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Primary sclerosing cholangitis, a chronic progressive cholestatic liver disease, is the most serious hepatobiliary complication of ulcerative colitis (UC). The authors present the case of a severe and intractable form of UC associated with primary sclerosing cholangitis, in which the diagnosis of this hepatobiliary complication was made during the postmortem examination. A 19-year-old man, with an 8-month diagnosis of UC, was non-responsive to any therapeutic approach. He presented at the emergency care unit severely ill and with cachexia, and subsequently died of septic shock. The postmortem examination confirmed the clinical diagnosis of severe UC and disclosed the presence of primary sclerosing cholangitis. Although laboratory tests have shown a typical cholestatic profile with elevated alkaline phosphatase and gamma-glutamyl transferase levels, hepatic dysfunction was related to sepsis. This report highlights how challenging the diagnosis of primary sclerosing cholangitis can be and shows the value of the postmortem examination to add important information to a medical diagnosis.

A técnica de biópsia hepática é indicada para doenças crônicas, nas quais o curso clínico é longo e a análise morfológica permite diagnosticar as lesões antes que os animais apresentem sinais clínicos, diminuindo as perdas econômicas ou a mortalidade dos animais afetados. A utilização de biópsia guiada pela ultra-sonografia aumenta a segurança da técnica. O presente estudo tem por objetivo descrever uma técnica de biópsia hepática com agulha, guiada pelo ultra-som, em bovinos jovens, sob anestesia local. Com base nos resultados obtidos, pôde-se concluir que a técnica em questão é simples, de fácil utilização na rotina e não implica riscos à saúde animal, sendo capaz de diagnosticar alterações hepáticas com segurança.

Made available in DSpace on 2015-08-26T19:19:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-12-01. Added 1 bitstream(s) on 2015-08-31T13:05:00Z : No. of bitstreams: 1 S1676-24442014000600452.pdf: 182786 bytes, checksum: 986c5c9c57a465f63324f798eee4e4dd (MD5) Na literatura, há poucos relatos sobre a ausência de geleia de Wharton. Relatamos o sétimo caso em uma primigesta de 22 anos, admitida após parto vaginal de feto natimorto. O cordão umbilical apresentava longo segmento com esfacelo da geleia e três vasos sanguíneos completamente separados uns dos outros, com mínima quantidade de geleia de Wharton remanescente ao redor de cada vaso. Ausência de geleia de Wharton associa-se a estresse, restrição de crescimento e óbitos fetais. Estudos quantitativos/ qualitativos sobre a geleia de Wharton representam campo de pesquisa aberto para possíveis correlações com condições e doenças obstétricas e óbitos fetais. There are few reports in the literature of the absence of Wharton's Jelly. Here we report the seventh case in a primigravida, 22 years old, admitted after vaginal delivery of stillborn. The umbilical cord have a long segment with disruption of cord structures and the three blood vessels were completely separated from each other, with a minimum amount of Wharton's jelly remaining around each vessel. The absence of Wharton' jelly is associated with fetal distress, intrauterine growth restriction, and fetal death. Quantitative/qualitative studies of Wharton's jelly represent an open field of research for possible correlations with obstetric conditions and fetal deaths. Universidade Estadual Paulista Medical School of Botucatu Department of Pathology Universidade Estadual de Campinas UNESP Universidade Estadual Paulista Medical School of Botucatu Department of Pathology UNESP

Made available in DSpace on 2022-04-28T19:55:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-01-01 The presence of various pathogenic fungi in rather unsuspected hosts and environments has always attracted the attention of the scientific community. Reports on the putative role of animals in fungal infections of humans bear important consequences on public health as well as on the understanding of fungal ecology. Fungi are ubiquitous in nature and their great capacity for adaptation allows them to survive and indeed, to thrive, in plants, trees and other natural substrata. Nonetheless, we are just beginning to learn the significance that these diverse fungal habitats have on the increasing number of immunosuppressed individuals. The accidental or permanent presence of fungi in animals, plants, soils and watercourses should not be taken too lightly because they constitute the source where potential pathogens will be contracted. If those fungal habitats that carry the largest risks of exposure could be defined, if seasonal variations in the production of infectious propagules could be determined, and if their mode of transmission were to be assessed, it would be possible to develop protective measures in order to avoid human infection. Additionally, unsuspected avenues for the exploration of fungal survival strategies would be opened, thus enhancing our capacity to react properly to their advancing limits. This paper explores several ecological connections between human pathogenic fungi and certain animals, trees, waterways and degraded organic materials. The occurrence of such connections in highly endemic areas will hopefully furnish more precise clues to fungal habitats and allow the design of control programs aimed at avoiding human infection. © Oxford University Press 2001. Corporación para Investigaciones Biológicas, Medellín Department of Family Medicine University of Wisconsin Medical School St. Luke’s Family Practice Center, Milwaukee, WI Departmento de Microbiología e Imunología Instituto de Biociências Universidad Estadual Paulista (UNESP), Botucatu, São Paulo Department of Pathology University of Texas Medical Branch, Galveston, TX Serviço de Micologia Médica Centro de Pesquisas Hospital Evandro Chagas FIOCRUZ RJ Disciplina de Biologia Celular Escola Paulista de Medicina UNIFESP, São Paulo Departmento de Patologia Faculdade de Medicina UNESP, Botucatu Universidade Federal de Roraima RR Brazil, 1301-Grajau Departmento de Patologia Escola Paulista de Medicina UNIFESP, Sã0 Paulo Research Center for Pathogenic Fungi and Microbial Toxicoses Chiba University Departmento de Microbiología e Imunología Instituto de Biociências Universidad Estadual Paulista (UNESP), Botucatu, São Paulo Departmento de Patologia Faculdade de Medicina UNESP, Botucatu

Neste trabalho apresentamos um caso de hiperplasia nodular focal que foi diagnosticado aos seis anos de idade e que está sendo acompanhado até o momento presente. Para o diagnóstico foram imprescindíveis as técnicas de imagem, tendo importância de realce a cintilografia hepatoesplênica e a tomografia computadorizada. Apresentamos, também, revisão da literatura sobre o assunto.In this case report we discuss a focal nodular hyperplasia diagnosed in a female, six-year old patient, as well as her follow-up from the diagnosis to the present time. Imaging techniques, particularly hepatosplenic scintigraphy and computed tomography, are essential for the diagnosis. Also, a literature review is presented.

