Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental
| Ano de defesa: | 2006 |
|---|---|
| Autor(a) principal: | |
| Orientador(a): | |
| Banca de defesa: | , , |
| Tipo de documento: | Tese |
| Tipo de acesso: | Acesso aberto |
| Idioma: | por |
| Instituição de defesa: |
Faculdade de Medicina de São José do Rio Preto
|
| Programa de Pós-Graduação: |
Programa de Pós-Graduação em Ciências da Saúde
|
| Departamento: |
Medicina Interna; Medicina e Ciências Correlatas
|
| País: |
BR
|
| Palavras-chave em Português: | |
| Palavras-chave em Inglês: | |
| Palavras-chave em Espanhol: | |
| Área do conhecimento CNPq: | |
| Link de acesso: | http://bdtd.famerp.br/handle/tede/71 |
Resumo: | The aim of the present study was to investigate the effects of the use of the anti-inflammatory protein annexin 1 (Anx-A1), which is found in most cells. It is characterized by its ability in binding to calcium and phospholipids, conferring protection against the initial effects of ischemia-reperfusion injury. Right nephrectomy was performed on 48 adult males Wistar rat, with sizes ranging between 250-300 g, maintained on a diet normosodic , normoprotein and with water ad libitum. The animals was divided into 3 groups: Annexin-1/Ischemia (Anx-A1-I/R) (n=16), vehicle (PBS40)-Ischemia (Vehicle-I/R) (n=16) and Sham Group (n=16). The endovenous administration of Anx-A1 was made 30 minutes before ischemia of the left renal artery. The animals of each group were divided and studied at 2 and 7 days post-reperfusion, in respect to the glomerular, tubular and renal structure functions. The results showed that there was a reduction in the glomerular filtration rate (GFR) in the Vehicle-I/R Groups at 2 and 7 days post-reperfusion (0.42 ± 0.02 mL/min-100g and 0.48 ± 0.05 mL/min-100g, respectively). There was a significantly greater filtration rate in the Anx-A1-I/R Groups compared to the Vehicle-I/R Groups (0.86 ± 0.05 mL/min-100g and 0.73 ± 0.04 mL/min-100g, respectively). A significant difference between the Anx-A1-I/R and Sham Groups (p-value < 0.01) was also observed (7days). The fractional sodium excretion (FeNa) was significantly higher in the Vehicle-I/R Groups when compared to the Anx-A1-I/R and Sham Groups on the 2nd and 7th post-perfusion days. On the 2nd day of the study, the fractional sodium excretion was 0.17 ± 0.01% for the Anx-A1-I/R, 0.42 ± 0.03% for the Vehicle-I/R and 0.21 ± 0.01% for the Sham groups (p-value < 0.001). On the 7th day, the values were 0.27 ± 0.03%, 0.52 ± 0.03% and 0.29 ± 0.01%, respectively (p-value < 0.001). The potassium excretion fraction (FeK) on the 2nd and 7th post-perfusion days did not differentiate between the Anx-A1-I/R and Sham Groups, but it was significantly higher in the Vehicle-I/R Groups. The urinary-plasmatic osmolality ratio (U/Posm) showed a significant reduction in the Vehicle-I/R Groups after 2 and 7 days when compared with the Anx-A1-I/R and Sham Groups. A histopathologic evaluation of renal cortex samples, taken on the 2nd and 7th post-perfusion days, revealed a significant increase in the intravascular and transmigrated neutrophils in ischemic areas of the Vehicle-I/R Groups. Additionally, high rates of transmigrated neutrophils were identified in the ischemia-reperfusion areas of samples of renal medulla from the Vehicle-I/R Group taken on the 2nd and 7th days. There was a significant reduction of the neutrophil transmigration in samples of renal medulla on the 2nd and 7th post-perfusion days in the Anx-A1-I/R Groups, as well as a lower intravascular neutrophil rate. On the 2nd and 7th post-perfusion days, the Sham Group presented with structures of distal and proximal convoluted tubules and well-preserved brush-border structures in the renal cortex and medulla samples as seen by light microscopy. Similar results were evidenced in the Anx-A1-I/R