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The macroscopic appearance of a tumor such as hepatocellular carcinoma (HCC) may be defined as its phenotype which is de facto dictated by its genotype. Therefore, macroscopic characteristics of HCC are unlikely random but rather reflect genomic traits of cancer, presumably acting as a valuable source of information that can be retrieved and exploited to infer prognosis. This review aims to provide a comprehensive overview of the available data on the prognostic value of macroscopic characterization in HCC. A total of 57 studies meeting eligible criteria were identified, including patients undergoing liver resection (LR; 47 studies, 83%) or liver transplant (LT; 9 studies, 16%). The following macroscopic variables were investigated: tumor size (n = 42 studies), number of nodules (n = 28), vascular invasion (n = 24), bile duct invasion (n = 6), growth pattern (n = 15), resection margin (n = 11), tumor location (n = 6), capsule (n = 2) and satellite (n = 1). Although the selected studies provided insightful data with notable prognostic performances, a lack of standardization and substantial gaps were noted in the report and the analysis of gross findings. This topic remains incompletely covered. While the available studies underscored the value of macroscopic variables in HCC prognostication, important lacks were also observed. Macroscopic characterization of HCC is likely an underexploited source of prognostic factors that must be actively explored by future multidisciplinary research.
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Context: Paragangliomas (PGLs) are rare tumors in adrenal and extra-adrenal locations. Metastasis are found in approximately 5% to 35% of PGLs, and there are no reliable predictors of metastatic disease. Objective: This work aimed to develop a prognostic score of metastatic potential in PGLs. Methods: A retrospective analysis was conducted of clinical data from a cohort with PGLs and tumor histological assessment. Patients were divided into metastatic PGL (presence of metastasis) and nonmetastatic PGL (absence of metastasis ≥96 months of follow-up) groups. Univariate and multivariable analysis were performed to identify predictors of metastatic potential. A prognostic score was developed based on coefficients of multivariable analysis. Kaplan-Meier curves were generated to estimate disease-specific survival (DSS). Results: Out of 263 patients, 35 patients had metastatic PGL and 110 patients had nonmetastatic PGL. In multivariable analysis, 4 features were independently related to metastatic disease and composed the Prognostic Score of Paragangliomas (PSPGL): presence of central or confluent necrosis (33 points), more than 3â mitosis/10 high-power field (HPF) (28 points), extension into adipose tissue (20 points), and extra-adrenal location (19 points). A PSPGL of 24 or greater showed similar sensitivity with higher specificity than the Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and Grading System for Adrenal Pheochromocytoma and Paraganglioma (GAPP). PSPGL less than or equal to 20 was associated with a risk of metastasis of approximately 10%, whereas a PSPGL of 40 or greater was associated with approximately 80%. The presence of metastasis and Ki-67 of 3% or greater were related to lower DSS. Conclusion: The PSPGL, composed of 4 easy-to-assess parameters, demonstrated good performance in predicting metastatic potential and good ability in estimating metastasis risk.
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We report the case of a patient with insidious onset and slowly progressive cognitive impairment, behavioral symptoms, temporal lobe seizures and delusional thoughts typical of delusional misidentification syndromes. Clinical presentation along with extensive diagnostic work-up revealed limbic encephalitis secondary to diffuse large B-cell lymphoma. The patient underwent immunotherapy with high-dose corticosteroid but no significant improvement was observed. No specific treatment for lymphoma was performed because the patient died of septic shock following a nosocomial respiratory infection. Delusional misidentification syndromes are an unusual and unique form of cognitive impairment in which a patient consistently misidentifies persons, places, objects, or events. Capgras syndrome is the most common subtype of this disorder, being defined by the recurrent and transient belief that someone close has been substituted by an imposter. These entities are generally associated with neurodegenerative diseases and psychiatric disturbances. Rare reports of associations between misidentification syndromes and autoimmune diseases such as multiple sclerosis have been published, but no papers address a correlation with limbic encephalitis or lymphoma.
