RESUMO
The occurrence of familial aortic dissection is rare in cases that are not linked to Marfan syndrome. We report the 3 cases of acute aortic dissection, involving both parents and their son. Case 1 (father case): 79-year-old male visited a nearby doctor complaining of severe chest and back pain. He was diagnosed as acute aortic dissection (Stanford type A). An emergency operation was carried out and he had an artificial vascular replacement of ascending aorta and arch portion. Case 2 (mother case): 73-year-old female was treated for hypertension. Suddenly, she had a terrible epigastralgia and back pain. The contrast enhanced chest computed tomography (CT) revealed an acute aortic dissection (Stanford type A). The ascending aortic aneurysm ruptured in the ambulance while she was transferred to our hospital. She arrived at our hospital after cardiac and respiratory arrest. We attempted to perform cardiac massage, but we could not bring her back to life. Case 3 (son case): 48-year-old male was transferred to our hospital diagnosed with acute aortic dissection (Stanford type A). The ascending aorta replacement was performed on the same day. We were able to save cases 1 and 3 by performing surgery. Aortic dissection is thought to be the disease of medial degeneration. Hereditary links to aortic dissection are not well understood, with the exception of Marfan syndrome cases. The investigation of genetic mechanisms related to aortic dissection will be expected in the future.
Assuntos
Aneurisma da Aorta Torácica/genética , Dissecção Aórtica/genética , Doença Aguda , Idoso , Dissecção Aórtica/etiologia , Dissecção Aórtica/cirurgia , Aneurisma da Aorta Torácica/etiologia , Aneurisma da Aorta Torácica/cirurgia , Saúde da Família , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The effects of exposure to butyltin compounds (BTs: tributyltin; TBT, dibutyltin; DBT and monobutyltin; MBT) and non-ortho coplanar PCBs (IUPAC 77, 126 and 169) on marine mammals and human lymphocyte were evaluated. Peripheral blood mononuclear cells (PBMCs) isolated from Dall's porpoises (Phocoenoides dalli), bottlenose dolphins (Tursiops truncatus), a California sealion (Zalophus californianus), a larga seal (Phocoa largha) and humans (Homo sapiens) were exposed at varying concentrations of BTs and coplanar PCBs. Concanavalin A (Con A)-stimulated mitogenesis found significantly suppressed (P<0.01) when the cells were exposed at 300 nM (89 ng/ml) of TBT and 330 nM of DBT (77 ng/ml), while MBT showed little cytotoxicity at treatment levels of up to 3,600 nM (620 ng/ml). BTs concentrations in the liver of Dall's porpoises from Japanese coastal waters ranged between 81-450 ng/g for TBT and 200-1,100 ng/g (wet wt.) for DBTs, which is greater than the cytotoxic levels registered in this study. In contrast, non-ortho coplanar PCBs did not suppress cell proliferation at concentrations of up to 30 nM (10 ng/ml). The residue levels of coplanar PCBs in the blubber of Dall's porpoises were 0.12-1.3 ng/g, which were one order of lower than those levels that do cell proliferation. When cells were exposed to a mixture of TBT/DBTand coplanar PCBs, the proliferation was significantly reduced to 33 nM DBT plus 34 nM CB-77 and 33 nM DBT plus 28 nM CB-169 mixtures, respectively. The investigations relating the contaminant-induced immunosuppression in marine mammals have been focused on persistent organochlorines such as PCBs. pesticides and dioxin compounds. However, this study suggested the possibility of BTs could also pose a serious threat to the immune functions in free-ranging marine mammals and humans.
