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1.
Arq. bras. med. vet. zootec. (Online) ; 73(1): 197-202, Jan.-Feb. 2021. ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1153066

RESUMO

Dioctophymosis is the disease caused by Dioctophyma renale, a large nematode, popularly known as giant kidney worm, and whose definitive hosts are the domestic dog and many wild mammal species. There are some reports of maned wolf parasitism by D. renale, however, in most cases the reports are restricted to the finding of the parasite during necropsy, without clinical assessment. The present report aimed to describe the clinical-therapeutic, ultrasonographic and pathological aspects of D. renale parasitism in a free-ranging maned wolf, emphasizing the treatment with an association of doramectin, praziquantel, pyrantel pamoate, and febantel that resulted in complete elimination of the parasite.(AU)


A dioctofimose é a doença causada pelo Dioctophyma renale, um nemátodo grande, popularmente chamado de verme gigante do rim e que tem como hospedeiro definitivo o cão doméstico e inúmeras espécies de mamíferos silvestres. Existem alguns relatos do parasitismo do lobo-guará por D. renale, contudo, na maioria das vezes, os relatos se restringem apenas ao achado do parasita durante a necropsia, sem a correlação clínica. O presente relato objetiva descrever os aspectos clínico-terapêuticos, ultrassonográficos e patológicos do parasitismo por D. renale em um lobo-guará de vida livre, enfatizando o tratamento com uma associação de doramectina, praziquantel, pamoato de pirantel e febantel, o que resultou na eliminação completa do parasita.(AU)


Assuntos
Animais , Feminino , Infecções por Enoplida/patologia , Infecções por Enoplida/veterinária , Infecções por Enoplida/diagnóstico por imagem , Canidae/parasitologia , Dioctophymatoidea , Animais Selvagens/parasitologia , Animais de Zoológico/parasitologia
2.
Med Oral Patol Oral Cir Bucal ; 25(3): e431-e438, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32134901

RESUMO

BACKGROUND: Although new digital pathology tools have improved the positive cell quantification, there is a heterogeneity of the quantification methods in the literature. The aim of this study was to evaluate and propose a novel dendritic cells quantification method in squamous cell carcinoma comparing it with a conventional quantification method. MATERIAL AND METHODS: Twenty-six squamous cell carcinomas HIV-positive cases affecting the oropharynx, lips and oral cavity were selected. Immunohistochemistry for CD1a, CD83, and CD207 was performed. The immunohistochemical stains were evaluated by automated examination using a positive pixel count algorithm. A conventional quantification method (unspecific area method; UA) and a novel method (specific area method; SA) were performed obtaining the corresponding density of positive dendritic cells for the intratumoral and peritumoral regions. The Mann-Whitney U test was used to verify the influence of the quantification methods on the positive cell counting according to the evaluated regions. Data were subjected to the ANOVA and Student's t-test to verify the influence of the tumour location, stage, histological grade, and amount of inflammation on the dendritic cells density counting. RESULTS: The cell quantification method affected the dendritic cells counting independently of the evaluated region (P-value <0.05). Significant differences between methods were also observed according to the tumour features evaluations. CONCLUSIONS: The positive cell quantification method influences the dendritic cells density results. Unlike the conventional method (UA method), the novel SA method avoids non-target areas included in the hotspots improving the reliability and reproducibility of the density cell quantification.


Assuntos
Carcinoma de Células Escamosas , Infecções por HIV , Células Dendríticas , Humanos , Projetos Piloto , Reprodutibilidade dos Testes
3.
R. bras. Ci. avíc. ; 21(1): eRBCA-2019-0789, abr. 2019. tab
Artigo em Inglês | VETINDEX | ID: vti-18833