We studied three different isolates of Paracoccidioides brasiliensis obtained from the mesenteric lymph node (D3LY1), the spleen (D3S1) and the liver (D3LIV1) of the same armadillo ( Dasypus novemcinctus ).Pulmonal inflammatory area was evaluated by intravenous inoculation of 106 yeast cells of each isolates in young, male, ddY mice. Moreover, the partial sequence of GP43kDa gene of P. brasiliensis was analyzed. The lung inflammatory area was greater in animals inoculated with isolate D3S1. The partial sequence of GP43kDa gene indicated that isolate D3S1 is different from isolates D3LY1 and D3LIV1. This study suggested that the same armadillo might be susceptible to multiple P. brasiliensis isolates simultaneously.

We compared the antigenic characteristics of two thermo-dependent dimorphic fungi isolated from soil in Botucatu, an endemic area of paracoccidioidomycosis (PCM) and Paracoccidioides brasiliensis. The soil isolates grew as cerebriform colonies at 37 °C (yeast form) and as cottonous colonies at 25 °C (mycelial form). No pathogenicity for ddY mice or hamsters were observed. In immunodiffusion test, there were precipitation bands between the 2 soil isolates and pooled PCM patient sera. There were also common precipitation bands at 21, 50 and 58 kDa between the soil isolates antigens and PCM patient sera by Western-blotting, but no gp43 kDa band. No gene for gp 43 kDa protein was detected in the soil isolates by PCR. The fact that these isolates were obtained from an endemic area of PCM and there were some antigenic similarities between the soil isolates and P. brasiliensis in immunodiffusion test and Western-blotting may have some importance in epidemiological surveys done with paracoccidioidin as well interfering with the immune response of the exposed population.

The exoantigen of Paracoccidioides brasiliensis standardized by Camargo et al. (AgR) was used to evaluate the in vivo and in vitro cell immune response of experimental animals and of patients with paracoccidioidomycosis (PBM). Fava Netto antigen (AgF) was tested in parallel as a control antigen. The study was conducted with mice and guinea pigs infected with P. brasiliensis or immunized with its fungal antigens, on patients with PBM and on their respective control groups. The cell immune response was analysed by skin tests, and by the macrophage and leucocyte migration inhibition tests (MMIT and LMIT) in the animals and in the patients, respectively. The skin test with AgR as paracoccidioidin was positive in infected or immunized mice and guinea pigs and negative in control animals. The skin tests with AgR (24 h) showed 96.7% positivity in patients with PBM and were negative in control individuals. Histopathological study of the in vivo tests in the different experimental models was consistent with a delayed hypersensitivity response (DHR). Immunohistochemical study of the skin tests of PBM patients demonstrated a predominance of T lymphocytes, confirming the nature of a DHR to the fungal antigens. The in vitro cell immune response showed variable results for the various experimental models, i.e. significant rates of MMIT in immunized mice, a tendency to positivity in infected guinea pigs, and the absence of migration inhibition in PBM patients. Taken together, the data indicate that the AgR is efficient as paracoccidioidin in the evaluation of DHR in PBM, with an optimum time of reading the test of 24 h.

