RATIONALE AND OBJECTIVES: Pulmonary contour extraction from thoracic x-ray computed tomography images is a mandatory preprocessing step in many automated or semiautomated analysis tasks. This study was conducted to quantitatively assess the performance of a method for pulmonary contour extraction and region identification. MATERIALS AND METHODS: The automatically extracted contours were statistically compared with manually drawn pulmonary contours detected by six radiologists on a set of 30 images. Exploratory data analysis, nonparametric statistical tests, and multivariate analysis were used, on the data obtained using several figures of merit, to perform a study of the interobserver variability among the six radiologists and the contour extraction method. The intraobserver variability of two human observers was also studied. RESULTS: In addition to a strong consistency among all of the quality indexes used, a wider interobserver variability was found among the radiologists than the variability of the contour extraction method when compared with each radiologist. The extraction method exhibits a similar behavior (as a pulmonary contour detector), to the six radiologists, for the used image set. CONCLUSION: As an overall result of the application of this evaluation methodology...
A case of a 23-year-old woman with a paraovarian tumor is presented. The patient complained of pelvic pain and abdominal swelling. Cystectomy was the initial surgical treatment, but after the histological diagnosis, a staging surgery was carried out. The clinical aspects and subsequent management of related cases are discussed, and a literature review is made.
Trimetazidine is an anti-ischemic drug whose cytoprotective mechanisms are not yet fully understood (but until now mainly related to the trimetazidine-induced "metabolic shift" from lipid beta-oxidation to glucose aerobic oxidation). We studied the effect of trimetazidine on the mitochondrial function of ischemic Wistar rat hearts perfused with glucose, using a model of ex-vivo perfusion (Langendorff system). We measured the electrical potential of the mitochondrial membrane, O2 consumption by the respiratory chain, energy charges generated and the enzyme activities of the respiratory chain complexes. In this model, trimetazidine had a preferential action on the oxidative system (mainly on complex I), increasing its enzyme activity and decreasing O2 consumption after phosphorylation; this could decrease oxygen free radical production and increase mitochondrial integrity, thus allowing the maintenance of the electrical potential. These results allow us to better understand the cytoprotective effects of trimetazidine in coronary artery disease.
OBJECTIVES: The cardioprotective effects of carvedilol (CV) may be explained in part by interactions with heart mitochondria. The objective of this work was to study the protection afforded by CV against oxidative stress induced in isolated heart mitochondria by hypoxanthine and xanthine oxidase (HX/XO), a well-known source of reactive oxygen species (ROS) in the cardiovascular system. METHODS: Mitochondria were isolated from Wistar rat hearts (n = 8) and incubated with HX/XO in the presence and in the absence of calcium. Several methods were used to assess the protection afforded by CV: evaluation of mitochondrial volume changes (by measuring changes in the optical density of the mitochondrial suspension), calcium uptake and release (with a fluorescent probe, Calcium Green 5-N) and mitochondrial respiration (with a Clark-type oxygen electrode). RESULTS: CV decreased mitochondrial damage associated with ROS production by HX and XO, as verified by the reduction of mitochondrial swelling and increase in mitochondrial calcium uptake. In the presence of HX and XO, CV also ameliorated mitochondrial respiration in the active phosphorylation state and prevented decrease in the respiratory control ratio (p < 0.05) and in mitochondrial phosphorylative efficiency (p < 0.001). CONCLUSIONS: The data indicate that CV partly protected heart mitochondria from oxidative damage induced by HX and XO...
BACKGROUND: Psoriasis is a chronic and recurrent inflammatory skin disease. The inflammatory response represents a fundamental ability of the organism to protect itself from infectious agents and from injury. OBJECTIVES: To evaluate the inflammatory response in mild and in severe psoriasis, to evaluate the endogenous systems counterbalancing the deleterious effects of the inflammation products, and to establish values of prognostic significance. METHODS: The study was performed in a control group (n = 40) and in 60 patients with psoriasis vulgaris, half presenting with mild psoriasis, and the other half with severe psoriasis. We evaluated total and differential leucocyte count; elastase, lactoferrin and lipid peroxidation as markers of neutrophil activation; total plasma antioxidant capacity (TAS), transferrin, ceruloplasmin, alpha(1)-antitrypsin and alpha(2)-macroglobulin as markers of the endogenous antioxidant and antiprotease systems; and fibrinogen, erythrocyte sedimentation rate, C-reactive protein (CRP), haptoglobin, C3 and C4 complement proteins as markers of inflammation. RESULTS: Our data suggested that psoriasis is an inflammatory condition in which neutrophils seem to play a crucial role by contributing to the development of oxidative and proteolytic stress. The worsening of the disease seemed to be linked to the enhancement of the inflammatory response and of the imbalance between neutrophil activation products and their inhibitors. CONCLUSIONS: We propose values for elastase...