Nós relatamos o caso de um paciente com início insidioso e lentamente progressivo de declínio cognitivo, sintomas comportamentais, crises convulsivas do lobo temporal e pensamentos delirantes típicos dos delírios monotemáticos de identificação. A apresentação clínica associada aos exames complementares levaram ao diagnóstico de encefalite límbica relacionada a linfoma difuso de grandes células B. O paciente foi submetido a imunoterapia com altas doses de corticoide sem melhora clínica. Não foi realizado tratamento específico para o linfoma em função do paciente ter evoluído para óbito por choque séptico secundário a infecção respiratória nosocomial. Os delírios monotemáticos de identificação representam uma forma única e incomum de comprometimento cognitivo nas quais o paciente consistentemente identifica de forma errônea pessoas, lugares, objetos ou eventos. A síndrome de Capgras é o subtipo mais comum dessas desordens, sendo definida como a crença recorrente e transitória que um impostor substituiu uma pessoa familiar. Essas entidades são geralmente relacionadas com doenças neurodegenerativas e distúrbios psiquiátricos. Raros relatos da associação entre os delírios monotemáticos de identificação e doenças autoimunes como esclerose múltipla foram publicados, porém não há artigos abordando a correlação com encefalite límbica ou linfoma.
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Humanos , Síndrome de Capgras , Encefalite Límbica , LinfomaRESUMO
Hemangioma de mama é um tumor benigno raro que apresenta pouca ou nenhuma captação de 18F-flúor-2-deoxi-Dglicose (FDG) na tomografia por emissão de pósitrons (PET). Relatamos um nódulo mamário compatível, patologicamente, com hemangioma, em uma mulher cuja PET scan demonstrou captação elevada de FDG (simulando tumor maligno). Também fizemos breve revisão das causas que levam a resultados falso-positivos e falso-negativos pela PET.
Breast hemangioma is a rare benign tumor that presents either absent or low 18F-fluoro-2-deoxy-D-glucose (FDG) uptake at positron emission tomography (PET). The authors report the case of a breast nodule pathologically compatible with hemangioma in a woman whose PET-scan has demonstrated increased FDG uptake (simulating a malignant tumor). A brief review of factors leading to false positive and false negative PET results is also undertaken.
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Humanos , Feminino , Pessoa de Meia-Idade , Mama , Neoplasias da Mama , Técnicas e Procedimentos Diagnósticos , Hemangioma Capilar , Reações Falso-Negativas , Reações Falso-Positivas , Mamografia , Tomografia por Emissão de Pósitrons , Sensibilidade e EspecificidadeRESUMO
O exame ultrassonográfico apresenta divergência na interpretação dos seus achados, devido à análise subjetiva e individual. Avaliou-se ultrassonograficamente a quantificação dos níveis de cinza de fígado de 18 gatos hígidos pela técnica de histograma, obtendo-se medidas referentes à ecogenicidade (LMEAN), ecotextura (NMOST/NALL) e desvio padrão da amplitude do eco (SD). As médias e desvio padrão dos valores encontrados foram para LMEAN 5,6 ±1,08, NMOST/NALL 28,31 ±3,84 e SD 11,48 ±1,77. Ressalta-se a importância da técnica do histograma na padronização de valores de normalidade referentes à ecogenicidade e ecotextura do fígado, favorecendo o diagnóstico e o monitoramento de hepatopatias difusas.
The ultrasonographic exam presents divergence in the interpretation of its findings, due to subjective and individual analysis. The livers of 18 healthy cats were evaluated by the ultrasonographic exam, making use of the gray-level histograms method. There were taken measures referring to the echogenicity (LMEAN), echotexture (NMOST/NALL) and echo amplitude standard deviation (SD). The mean values and standard deviations observed in this clinical assay were: LMEAN 5.6 ±1.08, NMOST/NALL 28.31 ±3.84 e SD 11.48 ±1.77. The gray-level histograms method is very important for the standardizing of hepatic echogenicity and echotexture values, helping in the diagnosis and monitoring of diffuse hepatopathies.
