Enhanced expression of NLRP3 inflammasome components by monocytes of patients with pulmonary paracoccidioidomycosis is associated with smoking and intracellular hypoxemia.

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by thermally dimorphic fungi of the genus Paracoccidioides that affects predominantly 30-60-year-old male rural workers. The main clinical forms of the disease are acute/subacute, chronic (CF); almost all CF patients develop pulmonary fibrosis, and they also exhibit emphysema due to smoke. An important cytokine in this context, IL-1ß, different from the others, is produced by an intracellular multimolecular complex called inflammasome that is activated by pathogens and/or host signs of damage. Inflammasome has been recognized for its contribution to chronic inflammatory diseases, from that, we hypothesized that this activation could be involved in paracoccidioidomycosis, contributing to chronic inflammation. While inflammasome activation has been demonstrated in experimental models of Paracoccidioides brasiliensis infection, no information is available in patients, leading us to investigate the participation of NLRP3-inflammasome machinery in CF/PCM patients from a Brazilian endemic area. Our findings showed increased priming in mRNA levels of NLRP3 inflammasome genes by monocytes of PCM patients in vitro than healthy controls. Similar intracellular protein expression of NLRP3, CASP-1, ASC, and IL-1ß were also observed in freshly isolated monocytes of PCM patients and smoker controls. Increased expression of NLRP3 and ASC was observed in monocytes from PCM patients under hypoxia in comparison with smoker controls. For the first time, we showed that primed monocytes of CF-PCM patients were associated with enhanced expression of components of NLRP3-inflammasome due to smoke. Also, hypoxemia boosted this machinery. These findings reinforce the systemic low-grade inflammation activation observed in PCM during and after treatment.

Light-emitting diode effects on combined decellularization of tracheae. A novel approach to obtain biological scaffolds.

PURPOSE: To obtain a decellularized tracheal scaffold associating traditional approaches with the novel light-emitting diode (LED) proposal. METHODS: This study was performed with New Zealand adult rabbits weighing 3.0 - 4.0 kg. Different protocols (22) were used combining physical (agitation and LED irradiation), chemical (SDS and Triton X-100 detergents), and enzymatic methods (DNase and RNase). RESULTS: Generally, the cells surrounding soft tissues were successfully removed, but none protocol removed cells from the tracheal cartilage. However, longer protocols were more effective. The cost-benefits relation of the enzymatic processes was not favorable. It was possible to find out that the cartilaginous tissue submitted to the irradiation with LED 630nm and 475 nm showed an increased number of gaps without cells, but several cells were observed to be still present. CONCLUSION: The light-emitting diode is a promising tool for decellularization of soft tissues.

Light-emitting diode effects on combined decellularization of tracheae. A novel approach to obtain biological scaffolds

PURPOSE: To obtain a decellularized tracheal scaffold associating traditional approaches with the novel light-emitting diode (LED) proposal. METHODS: This study was performed with New Zealand adult rabbits weighing 3.0 - 4.0 kg. Different protocols (22) were used combining physical (agitation and LED irradiation), chemical (SDS and Triton X-100 detergents), and enzymatic methods (DNase and RNase). RESULTS: Generally, the cells surrounding soft tissues were successfully removed, but none protocol removed cells from the tracheal cartilage. However, longer protocols were more effective. The cost-benefits relation of the enzymatic processes was not favorable. It was possible to find out that the cartilaginous tissue submitted to the irradiation with LED 630nm and 475 nm showed an increased number of gaps without cells, but several cells were observed to be still present. CONCLUSION: The light-emitting diode is a promising tool for decellularization of soft tissues. .

Oslerus osleri (Cobbold, 1876) infection in maned wolf (Chrysocyon brachyurus, illiger, 1815).