Brucella endocarditis was diagnosed in two patients with acute renal failure. Both patients had major aortic insufficiency, congestive cardiac failure and clinical and laboratory signs of an active infection, although adequate antibacterial therapy had already been introduced. Replacement of the aortic valve, together with the aortic root in one of the cases, were carried out as emergency procedures, followed by antibacterial treatment with rifampicin, doxycycline and co-trimoxazole. Both patients left the hospital cured and are well 2.5 and 2 years after the surgery, respectively.
As fracturas da extremidade superior do fémur são um importante factor de morbilidade e mortalidade após os 60 anos. Várias causas contribuem para a sua incidência. As consequências que delas advêm são extremamente graves e incapacitantes, bem como originam elevados custos na economia nacional. Neste trabalho avalia-se a morbilidade e mortalidade causada por fracturas da extremidade superior do fémur numa população hospitalar, bem como os vários factores que possam ter influência no processo. Pretende-se valorizar a importância da prevenção, do tratamento precoce e da recuperação eficaz desta patologia. Abstract Hip fractures are associated with high morbidity and mortality over the age of 60. Several causes are contributive to their incidence. The consequences of these fractures are extremely severe, carrying high economic costs. We have studied the morbidity and mortality caused by hip fractures in a hospital population and the several factors that may have influence on the process. We intend to underline the value of prevention, early treatment and adequate rehabilitation in this pathology.
A síndrome de Wells, também conhecido como celulite eosinofílica, é uma patologia cutânea rara. As lesões clínicas características incluem pápulas, vesículas ou grandes placas eritematosas, que podem aparecer em toda a superfície corporal, podendo mimetizar um quadro de urticária crónica. Os autores apresentam dois casos clínicos de doentes com o diagnóstico de S. Wells: doente 1, sexo feminino, 41 anos e doente 2, sexo masculino, 40 anos. Ambos apresentavam um quadro clínico de lesões maculopapulares generalizadas, pruriginosas recorrentes, que persistiam pelo menos 24 horas, refractárias a anti -histamínicos, com necessidade frequente de corticoterapia sistémica para controlo sintomatológico. Como sintomas associados salientam -se astenia, mialgias e artralgias. O estudo complementar em ambos os casos excluiu a presença doutra patologia associada e as biópsias cutâneas revelaram celulite eosinofílica. Ambos efectuaram dapsona 100 mg/dia com evolução clínica favorável. Estes casos demonstram a necessidade do estudo histopatológico cutâneo em doentes com lesões urticariformes com necessidade de recorrer frequentemente aos corticóides sistémicos e com reaparecimento das lesões com a redução ou interrupção destes fármacos.
Deciduoid Mesothelioma is a rare variant of epithelioid mesothelioma; it was initially thought that it only occurred in the peritoneum of young women and had nothing to do with asbestos exposure. However, since these early findings it has also been observed in the pleura and the pericardium, with possible association to asbestos. In general the prognosis is poor compared to epithelioid mesothelioma. 45 cases have been reported in the literature up to now, 22 of these were located in the pleural cavity. The authors describe a case of deciduoid pleural mesothelioma in a 40-year-old-woman who presented with right pleuritic chest pain, with no history of asbestos exposure, treated with chemotherapy followed by surgery and who died postoperatively.
The present work compares bone allografts with synthetic hydroxyapatite regarding density, porosity, pore size distribution and phase identification. The measurement of these parameters enables a more complete knowledge of the grafts structural properties, which necessarily leads to a better selection of the most appropriate bone substitutes.
O trabalho inclui conceitos gerais sobre a patologia cirúrgica da anca e da bacia, sob a forma de um sumário alargado, versando os seguintes temas:
fraturas e luxações do anel pélvico; fraturas do acetábulo; fraturas da coluna sacrococcígea; luxações da anca; fraturas da cabeça femoral; fraturas do colo femoral; fraturas da região trocanteriana; fraturas da diáfise femoral; displasia de desenvolvimento da anca; doença de Legg-Calvé-Perthes; sinovite transitória da anca; epifisiólise femoral superior; necrose assética da cabeça do fémur; coxartrose; conflito femoroacetabular.