Edson Mendes Boasquevisque

Effect of extract of medicinal plants on the labeling of blood elements with Technetium-99m and on the morphology of red blood cells: I—a study with Paullinia cupana

Drugs can alter the labeling and the morphology of red blood cells. As Paullinia cupana is used in popular medicine, we evaluated its influence on the labeling process using technetium-99m (Tc-99m). Blood was incubated with P. cupana, stannous chloride and Tc-99m. Samples were centrifuged and plasma (P) and blood cells (BC) were separated and precipitated with trichloroacetic acid. Soluble (SF) and insoluble fractions (IF) were isolated. The morphology of the blood cells was evaluated under an optical microscope. The results showed a significant (P = 0.05) decrease in the uptake of radioactivity for the RBC (97.93 +/- 0.74 to 36.90 +/- 4.71%), in IF-P and in IF-BC due to P. cupana extract. The study of the morphology of the RBC revealed alterations in the shape of these cells. We suggest that the P. cupana effect could be explained by an inhibition of the stannous and pertechnetate ions or oxidation of the stannous ion or by damages in the plasma membrane.

Effects of dual blockade of the renin angiotensin system in hypertensive type 2 diabetic patients with nephropathy

AIM To evaluate the effects of combined treatment of an ACE inhibitor and an angiotensin II receptor antagonist on parameters related to the progression of renal disease in type 2 diabetic patients. METHODS 20 hypertensive type 2 diabetic patients with non-nephrotic proteinuria (0.5 - 3.0 g/day) and estimated creatinine clearance > or = 40 ml/min/1.73m2 were randomly assigned to be treated with perindopril 8 mg/day (Per), irbesartan 300 mg/day (Irb) or a combination of both with the same doses (Per + Irb). Each treatment phase lasting 16 weeks was preceded by a four-week washout period. Diuretics, clonidine and hydralazine were used as supplementary drugs for blood pressure control. Patients were evaluated at baseline and at the end of each treatment phase. RESULTS 15 (3M/12F) patients completed all the phases. Use of Per, Irb and Per + Irb led to a reduction in 24-hour mean blood pressure of 6 mmHg, 4 mmHg and 4 mmHg, respectively. Changes in glomerular filtration rate were not significant at any phase. Renal plasma flow was significantly more elevated with Irb than Per. Treatment with both Irb and Per + Irb induced similar plasma renin elevation, but treatment with Per did not, suggesting escape. Plasma aldosterone was reduced only by treatment with Per + Irb (-36%, p < 0.02). Reduction in proteinuria during Per + Irb (-33%) was not significantly different from Per (-34%) or Irb (-22%). Urinary transforming growth factor beta1 (TGF-beta1) excretion was significantly reduced with both Irb (-24%, p < 0.05) and Per + Irb (-36%, p < 0.05) but not with Per (-11%, p = 0.60). CONCLUSION Only combined therapy with irbesartan plus perindopril concurrently reduces plasma aldosterone, proteinuria and urinary TGF-beta1.

The effect of mitomycin-C on the biodistribution of 99Tcm-MDP in Balb/c mice

Drug therapy can alter the biodistribution of radiopharmaceuticals. We studied the effect of mitomycin-C, a drug used in oncology, on the biodistribution in mice of 99Tcm-methylene diphosphonic acid (99Tcm-MDP). Three doses of mitomycin-C were administered. After the last dose, 99Tcm-MDP was injected and the animals were killed. The organs were isolated, their weight determined and the percent per gram injected dose (%ID/g) calculated. The %ID/g had increased in the pancreas, ovary, stomach, uterus, kidneys, spleen, thymus, heart, liver and lungs, but did not change significantly in thyroid, bone or brain. As a change in 99Tcm-MDP uptake by bone is not observed, a modification to bone scintigraphy is not required. As mitomycin-C treatment altered 99Tcm-MDP uptake in some organs, any hot spots should be evaluated carefully to avoid a misdiagnosis.

