A novel adjustable pulmonary artery banding system for hypoplastic left heart syndrome

OBJECTIVE: Hypoplastic left heart syndrome remains a challenge for worldwide surgeons. Initial palliation employing bilateral pulmonary artery banding along with ductal stent implantation and atrial septostomy has been proposed as an alternative approach. However, the surgically placed bands are fixed and may become inadequate after sternum closure or with somatic growth of the patient. We describe the first case in which a neonate with hypoplastic left heart syndrome was initially managed using a mini banding system that allows for fine percutaneous adjustments of pulmonary blood flow. METHOD: Through a mid sternotomy, a 5 day-old neonate underwent bilateral pulmonary artery banding using this new system combined with placement of a main pulmonary artery to innominate artery shunt. RESULTS: The patient had an uneventful postoperative course. Three percutaneous adjustments of the banding system were necessary to keep the arterial oxygen saturation in the 75%-85% range. On the 48th day of life, she was submitted to stent placement (6 mm) within the atrial septum to treat a restrictive atrial septal defect. The Norwood operation and the bidirectional Glenn shunt were carried out on the 106th day of life. The bands were removed with no distortion of the pulmonary arteries. CONCLUSIONS: The clinical use of this innovative pulmonary artery banding system was feasible, safe and effective. It allowed for customization of the pulmonary blood flow according to the underlying clinical needs, resulting in a more precise balance between the pulmonary and systemic circulations.OBJETIVO: A Síndrome de Hipoplasia de Câmaras Esquerdas representa um grande desafio para cirurgiões do mundo inteiro. Atualmente, tem sido proposto procedimento paliativo alternativo, por meio da bandagem bilateral das artérias pulmonares associada à colocação de stent no canal arterial e atrioseptostomia. No entanto, as bandagens utilizadas são fixas, podendo tornar-se inadequadas após o fechamento do esterno ou com o rápido crescimento somático do paciente. Descrevemos a primeira aplicação clínica do novo dispositivo miniaturizado de bandagem ajustável das artérias pulmonares em neonato portador da síndrome de hipoplasia de câmaras esquerdas, o qual permitiu ajustes percutâneos precisos do fluxo sangüíneo pulmonar. MÉTODO: Através de esternotomia mediana, neonato de 5 dias de vida foi submetido à bandagem pulmonar bilateral, usando este novo dispositivo, combinada com interposição de tubo de PTFE entre o tronco pulmonar e o tronco braquiocefálico. RESULTADOS: O paciente apresentou boa evolução pós-operatória. Três ajustes percutâneos das bandagens foram necessários para manter a saturação arterial de oxigênio entre 75-85%. No 48º dia de vida, o paciente foi submetido a atrioseptostomia com colocação de stent (6 mm) para tratamento de comunicação interatrial restritiva. No 106º dia de vida, realizou-se operação de Norwood associada à anastomose cavopulmonar bilateral. As bandagens foram removidas, sem distorção das artérias pulmonares. CONCLUSÕES: O uso clínico deste sistema inovador de bandagem ajustável das artérias pulmonares mostrou-se factível, seguro e eficaz. Permitiu o ajuste fino do fluxo pulmonar de acordo com as necessidades clínicas, proporcionando um equilíbrio preciso entre as circulações pulmonar e sistêmica.Universidade de São Paulo Faculdade de MedicinaChildren's HospitalHospital Samaritano de São PauloUSP FM HCUniversidade Federal de São Paulo (UNIFESP)UNIFES Curso de Rastreamento Pré-Natal das Malformações CardíacasUniversidade de São Paulo Faculdade de Medicina Instituto do CoraçãoInstituto do Coração de IpatingaInstituto do Coração de Juiz de ForaHospital for Sick ChildrenInstituto Dante Pazzanese de CardiologiaInstituto Dante Pazzanese de Cardiologia Seção Médica de Intervenção em Cardiopatias CongênitasHospital Samaritano de São Paulo Laboratório de CateterismoAssociação Sanatório Sírio Hospital do CoraçãoUNIFESP, EPMSciEL

Expressão recombinante e caracterização de uma endoxilanase não descrita de Trichoderma harzianum

