Acute Toxicity and Sub-lethal Effects of the Essential Oil of Aristolochia trilobata and Its Major Constituents on Nasutitermes corniger (Termitidae: Nasutitermitinae).

Nasutitermes corniger (Motschulsky, 1855) (Termitidae: Nasutitermitinae) is an important pest in urban environments and bioinsecticides can be an alternative to its control. Here, we determined the toxicity and repellence of the essential oil (EO) prepared from stems of Aristolochia trilobata L. (Aristolochiaceae) and its major constituents on N. corniger. We also investigated behavioral changes of individuals exposed to limonene. The lethal dose required to kill 50% of N. corniger population (LD50) of EO of A. trilobata was 2.44 µg mg-1. Limonene was the most toxic compound to N. corniger followed by linalool (LD50 = 1.02 and 1.29 µg mg-1, respectively). In addition, all treatments presented median lethal time (LT50) less than 11 h. A. trilobata EO and its constituents showed irritability activity, but only limonene repelled soldiers more than workers. The negative behaviors of N. corniger groups were higher in individuals treated with limonene. A. trilobata EO and its constituents, especially the limonene, are promising for the control of N. corniger due the high toxicity, repellence, and possible disturbance in the colonies.

Lethal Effect and Behavioral Responses of Leaf-Cutting Ants to Essential Oil of Pogostemon cablin (Lamiaceae) and Its Nanoformulation.

Leaf-cutting ants belonging to the genus Atta (Formicidae: Myrmicinae) are important pests in agricultural and forest environments. In the present study, we evaluated the formicidal activity of the essential oil of Pogostemon cablin and its nanoformulation on the leaf-cutting ants: Atta opaciceps (Borgmeier, 1939), Atta sexdens (Linnaeus, 1758), and Atta sexdens rubropilosa Forel, 1908. The nanoformulation was developed by magnetic stirring using polyoxyethylene (36%), pure ethanol (36%), essential oil of P. cablin (18%), and water (10%). Bioassays of acute toxicity by fumigation and behavioral bioassays in treated arenas, with and without choice, were performed. The essential oil of P. cablin and its nanoformulation demonstrated efficient insecticidal activity and irritability to ant species. The concentration required to kill 50% of workers varied from 1.06 to 2.10 µL L-1, with a mean time to death of less than or equal to 42 h. The essential oil of P. cablin and its nanoformulation reduced the displacement and velocity speed of the workers of A. opaciceps and A. sexdens rubropilosa in totally treated arenas. In the bioassays with choices, the three species of ants walked less and at a greater speed on the treated side of arena. This work demonstrates the potential of the essential oil of P. cablin and its nanoformulation to the generation of new formicidal products.

Plasmacytoma of the urethra treated by excisional biopsy.

Plasmacytoma is an unusual disease of plasma cells, its presentation in the urethra is rare. We report the sixth known case of primary urethral plasmacytoma, which was treated by surgical excision, without recurrence for 3 years of follow-up.

[Primary sclerosing cholangitis in children and adolescents]. / Colangite esclerosante primária em crianças e adolescentes.

Primary sclerosing cholangitis is a disease usually with a poor prognosis with a mean survival of 10-12 years, starting from the time of diagnosis. Among the different populations studied, males predominate in a ratio 2:1 with ages ranging from 20-78 (mean 42 years). This article describes four patients with this syndrome, a child of eight and three adolescents, thirteen and fourteen years old. It is possibly of autoimmune etiology, characterized by stenosis, dilatation and fibrosis involving the intrahepatic and extrahepatic biliary tree. We analyzed laboratory assays, clinical, immunological, laboratory assays, histological and cholangiographic aspects. In conclusion, in this age group perhaps of the small population sample there was no sex predominance, and 50% progressed without jaundice and without hepatomegaly. The serum levels of gamma glutamyltransferases and especially alkaline phosphatase were elevated compared to aminotransferases without increase of the serum auto antibodies. Only one patients displayed the typical histological appearance of primary sclerosing cholangitis. The diagnosis in al was confirmed by typical cholangiographic signs, restricted only to the intrahepatic biliary tree, identified in all those included in this study.

