although there were no available data on carcinogenicity of GMA, carcinogenic potential in the nasal cavity is highly expected. Further studies are needed to assess GMA exposure in humans. This study provides an alert of GMA human exposure and its genotoxic and carcinogenic potential.
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Compostos de Epóxi/toxicidade , Metacrilatos/toxicidade , Doenças Profissionais/induzido quimicamente , Dano ao DNA , Humanos , Exposição Ocupacional/efeitos adversosRESUMO
BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) is a progressive degenerative disease caused by imbalance between anabolic and catabolic stimuli. OBJECTIVE: The aim of this study was to evaluate histopathological changes, collagen degeneration and the expression of eleven TMJOA biomarkers in articular discs. METHODS: Specimens were obtained from eight female patients submitted to discectomy. Discs were divided into anterior band (AB), intermediate zone (IZ) and posterior band (PB) for computerised histomorphometric analyses. Each was assigned a histopathological degeneration score (HDS). Collagen degeneration was assessed with Picrosirius-polarisation method. Biomarkers were evaluated through immunohistochemistry, including IGF-1, OPG, VEGF, TNF-α, FGF-23, IHH, MMP-3, MMP-9, TGF-ß1 , BMP-2 and WNT-3. Image processing software was used to calculate average immature collagen ratios and immunostained areas. Spearman rank tests were applied to verify correlations, with significance level of 0.05. RESULTS: The HDS showed negative correlation with expression of VEGF in IZ and PB (P < .05) and positive with TNF-α in AB (P < .01). Collagen degeneration correlated with TGF-ß1 (P < .05), BMP-2 (P < .01) and IHH (P < .05) immunostained areas in the IZ; TGF-ß1, BMP-2 and IHH expression correlated among each other in AB and IZ (P < .05). CONCLUSION: Angiogenesis and tissue fragmentation may result from aberrant physiologic responses mediated by VEGF and TNF-α, compromising TMJ discs during OA progression. The expression of TGF-ß1, BMP-2 and IHH could be related to collagen degeneration in displaced discs and may participate in TMJOA pathogenesis.
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Osteoartrite , Transtornos da Articulação Temporomandibular , Feminino , Fator de Crescimento de Fibroblastos 23 , Humanos , Imuno-Histoquímica , Articulação TemporomandibularRESUMO
The TKSAMC is a web server which calculates protein charge-charge interactions via the Tanford-Kirkwood Surface Accessibility model with the Monte Carlo method for sampling different protein protonation states. The optimization of charge-charge interactions via directed mutations has successfully enhanced the thermal stability of different proteins and could be a key to protein engineering improvement. The server presents the electrostatic free energy contribution of each polar-charged residue to the protein native state stability. Specific residues are suggested to be mutated for improving thermal stability. The choice of a residue is based on its fraction of side chain exposed to solvent and its positive free energy contribution, which tends to destabilize the protein native state. Any residue energy contribution can be shown as a function of pH condition. The web server is freely available at UNESP (São Paulo State University - DF/IBILCE): http://tksamc.df.ibilce.unesp.br and also on GitHub https://github.com/contessoto/tksamc.
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Proteínas/química , Internet , Método de Monte Carlo , Mutação , Conformação Proteica , Dobramento de Proteína , Estabilidade Proteica , Proteínas/genética , Software , Eletricidade Estática , TermodinâmicaAssuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos , Úlcera da Córnea , Humanos , Úlcera da Córnea/etiologia , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/diagnóstico , Anticorpos Anticitoplasma de Neutrófilos , PeroxidaseRESUMO
Vascular involvement in IgG4-related disease (IgG4-RD), is a well-recognized feature and large vessel commitment, especially the aorta, can be the only manifestation of the disease. Being a newly recognized disease, its diagnosis and workup still represents a challenge in clinical practice. A 47-year-old-man with two aortic aneurysms ruptures, one at abdominal and the other at thoracic level, was referred to our rheumatology department. The initial analysis of the surgical specimen obtained 3 years earlier revealed a nonspecific aortitis. Re-evaluation of the biopsy with immunohistology now demonstrated the presence of IgG4 deposits. Evidence-based recommendations regarding diagnosis, treatment and follow-up of IgG4-related large-vessel involvement are lacking. In this particular case, histopathology were crucial. The authors review and discuss vascular involvement in IgG4-RD and respective treatment options.