RESUMO

Piper cubeba is an Asian pepper used in popular medicine for its known antimicrobial, antiparasitic, and anti-inflammatory actions. The study evaluated the effects of dietary inclusion of Piper cubeba ethanolic extract (PE) as a replacement for anantibiotic growth promoter (AGP) on the performance and biochemical serum profile of 1- to 21-d-old broilers (Cobb®). Two hundred one-d-old broilers were housed in experimental battery cages and distributed in a completely randomized design. The following treatments were applied: negative control (NC) - basal diet; positive control (PC) - basal diet with addition of AGP; and the basal diet with inclusion of 0.17%, 0.34%, and 0.52% of PE (NCE1, NCE2, and NCE3, respectively). Growth performance, biochemical serum profile and internal organ weights were evaluated. Birds fed the AGP presented higher feed intake compared with the other treatments (p 0.05). The PC, NC, and NCE1 treatments presented higher weight gain compared with those fed NCE2 and NCE3 (p 0.05). The NC, NCE1, and NCE2 diets promoted better feed conversion ratio than the PC and NCE3 (p 0.05). Lower triglyceride serum levels were determined in broilers fed the NC and NCE1 diets. Amylase serum levels were lower in NCE1 and NCE2 treatments compared with the NC (p 0.05), whereas those obtained with the PC and NCE3 diets were not different (p>0.05) from the others. Organ relative weights were not influenced by the treatments. The inclusion of 0.17% of PE did not compromise the growth performance, biochemical serum profile or organ relative weights of 21-d-old broilers.(AU)


Assuntos
Animais , Fenômenos Bioquímicos , Soro , Piper/química
4.
Tech Coloproctol ; 21(9): 755, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28900885

RESUMO

Unfortunately, one of the author name was wrongly published in the original publication. The complete correct name should read as follows "Beatriz Camargo Azevedo". The original article was updated.

5.
Tech Coloproctol ; 21(9): 745-754, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28819868

RESUMO

BACKGROUND: Neoadjuvant chemoradiation therapy (nCRT) for rectal cancer may lead to cure. As we currently lack reliable methods to clinically confirm the absence of disease, some patients undergo radical resection and have pathological complete response (pCR) still undergo surgery. Furthermore, it is uncertain if conventional one-level histopathological analysis is accurate enough to determine complete response. Confirming pCR is essential to determine the prognosis and to consider the patient's inclusion in trials of adjuvant therapy. The aim of this study was to determine whether the current 1-level approach is sufficient to confirm pCR. METHODS: Four hundred and thirty-five patients with rectal cancer who received nCRT followed by radical resection were analyzed. All cases identified as pCR by 1-level step section histological evaluation were reassessed with 3-level step sections and immunohistochemical analysis to verify the presence of residual disease. RESULTS: Out of 435 patients, 75 (17.2%) were staged as ypT0. Of these, 6 had lymph node involvement and 1 had distant metastasis, leaving 68 (15.6%) who had pCR. After the additional step sections, residual tumor was detected in 12 (17.6%) of these 68. The final pCR rate was 12.9%. Distant recurrence was detected in 7.1% of real-pCR patients compared to 16.7% in the false-pCR group (p = 0.291). Sensitivity of clinical assessment for detecting pCR was 35.7%, and the accuracy of 1-section histological evaluation to identify pCR was 82.4%. CONCLUSIONS: Histopathological analysis with 1-level step section is insufficient to determine complete tumor eradication. The 3-level sections methodology revealed residual tumor cells in patients initially classified as ypT0. Further studies with larger sample size are required to verify the clinical relevance of these residual tumor cells. Caution should continue to be applied to watch and wait strategies following nCRT.


Assuntos
Quimiorradioterapia Adjuvante/métodos , Terapia Neoadjuvante/métodos , Recidiva Local de Neoplasia/diagnóstico , Neoplasia Residual/diagnóstico , Neoplasias Retais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Colectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Neoplasia Residual/patologia , Prognóstico , Estudos Prospectivos , Neoplasias Retais/terapia , Reto/patologia , Estudos Retrospectivos , Resultado do Tratamento
6.
Pathologica ; 106(1): 7-13, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24897774

RESUMO

A 62-year-old female presented with abdominal pain, weight loss of 20 kg in the prior 6 months, and a palpable mass in the right upper quadrant during physical exam. Standard liver tests, including screening for hepatitis B and C and alpha-fetoprotein were negative or within normal limits. Computerized tomography depicted a transmural gallbladder tumor infiltrating into the adjacent liver with an irregular ill-defined mass occupying segments IV-V-VI, measuring 13.0 x 9.2 x 8.5 cm, with a solid-cystic component and heterogeneous captation of endovenous contrast media. Complete surgical resection of the neoplasm was achieved through an extended cholecystectomy and excision of hepatic segments IV, V and VI, with an uneventful follow-up 29 months until now. Morphological and immunohistochemical assessment favored a diagnosis of combined hepatocellular-cholangiocarcinoma arising in a gallbladder intracystic papillary neoplasm with invasive carcinoma. This case raises the hypothesis that the so-called "hepatoid adenocarcinoma of the gallbladder" may presently be better understood as a neoplasm derived from hepatobiliary stem/progenitor cells. Such cells have been recognized in the canals of Hering, in peribiliary glands within the liver and in the extrahepatic biliary tree, and in gallbladder mucosa.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Ductos Biliares Intra-Hepáticos/patologia , Colangiocarcinoma/patologia , Neoplasias da Vesícula Biliar/patologia , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Intra-Hepáticos/cirurgia , Colangiocarcinoma/cirurgia , Feminino , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do Tratamento
7.
Transplant Proc ; 42(5): 1763-8, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20620519