We compared the granuloma morphology and immune response of hamsters inoculated with Paracoccidioides brasiliensis (Pb) into the cheek pouch, which lacks lymphatic drainage, and into the footpad, which is rich in lymphatics. Our objective was to better understand the modulation of Pb granuloma in an immunocompetent animal inoculated in an immunologically privileged site. The humoral immune response (ELISA) and cell mediated immunity (footpad test) became positive on days 7 and 14, respectively in animals inoculated into footpad and on days 35 and 60 in animals inoculated into the pouch. Typical epithelioid granulomas were observed at both sites on day 14. The number of fungi gradually decreased from the beginning of the experiment in footpad lesions, but only after day 35 in pouch granulomas, when cell mediated immunity was detectable. The results indicate that typical epithelioid paracoccidioidomycotic granulomas may develop in the absence of a detectable immune response; however, they are incapable of controlling fungal reproduction. Lack of lymphatic drainage delays the appearance of a detectable immune response, but with time fungi escape from the pouch, elicit an immune response and reach other organs. Our results further indicate the importance of the lymphatics in the pathogenesis of paracoccidioidomycosis.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:04:21Z No. of bitstreams: 1 S0036-46651994000300005.pdf: 595431 bytes, checksum: f73d8a209f65720a2cf30b914c19be5e (MD5) Made available in DSpace on 2013-08-22T19:04:21Z (GMT). No. of bitstreams: 1 S0036-46651994000300005.pdf: 595431 bytes, checksum: f73d8a209f65720a2cf30b914c19be5e (MD5) Previous issue date: 1994-06-01 Made available in DSpace on 2013-09-30T20:07:10Z (GMT). No. of bitstreams: 2 S0036-46651994000300005.pdf: 595431 bytes, checksum: f73d8a209f65720a2cf30b914c19be5e (MD5) S0036-46651994000300005.pdf.txt: 7 bytes, checksum: 212b0306580d4f0044d18f9a3edcc832 (MD5) Previous issue date: 1994-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:17:10Z No. of bitstreams: 2 S0036-46651994000300005.pdf: 595431 bytes, checksum: f73d8a209f65720a2cf30b914c19be5e (MD5) S0036-46651994000300005.pdf.txt: 7 bytes, checksum: 212b0306580d4f0044d18f9a3edcc832 (MD5) Made available in DSpace on 2014-05-20T15:17:10Z (GMT). No. of bitstreams: 2 S0036-46651994000300005.pdf: 595431 bytes, checksum: f73d8a209f65720a2cf30b914c19be5e (MD5) S0036-46651994000300005.pdf.txt: 7 bytes, checksum: 212b0306580d4f0044d18f9a3edcc832 (MD5) Previous issue date: 1994-06-01 Estudou-se sequencialmente, à microscopia eletrônica de transmissão, a interação entre Paracoccidioides brasiliensis (Pb) e células inflamatórias em hamsters inoculados por via intratesticular. Seis horas após inoculações havia predominância de neutrófilos, estando presentes algumas células mononucleares e eosinófilos. Os neutrófilos foram progressivamente substituídos por células mononucleares. Fungos viáveis apresentavam-se fagocitados ou circunscritos por células inflamatórias, geralmente com ampla interface hospedeiro-parasita. Fungos mortos ou degenerados eram acompanhados de interfase estreita. A camada externa da parede do Pb era às vezes quebrada quando em contacto com neutrófilos, em vários pontos, sendo os fragmentos dessa parede descamados e fagocitados. Células fúngicas pequenas com um único núcleo se relacionavam com ampla interfase enquanto as células maiores e multinucleadas apresentavam paredes irregulares, por vezes, contendo lomasoma e/ou estrutura semelhante à mielina. Diferentes padrões de interação do Pb com células do hospedeiro podem ser decorrentes do a fluxo de células inflamatórias funcionalmente diferentes ao local de inoculação ou à idade dos fungos ou ambos os fatores. Interaction between Paracoccidioides brasiliensis (Pb) and inflammatory cells in hamster testis was studied sequentially by transmission electron microscopy. In early lesions (six hours after inoculation), polymorphonuclear neutrophils (PMNs) were the major and mononuclear cells and eosinophils were the minor constituents of the inflammatory cells. PMNs were later replaced by mononuclear cells. Viable Pb cells were phagocytosed or surrounded by inflammatory cells. Preserved Pb cells usually had broad host-parasite interphases, whereas dying ones had narrow interphases. The outer layer of the fungus wall was sometimes broken by PMN in some focal points, broken pieces being peeled off and phagocytosed. Small Pb cells were uninuclear, and were often related to broad interphase. Large Pb cells were multinucleated with irregularly shaped wall, and sometimes had lomasome and/or myelin like structures. Different interaction patterns of Pb with inflammatory cells may be due to functionally different host cell flow to the inoculation site or due to the age of Pb cells or both. UNESP Faculty of Medicine Department of Pathology Jikei Medical University Institute of Basic Medicine UNESP Faculty of Medicine Department of Pathology

A B S T R A C T Objectives: To determine whether histologic chorioamnionitis is associated with changes in gene expression of TLR-1, -2, -4 and -6, and to describe the localization of these receptors in fetal membranes. Study design: A total of 135 amniochorion membranes with or without histologic chorioamnionitis from preterm or term deliveries were included. Fragments of membranes were submitted to total RNA extraction. RNA was reverse transcribed and the quantification of TLRs expression measured by real time PCR. Results: All amniochorion membranes expressed TLR-1 and TLR-4, whereas 99.1% of membranes expressed TLR-2 and 77.4% expressed TLR-6. TLR-1 and TLR-2 expressions were significantly higher in membranes with histologic chorioamnionitis as compared to membranes without chorioamnionitis in preterm pregnancies (p = 0.003 and p < 0.001, respectively). Among the membranes of term pregnancies there were no differences in the expressions of such receptors regardless of inflammatory status. Regarding TLR-4 and TLR-6 expression, there was no difference among membranes with or without histologic chorioamnionitis, regardless gestational age at delivery. TLR-1, TLR-2, TLR-4 and TLR-6 expressions were observed in amniotic epithelial, chorionic and decidual cells. Conclusion: Amniochorion membranes express TLR-1, TLR-2, TLR-4 and TLR-6 and increased expression of TLR-1 and TLR-2 is related to the presence of histologic chorioamnionitis in preterm pregnancies. This study provides further evidence that amniochorion membranes act as a mechanical barrier to microorganisms and as components of the innate immune system.