Assuntos
Golfinhos/sangue , Imunossupressores/toxicidade , Linfócitos/efeitos dos fármacos , Compostos Orgânicos de Estanho/toxicidade , Bifenilos Policlorados/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Carga Corporal (Radioterapia) , Divisão Celular/efeitos dos fármacos , Depressão Química , Exposição Ambiental , Humanos , Imunossupressores/análise , Japão , Ativação Linfocitária/efeitos dos fármacos , Compostos Orgânicos de Estanho/análise , Bifenilos Policlorados/análise , Timidina/metabolismo , Poluentes Químicos da Água/análiseRESUMO
A 65-year-old man complained of exertional angina. Coronary angiography revealed 99% stenosis in the left anterior descending artery (LAD). He underwent percutaneous transluminal coronary angioplasty (PTCA) and stenting. Repeat angiography demonstrated restenosis of the previous PTCA and stenting site. He underwent coronary artery bypass grafting (CABG) with placement of the left internal thoracic artery (LITA) to LAD. Chest discomfort and V1-V3 ST elevation appeared on the first post operative day. Coronary angiography revealed occlusion of the LITA graft. He underwent re-operation. Because the radial artery was severely sclerotic, the great saphenous vein was used for the graft. Two weeks later, he began to show edema in the left lower extremity. Echoangiogram showed occlusion of the left deep vein with thrombus. He tested positive for anticardiolipin IgG and IgM antibodies. Eighteen months after re-operation, he had recurrent chest discomfort on exertion. Coronary angiography revealed 90% stenosis of the anastomosis (SVG-LAD). A second re-operation was performed. We used the right internal thoracic artery (RITA) for the graft. The postoperative angiography showed patent graft. The patient has been doing well without any complications.
Assuntos
Síndrome Antifosfolipídica/cirurgia , Idoso , Angioplastia Coronária com Balão , Estenose Coronária/cirurgia , Humanos , Masculino , Recidiva , Reoperação , Stents , Grau de Desobstrução VascularRESUMO
We carried out stent graft repair in two patients with Stanford type B thoracic aortic dissection. A 51-year-old male was admitted to our hospital because of thoracic aortic dissection. Chest CT revealed an aneurysm of the distal aortic arch. The entry was pointed out 1 cm distal from the take off of the left subclavian artery in three-dimensional CT (3 D-CT). He was treated with a Gianturco stent which was anchored into the 30 mm Hemashield graft under selective cerebral perfusion. Another case was a 72-year-old male with a descending aortic aneurysm. 3 D-CT showed that the entry existed 4 cm proximal to the celiac artery. We performed transluminal implantation of the spiral Z-stent covered with the woven Dacron graft. 3 D-CT was useful for the preoperative management and the surgical treatment of thoracic aortic dissection.
Assuntos
Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/cirurgia , Imageamento Tridimensional , Stents , Tomografia Computadorizada por Raios X , Idoso , Humanos , Imageamento Tridimensional/normas , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/normasRESUMO
We analyzed the mechanism that causes suppression of IL-12 p40 gene induction during Plasmodium berghei infection. Although IL-12 together with IFN-gamma plays an important role in protection against pathogenic infection, the IL-12 p70 protein production of infected macrophages is lower than that by the uninfected macrophages. We showed in the present study that the induction of IL-12 p40 gene but not IL-12 p35 gene in macrophages of P. berghei-infected mice was profoundly inhibited. The inhibition was induced by interaction with macrophages that had contacted with P. berghei-infected erythrocytes and was mediated by a soluble factor, IL-10. There was comparable activation of NF-kappaB in uninfected and infected cells. The induction of IFN-regulatory factor-1 gene was comparable in transcription level in uninfected and infected cells, while the unidentified complex formation of IFN-regulatory factor-1 was observed in infected cells. Therefore, the inhibition of the IL-12 p40 gene induction appeared to be regulated at transcriptional regulation level of the gene.
