RESUMO
BACKGROUND: 18F-fluoro-2-deoxy-D-glucose (18F-FDG) accumulations are commonly seen in the neck-related muscles of the surgical and non-surgical sides after surgery with neck dissection (ND) for oral cancers, which leads to radiologists having difficulty in diagnosing the lesions. To examine the alterations in 18F-FDG accumulation in neck-related muscles of patients after ND for oral cancer. MATERIAL AND METHODS: 18F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) in neck-related muscles were retrospectively analyzed after surgical dissection of cervical lymph nodes in oral cancers. RESULTS: According to the extent of ND of cervical lymph nodes, the rate of patients with 18F-FDG-PET-positive areas increased in the trapezius, sternocleidomastoid, and posterior neck muscles of the surgical and/or non-surgical sides. In addition, SUVmax of 18F-FDG-PET-positive areas in the trapezius and sternocleidomastoid muscles were increased according to the extent of the ND. CONCLUSIONS: In evaluating 18F-FDG accumulations after ND for oral cancers, we should pay attention to the 18F-FDG distributions in neck-related muscles including the non-surgical side as false-positive findings.
Assuntos
Fluordesoxiglucose F18/farmacocinética , Neoplasias Bucais/diagnóstico por imagem , Esvaziamento Cervical , Compostos Radiofarmacêuticos/farmacocinética , Humanos , Metástase Linfática , Neoplasias Bucais/patologia , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios XRESUMO
Glass welding by ultrashort laser pulses allows joining without the need of an absorber or a preheating and postheating process. However, cracks generated during the welding process substantially impair the joining strength of the welding seams. In this paper a sample preparation method is described that prevents the formation of cracks. The measured joining strength of samples prepared by this method is substantially higher than previously reported values.
RESUMO
Cryosurgery is a recognized method for the treatment of mucoceles in the oral cavity. In this study, cryosurgery was used for mucoceles at the lip or buccal mucosa, and the effect and the indication were evaluated clinically. The subjects were patients with a clinical diagnosis of mucocele on the lip or buccal mucosa and who chose cryosurgery after procedures for both surgical excision and cryosurgery for the lesion were explained. Cryosurgery was performed with a freezing device using liquid nitrogen without local anesthesia. Twenty-four patients chose cryosurgery, including seven preschool children. There were no serious adverse events during and after cryosurgery. Healing progress after cryosurgery was not affected by patient age, lesion size, or how long the patients had the lesion. Two cases later underwent surgical excision because cryosurgery was not successful. Twenty-three patients chose surgical excision, one case had a recurrence. The number of younger patients who chose cryosurgery was significantly higher than that who chose surgical excision. This study suggests that cryosurgery is effective for mucoceles of the lip or buccal mucosa and is a simple and safe treatment method, especially for preschool children.
Assuntos
Criocirurgia , Doenças da Boca , Mucocele , Pré-Escolar , Criocirurgia/efeitos adversos , Humanos , Doenças da Boca/cirurgia , Mucocele/diagnóstico , Mucocele/cirurgia , Recidiva Local de NeoplasiaRESUMO
This study investigated the utility of endocytoscopy, a novel emerging endoscopic system, for in situ real-time histology of oral mucosal lesions. Endocytoscopy involves the use of a contact light microscopy system with 380-fold magnification. With the development of endoscopic instruments, it has become possible to observe the abnormal microvascular and capillary patterns of tumour cells. The resolution of the endoscopic image is improved in situ, and a more detailed diagnosis is possible. In this study, endocytoscopy along with other diagnostic modalities was used in nine patients. Normal mucous membranes and oral malignant lesions were observed. Endocytoscopy enabled the pathological diagnosis of oral malignancies in situ and the observation of both structural and cytological atypia. In the future, it is expected that pathological diagnoses will be made in situ by direct viewing of living cells. This technique has the potential to allow an 'optical biopsy'.
