ELIA TAMASO ESPIN GARCIA CALZOLARI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
LIM/59 - Laboratório de Biologia Celular, Hospital das Clínicas, Faculdade de Medicina
LIM/59 - Laboratório de Biologia Celular, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- ENDOTOXEMIC MYOCARDIAL DYSFUNCTION: SUBENDOCARDIAL COLLAGEN DEPOSITION RELATED TO CORONARY DRIVING PRESSURE(2014) SORIANO, Francisco Garcia; GUIDO, Maria Carolina; BARBEIRO, Hermes Vieira; CALDINI, Elia Garcia; LORIGADOS, Clara Batista; NOGUEIRA, Antonio CarlosSepsis impairs the autoregulation of myocardial microcirculatory blood flow, but whether this impairment is correlated with myocardial remodeling is unknown. This study investigated the role of coronary driving pressure (CDP) as a determinant of microcirculatory blood flow and myocardial fibrosis in endotoxemia and sepsis. The study is composed of two parts: a prospective experimental study and an observational clinical study. The experimental study was performed on male Wistar rats weighing 300 to 320 g. Endotoxemia was induced in rats by lipopolysaccharide (LPS) injection (10 mg.kg(-1) intraperitoneally). Hemodynamic evaluation was performed 1.5 to 24 h after LPS injection by measuring the mean arterial pressure, CDP, left ventricular end-diastolic pressure, dP/dtmax, and dP/dtmin. Microspheres were also infused into the left ventricle to measure myocardial blood flow, and myocardial tissue was histologically assessed to analyze collagen deposition. The CDP, mean arterial pressure, and myocardial blood flow were reduced by 55%, 30%, and 70%, respectively, in rats 1.5 h after LPS injection compared with phosphate buffer saline injection (P < 0.05). The CDP was significantly correlated with subendocardial blood flow (r = 0.73) and fibrosis (r = 0.8). Left ventricular function was significantly impaired in the LPS-treated rats, as demonstrated by dP/dtmax (6,155 +/- 455 vs. 3,746 +/- 406 mmHg.s(-1), baseline vs. LPS; P < 0.05) and dP/dtmin (-5,858 +/- 236 vs. -3,516 +/- 436 mmHg.s(-1), baseline vs. LPS; P < 0.05). The clinical study was performed on 28 patients with septic shock analyzed for CDP. The CDP data and histological slices were collected from septic patients. In addition, the clinical data demonstrated fibrosis and 45% CDP reduction in nonsurvivors compared with survivors. In conclusion, the left ventricular subendocardial blood flow was positively correlated with CDP, and higher CDP was negatively correlated with myocardial collagen deposition. Thus, early reductions in myocardial blood flow and CDP facilitate late myocardial fibrosis in rats and likely in humans.
- Comparative Morphometric Analysis of 5 Interpositional Arterial Autograft Options for Adult Living Donor Liver Transplantation(2014) IMAKUMA, E. S.; BORDINI, A. L.; MILLAN, L. S.; MASSAROLLO, P. C. B.; CALDINI, E. T. E. G.In living donor liver transplantation, the right-sided graft presents thin and short vessels, bringing forward a more difficult anastomosis. In these cases, an interpositional arterial autograft can be used to favor the performance of the arterial anastomosis, making the procedure easier and avoiding surgical complications. Objective. We compared the inferior mesenteric artery (IMA), the splenic artery (SA), the inferior epigastric artery (TEA), the descending branch of the lateral circumflex femoral artery (LCFA), and the proper hepatic artery (PHA) as options for interpositional autograft in living donor liver transplantation. Method. Segments of at least 3 cm of all 5 arteries were harvested from 16 fresh adult cadavers from both genders through standardized dissection. The analyzed measures were proximal and distal diameter and length. The proximal diameter of the RHA and the distal diameter of the SA, IMA, IEA and the LCFA were compared to the distal diameter of the RHA. The proximal and distal diameters of the SA, TEA and LCFA were compared to study caliber gain of each artery. Results. All arteries except the IMA showed statistical significant difference in relation to the RHA in terms of diameter. Regarding caliber gain, the arteries demonstrated statistical significant difference. All the harvested arteries except PHA were 3 cm in length. Conclusion. The IMA demonstrated the best compatibility with the RI-TA in terms of diameter and showed sufficient length to be employed as interpositional graft. The PHA, the SA, the TEA and the LCFA presented statistically significant different diameters when compared to the RHA. Among these vessels, only the PHA did not show sufficient mean length.
- SMALL INTERFERING RNA TARGETING FOCAL ADHESION KINASE PREVENTS CARDIAC DYSFUNCTION IN ENDOTOXEMIA(2012) GUIDO, Maria C.; CLEMENTE, Carolina F.; MORETTI, Ana I.; BARBEIRO, Hermes V.; DEBBAS, Victor; CALDINI, Elia G.; FRANCHINI, Kleber G.; SORIANO, Francisco G.Sepsis and septic shock are associated with cardiac depression. Cardiovascular instability is a major cause of death in patients with sepsis. Focal adhesion kinase (FAK) is a potential mediator of cardiomyocyte responses to oxidative and mechanical stress. Myocardial collagen deposition can affect cardiac compliance and contractility. The aim of the present study was to determine whether the silencing of FAK is protective against endotoxemia-induced alterations of cardiac structure and function. In male Wistar rats, endotoxemia was induced by intraperitoneal injection of lipopolysaccharide (10 mg/kg). Cardiac morphometry and function were studied in vivo by left ventricular catheterization and histology. Intravenous injection of small interfering RNA targeting FAK was used to silence myocardial expression of the kinase. The hearts of lipopolysaccharide-injected rats showed collagen deposition, increased matrix metalloproteinase 2 activity, and myocyte hypertrophy, as well as reduced 24-h +dP/dt and -dP/dt, together with hypotension, increased left ventricular end-diastolic pressure, and elevated levels of FAK (phosphorylated and unphosphorylated). Focal adhesion kinase silencing reduced the expression and activation of the kinase in cardiac tissue, as well as protecting against the increased collagen deposition, greater matrix metalloproteinase 2 activity, and reduced cardiac contractility that occur during endotoxemia. In conclusion, FAK is activated in endotoxemia, playing a role in cardiac remodeling and in the impairment of cardiac function. This kinase represents a potential therapeutic target for the protection of cardiac function in patients with sepsis.