The plating efficiency of standard mycological media such as brain heart infusion (BHI) agar is poor for Paracoccidioides brasiliensis. We prepared a water-extract of yeast phase cells of P. brasiliensis and examined it for growth-enhancing activity for the fungus. The water-extract, when added to BHI agar to a concentration of 5%, improved the plating efficiency of the medium for the fungus to some extent, but the degree of improvement was considerably varied among P. brasiliensis isolates. By contrast, when the water-extract was added in combination with horse serum (4%), the plating efficiency was highly improved (to 94-99%) for all the P. brasiliensis isolates employed. The growth-enhancing factor(s) in the water-extract was heat-stable and heating at 120 degrees C for 15 min had little, if any, effect on growth-enhancing activity.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:17:27Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:43:57Z : No. of bitstreams: 1 2-s2.0-0026690096.pdf: 1274945 bytes, checksum: 77034f45809b3e90235c738499060105 (MD5) Made available in DSpace on 2014-05-27T11:17:27Z (GMT). No. of bitstreams: 0 Previous issue date: 1992-01-01 Aims: To compare the efficacy of histochemical and immunohistochemical methods in detecting forms of Sporothrix schenckii in tissue. Methods: Thirty five cutaneous biopsy specimens from 27 patients with sporotrichosis were stained by histochemical haemotoxylin and eosin, periodic acid Schiff, and Gomori's methenamine silver methods and an immunohistochemical (avidin-biotin complex immunoperoxidase) (ABC) technique associated with a newly produced rabbit polyclonal antibody anti-Sporothrix schenckii. Results: A total of 29 (83%) cases were positive by the ABC method used in association with anti-Sporothrix schenckii rabbit polyclonal antibodies. Histochemical methods, using silver staining, periodic acid Schiff, and conventional haematoxylin and eosin detected 37%, 23%, and 23% of forms of S schenckii, respectively. The ABC technique was significantly more reliable than periodic acid Schiff and silver staining techniques. Conclusions: It is concluded that immunostaining is an easy and rapid method which can efficiently increase the accuracy of the diagnosis of sporotrichosis in human tissue. Departamento de Patologia Faculdade Medicina-UNESP, Botucatu, SP 18610 Departamento de Patologia Faculdade Medicina-UNESP, Botucatu, SP 18610

Nonalcoholic fatty liver disease (NAFLD) is a clinical-pathological syndrome that encompasses a wide spectrum of morphologic alterations, ranging from simple hepatic steatosis to a more severe stage, known as nonalcoholic steatohepatitis (NASH). The purpose of this clinical report was to contribute to the understanding of mitochondrial alterations in NAFLD. The child (13-month-old) underwent initial biopsy in the year 2000 and was diagnosed with diffuse macro and microvesicular steatosis. Two additional biopsies were performed in 2001 and 2004. A high percentage of microvesicular steatosis was observed in the biopsies performed in 2000 and 2001. Mitochondrial size was slightly increased in the biopsy performed in the year 2000, significantly increased in 2001 and decreased in 2004. The presence of "mitochondrial hypertrophy" in the hepatocytes of an asymptomatic pediatric patient whose disease presentation was typical of NAFLD, excluding other pathological processes, allowed us to suspect that such a defect was considered the primary mitochondrial disorder.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:05:28Z No. of bitstreams: 1 S0036-46652010000300007.pdf: 964482 bytes, checksum: 54f4d6cd74cfa9899850cde78fa50605 (MD5) Made available in DSpace on 2013-08-22T19:05:28Z (GMT). No. of bitstreams: 1 S0036-46652010000300007.pdf: 964482 bytes, checksum: 54f4d6cd74cfa9899850cde78fa50605 (MD5) Previous issue date: 2010-06-01 Made available in DSpace on 2013-09-30T20:09:21Z (GMT). No. of bitstreams: 2 S0036-46652010000300007.pdf: 964482 bytes, checksum: 54f4d6cd74cfa9899850cde78fa50605 (MD5) S0036-46652010000300007.pdf.txt: 34657 bytes, checksum: dd562e7c39fe2020718054f35c5e3bd0 (MD5) Previous issue date: 2010-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:17:40Z No. of bitstreams: 2 S0036-46652010000300007.pdf: 964482 bytes, checksum: 54f4d6cd74cfa9899850cde78fa50605 (MD5) S0036-46652010000300007.pdf.txt: 34657 bytes, checksum: dd562e7c39fe2020718054f35c5e3bd0 (MD5) Made available in DSpace on 2014-05-20T15:17:40Z (GMT). No. of bitstreams: 2 S0036-46652010000300007.pdf: 964482 bytes, checksum: 54f4d6cd74cfa9899850cde78fa50605 (MD5) S0036-46652010000300007.pdf.txt: 34657 bytes, checksum: dd562e7c39fe2020718054f35c5e3bd0 (MD5) Previous issue date: 2010-06-01 Desde a década de 1970 não se notificavam casos autóctones de doença de Chagas aguda em São Paulo. em março de 2006 a Vigilância Epidemiológica registrou óbito por doença de Chagas aguda, em Itaporanga, de paciente de seis anos de idade. Exame histopatológico post mortem realizado no Hospital das Clínicas da Faculdade de Medicina de Botucatu confirmou o diagnóstico. Consultamos prontuários de hospitais e entrevistamos profissionais de saúde envolvidos além de familiares do paciente. Descrevemos medidas adotadas in loco para identificar a via de transmissão, reservatórios e vetores. Discutimos as possíveis fontes de infecção. Na região não foram identificados outros casos humanos, vetores ou reservatórios vertebrados infectados por Trypanosoma cruzi. Salientamos a importância de manter a vigilância, mesmo em áreas onde a transmissão de doença de Chagas está interrompida e naquelas ainda infestadas por triatomíneos. Deve-se admitir a hipótese diagnóstica de doença de Chagas quando observados: edema palpebral (uni ou bilateral), insuficiência cardíaca, miocardite, pericardite, anasarca, quadros similares aos de síndrome nefrótica ou glomerulonefrite sem causas outras aparentes, em pacientes com dados epidemiológicos positivos. Encontro, mesmo em raras ocasiões, de triatomíneos na região ou ainda contato com alimento contaminável com formas infectantes de T. cruzi. No vector transmitted cases of Chagas disease had been notified in the state of São Paulo since the 1970s. However, in March, 2006, the death of a six-year-old boy from the municipality of Itaporanga was notified to the Center for Epidemiological Survey of the São Paulo State Health Secretariat: an autochthonous case of acute Chagas disease. The postmortem histopathological examination performed in the Hospital das Clínicas of the Botucatu School of Medicine confirmed the diagnosis. Reference to hospital records, consultation with the health professionals involved in the case and interviews with members of the patient's family supplied the basis for this study. We investigated parasite route of transmission, probable local reservoirs and vectors. No further human cases of acute Chagas disease were diagnosed. No locally captured vectors or reservoirs were found infected with Trypanosoma cruzi. Alternative transmission hypotheses - such as the possible ingestion of foods contaminated with vector excreta - are discussed, as well as the need to keep previously endemic regions and infested houses under close surveillance. Clinicians should give due attention to such signs as uni- or bilateral palpebral edema, cardiac failure, myocarditis, pericarditis, anasarca and atypical signs of nephrotic syndrome or nephritis and consider the diagnostic hypothesis of Chagas disease. Superintendência de Controle de Endemias Centro de Vigilância Epidemiológica Dr. Alexandre Vranjac Secretaria de Vigilância em Saúde Grupo Técnico de Vigilância UNESP Faculdade de Medicina de Botucatu USP Faculdade de Medicina UNESP Faculdade de Medicina de Botucatu