Assuntos
Endoscopia/instrumentação , Microscopia/instrumentação , Mucosa Bucal/diagnóstico por imagem , Neoplasias Bucais/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgiaRESUMO
A modified technique of horseshoe osteotomy combined with Le Fort I osteotomy for superior and posterior repositioning of the maxilla is presented. Eight patients with maxillary excess associated with retrogenia or microgenia were treated with this technique in combination with genioplasty. The maxillary segment was repositioned a maximum of 5.0mm posteriorly and 7.0mm superiorly at point A. The mandible autorotated anterosuperiorly to achieve sound occlusion. Point B moved 2.0-10.0mm anteriorly and 5.0-10.0mm superiorly. The pogonion moved 7.0-17.0mm anteriorly in combination with genioplasty. All patients obtained sound occlusion and a good profile after the operation. Almost no skeletal relapse was observed during 1 year of postoperative follow-up. Patients with long faces with maxillary excess and retrogenia often have small, unstable condyles. In these cases, because surgical intervention to the ramus can result in postoperative progressive condylar resorption, maxillary single-jaw surgery with a horseshoe osteotomy, thereby avoiding ramus intervention, is a less invasive option.
Assuntos
Maxila/anormalidades , Maxila/cirurgia , Procedimentos Cirúrgicos Ortognáticos , Osteotomia/métodos , Adulto , Cefalometria , Feminino , Mentoplastia , Humanos , Japão , Osteotomia de Le Fort , Resultado do TratamentoRESUMO
Hyaluronic acid was purified from the horny layer of guinea pigs and its biochemical and physical properties were studied. The horny layer, obtained by applying n-hexadecane to guinea pig skin, was digested with pronase, and glycosaminoglycans in the digest were separated from UV-absorbing material by Sephadex G-75 chromatography (sample A, 17.5 mg). On DEAE-Sephadex chromatography, the fraction obtained with 0.5 M NaCl was found to contain 94% of the total uronic acid. This fraction, consisting mainly of hyaluronic acid, was dialyzed and lyophilized (sample B, 12.5 mg). Sample B, consisting of 26.1% uronic acid and 27.0% glucosamine on a dry weight basis, could be digested completely with Streptomyces hyaluronidase. Sample B had a low reduced viscosity which showed almost no concentration dependence. The intrinsic viscosity of sample B was 0.83 dl/g and its molecular weight, calculated from its viscosity, was 34,000. Sample B was eluted from Sepharose CL-6B as a broad peak between the void volume and the total column volume. The enzyme levels of hyaluronidase, beta-glucuronidase, and beta-N-acetylglucosaminidase in the n-hexadecane treated guinea pig skin increased to 1.7 to 2.5 fold those of controls after 6 days of the experiment. These results suggested that hyaluronic acid in the horny layer of n-hexadecane treated guinea pig skin might be degraded by hyaluronic acid degrading enzymes in the hyperkeratinized tissue.
Assuntos
Ácido Hialurônico/isolamento & purificação , Pele/análise , Animais , Cromatografia em Gel/métodos , Cromatografia por Troca Iônica/métodos , Eletroforese em Acetato de Celulose/métodos , Feminino , CobaiasRESUMO
A proteodermatansulfate was extracted from rat skin with 4 M guanidine hydrochloride containing protease inhibitors at 4 degrees C. It was separated from collagen on DEAE-cellulose in 7 M urea and was purified by cesium chloride density gradient centrifugation under associative conditions, DEAE-Sephadex column chromatography and then Sephadex G-200 gel filtration. On SDS-disc electrophoresis, the proteoglycan gave a single band staining for protein and a band of the same mobility staining with periodate-Schiff reagent. The proteoglycan contained 46% protein, and this was bound to dermatansulfate via an O-glycosidic linkage. The proteoglycan also contained 20% uronic acid and 16% hexosamine, but no detectable hydroxyproline. The ratio of galactosamine to glucosamine was 68. The dermatansulfate, the only glycosaminoglycan, had a hybrid structure containing iduronic acid and glucuronic acid as uronic acids. The content of glucuronic acid in uronic acid was much higher than that of pig skin dermatansulfate. The dermatansulfate had a slightly higher mobility on cellulose acetate electrophoresis than those from other sources. Gel chromatography on Sepharose CL-6B showed that the molecular weight of the dermatansulfate was 23,000, while that of the proteoglycan was 36,000. The elution profile of a mixture of the proteoglycan and hyaluronic acid on Sepharose 6B column chromatography was similar to that of the proteoglycan alone.
Assuntos
Condroitina/análogos & derivados , Dermatan Sulfato/análogos & derivados , Proteoglicanas/análise , Pele/análise , Animais , Colágeno/isolamento & purificação , Dermatan Sulfato/análise , Dermatan Sulfato/isolamento & purificação , Feminino , Guanidinas , Ácido Hialurônico/isolamento & purificação , Peso Molecular , Proteínas/análise , Proteoglicanas/isolamento & purificação , Ratos , Ácidos Urônicos/análiseRESUMO
A new electrophoretic method is presented for the determination of glucosamine and galactosamine. The technique is quite simple and rapid, it involves cellulose acetate electrophoresis in borate buffer (200 V, 15 min) and silver nitrate staining. Hexosamine samples of 0.36-1.80 micrograms were separated and stained within 30 min. This method was applied for the hexosamine analysis of glycosaminoglycans.
