GLAUCIA APARECIDA BENTO DOS SANTOS

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Projetos de Pesquisa
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Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico

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Agora exibindo 1 - 10 de 14
  • article 31 Citação(ões) na Scopus
    Magnetic resonance diffusion tensor imaging for the pedunculopontine nucleus: proof of concept and histological correlation
    (2017) ALHO, A. T. D. L.; HAMANI, C.; ALHO, E. J. L.; SILVA, R. E. da; SANTOS, G. A. B.; NEVES, R. C.; CARREIRA, L. L.; ARAUJO, C. M. M.; MAGALHAES, G.; COELHO, D. B.; ALEGRO, M. C.; MARTIN, M. G. M.; GRINBERG, L. T.; PASQUALUCCI, C. A.; HEINSEN, H.; FONOFF, E. T.; AMARO JR., E.
    The pedunculopontine nucleus (PPN) has been proposed as target for deep brain stimulation (DBS) in patients with postural instability and gait disorders due to its involvement in muscle tonus adjustments and control of locomotion. However, it is a deep-seated brainstem nucleus without clear imaging or electrophysiological markers. Some studies suggested that diffusion tensor imaging (DTI) may help guiding electrode placement in the PPN by showing the surrounding fiber bundles, but none have provided a direct histological correlation. We investigated DTI fractional anisotropy (FA) maps from in vivo and in situ postmortem magnetic resonance images (MRI) compared to histological evaluations for improving PPN targeting in humans. A post-mortem brain was scanned in a clinical 3T MR system in situ. Thereafter, the brain was processed with a special method ideally suited for cytoarchitectonic analyses. Also, nine volunteers had in vivo brain scanning using the same MRI protocol. Images from volunteers were compared to those obtained in the post-mortem study. FA values of the volunteers were obtained from PPN, inferior colliculus, cerebellar crossing fibers and medial lemniscus using histological data and atlas information. FA values in the PPN were significantly lower than in the surrounding white matter region and higher than in areas with predominantly gray matter. In Nissl-stained histologic sections, the PPN extended for more than 10 mm in the rostro-caudal axis being closely attached to the lateral parabrachial nucleus. Our DTI analyses and the spatial correlation with histological findings proposed a location for PPN that matched the position assigned to this nucleus in the literature. Coregistration of neuroimaging and cytoarchitectonic features can add value to help establishing functional architectonics of the PPN and facilitate neurosurgical targeting of this extended nucleus.
  • article 23 Citação(ões) na Scopus
    High thickness histological sections as alternative to study the three-dimensional microscopic human sub-cortical neuroanatomy
    (2018) ALHO, Eduardo Joaquim Lopes; ALHO, Ana Tereza Di Lorenzo; GRINBERG, Lea; AMARO JR., Edson; SANTOS, Glaucia Aparecida Bento dos; SILVA, Rafael Emidio da; NEVES, Ricardo Caires; ALEGRO, Maryana; COELHO, Daniel Boari; TEIXEIRA, Manoel Jacobsen; FONOFF, Erich Talamoni; HEINSEN, Helmut
    Stereotaxy is based on the precise image-guided spatial localization of targets within the human brain. Even with the recent advances in MRI technology, histological examination renders different (and complementary) information of the nervous tissue. Although several maps have been selected as a basis for correlating imaging results with the anatomical locations of sub-cortical structures, technical limitations interfere in a point-to-point correlation between imaging and anatomy due to the lack of precise correction for post-mortem tissue deformations caused by tissue fixation and processing. We present an alternative method to parcellate human brain cytoarchitectural regions, minimizing deformations caused by post-mortem and tissue-processing artifacts and enhancing segmentation by means of modified high thickness histological techniques and registration with MRI of the same specimen and into MNI space (ICBM152). A three-dimensional (3D) histological atlas of the human thalamus, basal ganglia, and basal forebrain cholinergic system is displayed. Structure's segmentations were performed in high-resolution dark-field and light-field microscopy. Bidimensional non-linear registration of the histological slices was followed by 3D registration with in situ MRI of the same subject. Manual and automated registration procedures were adopted and compared. To evaluate the quality of the registration procedures, Dice similarity coefficient and normalized weighted spectral distance were calculated and the results indicate good overlap between registered volumes and a small shape difference between them in both manual and automated registration methods. High thickness high-resolution histological slices in combination with registration to in situ MRI of the same subject provide an effective alternative method to study nuclear boundaries in the human brain, enhancing segmentation and demanding less resources and time for tissue processing than traditional methods.