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2014-02-26T17:02:11Z No. of bitstreams: 1 WOS000254388800006.pdf: 164317 bytes, checksum: d8c8f9cb94cf8e531d92cba327727ad9 (MD5) Made available in DSpace on 2014-02-26T17:02:11Z (GMT). No. of bitstreams: 1 WOS000254388800006.pdf: 164317 bytes, checksum: d8c8f9cb94cf8e531d92cba327727ad9 (MD5) Previous issue date: 2007-12-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:20:34Z No. of bitstreams: 1 WOS000254388800006.pdf: 164317 bytes, checksum: d8c8f9cb94cf8e531d92cba327727ad9 (MD5) Made available in DSpace on 2014-05-20T15:20:34Z (GMT). No. of bitstreams: 1 WOS000254388800006.pdf: 164317 bytes, checksum: d8c8f9cb94cf8e531d92cba327727ad9 (MD5) Previous issue date: 2007-12-01 The combination of pegylated interferon (PEG-INF) and ribavirin is currently the best treatment for chronic hepatitis C, providing a sustained virological response (SVR) in 54%-63% of patients. In patients infected with hepatitis C virus (HCV) genotype 1, the SVR rate is 42%-52%. To evaluate the treatment efficacy of this drug combination, we conducted an open, prospective study of 58 consecutive treatment-naive patients infected with HCV genotype 1 and treated at a university hospital, comparing those presenting an SVR (SVRs), nonresponders (NRs), and relapsers (RELs). Among the intent-to-treat patients, an end-of-treatment virological response was achieved in 69 % of the sample as a whole and in 52 % of the SVRs. We found that being an SVR was significantly associated with mild fibrosis (p = 0.04) and with undetectable HCV RNA at weeks 12 and 24 of treatment (p < 0.0001). Comparing the SVR and REL groups, we observed that being older than 40 was significantly associated with being a REL (p = 0.04). Being an NR was found to be associated with severe fibrosis and moderate inflammatory infiltrates (portal or periportal). In the polytomous logistic regression, no independent factors were associated with the REL group when compared with the SVR group. We conclude that RELs and NRs differ in comparison with SVRs. The RELs accounted for 17% of the sample. The HCV RNA test results at weeks 12 and 24 of treatment, although independent predictors of non-response (OR: 4.8 and 8.2, respectively), did not differ between SVRs and RELs. UNESP, Fac Med Botucatu, Dept Internal Med, BR-18618000 Botucatu, SP, Brazil Hemoctr Botucatu, Virol Lab, Botucatu, SP, Brazil Dept Pathol, Botucatu, SP, Brazil UNESP, Fac Med Botucatu, Dept Internal Med, BR-18618000 Botucatu, SP, Brazil