RESUMO

Posttransplantation lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation that has been linked to Epstein-Barr virus (EBV) infection. The aim of this article was to describe a single-center experience with the multiplicity of clinical presentations of PTLD. Among 350 liver transplantations performed in 303 children, 13 survivor children displayed a histological diagnosis of PTLD (13/242 survivors; 5.4%). The age at diagnosis ranged from 12 to 258 months (median, 47), and the time from transplantation ranged from 1 to 84 months (median, 13). Ten of these children (76.9%) were EBV-naïve prior to transplantation. Fever was present in all cases. The clinical signs at presentation were anemia (92.3%), diarrhea and vomiting (69.2%), recurrent upper airway infections (38.4%), Waldeyer ring lymphoid tissue hypertrophy (23.0%), abdominal mass lesions (30.7%), massive cervical and mediastinal adenopathy (15.3%), or gastrointestinal and respiratory symptoms (30.7%). One child developed fulminant hepatic allograft failure secondary to graft involvement by PTLD. Polymorphic PTLD was diagnosed in 6 patients; 7 had the diagnosis of lymphoma. Treatment consisted of stopping immunosuppression as well as starting intravenous gancyclovir and anti-CD20 monoclonal antibody therapy. The mortality rate was 53.8%. The clinical presentation of PTLD varied from fever of unknown origin to fulminant hepatic failure. The other symptoms that may be linked to the diagnosis of PTLD are pancytopenia, tonsil and adenoid hypertrophy, cervical or mediastinal lymph node enlargement, as well as abdominal masses. Despite numerous advances, the optimal treatment approach for PTLD is not completely known and the mortality rate is still high.


Assuntos
Transplante de Fígado/efeitos adversos , Transtornos Linfoproliferativos/diagnóstico , Complicações Pós-Operatórias/patologia , Atresia Biliar/cirurgia , Criança , Pré-Escolar , Neoplasias do Colo/patologia , Ciclosporina/uso terapêutico , Quimioterapia Combinada , Infecções por Vírus Epstein-Barr/epidemiologia , Feminino , Herpesvirus Humano 4/isolamento & purificação , Humanos , Imunossupressores/uso terapêutico , Lactente , Transplante de Fígado/imunologia , Linfonodos/patologia , Linfoma de Células B/patologia , Transtornos Linfoproliferativos/etiologia , Transtornos Linfoproliferativos/patologia , Masculino , Prednisona/uso terapêutico , Estudos Retrospectivos , Sobreviventes , Tacrolimo/uso terapêutico
8.
Braz. j. med. biol. res ; 42(10): 958-962, Oct. 2009. ilus, tab
Artigo em Inglês | LILACS | ID: lil-526198