Groups with preserved structures in the tubules, basal membrane and glomeruli. In the Vehicle-IR Groups, numerous monocytes, cellular debris inside proximal convoluted tubules, dilated capillaries and alterations in the basal membrane structure were seen. These results suggest that the administration of annexin-1 thirty minutes before renal ischemia in rat , prevents the transmigration of neutrophils and confers protection against the initial effects of ischemia-reperfusion injury, as well as providing protection to the glomerular, tubular and renal structure functions. |
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Burdmann, Emmanuel de AlmeidaCPF:01180433823http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4793969P6&dataRevisao=nullAzoubel, ReinaldoCPF:01542680891http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4780809Y6&dataRevisao=nullOliani, Sonia MariaCPF:00000000008http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4796833D6&dataRevisao=nullGlina, SidneyCPF:00000000009http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4728280E3&dataRevisao=nullArruda, José Germano Ferraz deCPF:01889182800http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4779639P1&dataRevisao=nullYu, LuisCPF:89144422849http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4793960Z8&dataRevisao=nullCPF:04556553830http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4775559P7&dataRevisao=nullFacio Júnior, Fernando Nestor2016-01-26T12:51:24Z2006-07-232006-03-14FACIO JÚNIOR, Fernando Nestor. Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental. 2006. 90 f. Tese (Doutorado em Medicina Interna; Medicina e Ciências Correlatas) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, 2006.http://bdtd.famerp.br/handle/tede/71The aim of the present study was to investigate the effects of the use of the anti-inflammatory protein annexin 1 (Anx-A1), which is found in most cells. It is characterized by its ability in binding to calcium and phospholipids, conferring protection against the initial effects of ischemia-reperfusion injury. Right nephrectomy was performed on 48 adult males Wistar rat, with sizes ranging between 250-300 g, maintained on a diet normosodic , normoprotein and with water ad libitum. The animals was divided into 3 groups: Annexin-1/Ischemia (Anx-A1-I/R) (n=16), vehicle (PBS40)-Ischemia (Vehicle-I/R) (n=16) and Sham Group (n=16). The endovenous administration of Anx-A1 was made 30 minutes before ischemia of the left renal artery. The animals of each group were divided and studied at 2 and 7 days post-reperfusion, in respect to the glomerular, tubular and renal structure functions. The results showed that there was a reduction in the glomerular filtration rate (GFR) in the Vehicle-I/R Groups at 2 and 7 days post-reperfusion (0.42 ± 0.02 mL/min-100g and 0.48 ± 0.05 mL/min-100g, respectively). There was a significantly greater filtration rate in the Anx-A1-I/R Groups compared to the Vehicle-I/R Groups (0.86 ± 0.05 mL/min-100g and 0.73 ± 0.04 mL/min-100g, respectively). A significant difference between the Anx-A1-I/R and Sham Groups (p-value < 0.01) was also observed (7days). The fractional sodium excretion (FeNa) was significantly higher in the Vehicle-I/R Groups when compared to the Anx-A1-I/R and Sham Groups on the 2nd and 7th post-perfusion days. On the 2nd day of the study, the fractional sodium excretion was 0.17 ± 0.01% for the Anx-A1-I/R, 0.42 ± 0.03% for the Vehicle-I/R and 0.21 ± 0.01% for the Sham groups (p-value < 0.001). On the 7th day, the values were 0.27 ± 0.03%, 0.52 ± 0.03% and 0.29 ± 0.01%, respectively (p-value < 0.001). The potassium excretion fraction (FeK) on the 2nd and 7th post-perfusion days did not differentiate between the Anx-A1-I/R and Sham Groups, but it was significantly higher in the Vehicle-I/R Groups. The