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1.
Acta Trop ; 235: 106628, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35952923

RESUMO

As land use intensifies in tropical forests, it is expected that species assemblages will be modified and that key functions of these ecosystems will be affected. The latter scenario is important from a public health perspective, because the land use change has been linked the outbreaks of vector-borne diseases. In this study, we evaluated the response of Phlebotominae (Diptera: Psychodidae) assemblages and their pattern of co-occurrence in four sites with different land use in an emerging cutaneous leishmaniasis focus in Yucatan, Mexico. Our hypothesis is that the conservation status (as forest cover) will positively influence the structure and composition of sand flies' assemblages. Using three different traps over a period of five months, a sampling effort of 1, 440 night-traps was performed. A total of 7, 897 sand fly specimens belonging to six genera and 10 species were collected. Our hypothesis was partially achieved since sand fly diversity increased as forest cover increased and vice versa, however random patterns of co-occurrence in assemblages were detected among sites. Even though the high abundance of sand flies in the forest fragment suggests an amplification effect, our results show that different vector species directly dominate in each site. We discuss the potential implications of the nestedness of species dominance. We suggest that in this emerging focus and under the land use gradient, Lutzomyia cruciata and Psathyromyia cratifer could play a pivotal role in maintaining the transmission cycles of Leishmania. The apparent generalist or colonialist profile of Lu. cruciata in disturbed areas deserves attention, due to the potential risk of leishmaniasis "domiciliation". This information is essential to understand the eco-epidemiology of leishmaniasis and the factors associated with its emergence in Yucatan, Mexico.


Assuntos
Leishmaniose Cutânea , Phlebotomus , Psychodidae , Animais , Ecossistema , Insetos Vetores , Leishmaniose Cutânea/epidemiologia , México/epidemiologia
2.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 508-512, Mar.-Apr. 2021. tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1248944

RESUMO

Mycobacterium avium subesp. paratuberculosis (MAP) e o vírus da leucemia bovina (BLV) são agentes que causam grandes perdas econômicas nos rebanhos. O objetivo deste estudo foi avaliar a situação epidemiológica da paratuberculose bovina (PTB) e leucose enzoótica bovina (EBL) em rebanhos leiteiros de Lagoa Formosa, Minas Gerais, Brasil. Foram coletadas 236 amostras de sangue de vacas, as quais foram submetidas aos testes ELISA e imunodifusão em gel de ágar para detecção de anticorpos contra MAP e BLV. A soroprevalência de anticorpos contra MAP e BVL foi de 20% para os rebanhos e 6% para os animais e de 85% para os rebanhos e 50,42% para os animais, respectivamente. A presença dessas enfermidades deve servir como um alerta para os produtores e veterinários, para que concentrem maior atenção na implementação de medidas higiênico-sanitárias, incorporando elementos de vigilância com base nos riscos identificados no estudo.(AU)


Assuntos
Animais , Bovinos , Paratuberculose/epidemiologia , Fatores de Risco , Mycobacterium avium subsp. paratuberculosis/isolamento & purificação , Leucose Enzoótica Bovina/epidemiologia , Vírus da Leucemia Bovina/isolamento & purificação , Brasil , Ensaio de Imunoadsorção Enzimática/veterinária , Imunodifusão/veterinária
3.
Ultramicroscopy ; 157: 79-87, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26094203

RESUMO

We describe a fast and accurate method for the reconstruction of macromolecular complexes from a set of projections. Direct Fourier inversion (in which the Fourier Slice Theorem plays a central role) is a solution for dealing with this inverse problem. Unfortunately, the set of projections provides a non-equidistantly sampled version of the macromolecule Fourier transform in the single particle field (and, therefore, a direct Fourier inversion) may not be an optimal solution. In this paper, we introduce a gridding-based direct Fourier method for the three-dimensional reconstruction approach that uses a weighting technique to compute a uniform sampled Fourier transform. Moreover, the contrast transfer function of the microscope, which is a limiting factor in pursuing a high resolution reconstruction, is corrected by the algorithm. Parallelization of this algorithm, both on threads and on multiple CPU's, makes the process of three-dimensional reconstruction even faster. The experimental results show that our proposed gridding-based direct Fourier reconstruction is slightly more accurate than similar existing methods and presents a lower computational complexity both in terms of time and memory, thereby allowing its use on larger volumes. The algorithm is fully implemented in the open-source Xmipp package and is downloadable from http://xmipp.cnb.csic.es.