RESUMO

Non-alcoholic steatohepatitis (NASH) has been associated with hepatocellular carcinoma (HCC) often arising in histologically advanced disease when steatohepatitis is not active (cryptogenic cirrhosis). Our objective was to characterize patients with HCC and active, histologically defined steatohepatitis. Among 394 patients with HCC detected by ultrasound imaging over 8 years and staged by the Barcelona Clinic Liver Cancer (BCLC) criteria, we identified 7 cases (1.7 percent) with HCC occurring in the setting of active biopsy-proven NASH. All were negative for other liver diseases such as hepatitis C, hepatitis B, autoimmune hepatitis, Wilson disease, and hemochromatosis. The patients (4 males and 3 females, age 63 ± 13 years) were either overweight (4) or obese (3); 57 percent were diabetic and 28.5 percent had dyslipidemia. Cirrhosis was present in 6 of 7 patients, but 1 patient had well-differentiated HCC in the setting of NASH without cirrhosis (fibrosis stage 1) based on repeated liver biopsies, the absence of portal hypertension by clinical and radiographic evaluations and by direct surgical inspection. Among the cirrhotic patients, 71.4 percent were clinically staged as Child A and 14.2 percent as Child B. Tumor size ranged from 1.0 to 5.2 cm and 5 of 7 patients were classified as early stage; 46 percent of all nodules were hyper-echoic and 57 percent were <3 cm. HCC was well differentiated in 1/6 and moderately differentiated in 5/6. Alpha-fetoprotein was <100 ng/mL in all patients. HCC in patients with active steatohepatitis is often multifocal, may precede clinically advanced disease and occurs without diagnostic levels of alpha-fetoprotein. Importantly, HCC may occur in NASH in the absence of cirrhosis. More aggressive screening of NASH patients may be warranted.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Hepatocelular/complicações , Fígado Gorduroso/complicações , Cirrose Hepática/complicações , Neoplasias Hepáticas/complicações , Carcinoma Hepatocelular/patologia , Fígado Gorduroso/patologia , Cirrose Hepática/patologia , Neoplasias Hepáticas/patologia , Estadiamento de Neoplasias
9.
Braz J Med Biol Res ; 42(10): 958-62, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19787150

RESUMO

Non-alcoholic steatohepatitis (NASH) has been associated with hepatocellular carcinoma (HCC) often arising in histologically advanced disease when steatohepatitis is not active (cryptogenic cirrhosis). Our objective was to characterize patients with HCC and active, histologically defined steatohepatitis. Among 394 patients with HCC detected by ultrasound imaging over 8 years and staged by the Barcelona Clinic Liver Cancer (BCLC) criteria, we identified 7 cases (1.7%) with HCC occurring in the setting of active biopsy-proven NASH. All were negative for other liver diseases such as hepatitis C, hepatitis B, autoimmune hepatitis, Wilson disease, and hemochromatosis. The patients (4 males and 3 females, age 63 +/- 13 years) were either overweight (4) or obese (3); 57% were diabetic and 28.5% had dyslipidemia. Cirrhosis was present in 6 of 7 patients, but 1 patient had well-differentiated HCC in the setting of NASH without cirrhosis (fibrosis stage 1) based on repeated liver biopsies, the absence of portal hypertension by clinical and radiographic evaluations and by direct surgical inspection. Among the cirrhotic patients, 71.4% were clinically staged as Child A and 14.2% as Child B. Tumor size ranged from 1.0 to 5.2 cm and 5 of 7 patients were classified as early stage; 46% of all nodules were hyper-echoic and 57% were <3 cm. HCC was well differentiated in 1/6 and moderately differentiated in 5/6. Alpha-fetoprotein was <100 ng/mL in all patients. HCC in patients with active steatohepatitis is often multifocal, may precede clinically advanced disease and occurs without diagnostic levels of alpha-fetoprotein. Importantly, HCC may occur in NASH in the absence of cirrhosis. More aggressive screening of NASH patients may be warranted.


Assuntos
Carcinoma Hepatocelular/complicações , Fígado Gorduroso/complicações , Cirrose Hepática/complicações , Neoplasias Hepáticas/complicações , Adulto , Idoso , Carcinoma Hepatocelular/patologia , Fígado Gorduroso/patologia , Feminino , Humanos , Cirrose Hepática/patologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias
10.
Transplant Proc ; 40(5): 1641-4, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18589165

RESUMO

OBJECTIVE: We sought to evaluate the effects of immunosuppressant drugs (corticosteroid, cyclosporine [CsA], and tacrolimus [Tac]) on liver regeneration in growing animals submitted to 70% hepatectomy. MATERIALS AND METHODS: Newborn and weaning rats were submitted to 70% hepatectomy receiving separately methylprednisolone, CsA, or Tac. All animals were sacrificed 24 hours after the procedure. The remnant liver lobes were subjected to histomorphometric analyses with determination of hepatocyte mitotic index. RESULTS: Administration of immunosuppressants did not change the mitotic index of the regenerating liver in newborn animals. In weaning rats, methylprednisolone reduced the mitotic index (P = .01) and Tac caused a greater increase in this rate (P = .001). CsA had no effect on mitotic index. The number of hepatocyte mitoses in newborn animal livers was greater than that in weaning animal livers (P = .001). CONCLUSION: In situations in which intense, fast processes of liver regeneration are crucial, the advantages of the use of Tac must be considered, such as in pediatric transplant patients.


