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Search Results: 1 - 10 of 126741 matches for " Manoel Jo?o Batista Castello;Bonduki "
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Gene Expression Analysis of Extracellular Matrix and Cytokines after Uterine Artery Embolization  [PDF]
André Bernardo, Tatiana Carvalho de Souza Bonetti, Ismael Dale Cotrim Guerreiro da Silva, Mariano Tamura Vieira Gomes, Rodrigo Aquino Castro, Manoel Joo Batista Castello Gir?o, Claudio Emilio Bonduki
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.415132
Abstract: Arterial embolization of myomas (AEM) is an established option for the conservative treatment of uterine leio-myomas; it treats all present uterine nodules at once, is less invasive than other procedures and effective in controlling symptoms, and does not require long term hospitalizations. Nevertheless, the potential impact on endometrial morphological and functional outcomes after the procedure is still controversial based on reports of endometritis or eventual transient ischemia. This study evaluated endometrial reorganization in uterine leiomyoma patients, before and after AEM, through gene expression analyses of extracellular matrix and cytokines genes in theendometrial tissue. Eight patients with leiomyomas were evaluated before AEM and 6 months after. The examinations included transvaginal pelvic ultrasonography, dosing of the follicle-stimulating hormone, and endometrial biopsy during the second phase of the menstrual cycle. RNA was extracted from endometrial samples, cDNA was synthesized, and applied on PCR arrayTM plates to evaluate the expression of extracellular matrix (ECM) genes and cytokines and their receptors’ genes (CYT). The ECM overexpressed genes were MMP (1, 3, 10, 11, and 14), CTGF1, ICAM1, TBHS1, ITGA2, ITGA3, ITGB3, COL7A1, COL12A, SPP1, and TNC; ADAMTS8 was underexpressed. The CYT overexpressed genes were SPP1, BCL6, CXCL12, IL-8, and CEBPB; CXCL13 and CCL21 were underexpressed. The ECM results showed overexpression of proteases that are responsible for dysfunctions in the ECM, and of genes responsible for adhesion and membrane components. The CYT results showed overexpression of chemokines responsible for endometrial repair, and underexpression of cytokines involved in inflammatory processes in the endometrial tissue. AEM treatment did not negatively affect the endometrial function at 6 months after embolization. This study broadens the knowledge about using a procedure that is relevant to the treatment of leiomyomas and contributes to the establishment of future guidelines for the decision making process for physicians and patients.
Impacto da emboliza??o arterial do leiomioma uterino no volume uterino, diametro do mioma dominante e na fun??o ovariana
Bernardo, André;Gomes, Mariano Tamura Vieira;Castro, Rodrigo Aquino;Gir?o, Manoel Joo Batista Castello;Bonduki, Claudio Emilio;Yokoyama, Claudio Atsushi;
Revista Brasileira de Ginecologia e Obstetrícia , 2011, DOI: 10.1590/S0100-72032011000800006
Abstract: purpose: to evaluate the impact of uterine artery embolization (uae) on uterine volume (uv), greater myoma diameter (gmd) and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (tvpus) and by the determination of follicle-stimulating hormone (fsh). methods: thirty patients with leiomyomas were submitted to uae. tvpus and fsh determination were performed before and three months after uae. uv was determined in cm3, gmd in cm and fsh in iu/ml. data are reported as as mean standard deviation (sd) and were analyzed statistically by the nonparametric mann-whitney test. results: twenty-nine patients were analyzed. before uae, mean uv was 402.4 165.9 cm3 and gmd was 5.9 2.1 cm. after uae, mean uv was 258.9 118.6 cm3 and gmd was 4.6 1.8 cm. mean fsh concentration was 4.9 3.5 iu/ml before uae and 5.5 4.7 iu/ml after uae, with p=0.5. there was a 35% reduction of uv and a 22% reduction of gmd, with no changes in fsh values after three months. conclusion: the procedure significantly reduced uv and gmd but did not cause a significant increase in fsh levels, thus causing no changes in ovarian function.