4.
Res Vet Sci ; 97(2): 325-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25039064

RESUMO

The objective of this survey was to investigate the prevalence of Hepatozoon infection in dogs in the rural and urban areas of Uberlândia, Brazil by PCR and molecular characterization. DNA was obtained from blood samples collected from 346 local dogs from both genders and various ages. Seventeen PCR products from positive blood samples of urban dogs and 13 from the rural dogs were sequenced. Partial sequences of the 18S rRNA gene indicated that all 30 dogs were infected with Hepatozoon canis similar in sequence to H. canis from southern Europe. Four local dog sequences were submitted to GenBank (accessions JN835188; KF692038; KF692039; KF692040). This study indicates that H. canis is the cause of canine hepatozoonosis in Uberlândia and that infection is similarly widespread in rural and urban dogs.


Assuntos
Apicomplexa/genética , DNA de Protozoário/genética , Doenças do Cão/epidemiologia , Infecções Protozoárias em Animais/epidemiologia , Saúde da População Rural , Saúde da População Urbana , Fatores Etários , Animais , Brasil/epidemiologia , DNA de Protozoário/sangue , Bases de Dados de Ácidos Nucleicos , Doenças do Cão/sangue , Doenças do Cão/diagnóstico , Cães , Feminino , Masculino , Reação em Cadeia da Polimerase/veterinária , Prevalência , Infecções Protozoárias em Animais/sangue , Infecções Protozoárias em Animais/diagnóstico , Fatores Sexuais
5.
Case Reports Immunol ; 2012: 931528, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-25954556

RESUMO

Toxic epidermal necrolysis is the most severe form of drug-induced skin reaction and includes denudation of >30% of total body surface area. The mechanism of disease is not completely understood, but immunologic mechanisms, cytotoxic reactions, and delayed hypersensitivity seem to be involved. We report a case of cephazolin-induced toxic epidermal necrolysis treated with intravenous immunoglobulin and N-acetylcysteine with excellent response.

6.
Arq. bras. med. vet. zootec ; 63(4): 1022-1024, ago. 2011.
Artigo em Português | LILACS | ID: lil-599626

RESUMO

The first epidemiologic inquiry to Brucella abortus (B. abortus) and Brucella ovis (B. ovis) was carried out in sheep from Uberlândia county, MG. A total of 334 blood serum samples of sheep from both sexes and different ages and breeds were collected in 12 farms. An epidemiologic questionnaire was applied for each farm. Tests for B. abortus and B. ovis antibodies were Buffered Acidified Antigen and Complement Fixation, respectively. None of the sheep was reactive to B. abortus and B. ovis; however, the adoption of sanitary measures is important to avoid the introduction of infections caused by these bacteria.


Assuntos
Animais , Brucella abortus , Brucella ovis , Brucelose , Ovinos , Anticorpos , Antígenos
7.
Arq. Inst. Biol. (Online) ; 77(3): 411-417, jul.-set. 2010. tab
Artigo em Português | VETINDEX, LILACS | ID: biblio-1391314

RESUMO

Objetivou-se com este estudo realizar o primeiro inquérito soro-epidemiológico para o vírus da maedi-visna e Chlamydophila spp. em 12 rebanhos de ovinos do Município de Uberlândia, MG. Foram utilizadas 334 amostras de soro sanguíneo de ovinos e aplicou-se um inquérito epidemiológico a cada propriedade. Os testes realizados para a pesquisa de anticorpos contra o vírus da maedi-visna e Chlamydophila spp. foram imunodifusão em gel de ágar (IDGA) e reação de fixação do complemento (RFC), respectivamente. Não foram detectados ovinos reagentes para maedi-visna. Verificou-se uma prevalência de 3,3% para Chlamydophila spp., com títulos variando de 32 a 64. Não houve diferença estatística significativa (p > 0,05) para os fatores de risco analisados. Ressalta-se a importância dos sistemas de vigilância epidemiológica para atuar no controle dessas infecções, evitando a introdução do vírus da maedi-visna e uma maior propagação da Chlamydophila spp. neste município.