Assuntos
Ciclosporina/farmacologia , Hepatectomia/métodos , Hepatócitos/citologia , Imunossupressores/farmacologia , Regeneração Hepática/fisiologia , Mitose/efeitos dos fármacos , Tacrolimo/farmacologia , Envelhecimento/fisiologia , Animais , Animais Recém-Nascidos , Animais Lactentes , Hepatócitos/efeitos dos fármacos , Terapia de Imunossupressão , Cinética , Metilprednisolona/farmacologia , Índice Mitótico , Modelos Animais , Ratos , Desmame
11.
Braz. j. med. biol. res ; 41(3): 235-240, Mar. 2008. tab
Artigo em Inglês | LILACS | ID: lil-476568

RESUMO

Occult hepatitis B virus (HBV) infection has been reported among patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC). Our aim was to evaluate the presence of occult HBV infection in patients with HCV-related liver cirrhosis (LC) with or without HCC in São Paulo, Brazil. Serum and liver tissue samples from 50 hepatitis B surface antigen-negative patients with HCV-related LC who underwent liver transplantation at the University of São Paulo School of Medicine Hospital from 1993 to 2004 were divided into groups with LC only (N = 33) and with LC plus HCC (N = 17). HBV DNA was assayed for serum and paraffin-embedded liver tissue (tumoral and non-tumoral) using real time PCR and only 1 case with HCC had HBV DNA-positive serum. All liver samples were negative. HCV genotype 3 was detected in 17/39 (43.7 percent) cases. In conclusion, using a sensitive real time PCR directed to detect HBV variants circulating in Brazil, occult hepatitis B infection was not found among HCV-positive cirrhotic patients and was rarely found among HCV-positive HCC patients. These results are probably related to the low prevalence of HBV infection in our population. Furthermore, we have also shown that HCV genotype 3 is frequently found in Brazilian cirrhotic patients, particularly when they also have HCC. More studies involving a large number of cases should be carried out to confirm these data and to further characterize Brazilian HCV genotype isolates to elucidate genetic features that might be related to its carcinogenic potential.


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Hepatocelular/virologia , Hepatite B/diagnóstico , Hepatite C/complicações , Cirrose Hepática/virologia , Neoplasias Hepáticas/virologia , Brasil/epidemiologia , Genótipo , Hepacivirus/genética , Hepacivirus/imunologia , Anticorpos Anti-Hepatite B/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Anticorpos Anti-Hepatite C/sangue , Hepatite C/epidemiologia
12.
Braz J Med Biol Res ; 41(3): 235-40, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18097499

RESUMO

Occult hepatitis B virus (HBV) infection has been reported among patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC). Our aim was to evaluate the presence of occult HBV infection in patients with HCV-related liver cirrhosis (LC) with or without HCC in São Paulo, Brazil. Serum and liver tissue samples from 50 hepatitis B surface antigen-negative patients with HCV-related LC who underwent liver transplantation at the University of São Paulo School of Medicine Hospital from 1993 to 2004 were divided into groups with LC only (N = 33) and with LC plus HCC (N = 17). HBV DNA was assayed for serum and paraffin-embedded liver tissue (tumoral and non-tumoral) using real time PCR and only 1 case with HCC had HBV DNA-positive serum. All liver samples were negative. HCV genotype 3 was detected in 17/39 (43.7%) cases. In conclusion, using a sensitive real time PCR directed to detect HBV variants circulating in Brazil, occult hepatitis B infection was not found among HCV-positive cirrhotic patients and was rarely found among HCV-positive HCC patients. These results are probably related to the low prevalence of HBV infection in our population. Furthermore, we have also shown that HCV genotype 3 is frequently found in Brazilian cirrhotic patients, particularly when they also have HCC. More studies involving a large number of cases should be carried out to confirm these data and to further characterize Brazilian HCV genotype isolates to elucidate genetic features that might be related to its carcinogenic potential.