The use of alternative and renewable fuels is vital to solve the problems derived from the dependence of fuels, and the vegetal biomass is the only renewable source available in large scale that can be converted in energy. The bioethanol production has demonstrated a huge potential to minimize the environmental changes resultant from fossil fuels consumption. Nevertheless, the production costs of cellulolytic complexes lays out one of the major obstacle of the economical viability of the second generation ethanol. Therefore, the bioprospection and the understanding of enzymes involved in the process can improve the complexes productivity. Xylanases are enzymes used in several biotechnological processes, primordially for biopulping and biobleaching in papel industries. However, current surveys have investigated these enzymes due to an accessory role for bioethanol production. In this study, an endoxylanase (xyn3) gene from Trichoderma harzianum was cloned into Pichia pastoris. The constitutive vector pGAPZαA was used, changing the α-factor by the native signal peptide of the enzyme, and with a 6xHisTag at C-terminus. The recombinant protein were expressed in two majority forms, one with a molecular mass of 35 kDa (non-glycosylated) and the other with 60 kDa (glycosylated). Both forms showed xylanolytic activity in zymogram and were biochemically analyzed. The enzymes present optimal temperature of 40°C and pH 6.5, and stable activity until 30°C. The glycosylation plays important role in the enzymatic kinects of the recombinant enzyme, showing a catalytic efficiency twice higher of glycosylated form, in comparison with the activity of the non-glycosylated form. Even in this study, the effects of cellulose and xylan on the regulation of expression of the xyn2, xyn3 and egl3 genes were investigated to T. harzianum. All studied genes were overexpressed under all induction conditions and the results indicate a higher and earlier expression of these genes in fungus induction using a mixture of cellulose and xylan. Furthermore, an advance in the period of induction was observed while the fungus was cultivated with steam explosed bagasse supplemented with endoxylanase 3, when compared with the pure bagasse utilization. These findings enhance the vii understanding of enzymatic mode of action involved in deconstruction of plant cellular wall, whick can be used in the second generation ethanol production.Universidade Federal de Minas GeraisA utilização de combustíveis alternativos e renováveis é vital para resolver os problemas derivados da dependência de combustíveis fosseis, e a biomassa vegetal é a única fonte renovável disponível em larga escala que pode ser convertida em energia. A produção de bioetanol tem demonstrado um enorme potencial para minimizar as alterações ambientais resultantes do consumo de combustíveis fósseis. No entanto, os custos de produção de complexos celulolíticos constituem um dos maiores obstáculos da viabilidade econômica do etanol de segunda geração. Portanto, a bioprospecção e a compreensão das enzimas envolvidas no processo podem melhorar a produtividade dos complexos. Xilanases são enzimas usadas em vários processos biotecnológicos, primordialmente para biopolpação e biobranqueamento nas indústrias de papel e celulose. No entanto, as pesquisas atuais têm buscado por estas enzimas devido a um papel acessório na produção de bioetanol. Neste estudo, uma endoxilanase (xyn3) de Trichoderma harzianum foi clonada em Pichia pastoris. O vetor de expressão constitutivo pGAPZαA foi usado, alterando-se o factor-α pelo peptídeo sinal nativo da enzima, e com uma sequência 6xHisTag no C-terminal. A proteína recombinante foi expressa em duas formas majoritárias, uma com uma massa molecular de 35 kDa (não-glicosilada) e a outra com 60 kDa (glicosilada). Ambas as formas mostraram atividade xilanolítica em zimograma e foram analisadas bioquimicamente. As enzimas mostraram temperatura ótima de 40°C e pH 6,5, e com atividade estável até aproximadamente 30°C. A glicosilação apresentou um papel importante na cinética enzimática da enzima recombinante, que mostrou uma eficiência catalítica duas vezes mais elevada em sua forma glicosilada, em comparação com a atividade da forma não-glicosilada. Ainda neste estudo, foram investigados os efeitos de celulose e xilana na regulação da expressão dos genes xyn2, xyn3 e egl3 no T. harzianum. Todos os genes estudados foram superexpressos sob todas as condições de indução e os resultados indicaram uma expressão mais elevada e precoce destes genes utilizando-se uma mistura de celulose e xilana. Além disso, um avanço no período de indução foi observado quando o fungo foi cultivado com bagaço explodido suplementado com endoxilanase 3, quando comparado com a utilização do bagaço v puro. Estes resultados contribuem para o entendimento do mecanismo de ação do sistema enzimático envolvido na desconstrução da parede celular vegetal, o qual pode ser utilizado na produção do etanol de segunda geração

Exploring the limitations of isobutanol production by engineered industrial Saccharomyces cerevisiae strains