The aim of this study was to carry out the first investigation into the serological prevalence of maedi-visna virus and Chlamydophila spp. on 12 sheep breeding farms in Uberlândia County, MG, Brazil. A total of 334 blood serum samples were used and an epidemiological survey was completed by each farm. The tests to detect maedi-visna and Chlamydophila spp. antibodies were an agar gel immunodiffusion (AGID) and a complement fixation test (CFT), respectively. None of the sheep were reactive to maedi-visna. The detection of antibodies against Chlamydophila spp. was 3.3%, with titers varying from 32 to 64. There was no statistically significant difference (p > 0.05) in regard to the risk factors analyzed. The importance of epidemiological surveillance systems to aid in the control of these infections is emphasized, in order to avoid the introduction of maedi-visna virus and a wider spread of Chlamydophila spp. in this county.


Assuntos
Animais , Ovinos/virologia , Infecções por Chlamydia/epidemiologia , Vírus Visna-Maedi/isolamento & purificação , Pneumonia Intersticial Progressiva dos Ovinos/epidemiologia , Brasil , Imunodifusão/veterinária , Aborto Animal/etiologia
8.
Bioinformatics ; 26(21): 2786-7, 2010 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-20802209

RESUMO

SUMMARY: Interpretation of electron tomograms is difficult due to the high noise levels. Thus, denoising techniques are needed to improve the signal-to-noise ratio. XMSF (Microscopy Mean Shift Filtering) is a fast, user-friendly application that succeeds in filtering noise while preserving the structures of interest. It is based on the extension to 3D of a method widely applied in other image processing fields under very different scenarios. XMSF has been tested for a variety of tomograms, showing a great potential to become a state-of-the-art filtering program in electron tomography. Applied iteratively, the algorithm yields pre-segmented volumes facilitating posterior segmentation tasks. Moreover, execution times remain low thanks to parallel computing techniques to exploit current multicore computers. AVAILABILITY: http://sites.google.com/site/xmsfilter/


Assuntos
Tomografia com Microscopia Eletrônica/métodos , Imageamento Tridimensional/métodos , Software , Algoritmos , Processamento de Imagem Assistida por Computador , Sensibilidade e Especificidade
9.
J Struct Biol ; 171(2): 197-206, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20362059

RESUMO

Two-dimensional analysis of projections of single-particles acquired by an electron microscope is a useful tool to help identifying the different kinds of projections present in a dataset and their different projection directions. Such analysis is also useful to distinguish between different kinds of particles or different particle conformations. In this paper we introduce a new algorithm for performing two-dimensional multireference alignment and classification that is based on a Hierarchical clustering approach using correntropy (instead of the more traditional correlation) and a modified criterion for the definition of the clusters specially suited for cases in which the Signal-to-Noise Ratio of the differences between classes is low. We show that our algorithm offers an improved sensitivity over current methods in use for distinguishing between different projection orientations and different particle conformations. This algorithm is publicly available through the software package Xmipp.


Assuntos
Microscopia Eletrônica/métodos , Algoritmos , Bacteriorodopsinas/ultraestrutura , Ribossomos/ultraestrutura , Software
10.
J Struct Biol ; 167(3): 252-60, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19555764

RESUMO

The 3D reconstruction of biological specimens using Electron Microscopy is currently capable of achieving subnanometer resolution. Unfortunately, this goal requires gathering tens of thousands of projection images that are frequently selected manually from micrographs. In this paper we introduce a new automatic particle selection that learns from the user which particles are of interest. The training phase is semi-supervised so that the user can correct the algorithm during picking and specifically identify incorrectly picked particles. By treating such errors specially, the algorithm attempts to minimize the number of false positives. We show that our algorithm is able to produce datasets with fewer wrongly selected particles than previously reported methods. Another advantage is that we avoid the need for an initial reference volume from which to generate picking projections by instead learning which particles to pick from the user. This package has been made publicly available in the open-source package Xmipp.


Assuntos
Algoritmos , Inteligência Artificial , Imageamento Tridimensional/métodos , Adenoviridae/química , Antígenos Virais de Tumores/química , Microscopia Eletrônica , Tamanho da Partícula , Proteína de Replicação A/química
11.
BMC Bioinformatics ; 10: 124, 2009 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-19397789

RESUMO

BACKGROUND: Tilt series are commonly used in electron tomography as a means of collecting three-dimensional information from two-dimensional projections. A common problem encountered is the projection alignment prior to 3D reconstruction. Current alignment techniques usually employ gold particles or image derived markers to correctly align the images. When these markers are not present, correlation between adjacent views is used to align them. However, sequential pairwise correlation is prone to bias and the resulting alignment is not always optimal. RESULTS: In this paper we introduce an algorithm to find regions of the tilt series which can be tracked within a subseries of the tilt series. These regions act as landmarks allowing the determination of the alignment parameters. We show our results with synthetic data as well as experimental cryo electron tomography. CONCLUSION: Our algorithm is able to correctly align a single-tilt tomographic series without the help of fiducial markers thanks to the detection of thousands of small image patches that can be tracked over a short number of images in the series.