Assuntos
Regulação para Baixo/genética , Regulação para Baixo/imunologia , Regulação da Expressão Gênica/imunologia , Interleucina-12/antagonistas & inibidores , Interleucina-12/genética , Malária/imunologia , Plasmodium berghei/imunologia , Animais , Líquido Ascítico/genética , Líquido Ascítico/imunologia , Líquido Ascítico/metabolismo , Líquido Ascítico/parasitologia , Quimiocinas/biossíntese , Quimiocinas/genética , Proteínas de Ligação a DNA/metabolismo , Proteínas de Ligação a DNA/fisiologia , Eritrócitos/imunologia , Eritrócitos/parasitologia , Fator Regulador 1 de Interferon , Interleucina-10/biossíntese , Interleucina-10/fisiologia , Interleucina-12/biossíntese , Líquido Intracelular/imunologia , Líquido Intracelular/metabolismo , Antígeno de Macrófago 1/biossíntese , Malária/genética , Malária/patologia , Camundongos , Camundongos Endogâmicos C57BL , NF-kappa B/metabolismo , NF-kappa B/fisiologia , Fagocitose/imunologia , Fosfoproteínas/metabolismo , Fosfoproteínas/fisiologia , Ativação TranscricionalRESUMO
The purpose of this study was to clarify which myocardial histological findings associated with dilated cardiomyopathy (DCM) are reflected in quantitative 201Tl myocardial SPECT. We obtained studied SPECT images from 21 patients with DCM 10 minutes and 2 hours after they received an injection of 111 MBq 201Tl at rest. We calculated the percent coefficient of variation of myocardial 201Tl counts [%CV(TI)], the washout rate (WR), standard deviation of WR [SD(WR)], extent score (ES) and severity score (SS). We used image analysis to measure % fibrosis, % myocytes, the ratio of fibrous tissue to myocyte tissue (F/My), myocyte size and standard deviation of myocyte size [SD(My)] in left ventricular endomyocardial biopsy specimens. The %CV(Tl) was correlated with % fibrosis and F/My. The ES and SS also correlated with F/My. The correlation between SD(WR) and SD(My) was significant. The present findings suggest that %CV(Tl), ES and SS of rest 201Tl SPECT reflect myocardial fibrosis and that the standard deviation of washout reflects the distribution of myocyte size.
Assuntos
Cardiomiopatia Dilatada/diagnóstico por imagem , Cardiomiopatia Dilatada/patologia , Coração/diagnóstico por imagem , Radioisótopos de Tálio , Tomografia Computadorizada de Emissão de Fóton Único , Biópsia , Cardiomiopatia Dilatada/fisiopatologia , Feminino , Fibrose , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Compostos RadiofarmacêuticosRESUMO
The purposes of the present study were to define precisely the ultrastructural features of apoptosis in cultured cardiomyocytes and to determine whether DNA fragmentation is essential for the apoptotic morphology. When cultured neonatal murine cardiomyocytes were incubated with an agonistic anti-Fas antibody in the presence of a non-toxic amount of actinomycin D or cycloheximide, approximately 70% of them had lost their viability after 24 h. The dead cardiomyocytes showed the typical ultrastructural changes of apoptosis on transmission and scanning electron microscopy, as well as by positive in situ nick end-labelling (TUNEL), positive Taq polymerase-based in situ ligation, a DNA ladder pattern on gel electrophoresis, and an increase in the active fragment of caspase-3. According to TUNEL at the electron microscopic level, apoptotic nuclear change, cytoplasmic shrinkage, and DNA fragmentation always occurred simultaneously in apoptotic cardiomyocytes. Other ultrastructural features of apoptosis were the appearance of abundant lipid-like structures in the cytoplasm of cardiomyocytes at the early phase, and a high incidence of plasma membrane rupture and formation of apoptotic bodies at the later phase. When zinc, an inhibitor of Ca2+/Mg2+-dependent endonuclease, was added to the present model, activation of caspase-3 and an apoptotic ultrastructure were still observed in spite of the lack of DNA fragmentation, indicating that this type of myocyte death is also apoptosis. In conclusion, the typical apoptotic ultrastructure and DNA fragmentation occur simultaneously in association with caspase-3 activation in Fas-stimulated cultured cardiomyocytes. Apoptotic morphology can, however, be observed even without DNA fragmentation.