Oslerus osleri is a small nematode that infects the respiratory tract of domestic and wild canids and is responsible for causing chronic nodular tracheobronchitis. This paper aims to report a case of parasitism by O. osleri in a free-living maned wolf (Chrysocyon brachyurus) that was struck by a motor vehicle. Fecal samples were collected, and the presence of spiral larvae, with "S"-shaped tails, was observed on flotation. This characteristic was compatible with the Filaroididae Family larvae of O. osleri. Although the animal did not show clinical signs of respiratory system impairment, a tracheobronchoscopy was performed. Semitransparent nodules, 5 mm in diameter, containing adult parasites were observed in the third distal portion of the trachea, cranial to the carina. Larval morphological characteristics and the nodular locations were compatible with an O. osleri respiratory tract infection.

Tratamento cirúrgico de aspergiloma pulmonar / Surgical treatment of pulmonary aspergilloma

O objetivo deste estudo foi analisar o resultado do tratamento cirúrgico de aspergiloma pulmonar. Para tanto, foram avaliados 14 pacientes adultos (7 homens e 7 mulheres) e tratados no Hospital Universitário da Faculdade de Medicina de Botucatu, em Botucatu (SP), entre 1981 e 2009. Dados foram coletados dos registros médicos dos pacientes. Dez pacientes (71 por cento) apresentaram aspergiloma pulmonar simples, e 4 (29 por cento) apresentaram aspergiloma pulmonar complexo. O sintoma mais frequente foi hemoptise, e a pneumopatia preexistente mais prevalente foi tuberculose. Dois pacientes (14 por cento) foram submetidos a mais de um procedimento cirúrgico. Não houve mortalidade operatória. Metade dos pacientes apresentou complicações pós-operatórias, sendo fuga aérea prolongada e empiema as mais frequentes.

The objective of this study was to analyze the outcome of surgical treatment of pulmonary aspergilloma. To that end, we evaluated 14 adult patients so treated between 1981 and 2009 at the Botucatu School of Medicine University Hospital, in the city of Botucatu, Brazil. Data were collected from the medical records of the patients. Ten patients (71 percent) presented with simple pulmonary aspergilloma, and 4 (29 percent) presented with complex pulmonary aspergilloma. Hemoptysis was the most common symptom, and tuberculosis was the most prevalent preexisting lung disease. Two patients (14 percent) underwent surgery on more than one occasion. There were no intraoperative deaths. Half of the patients developed postoperative complications, prolonged air leak and empyema being the most common.

Surgical treatment of pulmonary aspergilloma.

The objective of this study was to analyze the outcome of surgical treatment of pulmonary aspergilloma. To that end, we evaluated 14 adult patients so treated between 1981 and 2009 at the Botucatu School of Medicine University Hospital, in the city of Botucatu, Brazil. Data were collected from the medical records of the patients. Ten patients (71%) presented with simple pulmonary aspergilloma, and 4 (29%) presented with complex pulmonary aspergilloma. Hemoptysis was the most common symptom, and tuberculosis was the most prevalent preexisting lung disease. Two patients (14%) underwent surgery on more than one occasion. There were no intraoperative deaths. Half of the patients developed postoperative complications, prolonged air leak and empyema being the most common.

Tuberculose ativa em pacientes cirúrgicos com baciloscopia negativa no pré-operatório / Active tuberculosis in surgical patients with negative preoperative sputum smear results

OBJETIVO: Verificar a proporção de pacientes com baciloscopia negativa no pré-operatório e que apresentaram TB ativa na peça cirúrgica. MÉTODOS: Estudo retrospectivo de pacientes com diagnóstico histopatológico de TB ativa ou sequelar e operados entre os anos de 2003 e 2006 em um hospital universitário. Foram pesquisados antecedentes e aspectos clínicos relativos à doença, pesquisa de bacilos álcool-ácido resistentes (BAAR), tipo de cirurgia realizada e exame histopatológico da peça cirúrgica. RESULTADOS: Foram incluídos 43 pacientes, com média de idade de 44 ± 19 anos, sendo 27 do sexo masculino. Apresentavam história prévia de TB com tratamento adequado 28 pacientes, e 15 não referiam antecedentes para TB. O principal motivo da procura pelo serviço foi infecção de repetição, seguida por achados em exames de imagem. Dos 43 pacientes, foi pesquisado BAAR no pré-operatório em 35: 32 apresentaram resultados negativos e 3, resultados positivos. Dos 35 pacientes pesquisados, 26 apresentavam diagnóstico histopatológico de TB ativa e 9 de TB sequelar na peça cirúrgica; os outros 8 também foram diagnosticados com TB sequelar. A proporção de TB ativa em doentes com baciloscopia negativa foi de 72 por cento (23/32), e o de baciloscopia negativa em TB ativa foi de 88 por cento (23/26), sendo a pesquisa de BAAR positiva somente em 11,5 por cento (3/26). CONCLUSÕES: A baciloscopia direta tem rendimento muito baixo, e muitos pacientes mesmo já tratados podem permanecer com TB em atividade com baciloscopia negativa. A TB ativa pode ser confundida com infecções secundárias ou com câncer.