Saccharomyces cerevisiae is a natural producer of isobutanol, which has more advantages as biofuel than ethanol, i.e. superior combustion energy, weaker corrosive action and reduced aqueous miscibility. Isobutanol is produced by the combination of the valine biosynthesis and the Ehrlich pathway. In this work, an industrial strain was employed for isobutanol production, in which the valine pathway was relocated into the cytosol. The valine pathway in yeast has a cofactor imbalance, since the glycolysis produces NADH, while Ilv5 employs NADPH for the reaction. Therefore, the cofactor specificity of the pathway was rebalanced with exchange of Ilv5 by an NADH-consuming mutant, IlvC6E6. Furthermore, Ilv6, which regulates the feed-back inhibition of the valine biosynthesis, was tested to boost isobutanol production; however, none of these Ilv6 alternatives could greatly enhance isobutanol production. Therefore, due to a still low production yield, the bottlenecks of the isobutanol pathway were deeper studied. The major observed bottleneck concerned the conversion of DIV into KIV, since high concentrations of acetoin, 2,3-butandiol and, specially, DIV were observed in the fermentation supernatant, while neither KIV nor isobutyraldehyde were detected. This step is performed by the dihydroxy-acid dehydratase, Ilv3, which needs iron-sulfur clusters for its activity. Therefore, the first approach to circumvent this limitation was to increase the FeS assembly and its transference into the cytoplasm; however, Ilv3Δ19 activity was not improvement. Afterwards, Ilv3 alternatives were screened for substitution of Ilv3Δ19. Heterologous ILV3 orthologous with possible advantages were investigated, but Ilv3Δ19 was still the most promising alternative. Furthermore, sugar-acid enolases were tested as Ilv3Δ19 substitutes. These enolases also catalyze the dehydration of the substrate in the same way as Ilv3, but uses Mg2+ as cofactor. One of the employed enolases could complement valine auxotrophy; however, it allowed just a very slow growth of the Δilv3 strain and its activity could not be enhanced by mutagenesis studies. Interestingly, we observed that once DIV is secreted out of the cell, it cannot be re-uptaken from the medium and this possibly further aggravates the pathway flux and Ilv3Δ19 activity. In order to suppress DIV waste, two strategies were formulated: the deletion of the possible DIV transporter, and the substrate channeling of DIV from IlvC6E6 to Ilv3Δ19. In order to find possible DIV export proteins, a transcriptome analysis of a strain producing high amounts of DIV against a strain producing no detected DIV were compared. Several transporters were found upregulated in the DIV producing strain, but, alone, none of these were responsible for the DIV efflux. For the substrate channeling, an artificial enzymatic net was constructed by the fusion of IlvC6E6 and Ilv319 with synthetic zippers, which have high affinity to each other, and as both enzymes are alone organized as oligomers. The use of this enzymatic net enhanced not only the isobutanol production in about 17%, but also 3-methyl-butanol production yield was 25% increased. Nevertheless, together with bottlenecks arising from Ilv3 activity, the isobutanol production is limited by the ethanol production, which is the main product of S. cerevisiae. Therefore, in order to abolish ethanol production, PDC1 and PDC5 were deleted. Moreover, BDH1 and BDH2 were also deleted to create an NADH-driving force towards isobutanol production. However, the isobutanol yield of this mutant was even lower than that of the strain without the mentioned deletions. As a high production of isobutyric acid was observed, and it could be produced directly from KIV, different KIV decarboxylases and isobutanol dehydrogenases were investigated; but without improvement. Then, alternative pathways were abolished in other to favor isobutanol production, e.g. valine, leucine, isoleucine and panthotenate biosyntheses. Nevertheless, isobutanol yields were still low and the main byproducts were glycerol, acetoin, DIV and isobutyric acid. Despite the outcomes were not enough to enhance isobutanol production up to commercially required yields, these results help in the comprehension of the bottlenecks surrounding the isobutanol production pathway and serve as basis for further studies within the branched-chain amino acids biosynthesis and Ehrlich pathway

Crystallization and preliminary X-ray diffraction analysis of endoglucanase III from Trichoderma harzianum

Endoglucanases are enzymes that hydrolyze cellulose and are important components of the cellulolytic complex. In contrast to other members of the complex, they cleave internal beta-1,4-glycosidic bonds in the cellulose polymer, allowing cellulose to be used as an energy source. Since biomass is an important renewable source of energy, the structural and functional characterization of these enzymes is of interest. In this study, endoglucanase III from Trichoderma harzianum was produced in Pichia pastoris and purified. Crystals belonging to the orthorhombic space group P212121, with unit-cell parameters a = 47.54, b = 55.57, c = 157.3 angstrom, were obtained by the sitting-drop vapour-diffusion method and an X-ray diffraction data set was collected to 2.07 angstrom resolution.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2009/14333-6, 2008/56255-9, 2009/52840-7]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) via INCT do BioetanolConselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) via INCT do Bioetanol[471834/2009-2][490022/2009-0

Late physiotherapy rehabilitation changes gait patterns in post-stroke patients

Study aim: To determine whether a physiotherapy protocol improves the electromyographic activation (EA) during the hemiparetic gait in patients with delayed access to rehabilitation

Linha do tempo na história da Matemática

Ao ensinar matemática, é necessário levar em conta a curiosidade e a criatividade dos alunos. O objetivo deste trabalho é relatar a construção de uma linha do tempo da matemática e a utilização da história da matemática como metodologia de ensino. O artigo apresenta esta experiência do projeto que proporcionou aos bolsistas do PIBID (Programa Institucional de Bolsa de Iniciação à Docência) entender e compreender a importância da utilização da história da matemática na prática docente e as diferentes formas de aprender do aluno, com ênfase no ensino por meio da aprendizagem visual. Este trabalho foi desenvolvido no laboratório de educação matemática do IFC - Instituto Federal Catarinense – Campus Avançado Sombrio, por meio da aplicação da temática de estudo com uma turma de matemática do 7º Ano dos Anos Finais do Ensino Fundamental da Escola de Educação Básica Protásio Joaquim da Cunha, da cidade de Sombrio/SC. A linha do tempo foi utilizada para exemplificar o conteúdo, intitulado “Números Inteiros”, que vem sendo trabalhado com os alunos. O desenvolvimento deste trabalho possibilitou desenvolver a percepção de que a matemática não se trata unicamente de fórmulas, mas sim de uma ciência multidisciplinar que envolve grande parte das demais ciências e participa do desenvolvimento tecnológico