Avalia??o da propor??o de colágeno no tecido uterino antes e após tratamento do leiomioma uterino pela emboliza??o arterial
Bonduki, Cláudio Emílio;Dornelas Junior, Gilmar de Oliveira;Bernardo, André;Sim?es, Manuel de Jesus;Castro, Rodrigo de Aquino;Gomes, Mariano Tamura Vieira;Gir?o, Manoel Joo Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2009, DOI: 10.1590/S0100-72032009001200004
Abstract: purpose: to analyze histomorphometric consequences of the uterine arteries embolization (uae) in the uterine tissue, especially by collagen tissue quantification through uterine biopsy, before and after treatment of uterine leiomyoma. methods: 15 patients with symptomatic leyomioma and/or infertility, submitted to uae, participated in the study according to the study exclusion criteria, after having signed an informed consent. uterine biopsy was performed in the secretory phase of the menstrual cycle, before and three months after the procedure, to evaluate the collagen. after the histological processing of the material, 3 μ slices were prepared, some of them dyed with hematoxiline-eosin (he) and others with the specific dye for collagen fibers (picrosirius red). then, the slides were examined and interpreted, and the collagen quantified. the amount was calculated as the percent of the area composed by collagen, and the result expressed in mean±standard deviation (sd). data has then been submitted to statistical analysis by student's paired t test (p<0.05). results: the presence of smooth muscle cells was observed in the biopsies performed before the treatment, surrounded by a rich network of collagen fibers, which are part of the tumor, blood vessels and fibroblast nuclei. on the slides of biopsies performed after the treatment, it was observed the presence of widespread coagulation necrosis, vascular thrombosis, calcification and lymphoplasmocitary infiltration areas and clear reduction of the collagen component. the percentage of collagen fibers was higher in the pre-uae group (84.07±1.41), than in the post-uae (81.05±1.50) group, with p<0.0001, and 95% confidence interval (ci95%) from 2.080 to 3.827. conclusion: the quantitative and qualitative collagen reduction clearly shows that the proposed treatment is efficient in reducing the tumoral mass, composed mainly by collagen fibers intermingled with neoplasic smooth muscle cells. nevertheless, complementary studi
Gravidez e parto após emboliza??o arterial para tratamento de leiomioma uterino
Bonduki, Cláudio Emilio;Gon?alves, Patrícia;Yokohama, Cláudio;Costa, Odon Ferreira da;Baracat, Edmund Chada;Lima, Geraldo Rodrigues de;Gir?o, Manoel Joo Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2006, DOI: 10.1590/S0100-72032006001000005
Abstract: purpose: to analyze gestation evolution and deliveries after myoma treatment by embolization of the uterine arteries. methods: in the initial evaluation, 112 patients submitted to embolization of uterine arteries were included for treatment of myoma. from those, only nine wanted to be submitted to conservative treatment in order to keep their reproductive capacity. this procedure was indicated to the nine patients, since they were not susceptible to a conservative surgical treatment. they were submitted to embolization of the uterine arteries with particles of polyvinyl alcohol or embospheres with diameters ranging from 500 to 700 μm, and they have evolved without intercurrence. results: during the follow-up of these patients, there was a good clinical response with significant reduction in the uterus and myoma volumes. four of them got pregnant, two had an early abortion and two evolved normally till the end of gestation with a term delivery. one of these had twins. conclusion: embolization of the uterine arteries is an option for the treatment of uterine myoma, and presents good clinical and anatomical results, allowing patients to preserve their reproductive capacity.
Susceptibility to Fluconazole and Ketoconazole of Candida spp. Isolated from Primary and Episodic Vulvovaginites by E-Test (S?o Paulo, SP, Brazil)  [PDF]
Humberto Fabio Boatto, Manoel Joo Batista Castello Gir?o, Elaine Cristina Francisco, Alexandre Paulo Machado, Maria Sayonara de Moraes, Olga Fischman
Open Journal of Obstetrics and Gynecology (OJOG) , 2016, DOI: 10.4236/ojog.2016.612086
Abstract: Purpose: To evaluate the profile of in vitro susceptibility of yeasts isolated from cases of primary and espisodic vulvovaginitis to two antifungal agents. Methods: 40 Candida isolates from episodes of vulvovaginal candidiasis were identified by classic methodologies. The susceptibility testing of the in vitro fluconazole and ketoconazole activity against the isolates was accessed by E-test. Results: C. albicans was the most common species identified in 70% of the occurrences followed by C. glabrata (20%), C. tropicalis (7.5%), and C. guilliermondii (2.5%). In the susceptibility profile to antifungal agents, 12.5% and 16.7% of the isolates obtained from primary and episodic vulvovaginal candidiasis were resistant to fluconazole, respectively. To ketoconazole, we found that 6.25% and 12.5% of the isolates respectively from primary vulvovaginal candidiasis (PVVC) and episodic vulvovaginal candidiasis (EVVC) had high MIC values. Conclusions: E-test is a reliable method for the susceptibility testing of Candida spp. due to its simplicity, reproducibility, and lack of specialized equipment. Resistant strains and non-albicans species were verified