[Diffuse primary malignant mesothelioma in abdominal cavity]. / Mesotelioma maligno primário difuso em cavidade abdominal.

Two cases of diffuse malignant mesothelioma of abdominal cavity were analysed. These tumors arise from the peritoneum and are also found in the parietal and visceral pleura, pericardium and in vaginal tunic. All of them, infra or supra-diaphragmatic, are associated with asbestos exposure in at least 80% of cases. It is difficult to explain how inhaled asbestos induces peritoneal neoplasms. This aspects become very important in the diagnostic, basically why it is done at laparotomy or laparoscopy. When was proceed the biopsy of the lesions, and occasionally by identification of malignant mesothelial cells in ascitic fluid. In this two cases exposed considerations about the advanced phase of diagnostic are made, the diagnostic was performed in the majority of the collected cells, showing the advanced stage of the disease. At that time of diagnosis we observed poor evolution. We call attention to the importance of precancer diagnosis, the best chance to treatment options, always based on surgical resections, radiation or chemotherapy alone or combined. If the radical surgery is not possible, this patients must be treated by chemotherapy or radiotherapy, defined after complete staging of the disease.

[Treatment of hemorrhagic congestive gastropathy with TIPS implantation. Pilot study]. / Tratamento da gastropatia congestiva hemorrágica através do implante do TIPS. Estudo piloto.

Minimally invasive percutaneous procedures has an important place in internal medicine. In this concept is included a transjugular intrahepatic portosystemic shunts (TIPS). In this pilot study we describe the indication of this therapeutic modality in three cirrhotic patients with hemorrhagic congestive gastropathy unresponsive to infusion of drugs that reduce the portal pressure. All of them were treated by TIPS and control of gastric bleeding occurred in all. One of these showed partial stenosis of the wallstent, treated by prosthesis dilatation. Another developed portosystemic encephalopathy controlled by usual therapeutic measures in the other we implanted two TIPS to obtain a low pressure level of the hepatic-portal gradient. They had no further necessity of blood transfusion, with better hemodynamic conditions and biochemical tests with reduction of the values of the GHP. We conclude that TIPS may be useful to treat hemorrhagic congestive gastropathy acting like a bridge for subsequent elective liver transplantation under good clinical and hemodynamic conditions.

[Reversal of hepatorenal syndrome after liver transplantation. Considerations about 3 patients]. / Reversão da síndrome hepatorrenal após transplante de fígado. Considerações sobre três pacientes.

Hepatorenal syndrome was observed in 25% of the patients with end stage liver disease. In this situation they stayed longer time in intensive unit treatment, hemodialysis. This evolution was observed in 67% of them with this complication after surgery. In this report we describe three patients with hepatorenal syndrome reversible after liver transplant. We define the form of management of these patients after surgery, regard treatment with cyclosporine A, only 72 h after surgery, without administration of aminoglycosides and amphoterycin. This good evaluation also depends of absence of arterial hypotension or infection episodes during and after surgery. It also depends of the good conditions of the implanted liver.

[Transjugular intrahepatic portosystemic shunts (TIPS) as a bridge for liver transplantation]. / Anastomose portossistêmica intra-hepática (TIPS) como ponte para o transplante de fígado.

Transjugular intrahepatic portosystemic shunts (TIPS) represents a new surgical technique minimally invasive utilized in the treatment of portal hypertension. Such technique avoid the risks of general anesthesia, and major surgery like portocava anastomosis, reducing the hepatic-portal gradient, and help bleeding esophagogastric varices, hemorrhagic congestive gastropathy and refractary ascites. Certainly diminishes the intensity of intraperitoneal colorectal circulation and the necessity of blood transfusion during surgery for liver transplantation. In this report we reported the first case in Brazil of the implant of TIPS like preparation for liver transplantation in cirrhotic alcoholic patient. We made consideration about techniques aspects and surgery evolution. This new interesting technique applied for this type of patients is indicated as a bridge for candidates for liver transplantation.