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Animais , Gatos , Gatos , Ultrassonografia/veterináriaRESUMO
O hipertiroidismo é uma doença multissistêmica caracterizada pela elevação dos níveis séricos dos hormônios tireoidianos, sendo uma endocrinopatia comum em gatos. O objetivo deste trabalho foi avaliar possíveis alterações cardíacas pelo exame ecocardiográfico em gatos com tirotoxicose induzida. Foram utilizados nove gatos adultos, sem distinção de sexo ou raça e sem alterações que pudessem interferir nos resultados do estudo. Para indução à tirotoxicose, foram administrados, por via oral, comprimidos, na dose de 150µg kg-1 de levotiroxina sódica, a cada 24 horas, durante 70 dias. Os exames foram realizados em dois momentos: um momento antes da indução e outro ao término do protocolo experimental. Dos parâmetros avaliados, foi observada diminuição estatisticamente significativa nos valores de diâmetro interno do ventrículo esquerdo, tanto na sístole, quanto na diástole. O diâmetro diastólico (DDVE) médio nos animais variou de 14,97mm, no momento inicial, para 13,27mm, no momento final. Os valores médios do diâmetro sistólico (DSVE) variaram de 8,92mm para 7,92mm, nos momentos inicial e final, respectivamente. Os outros parâmetros avaliados não sofreram alterações. Dessa forma, já foi possível caracterizar alterações cardiovasculares secundárias ao excesso dos hormônios tiroidianos nesse curto prazo de indução, porém não havendo a instalação de um quadro de insuficiência cardíaca congestiva. Ressalta-se a necessidade de um diagnóstico precoce do hipertiroidismo felino para evitar a evolução dos efeitos cardiovasculares dessa enfermidade.
Hyperthyroidism is a multisystemic disease arising from the excessive serum levels of the thyroid hormones, being a common endocrinopathy in cats. This study aimed at the evaluation of possible cardiac abnormalities by the echocardiographic exam in cats with induced thyrotoxicosis. Nine adult cats, regardless of sex or race and without alterations that could interfere in the study results, were used. To induce the thyrotoxicosis, levothyroxine sodium oral tablets in doses of 150µg kg-1 every 24 hours over 70 days were administered. The examinations were conducted in two stages: a time before induction, and another at the end of the experimental protocol. It was observed a statistically significant decrease in left ventricle internal diameter during systole and diastole. The others evaluated parameters didn't suffer any alteration. The mean value of the left ventricle diastolic diameter (LVDD) was 14.97mm in the initial moment, and 13.27mm in the final moment. The mean values of the left ventricle systolic diameter (LVSD) were 8.92mm and 7.92mm at the initial and final moments respectively. The others evaluated parameters didn't suffer any alteration. Thus, it was possible to characterize cardiovascular changes secondary to the excess of thyroid hormones in this short period of induction, but none of the cats presented congestive heart failure. It is emphasized the need for an early diagnosis of the feline hyperthyroidism, in order to prevent the development of cardiovascular effects of this disease.
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Este estudo avaliou ultrassonograficamente o fígado de gatos submetidos à tirotoxicose induzida pela técnica de histograma dos níveis de cinza com o objetivo de melhor avaliar possíveis alterações hepáticas decorrentes do excesso de hormônios tiroidianos. Para isto, foram utilizados nove gatos hígidos, adulto-jovens, que receberam diariamente 150μg/kg de levotiroxina sódica, por 60 dias. O histograma hepático não demonstrou diferença estatística ao nível de 5% de significância entre os momentos avaliados; entretanto, as variações dos valores das variáveis estudadas sugeriram a promoção de aumento da heterogeneidade e diminuição da ecogenicidade do parênquima hepático quando comparado ao momento inicial. A avaliação citopatológica e histopatológica revelou quadro de hepatite tirotóxica em todos os animais
This study evaluated ultrasonographically the liver of cats submitted to induced thyrotoxicosis by the technique of gray-level histogram with the objective of better evaluating the possible hepatic alterations decurring from the excess of the thyroid hormones. For that, there were used nine adult-young healthy cats, which received daily 150ìg/kg of sodic levotiroxin, for 60 days. The hepatic histogram has not demonstrated statistical differences in the 5% level of significance between the evaluated moments; however, the variations of the studied variables values suggested an increasing of the heterogeneity and a decreasing of the echogenicity of the hepatic parenchyma when compared to the initial moment. The cytopathologic and histopathologic evaluations have shown of a clinical picture of thyrotoxic hepatitis in all the animals
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Animais , Gatos , Fígado , Tireotoxicose , Tireotoxicose/induzido quimicamente , Tireotoxicose/patologiaRESUMO
Neste trabalho foi utilizada a metodologia Bayesiana para ajustar o modelo não-linear logístico para dados de crescimento de duas cultivares de feijoeiro, "Neguinho" e "Carioca". O delineamento experimental utilizado foi o inteiramente casualizado, com vinte repetições, no esquema de parcelas subdivididas, sendo que os tratamentos principais foram constituídos pelas cultivares e as subparcelas foram constituídas por 17 períodos de avaliações, do plantio até aos 85 dias. A metodologia permitiu comparar as curvas de crescimentos sem utilizar a teoria assintótica e estes resultados mostraram um maior incremento em altura para a cultivar "Carioca".
