Conjunctival epithelial cells cultivated ex vivo from patients with total limbal stem cell deficiency.

PURPOSE: Reconstruction of the ocular surface is challenging. As an alternative to mucosal and limbal epithelial, we study the feasibility of cultivated human conjunctival epithelial (HCjE) cells of patients with total limbal stem cell deficiency (LSCD). METHODS: We studied superior forniceal conjunctival biopsies harvested from 9 living donors with total LSCD of several etiologies who underwent surgery for ocular surface reconstruction. The conjunctival explants were cultivated on serum and growth factor supplemented DMEM/F12 under submerged conditions on denuded human amniotic membrane and tissue culture dishes. The area of cell growth was assessed. Cell morphology was analyzed by light microscopy, impression cytology, and transmission electron microscopy. Cultures were evaluated for epithelial cytokeratins (CK3, CK19), proliferation marker (Ki-67), and putative stem cells markers (ABCG2 and p63). Confocal immunofluorescence was also performed to assess CK3, CK19, Ki-67, ABCG2, and p63. RESULTS: The HCjE cells cultivated ex vivo were successfully expanded on denuded amniotic membrane but with a slower growth than in the tissue culture dish. Transmission electron microscopy showed stratified epithelium with microvilli, desmosomes, and hemidesmosomes. Impression cytology showed PAS+ cells that resembled goblet cells. Immunocytochemical analysis showed positivity for CK3, CK19, Ki-67, ABCG2, and p63. Confocal immunofluorescence was positive for CK3, CK19, Ki-67, ABCG2, and p63. CONCLUSIONS: Our results showed that it is possible to cultivate HCjE cells ex vivo of patients with ocular surface diseases. This method is important for ocular surface reconstruction in patients with bilateral total LSCD.

Perfil cardiopulmonar do paciente submetido à cirurgia de catarata / Cardiopulmonar outline undergone cataract surgery

Foi estudado um grupo de 285 pacientes portadores de catarata submetidos a um protocolo de avaliaçäo pré-anestésica, com o objetivo de determinar a distribuiçäo em relaçäo ao sexo e faixa etária das doenças sistêmicas mais prevalentes na amostra. A média da idade foi de 69,9 +/- 11,57 anos, e o predomínio foi do sexo feminino, com 172 casos. A distribuiçäo das afecçöes por faixa etária ocorreu de forma similar para ambos os sexos. Entre as patologias, predominaram as doenças cardiovasculares, a hipertensäo arterial sistêmica (HAS) foi a afecçäo mais prevalente, ocorrendo em 162 pacientes. Os valores pressóricos foram distribuídos por faixa etária segundo a classificaçäo do V JOINT, com o predomínio de portadores de HAS classe I, com 109 casos. Outras doenças cardiovasculares detectadas foram angina, com 55 pacientes, arritmias (36) e bloqueio de ramo (29). Entre as pneumopatias, a doença pulmonar obstrutiva crônica predominou, com 39 casos, seguida por asma (7) e tuberculose (6)