Assuntos
Carcinoma Hepatocelular/virologia , Hepatite B/diagnóstico , Hepatite C/complicações , Cirrose Hepática/virologia , Neoplasias Hepáticas/virologia , Idoso , Brasil/epidemiologia , Feminino , Genótipo , Hepacivirus/genética , Hepacivirus/imunologia , Hepatite B/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Hepatite C/epidemiologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade
13.
Transplant Proc ; 37(10): 4354-8, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16387119

RESUMO

BACKGROUND: Hepatic epithelioid hemangioendothelioma is a rare malignant tumor of vascular origin with frequent multifocal appearance. Liver resection may cause tumor spread. Liver transplantation has been indicated for unresectable nodules. We hypothesized that adjuvant interferon treatment is effective to prevent metastasis after liver resection. We report a case of multifocal hepatic epithelioid hemangioendothelioma successfully treated with interferon pulse therapy and bilobar hepatic resection. METHODOLOGY: CT scan and magnetic resonance imaging diagnosed three nodules in the liver (segments IV, VI and VII). Histopathology and specific immunostaining of a percutaneous nodule biopsy confirmed the diagnosis of hepatic epithelioid hemangioendothelioma. The treatment protocol included daily interferon alpha 2b 9 weeks before and 1 week after resection of liver segments IV, VI and VII. RESULTS: The postoperative outcome was complicated by a self-limited biliary fistula. The patient remains tumor free at 3 years after liver resection and currently enjoys excellent health. CONCLUSION: Interferon pulse therapy and hepatic resection was a good option to treat multifocal bilobar hepatic epithelioid hemangioendothelioma; it may prevent metastasis dissemination.


Assuntos
Hemangioendotelioma Epitelioide/cirurgia , Interferon-alfa/uso terapêutico , Neoplasias Hepáticas/cirurgia , Adulto , Antineoplásicos/uso terapêutico , Terapia Combinada , Feminino , Hemangioendotelioma Epitelioide/tratamento farmacológico , Hemangioendotelioma Epitelioide/patologia , Hepatectomia , Humanos , Interferon alfa-2 , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Proteínas Recombinantes , Fatores de Tempo , Resultado do Tratamento
14.
Pathologica ; 93(3): 189-95, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11433611

RESUMO

In order to assess further biological evidence for similarities among the "diagnostic classes" of cervical lesions, which are now a matter of international discussion in the search for a uniform classification, the purpose of this study was to characterize the immunoexpression of cell proliferation markers (proliferating cell nuclear antigen, PCNA and Ki-67) and protein p53. Each marker was individually quantified in basal, intermediate, and superficial epithelial compartments presenting chronic cervicitis (CC) accompanied by the cytopathic effects of infection by human papillomavirus (CCHPV) or not (CC), as well as in cervical intraepithelial neoplasia (CIN) grades I, II, and III. A total of 100 patients were evaluated and the positive nuclei were counted separately, including all extensions of the available epithelium. The percentage of PCNA- and Ki-67-positive cells increased with increasing grade of the cervical lesions, although PCNA immunoreactivity was always greater than the immunoreactivity observed with Ki-67 antigen. The immunoexpression of p53 protein was found to be weak, with no remarkable behavior in any specific "diagnostic class". The differences in cell proliferation markers found herein further emphasize the progressive loss of epithelial layer organization in the course of the development of preneoplastic changes in cervical squamous epithelium. Furthermore, difficulties in morphologically distinguishing "borderline lesions" persist when cell cycle markers are studied, further supporting the suggestion to consider the lesions of CCHPV and CIN I together as only one diagnostic class. Conversely, the different immune profile found between CIN II and III further supports the validity of the subdivision of CIN into three groups.


Assuntos
Regulação da Expressão Gênica , Antígeno Ki-67/biossíntese , Antígeno Nuclear de Célula em Proliferação/biossíntese , Proteína Supressora de Tumor p53/biossíntese , Doenças do Colo do Útero/metabolismo , Biomarcadores Tumorais , Biópsia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Divisão Celular , Núcleo Celular/química , Transformação Celular Neoplásica , Transformação Celular Viral , Neoplasia Intraepitelial Cervical/classificação , Neoplasia Intraepitelial Cervical/genética , Neoplasia Intraepitelial Cervical/metabolismo , Neoplasia Intraepitelial Cervical/patologia , Doença Crônica , Progressão da Doença , Células Epiteliais/metabolismo , Feminino , Regulação Neoplásica da Expressão Gênica , Genes p53 , Humanos , Antígeno Ki-67/genética , Proteínas de Neoplasias/biossíntese , Proteínas de Neoplasias/genética , Papillomaviridae , Infecções por Papillomavirus/genética , Infecções por Papillomavirus/metabolismo , Infecções por Papillomavirus/patologia , Antígeno Nuclear de Célula em Proliferação/genética , Infecções Tumorais por Vírus/genética , Infecções Tumorais por Vírus/metabolismo , Infecções Tumorais por Vírus/patologia , Doenças do Colo do Útero/classificação , Doenças do Colo do Útero/genética , Doenças do Colo do Útero/patologia , Neoplasias do Colo do Útero/classificação , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/patologia , Cervicite Uterina/metabolismo , Cervicite Uterina/patologia
15.
Head Neck ; 22(4): 373-9, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10862021