Assuntos
Algoritmos , Tomografia com Microscopia Eletrônica/métodos , Processamento de Imagem Assistida por Computador/métodos , Simulação por Computador , Modelos Biológicos , Imagens de Fantasmas
12.
J Struct Biol ; 165(1): 19-26, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18940260

RESUMO

Three-dimensional electron microscopy allows direct visualization of biological macromolecules close to their native state. The high impact of this technique in the structural biology field is highly correlated with the development of new image processing algorithms. In order to achieve subnanometer resolution, the size and number of images involved in a three-dimensional reconstruction increase and so do computer requirements. New chips integrating multiple processors are hitting the market at a reduced cost. This high-integration, low-cost trend has just begun and is expected to bring real supercomputers to our laboratory desktops in the coming years. This paper proposes a parallel implementation of a computation-intensive algorithm for three-dimensional reconstruction, ART, that takes advantage of the computational power in modern multicore platforms. ART is a sophisticated iterative reconstruction algorithm that has turned out to be well suited for the conditions found in three-dimensional electron microscopy. In view of the performance obtained in this work, these modern platforms are expected to play an important role to face the future challenges in three-dimensional electron microscopy.


Assuntos
Imageamento Tridimensional/métodos , Microscopia Eletrônica , Adenoviridae/ultraestrutura , Algoritmos , Proteínas do Capsídeo/ultraestrutura
13.
Genet Mol Res ; 7(4): 986-99, 2008 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-19048478

RESUMO

The antimicrobial peptide indolicidin (IND) and the mutant CP10A in hydrated micelles were studied using molecular dynamics simulations in order to observe whether the molecular dynamics and experimental data could be sufficiently correlated and a detailed description of the interaction of the antimicrobial peptides with a model of the membrane provided by a hydrated micelle system could be obtained. In agreement with the experiments, the simulations showed that the peptides are located near the surface of the micelles. Peptide insertions agree with available experimental data, showing deeper insertion of the mutant compared with the peptide IND. Major insertion into the hydrophobic core of the micelle by all tryptophan and mutated residues of CP10A in relation to IND was observed. The charged residues of the terminus regions of both peptides present similar behavior, indicating that the major differences in the interactions with the micelles of the peptides IND and CP10A occur in the case of the hydrophobic residues.


Assuntos
Anti-Infecciosos/química , Peptídeos Catiônicos Antimicrobianos/química , Sequência de Aminoácidos , Anti-Infecciosos/metabolismo , Peptídeos Catiônicos Antimicrobianos/genética , Peptídeos Catiônicos Antimicrobianos/metabolismo , Sítios de Ligação , Dicroísmo Circular , Simulação por Computador , Interações Hidrofóbicas e Hidrofílicas , Bicamadas Lipídicas/química , Micelas , Modelos Moleculares , Conformação Molecular , Mutação , Fosforilcolina/análogos & derivados , Fosforilcolina/química , Fosforilcolina/metabolismo , Conformação Proteica
14.
Genet Mol Res ; 7(4): 1070-88, 2008 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-19048486

RESUMO

Some antimicrobial peptides have a broad spectrum of action against many different kinds of microorganisms. Gomesin and protegrin-1 are examples of such antimicrobial peptides, and they were studied by molecular dynamics in this research. Both have a beta-hairpin conformation stabilized by two disulfide bridges and are active against gram-positive and gram-negative bacteria, as well as fungi. In this study, the role of the disulfide bridge in the maintenance of the tertiary peptide structure of protegrin-1 and gomesin is analyzed by the structural characteristics of these peptides and two of their respective variants, gomy4 and proty4, in which the four cysteines are replaced by four tyrosine residues. The absence of disulfide bridges in gomy4 and proty4 is compensated by overall reinforcement of the original hydrogen bonds and extra attractive interactions between the aromatic rings of the tyrosine residues. The net effects on the variants with respect to the corresponding natural peptides are: i) maintenance of the original beta-hairpin conformation, with great structural similarities between the mutant and the corresponding natural peptide; ii) combination of positive Phi and Psi Ramachandran angles within the hairpin head region with a qualitative change to a combination of positive (Phi) and negative (Psi) angles, and iii) significant increase in structural flexibility. Experimental facts about the antimicrobial activity of the gomesin and protegrin-1 variants have also been established here, in the hope that the detailed data provided in the present study may be useful for understanding the mechanism of action of these peptides.


