Survival and prognostic factors of patients treated for Stage I to Stage III endometrial carcinoma in a reference cancer center in Southern Brazil.

PURPOSE: To describe two- and five-year survival of patients with Stage I to III endometrial carcinoma and to identify prognostic factors. STUDY DESIGN: Concurrent cohort study. PATIENTS AND METHODS: Seventy-two patients were operated on by the same surgeon and followed up for at least two years. All the histopathological examinations were performed by the same pathologist. Survival was analyzed by the Kaplan-Meier method. Age, body mass index, tumor grade, myometrial invasion, histological type and stage were correlated with death. RESULTS: Overall survival at two and five years was 90.2% and 81.4%, respectively. By bivariate analysis, FIGO stage, myometrial invasion, tumor grade, histology, adnexal and/or lymph node metastasis and age were significant predictors of death (p < 0.05). Multivariate analysis revealed significant associations with death: FIGO Stage III (p = 0.001), histological type other than endometrioid (p = 0.027) and age 70 or more (p = 0.04). CONCLUSION: Endometrial carcinoma Stage III patients, histological types other than endometrioid and age 70 years or more are at significant risk for death.

Herpes simplex virus type 2 and Chlamydia trachomatis in adenocarcinoma of the uterine cervix.

INTRODUCTION: Adenocarcinoma of the uterine cervix (AC) occurs in 15-20% of primary cervical neoplasias. Although some etiologic factors for squamous cell carcinoma are well defined, and its relationship with sexually transmitted disease as human papillomavirus (HPV) is established, we still do not know about the causative factors of most of AC besides HPV infection. OBJECTIVES: To determine the presence of herpes simplex virus type 2 (HSV-2) and Chlamydia trachomatis (CT) DNA in AC specimens, and its correlation with HPV infection. METHODS: 206 paraffin-embedded cases of AC were selected to DNA extraction. The specimens and the DNA were isolated. Samples were first screened for beta-globin DNA sequences, and 67 cases were considered adequate to further analysis. In a previous analysis, DNA of HPV was identified in 79.4% of specimens included in this series (51% HPV 18 and 34% HPV 16). The local ethical committee approved the study. RESULTS: All samples were negative for HSV-2 DNA and CT DNA. CONCLUSIONS: In our series HSV-2 DNA and CT DNA were not found to be integrated to the genome of adenocarcinoma of the uterine cervix and do not seem to be a co-factor for HPV on the etiology of this histologic subtype.

[Experimental cirrhosis induced by carbon tetrachloride inhalation: adaptation of the technique and evaluation of lipid peroxidation]. / Cirrose experimental induzida pela inalação de tetracloreto de carbono: adaptação da técnica e avaliação da peroxidação lipídica.

BACKGROUND: Long-term administration of carbon tetrachloride is an accepted experimental model to produce hepatic fibrosis. Oxidative stress has been postulated as a major molecular mechanism involved in carbon tetrachloride hepatotoxicity, where the reactive oxygen species play an important role in the pathogenesis of liver fibrosis. AIMS: This study was conducted to evaluate the effectiveness of an experimental model of hepatic cirrhosis induced by carbon tetrachloride inhalation as well as the importance of lipid peroxidation and the characteristics of the ascitic fluid in this model. METHODS: At first the hepatic histologic findings were assessed using the hematoxilineosin technique in different moments of carbon tetrachloride inhalation (5th, 7th, 9th, 12th weeks). Later, at the end of 15 weeks of the study the rats were divided in three groups (control; control + phenobarbital; and carbon tetrachloride + phenobarbital) for lipid peroxidation, ascitic fluid and histologic characteristics evaluation. For the lipid peroxidation analysis, thiobarbituric acid and QL techniques were used. Cytologic and bacteriologic parameters were analysed in the ascitic fluid. RESULTS: Cirrhosis was established in 100% of carbon tetrachloride rats between the 12th and 15th weeks with an elevation in the lipid peroxidation carbon tetrachloride rats' livers. Ascitic fluid infection was observed in one of seven rats who has developed ascites. CONCLUSIONS: The carbon tetrachloride inhalation method developed in this study is effective in cirrhosis induction and ascites formation, and the carbon tetrachloride cirrhosis physiopathogenesis is probably related to the oxidative stress installation.

Expression of alpha4beta1 and alphavbeta3 integrins in the endometrium of women using the T200 copper intrauterine device.