Assuntos
Apoptose/genética , Fragmentação do DNA , Miocárdio/ultraestrutura , Receptor fas/fisiologia , Animais , Caspase 3 , Caspases/metabolismo , Técnicas de Cultura de Células , Morte Celular/efeitos dos fármacos , Cicloeximida/farmacologia , Dactinomicina/farmacologia , Precursores Enzimáticos/metabolismo , Marcação In Situ das Extremidades Cortadas , Camundongos , Camundongos Endogâmicos BALB C , Microscopia Eletrônica , Microscopia Eletrônica de Varredura , Miocárdio/enzimologia , Zinco/farmacologia , Receptor fas/imunologiaAssuntos
Células Apresentadoras de Antígenos/imunologia , Antígenos Heterófilos/imunologia , Catepsina B/antagonistas & inibidores , Dipeptídeos/farmacologia , Terapia de Imunossupressão/métodos , Transfusão de Linfócitos , Linfócitos T/imunologia , Animais , Inibidores de Cisteína Proteinase/farmacologia , Ativação Linfocitária , Teste de Cultura Mista de Linfócitos , Camundongos , Ratos , BaçoRESUMO
In the present study, we investigated whether gallic acid (GA) can induce death in cultured vascular smooth muscle cells (VSMCs), and whether production of the hydroxyl radical (.OH) is involved in the process of GA action. GA killed cultured VSMCs from rat aorta, in a dosc- and time-dependent manner. Cytoplasmic shrinkage and nuclear condensation were observed light microscopically in GA-treated VSMCs, which appeared apoptotic. However, the ultrastructure of the VSMC was not typical of apoptosis: nuclear condensation was not glossy, and the plasma membrane and subccellular organelles were disrupted. Although the VSMC were positive for in situ nick end-labeling (TUNEL). they did not show a DNA ladder pattern on gel electrophoresis and were negative for T aq polymerase-based in situ ligation, which is more specific for apoptosis than TUNEL. Moreover. GA-induced cell death was not prevented by Boc-Asp-fmk (a pan-caspase inhibitor). Production of OH was detected in GA-treated VSMCs using high-performance liquid chromatography with salicylic acid as a trapping agent. Lipid peroxidation was also observed. The production of .OH was inhibited by catalase (CAT) and deferoxamine (DFX), and these treatments completely rescued VSMCs from cell death. In a cell-free system, GA produced .OH in the presence of Fe2+-EDTA, which was quenched by CAT and DFX, suggesting involvement of the Haber-Weiss reaction. Oxidative stress by reactive oxygen species, .OH in particular, is one of the mechanisms of GA-induced death of VSMCs, the mode of which was different from typical apoptosis.
Assuntos
Ácido Gálico/farmacologia , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/patologia , Animais , Morte Celular/efeitos dos fármacos , Células Cultivadas , Peroxidação de Lipídeos , Microscopia Eletrônica , Músculo Liso Vascular/metabolismo , Ratos , Ratos Sprague-DawleyRESUMO
There is a type of arteriosclerosis with remodeling of middle-size arteries in which intimal hyperplasia of smooth muscle cells (SMCs) plays the main role, and there are few macrophages, T lymphocytes, and foam cells. It is unknown whether apoptosis and the expression of Bax, an inducer of apoptosis, are increased according to the progression of this type of human arteriosclerosis, which is different from so-called atherosclerosis. Bax heterodimerizes with Bcl-2, an inhibitor of apoptosis, and the ratio of Bax to Bcl-2 determines cellular apoptosis or survival. Thus, we investigated apoptosis and the expressions of Bax, bax mRNA, and Bcl-2 in human arteriovenous (AV) fistulas used for hemodialysis, a representative of arteriosclerosis of the aforementioned type. The material was 20 radial arteries obtained from 20 patients with chronic renal failure undergoing AV shunt surgery. SMCs, macrophages, and T lymphocytes were immunohistochemically identified at the light microscopic (LM) level. Apoptosis was detected by in situ terminal deoxynucleotidyl transferase (TdT)-mediated digoxigenin-dUTP nick end labeling (TUNEL) at both the LM and electron microscopic (EM) level. Cell proliferating activity was estimated by proliferating cell nuclear antigen (PCNA). Bax and Bcl-2 were detected by immunohistochemistry and Western blot analysis. Expression of bax mRNA was detected by in situ hybridization. LM TUNEL-positive cells in both the intima and media were significantly increased according to the percent stenosis of the vessels. EM analysis revealed that ultrastructures of apoptotic SMCs were seen in both synthetic and contractile phenotypes. Their frequency of occurrence in the intima and media were greater in those vessels with >50% stenosis than in those with <50% stenosis (5.2+/-0.7% versus 1.0+/-0.3% in the intima and 2. 