[Ultrasonically guided needle biopsy in malignant focal solid nodules of the liver]. / Biopsia percutânea guiada por ultra-som em lesões nodulares sólidas focais malignas do fígado.

In the most of the cases, the diagnosis of focal solid hepatic lesions are performed by ultrasonography, computed tomography, magnetic resonance and hepatic angiography imagig. However, the distinction between benign and malignant neoplasias, sometimes is made after liver biopsy. This report is about 32 of these lesions, diagnosed after guided liver biopsy by ultrasonography. The efficacy of this propedeutic method, minimally invasive, is defined emphasizing that there are no mortality and low levels of morbidity.

Cholelithiasis in cirrhotic patients. (Analysis of cholelithiasis among patients with liver cirrhosis in São Paulo, Brazil).

During the past 20 years, several authors have reported increased prevalence of cholelithiasis in liver cirrhosis. This biliary disease has been implicated with the deterioration of liver function, liver disease of alcoholic origin or even the presence of hypersplenism in this patient population. This study analyzes the incidence and possible factors which are responsible for promoting cholelithiasis in cirrhosis. The study included 110 cirrhotic patients of a private center specialized in treating liver diseases. The incidence of cholelithiasis was 27.3% (25.3% in males and 33.3% in females). There was no correlation between liver function defined by Child's classification or through the laboratory examinations (AST, ALT, AP, GGT, PT, Alb, TB, DB, PA) and the presence of gallstones. No evidence was found that the etiology of cirrhosis or the presence/absence of hypersplenism affected the prevalence of cholelithiasis in this population. In conclusion, an increased prevalence of cholelithiasis was verified in this population of cirrhotics but the pathogenesis is still obscure.

Neurochemical effects of L-pyroglutamic acid.

The effect of L-pyroglutamic acid, a metabolite that accumulates in pyroglutamic aciduria, on different neurochemical parameters was investigated in adult male Wistar rats. Glutamate binding, adenylate cyclase activity and G protein coupling to adenylate cyclase were assayed in the presence of the acid. L-pyroglutamic acid decreased Na(+)-dependent and Na(+)-independent glutamate binding. Basal and GMP-PNP stimulated adenylate cyclase activity were not affected by the acid. Furthermore, rats received unilateral intrastriatal injections of 10-300 nmol of buffered L-pyroglutamic acid. Vehicle (0.25 M Tris-Cl, pH 7.35-7.4) was injected into the contralateral striatum. Neurotoxic damage was assessed seven days after the injection by histological examination and by weighing both cerebral hemispheres. No difference in histology or weight could be identified between hemispheres. These results suggest that, although capable of interfering with glutamate binding, pyroglutamate did not cause a major lesion in the present model of neurotoxicity.

[Hepatic hemangioma. Analysis of 103 cases. Clinical considerations and imaging methods]. / Hemangiomas hepáticos. Análise de 103 casos. Considerações clínicas e dos métodos de imagem.

Hemangiomas are the most common benign vascular tumor found in the liver. In this study, 103 cases of hepatic hemangiomas were analysed in a retrospective manner. Image aspects such as those seen in ultrassonography, computed tomography, nuclear magnetic resonance and arteriography are discussed. The incidence was higher amongst the female sex, between individuals from 40 to 60 years old, which presented predominantly without symptoms (66%) and localized mainly in the right hepatic lobe (74%). The meaning of those aspects, when adopted, permits the clinicians to differentiate benign from malignant nodular lesions in the liver.

Multicentric granular cell tumor of the colon: report of a patient with 52 tumors.