Avalia??o postural em mulheres com dor pélvica cr?nica
Miranda, Renata;Schor, Eduardo;Gir?o, Manoel Joo Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2009, DOI: 10.1590/S0100-72032009000700006
Abstract: objective: to evaluate by photogrammetry, postural changes in women with chronic pelvic pain. methods: thirty women with complaint of chronic pelvic pain and 37 without it, in a total of 67 women, were evaluated. the evaluation was realized through anamnesis, fixed markers in defined anatomical sites, and frontal, posterior, left and right lateral photographies. photo analysis has been done by the software coreldraw?, version 11.0. quantitative values for postural analysis of the ankle, the knee in the saggittal plan, pelvis, lumbar lordosis, thoracic kyphosis, adducted/abducted scapula, shoulders, head and third finger on the floor test were obtained. the qualitative variables studied were the knee (varus, valgus or normal), the presence or not of winged scapula and leveling of shoulders. the statistical package for social sciences, version 16.0 was used for the statistical analyses. fisher's exact test and monte-carlo method were used to compare the qualitative variables, and for the quantitative data, t or mann-whitney test was used. the comparisons among continuous data, corrected for possible confusion variables were realized by the univariate covariance analysis. significance level was established at 0.05 or 5%. results: there were significant differences between cases and controls for protruded head (47.5 and 52.0o, respectively; p<0.0001) and for protruded shoulders (1.9 and 1.6 cm, respectively; p=0.03). the other variables did not show significant differences. conclusions: based on these results, attention to head and shoulder posture, to antalgic postures and to the emotional factor is recommended. women with chronic pelvic pain should be treated, taking into consideration individual muscle-skeletal changes, and social and emotional conditions.
Pólipos endometriais: aspectos clínicos, epidemiológicos e pesquisa de polimorfismos
Miranda, Simone Madeira Nunes;Gomes, Mariano Tamura;Silva, Ismael Dale Cotrim Guerreiro da;Gir?o, Manoel Joo Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2010, DOI: 10.1590/S0100-72032010000700004
Abstract: purpose: to evaluate the clinical and epidemiological risk factors for endometrial cancer in postmenopausal women with endometrial polyps, as well as the genetic polymorphism of the progesterone receptor (progins). methods: a case-control study was designed with 160 postmenopausal women with endometrial polyps, compared to a normal control group of 400 postmenopausal women. the genotyping of progins polymorphism was determined by the polymerase chain reaction. clinical and epidemiological data were compared between benign endometrial polyps and 118 of the control subjects. variables were also compared with regard to benign and malignant endometrial polyps. results: comparison of the epidemiological variables between groups showed a significant difference for age, ethnicity, time since menopause, parity, tamoxifen use, hypertension and breast cancer, all of them more prevalent in the polyp group. after adjustment for age, statistical significance remained only for parity (or=1.1), hypertension (or=2.2) and breast cancer (or=14.4). there were six cases of malignant polyps (3.7%). the frequency of bleeding was 23.4% for benign polyps and 100% for malignant polyps, with large polyps being detected in 54.6% of the benign cases and in 100 of the malignnat ones. the frequency of arterial hypertension was 54.5% for benign polyps and 83.3% for the malignant ones. the frequency of progins t1/t1, t1/t2 and t2/t2 polymorphism was 79.9%, 19.5% and 0.6%, respectively, for the polyp group, and 78.8%, 20.8% and 0.5% for the control group. conclusions: elderly age, hypertension, and breast cancer were significantly associated with endometrial polyps. the presence of progins polymorphism was not significantly associated with endometrial polyps. the incidence of malignant polyps was low and strongly associated with bleeding, large-sized polyp and arterial hypertension.
Peritoneal borderline cystoadenocarcinoma
Gir?o, Manoel Joo Batista Castello;Sartori, Marair Gracio Ferreira;Gon?alves, Wagner José;Lima, Geraldo Rodrigues de;
Sao Paulo Medical Journal , 1998, DOI: 10.1590/S1516-31801998000100008
Abstract: carcinomas of peritoneal origin represent a seldom diagnosed entity of unknown etiology, with important implications in terms of prophylactic oophorectomy. initially described in patients belonging to families at high risk for ovarian cancer, it possibly has a pathogeny similar to that of endosalpingiosis and of some cases of endometriosis. we report a case of peritoneal borderline mucinous carcinoma with an anatomopathological diagnosis of normal ovaries.