1+/-0.5% versus 0.2+/-0.1% in the media). The proportion of apoptotic SMCs with ruptured plasma membranes was greater than that of apoptotic SMCs with intact membranes in the intima of the former (4.1+/-0.6% versus 1.1+/-0.1%). Only those SMCs with apoptotic ultrastructures had TUNEL-positive nuclei with moderate or marked accumulation of immunogold particles at the EM level. However, ultrastructures of oncosis (primary necrosis) were not observed. Immunohistochemical analyses showed significant positive correlations between percent stenosis of vessels and the percentage of either PCNA-positive intimal cells or Bax-positive areas in the intima and media. Bcl-2-positive cells were not observed in the intima but mainly in the outer media. The percentage of Bcl-2-positive medial cells was definitely decreased at an early stage after formation of the AV fistula but did not change according to the duration of hemodialysis or the progression of arteriosclerosis. Western blot analysis of Bax or Bcl-2 and in situ hybridization of bax mRNA confirmed the immunohistochemical data. Thus, regulation of cellularity in intimal hyperplasia of SMCs in human arteriosclerosis with remodeling is mediated by proliferation and apoptosis but not oncosis. The apoptosis is probably induced by an increase in the Bax to Bcl-2 ratio.
Assuntos
Apoptose/fisiologia , Músculo Liso Vascular/patologia , Músculo Liso Vascular/fisiopatologia , Proteínas Proto-Oncogênicas/metabolismo , Artéria Radial/patologia , Artéria Radial/fisiopatologia , Adulto , Idoso , Arteriosclerose/metabolismo , Arteriosclerose/patologia , Arteriosclerose/fisiopatologia , Anastomose Arteriovenosa , Feminino , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Músculo Liso Vascular/metabolismo , Antígeno Nuclear de Célula em Proliferação/metabolismo , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , RNA Mensageiro/metabolismo , Artéria Radial/metabolismo , Diálise Renal , Túnica Íntima/metabolismo , Túnica Íntima/patologia , Túnica Íntima/fisiopatologia , Proteína X Associada a bcl-2RESUMO
A 47-year-old woman with heterozygous Fabry's disease with pre-excitation syndrome has been followed up for 15 years. Diagnosis was confirmed by the typical electron microscopic feature of the endomyocardial specimen and a decreased plasma alpha-galactosidase activity. As the disease progressed, the interventricular septum thickened from 11 to 17 mm as measured by echocardiography, while the AH interval was prolonged from 80 to 140 msec. In Fabry's disease, the PR interval has been reported to be variable from short PR to AV block. Therefore, this case may be helpful to understand the time course in the AV conduction abnormalities with the progression of Fabry's disease.
Assuntos
Doença de Fabry/complicações , Heterozigoto , Síndromes de Pré-Excitação/complicações , Biópsia , Progressão da Doença , Ecocardiografia , Eletrocardiografia , Doença de Fabry/diagnóstico , Doença de Fabry/enzimologia , Doença de Fabry/genética , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Miocárdio/ultraestrutura , Síndromes de Pré-Excitação/diagnóstico , Síndromes de Pré-Excitação/enzimologia , alfa-Galactosidase/sangueRESUMO
BACKGROUND: The presence of apoptotic myocytes has been reported in human hearts with dilated cardiomyopathy (DCM) on the basis of a positive finding of DNA in situ nick end-labeling (TUNEL). However, ultrastructural evidence of myocyte apoptosis has not been obtained. METHODS AND RESULTS: A total of 80 endomyocardial biopsies were obtained from right and left ventricles of 20 patients with DCM and 20 normal control subjects. TUNEL-positive myocytes were found by light microscope in 15% of DCM specimens (controls, 0%, P<0.05), and the percentage of TUNEL-positive myocytes per section in DCM was 1. 0+/-2.7% (mean+/-SD). According to TUNEL at the electron microscopic level (EM-TUNEL), immunogold particles, which label DNA breaks with 3'-OH terminals, were markedly accumulated in the bizarre-shaped nuclei, with widespread clumping of chromatin (so-called "hypertrophied nuclei") of the myocytes obtained from DCM. Their ultrastructure was neither apoptotic nor necrotic but rather that of living cells. Taq polymerase-based DNA in situ ligation assay, which detects double-stranded DNA fragments more specifically than TUNEL, did not detect a positive reaction in any case. In mirror sections, all of the TUNEL-positive myocytes in DCM simultaneously expressed proliferating cell nuclear antigen, which is required for both DNA replication and repair, but Ki-67, a replication-associated antigen, was completely negative in all cases, which appeared to rule out cell proliferation activity. CONCLUSIONS: Most of the TUNEL-positive myocytes in hearts with DCM are not apoptotic but rather living cells with increasing activity of DNA repair.