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Aneurisma da Aorta Abdominal/imunologia , Aneurisma da Aorta Torácica/imunologia , Ruptura Aórtica/etiologia , Aortite/imunologia , Doença Relacionada a Imunoglobulina G4/imunologia , Idoso , Aneurisma da Aorta Abdominal/patologia , Aneurisma da Aorta Torácica/patologia , Ruptura Aórtica/imunologia , Ruptura Aórtica/cirurgia , Aortite/sangue , Aortite/complicações , Aortite/tratamento farmacológico , Biomarcadores/sangue , Feminino , Humanos , Doença Relacionada a Imunoglobulina G4/sangue , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/tratamento farmacológico , Fatores Imunológicos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Plasmócitos/imunologia , Rituximab/administração & dosagemRESUMO
The purpose of this study was to evaluate the presence of Toxoplasmosis gondii in samples of peripheral blood from patients with varying etiologies of uveitis. Whole blood from patients with different forms of uveitis was tested for the presence of T. gondii using real-time PCR targeting the well-characterized 529 bp fragment. Extracted DNA was both frozen. Thirty-one patients were included in the current study and grouped as follows: acute toxoplasmosis (n = 10); toxoplasmic retinal scars (n = 9); non-infectious etiologies of uveitis (n = 6); and IgG negative for toxoplasmosis (n = 6). In total, only two patients were shown to have circulating T. gondii in peripheral blood; both of these patients were IgG positive for toxoplasmosis, were receiving immunosuppressive therapy for autoimmune uveitis, and had no clinical features of toxoplasmosis. T. gondii was identified in peripheral blood of some immunosuppressed patients. No other patients, including those with acute toxoplasmosis, had circulating parasites in peripheral blood.
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Toxoplasma/isolamento & purificação , Toxoplasmose Ocular/sangue , Uveíte/parasitologia , Adulto , Anticorpos Antiprotozoários/sangue , DNA de Protozoário/sangue , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Reação em Cadeia da Polimerase , Testes Sorológicos/métodos , Uveíte/sangue , Adulto JovemRESUMO
INTRODUCTION: IgG4-related disease (IgG4-RD) is an immune- -mediated fibro-inflammatory condition with unknown etiology that can affect various organs. Although its prevalence is still unknown, it appears to be more frequent in adult males. Cardiovascular manifestations are rare and can include idiopathic retroperitoneal periaortic fibrosis, inflammatory aortic aneurism, inflammatory periarteritis and inflammatory pericarditis. Vascular involvement is a well-recognized feature and large vessel commitment, especially the aorta, can be the only manifestation of the disease. The gold standard diagnosis is histological. METHODS: A 47-year-old man presented rupture of two aortic aneurysms: one thoracic and one abdominal, and underwent surgical correction. A segment of the aorta artery wall measuring 3x2x0.5cm, exhibited smooth intimate and white vinous adventitia, medium tunic was white, through firm tissue with loss of elasticity. RESULTS: In addition to heterogenous collagenation with destruction of the elastic network of the aortic mediae tunica, there was fibrin deposition and neutrophil overlap. Lymphoid follicles with reactive germinate centers were along the tunica media and adventitia, without phenotype of endothelitis and absence of either macrophages and Langerhans cells (CD1a). Plasmocytes showed immunopositivity to IgG4, with heterogeneous and well defined localization, supporting the diagnosis of igG4 Disease. Serological studies showed negativity for vasculitis, hereditary connective tissue diseases were not component of the clinical set and normal serum IgG4 concentration was determined. CONCLUSION: Few cases of involvement of large vessels by IgG4- -RD have been reported in literature. Serum IgG4 concentration may be normal in one third of patients. In this case, IgG4 immunostaining was crucial for the diagnosis of IgG4-RD aortitis, together with the hyaline destruction of the tunica media (ESP 2015 / Aagaimy 2013). There is still no clinical knowledge for the treatment and monitoring of the involvement of large vessels by IgG4-RD.
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Aneurisma Aórtico , Aortite , Imunoglobulina G , Esclerose , Aorta , Aortite/imunologia , Aortite/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Plasmócitos , Esclerose/imunologia , Esclerose/cirurgiaRESUMO
INTRODUCTION: Cardiovascular syphilis can manifest as aortic aneurysms, aortic regurgitation and coronary ostial stenosis. Tertiary syphilis was the most commom reported cause of thoracic aortic aneurysm in the pre-antibiotic era, contributing to 5- 10% of cardiovascular deaths. However, in the 21st century, it has virtually disappered from the devoloping nations. Tertiay syphilis may develop in about one third of cases of untreated syphilis. In the pre-penicilin era, it was calculated that cardiovascular syphilis was responsible for 10-15% of clinical syphilis. METHODS: We present a rare case of syphilitic aortitis in a era of highly effective antibiotics. RESULTS: A 48-year-old man with no known clinical cardiac pathology went to emergency with an episode of chest pain of short duration and great intensity, being hospitalized with a differential diagnosis of coronary disease, ascending aortic aneurysm and aortic valve regurgitation. Two segments of the aorta, 5cm and 9.5cm length were observed, both had thickened wall (1cm), and firm plaques with diferent shapes and sizes. The intima of the aorta appeared rough and pitted, with the appearance of tree bark. There were heterogeneous lesions of the tunica media: hyalinization and calcification, macrophages aggregates, areas of hemorrhage and lymphoplasmacytic infiltrate forming vascular sheaths. Adventitia exhibited hyperplasia of nerve pathways with surrounding lymphoplasmocytic infiltrate. The diagnosis of syphilitic aortitis was purposed and serological analysis revealed positivity for Treponema pallidum. Patient underwent surgical correction of an aortic aneurysm. CONCLUSION: The serological positivity for Treponema pallidum and the histopathological study allowed the currently rare diagnosis of Ascending Aortic Aneurysm by Tertiary Syphilis. In the present scenario with early and widespread use of antibiotics, it is considered a very rare disease.