urinary-plasmatic osmolality ratio (U/Posm) showed a significant reduction in the Vehicle-I/R Groups after 2 and 7 days when compared with the Anx-A1-I/R and Sham Groups. A histopathologic evaluation of renal cortex samples, taken on the 2nd and 7th post-perfusion days, revealed a significant increase in the intravascular and transmigrated neutrophils in ischemic areas of the Vehicle-I/R Groups. Additionally, high rates of transmigrated neutrophils were identified in the ischemia-reperfusion areas of samples of renal medulla from the Vehicle-I/R Group taken on the 2nd and 7th days. There was a significant reduction of the neutrophil transmigration in samples of renal medulla on the 2nd and 7th post-perfusion days in the Anx-A1-I/R Groups, as well as a lower intravascular neutrophil rate. On the 2nd and 7th post-perfusion days, the Sham Group presented with structures of distal and proximal convoluted tubules and well-preserved brush-border structures in the renal cortex and medulla samples as seen by light microscopy. Similar results were evidenced in the Anx-A1-I/R Groups with preserved structures in the tubules, basal membrane and glomeruli. In the Vehicle-IR Groups, numerous monocytes, cellular debris inside proximal convoluted tubules, dilated capillaries and alterations in the basal membrane structure were seen. These results suggest that the administration of annexin-1 thirty minutes before renal ischemia in rat , prevents the transmigration of neutrophils and confers protection against the initial effects of ischemia-reperfusion injury, as well as providing protection to the glomerular, tubular and renal structure functions.O presente estudo objetivou investigar os efeitos do uso da anexina 1 (Anx-A1), considerada proteína antiinflamatória e que está presente na maioria das células. Caracteriza-se pela sua habilidade em ligar-se ao cálcio e fosfolipídeos, conferindo proteção contra os efeitos iniciais da lesão por isquemia e reperfusão. Realizou-se nefrectomia à direita em 48 ratos (Wistar-adultos-machos), pesando entre 250-300 gramas, mantidos com dieta normosódica , normoprotéica e água ad libitum. Os animais foram divididos em 3 grupos: Anexina 1-Isquemia (Anx-A1-I/R) (n=16), Veículo(PBS-40)-Isquemia (Veic-I/R) (n=16) e grupo Sham (n=16). A administração de anexina1 endovenosa foi realizada 30 minutos antes do clampeamento da artéria renal esquerda. Após reperfusão, os animais de cada grupo foram divididos e estudados com 2 e 7 dias, quanto às funções glomerulares , tubulares e à estrutura renal. Os resultados mostraram que houve redução da taxa de filtração glomerular (RFG) nos grupos veículo-I/R com 2 e 7 dias de experimento (0,42 ± 0,02 ml-min-100g e 0,48 ± 0,05 ml-min-100g, respectivamente) e verificamos aumento significativo da taxa de filtração glomerular nos grupos Anx-A1-I/R comparados aos grupos veículo-I/R (0,86 ± 0,05ml-min-100g e 0,73 ± 0,04ml-min-100g, respectivamente). Observou-se diferença significativa entre os grupos Anx-A1-I/R e Sham com 7 dias (p<0,01). A excreção fracional de sódio (FeNa) apresentou-se significantemente aumentada nos grupos veículo-I/R, comparada aos grupos Anx-A1-I/R e Sham nos 2º e 7º dias de experimento; apresentando assim no 2º dia de estudo,Anx-A1-I/R (0,17 ± 0,01%), Veic-I/R (0,42 ± 0,03%) e Sham (0,21 ± 0,01%) (p<0,001); e no 7º dia, Anx-A1-I/R (0,27 ± 0,03%), Veic-I/R (0,52 ± 0,03%) e Sham (0,29 ± 0,01%) (p<0,001). A fração de excreção de potássio (FeK) com 2 e 7 dias de experimento não diferiram entre os grupos Anx-A1-I/R e Sham, mas a FeK aumentou significativamente nos grupos Veic-IR. A razão das osmolalidades urinário-plasmáticas (U/Posm) mostraram uma redução importante nos grupos Veic-I/R em experimentos com 2 e 7 dias, comparados aos grupos Anx-A1-I/R e Sham. A avaliação histopatológica revelou aumento significativo de