  • article 7 Citação(ões) na Scopus
    Is Olfactory Epithelium Biopsy Useful for Confirming Alzheimer's Disease?
    (2019) GODOY, Maria Dantas Costa Lima; FORNAZIERI, Marco Aurelio; DOTY, Richard L.; PINNA, Fabio de Rezende; FARFEL, Jose Marcelo; SANTOS, Glaucia Bento dos; MOLINA, Mariana; FERRETTI-REBUSTINI, Renata E. L.; LEITE, Renata E. P.; SUEMOTO, Claudia K.; GRINBERG, Lea T.; PASCRALUCCI, Carlos A. G.; VOEGELS, Richard Louis; NITRINI, Ricardo; JACOB FILHO, Wilson
    Objectives: The clinical symptoms of Alzheimer's disease (AD) are preceded by a long asymptomatic period associated with ""silent"" deposition of aberrant paired helical filament (PHF)-tau and amyloid-beta proteins in brain tissue. Similar depositions have been reported within the olfactory epithelium (OE), a tissue that can be biopsied in vivo. The degree to which such biopsies are useful in identifying AD is controversial. This postmortem study had 3 main goals: first, to quantify the relative densities of AD-related proteins in 3 regions of the olfactory neuroepithelium, namely, the nasal septum, middle turbinate, and superior turbinate; second, to establish whether such densities are correlated among these epithelial regions as well as with semi-quantitative ratings of general brain cortex pathology; and third, to evaluate correlations between the protein densities and measures of antemortem cognitive function. Methods: Postmortem blocks of olfactory mucosa were obtained from 12 AD cadavers and 24 controls and subjected to amyloid-beta and PHF-tau immunohistochemistry. Results: We observed marked heterogeneity in the presence of the biomarkers of tau and amyloid-beta among the targeted olfactory epithelial regions. No significant difference was observed between the cadavers with AD and the controls regarding the concentration of these proteins in any of these epithelial regions. Only one correlation significant was evident, namely, that between the tau protein densities of the middle and the upper turbinate (r = .58, P = .002). Conclusion: AD-related biomarker heterogeneity, which has not been previously demonstrated, makes comparisons across studies difficult and throws into question the usefulness of OE amyloid-beta and PHF-tau biopsies in detecting AD.
  • conferenceObject
    Magnetic resonance diffusion tensor imaging for the pedunculopontine nucleus: Correlation between neuroimaging and cytoarchitectonic features
    (2016) ALHO, A. T. D. L.; HAMANI, C.; ALHO, E. J. L.; SILVA, R. E. da; SANTOS, G. A. B. dos; NEVES, R. C.; ARAUJO, C. M. M.; MAGALHAES, G.; GRINBERG, L. T.; HEINSEN, H.; FONOFF, E. T.; AMARO-JUNIOR, E.
  • article 3 Citação(ões) na Scopus
    Right Cardiac Chambers Involvement by a Malignant Testicular Germ Cell Tumor: An Imaging-pathologic Correlation
    (2016) NASCIMENTO, Felipe Barjud Pereira Do; ALBIERI, Lilian; SANTOS, Glaucia Aparecida Bento dos; DOLHNIKOFF, Marisa
    The cardiac chamber's involvement with neoplastic embolism has been rarely reported; it is mostly associated with gastric, breast, lung, liver, and prostate cancers, and usually affects the pulmonary arteries. This paper reports a case of a 31-year-old man with a malignant testicular germ cell tumor who presented with multiple episodes of pulmonary thromboembolism and died of sudden respiratory failure 1 year after the initial diagnosis. Death was attributed to massive pulmonary embolism and pulmonary infarction associated with a neoplastic thrombus that extended from the gonadal veins to pulmonary arteries. A postmortem computerized tomographic angiography and autopsy confirmed this finding. (C) 2016 Elsevier Inc.