In this paper the Bayesian methodology was used to fit the logistic nonlinear model to growth data of two common bean cultivars, 'Neguinho' and 'Carioca'. The experiment was a split plot under a completely randomized design with twenty replicates, being the main treatments constituted by cultivars and the sub plots constituted by seventeen periods of evaluations, from planting to 85 days. The methodology allowed comparing the growth curves without using the asymptotic theory, and these results showed a larger height increment for the 'Carioca' cultivar.
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Objetivou-se neste trabalho avaliar o efeito de substratos com diferentes características físicas e químicas na formação de mudas e o desenvolvimento no campo das espécies Cedrela fissilis Vell. (cedro rosa), Eucalyptus grandis W. Hill ex Maiden (eucalipto), Acacia holocericea A. Cunn. ex G. Don (acácia) e Schinus terebinthifolius Raddi (aroeirinha), produzidas em tubetes de 55 cm³. Os substratos no viveiro foram constituídos de diversas combinações dos seguintes materiais: húmus de minhoca, esterco bovino curtido, esterco de galinha, turfa, casca de amendoim processada, casca de arroz carbonizada e palha de café. Na primeira etapa foi utilizado o delineamento inteiramente casualizado (DIC). Foram avaliadas as variáveis morfológicas das mudas e suas relações. O delineamento estatístico no campo foi em blocos, em parcelas subdivididas e as covas foram preenchidas com dois diferentes tipos de adubações - esterco bovino e esterco bovino + condicionador de solo. Nessa etapa, foram avaliadas as variáveis altura e diâmetro das plantas. Os dados foram submetidos à análise de variância e ao teste de média (Newman-Keuls 5 por cento). Conforme os resultados obtidos na etapa de viveiro, os substratos que podem ser recomendados para produção de mudas das espécies estudadas foram os à base de Húmus de minhoca, casca de amendoim processada e turfa. Na etapa de campo, a adubação com esterco bovino + condicionador de solo proporcionou maiores valores das variáveis em todas as espécies, com exceção da altura das plantas para a acácia.
This experiment was installed with the aim of evaluating the substrates effect with different chemical and physical characteristics in the formation of seedling of Cedrela fissilis Vell. (cedro rosa), Eucalyptus grandis W. Hill ex Maiden (eucalipto), Acacia holocericea A. Cunn. ex G. Don (acacia) and Schinus terebinthifolius Raddi (aroeirinha) produced in tubes of 55 cm³. The substrates had been constituted of several combinations of the following materials: húmus of earthworm, tanned cattle manure, fertilizer of hen, turf, rind of processed peanut, carbonized rind of rice, coffee straw. The experimental outline used was entirely randomized. The morphologic parameters of seedling and their relations were evaluated. The pits were filled with two types of fertilization: cattle manure and cattle manure + conditioning of soil in field. The data were submitted to the analysis of variance and the test of average (Newman-Keuls 5 percent). The results obtained in the nursery stage that can be recommended for production of seedlings of the studied essences were the base substrates of earthworm humus, peanut peel processed and peat. In the field stage, except for the species acacia, for the variable height of the plants, the fertilization with cattle manure + conditioning of soil was the best for all the appraised variables, providing better development of the seedlings in relation to the fertilization with cattle manure only.
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Para avaliar o uso da eletroacupuntura (EA) sobre os aspectos clínicos e deambulatórios, 36 coelhos tiveram o tendão calcanear comum seccionado e, após 30 dias, receberam enxerto de peritônio bovino conservado em solução supersaturada de sal. Em seguida, os animais foram distribuídos aleatoriamente em três grupos de igual número: no primeiro grupo, os coelhos foram estimulados pela EA do segundo ao 11° dia de pós-operatório (PO) (E10); no segundo grupo do 11o ao 31o dia de PO (E20) e, no terceiro grupo, os animais não foram estimulados (C). Verificou-se, nos animais do E10, durante o PO, ausência de edema e hiperemia no membro tratado pela EA. Não se observou diferença significativa (P>0,05) entre os grupos quanto ao grau de deambulação dos animais. Todos os coelhos tiveram completa recuperação da deambulação até os 51 dias de PO. A utilização da eletroacupuntura na fase precoce da cicatrização do tendão calcanear comum de coelhos impediu a formação de edema e hiperemia. O tratamento com eletroacupuntura no PO não melhorou o desempenho da deambulação.
