RESUMO
Highly reactive oxyradicals and electronically excited triplet carbonyls can be generated in vitro by iron complexes and heme enzyme-catalyzed aerobic oxidation of synthetic or naturally occurring substances capable of enolization in aqueous medium. Monoenols and enamines, obtained by (alpha-methyne-carbonyl and -imine enolization, undergo dioxygen insertion and ultimately originate triplet species; e.g., isobutanal, 3-methylacetoacetone, Schiff bases. In turn, (alpha-hydroxy- and (alpha-aminocarbonyls (e.g., carbohydrates, 5-aminolevulinic acid) tautomerize to enediols and enolamines and yield oxyradicals, initiated by electron transfer to dioxygen, as polyphenols (e.g., 6-hydroxydopamine) and polyphenolamines do. Free radicals and excited species have been implicated in several normal and pathological processes. We here briefly review our contributions to this research area, emphasizing a possible in vivo prooxidant role for 5-aminolevulinic acid, the heme precursor accumulated in several porphyric disorders (e.g., lead poisoning, acut intermittent porphyria, tyrosinosis).
Assuntos
Animais , Humanos , Ácido Aminolevulínico/química , Técnicas In Vitro , Espécies Reativas de Oxigênio , Radicais Livres , Iminoácidos/metabolismo , Ferro/metabolismo , Chumbo/metabolismoRESUMO
We evaluated 51 tests of 99mTc-DISIDA excretion by the biliary tree in patients with neonatal cholestasis. The aim of the present study was to verify the value of this test in the differentiation of this syndrome, correlating it to the clinical and laboratory data. The case studied were divided into two groups: extrahepatic biliary atresia, 26 patients (50.9%) and no-extrahepatic biliary atresia, 25 patients (49.1%). Analyzing the results, we concluded that this test had 96% sensitivity, 56% specificity, 69% positive predictive value, 93% negative predictive value and 76.5% accuracy. The accuracy of this test was only lower than that of hepatic biopsy. We conclude that the hepatobiliary scintigraphy was very useful in the definition of extrahepatic biliary atresia, with less value in the group of neonatal hepatitis, perhaps due to the delayed referral of the patients, short time of the scintigraphy study or factors related to the etiology of cholestasis itself.