Assuntos
Anti-Infecciosos/química , Peptídeos Catiônicos Antimicrobianos/química , Dissulfetos/química , Bases de Dados de Proteínas , Ligação de Hidrogênio , Modelos Moleculares , Conformação Molecular , Estrutura Secundária de Proteína , Relação Estrutura-Atividade
15.
Bioinformatics ; 23(24): 3391-3, 2007 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-17872913

RESUMO

UNLABELLED: Electron tomography is the leading technique to elucidate the structure of complex biological specimens. Due to the resolution needs, huge reconstructions are required. Grid computing has the potential to face the significant computational demands involved. However, there are a number of key issues, such as stability or difficult user-grid interaction, that currently preclude fully exploitation of its potential. EGEETomo is a user-friendly application that facilitates the interaction with the grid for the non-specialized user and automates job submission and supervision. In addition, EGEETomo is supplied with an automated fault recovery mechanism, which is key to make all the work transparent to the user. EGEETomo significantly accelerates tomographic reconstruction by exploiting the computational resources in the EGEE grid with minimal user intervention. AVAILABILITY: http://www.ace.ual.es/~jrbcast/EGEETomo.tar.gz


Assuntos
Algoritmos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Internet , Microscopia Eletrônica/métodos , Software , Tomografia/métodos
16.
J Struct Biol ; 148(2): 194-204, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15477099

RESUMO

X-windows based microscopy image processing package (Xmipp) is a specialized suit of image processing programs, primarily aimed at obtaining the 3D reconstruction of biological specimens from large sets of projection images acquired by transmission electron microscopy. This public-domain software package was introduced to the electron microscopy field eight years ago, and since then it has changed drastically. New methodologies for the analysis of single-particle projection images have been added to classification, contrast transfer function correction, angular assignment, 3D reconstruction, reconstruction of crystals, etc. In addition, the package has been extended with functionalities for 2D crystal and electron tomography data. Furthermore, its current implementation in C++, with a highly modular design of well-documented data structures and functions, offers a convenient environment for the development of novel algorithms. In this paper, we present a general overview of a new generation of Xmipp that has been re-engineered to maximize flexibility and modularity, potentially facilitating its integration in future standardization efforts in the field. Moreover, by focusing on those developments that distinguish Xmipp from other packages available, we illustrate its added value to the electron microscopy community.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Microscopia Eletrônica/métodos , Software , Algoritmos , Simulação por Computador , Cristalografia por Raios X/métodos , Imagens de Fantasmas
17.
Bioinformatics ; 20(17): 3286-8, 2004 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-15217810

RESUMO

Three-Dimensional Electron Microscopy (3DEM) has turned out to be a major player in structural proteomics. In 3DEM, tens of thousands of EM images from a macromolecule at different views are combined to derive its structure by means of a 3D reconstruction algorithm. However, for an optimal reconstruction, the most suitable algorithm has to be used and its parameters have to be tuned for the macromolecule under study and the experimental conditions found. The use of phantoms is central to objective comparison of reconstruction algorithms and optimization of their parameters. Phan3D is a tool intended to provide a fully visual and interactive environment that facilitates the design of phantoms resembling biological specimens in 3DEM. Phan3D has been developed as an alternative to the tedious, error-prone and old-fashioned phantom design that is based on hand-written text description files.


Assuntos
Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Microscopia Eletrônica/métodos , Modelos Biológicos , Imagens de Fantasmas , Software , Interface Usuário-Computador , Gráficos por Computador , Simulação por Computador , Desenho Assistido por Computador , Microscopia Eletrônica/instrumentação , Modelos Moleculares , Proteínas/ultraestrutura
18.
Oncol. clín ; 8(3): 893-897, sept. 2003. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-391178

RESUMO

El sarcoma del estroma mamario es una variante rara, latamente maligna, de los sarcomas de partes blandas. Su tratamiento convencional es la cirugía, la cual se asocia con un pobre pronóstico. Nosostros reportamos aquí un caso observado en una mujer de 56 años de edad. Una cirugía conservadora fue realizada, seguida de terapia radiante. Sin embargo, se observó una rápida progresión de la enfermedad con desarrollo de metástasis óseas, hepáticas y pulmonares, que resultó refractaria a la terapia sistemática. La sobrevida desde el diagnóstico fue de 16 meses. Una revisión de la literatura acerca del sarcoma del estroma mamario fue conducida