In order to evaluate the use of eletroacupuncture (EA) on clinical and functional aspects, the Acchiles tendon of thirty-two rabbits was sectioned and after 30 days was grafted using salt supersatured - stored bovine peritoneum graft. Then, animals were distributed into three equally groups. They were stimulated by EA from the second to 11th post - operative day (S10 group), from 11th to 31th pos-operative day (S20 group), or were not stimulated (C group). Neither edema nor hyperemia were detected on S10 animals. There were no significant (P>0.05) differences between groups related to functional aspects. All rabbits were recovered until the 51th day of the post-operative period. The use of eletroacupuncture on acute Acchiles tendon healing avoided edema and hyperemia, but did not improve functional aspects.
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The soybean (Glycine max (L.) Merrill) frogeye leaf spot is caused by the fungus Cercospora sojina Hara and is a widespread disease in Brazil and other countries, causing severe losses in grain yield and also affecting seed quality. The availability of DNA markers linked to genes for resistance to this disease would accelerate breeding programs, particularly when other traits are also being evaluated. Bulked segregant analysis was applied to 3 F2 populations derived from crosses between the resistant cultivars Parana, Cristalina and Uberaba, and the susceptible cultivar Bossier. In the cross 'Parana' x 'Bossier', 2 RAPD markers were identified, CSOPA1800C and CSOPA21,250C, located at 4.4 1.8 centiMorgans (cM) and 3.4 1.7 cM respectively from the resistance locus. DNA fragments of similar molecular weight were observed in the population derived from the cross 'Cristalina' x 'Bossier' at 2.3 1.2 and 4.7 1.5 cM from the resistance locus, respectively. In the offspring of the cross 'Uberaba' x 'Bossier', a DNA fragment corresponding to marker CSOPA1800C was detected at 5.6 2.1 cM from the resistance locus. Although marker CSOPA21,250C was not observed in this population, an additional marker was detected (CSOUB11,100C) at 6.7 2.2 cM from the resistance locus. The 1,250 bp fragment of CSOPA21,250C was cloned and converted into a SCAR marker, which amplified a single fragment whose size corresponded to the cloned segment of the crosses involving cultivars Cristalina and Parana. Markers CSOPA1800C, CSOPA21,250C and CSOUB11,100C were mapped to soybean linkage group J with the aid of known SSRs linked to the Rcs3 locus, indicating that the RAPD and SCAR markers identified in our research also tag this resistance gene
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Glycine max/microbiologia , Fungos , Biomarcadores , Doenças das PlantasRESUMO
Seven soybean cultivars (Bossier, Cristalina, Davis, Kent, Lincoln, Paraná and Uberaba), with different levels of resistance to Cercospora sojina, race 04, were crossed according to a diallel design, with no reciprocals, to determine the general and the specific combining abilities for the resistance. The evaluations of the reaction to the disease were performed 20 days after the inoculation of the fungus on the most infected leaflet of the plant, in the parents and in the F1 hybrids. To quantify the resistance, the following characteristics were evaluated: infection degree (ID); number of lesions per leaflet (NLL); lesion mean diameter (LMD); lesioned leaf area (LLA); percentage of lesioned leaf area (PLLA); number of lesions per square centimeter (NLC) and disease index (DI). The relative importance of each characteristic was evaluated by the canonical variables analysis and the LLA and NLL characteristics were eliminated from the multivariate function. With the remaining five characteristics, a multivariate index was created using the first canonical vector, which was submitted to the diallel analysis, according to Griffings fixed model, method 2. The most important characters to discriminate resistant from susceptible soybean plants to C. sojina were: ID, LMD, NLC, DI and PLLA. Cristalina, Davis and Uberaba cultivars are the best ones among those tested that can be recommended as parents in soybean breeding programs seeking resistance to Cercospora sojina. The additive, dominant and epistatic genetic effects were important for the expression of the resistance, although the additive genetic effect was the most important component.