neutrófilos intravasculares e transmigrados, em áreas isquêmicas dos grupos Veic-I/R, de amostras avaliadas da porção do córtex renal com 2 e 7 dias. Verificaram-se altas taxas de transmigração de neutrófilos nas áreas de isquemia-reperfusão nos grupos Veic-I/R com 2 e 7 dias, em amostras avaliadas de medula renal. Houve significativa redução do extravasamento de neutrófilos em análise quantitativa, nas amostras de medula renal com 2 e 7 dias de estudo, nos grupos anexina 1-I/R, bem como menor taxa de neutrófilos no espaço intravascular. À microscopia de luz, verificou-se que, em amostras de córtex e medula renal, com 2 e 7 dias, o grupo Sham apresentou estruturas dos túbulos contorcidos proximais, distais e borda em escova bem preservados. Notou-se resultados semelhantes nos grupos de anexina1-I/R, com estruturas preservadas nos túbulos, membrana basal e glomérulos. Nos grupos Veic-I/R, verificou-se a presença de debris celulares no interior de túbulos contorcidos proximais, capilares dilatados e alterações na estrutura da membrana basal. Estes resultados sugerem que a administração da anexina1, trinta minutos antes da isquemia renal em ratos, previne a transmigração de neutrófilos e confere proteção contra os efeitos iniciais da lesão por isquemia e reperfusão, bem como proteção das funções glomerulares, tubulares e da estrutura renal.Made available in DSpace on 2016-01-26T12:51:24Z (GMT). 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| dc.title.por.fl_str_mv |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental |
| title |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental |
| spellingShingle |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental Facio Júnior, Fernando Nestor Isquemia Reperfusão Anexina-1 Necrose Tubular Aguda Insuficiência Renal Aguda Anexina I Nefropatias Ischemia Acute Kidney Failure Acute Kidney Tubular Necrosis Annexin I Kidney Diseases Nephrology Reperfusion Annexin 1 Acute Necrosis Tubular Reperfusión Necrosis Tubular Aguda CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEFROLOGIA |
| title_short |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental |
| title_full |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental |
| title_fullStr |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental |
| title_full_unstemmed |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental |
| title_sort |
Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental |
| author |
Facio Júnior, Fernando Nestor |
| author_facet |
Facio Júnior, Fernando Nestor |
| author_role |
author |
| dc.contributor.advisor1.fl_str_mv |
Burdmann, Emmanuel de Almeida |
| dc.contributor.advisor1ID.fl_str_mv |
CPF:01180433823 |
| dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4793969P6&dataRevisao=null |
| dc.contributor.advisor-co1.fl_str_mv |
Azoubel, Reinaldo |
| dc.contributor.advisor-co1ID.fl_str_mv |
CPF:01542680891 |
| dc.contributor.advisor-co1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4780809Y6&dataRevisao=null |
| dc.contributor.advisor-co2.fl_str_mv |
Oliani, Sonia Maria |
| dc.contributor.advisor-co2ID.fl_str_mv |
CPF:00000000008 |
| dc.contributor.advisor-co2Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4796833D6&dataRevisao=null |
| dc.contributor.referee1.fl_str_mv |
Glina, Sidney |
| dc.contributor.referee1ID.fl_str_mv |
CPF:00000000009 |
| dc.contributor.referee1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4728280E3&dataRevisao=null |
| dc.contributor.referee2.fl_str_mv |
Arruda, José Germano Ferraz de |
| dc.contributor.referee2ID.fl_str_mv |
CPF:01889182800 |
| dc.contributor.referee2Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4779639P1&dataRevisao=null |
| dc.contributor.referee3.fl_str_mv |
Yu, Luis |
| dc.contributor.referee3ID.fl_str_mv |
CPF:89144422849 |