Bacterial clearance after total splenectomy and splenic autotransplantation in rats

Wistar rats submitted to isolated total splenectomy or total splenectomy combined with splenic autotransplantation were inoculated with 99mtechnetium-labeled Escherichia coli. Measurement of isotope uptake in the organs of the mononuclear phagocytic system showed a greater bacterial bloodstream clearance in rats with splenic autotransplantation. Although uptake of bacteria in the spleen was higher in the control group, the number of bacteria remaining in the bloodstream did not differ between groups. These results indicate that splenic autotransplantation preserves the phagocytic function of the spleen.

Variações anatômicas do complexo ostiomeatal: achados tomográficos em 200 pacientes

OBJETIVO: O objetivo deste trabalho foi verificar a frequencia e os tipos de variacoes anatomicas do com-plexo ostiomeatal. MATERIAIS E METODOS: Foram revisadas 200 tomografias computadorizadas de pa-cientes com suspeita clinica de sinusopatia. RESULTADOS: Observamos um ou mais tipos de variacoes ana-tomicas em 83,5% dos pacientes, as mais frequentes envolvendo o corneto medio (84%) e o septo nasal(34%). Outras variantes anatomicas comuns encontradas foram a presenca de aeracao do agger nasi e celulasetmoidais infra-orbitarias (celulas de Haller). CONCLUSAO: As variacoes anatomicas do complexo ostio-meatal anterior sao muito corriqueiras. As mais frequentes envolvem o corneto medio e o septo nasal.Unitermos: Tomografia computadorizada; Complexo ostiomeatal; Cavidades paranasais; Anatomia; Drena-gem.OBJECTIVE: The present study was aimed at evaluating the frequency and types of anatomical variants ofthe ostiomeatal complex. MATERIALS AND METHODS: Computed tomography studies of 200 patientsevaluated for clinical suspicion of sinusopathy were reviewed. RESULTS: Two or more types of anatomicalvariants were observed in 83.5% of the patients. The most frequent anatomical variants involved the middleturbinate (84%) and the nasal septum (34%). Other common variants found were the presence of pneumatizedagger nasi cells and infraorbital ethmoid cells (Haller cells). CONCLUSION: The prevalence of anatomicalvariants in the ostiomeatal complex is high, the most frequent ones involving the middle turbinate and thenasal septum.Keywords: Computed tomography; Ostiomeatal complex; Paranasal cavities; Anatomy; Drainage.

Assessment of the effect of vincristine on the biodistribution of 99Tcm-labelled glucoheptonic acid in female Balb/c mice.

There is evidence that the biodistribution and the pharmacokinetics of 99Tcm radiopharmaceuticals can be modified by some drugs, pathological states, irradiation and surgical procedures. Vincristine have been widely used in various chemotherapeutic protocols in oncology. We are trying to develop an animal model to assess the toxicology in different organs of compounds used as therapeutic drugs. We have studied the effect of vincristine on the distribution of 99Tcm-glucoheptonic acid (99Tcm-GHA) in female mice. After the last dose of vincristine, 99Tcm-GHA (7.4 MBq) was injected, the animals sacrificed and the percentage of radioactivity determined in the isolated organs. The percentage of activity was significantly decreased in the uterus, ovary, spleen, thymus, lymph nodes (inguinal and mesenteric), kidney and heart, but was not significantly altered in the lung, liver, pancreas, stomach, thyroid, brain and bone. Our results can be explained by the metabolic, toxic, therapeutic and immunosuppressive actions of this chemotherapeutic drug.