- Effects of Time on Ultrastructural Integrity of Parathyroid Tissue Before Cryopreservation(2011) BARREIRA, Carlos Eduardo Santa Ritta; CERNEA, Claudio Roberto; BRANDAO, Lenine Garcia; CUSTODIO, Melani Ribeiro; CALDINI, Elia Tamaso Espin Garcia; MONTENEGRO, Fabio Luiz de MenezesCryopreservation of parathyroid tissue is used in the surgical treatment of secondary hyperparathyroidism. After surgical resection, the tissue is temporarily maintained in a cell culture solution until it arrives at the specialized laboratory where the cryopreservation process will take place. The present study evaluates the time that the human hyperplastic parathyroid gland tissue can wait before cryopreservation, based on parathyroid cell ultrastructural integrity. This prospective study included 11 patients who underwent total parathyroidectomy with heterotopic autotransplantation and cryopreservation of parathyroid tissue fragments. Part of the tissue was kept in cell culture solution at 4A degrees C. Five time periods between 2 and 24 h were defined, and parathyroid fragments were kept in the solution for that length of time. At the end of each period, the fragments were removed from the transport solution, fixed, and prepared for ultrathin sections. Of the 11 cases studied, 10 showed ultrastructural findings consistent with cellular viability in tissue fragments that remained in the transport solution up to 12 h. Electron microscopy revealed that cell adhesion and the integrity of plasma membranes, nuclei, and mitochondria were preserved in one case for up to 24 h. Changes in mitochondrial structure represented the most constant ultrastructural damage seen in the cases studied, in addition to the presence of edema and cell vacuoles. Analysis of the ultrastructure of hyperplastic parathyroid gland tissue showed that ultrastructural integrity was in most cases properly maintained in fragments stored up to 12 h in a cell culture solution at 4A degrees C.
- Skin Changes Due to Massive Weight Loss: Histological Changes and the Causes of the Limited Results of Contouring Surgeries(2021) I, Rodrigo Rocha; CINTRA JUNIOR, Wilson; MODOLIN, Miguel L. A.; TAKAHASHI, Giulia G.; CALDINI, Elia T. E. G.; GEMPERLI, RolfPurpose Outcomes of body contouring surgeries in patients who previously had obesity are limited because of the loss of skin quality. This study aimed to evaluate the morphometric characteristics of collagen and elastic fibers of the skin in the abdominal epigastric region of patients who had massive weight loss following bariatric surgery and compared such with the skin characteristics of patients with morbid obesity. Methods This observational study compared skin fragments from the epigastric region of 20 patients who had massive weight loss due to bariatric surgery and 20 patients with morbid obesity. The morphometric analysis was performed on the collagen system using the Picrosirius/polarized light method and on the elastic system using the Weigert's resorcin-fuchsin method. Results Reduction of thick collagen fibers (p = 0.048), increased thin collagen fibers (p = 0.0085), and increased elastic fiber density (p < 0.001) were observed in the massive weight loss group. No differences were found between the groups regarding mean age (p = 0.917) and total amount of collagen fibers (p = 0.3619). Structural dermis alterations in the massive weight loss group demonstrated collagenous remodeling, with consequent reduction of thick, organized, structured, and directed fibers in favor of thin, misaligned, and loosely arranged fibers. Weight loss was also associated with increased skin elasticity. Conclusion The morphometric changes in the collagen and elastic system scientifically explained the already established clinical perception of cutaneous alterations in patients who had massive weight loss following bariatric surgeries.
- Comparative long-term study between two dermal regeneration templates for the reconstruction of burn scar contractures in humans: Clinical and histological results(2020) VANA, Luiz Philipe Molina; BATTLEHNER, Claudia Naves; FERREIRA, Marcelo Alves; CALDINI, Elia Garcia; GEMPERLI, Rolf; ALONSO, NivaldoThe advent of dermal regeneration templates has fostered major advances in the treatment of acute bums and their sequelae, in the last three decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are few. The goal of this study was to prospectively analyze the outcome of randomized patients treated with two of the existing templates, followed by thin skin autograft. They are both 2mm-thick bovine collagen templates (Matriderm (R) and Integra (R)), the latter includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from bum sequelae (n =12 per template) in a two-step procedure. Negative pressure therapy was applied after surgery; patients were monitored for 12 months. No infra or postoperative complications were observed. Data on scar skin quality (Vancouver scar scale), rate of mobility recovery, and graft contraction were recorded; as well as morphological analyses at light microscopical level. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The double layer template showed the best performance in retraction rate, skin quality and mobility recovery. The subepidermal newly-formed connective tissue showed no histoarchitectural differences between the templates. The double layer template was not absorbed up to 12 months after placement.