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:05:55Z No. of bitstreams: 1 S1516-31802007000500006.pdf: 223943 bytes, checksum: 27a4995cd140663036e0867d4dfba435 (MD5) Made available in DSpace on 2013-08-22T19:05:55Z (GMT). No. of bitstreams: 1 S1516-31802007000500006.pdf: 223943 bytes, checksum: 27a4995cd140663036e0867d4dfba435 (MD5) Previous issue date: 2007-09-01 Made available in DSpace on 2013-09-30T18:17:44Z (GMT). No. of bitstreams: 2 S1516-31802007000500006.pdf: 223943 bytes, checksum: 27a4995cd140663036e0867d4dfba435 (MD5) S1516-31802007000500006.pdf.txt: 30055 bytes, checksum: 0fa77d7a8fa2a34f57dc294727bbc51f (MD5) Previous issue date: 2007-09-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:40Z No. of bitstreams: 2 S1516-31802007000500006.pdf: 223943 bytes, checksum: 27a4995cd140663036e0867d4dfba435 (MD5) S1516-31802007000500006.pdf.txt: 30055 bytes, checksum: 0fa77d7a8fa2a34f57dc294727bbc51f (MD5) Made available in DSpace on 2014-05-20T13:33:40Z (GMT). No. of bitstreams: 2 S1516-31802007000500006.pdf: 223943 bytes, checksum: 27a4995cd140663036e0867d4dfba435 (MD5) S1516-31802007000500006.pdf.txt: 30055 bytes, checksum: 0fa77d7a8fa2a34f57dc294727bbc51f (MD5) Previous issue date: 2007-09-01 CONTEXTO E OBJETIVO: Urticária-angioedema crônico é enfermidade freqüente, complexa e multicausal. O objetivo foi estudar as características sociodemográficas, clínicas, os fatores causais, agravantes e a evolução da enfermidade. TIPO DE ESTUDO E LOCAL: Descritivo e prospectivo, realizado no ambulatório de Dermatologia da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp). MÉTODOS: Foram avaliados pacientes com diagnóstico de urticária-angioedema crônico através de dados sociodemográficos, anamnese, exames dermatológico, clínico e laboratorial, com ênfase nos fatores causais, agravantes e na evolução da enfermidade. RESULTADOS: 125 pacientes foram incluídos, 95 mulheres e 30 homens. Predominaram mulheres de 30 a 40 anos e homens de 10 a 20 anos. A idade média foi de 35 anos para as mulheres e 32 anos para os homens. Predominaram pacientes de raça branca, residentes em zona urbana e casados. O tempo médio de doença foi de 45,6 meses e de cada lesão foi de 5,6 horas. A metade dos casos tinha surtos diariamente e associação de urticária com angioedema. Não houve horário preferencial de aparecimento dos surtos, mas o noturno foi o horário de piora mais citado. A causa foi esclarecida em 37,6%, predominando as infecções. O estresse foi o agravante mais referido. O tempo médio de acompanhamento foi de 11,7 meses e 60% evoluíram para o controle, 32% melhoraram, 9% mantiveram-se inalterados e um caso piorou. CONCLUSÕES: Urticária-angioedema ocorreu mais em mulheres de meia-idade. A causa foi esclarecida em um terço dos pacientes e metade deles teve controle da doença em aproximadamente um ano. CONTEXT and OBJECTIVE: Chronic urticaria-angioedema is a common, multiple-cause complaint. The aim was to investigate the sociodemographic and clinical characteristics, causal and aggravating factors and evolution of urticaria-angioedema. DESIGN and SETTING: This was a descriptive prospective study carried out at the Dermatology outpatient clinic of Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp). METHODS: A total of 125 patients with chronic urticaria-angioedema were evaluated to obtain sociodemographic data, anamnesis, dermatological and general clinical data and laboratory data, emphasizing causal and aggravating factors and complaint evolution. RESULTS: Chronic urticaria-angioedema occurred mainly in females (mean age: 35 years), but also in men (mean age: 32 years). White color and living in urban areas also predominated. There was no preferential time for symptoms to appear, and nighttime was the most commonly reported time for clinical worsening. Around half of the patients had urticaria associated with angioedema. There were no associated factors in most of the cases, and stress was the most commonly reported aggravating factor. The cause was ascertained in 37.6% of our cases. The mean duration of follow-up was 11.7 months. Around 60% of the patients evolved with the problem under control, 32% improved, 9% had no change in dermatological condition and only one patient worsened. CONCLUSIONS: Chronic urticaria-angioedema was more common among middle-aged women. It is a long-term disease, and its cause was explained in about one-third of the patients. Half of the patients presented disease control after treatment lasting an average of approximately one year. Universidade Estadual Paulista Faculdade de Medicina de Botucatu Hospital das Clínicas Universidade Estadual Paulista Faculdade de Medicina de Botucatu Hospital das Clínicas

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:48:20Z No. of bitstreams: 1 S0100-39842007000400016.pdf: 224875 bytes, checksum: 914f735195d54ce0c1aa97d3e1e5382f (MD5) Made available in DSpace on 2013-08-22T18:48:20Z (GMT). No. of bitstreams: 1 S0100-39842007000400016.pdf: 224875 bytes, checksum: 914f735195d54ce0c1aa97d3e1e5382f (MD5) Previous issue date: 2007-08-01 Made available in DSpace on 2013-09-30T19:38:09Z (GMT). No. of bitstreams: 2 S0100-39842007000400016.pdf: 224875 bytes, checksum: 914f735195d54ce0c1aa97d3e1e5382f (MD5) S0100-39842007000400016.pdf.txt: 13386 bytes, checksum: 48e2d4aecce4cea1244fceac6a379074 (MD5) Previous issue date: 2007-08-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:37:53Z No. of bitstreams: 2 S0100-39842007000400016.pdf: 224875 bytes, checksum: 914f735195d54ce0c1aa97d3e1e5382f (MD5) S0100-39842007000400016.pdf.txt: 13386 bytes, checksum: 48e2d4aecce4cea1244fceac6a379074 (MD5) Made available in DSpace on 2014-05-20T13:37:53Z (GMT). No. of bitstreams: 2 S0100-39842007000400016.pdf: 224875 bytes, checksum: 914f735195d54ce0c1aa97d3e1e5382f (MD5) S0100-39842007000400016.pdf.txt: 13386 bytes, checksum: 48e2d4aecce4cea1244fceac6a379074 (MD5) Previous issue date: 2007-08-01 Neste trabalho apresentamos um caso de hiperplasia nodular focal que foi diagnosticado aos seis anos de idade e que está sendo acompanhado até o momento presente. Para o diagnóstico foram imprescindíveis as técnicas de imagem, tendo importância de realce a cintilografia hepatoesplênica e a tomografia computadorizada. Apresentamos, também, revisão da literatura sobre o assunto. In this case report we discuss a focal nodular hyperplasia diagnosed in a female, six-year old patient, as well as her follow-up from the diagnosis to the present time. Imaging techniques, particularly hepatosplenic scintigraphy and computed tomography, are essential for the diagnosis. Also, a literature review is presented. Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Departamento de Pediatra Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Departamento de Doenças Tropicais e Diagnóstico por Imagem Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Departamento de Pediatra Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Departamento de Doenças Tropicais e Diagnóstico por Imagem