  • article 15 Citação(ões) na Scopus
    Ultrasound-guided minimally invasive autopsies: A protocol for the study of pulmonary and systemic involvement of COVID-19
    (2020) MONTEIRO, Renata Aparecida de Almeida; DUARTE-NETO, Amaro Nunes; SILVA, Luiz Fernando Ferraz da; OLIVEIRA, Ellen Pierre de; THEODORO FILHO, Jair; SANTOS, Glaucia Aparecida Bento dos; OLIVEIRA, Ilka Regina Souza de; MAUAD, Thais; SALDIVA, Paulo Hilario do Nascimento; DOLHNIKOFF, Marisa
  • article 79 Citação(ões) na Scopus
    Transpulmonary Pressure Describes Lung Morphology During Decremental Positive End-Expiratory Pressure Trials in Obesity
    (2017) FUMAGALLI, Jacopo; BERRA, Lorenzo; ZHANG, Changsheng; PIRRONE, Massimiliano; SANTIAGO, Roberta R. De Santis; GOMES, Susimeire; MAGNI, Federico; SANTOS, Glaucia A. B. dos; BENNETT, Desmond; TORSANI, Vinicius; FISHER, Daniel; MORAIS, Caio; AMATO, Marcelo B. P.; KACMAREK, Robert M.
    Objectives: Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. Design: Prospective, crossover, nonrandomized interventional study. Setting: Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (Sao Paulo, Brazil). Patients/Subjects: Critically ill obese patients with acute respiratory failure and anesthetized swine. Interventions: Clinical data from 16 mechanically ventilated critically ill obese patients were analyzed. An animal model of obesity with reversible atelectasis was developed by placing fluid filled bags on the abdomen to describe changes of lung mechanics, lung morphology, and pulmonary hemodynamics in 10 swine. Measurements and Main Results: In obese patients (body mass index, 48 +/- 11 kg/m(2)), 21.7 +/- 3.7 cm H2O of positive end-expiratory pressure resulted in the lowest elastance of the respiratory system (18.6 +/- 6.1 cm H2O/L) after a recruitment maneuver and decremental positive end-expiratory pressure and corresponded to a positive (2.1 +/- 2.2 cm H2O) end-expiratory transpulmonary pressure. Ventilation at lowest elastance positive end-expiratory pressure preceded by a recruitment maneuver restored end-expiratory lung volume (30.4 +/- 9.1 mL/kg ideal body weight) and oxygenation (273.4 +/- 72.1 mm Hg). In the swine model, lung collapse and intratidal recruitment/derecruitment occurred when the positive end-expiratory transpulmonary pressure decreased below 2-4 cm H2O. After the development of atelectasis, a decremental positive end-expiratory pressure trial preceded by lung recruitment identified the positive end-expiratory pressure level (17.4 +/- 2.1 cm H2O) needed to restore poorly and nonaerated lung tissue, reestablishing lung elastance and oxygenation while avoiding increased pulmonary vascular resistance. Conclusions: In obesity, low-to-negative values of transpulmonary pressure predict lung collapse and intratidal recruitment/derecruitment. A decremental positive end-expiratory pressure trial preceded by a recruitment maneuver reverses atelectasis, improves lung mechanics, distribution of ventilation and oxygenation, and does not increase pulmonary vascular resistance.
  • article 13 Citação(ões) na Scopus
    Three-dimensional and stereological characterization of the human substantia nigra during aging
    (2016) ALHO, Ana Tereza Di Lorenzo; SUEMOTO, Claudia Kimie; POLICHISO, Livia; TAMPELLINI, Edilaine; OLIVEIRA, Katia Cristina de; MOLINA, Mariana; SANTOS, Glaucia Aparecida Bento; NASCIMENTO, Camila; LEITE, Renata Elaine Paraizo; FERRETI-REBUSTINI, Renata Eloah de Lucena; SILVA, Alexandre Valotta da; NITRINI, Ricardo; PASQUALUCCI, Carlos Augusto; JACOB-FILHO, Wilson; HEINSEN, Helmut; GRINBERG, Lea Tenenholz
    The human brain undergoes non-uniform changes during aging. The substantia nigra (SN), the source of major dopaminergic pathways in the brain, is particularly vulnerable to changes in the progression of several age-related neurodegenerative diseases. To establish normative data for high-resolution imaging, and to further clinical and anatomical studies we analyzed SNs from 15 subjects aged 50-91 cognitively normal human subjects without signs of parkinsonism. Complete brains or brainstems with substantia nigra were formalin-fixed, celloidin-mounted, serially cut and Nissl-stained. The shapes of all SNs investigated were reconstructed using fast, high-resolution computer-assisted 3D reconstruction software. We found a negative correlation between age and SN volume (p = 0.04, rho = -0.53), with great variability in neuronal numbers and density across participants. The 3D reconstructions revealed SN inter- and intra-individual variability. Furthermore, we observed that human SN is a neuronal reticulum, rather than a group of isolated neuronal islands. Caution is required when using SN volume as a surrogate for SN status in individual subjects. The use of multimodal sequences including those for fiber tracts may enhance the value of imaging as a diagnostic tool to assess SN in vivo. Further studies with a larger sample size are needed for understanding the structure-function interaction of human SN.