OBJECTIVE: To determine the proportion of negative preoperative sputum smear results among patients presenting active TB, as identified through the evaluation of surgical samples. METHODS: A retrospective study of patients undergoing surgery between 2003 and 2006 at a university hospital and receiving a histopathological diagnosis of active or latent TB. We reviewed patient histories, TB-related clinical aspects, acid-fast bacilli (AFB) test results, type of surgery performed and histopathological findings in surgical samples. RESULTS: We included 43 patients, 27 of whom were male. The mean age was 44 ± 19 years. Twenty-eight patients had a history of TB (treated appropriately), and 15 reported no history of the disease. The main reason for seeking treatment was recurrent infection, followed by alterations seen in imaging studies. Of the 43 patients, 35 underwent preoperative AFB testing: 32 tested negative, and 3 tested positive. Among those 35 patients, the histopathological diagnosis was active TB in 26 and latent TB in 9. The 8 patients not submitted to preoperative AFB testing were also diagnosed with latent TB. The proportion of active TB in patients with negative sputum smear results was 72 percent (23/32), whereas that of negative sputum smear results in patients with active TB was 88 percent (23/26). Only 11.5 percent (3/26) of the patients had tested positive for AFB. CONCLUSIONS: Direct sputum smear microscopy has a very low yield. Many previously treated patients can present negative sputum smear results and yet have active TB. Active TB can be mistaken for secondary infections or for cancer.

Lung cancer: histology, staging, treatment and survival.

OBJECTIVE: To analyze principal histological types of lung cancer, as well as the staging, treatment and survival of lung cancer patients. METHODS: This was a retrospective study based on the analysis of medical charts of patients treated at the Botucatu School of Medicine Hospital das Clínicas over a six-year period. RESULTS: From January of 2000 to January of 2006, 240 patients with lung cancer, most (64%) of whom were male, were treated. The most common histological type was squamous cell carcinoma (37.5%), followed by adenocarcinoma (30%), neuroendocrine carcinoma (19.6%) and large cell carcinoma (6.6%). Only 131 patients (54.6%) were treated. Of those, 52 patients (39.7%) received only chemotherapy, 32 (24.4%) were treated with chemotherapy combined with radiotherapy, and 47 (35.9%) were submitted to surgery alone or surgery accompanied by chemotherapy, with or without radiotherapy. Only 27 patients (20.6%) were submitted to surgery alone. Concerning staging, 34.4% presented stage IV at the time of diagnosis, 20.6% presented stage IIIB, 16.8% presented stage IIIA, and the remaining 28.2% were classified as stage I or II. Five-year survival was 65% for those in stage I and 25% for those in the remaining stages. CONCLUSIONS: Of the various histological types, the most common was squamous cell carcinoma and the least common was large cell carcinoma. Most cases presented advanced stages at the moment of diagnosis, and less than 30% of the cases presented early stages. This accounts for the low survival rate and the small number of patients submitted to surgical treatment alone, the majority being submitted to chemotherapy alone.