Assuntos
Apoptose , Cardiomiopatia Dilatada/diagnóstico , Reparo do DNA , Marcação In Situ das Extremidades Cortadas , Miocárdio/patologia , Replicação do DNA , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/análise , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Antígeno Nuclear de Célula em Proliferação/análise , Taq PolimeraseRESUMO
Two cell types, macrophages and smooth muscle cells (SMCs), play important roles in the development of atherosclerotic lesions. Both contribute to the formation of the lesions not only by their presence but also by taking in or releasing extracellular substrates during life and at death. The present study aimed to elucidate their turnover, focusing on the detailed description of the modes of death in each cell type, and the roles of their death in the progression from early into advanced atherosclerotic lesions. Ascending aortas were obtained from New Zealand white male rabbits fed a diet with 1% cholesterol for 3 months (3-M group, n= 6) and 6 months (6-M group, n = 6). They were histologically examined, and the cell death was checked by in situ nick end-labeling (TUNEL), using a Taq polymerase-based in situ ligation assay with/without combination of immunohistochemistry, electron microscopy (EM), and TUNEL at the EM level. Intimal hyperplasia and luminal stenosis advanced with increased dietary interval, and the aortic intima of the 3-M group consisted of histological types I-III atherosclerotic lesions, whereas that of the 6-M group included types III-V. Along with the progression, the cellular population decreased, but the area of fibrosis increased. The percentage area of macrophages declined (from 60% +/- 5% to 23% +/- 2%), but that of SMCs increased (from 5% +/- 1% to 10% +/- 2%). The positive cells for in situ ligation were less frequent in the 6-M group (0.05% +/- 0.01%) than in the 3-M group (0.2% +/- 0.04%), which was due to a decrease in SMCs positive for in situ ligation. The frequency of TUNEL-positive cells was higher than that of in situ ligation-positive cells in both groups, suggesting that cell death involved not only apoptosis but also oncosis. This was confirmed using EM: cell death occurred via both apoptosis and oncosis. EM-TUNEL positively labeled not only apoptotic but also some oncotic nuclei. Death of macrophages and SMCs involves both apoptosis and oncosis in the aortic intima of hypercholesterolemic rabbits. Decline in the dying rate of SMCs might be associated with the formation of SMC-rich and collagen-rich lesions in the late advanced stage of atherosclerosis, although such a cause-effect relationship is to be further confirmed.