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama , Sarcoma , Neoplasias da Mama , Índice Mitótico , Prognóstico , Sarcoma , Taxa de Sobrevida
19.
Neurosci Lett ; 281(2-3): 147-50, 2000 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-10704764

RESUMO

This study was designed to investigate the presence of growth hormone receptor (GHR) expression in the human brain tissue, both normal and tumoral, as well as in the human glioblastoma cell line U87MG. Reverse transcription-polymerase chain reaction revealed the presence of GHR mRNA in all brain samples investigated and in U87MG cells. GHR immunoreactivity was also detected in this cell line using both immunocytochemistry and western blotting. All together, our data demonstrate the existence of GHR expression within the central nervous system (CNS), thus supporting a possible role for GH in the CNS physiology.


Assuntos
Neoplasias Encefálicas/metabolismo , Encéfalo/metabolismo , Receptores da Somatotropina/metabolismo , Western Blotting , Lobo Frontal/metabolismo , Glioblastoma/metabolismo , Glioblastoma/patologia , Humanos , Imuno-Histoquímica , Lobo Parietal/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Lobo Temporal/metabolismo , Células Tumorais Cultivadas
20.
Int J Radiat Oncol Biol Phys ; 39(5): 989-96, 1997 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-9392536

RESUMO

PURPOSE: To review the long-term experience of helium ion therapy as a therapeutic alternative to enucleation for uveal melanoma, particularly with respect to survival, local control, and morbidity. METHODS AND MATERIALS: 347 patients with uveal melanoma were treated with helium ion RT from 1978-1992. A nonrandomized dose-searching study was undertaken, with doses progressively reduced from 80 GyE in five fractions to 48 GyE in four fractions, given in 3-15 days, mean of 7 days. RESULTS: Local control was achieved in 96% of patients, with no difference in the rate of local control being seen at 80, 70, 60, or 50 GyE in five fractions. At the lowest dose level of 48 GyE in four fractions, the local control rate fell to 87%. Fifteen of 347 patients (4%) had local regrowth in the eye requiring enucleation (12 patients), laser (1 patient) or reirradiation (2 patients). The time of appearance of local regrowth ranged from 4 months to 5 years posttreatment, with 85% occurring within 3 years. Of the 347 patients, 208 are alive as of May 1, 1997. The median follow up of all patients is 8.5 years, range 1-17 years. Kaplan-Maier (K-M) survival is 80% at 5 years, 76% at 10 years, and 72% at 15 years posttreatment. Patients with tumors not involving the ciliary body have a 15-year K-M survival of 80%. The results for patients whose tumors involved the ciliary body are poor, with a 15-year K-M survival of 43%. Seventy-five percent of patients with tumors at least 3.0 mm from the fovea and optic nerve, and initial ultrasound height less than 6.0 mm, retained vision of 20/200 or better posttreatment. Patients with tumors larger than 6 mm in thickness, or with tumors lying close to the optic nerve or fovea, have a reduced chance of retaining useful vision. The enucleation rate is 19%, 3% for local failure and 16% because of complications of the helium RT, particularly neovascular glaucoma, which occurred in 35% of patients. CONCLUSIONS: Local control and retention of the eye are excellent. Complications of therapy reduce vision and eye preservation. Twenty-four percent of patients manifested distant metastases 6 to 146 months posttreatment, mean of 43 months, median of 36 months. Late-appearing distant metastases do not appear to be caused by persistent tumor in the eye. The risk of metastases is high for patients with tumors greater than 7 mm in initial ultrasound height (37%), anterior tumors involving the ciliary body (47%), and in those with local failure (53%). Patients with tumors not involving the ciliary body and initial dimensions less than 10 mm had only an 8% chance of death from melanoma. A search for effective adjuvant therapy is needed for patients at high risk of metastases (large tumors, ciliary body involved, local regrowth in eye).


Assuntos
Hélio/uso terapêutico , Melanoma/radioterapia , Neoplasias Uveais/radioterapia , Corpo Ciliar , Enucleação Ocular , Seguimentos , Humanos , Melanoma/mortalidade , Dosagem Radioterapêutica , Neoplasias Uveais/mortalidade , Transtornos da Visão/etiologia
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