RESUMO
BACKGROUND: Hepatocellular carcinoma is one of the most common malignancies worldwide. Liver transplantation has emerged as a good option for early-stage hepatocellular carcinoma yielding survival rates as good as for recipients without this type of tumor. OBJECTIVE: To assess the outcome of cirrhotic patients with hepatocellular carcinoma undergoing liver transplantation at the Liver Transplantation Service of the "Hospital de Clinicas", Federal University of Paraná, Curitiba, PR, Brazil. METHODS: Retrospective study of cirrhotic patients with hepatocellular carcinoma undergoing orthotopic liver transplantation at the mentioned Institution between September 1991 and September 2000. The diagnosis of hepatocellular carcinoma was established during the pretransplant workup in five patients and the tumor was an incidental finding in the native liver in three. The indication for liver transplantation was restricted to solitary tumor equal to or less than 5 cm or up to 3 nodules, with each nodule measuring less than 3 cm, and no evidence of vascular invasion or extrahepatic spread. Patient survival and evidence of tumoral recurrence posttransplant were evaluated. RESULTS: The most common cause for pretransplantation liver disease was hepatitis C virus (50%). On examination of the explanted liver, the majority of patients (6/8, 75%) had a single lesion; one patient had two nodules and one had a multifocal hepatocellular carcinoma found incidentally in the native liver. Tumor size ranged from 0.2 to 5.0 cm. All cases had neither vascular invasion nor linfonodal envolvement. All patients remained alive and free of tumor recurrence at the time of the study with a mean follow-up of 18.5 months (range, 5-29 months). CONCLUSION: Liver transplantation is a good therapeutic option for early stage hepatocellular carcinoma arising in cirrhotic patients. With proper selection, liver transplantation can offer excellent survival rates free of tumor recurrence.
Assuntos
Carcinoma Hepatocelular/cirurgia , Cirrose Hepática/cirurgia , Neoplasias Hepáticas/cirurgia , Transplante de Fígado , Adolescente , Adulto , Carcinoma Hepatocelular/patologia , Pré-Escolar , Feminino , Seguimentos , Humanos , Cirrose Hepática/complicações , Neoplasias Hepáticas/patologia , Transplante de Fígado/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Reoperação , Estudos Retrospectivos , Análise de Sobrevida , Resultado do TratamentoRESUMO
After an accident in a chemical plant in Seveso, Italy, on July 10, 1976, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) spread over a populated area. The event was exceptional because children were also affected and because the contamination took place not only through direct exposure but also through inhalation and the ingestion of contaminated foods, especially fruits and vegetables. This paper illustrates the early dermatologic lesions, the late acneic (chloracne) lesions, and their evolution during a 10-year period. Peculiar cutaneous findings, histologic data, and a comparison with previously reported similar accidents are also included.
Assuntos
Dioxinas/efeitos adversos , Dibenzodioxinas Policloradas/efeitos adversos , Dermatopatias/induzido quimicamente , Acidentes de Trabalho , Acne Vulgar/induzido quimicamente , Adolescente , Adulto , Fatores Etários , Criança , Glândulas Écrinas/patologia , Poluentes Ambientais/efeitos adversos , Eritema/induzido quimicamente , Feminino , Seguimentos , Humanos , Lactente , Itália , Masculino , Dermatopatias/patologiaAssuntos
Anti-Inflamatórios/uso terapêutico , Dermatite/tratamento farmacológico , Pregnadienodiois/uso terapêutico , Administração Tópica , Adolescente , Adulto , Idoso , Ensaios Clínicos como Assunto , Método Duplo-Cego , Avaliação de Medicamentos , Feminino , Glucocorticoides , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Provisional data on selected sanitary events which took place at Seveso after July 10 1976 are reported. 187 cases of chloracne, mostly in children, were detected, 50 just after the accident, the others within a year. Most polluted area (zone A) provided almost all "early" and most severe cases, but the territorial distribution of chloracne prevalence rates showed some inconsistencies with the soil TCDD pollution map; interpretations for such findings are discussed. Thirty-eight birth defects were detected in 1977 (none in zones A and B), more than in previous years, but still less than expected in a well controlled "normal" population: no clustering around a given type was observed. Spontaneous abortions, evaluated both as abortion rates and as pregnancy loss rates, showed scattered and statistically non-significant variations, inconsistent with the pollution map. No differences in birth and death rates compared to surrounding areas were observed. Data on ad hoc cytogenetic, neurological and immunological surveys are commented. Limitations of the presently available data are discussed and further research lines are anticipated.
Assuntos
Acidentes de Trabalho , Dioxinas/toxicidade , Poluição Ambiental , Dibenzodioxinas Policloradas/toxicidade , Anormalidades Induzidas por Medicamentos/epidemiologia , Aborto Espontâneo/induzido quimicamente , Aborto Espontâneo/epidemiologia , Acne Vulgar/induzido quimicamente , Acne Vulgar/epidemiologia , Adolescente , Adulto , Fatores Etários , Coeficiente de Natalidade , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Itália , Mortalidade , Dibenzodioxinas Policloradas/análise , Gravidez , Solo/análiseRESUMO
Commercial solutions of clotrimazole, tolnaftate and tolcyclate were tested for 12 h in cultures of Microsporum canis. They induced modifications in particle distribution, a blebbing of particle-free areas and the appearance of lamellar figures on the plasma membrane of fungus cells. The first two changes in the plasma membrane might be ascribed to a modification of the spectrin-like meshwork, while the third could be the result of a crystalline organization of membrane lipids.