Câncer de pulmão: histologia, estádio, tratamento e sobrevida / Lung cancer: histology, staging, treatment and survival

OBJETIVO: Analisar os principais tipos histológicos, estádio, tratamento e sobrevida dos portadores de câncer de pulmão. MÉTODOS: Estudo retrospectivo a partir da análise dos prontuários de pacientes acompanhados no Hospital das Clínicas da Faculdade de Medicina de Botucatu, num período de seis anos. RESULTADOS: De janeiro de 2000 a janeiro de 2006, foram acompanhados 240 doentes com câncer de pulmão, com predominância do sexo masculino (64 por cento). O tipo histológico mais freqüente foi o carcinoma escamoso (37,5 por cento), seguido pelo adenocarcinoma (30 por cento), carcinoma neuroendócrino (19,6 por cento) e carcinoma de grandes células (6,6 por cento). Apenas 131 pacientes (54,6 por cento) foram tratados. Destes, 52 pacientes (39,7 por cento) foram submetidos à quimioterapia exclusiva, 32 (24,4 por cento) realizaram quimioterapia associada à radioterapia e 47 (35,9 por cento) foram submetidos à cirurgia associada ou não à quimioterapia exclusiva e/ou radioterapia. Somente 27 pacientes (20,6 por cento) foram submetidos à cirurgia exclusiva.Em relação ao estadiamento, 34,4 por cento apresentavam, no momento do diagnóstico, estádio IV, 20,6 por cento estádio IIIB, 16,8 por cento estádio IIIA e os outros 28,2 por cento pertenciam aos estádios I e II. A sobrevida em cinco anos foi de 65 por cento para o estádio I e 25 por cento para os estádios remanescentes. CONCLUSÕES: O tipo histológico predominante foi o carcinoma escamoso e o de menor freqüência foi o carcinoma de grandes células. A maioria se encontrava em estádio avançado ao diagnóstico, estando nos estádios iniciais menos de 30 por cento dos casos. Isto justifica a baixa sobrevida e a pequena quantidade de pacientes submetidos ao tratamento cirúrgico exclusivo, em comparação à maioria que foi submetida à quimioterapia exclusiva.

OBJECTIVE: To analyze principal histological types of lung cancer, as well as the staging, treatment and survival of lung cancer patients. METHODS: This was a retrospective study based on the analysis of medical charts of patients treated at the Botucatu School of Medicine Hospital das Clínicas over a six-year period. RESULTS: From January of 2000 to January of 2006, 240 patients with lung cancer, most (64 percent) of whom were male, were treated. The most common histological type was squamous cell carcinoma (37.5 percent), followed by adenocarcinoma (30 percent), neuroendocrine carcinoma (19.6 percent) and large cell carcinoma (6.6 percent). Only 131 patients (54.6 percent) were treated. Of those, 52 patients (39.7 percent) received only chemotherapy, 32 (24.4 percent) were treated with chemotherapy combined with radiotherapy, and 47 (35.9 percent) were submitted to surgery alone or surgery accompanied by chemotherapy, with or without radiotherapy. Only 27 patients (20.6 percent) were submitted to surgery alone. Concerning staging, 34.4 percent presented stage IV at the time of diagnosis, 20.6 percent presented stage IIIB, 16.8 percent presented stage IIIA, and the remaining 28.2 percent were classified as stage I or II. Five-year survival was 65 percent for those in stage I and 25 percent for those in the remaining stages. CONCLUSIONS: Of the various histological types, the most common was squamous cell carcinoma and the least common was large cell carcinoma. Most cases presented advanced stages at the moment of diagnosis, and less than 30 percent of the cases presented early stages. This accounts for the low survival rate and the small number of patients submitted to surgical treatment alone, the majority being submitted to chemotherapy alone.

Osteocondromatose múltipla hereditária com envolvimento costal / Rib involvement in hereditary multiple osteochondromatosis

This is a case report on Hereditary Multiple Osteochondromatosis (HMO) with rib involvement. The authors present aspects of thoracic surface anatomy, and thoracic images (X-rays, computed tomography, magnetic nuclear resonance), as well as the operating procedure.

Condroma pulmonar isolado: caso incompleto da tríade de Carney? / Isolated pulmonary chondroma: a case of incomplete Carney triad?