Assuntos
Aorta Torácica/ultraestrutura , Apoptose , Arteriosclerose/patologia , Hipercolesterolemia/patologia , Músculo Liso Vascular/ultraestrutura , Actinas/genética , Actinas/metabolismo , Animais , Aorta Torácica/metabolismo , Arteriosclerose/metabolismo , Arteriosclerose/fisiopatologia , DNA/análise , Primers do DNA/química , Progressão da Doença , Técnica Indireta de Fluorescência para Anticorpo , Hipercolesterolemia/metabolismo , Hipercolesterolemia/fisiopatologia , Marcação In Situ das Extremidades Cortadas , Macrófagos/metabolismo , Macrófagos/ultraestrutura , Masculino , Músculo Liso Vascular/metabolismo , Reação em Cadeia da Polimerase , CoelhosRESUMO
Myocardial infarction (MI) progresses from the acute death of myocytes and the infiltration of inflammatory cells into granulation, followed by scars. During the healing process, the myocardial interstitial cell population in the infarcted tissues increases markedly and then decreases. We postulated that apoptosis is responsible for this process. Twenty-four male Japanese white rabbits underwent a 30-minute occlusion of the left coronary artery followed by reperfusion for 2 days, 2 weeks, or 4 weeks (n=8 each). The histological features consisted of dead cardiomyocytes and marked leukocyte infiltration at 2 days after MI and granulation consisting of numerous alpha-smooth muscle actin-positive myofibroblasts, macrophage antigen-positive macrophages, and neovascularization at 2 weeks. At 4 weeks, the cellularity decreased markedly, and scars were evident. Interstitial cells with positive nick end labeling were significantly more frequent at the light microscopic level in the 2-day MI samples (5.3+/-3.6% in the center and 6.9+/-3.3% in the periphery of the infarct region) than in the 2-week (2.5+/-1.0%) and 4-week (0.5+/-0.5%) samples. DNA electrophoresis showed a clear ladder in tissues from the ischemic areas at 2 days after MI but not at 2 and 4 weeks after MI. Ultrastructurally, typical apoptotic figures, including apoptotic bodies and condensed nuclei without ruptured plasma membranes, were detected in leukocytes from all hearts with 2-day MI and in myofibroblasts, endothelial cells, and macrophages from all hearts with 2-week MI. In the electron microscopic in situ nick end labeling, immunogold particles intensely labeled the condensed chromatin of the typical apoptotic nuclei. These particles were also accumulated on nuclei of the interstitial cells showing homogeneous density but not definite condensation as typical apoptotic nuclei, suggesting an early stage of apoptosis. Thus, apoptosis plays an important role in the disappearance of both the infiltrated leukocytes and the proliferated interstitial cells after MI. This finding may have therapeutic implications for postinfarct ventricular remodeling through apoptosis handling during the healing stage of MI.
Assuntos
Apoptose/fisiologia , Infarto do Miocárdio/patologia , Infarto do Miocárdio/fisiopatologia , Cicatrização/fisiologia , Animais , Biotina , DNA/análise , Fragmentação do DNA , Nucleotídeos de Desoxiuracil , Eletroforese em Gel de Ágar , Endotélio Vascular/patologia , Endotélio Vascular/ultraestrutura , Leucócitos/patologia , Leucócitos/ultraestrutura , Masculino , Microscopia Eletrônica , Fibras Musculares Esqueléticas/patologia , Fibras Musculares Esqueléticas/ultraestrutura , Coelhos , Sefarose , Coloração e RotulagemRESUMO
Bacterial examinations of temporary pacing wires (P-wires), pulmonary arterial (P-A) catheters, and drainage tubes temporarily inserted during open-heart surgery were performed in 213 patients. Bacteria were detected in 19 (2.8%) of 672 specimens gathered from the subject patients, with coagulase-negative Staphylococcus (CNS) being most frequently observed. P-wires accounted for 17 out of 19 of the culture-positive specimens, and 7 of the P-wires remained in place for more than two weeks. The frequency of infection with the P-wires was significantly higher than with the P-A catheters or drainage tubes. The period of time that the P-wire was left in place significantly longer than for P-A catheter or drainage tube. There was, however, no statistically significant difference between the culture-positive and negative groups in respect to age, detention periods, operation times, CPB times, or length of ICU stay. As a result of these findings, we have concluded that P-wires should be removed as soon as possible following surgery, and in any case, a meticulous care should be taken to prevent transcutaneous infection.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Cateterismo de Swan-Ganz , Drenagem/instrumentação , Contaminação de Equipamentos , Marca-Passo Artificial/efeitos adversos , Complicações Pós-Operatórias/microbiologia , Infecções Relacionadas à Prótese/etiologia , Staphylococcus/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Resistência a Meticilina , Pessoa de Meia-Idade , Artéria Pulmonar , Staphylococcus aureus/isolamento & purificaçãoRESUMO
The laser-induced fluorescence spectra of living leaves of seven different trees were investigated by using a 355-nm pulsed Nd:YAG laser. The shapes of the spectra (360-800 nm) varied depending on the season and growing conditions. Generally, red fluorescence (>650 nm) was larger during summer to autumn, which offers information on the activity of photosynthesis, and blue-green fluorescence (<650 nm) was relatively large in early summer and late autumn to winter, which offers information on the progress of growth and senescence. The spectral shapes also varied depending on the organic constituents inside the leaves. Separation of the spectra into their components was tried to identify the leaves' constituents. These basic data are indispensable for developing a vegetation-monitoring fluorescence lidar.