Análise dos Vasos do Trato Urinário Inferior de Ratas Durante e Após a Prenhez
Kosmiskas José Vicente,Gir?o Manoel Joo Batista Castello,Sartori Marair Gracio Ferreira,Baracat Edmund Chada
Revista Brasileira de Ginecologia e Obstetrícia , 2002,
Abstract: Objetivos: estudar as varia es da anatomia vascular de ratas, avaliando o número de vasos da uretra proximal e distal, da jun o vésico-uretral e da bexiga, durante e após a prenhez. Métodos: trinta ratas, com teste positivo de acasalamento, foram divididas aleatoriamente em três grupos contendo 10 animais cada, a saber: GI - ratas no 10o dia de prenhez; GII - ratas no 20o dia de prenhez; GIII - ratas no 5o dia de puerpério; um grupo controle (GIV) era composto de 10 ratas na fase de estro. Foram contados os vasos sangüíneos em quatro laminas, por animal, coradas pelo método do tricr mico de Masson, com ocular de integra o de 25 pontos, acoplada a microscopia de luz, com objetiva de 40 X. As regi es estudadas foram uretra proximal e distal, jun o vésico-uretral e bexiga. Resultados: n o houve varia o significativa no número de vasos da bexiga, da jun o vésico-uretral e da uretra proximal nas ratas durante a gesta o ou em rela o ao grupo controle. Na uretra distal, o número de vasos no grupo controle foi 13,7, sendo significativamente menor do que nos grupos com prenhez (20,5 a 24,4 vasos). Conclus es: as ratas prenhes apresentaram maior número de vasos na uretra distal do que aquelas em estro. Nos demais locais estudados n o houve diferen as entre os grupos.
Colpossacrofixa o para corre o do prolapso da cúpula vaginal
Zucchi Eliana Viana Monteiro,Kati Léa Mina,Gir?o Manoel Joo Batista Castello,Sartori Marair Gracio Ferreira
Revista Brasileira de Ginecologia e Obstetrícia , 2003,
Abstract: OBJETIVO: avaliar o resultado da técnica da colpossacrofixa o (CSF) para tratamento de pacientes que apresentaram prolapso de cúpula vaginal pós-histerectomia e que foram tratadas no período de 1995 a 2000. MéTODOS: foram incluídas, retrospectivamente, 21 pacientes com prolapso de cúpula vaginal pós-histerectomia e corre o prévia de cistocele e retocele. Foram analisados a idade, paridade, peso e índice de massa corpórea (IMC) o intervalo entre a histerectomia e o aparecimento do prolapso. A colpossacrofixa o foi realizada em 15 pacientes, das quais se avaliaram o tempo cirúrgico, perda sangüínea e recidiva. As pacientes submeteram-se a CSF com ou sem interposi o de prótese de material sintético entre a cúpula vaginal e o sacro. RESULTADOS: para 15 das 21 pacientes acompanhadas em nosso servi o, a técnica de CSF foi a de elei o. Em um caso houve dificuldade técnica intra-operatória e optou-se pela corre o a Te Linde. A média de idade das pacientes foi de 63,7 (47 a 95 anos), paridade 4,6 e o IMC 26,9. A CSF foi realizada, em média, 18 anos após histerectomia total abdominal e 3 anos após histerectomia vaginal. O tempo cirúrgico médio foi de 2 horas e 15 minutos, sem necessidade de transfus o sanguínea. N o houve recidiva do prolapso ou dos sintomas pré-operatórios (seguimento de 1 a 5 anos). CONCLUS ES: o tratamento cirúrgico do prolapso de cúpula vaginal pode ser realizado pela via vaginal (colpocleise ou fixa o ao ligamento sacroespinhoso) e pela via abdominal (colpossacrofixa o). Esta última apresenta a vantagem de restaurar o eixo vaginal preservando sua profundidade, o que, além de melhorar o prolapso, permite o restabelecimento das fun es sexuais, intestinal e urinária (principalmente quando associada a colpofixa o - Burch). Assim, quando o diagnóstico e tratamento s o adequados e a equipe cirúrgica tem pleno conhecimento da anatomia pélvica, podemos afirmar que a CSF atinge seu objetivo no tratamento do prolapso de cúpula vaginal, com excelente corre o e mínima morbidade.
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