Um homem, de 45 anos, com infecções pulmonares de repetição havia quatro anos apresentou-se com tosse, secreção amarelada, escarros hemópticos e dor torácica não pleural. A tomografia revelou nódulo calcificado ocluindo brônquio lobar inferior direito. Realizada bilobectomia inferior e média, o exame histopatológico revelou condroma endobrônquico, bem circunscrito. O condroma pulmonar é um tumor raro, em geral associado à tríade de Carney (condroma, leiomiossarcoma gástrico e paraganglioma extra-adrenal), sendo o menos freqüente dos três componentes. No presente caso, os outros dois componentes não foram observados. Podem, entretanto, se manifestar tardiamente, sendo, assim, necessário seguimento clínico em longo prazo do paciente.

Compensatory lung growth: protein, DNA and RNA lung contents in undernourished trilobectomized rats.

PURPOSE: To demonstrate compensatory lung growth (CLG) by lung contents of proteins, DNA, and RNA in undernourished young adult rats, submitted to pulmonary trilobectomy. METHODS: We used 137 male Wistar rats, randomly distributed into 9 groups; they were submitted to three treatments (control, thoracotomy, and trilobectomy), and sacrificed at three different times (7, 30, and 90 days). In trilobectomy we removed the right median, accessory, and caudal lobes. We studied lung proteins, DNA, and RNA contents. RESULTS: In the cranial lobe and left lung, protein content was higher in trilobectomized rats however there was insufficient CLG to make up for the loss. The increase of DNA in the cranial lobe and left lung of trilobectomized rats was sufficient to compensate for this loss, resulting in a similar content to controls. RNA content in trilobectomized rats, was higher in the cranial lobe and left lung, more efficient in the cranial lobe, but less than in the other groups. CONCLUSIONS: CLG occurred in trilobectomized rats, probably with cell hyperplasia and little hypertrophy, due to the large DNA compensation and small RNA compensation. This was markedly different to well-nourished animals, who had pronounced hypertrophy.

Compensatory lung growth: protein, DNA and RNA lung contents in undernourished trilobectomized rats

OBJETIVO: demonstrar se ocorre crescimento pulmonar compensatório (CPC) representado pelos conteúdos de proteínas, DNA e RNA no rato adulto jovem, subnutrido, submetido à trilobectomia pulmonar. MÉTODOS: Utilizamos 137 ratos "Wistar", machos, distribuídos por sorteio, em 9 grupos, submetidos a três tratamentos (controle, toracotomia, trilobectomia), sacrificados em três momentos (7, 30 e 90 dias). Na trilobectomia foram extirpados os lobos médio, acessório e caudal direitos. Variáveis estudadas: conteúdos pulmonares de proteínas, DNA e RNA. RESULTADOS: No lobo cranial e pulmão esquerdo o conteúdo protéico foi maior nos trilobectomizados. Ocorreu CPC insuficiente para suprir a perda desta variável, sendo menor nos pulmões dos trilobectomizados. O incremento nos conteúdos de DNA do lobo cranial e pulmão esquerdo dos trilobectomizados foram suficientes para compensar a perda desta variável, resultando num conteúdo de DNA dos pulmões semelhante aos controle. O conteúdo de RNA, nos trilobectomizados, foi maior no lobo cranial e pulmão esquerdo, com maior eficiência no primeiro, insuficiente para que se aproximassem aos obtidos nos demais grupos, ficando menores. CONCLUSÃO: Nos trilobectomizados ocorreu CPC, provavelmente com hiperplasia celular e pouca hipertrofia, devido a grande compensação do DNA e pequena do RNA. Esta foi a grande diferença quando comparamos este resultado ao obtido com animais nutridos, que apresentavam hipertrofia pronunciada.