| dc.contributor.referee3Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4793960Z8&dataRevisao=null |
| dc.contributor.authorID.fl_str_mv |
CPF:04556553830 |
| dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4775559P7&dataRevisao=null |
| dc.contributor.author.fl_str_mv |
Facio Júnior, Fernando Nestor |
| contributor_str_mv |
Burdmann, Emmanuel de Almeida Azoubel, Reinaldo Oliani, Sonia Maria Glina, Sidney Arruda, José Germano Ferraz de Yu, Luis |
| dc.subject.por.fl_str_mv |
Isquemia Reperfusão Anexina-1 Necrose Tubular Aguda Insuficiência Renal Aguda Anexina I Nefropatias |
| topic |
Isquemia Reperfusão Anexina-1 Necrose Tubular Aguda Insuficiência Renal Aguda Anexina I Nefropatias Ischemia Acute Kidney Failure Acute Kidney Tubular Necrosis Annexin I Kidney Diseases Nephrology Reperfusion Annexin 1 Acute Necrosis Tubular Reperfusión Necrosis Tubular Aguda CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEFROLOGIA |
| dc.subject.eng.fl_str_mv |
Ischemia Acute Kidney Failure Acute Kidney Tubular Necrosis Annexin I Kidney Diseases Nephrology Reperfusion Annexin 1 Acute Necrosis Tubular |
| dc.subject.spa.fl_str_mv |
Reperfusión Necrosis Tubular Aguda |
| dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEFROLOGIA |
| description |
The aim of the present study was to investigate the effects of the use of the anti-inflammatory protein annexin 1 (Anx-A1), which is found in most cells. It is characterized by its ability in binding to calcium and phospholipids, conferring protection against the initial effects of ischemia-reperfusion injury. Right nephrectomy was performed on 48 adult males Wistar rat, with sizes ranging between 250-300 g, maintained on a diet normosodic , normoprotein and with water ad libitum. The animals was divided into 3 groups: Annexin-1/Ischemia (Anx-A1-I/R) (n=16), vehicle (PBS40)-Ischemia (Vehicle-I/R) (n=16) and Sham Group (n=16). The endovenous administration of Anx-A1 was made 30 minutes before ischemia of the left renal artery. The animals of each group were divided and studied at 2 and 7 days post-reperfusion, in respect to the glomerular, tubular and renal structure functions. The results showed that there was a reduction in the glomerular filtration rate (GFR) in the Vehicle-I/R Groups at 2 and 7 days post-reperfusion (0.42 ± 0.02 mL/min-100g and 0.48 ± 0.05 mL/min-100g, respectively). There was a significantly greater filtration rate in the Anx-A1-I/R Groups compared to the Vehicle-I/R Groups (0.86 ± 0.05 mL/min-100g and 0.73 ± 0.04 mL/min-100g, respectively). A significant difference between the Anx-A1-I/R and Sham Groups (p-value < 0.01) was also observed (7days). The fractional sodium excretion (FeNa) was significantly higher in the Vehicle-I/R Groups when compared to the Anx-A1-I/R and Sham Groups on the 2nd and 7th post-perfusion days. On the 2nd day of the study, the fractional sodium excretion was 0.17 ± 0.01% for the Anx-A1-I/R, 0.42 ± 0.03% for the Vehicle-I/R and 0.21 ± 0.01% for the Sham groups (p-value < 0.001). On the 7th day, the values were 0.27 ± 0.03%, 0.52 ± 0.03% and 0.29 ± 0.01%, respectively (p-value < 0.001). The potassium excretion fraction (FeK) on the 2nd and 7th post-perfusion days did not differentiate between the Anx-A1-I/R and Sham Groups, but it was significantly higher in the Vehicle-I/R Groups. The urinary-plasmatic osmolality ratio (U/Posm) showed a significant reduction in the Vehicle-I/R Groups after 2 and 7 days when compared with the Anx-A1-I/R and Sham Groups. A histopathologic evaluation of renal cortex samples, taken on the 2nd and 7th post-perfusion days, revealed a significant increase in the intravascular and transmigrated neutrophils in ischemic areas of the Vehicle-I/R Groups. Additionally, high rates of transmigrated neutrophils were identified in the ischemia-reperfusion areas of samples of renal medulla