Assuntos
Galactosamina/análise , Glucosamina/análise , Animais , Eletroforese em Acetato de Celulose/métodos , Técnicas In Vitro , Camundongos , Camundongos Endogâmicos ICR , Ratos , Ratos Endogâmicos , Tubarões , Pele/análise , Suínos , BaleiasRESUMO
The pharmacokinetics of pamiteplase and recombinant tissue-type plasminogen activator (rt-PA) in rats, dogs, and monkeys were examined using a newly developed enzyme-linked immunosorbent assay (ELISA). Plasma concentrations after intravenous administration of pamiteplase to rats declined in a triphasic manner. Plasma concentrations after intravenous administration of pamiteplase to dogs or monkeys declined in a biphasic manner. The area under the plasma concentration-time curve from zero to infinity (AUC(0-->infinity)) in rats and dogs increased with increasing dose. The half-life and mean residence time of pamiteplase in rats, dogs, and monkeys were shown to be longer than those of rt-PA. Total clearance (CL(total)) of pamiteplase was only 7-16% that of rt-PAs, suggesting that concentrations of pamiteplase in plasma were higher and more continuous than those of rt-PA in these experimental animals. The data suggest that a bolus administration of pamiteplase shows the same thrombolytic activity as continuous infusion of rt-PA in experimentally induced thrombosis in rats and dogs. The pharmacokinetic parameters distribution volume at the steady state and CL(total) calculated by immunoreactive concentration after administration of pamiteplase to rats, dogs, and monkeys show high correlation with body weights (r(2)=.7728 and .9039).
Assuntos
Proteínas Recombinantes/farmacocinética , Ativador de Plasminogênio Tecidual/farmacocinética , Animais , Área Sob a Curva , Peso Corporal , Cães , Ensaio de Imunoadsorção Enzimática/normas , Meia-Vida , Haplorrinos , Injeções Intravenosas , Masculino , Taxa de Depuração Metabólica , Ratos , Ratos Endogâmicos F344 , Proteínas Recombinantes/sangue , Ativador de Plasminogênio Tecidual/sangueRESUMO
Two siblings with succinic acidemia, a hitherto unreported organic acidemia, were investigated. Succinic acidemia, lactic acidosis and respiratory distress were observed in one of the siblings, who died 37 days after birth, and succinic acidemia was also detected in the next sibling at the fetal stage. NADH-cytochrome c reductase activity was significantly low in both cases and NADH-ferricyanide reductase activity was also low in the fetal case, suggesting a complex I deficiency of the electron transport system in the mitochondrial membrane.
Assuntos
Acidose Láctica/congênito , Redutases do Citocromo/deficiência , NADH Desidrogenase/deficiência , Succinatos/sangue , Acidose Láctica/enzimologia , Acidose Láctica/metabolismo , Líquido Amniótico/análise , Transporte de Elétrons , Feminino , Doenças Fetais/enzimologia , Humanos , Recém-Nascido , Mitocôndrias Hepáticas/análise , Gravidez , Ácido SuccínicoRESUMO
We have investigated the photosensitized monomerization of the cis,syn-cyclobutane dimer of 1,3-dimethylthymine using riboflavin tetraacetate and a 5-deazaflavin derivative as photosensitizer. Although little monomerization of the dimer is induced by photoexcitation of the flavins in the absence of any additives, the flavins can function as an efficient photosensitizer in the presence of magnesium perchlorate. Mechanistic studies involving spectroscopic, quantum-yield and flash-photolysis measurements demonstrated that the photosensitized monomerization exclusively proceeds through electron transfer from the dimer to the triplet flavins complexed with Mg2+. The effects of magnesium perchlorate are compared with those on the chloranil-photosensitized monomerization and also with the effects of HClO4 on the flavin-photosensitized reaction.
