RESUMEN
This study aimed at evaluating acute pulmonary remodeling, focusing on alterations of fibers of the collagenous and elastic systems in ARDS in the exudative phase according to the etiology of the disease. ARDS patients (n = 23), who died in our institution between 1989 and 1997, were retrospectively studied. Ten patients who died in accidents, without any pathological changes in the lung, and ten patients with Congestive Heart Failure (CHF), submitted to mechanical ventilation, were used as control groups. Histological slides were sampled from the autopsied lungs and stained by the Picrosirius and Weigert's resorcin-fuchsin methods. The fiber content of the collagenous and elastic systems of the alveolar septum was measured by image analysis. All patients were in the early ARDS phase (n = 23), 10 pulmonary and 13 extra-pulmonary diseases. Collagen content was greater in pulmonary (1.23+/-0.27) than in extra-pulmonary (0.92+/-0.39) ARDS in the early phase of the disease (p = 0.05). No differences were observed concerning the elastic fibers' content. Extracellular matrix (ECM) remodeling occurs early in the development of acute lung injury and appears to depend on the site of initial insult (pulmonary or extrapulmonary). The present study provides the basis for a prospective, controlled investigation.
Asunto(s)
Matriz Extracelular/patología , Alveolos Pulmonares/patología , Síndrome de Dificultad Respiratoria/patología , Cicatrización de Heridas , Enfermedad Aguda , Adolescente , Adulto , Anciano , Colágeno/metabolismo , Tejido Elástico/metabolismo , Tejido Elástico/patología , Matriz Extracelular/metabolismo , Humanos , Procesamiento de Imagen Asistido por Computador , Persona de Mediana Edad , Alveolos Pulmonares/metabolismo , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/fisiopatología , Estudios RetrospectivosRESUMEN
A challenge that research managers have to face is how to "reallocate" agency budgets in order to bring them in line with the results of performance reviews. Research policies must develop a strategic plan describing their goals, devise yardsticks to measure their progress, and tie that performance to allocate research funds with some degree of priority. Though Brazil already has a substantial presence in world's science, scientific enterprise must be used to strengthen it. The first step should be to raise standards in Brazilian science by concentrating the resources on supporting excellence. A strategy to judge biomedical research productivity should include tactics to disclose whether the resulting publications have appeared in the field's most respected, peer-reviewed journals. A pilot project to road-test the above-discussed ideas on performance measurements was conducted at the Laboratories of Medical Research (Clinical Hospital, University of SAsunto(s)
Humanos
, Apoyo a la Investigación como Asunto/estadística & datos numéricos
, Bibliometría
, Investigación/economía
, Brasil
RESUMEN
Em 63 pacientes submetidos a reconstruçao intra-articular do ligamento cruzado anterior com enxerto autógeno do tendao patelar, os autores analisam as dimensoes do tendao patelar do joelho operado e do contralateral nao operado por meio de exame ultra-sonográfico. Cinqüenta e um pacientes sao do sexo masculino e doze, do feminino. As idades variaram de 23 a 47 anos, com média de 30,5 anos. O período do pós-operatório em que os exames foram realizados variou de um a 50 meses, com média de 18,8 meses. Oito pacientes foram submetidos a estudo histológico do tendao patelar remanescente através de biópsia da área doadora de enxerto. O momento do pós-operatório em que as biópsias foram realizadas variou de 33 a 56 meses, com média de 40,8 meses. Observou-se, pela ultra-sonografia, que a largura do tendao patelar doador se equivale à do joelho contralateral a partir do 19§ mês do pós-operatório. A espessura dotendao patelar doador na fase precoce do pós-operatório é de 235 por cento da espessura do tendao patelar contralateral; decresce progressivamente mas mantém-se maior que o lado nao operado em todos os períodos pós-operatório estudados no trabalho. As observaçoes morfológicas demonstraram que o tecido cicatricialformado, embora se assemelhe muito ao normal, nao alcança o mesmo grau de organizaçao original tanto à microscopia de luz quanto à microscopia eletrônica. Observou-se que a reestruturaçao completa dos fascículos nunca foi alcançada nos tendoes patelares operados e que sua composiçao tissular encontrava-se alterada.