RESUMO
Arachnoid cysts very rarely occur within the ventricular system, where no arachnoid tissue exists. We present three cases of intraventricular arachnoid cyst with special reference to its origin. The first patient was a 5-year-old boy who complained of headaches and enlargement of his head. A CT scan revealed obstructive hydrocephalus and a large cystic lesion in the right lateral ventricle. The symptoms resolved after fenestration of the cyst and cystoperitoneal shunt. The second patient was a 49-year-old woman who complained of headache and numbness in her left upper extremity. A CT scan and MRI revealed a large cyst in the trigone of the right lateral ventricle. Fenestration of the cyst wall and cystoperitoneal shunt were performed relieving her complaints. The third patient was a 42-year-old man who complained of frequent seizures and dizziness. A CT scan and MRI demonstrated a moderate size cystic mass in the inferior horn of the right lateral ventricle. The symptoms were improved by partial resection of the cyst wall. Immunohistochemical studies and light microscopy confirmed that the cyst walls were composed of arachnoid membrane, implying that the cysts were arachnoid cysts. CT and MRI in these three cases showed widening of the choroidal fissure bordering the cyst wall, occasionally involving a part of the protruding cyst wall. On enhanced CT and MRI, the choroid plexus in the trigone of ipsilateral lateral ventricle was displaced anterolaterally, implying that the cysts had grown from outside the choroid plexus. Postoperative MRI demonstrated the shrunken cyst wall attached to the choroidal fissure. The surgical findings in case 3 also showed that the cyst wall was attached firmly to the choroid plexus. These findings appeared to indicate that the intraventricular arachnoid cyst originated from the arachnoid layer drawn into the choroidal fissure with choroidal vascular mesenchyme.
Assuntos
Cistos Aracnóideos/etiologia , Encefalopatias/etiologia , Ventrículos Cerebrais , Adulto , Cistos Aracnóideos/diagnóstico por imagem , Cistos Aracnóideos/cirurgia , Encefalopatias/diagnóstico por imagem , Encefalopatias/cirurgia , Ventrículos Cerebrais/patologia , Ventrículos Cerebrais/cirurgia , Ventriculografia Cerebral , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
A 15-year-old boy with proteinuria and hematuria is reviewed in this study. He was first found to have urinary abnormalities at the age of 13 years, and his renal function was exacerbated for a short duration. Renal biopsy was performed to make a histological diagnosis and to establish adequate therapy. Light microscopy showed marked tubulointerstitial inflammation with granulomatous changes, and electron microscopy revealed that numerous osmiophilic inclusions were present in podocytes, mesangial cells, and endothelial cells of the glomeruli and in epithelial cells of the tubules. The alpha-galactosidase activity of lymphocytes from the patient was measured, and the results of this assay indicated that the patient's lymphocytes had a low level of alpha-galactosidase activity. Therefore, the patient was diagnosed as having Fabry's disease with renal dysfunction. This study demonstrated that the onset age of renal insufficiency in Fabry's disease may be earlier than that described previously, and that when granulomatous interstitial nephritis is developed, renal function may deteriorate progressively.
Assuntos
Doença de Fabry/diagnóstico , Nefrite Intersticial/diagnóstico , Adolescente , Idade de Início , Biomarcadores/sangue , Doença de Fabry/complicações , Humanos , Rim/patologia , Linfócitos/enzimologia , Masculino , Nefrite Intersticial/etiologia , Nefrite Intersticial/patologia , alfa-Galactosidase/sangueRESUMO
Immunochemical relationships between salt-soluble proteins (albumins plus globulins) from buckwheat and indigo seeds were shown by immunoblot and immunodiffusion analyses using rabbit antisera raised against buckwheat globulins. These antigenic crossreactivities were roughly consistent with their polypeptide components judged by two-dimensional electrophoresis and SDS-PAGE analyses.