Assuntos
Flavinas/química , Compostos de Magnésio/química , Percloratos/química , Fármacos Fotossensibilizantes/química , Dímeros de Pirimidina/efeitos da radiação , Timina/análogos & derivados , Modelos Químicos , Conformação Molecular , Dímeros de Pirimidina/química , Riboflavina/química , Timina/química , Timina/efeitos da radiação , Raios UltravioletaRESUMO
The photosensitized monomerization of the cyclobutane dimers of 1,3-dimethylthymine by p-chloranil was investigated by means of steady-state irradiation and laser-flash photolysis. Quantum yields for the monomerization are 0.34 for the cis,syn dimer, 0.39 for the trans,syn dimer, and much less than 10(-2) for the cis,anti isomer. Formation of the chloranil anion radical associated with quenching of triplet chloranil by the dimers demonstrates that electron transfer from dimers to triplet chloranil occurs to initiate the monomerization. Kinetic analysis suggested that the syn-dimer cation radicals undergo the ring cleavage at greater than or equal to 10(9) s-1 before escaping from the solvent cage, while the reactivity of the anti-dimer cation radical is very low. The different reactivities of the syn and anti dimer cation radicals are discussed in terms of through-bond coupling between the n orbitals of N(1) and N(1') involving the cyclobutane-ring sigma orbitals. In the cases of the syn-dimers, the sensitizer-dimer ion-radical pairs undergo the rapid geminate recombination that works as a major energy dissipating channel responsible for the lower-than-unity quantum yields. It has been found that the presence of Mg(ClO4)2 at 0.1 M enhances approximately 1.5 times either the monomerization of the syn dimers or the formation of the chloranil anion radical. A laser-flash photolysis study shows that Mg2+ forms a complex with either the triplet or the anion radical of chloranil. The net salt effects are attributed to the retardation of the rapid geminate recombination by the participation of Mg2+ in the sensitizer-dimer ion-radical pairs.
Assuntos
Cloranila/química , Compostos de Magnésio , Magnésio , Percloratos , Dímeros de Pirimidina/efeitos da radiação , Lasers , Estrutura Molecular , Fotólise , Teoria QuânticaRESUMO
We studied 68 Japanese NIDDM patients (38 men and 30 women), aged 56.9+/-1.2 years (range 33-75 years), with a BMI of 23.1+/-0.5 kg/m2 without hypertension, dyslipidemia, and diabetic macroangiopathy for evaluating the relationship between serum soluble vascular cell adhesion molecule-1 (sVCAM-1) levels and the severity of diabetic retinopathy. Fundus examination was performed by an ophthalmologist using an ophthalmoscope, and the findings were graded as: (1) no signs of diabetic retinopathy (NDR), (2) background diabetic retinopathy (BDR), or (3) proliferative diabetic retinopathy (PDR). Serum sVCAM-1 levels were measured in duplicate by enzyme-linked immunosorbent assay using the soluble VCAM-1 KIT (R&D Systems Ltd., Ablingdon, Oxfordshire, UK). There was no difference in serum sVCAM-1 levels between patients with BDR (n = 17) and patients with NDR (n = 40) (1035.3+/-104.4 and 978.8+/-48.9 ng/ml, respectively, P = 0.8), but patients with PDR (n = 11) showed a significant increase of serum sVCAM-1 levels compared with patients with NDR (1281.8+/-166.3 and 978.8+/-48.9 ng/ml, respectively, P = 0.02). Although serum sVCAM-1 levels were correlated, not only with age but also with the known diabetic duration (r = 0.39, P = 0.001, and r = 0.40, P = 0.0007, respectively), age-adjusted sVCAM-1 levels were still significantly higher in the PDR group than in the NDR group. In contrast. serum sVCAM-1 levels were not related to the presence of diabetic nephropathy or HbA1c levels. Our results suggest that sVCAM-1 might be implicated in the development of the diabetic retinopathy, and measurement of serum sVCAM-1 levels in NIDDM patients maybe clinically useful for assessing the severity and possibly the activity of diabetic retinopathy.
Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/sangue , Molécula 1 de Adesão de Célula Vascular/sangue , Adulto , Idoso , Biomarcadores/sangue , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Creatinina/sangue , Diabetes Mellitus Tipo 2/sangue , Retinopatia Diabética/fisiopatologia , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangueRESUMO
The XPA (xeroderma pigmentosum group A) gene encodes a protein of 273 amino acids with a zinc finger motif. The human XPA cDNA was placed in an Escherichia coli expression vector for the synthesis of the recombinant XPA protein. The molecular weight of the wild-type protein was about 40 kDa in SDS-PAGE. Microinjection of the wild-type protein specifically restored the defect of UV-induced unscheduled DNA synthesis in XP-A cells. Thus, the bacterially expressed XPA protein retains biochemical properties identical to those of natural sources. The wild-type protein binds preferentially to UV-, cis-diamminedichloroplatinum(II) (cisplatin)- or osmium tetroxide (OsO4)-damaged DNA as assayed by retention on nitrocellulose filters. In addition, the data from atomic absorption and UV-CD spectra revealed that the wild-type protein is a zinc metalloprotein with secondary structure. Furthermore, the mutant protein, of which the cysteine-103 residue in the zinc finger motif was replaced with serine, has a vastly different protein conformation resulting in a loss of XP-A correcting and DNA-binding activities. These findings indicate that the XPA protein is a zinc-binding protein with affinity for various DNA damages, and a cysteine residue in the C4-type zinc finger motif is indispensable for normal protein conformation.
Assuntos
Dano ao DNA , Proteínas de Ligação a DNA/metabolismo , DNA/metabolismo , Metaloproteínas/metabolismo , Zinco/análise , Aminoácidos/análise , Linhagem Celular , DNA/biossíntese , DNA Viral/efeitos da radiação , Proteínas de Ligação a DNA/química , Proteínas de Ligação a DNA/genética , Escherichia coli/genética , Humanos , Metaloproteínas/química , Metaloproteínas/genética , Microinjeções , Peso Molecular , Ligação Proteica , Conformação Proteica , Proteínas Recombinantes de Fusão/biossíntese , Raios Ultravioleta , Xeroderma Pigmentoso , Proteína de Xeroderma Pigmentoso Grupo ARESUMO
Time-course of plasma concentration of unchanged drug of the dopamine DA1-receptor agonist (-)-(S)-4-(3,4-dihydroxyphenyl)-7,8-dihydroxy-1,2,3,4- tetrahydroisoquinoline hydrochloride hydrate (YM435), and its effects on blood pressure and renal blood flow were investigated in anaesthetized dogs. Continuous intravenous infusion of YM435 (0.1-3 micrograms kg-1 min-1) rapidly increased renal blood flow and lowered blood pressure in a dose-dependent manner. These effects remained generally stable throughout the infusion period. Following the start of infusion, plasma concentration of unchanged drug also rose rapidly and dose-dependently and remained virtually constant throughout the infusion period. A significant correlation was observed between log YM435 plasma concentration and the increase in renal blood flow (r = 0.93, P < 0.0001) and between the former and the reduction in blood pressure (r = 0.93, P < 0.0001). The present results indicate that YM435 produces renal vasodilatation and lowering of blood pressure in a dose-dependent manner and with rapid onset following continuous intravenous infusion, and that these effects are generally stable throughout the period of infusion. These haemodynamic effects of YM435 were in good agreement with the time-course of plasma concentration of unchanged drug.
Assuntos
Isoquinolinas/farmacologia , Receptores de Dopamina D1/agonistas , Tetra-Hidroisoquinolinas , Vasodilatadores/farmacologia , Animais , Pressão Sanguínea/efeitos dos fármacos , Cães , Feminino , Isoquinolinas/sangue , Isoquinolinas/farmacocinética , Masculino , Receptores de Dopamina D1/efeitos dos fármacos , Circulação Renal/efeitos dos fármacos , Vasodilatadores/sangue , Vasodilatadores/farmacocinéticaRESUMO
BACKGROUND: Clinical studies have reported a correlation between the surface roughness of implant abutments and the rate of supragingival and subgingival plaque formation. In order to maintain periimplant health, it is important to understand the relationship between abutment surface characteristics and plaque formation. PURPOSE: The aim of this study was to use high image resolution imaging techniques for analysis of implant abutment surface topography. MATERIALS AND METHODS: Five commercially available implant abutments (Brånemark, Nobel Biocide, AB, Goteborg, Sweden, Astra, Astra Tech AB, Mondal, Sweden, IMZ, Friatec AG, Mannheim, Germany, Steri-Oss, Denar Corp, Anaheim, Calif, USA, and POI, Kyocera Corp, Kyoto, Japan) were visually and quantitatively characterized using an atomic force microscope. RESULTS: Statistical analysis by analysis of variance and Fishers's Protected Least Significant Differences showed significant differences (p < .05) between arithmetic mean deviation values of surface relative to the center plane (Sa). Power spectral density analysis also was effective as a spacing parameter. Sectional profiles measured the exact length, depth, or height of the specific features on the images. CONCLUSIONS: Within the limits of this study, the Brånemark, Astra and IMZ abutments displayed turning marks in x direction from the procedure. The Steri-Oss abutment showed smoothest surface among the five abutments tested.
