RESUMO
OBJECTIVE: This study evaluated the effects of growth hormone (GH) on morphology and myogenic regulatory factors (MRF) gene expression in skeletal muscle of rats with ascending aortic stenosis (AAS) induced chronic heart failure. DESIGN: Male 90-100g Wistar rats were subjected to thoracotomy. AAS was created by placing a stainless-steel clip on the ascending aorta. Twenty five weeks after surgery, rats were treated with daily subcutaneous injections of recombinant human GH (2mg/kg/day; AAS-GH group) or saline (AAS group) for 14 days. Sham-operated animals served as controls. Left ventricular (LV) function was assessed before and after treatment. IGF-1 serum levels were measured by ELISA. After anesthesia, soleus muscle was frozen in liquid nitrogen. Histological sections were stained with HE and picrosirius red to calculate muscle fiber cross-sectional area and collagen fractional area, respectively. MRF myogenin and MyoD expression was analyzed by reverse transcription PCR. RESULTS: Body weight was similar between groups. AAS and AAS-GH groups presented dilated left atrium, left ventricular (LV) hypertrophy (LV mass index: Control 1.90+/-0.15; AAS 3.11+/-0.44; AAS-GH 2.94+/-0.47 g/kg; p<0.05 AAS and AAS-GH vs. Control), and reduced LV posterior wall shortening velocity. Soleus muscle fiber area was significantly lower in AAS than in Control and AAS-GH groups; there was no difference between AAS-GH and Control groups. Collagen fractional area was significantly higher in AAS than Control; AAS-GH did not differ from both Control and AAS groups. Serum IGF-1 levels decreased in AAS compared to Control. MyoD mRNA was significantly higher in AAS-GH than AAS; there was no difference between AAS-GH and Control groups. Myogenin mRNA levels were similar between groups. CONCLUSION: In rats with aortic stenosis-induced heart failure, growth hormone administration increases MyoD gene expression above non-treated animal levels, preserves muscular trophism and attenuates interstitial fibrosis. These results suggest that growth hormone may have a potential role as an adjuvant therapy for chronic heart failure.
Assuntos
Hormônio do Crescimento/farmacologia , Insuficiência Cardíaca/patologia , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/patologia , Animais , Doença Crônica , Modelos Animais de Doenças , Regulação para Baixo/efeitos dos fármacos , Ecocardiografia , Expressão Gênica/efeitos dos fármacos , Insuficiência Cardíaca/sangue , Fator de Crescimento Insulin-Like I/análise , Masculino , Proteína MyoD/genética , Proteína MyoD/metabolismo , Tamanho do Órgão/efeitos dos fármacos , Placebos , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
Craniopharyngiomas and germ cell tumors (GCT) may affect the pituitary-hypothalamic region during childhood. Although different in origin, their clinical and radiological features may be similar. In this article we present a 5-year-old girl with clinical and radiological findings (computer tomography calcification) that were initially considered as craniopharyngioma. However clinical outcome, blood and cerebral spinal fluid tumoral markers, and results from anatomopathology and immunohistochemistry disclosed a mixed GCT. This case report highlights that some clinical features and radiological findings of pituitary-hypothalamic tumors may be misdiagnosed as craniopharyngioma mainly when there is a mature teratoma with cartilaginous tissue differentiation.
Craniofaringiomas e tumores mistos de células germinativas (TCG) podem acometer a região hipotálamo-hipofisária durante a infância. Embora tenham diferentes origens, as manifestações clínicas e achados radiológicos podem ser semelhantes. Nosso objetivo é relatar o caso de uma paciente de 5 anos de idade, cujas manifestações clínicas e achados radiológicos (presença de calcificações à tomografia computadorizada [TC]) foram inicialmente considerados como provável craniofaringioma. No entanto, a piora clínica progressiva, marcadores tumorais séricos e liquóricos elevados, assim como os resultados do estudo anatomopatológico e imunoistoquímico revelaram tratar-se de TCG. Este caso enfatiza que alguns achados clínicos e radiológicos de tumores da região hipotálamo-hipofisária podem ser erroneamente diagnosticados como craniofaringiomas, principalmente se houver presença de teratoma maduro com diferenciação em tecido cartilaginoso.
Assuntos
Pré-Escolar , Feminino , Humanos , Craniofaringioma/patologia , Neoplasias Hipotalâmicas/patologia , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Hipofisárias/patologia , Craniofaringioma , Craniofaringioma/cirurgia , Diagnóstico Diferencial , Neoplasias Hipotalâmicas , Neoplasias Hipotalâmicas/cirurgia , Neoplasias Embrionárias de Células Germinativas , Neoplasias Embrionárias de Células Germinativas/cirurgia , Neoplasias Hipofisárias , Neoplasias Hipofisárias/cirurgia , Teratoma/patologia , Teratoma , Teratoma/cirurgiaRESUMO
Craniopharyngiomas and germ cell tumors (GCT) may affect the pituitary-hypothalamic region during childhood. Although different in origin, their clinical and radiological features may be similar. In this article we present a 5-year-old girl with clinical and radiological findings (computer tomography calcification) that were initially considered as craniopharyngioma. However clinical outcome, blood and cerebral spinal fluid tumoral markers, and results from anatomopathology and immunohistochemistry disclosed a mixed GCT. This case report highlights that some clinical features and radiological findings of pituitary-hypothalamic tumors may be misdiagnosed as craniopharyngioma mainly when there is a mature teratoma with cartilaginous tissue differentiation.