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:04:02Z No. of bitstreams: 1 S1413-86702005000200004.pdf: 84869 bytes, checksum: 2b1b7f3a96f69ecf84bd6efa3078375f (MD5) Made available in DSpace on 2013-08-22T19:04:02Z (GMT). No. of bitstreams: 1 S1413-86702005000200004.pdf: 84869 bytes, checksum: 2b1b7f3a96f69ecf84bd6efa3078375f (MD5) Previous issue date: 2005-04-01 Made available in DSpace on 2013-09-30T20:06:36Z (GMT). No. of bitstreams: 2 S1413-86702005000200004.pdf: 84869 bytes, checksum: 2b1b7f3a96f69ecf84bd6efa3078375f (MD5) S1413-86702005000200004.pdf.txt: 25661 bytes, checksum: 41f66a659e37aa2e4d5420a981ce5375 (MD5) Previous issue date: 2005-04-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:17:01Z No. of bitstreams: 2 S1413-86702005000200004.pdf: 84869 bytes, checksum: 2b1b7f3a96f69ecf84bd6efa3078375f (MD5) S1413-86702005000200004.pdf.txt: 25661 bytes, checksum: 41f66a659e37aa2e4d5420a981ce5375 (MD5) Made available in DSpace on 2014-05-20T15:17:01Z (GMT). No. of bitstreams: 2 S1413-86702005000200004.pdf: 84869 bytes, checksum: 2b1b7f3a96f69ecf84bd6efa3078375f (MD5) S1413-86702005000200004.pdf.txt: 25661 bytes, checksum: 41f66a659e37aa2e4d5420a981ce5375 (MD5) Previous issue date: 2005-04-01 Progression of chronic hepatitis C is known to be associated with some factors, but influence of HCV genotypes is still controversial. Association between HCV genotypes and other risk factors was examined to determine which factors are associated with progression of infection. One hundred consecutive anti-HCV positive volunteer blood donors were evaluated for several risk factors, examined for HCV genotypes, and submitted to hepatic biopsy and biochemical exams.HCV genotyping were carried out in 89 patients and hepatic biopsy in 78. Transmission routes were found to be illicit intravenous drug use (26%), Gluconergan® use in a non-safe manner (48%) and blood transfusion (15%). HCV genotype was 1 in 45%, 3 in 40%, and it was not associated with the stage of fibrosis or with inflammatory activity. There was no significant association of factors related to infection, chronic alcohol use, or duration of illness, with progression of the lesion. There was a significant association of aminotransferase levels and the fibrosis stage. Univariate analysis showed that the age at contamination, patient's age, GT-gamma, and aminotransferase levels over three times the upper normal limits, were associated with fibrosis stages 2 to 4. Multivariate analysis detected age (odds ratio=1.19), and GT-gamma (odds ratio=2.02) as independent factors. UNESP Botucatu School of Medicine Campinas State University UNESP Botucatu School of Medicine

Chronic hepatitis by HCV is progressive towards cirrhosis, with variable rate. We evaluated the rate of fibrosis progression (RFP), risk factors associated with advanced fibrosis (F3 and F4), and estimated the evolution time to cirrhosis.We transversely selected 142 blood donors infected only with HCV, with a known route of infection, submitted to liver biopsy at admission. RFP= ratio between stage of fibrosis (METAVIR)/estimated duration of infection in years. Non-parametric tests and logistic regression analysis, with significance level of 5% were used.Median RFP was 0.086 U/year (0.05-0.142). Ten patients had F4 and 25 had F3. Median RFP values were significantly different (p=0.001) from one age group at contamination to the others and ALT and AST levels. There were no differences in the expected evolution to cirrhosis between intermediate fibrosers (F2) and the rapid fibrosers (F3 and F4). The independent variables associated with advanced fibrosis were ALT (OR 7.2) and GGT (OR 6.4) and age at inclusion (OR 1.12).This study suggests that RFP is extremely variable, it is exponential with age, and mainly influenced by host characteristics, especially age at contamination and possibly ethnical group. These asymptomatic patients had high percentage of fibrosis F2, F3 and F4.

We describe a case of a diffuse large B-cell lymphoma with extensive emperipolesis phenomenon. Light microscopy revealed numerous CD68-positive/S-100-negative histiocytes containing viable neoplastic hematopoietic cells in their cytoplasm. Electron microscopy confirmed these findings. In this case, there was no evidence of Rosai-Dorfman disease either clinically or histologically. This report emphasizes that emperipolesis is not restricted to Rosai-Dorfman disease and can be found in other conditions including non-Hodgkin lymphomas.

Liver and lymph nodes injuries characterized by clusters of foamy macrophages, some of them containing birefringent crystals, were observed in cattle fed on Brachiaria brizantha hay. The cattle were from an experimental group poisoned with Senecio brasiliensis known to cause hepatic fibrosis and hepatocyte megalocytosis. One of the animals developed photosensitivity but the exact cause wasn't determined since both plants were fed. The foamy macrophages were present from the 30th d of feeding. Early appearance of these lesions may be particular to the animal specie used or due to the presence of both toxic plants.

We studied an experimental model of resection arthroplasty with or without tendon ball interposition in the wrist of dogs. Animals were divided into two groups. Animals in group A were treated by resection of the os carpi radiale with interposition of a ball made from the tendon of the extensor carpi radialis and the group B underwent bone resection alone. Animals were assessed 1, 6, 12 and 24 weeks after operation. In all of them the wrist joint was stable and had good mobility, allowing walking supported by the operated limb. In both groups biological material filled the cavity created by bone resection. A progressive repair process resulted in fibroplasia with areas of fibrocartilaginous metaplasia. The tendon ball showed complete ischaemic necrosis at the end of the first week, which delayed the healing process.