RESUMO

BACKGROUND: Thyroid follicular neoplasms (adenoma and carcinoma) may pose considerable difficulties to the differential diagnosis. Because such a distinction is not possible at fine-needle aspiration, surgery is often necessary. Clinical information such as age, sex, and node size is important in case of suspected carcinoma. Follicular carcinoma is characterized by capsular invasion, vascular invasion, and metastatic dissemination mainly by the hematogenic pathway. This invasion depends on collagen degradation in capsule and in subendothelial basement membrane. Collagen degradation has been widely researched in the angiogenesis process and in the hematogenic dissemination mechanism. In this study, we performed clinical and histopathologic assessment of 74 follicular neoplasms, as well as immunohistochemical reactions for CD-34 protein to estimate angiogenesis and for metalloproteinase-9, an enzyme that degrades type IV collagen. METHODS: The research was carried out retrospectively in 74 patients who had surgery and were followed up at HC-FMUSP and IBCC. Clinical, histologic, and immunohistochemical variables were compared among the groups of follicular neoplasms and a control group of 36 patients with colloid goiter. RESULTS: No significant statistical difference was found between patients with follicular adenoma and thyroid follicular carcinoma concerning sex (p =.092), age (p =.098), thyroid node size (p =.426), vascularization (p =.388), and immunostaining intensity for metalloproteinase-9 (p =.055). The proportion of immunoreactive cells for metalloproteinase-9 in follicular carcinoma cases was higher than that observed in follicular adenoma cases (p <.001). Patients in more advanced stages of carcinoma were more than 45 years old (p =.006), presented extensive invasion (p <.001), had less vascularization (p =.046), and a had higher proportion of immunoreactive cells for metalloproteinase-9 (p <.001). CONCLUSIONS: The proportion of immunoreactive cells for metalloproteinase-9 in follicular carcinoma was higher than that observed in follicular adenoma, with a significant statistical difference (p <.001). This method must be developed to apply in material obtained by fine-needle aspiration to differentiate follicular adenoma from carcinoma.


Assuntos
Adenocarcinoma Folicular/enzimologia , Adenocarcinoma Folicular/patologia , Metaloendopeptidases/metabolismo , Neovascularização Patológica/patologia , Neoplasias da Glândula Tireoide/enzimologia , Neoplasias da Glândula Tireoide/patologia , Adenocarcinoma Folicular/irrigação sanguínea , Adenocarcinoma Folicular/cirurgia , Adulto , Idoso , Antígenos CD34/análise , Biomarcadores Tumorais/análise , Distribuição de Qui-Quadrado , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Probabilidade , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/irrigação sanguínea , Neoplasias da Glândula Tireoide/cirurgia
16.
Endoscopy ; 31(4): 281-5, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10376452