Assuntos
Craniofaringioma/patologia , Neoplasias Hipotalâmicas/patologia , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Hipofisárias/patologia , Pré-Escolar , Craniofaringioma/diagnóstico por imagem , Craniofaringioma/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Hipotalâmicas/diagnóstico por imagem , Neoplasias Hipotalâmicas/cirurgia , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Neoplasias Embrionárias de Células Germinativas/cirurgia , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Radiografia , Teratoma/diagnóstico por imagem , Teratoma/patologia , Teratoma/cirurgiaRESUMO
OBJECTIVE: The purpose of this study was to identify echocardiographic parameters that allow distinguishing different levels of cardiac dysfunction in aortic banded rats. METHODS: Wistar male rats (90-100 g) were subjected to aortic banding (n=23) or a sham operation (n=12). The following echocardiographic parameters were evaluated and used to group rats into groups with similar characteristics using cluster analysis: absolute values and after normalization to body weight of left ventricular end-diastolic diameter (LVDD) and left atrial systolic diameter; left ventricular end-systolic diameter (LVSD); LV weight to body weight ratio (LVW/BW); three indexes of left ventricular shortening (endocardial fractional shortening, EFS; midwall FS, MFS; and posterior wall shortening velocity, (PWSV). RESULTS: The cluster analysis could group aortic banded rats into two groups: mild (n=13) and severe (n=9) stage of heart failure. There was no overlapping among the values of the 95% confidence interval of the following parameters between the two groups: LVDD, LVSD, EFS, MFS, LVW/BW, and PWSV. CONCLUSION: It is feasible to distinguish two groups of aortic banded rats according to the level of cardiac dysfunction using those echocardiographic parameters. This allows to perform longitudinal studies in homogeneous groups of rats with aortic banding and cardiac dysfunction.
Assuntos
Estenose da Valva Aórtica/complicações , Baixo Débito Cardíaco/etiologia , Hipertrofia Ventricular Esquerda/etiologia , Disfunção Ventricular/etiologia , Animais , Estenose da Valva Aórtica/diagnóstico por imagem , Modelos Animais de Doenças , Ecocardiografia , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Masculino , Ratos , Ratos Wistar , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Disfunção Ventricular/diagnóstico por imagem , Remodelação VentricularRESUMO
OBJETIVO: O objetivo deste estudo foi identificar variáveis ecocardiográficas que definam graus de disfunção cardíaca em ratos com estenose aórtica (EAo). MÉTODOS: Ratos Wistar (n = 23), machos (90-100 g), foram submetidos a cirurgia para indução de EAo. As variáveis ecocardiográficas analisadas foram: diâmetros diastólico do ventrículo esquerdo (DDVE) e sistólico do átrio esquerdo em valores absolutos e normalizados para o peso corporal; diâmetro sistólico do VE (DSVE); três índices de encurtamento do VE ( por cento de encurtamento endocárdico, por centoEnc.Endo; por cento de encurtamento miocárdico, por centoEnc.Mio; e velocidade de encurtamento da parede posterior do VE, VEPP); e índice de massa do VE (IMVE). Essas variáveis foram utilizadas para a análise de agrupamento ("cluster analysis"). RESULTADOS: A análise de agrupamento possibilitou separar os ratos com EAo em dois grupos: disfunção leve (n = 13) e disfunção severa (n = 9). Os intervalos de confiança das seguintes variáveis não apresentaram superposição dos seus valores: DDVE, DSVE, por centoEnc.Endo, por centoEnc.Mio, IMVE e VEPP. CONCLUSÃO: A utilização conjunta dos intervalos de confiança dessas variáveis permite identificar dois grupos de ratos com estenose aórtica e diferentes graus de comprometimento cardíaco, possibilitando a realização de estudos longitudinais com grupos homogêneos de animais.
Assuntos
Animais , Masculino , Ratos , Estenose da Valva Aórtica/complicações , Baixo Débito Cardíaco/etiologia , Hipertrofia Ventricular Esquerda/etiologia , Disfunção Ventricular/etiologia , Estenose da Valva Aórtica , Modelos Animais de Doenças , Ecocardiografia , Hipertrofia Ventricular Esquerda , Ratos Wistar , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Remodelação Ventricular , Disfunção VentricularRESUMO
Este trabalho foi realizado para verificar se a ultra-sonografia do pâncreas oferece dados auxiliares na classificação de diabéticos adultos dos tipos 1 e 2. O tamanho e a ecogenicidade do pâncreas foram determinados pela ultra-sonografia em 81 diabéticos, sendo 20 do tipo 1 e 61 do tipo 2 (53 obesos e oito não-obesos). Os pacientes tipo 2 obesos diferiram dos demais por apresentarem área total e diâmetro ântero-posterior do corpo do pâncreas significativamente maiores. Quanto à ecogenicidade pancreática, esta estava aumentada com maior freqüência nos diabéticos tipo 2 obesos que nos diabéticos tipo 1. Consideramos, assim, que a ultra-sonografia do pâncreas constitui metodologia auxiliar na classificação de diabéticos entre os tipo 1 e 2, sendo menos eficaz quando os últimos não são obesos.