Granular cell myoblastoma is an uncommon benign tumor that can be located anywhere in the body. Multiple tumors of the gastrointestinal tract are quite rare, having been reported infrequently in the English literature. The histologic, immunohistochemical, and electron microscopic findings in our case, as well as in others reported, suggest that its histogenesis may be related to Schwann cells. One case of multifocal granular cell tumor presenting 52 tumors from the cecum to the sigmoid is described, and the previously reported cases with similar presentation are reviewed. We suggest that in such cases, a long period of observation with repeated colonoscopy may be more appropriate than an aggressive approach.

Small cell carcinoma of the esophagus. Clinicopathological and immunohistochemical findings in four cases.

Small cell carcinoma of the esophagus is an uncommon neoplasm. The authors report the clinicopathologic and immunohistochemical findings in four cases. Dysphagia was the most frequent symptom at presentation. Only one patient was treated by surgery; the other did not receive any treatment. Histologically, three were oat-cell type tumors with areas of intermediate cell type. Combined cell type was not present. Immunohistochemistry demonstrated positivity for neuron-specific enolase and for chromogranin in all four cases. One case was a double primary carcinoma, a squamous cell carcinoma and a small cell carcinoma.

Pancreatic metastasis from renal cell carcinoma.

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.

[Prevalence of the various types of gastritis in patients with upper dyspeptic symptoms]. / Prevalência dos diferentes tipos de gastrites em pacientes com queixas digestivas altas.

Multiple site biopsy specimens from 153 patients were examined retrospectively for the presence of gastritis and Helicobacter-like organisms (HLO). Chronic gastritis was classified as superficial gastritis, diffuse antral gastritis, postgastrectomy (reflux) gastritis, diffuse corporal atrophic gastritis, and multifocal atrophic gastritis. In some cases technical problems did not make possible to define the type of chronic gastritis and we introduce the terms unclassified gastritis and minimal inflammatory changes to name those cases. In our opinion they represent superficial biopsies from cases of diffuse antral gastritis. Diffuse antral gastritis was found in 60% of patients followed by multifocal atrophic gastritis found in 20% of patients. HLO was searched in histological sections stained by a modified Giemsa stain. The typical curved bacilli were seen in the gastric mucus or closely attached to the top of superficial or foveolar epithelial cells in 83% of patients. Although we have noted high correlation between activity of chronic gastritis and infection by HLO such correlation was not possible between the degree of activity and the degree of infection.

Carcinoma cuniculatum originating from intertriginous lesions.

Three cases of long-standing carcinoma cuniculatum originating from intertriginous lesions, which resembled athlete's foot in their initial stages, were reported. The authors suggest cutaneous malignancy to be considered in the differential diagnosis of intertriginous lesions unresponsive to usual therapeutic measures.

Carcinoma cuniculatum of the buttock. An unusual case with an inverted growth.

A rare case of carcinoma cuniculatum involving the buttock in a 56-year-old male is presented. This case is uncommon in that the tumor was largely subcutaneous, while the usual carcinoma cuniculatum is an exophytic growth. Although carcinoma cuniculatum has a wide clinical and histological spectrum, to our knowledge there has been only 1 case with similar histological features, located in a pilonidal sinus, and another case located on the buttock.

[Aortic-esophageal fistula caused by inflammatory pseudotumor of the esophagus]. / Fístula esôfago-aórtica causada por pseudotumor inflamatório do esôfago.

A 56-year-old, otherwise healthy man died in operative room from a massive esophageal hemorrhage, one week after a single episode of postprandial odynophagia. Surgical specimen of the esophagus and the aorta showed a fistulous tract extending from an esophageal tumoral mass to the aorta. Histological examination disclosed the microscopic finding of the so-called inflammatory pseudotumor of the esophagus (IPT). To our knowledge, this is the first reported case of such unusual complication of IPT, resulting in fatal gastrointestinal bleeding.