Comprometimento órbito-craniano por tumores malignos sinonasais: estudo por tomografia computadorizada

Tumores malignos das cavidades sinonasais sao raros e frequentemente diagnosticados em estagio avancado da doenca. A extensao destes tumores para locais criticos como a orbita e o crânio gera dificuldades no tratamento destas lesoes. Dez pacientes com neoplasia maligna sinonasal, sem qualquer tratamento previo e com evidencia radiologica de extensao orbito-craniana, foram estudados por tomografia computadorizada. Dos dez tumores, cinco (50%) foram neoplasias epiteliais, tendo sido a mais comum o carcinoma epidermoide (tres casos). O sitio de origem tumoral mais comum foi o seio etmoidal, em quatro pacientes (40%), seguido pelo seio maxilar (30%) e pela fossa nasal (30%). Dezesseis orbitas foram comprometidas, ja que seis pacientes (60%) apresentaram acometimento orbitario tumoral bilateral. Os tumores se estenderam mais frequentemente para as orbitas atraves de erosao da parede medial e do soalho orbitarios. A maioria das orbitas teve todos os compartimentos acometidos. Extensao dos tumores para a cavidade craniana foi mais comum atraves do teto etmoidal (70%) e teto orbitario (30%). A fossa craniana anterior foi acometida em oito casos (80%), seguida pela fossa craniana media (40%) e pelo lobo frontal (excluindo-se a fossa anterior) (30%). Trinta e sete regioes da face foram acometidas pelos dez tumores, excluindo-se o sitio de origem da neoplasia e a regiao orbito-craniana, corroborando a grande extensao loco-regional do tumor no momento do diagnostico.

Tumores malignos da cavidade nasal: avaliação por tomografia computadorizada

OBJETIVO: Analisar os aspectos tomograficos dos tumores malignos da cavidade nasal. MATERIAIS E METODOS: Foram estudados 18 pacientes - dez homens e oito mulheres - com tumor da cavidade nasal, os quais realizaram tomografia computadorizada da face. RESULTADOS: Dos tumores, seis eram casos de carcinoma epidermoide, tres melanomas, dois carcinomas adenoides cisticos, um adenocarcinoma polimorfico de baixo grau, um carcinoma indiferenciado, um carcinoma neuroendocrino, um linfoma nao-Hodgkin, um rabdomiossarcoma alveolar, um sarcoma fusocelular grau II e um estesioneuroblastoma. As lesoes foram mais frequentes (p > 0,05) no lado esquerdo e no andar medio. CONCLUSAO: Os carcinomas epidermoides apresentam grau de destruicao correspondente ao seu volume, semelhante aos tumores epidermoides de outros sitios. O septo nasal foi acometido de maneira diferente, de acordo com os tipos histologicos.

Alterações parenquimatosas na trombose venosa cerebral: aspectos da ressonância magnética e da angiorressonância