from the Vehicle-I/R Group taken on the 2nd and 7th days. There was a significant reduction of the neutrophil transmigration in samples of renal medulla on the 2nd and 7th post-perfusion days in the Anx-A1-I/R Groups, as well as a lower intravascular neutrophil rate. On the 2nd and 7th post-perfusion days, the Sham Group presented with structures of distal and proximal convoluted tubules and well-preserved brush-border structures in the renal cortex and medulla samples as seen by light microscopy. Similar results were evidenced in the Anx-A1-I/R Groups with preserved structures in the tubules, basal membrane and glomeruli. In the Vehicle-IR Groups, numerous monocytes, cellular debris inside proximal convoluted tubules, dilated capillaries and alterations in the basal membrane structure were seen. These results suggest that the administration of annexin-1 thirty minutes before renal ischemia in rat , prevents the transmigration of neutrophils and confers protection against the initial effects of ischemia-reperfusion injury, as well as providing protection to the glomerular, tubular and renal structure functions. |
| publishDate |
2006 |
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2006-07-23 |
| dc.date.issued.fl_str_mv |
2006-03-14 |
| dc.date.accessioned.fl_str_mv |
2016-01-26T12:51:24Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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FACIO JÚNIOR, Fernando Nestor. Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental. 2006. 90 f. Tese (Doutorado em Medicina Interna; Medicina e Ciências Correlatas) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, 2006. |
| dc.identifier.uri.fl_str_mv |
http://bdtd.famerp.br/handle/tede/71 |
| identifier_str_mv |
FACIO JÚNIOR, Fernando Nestor. Efeitos da anexina1 na isquemia e reperfusão renal: estudo funcional e histopatológico em modelo experimental. 2006. 90 f. Tese (Doutorado em Medicina Interna; Medicina e Ciências Correlatas) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, 2006. |
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http://bdtd.famerp.br/handle/tede/71 |
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por |
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por |
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info:eu-repo/semantics/openAccess |
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Faculdade de Medicina de São José do Rio Preto |
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Programa de Pós-Graduação em Ciências da Saúde |
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FAMERP |
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BR |
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Medicina Interna; Medicina e Ciências Correlatas |
| publisher.none.fl_str_mv |
Faculdade de Medicina de São José do Rio Preto |
| dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da FAMERP instname:Faculdade de Medicina de São José do Rio Preto (FAMERP) instacron:FAMERP |
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Faculdade de Medicina de São José do Rio Preto (FAMERP) |
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FAMERP |
| institution |
FAMERP |
| reponame_str |
Biblioteca Digital de Teses e Dissertações da FAMERP |
| collection |
Biblioteca Digital de Teses e Dissertações da FAMERP |
| bitstream.url.fl_str_mv |
http://bdtd.famerp.br/bitstream/tede/71/1/fernandonestor_tese.pdf |
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af0a555c2adb2f553fd7214a6ca2774b |
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MD5 |
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Biblioteca Digital de Teses e Dissertações da FAMERP - Faculdade de Medicina de São José do Rio Preto (FAMERP) |
| repository.mail.fl_str_mv |
sbdc@famerp.br||joao.junior@famerp.br |
| _version_ |
1809113751866048512 |