Made available in DSpace on 2022-04-28T19:54:34Z (GMT). No. of bitstreams: 0 Previous issue date: 1998-01-01 Paracoccidioides brasiliensis, the causative agent of paracoccidioidomycosis (PCM), was first isolated from armadillos from the Amazonian region where the mycosis is uncommon. In the present study, we report on the high incidence of PCM infection in armadillos from a hyperendemic region of the disease. Four nine-banded armadillos (Dasypus novemcinctus) were captured in the endemic area of Botucatu, Sao Paulo, Brazil, killed by manual cervical dislocation and autopsied under sterile conditions. Fragments of lung, spleen, liver, and mesenteric lymph nodes were processed for histology, cultured on Mycosel agar at 37°C, and homogenized for inoculation into the testis and peritoneum of hamsters. The animals were killed from week 6 to week 20 postinoculation and fragments of liver, lung, spleen, testis, and lymph nodes were cultured on brain heart infusion agar at 37°C. Paracoccidioides brasiliensis was isolated from three armadillos both by direct organ culture and from the liver, spleen, lung, and mesenteric lymph nodes of hamsters. In addition, one positive armadillo presented histologically proven PCM disease in a mesenteric lymph node. The three armadillos isolates (Pb-A1, Pb-A2, and Pb-A4) presented thermo-dependent dimorphism, urease activity, and casein assimilation, showed amplification of the gp43 gene, and were highly virulent in intratesticularly inoculated hamsters. The isolates expressed the gp43 glycoprotein, the immunodominant antigen of the fungus, and reacted with a pool of sera from PCM patients. Taken together, the present data confirm that armadillos are a natural reservoir of P. brasiliensis and demonstrate that the animal is a sylvan host to the fungus. Departamento de Microbiologia Instituto de Biociências UNESP, Botucatu, Sao Paulo Res. Ctr. Pathogenic Fungi/M.T. Chiba University, Chiba Departamento de Patologia Faculdade de Medicina UNESP, Botucatu, Sao Paulo Disciplina de Biologia Celular Universidade Federal de Sao Paulo, Sao Paulo Departamento de Microbiologia Instituto de Biociências UNESP, Botucatu, Sao Paulo Departamento de Patologia Faculdade de Medicina UNESP, Botucatu, Sao Paulo

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:45:28Z No. of bitstreams: 1 S0074-02761996000600002.pdf: 32628 bytes, checksum: 8a962f8a96197889aab59d2e171a52ac (MD5) Made available in DSpace on 2013-08-22T18:45:28Z (GMT). No. of bitstreams: 1 S0074-02761996000600002.pdf: 32628 bytes, checksum: 8a962f8a96197889aab59d2e171a52ac (MD5) Previous issue date: 1996-12-01 Made available in DSpace on 2013-09-30T19:34:31Z (GMT). No. of bitstreams: 2 S0074-02761996000600002.pdf: 32628 bytes, checksum: 8a962f8a96197889aab59d2e171a52ac (MD5) S0074-02761996000600002.pdf.txt: 22888 bytes, checksum: 4a821abeb2ab376044469f9f00f68fee (MD5) Previous issue date: 1996-12-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:09:23Z No. of bitstreams: 2 S0074-02761996000600002.pdf: 32628 bytes, checksum: 8a962f8a96197889aab59d2e171a52ac (MD5) S0074-02761996000600002.pdf.txt: 22888 bytes, checksum: 4a821abeb2ab376044469f9f00f68fee (MD5) Made available in DSpace on 2014-05-20T15:09:23Z (GMT). No. of bitstreams: 2 S0074-02761996000600002.pdf: 32628 bytes, checksum: 8a962f8a96197889aab59d2e171a52ac (MD5) S0074-02761996000600002.pdf.txt: 22888 bytes, checksum: 4a821abeb2ab376044469f9f00f68fee (MD5) Previous issue date: 1996-12-01 In an attempt to isolate Paracoccidioides brasiliensis from nature 887 samples of soil from Botucatu, SP, Brazil, were collected cultured in brain heart infusion agar supplemented with dextrose, in potato dextrose agar and in yeast extract starch dextrose agar, all with antibiotics, at 25º and 37ºC. Five thermo-dependent dimorphic fungi morphologically resembling P. brasiliensis were isolated; two from armadillo holes; further studies of the biology, antigenicity and genetic features of the five dimorphic fungi are necessary to clarify their taxonomy and their possible relation to P. brasiliensis. In addition, 98 dematiaceous fungi and 581 different species of Aspergillus spp. were also isolated. Our findings emphasize that armadillos and their environment are associated with thermo-dimorphic fungi and confirm the ubiquity of pathogenic dematiaceous fungi and Aspergillus spp. UNESP Faculdade de Medicina Departamento de Patologia Chiba University Research Center for Pathogenic Fungi and Microbial Toxicoses Natural History Museum and Institute UNESP Faculdade de Medicina Departamento de Moléstias Infecciosas e Parasitárias UNESP Faculdade de Medicina Departamento de Patologia UNESP Faculdade de Medicina Departamento de Moléstias Infecciosas e Parasitárias

Hypersensitivity pneumonitis was induced in mice immunized with Paracoccidioides brasiliensis and challenged, one week later, with soluble (SPbAg) or particulate (PPbAg) antigen (formalin-killed yeast cells), administered by the intratracheal route. Between 24 and 48 h post-challenge, animals developed an interstitial and intra-alveolar pneumonitis. Macrophages and lymphocytes arranged focally into loose or mature granulomata were observed by light and electron microscopy. The distribution and fate of antigens was studied by immunofluorescence. Three hours after challenge with SPbAg the lungs showed linear fluorescent deposits, whereas after challenge with PPbAg the pattern was globular, corresponding to the particulate antigen. After 24 and 48 h, the pattern was diffuse and finely granular in both groups, with a decreasing number of animals showing detectable fluorescence. Immunization induced a positive footpad swelling test (FPT) in all animals. After pulmonary challenge, there was a significant decrea...