OBJETIVO: Determinar a frequencia e localizacao das alteracoes parenquimatosas da trombose venosa cerebral nos exames de ressonância magnetica e de angiorressonância, bem como a correlacao com o territorio e a drenagem venosa comprometida. MATERIAIS E METODOS: Foram analisados exames de 21 pacientes realizados entre 1996 e 2004, com diagnostico clinico e radiologico de trombose venosa cerebral em exames de ressonância magnetica e de angiorressonância nas sequencias 2D PC, 3D PC e 3D TOF com contraste paramagnetico. Analise estatistica foi realizada com o teste do qui quadrado. Quatro pacientes tinham exames de controle e tres realizaram angiografia por subtracao digital. RESULTADOS: Dos 21 pacientes, 18 eram mulheres, todos com idade entre tres e 82 anos (media de 40 anos e mediana de 36 anos). Os principais fatores etiologicos foram infeccao, uso de contraceptivos orais, reposicao hormonal e colagenoses. Predominaram os sintomas de deficit focal, cefaleia, alteracao do nivel de consciencia e convulsoes. Por frequencia, as manifestacoes parenquimatosas foram: edema/infarto de distribuicao cortical e/ou subcortical, congestao venosa e circulacao colateral, realce meningeo e infarto ou edema dos talamos e nucleos da base. Os principais seios comprometidos foram o sagital superior, o transverso esquerdo, o sigmoide esquerdo e o seio reto, sendo incomum o acometimento dos seios cavernosos e de veias corticais. CONCLUSAO: A trombose venosa cerebral e causa incomum de acidente vascular encefalico, com prognostico favoravel pelo carater reversivel das lesoes. Seu diagnostico depende fundamentalmente da capacidade do radiologista reconhecer suas formas de apresentacao, principalmente nos casos em que ele e sugerido pelas alteracoes parenquimatosas e nao necessariamente pela visualizacao do trombo. A precisao e a rapidez no diagnostico permitem o pronto tratamento, reduzindo a morbi-mortalidade da doenca. Unitermos: Ressonância magnetica; Trombose venosa cerebral; Infarto cerebral; Hemorragia intracraniana. Parenchymal abnormalities in cerebral venous thrombosis: findings of magnetic resonance imaging and magnetic resonance angiography. OBJECTIVE: To determine the frequency and localization of parenchymal abnormalities in cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography as well as their correlation with the territory and affected venous drainage. MATERIALS AND METHODS: Retrospective analysis (1996 to 2004) of 21 patients (3 male and 18 female) age range between 3 and 82 years (mean 40 years, median 36 years) with clinical and radiological diagnosis of cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography in 2D PC, 3D PC and contrast-enhanced 3D TOF sequences. The statistical analysis was performed with the qui-square test. Four patients had follow-up exams and three patients underwent digital subtraction angiography. RESULTS: Main predisposing factors were: infection, use of oral contraceptives, hormone replacement therapy and collagenosis. Predominant symptoms included: focal deficit, headache, alteration of consciousness level and seizures. Most frequent parenchymal manifestations were: cortical/subcortical edema or infarct, venous congestion and collateral circulation, meningeal enhancement and thalamic and basal ganglia edema or infarct. Occlusion occurred mainly in superior sagittal, left transverse, left sigmoid and straight sinuses. Cavernous sinus and cortical veins thrombosis are uncommon events. CONCLUSION: Cerebral venous thrombosis is an uncommon cause of stroke, with favorable prognosis because of its reversibility. Diagnosis is highly dependent on the radiologist capacity to recognize the presentations of this disease, principally in cases where the diagnosis is suggested by parenchymal abnormalities rather than necessarily by visualization of the thrombus itself. An accurate and rapid

Proptose ocular como manifestação clínica de tumores malignos extra-orbitários: estudo pela tomografia computadorizada

Systemic diseases, primary orbital diseases and extraorbital lesions extending into the orbit may lead to ocular proptosis. Eleven patients with ocular proptosis caused by non previously treated extraorbital malignant tumors were studied with computed tomography. Nonepithelial neoplasms were the most common tumors (82%) including three rabdomyosarcomas (27%), three non-Hodgkins lymphomas (27%), and other sarcomas in two patients (18%). Squamous cell carcinoma (9%), Burkitts lymphoma (9%) and poorly differentiated carcinoma (9%) were also identified. The most common primary sites of the tumors were the sinonasal cavities (nine cases; 82%), particularly the ethmoidal sinus (five cases). Ocular proptosis was the only ophthalmic sign in four patients (36%) whereas one patient had bilateral ocular proptosis as the only sign of disease. Seventeen orbits were involved due to six patients had bilateral tumor extension into the orbits. Tumor extension into the orbits was mainly through the orbital bone (16 orbits; 94%). There was involvement of all compartments in most of the orbits (59%). The tumor was extraconal in 16 orbits. Computed tomography revealed ocular proptosis in 15 of the 17 orbits (88%), which was bilateral in four cases (eight orbits). Grade 2 ocular proptosis was observed in seven patients (47%). Forty-four regions of the face and skull were involved, excluding the orbits and the primary site of the tumor, indicating extensive loco-regional disease at the time of the diagnosis.