RESUMO

BACKGROUND AND STUDY AIMS: Squamous cell carcinoma of the esophagus (SCCE) becomes symptomatic at a late stage when the disease is already advanced, and this contributes to its poor prognosis. Esophagoscopy of asymptomatic individuals exposed to known risk factors associated with the development of this cancer may facilitate the diagnosis of early cancerous or precancerous lesions; however, conventional esophagoscopy is not accurate enough. The aim of this study was to measure the value of Lugol chromoendoscopy of the esophagus (LCE) as an endoscopic technique to detect dysplasia in patients at risk. PATIENTS AND METHODS: We studied 190 male patients older than 35 attending an outpatient unit for alcoholics who consumed more than 80g of alcohol, more than 10 cigarettes and more than 500 ml 'maté' (a hot infusion of herbs) per day over 10 years. All underwent conventional upper gastrointestinal endoscopy followed by LCE, a spraying of Lugol 3% on the entire esophagus. All patients denied dysphagia. Biopsies were obtained from any unstained areas larger than 5mm and also from stained areas in all individuals. Biopsies were analyzed independently by two pathologists unaware of the biopsy sites. All conventional esophagoscopies showed normal mucosa, except for two suspicious small elevated lesions, confirmed histologically to be SCCE. These two cases were excluded from the statistical analysis. RESULTS: The LCE found unstained areas in 23 patients and a uniformly stained esophageal mucosa in the remaining 165. Biopsies taken from these 23 unstained areas showed dysplasia in six (two high grade and four low grade), and the ones from the 165 stained areas taken at the middle esophagus showed low-grade dysplasia in seven. There was a high prevalence (6.9%) of dysplastic lesions in these individuals and occult dysplasia was significantly more frequent in unstained than stained areas (p = 0.0017). LCE showed a sensitivity of 46%, a specificity of 90%, a positive predictive value of 26% and a negative predicitve value of 96% when unstained areas were compared to stained ones. Agreement between two independent pathologists was high, with a kappa coefficient of 0.64. CONCLUSION: We concluded that individuals who abuse alcohol, smoke and consume 'maté' have a high prevalence of dysplastic lesions that can be better detected by LCE. Esophagi with unstained areas had an eight-fold higher chance of revealing dysplasia than the uniformly stained ones. LCE is an easy and inexpensive method. It improves the detection of dysplasia and should be added to conventional upper GI endoscopy in patients at risk for SCCE.


Assuntos
Alcoolismo/complicações , Carcinoma de Células Escamosas/patologia , Corantes , Neoplasias Esofágicas/patologia , Esofagoscopia , Esôfago/patologia , Iodetos , Lesões Pré-Cancerosas/patologia , Bebidas , Biópsia , Humanos , Masculino , Pessoa de Meia-Idade , Membrana Mucosa/patologia , Fatores de Risco , Sensibilidade e Especificidade , Fumar
18.
J Pediatr (Rio J) ; 73(2): 115-8, 1997.
Artigo em Português | MEDLINE | ID: mdl-14685427

RESUMO

OBJECTIVE: To alert the pediatricians about a disease caused by herbal teas considered harmless. METHODS: Report of a case of Hepatic Veno-Occlusive Disease in a child and review of the literature (MEDLINE and LILACS). RESULTS: Description of a case of a sudden beginning portal hypertension, secondary to Hepatic Veno-Occlusive Disease in a 2 year and 5 month-old-patient, coming from Cruz Alta-RS-Brazil, after a chronic consumption of herbal tea called "maria-mole" (Senecio brasiliensis), which contains pyrrolizidine alkaloids, known as hepatotoxic. After an adequate treatment, the patient presented a complete clinical and laboratorial recovery, and nowadays he doesnt show any symptoms anymore. CONCLUSIONS: Prevention of this disease depends on its divulgation among physicians and the general population, and the knowledge of toxic effects of many "innocuous" teas.

19.
Mycoses ; 38(7-8): 281-4, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-8559190

RESUMO

We report a case of mixed intranasal infection caused by Fusarium solani and a zygomycete, with probable sinus and brain involvement. The patient had chronic myelogenous leukaemia and was treated with chemotherapy. Diagnosis of the infection was established by direct examination of the intranasal eschar and histopathological study of an excisional biopsy. Only F. solani was isolated from both specimens. Difficulties in diagnosis and treatment of these infections are discussed.


Assuntos
Fungos/isolamento & purificação , Fusarium/isolamento & purificação , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Micoses/microbiologia , Cavidade Nasal , Doenças Nasais/microbiologia , Feminino , Humanos , Pessoa de Meia-Idade
20.
Arq Gastroenterol ; 29(3): 110-2, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1307210

RESUMO

We report a case of renal cell carcinoma that metastasized to the pancreas 7 years after the initial excision. The primary and the metastatic tumors were histologically similar. Upper gastrointestinal bleeding was the leading symptom in the present case and the cause of the patient's death.


Assuntos
Carcinoma de Células Renais/secundário , Neoplasias Renais/patologia , Neoplasias Pancreáticas/secundário , Idoso , Carcinoma de Células Renais/complicações , Hemorragia/etiologia , Hemorragia/mortalidade , Humanos , Masculino , Neoplasias Pancreáticas/complicações
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