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Aneurisma Aórtico , Insuficiência da Valva Aórtica , Estenose Coronária , Sífilis Cardiovascular , Aneurisma Aórtico/etiologia , Aneurisma Aórtico/cirurgia , Insuficiência da Valva Aórtica/etiologia , Estenose Coronária/etiologia , Estenose Coronária/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Sífilis Cardiovascular/complicações , Sífilis Cardiovascular/diagnóstico , Sífilis Cardiovascular/cirurgiaRESUMO
INTRODUCTION: Takayasu aortitis is a well known yet rare form of large vessel vasculitis. Also known as pulseless disease, occlusive thromboaortopathy, and Martorell syndrome, is a chronic inflammatory aortitis. Vessel inflammation leads to wall thickening, fibrosis, stenosis, and thrombus formation. METHODS: A 64-year-old woman was referred to emergency for lack of pulse in the upper and lower limbs and changes in heart rate. AngioRMN revealed dissection of the ascending aorta while in PET, intense uptake of FDG-F18 involving ascending, crossa, descending thoracic and abdominal segments of the aorta, was evident urgent surgical correction occurred. An aorta ring segment with 2.5cm length, showed whitish and smooth intimate, with linear transversal laceration, with regular borders. Dissection 1cm long of the medial tunica was occupied by a clot in continuity with a thrombus occupying the neoformed lumen. RESULTS: Microscopy examination confirmed hyalinization of the tunica media with impregnation of fibrin / thrombus with blood cell elements. Endothelial inflammatory characteristics together with vasa vasorum and vascular trajectory of the periphery of the tunica media with inflammatory cells involvement allowed the diagnosis of Takayasu aortitis. CONCLUSION: Takayasu aortitis is rare in the presented age group, with early non-specific symptoms. The diagnosis of aortic dissection was crucial, constituting a medical emergency. Heather L-Gomik (2008) supports the hyaline structural alteration of the tunica media. The disease has been recognized for more than 100 years, and patients with Takayasu aortitis remain relatively poor and treatment is suboptimal. Key areas for improvement include the need for increase disease awareness and earlier diagnosis, and improved means for monitoring disease activity. The demonstration of diferential expression of Toll-like receptors in arteries, is particularly intriguing and worthy of further investigation.
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Dissecção Aórtica , Arterite de Takayasu , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/cirurgia , Aorta/patologia , Artérias , Feminino , Humanos , Pessoa de Meia-Idade , Arterite de Takayasu/diagnóstico , Arterite de Takayasu/cirurgiaRESUMO
The technical implementation of a multi-MHz data acquisition scheme for laser-X-ray pump-probe experiments with pulse limited temporal resolution (100â ps) is presented. Such techniques are very attractive to benefit from the high-repetition rates of X-ray pulses delivered from advanced synchrotron radiation sources. Exploiting a synchronized 3.9â MHz laser excitation source, experiments in 60-bunch mode (7.8â MHz) at beamline P01 of the PETRAâ III storage ring are performed. Hereby molecular systems in liquid solutions are excited by the pulsed laser source and the total X-ray fluorescence yield (TFY) from the sample is recorded using silicon avalanche photodiode detectors (APDs). The subsequent digitizer card samples the APD signal traces in 0.5â ns steps with 12-bit resolution. These traces are then processed to deliver an integrated value for each recorded single X-ray pulse intensity and sorted into bins according to whether the laser excited the sample or not. For each subgroup the recorded single-shot values are averaged over â¼107â pulses to deliver a mean TFY value with its standard error for each data point, e.g. at a given X-ray probe energy. The sensitivity reaches down to the shot-noise limit, and signal-to-noise ratios approaching 1000 are achievable in only a few seconds collection time per data point. The dynamic range covers 100â photonsâ pulse-1 and is only technically limited by the utilized APD.
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A 68-year-old male with a previous history of 3 dysplastic skin nevi was referred to ophthalmology for a 1-year history of a progressive growth of a firm nodule in the lower left eyelid. Examination revealed a firm nodule in the inferior anterior orbit and mild conjunctival pigmentation on the left inferior fornix. A conjunctival incisional biopsy was taken, showing a melanoma. Because of the infiltration by the mass of the orbit on magnetic resonance imaging, an exenteration was performed. Histopathological analysis showed a unique conjunctival melanoma showing morphological diversity; specifically, a pattern characteristic of conjunctival melanoma, and the concurrent presence of staghorn patterns, signet-ring cells, and rosettoid patterns. Seven years of follow-up shows that the patient is alive with no further metastasis or recurrence. This report represents the first documented case of multiple morphologic patterns within a conjunctival melanoma.