Crescimento pulmonar compensatório (CPC): massa corpórea, conteúdo protéico e massa pulmonares em ratos subnutridos trilobectomizados / Compensatory lung growth: body mass, protein content and lung mass in undernourished trilobectomized rats

OBJETIVO:Avaliar o comportamento bioquímico do CPC após trilobectomia no rato adulto jovem subnutrido. MÉTODOS: Foram utilizados 137 ratos "Wistar", machos, subnutridos pela oferta de 33 por cento da ingestão diária normal na fase de adaptação e durante o experimento, distribuídos por sorteio, em 9 grupos experimentais, submetidos a três tratamentos (Controle, Toracotomia, Trilobectomia) e sacrificados em três momentos (7, 30 e 90 dias). Na Trilobectomia foram extirpados os lobos médio, acessório e caudal direitos, que representavam 55 por cento do tecido pulmonar. Estudou-se os seguintes atributos e variáveis: massa corpórea e pulmonar, relação entre massa pulmonar e corpórea e conteúdos protéicos pulmonares. RESULTADOS: No lobo cranial e no pulmão esquerdo, tanto a massa quanto os conteúdos protéicos, nos trilobectomizados, foram maiores em todos os momentos do estudo quando comparados aos demais, sendo este aumento suficiente para compensar a perda dos três lobos. Os conteúdos protéicos do lobo cranial e do pulmão esquerdo, nos trilobectomizados, tiveram o mesmo comportamento da massa pulmonar, mas este aumento não foi suficiente para compensar a perda dos três lobos. CONCLUSÕES: Nos ratos adultos subnutridos trilobectomizados ocorre CPC. A recuperação da massa pulmonar é total, mas o conteúdo protéico pulmonar apesar de aumentar, não chega aos valores dos ratos não trilobectomizados.

Resultado da timectomia ampliada no tratamento de pacientes com Miastenia gravis / Extended thymectomy for treating patients with Myasthenia gravis (MG)

INTRODUÇAO: Diversas variações da timectomia podem ser realizadas, dentre elas a transesternal ampliada. A literatura sugere que, quanto mais extenso o procedimento para ressecção da glândula e tecidos do mediastino anterior, melhores os resultados e prognóstico. OBJETIVO: Avaliar retrospectivamente a resposta à timectomia ampliada em portadores de Miastenia gravis. MÉTODO: Foram avaliados 46 portadores de Miastenia gravis, submetidos à plasmaferese pré-operatória e à timectomia ampliada, entre agosto de 1992 e janeiro de 2003, divididos em três grupos, segundo o tempo decorrido desde o início dos sintomas: menor que 12 meses, 13 a 24 meses e maior que 25 meses. RESULTADOS: Trinta e um pacientes eram do sexo feminino e 15 do masculino. A média de idade foi de 30 anos. O tempo médio de evolução da doença foi de 26,3 meses. O acompanhamento ambulatorial pós-operatório foi em média de 26,6 meses. Quanto ao grau de resposta à timectomia, 89 por cento dos pacientes tiveram boa resposta, sendo que 50 por cento apresentaram remissão completa. Ocorreu um óbito nesta série. O exame anatomopatológico demonstrou que a hiperplasia tímica foi o achado mais freqüente. Apenas 3 pacientes (6,5 por cento) apresentaram timomas benignos. Em 5 pacientes (10,8 por cento) encontramos tecido tímico extraglandular: na gordura peritímica em 2 deles, na gordura pericárdica em 1, junto ao nervo frênico esquerdo em outro e na janela aorto-pulmonar em outro. CONCLUSAO: A timectomia ampliada para tratamento da Miastenia gravis mostrou-se segura, eficiente, e apresentou alta porcentagem de remissão completa. Houve a detecção de tecido tímico extraglandular em alguns pacientes. Tão logo seja feito o diagnóstico, está indicada como terapêutica associada à plasmaferese pré-operatória e à medicamentosa, independentemente da idade, patologia tímica, e início dos sintomas.

Pseudotumor inflamatório do pulmão / Inflammatory pseudotumor of the lung

We report a case of a ten year old boy with an inflammatory pseudotumor in the right upper lobe. Surgical excision was undertaken. Inflammatory pseudotumors of the lung often occur in children. We recommend complete resection for diagnosis and cure. This tumor can mimic malignant neoplastic lesions and can recur after surgical treatment.