  • article 7 Citação(ões) na Scopus
    Detection of the source of hemorrhage using postmortem computerized tomographic angiography in a case of a giant juvenile nasopharyngeal angiofibroma after surgical treatment
    (2015) NASCIMENTO, Felipe Barjud Pereira do; SANTOS, Glaucia Aparecida Bento dos; MELO, Nelson Almeida d'Avila; DAMASCENO, Eduarda Bittencourt; MAUAD, Thais
    Purpose Postmortem computerized tomographic angiography (PMCTA) has been increasingly used in forensic medicine to detect and locate the source of bleeding in cases of fatal acute hemorrhage. In this paper, we report a case of postoperative complication in a patient with a giant juvenile nasopharyngeal angiofibroma in which the source of bleeding was detected by PMCTA. Methods A case description and evaluations of the pre- and postoperative exams, postmortem CT angiogram, and conventional autopsy results are provided. Results The source of bleeding was identified by postmortem CT angiography but not by conventional autopsy. The established protocol, injecting contrast medium into the femoral artery, was effective in identifying the source of bleeding. Conclusions Postoperative bleeding is a rare and frequently fatal complication of juvenile nasopharyngeal angiofibroma. As a complement to conventional autopsy, postmortem angiography is a valuable tool for the detection of lethal acute hemorrhagic foci, and establishing a routine procedure for PMCTA may improve its efficiency.
  • article 43 Citação(ões) na Scopus
    Prevalence of dementia subtypes in a developing country: a clinicopathological study
    (2013) GRINBERG, Lea T.; NITRINI, Ricardo; SUEMOTO, Claudia K.; FERRETTI-REBUSTINI, Renata Eloah de Lucena; LEITE, Renata E. P.; FARFEL, Jose Marcelo; SANTOS, Erika; ANDRADE, Mara Patricia Guilhermino de; ALHO, Ana Tereza Di Lorenzo; LIMA, Maria do Carmo; OLIVEIRA, Katia C.; TAMPELLINI, Edilaine; POLICHISO, Livia; SANTOS, Glaucia B.; RODRIGUEZ, Roberta Diehl; UEDA, Kenji; PASQUALUCCI, Carlos A.; JACOB-FILHO, Wilson
    OBJECTIVES: To assess the distribution of dementia subtypes in Brazil using a population-based clinicopathological study. METHOD: Brains from deceased individuals aged >= 50 years old were collected after the next of kin signed an informed consent form and provided information through standardized questionnaires. Post-mortem clinical diagnoses were established in consensus meetings, and only cases with moderate or severe dementia or without cognitive impairment were included in the analysis. Immunohistochemical neuropathological examinations were performed following the universally accepted guidelines. A diagnosis of Alzheimer's disease was made when there were at least both a moderate density of neuritic plaques (Consortium to Establish a Register for Alzheimer's disease B or C) and Braak stage III for neurofibrillary tangle distribution. For the diagnosis of vascular dementia, at least three zones or strategic areas had to be affected by infarcts, lacunae, or microinfarcts. RESULTS: From 1,291 subjects, 113 cases were classified as having moderate or severe dementia, and 972 cases were free of cognitive impairment. The neuropathological diagnoses of the dementia sub-group were Alzheimer's disease (35.4%), vascular dementia (21.2%), Alzheimer's disease plus vascular dementia (13.3%), and other causes of dementia (30.1%). Small-vessel disease, which alone was not considered sufficient for a vascular dementia diagnosis, was present in 38.9% of all of the dementia cases and in 16.8% of the group without cognitive impairment (odds ratio = 2.91; 95% confidence interval, 1.53-5.51), adjusted for age, sex, and education. CONCLUSIONS: The relatively high frequencies of vascular dementia and small-vessel disease in the dementia sub-group constitute relevant findings for public health initiatives because control of vascular risk factors could decrease the prevalence of dementia in developing countries.