Assuntos
Humanos , Masculino , Feminino , Diabetes Mellitus Tipo 2 , Diabetes Mellitus Tipo 1 , Pâncreas , Diabetes Mellitus , PâncreasRESUMO
OBJECTIVE: To assess the cardiovascular features of Ullrich-Turner's syndrome using echocardiography and magnetic resonance imaging, and to correlate them with the phenotype and karyotype of the patients. The diagnostic concordance between the 2 methods was also assessed. METHODS: Fifteen patients with the syndrome were assessed by echocardiography and magnetic resonance imaging (cardiac chambers, valves, and aorta). Their ages ranged from 10 to 28 (mean of 16.7) years. The karyotype was analyzed in 11 or 25 metaphases of peripheral blood lymphocytes, or both. RESULTS: The most common phenotypic changes were short stature and spontaneous absence of puberal development (100%); 1 patient had a cardiac murmur. The karyotypes detected were as follows: 45,X (n=7), mosaics (n=5), and deletions (n=3). No echocardiographic changes were observed. In regard to magnetic resonance imaging, coarctation and dilation of the aorta were found in 1 patient, and isolated dilation of the aorta was found in 4 patients. CONCLUSION: The frequencies of coarctation and dilation of the aorta detected on magnetic resonance imaging were similar to those reported in the literature (5.5% to 20%, and 6.3% to 29%, respectively). This confirmed the adjuvant role of magnetic resonance imaging to Doppler echocardiography for diagnosing cardiovascular alterations in patients with Ullrich-Turner's syndrome.
Assuntos
Ecocardiografia Doppler/métodos , Imageamento por Ressonância Magnética/métodos , Síndrome de Turner/fisiopatologia , Adolescente , Adulto , Criança , Feminino , Humanos , Cariotipagem , Fenótipo , Síndrome de Turner/diagnóstico , Síndrome de Turner/genéticaRESUMO
OBJECTIVE: To assess the cardiovascular features of Ullrich-Turner's syndrome using echocardiography and magnetic resonance imaging, and to correlate them with the phenotype and karyotype of the patients. The diagnostic concordance between the 2 methods was also assessed. METHODS: Fifteen patients with the syndrome were assessed by echocardiography and magnetic resonance imaging (cardiac chambers, valves, and aorta). Their ages ranged from 10 to 28 (mean of 16.7) years. The karyotype was analyzed in 11 or 25 metaphases of peripheral blood lymphocytes, or both. RESULTS: The most common phenotypic changes were short stature and spontaneous absence of puberal development (100 percent); 1 patient had a cardiac murmur. The karyotypes detected were as follows: 45,X (n=7), mosaics (n=5), and deletions (n=3). No echocardiographic changes were observed. In regard to magnetic resonance imaging, coarctation and dilation of the aorta were found in 1 patient, and isolated dilation of the aorta was found in 4 patients. CONCLUSION: The frequencies of coarctation and dilation of the aorta detected on magnetic resonance imaging were similar to those reported in the literature (5.5 percent to 20 percent, and 6.3 percent to 29 percent, respectively). This confirmed the adjuvant role of magnetic resonance imaging to Doppler echocardiography for diagnosing cardiovascular alterations in patients with Ullrich-Turner's syndrome
Assuntos
Humanos , Feminino , Criança , Adolescente , Adulto , Ecocardiografia Doppler , Imageamento por Ressonância Magnética , Síndrome de Turner , Cariotipagem , Fenótipo , Síndrome de TurnerRESUMO
OBJECTIVE: To determine the frequency of hypothyroidism in a sample of hyperlipemic patients and evaluate clinical and laboratory factors indicative of thyropathy among them. METHODS: Fifty-one hyperlipemic patients, grouped according to an earlier or recent diagnosis of their thyroid function into euthyroid and hypothyroid, were evaluated with clinical and laboratory examinations of blood levels of free T4 and TSH (by radioimmunoassay). Patients were on average 46.8 + or - 11.7 years old, predominantly of the female sex (62.5 percent); 31 percent had a previous diagnosis of hypothyroidism and were under treatment with thyroxin. RESULTS: Fourteen three percent of patients analyzed had hypothyroidism, which had not been detected before. Differentiating attributes of the groups analyzed were: a predominance of females among the hypothyroid patients and a higher HDL serum concentration among those recently diagnosed. CONCLUSION: In the present study, new cases of hypothyroidism in hyperlipemic patients were a frequent occurrence, yet few clinical and laboratory data except tests evaluating free T4 and TSH in the blood indicated which patients had thyroid dysfunction