Compensatory lung growth: lung protein, DNA and RNA contents in trilobectomized rats

Aiming at assessing compensatory lung growth after trilobectomy in rats, 3 groups of animals (control, thoracotomy and trilobectomy) were studied over 3 time intervals (7, 30 and 180 days post-operation). Protein. DNA and RNA contents in each lung were evaluated. The study of the left lung protein content reveals that compensatory growth ceased by day 30, whereas it continued to occur in the cranial lobe as long as 180 days post-operation. The lung DNA content in trilobectomized animals remained smaller than in the animals of the other groups demonstrating that compensatory growth was not brought about by hyperplasia. The lung RNA content in trilobectomized animals increased similarly to the lung protein content, demonstrating that the cells of the lung tissue must have had an increase in volume as no significant increase in their number occurred, as shown by the analysis of the lung DNA content. Therefore, it may be concluded that, in our experiment with adult animals, compensatory lung gowth after trilobectomy in rats occured due to an increase in the lung protein content and RNA content, suggesting a cellular volume increase (hypertrophy) and a probable increase in the intraveolar septs rather than an important cell multiplication.

Biópsia pulmonar a céu aberto: quando indicar? / Open-lung biopsy: when to indicate?

Os autores objetivaram avaliar as correlações entre o momento da indicação da biópsia pulmonar a céu aberto, o estado clínico do paciente e as complicações decorridas. Foram analisados 34 pacientes de novembro de 1974 a abril de 1995. Os pacientes incluídos no estudo foram classificados, segundo o seu estado físico e risco anestésico-cirúrgico, pelo sistema da Sociedade Americana de Anestesiologia (ASA) nos víveis I, II, III, IV e V. Também foram agrupados, de acordo com o padrão respiratório, nas seguintes categorias: não-comprometidos, uso de oxigenoterapia, indicação de intubação e ventilação mecânica.

The objective of this work was to avaliate the correlations between the moment of open-lung biopsy indication, the patient clinical status and its complications. Thirty-four patients were studied in the period of november of 1974 to april of 1995. They were classified by their physical status and anaesthetic surgery risc by ASA on, I, II, II, IV and V levels and they were classed according to the respiratory standard in: no compromise, requiring oxygen therapy, met intubation and mechanical ventilation.

Compensatory lung growth: lung mass and protein content in trilobectomized rats

Aiming at assessing compensatory lung growth after trilobectomy in rats, 3 groups of animals (control, thoracotomy and trilobectomy) were studied over 3 time intervals (7,30 and 180 days post-operation). Body mass, lung mass and protein content in each lung were evaluated. The results reveal that, in trilobectomy animals, the remaining lung mass was restored by day 7. A fast growth rate was observed in both the left lung and cranial lobe over the 7 first days after trilobectomy. Total lung protein behaved similarly to total lung mass, demonstrating that lung mass and total protein increased proportionally. In the left lung, both mass and protein content ceased to increase by day 30, whereas in the cranial lobe this increasing still occurred by day 180. Therefore, it may be concluded that, in our experiment, compensatory lung growth after trilobectomy in adult rats occurred due to an increase in the lung protein content, suggesting a cellular volume increase (hypertrophy).

Estenose subglótica / Stenosis subglottic

No presente trabalho, relatamos 19 casos de estenose laringotraqueal. Destes casos, 15 eram de estenose subglótica, 1 de traquéia e, em outros 2 casos, observamos comprometimento de estensas áareas da laringe e traquéia devido às alteraçöes causadas por doenças inflamatórias crônicas. Em 11 pacientes, foi realizada a reconstruçäo laringotraqueal com a técnica de enxerto de cartilagem costal, laringofissura e colocaçäo de molde. As dificuldades maiores, em relaçäo à técnica, foram observadas, principalmente em crianças, quando da retirada da cânula de traqueostomia devido à formaçäo de tecido de granulaçäo no orifício e na luz traqueal, e a estenose parcial subglótica.