Utility of mapping lymph nodes cleared from rectal adenocarcinoma specimens.

The lymph node clearing technique improves the detection of lymph nodes in colorectal cancer specimens. The purpose of this study was to determine the utility of mapping the lymph nodes cleared from rectal adenocarcinoma specimens by evaluating the possible relationship between the pattern of lymph node metastases to the site of the recurrent disease. A retrospective medical record review was performed in 40 patients with primary rectal adenocarcinoma. The specimens were analysed by lymph node clearing technique and mapped after surgery. The lymph nodes were mapped according to their location in the cleared specimens. Statistical analysis was performed using the chi 2-test. A total of 1290 lymph nodes were cleared in 40 specimens. Of these, 1126 (87%) lymph nodes were < or = 5 mm. One-hundred and ten (9%) lymph nodes were metastatic. Sixty-seven (61%) of these 110 lymph nodes were 5 mm or less in size. The majority of lymph nodes with or without metastases were in the pelvis, as opposed to an extrapelvic location (P = 0.0001). Eleven patients recurred. In nine of these patients the recurrence showed a direct relationship between the level of metastatic lymph node location (pelvic vs. extrapelvic) and the site of the recurrent disease (loco-regional or systemic, P = 0.05). The majority of lymph nodes, both normal and metastatic, cleared from specimens from rectal adenocarcinoma were < or = 5 mm in diameter. The lymph node mapping technique may help in predicting the site of recurrence.

Injury patterns in motor vehicle fatalities.

A retrospective pilot study of motor vehicle incident fatalities was conducted to determine what relationships exist between injuries received by deceased drivers, passengers, and a control population of pedestrians, and some of the environmental factors existing at the time of the incident. A number of correlations were established between the types and locations of injuries received, seat belt use, position of the injured party, and so forth. A study of this type, if performed on a large enough population, could lead to predictive models for the determination of position of the victims within a motor vehicle at the time of a fatal crash, based on a unique clustering of injuries.

[Rapunzel's syndrome (trichobezoar)]. / Síndrome de Rapunzel (tricobezoar).

The Rapunzel syndrome is uncommon, only 6 cases have been previously reported. Its characteristics are: 1) the body of a trichobezoar located in the stomach, and its tail in the small bowel and/or in the right colon, 2) small or large bowel obstruction, 3) occurring in psychiatric patients and, 4) trichophagia. We have added an additional patient, who was submitted to our hospital with diagnosis of abdominal mass, who, during his work-up was found with the above mentioned characteristics. The patient underwent a exploratory celiotomy, gastrotomy, and the trichobezoar was removed. The pathogenesis and current treatment are reviewed.

[Proctocolectomy with ileoanal anastomosis: morbidity and functional results in patients with and without colorectal cancer]. / Protocolectomía con ileoanoanastomosis: morbilidad y resultados funcionales en pacientes con y sin cáncer colorrectal.

BACKGROUND: The elective prophylaxis for colorectal cancer in patients with familial adenomatous polyposis (FAP) or with ulcerative colitis (UC) is the RPIPAA. AIMS: To evaluate the functional results and the morbidity rate in patients who underwent restorative proctocolectomy with ileal-pouch anal anastomosis (RPIPAA). METHODS: All patient underwent a proctocolectomy with a J reservoir, ileal pouch-anal anastomosis. RESULTS: There were 8 males and 3 females with a mean age of 31 years; the diagnoses were: FAP (n = 4); FAP + colorectal cancer (n = 3); metachronous colorectal cancer (n = 3) and UC + right colon cancer (n = 1). The average surgical time and the intraoperative bleeding were 5.6 h and 600 ml respectively. There were no operative deaths. The surgical complications were: section of left urether (n = 1); hemoperitoneum of 1,200 ml (n = 1); minor pelvic sepsis (n = 1); ileoanal stenosis (n = 1) and pouchitis (n = 1). Tumor staging was: Dukes A (n = 2), B1 (n = 1), B2 (n = 4). The mean follow-up was 22 months. Average of stools at the 3rd, 6th and 12th month was: 7.4, 5.6 and 3.8 respectively. Sexual function was: normal (n = 8), retrograde ejaculation (n = 2) and impotence (n = 1). The use of antidiarrheal agents in 24 hours at the third, sixth and twelfth month was 3, 2 and .8 respectively. CONCLUSIONS: The RPIPAA is associated with a low rate of morbidity and good functional results, similar to previously published results. However, these results should be taken with caution due to the small, selected and retrospective nature of the study.

Spatial distribution of Euschistus heros (F.) (Hemiptera: Pentatomidae) in soybean.

Soybean bugs are major crop pests that cause significant reduction in harvest yield and influence grain quality. The aim of this study was to verify the spatial distribution of Euschistus heros (F.) (Hemiptera: Pentatomidae) in conventional and transgenic soybean cultivars. The experiment was conducted during the 2010-2011 crop season in UNESP/FCAV, Jaboticabal, SP, Brazil, in two fields of 10,000-m(2) area that were subdivided into 100 plots (10 m × 10 m). The cultivars sown were M 7908 RR and its isoline M-SOY 8001. The number of the first to fifth instars and the number of adults were determined. To evaluate insect dispersion in the area, the following indices were used: variance/mean ratio, Morisita index, Green coefficient, and the k exponent of the negative binomial distribution. To study probabilistic models to describe the spatial distribution of the insects, the adjustments of the Poisson and negative binomial distributions were tested. The first to third instars showed aggregated spatial distribution, whereas the fourth and fifth instars, and adults, isolated or grouped, showed variation in the arrangement, ranging from moderately aggregated to randomly dispersed. During the adjustment of probability distributions, the negative binomial distribution model showed adjustment for the first to third instars, fourth and fifth instars, adults, and fourth and fifth instars plus adults.

Painful lytic bone lesion in an adult with chronic myelogenous leukemia.

The occurrence of blast cell granulocytic tumors (chloromas, myeloblastomas) associated with chronic myelogenous leukemia has been well documented. However, the production of lytic lesions by nonmyeloblastomatous hematopoietic cell forms in chronic myelogenous leukemia has been described only once previously. The pain associated with osteolysis in this particular patient preceded roentgenographic appearance of lytic lesion and diagnosis of chronic myelogenous leukemia. Biopsy of lytic lesion demonstrated infiltration with cell forms nearly identical with those of simultaneously performed bone marrow aspiration.

Analysis and quantification of pheomelanins by radioimmunoassay.

An antiserum against alpha-amino-(4-hydroxy-6-benzothiazolyl)propionic acid (AHBP), a major product obtained after hydriodic acid hydrolysis of pheomelanin, was raised in rabbits immunized with AHBP coupled to bovine serum albumin (BSA). The antiserum was used to develop a radioimmunoassay (RIA) to AHBP. The limit of detection of the RIA is 0.1 ng of AHBP. The antiserum does not crossreact with other major hydriodic acid degradation products, and the assay has been used to estimate the amounts of AHBP in synthetic and natural melanins.