Assuntos
Dente Suporte , Implantes Dentários , Planejamento de Prótese Dentária , Análise de Variância , Microscopia de Força Atômica , Propriedades de SuperfícieAssuntos
Linfoma de Células T/sangue , Receptores de Interleucina-2/sangue , Neoplasias Cutâneas/sangue , Raios Ultravioleta , Biópsia , Feminino , Humanos , Linfoma de Células T/patologia , Linfoma de Células T/radioterapia , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/radioterapiaRESUMO
A 59-year-old man was admitted to our hospital because of muscular pain, weakness, and anorexia. He had been treated with 600 mg/day of fosfestrol, a synthetic estrogen, for 10 years for prostatic carcinoma. Endocrinological studies demonstrated adrenocortical insufficiency due to inadequate ACTH secretion. After initiation of glucocorticoid replacement therapy, his symptoms subsided rapidly. To our knowledge, an association between estrogenic agents, including fosfestrol, and secondary adrenocortical insufficiency has not been previously reported. Physicians who treat patients with long-term and high-dose strong estrogenic agents should be cautious about the possible emergence of secondary adrenocortical insufficiency.
Assuntos
Insuficiência Adrenal/induzido quimicamente , Antineoplásicos/efeitos adversos , Dietilestilbestrol/análogos & derivados , Neoplasias da Próstata/tratamento farmacológico , Insuficiência Adrenal/metabolismo , Hormônio Adrenocorticotrópico/metabolismo , Antineoplásicos/uso terapêutico , Dietilestilbestrol/efeitos adversos , Dietilestilbestrol/uso terapêutico , Humanos , Hidrocortisona/metabolismo , Masculino , Pessoa de Meia-IdadeRESUMO
The addition of 1,4-diazabicyclo-[2,2,2]octane (DABCO) (100 mM) or 1,2-dihydroxybenzene-3,5-disulfonic acid (Tiron) (1 mM) to a reaction mixture containing 10 mM linoleic acid (LA), 20% EtOH, and 135 microM dehydroascorbic acid (DHA) as a catalyst suppressed LA peroxidation, but the addition of mannitol (approximately 100 mM), uric acid (100 microM), and catalase (6.5 units) did not. DHA or 2,3-diketo-L-gulonic acid (DKG) accelerated LA peroxidation, but the splitting products of DHA did not affect LA peroxidation. These results suggest that some specific radicals are liberated in the degradation of DHA or DKG.
Assuntos
Sal Dissódico do Ácido 1,2-Di-Hidroxibenzeno-3,5 Dissulfônico/farmacologia , Ácido Ascórbico/análogos & derivados , Benzenossulfonatos/farmacologia , Ácido Desidroascórbico/metabolismo , Etanol/farmacologia , Ácidos Linoleicos/metabolismo , Piperazinas/farmacologia , Catálise , Concentração de Íons de Hidrogênio , Peróxidos LipídicosRESUMO
Between 1973 and 1992, a routine voiding cystourethrography screening was performed in all children attending our urological clinic. A total of 1023 children were diagnosed as cases of primary vesicoureteral reflux; 166 (210 renal units) of them were asymptomatic and were studied retrospectively. Ninety-one patients presented with enuresis, 39 with hypospadias, 14 with undescended testis, 8 with asymptomatic proteinuria and 14 had other manifestations such as intersexuality, inguinoscrotal swelling, abnormal external genitalia, etc. We documented high-grade reflux (IV-V) in 16.2% and renal scarring in 16.7% of the 210 renal units. None of the children showed features of urinary tract infection (UTI) or had a definite history in the past, but 23.5% of the 166 cases developed UTI during their follow-up period. Spontaneous resolution of reflux was observed in 52.7% of the 150 renal units and progression of renal scarring in 20% during follow-up. Antireflux operation was performed in 15 cases (26 renal units). In 9 children (5.4%) we found gross renal damage which progressed in two cases to end-stage renal disease followed by renal transplantation. A small kidney was noted in 5 patients and hypertension in two. It is concluded that the natural history of asymptomatic reflux is almost the same as in symptomatic reflux. Thus, routine voiding cystourethrography is suggested in all children attending a urological clinic in order to detect reflux as early as possible.