OBJECTIVE: To investigate the expression of alpha4 and beta3 integrin subunit levels in the endometrium of healthy women and copper intrauterine device (IUD) T200 users. DESIGN: Case control study. SETTING: An academic teaching hospital and a primary care clinic. PATIENT(S): Thirteen copper IUD users and 13 normal fertile women. INTERVENTION(S): Timed endometrial biopsies during the mid-secretory phase (days 20 to 24). MAIN OUTCOME MEASURE(S): Histologic dating of endometrium and immunohistochemical staining intensity of alpha4 and beta3, using the semiquantitative immunohistochemical score (HSCORE). RESULT(S): All endometrial biopsies consistent with menstrual dates were examined for integrin expression (beta3 and alpha4). No difference in alpha4 integrin expression was found between IUD users and controls in both luminal and glandular epithelium. In fertile controls, alphavbeta3 staining was present in 100% and 38.4% of glandular and luminal epithelium, respectively. In contrast, only 61.5% of the IUD users had any alphavbeta3 staining in the glandular epithelium and only 53.9% in the luminal epithelium. The intensity of immunoreactivity between the two groups (mean HSCORE) did not differ significantly. CONCLUSION(S): Proportionately, significantly fewer women using copper IUD had positive alphavbeta3 immunoreactivity in the glandular epithelium of mid-secretory endometrium.

The effects of allopurinol in hepatic ischemia and reperfusion: experimental study in rats.

BACKGROUND/AIMS: Some studies have shown that postischemic hepatic dysfunction is mainly due to oxygen free radicals that are generated by xanthine oxidase. The present study was undertaken to determine the effect of allopurinol, an inhibitor of xanthine oxidase, on oxidative stress, liver injury and histologic alterations induced by hepatic ischemia-reperfusion in rats. METHODS: One hundred and sixty Wistar rats were used and divided into three groups. Group 1: sham operation; group 2: 50 min of ischemia followed by 1 h of reperfusion, and group 3: pretreatment with allopurinol and 50 min of ischemia followed by 1 h of reperfusion. The effect of allopurinol was evaluated by plasma levels of alanine aminotransferase and aspartate aminotransferase, histopathologic studies, and lipid peroxidation measured by the thiobarbituric acid reactive substances method and chemiluminescence initiated by tert-butyl hydroperoxide technique. RESULTS: Ischemia followed by reperfusion promoted an increase in lipid peroxidation of the hepatic cells when compared to the sham-operated group (p<0.05). This increase was attenuated in the group treated with allopurinol (p< 0.05). Allopurinol also showed a protective effect on hepatocellular necrosis (p<0.05), and the plasma levels of liver enzymes returned earlier to the normal range in rats pretreated with allopurinol in comparison to those that did not receive the drug (p<0.05). CONCLUSIONS: Allopurinol exerted a protective effect on hepatic ischemia and reperfusion in rats. The administration of this drug prior to liver operations should be considered to be submitted to trials in humans.

Effects of ischemia and reperfusion on oxidative stress in hepatic cirrhosis induced by carbon tetrachloride in rats.

The present study was undertaken to determine the effect of ischemia and reperfusion on oxidative stress in hepatic cirrhosis induced by carbon tetrachloride (CCl4) in rats by the evaluation of lipid peroxidation products (LPO). Cirrhosis of the liver was induced by CCl4 administration. This drug was dissolved in mineral oil and the control group received only mineral oil intraperitoneally. Forty-five minutes of ischemia followed by one hour of reperfusion were performed. LPO products were evaluated by the thiobarbituric acid reactive substances method (TBARS) and chemiluminescence initiated by tert-butyl hydroperoxide technique (CL). The liver was submitted to histologic evaluation to check whether cirrhosis was present. The results demonstrated that ischemia-reperfusion caused an increase of LPO products in cirrhotic rats when compared to the control group (p < 0.05). Hepatic cirrhosis was present in all animals treated with CCl4 and no significant histologic alterations were observed in the control group. According to this study, we can conclude that the effect of ischemia and reperfusion in a rat model of hepatic cirrhosis caused a significant increase of the hepatic-levels of LPO products when compared to the noncirrhotic livers.

Protective effect of allopurinol in the renal ischemia--reperfusion in uninephrectomized rats.

The effect of allopurinol (an inhibitor of xanthine oxidase) on oxidative stress, renal dysfunction, and histologic alterations was evaluated during the renal ischemia--reperfusion in uninephrectomized rats. Renal malondialdehyde and serum creatinine levels significantly increased after renal ischemia--reperfusion. However, the pretreatment with allopurinol demonstrated a protector effect in these parameters. Renal ischemia--reperfusion provoked a significant renal damage in the operated group. Tubular atrophy and interstitial fibrosis were attenuated by allopurinol when given prior to the surgery. In our study, allopurinol had a strong tendency to exert a beneficial effect during renal ischemia--reperfusion in uninephrectomized rats.

The role of colchicine in prevention of hepatic cirrhosis induced by carbon tetrachloride.

BACKGROUND/AIMS: The present study was undertaken to determine whether colchicine has a beneficial effect in the prevention of hepatic cirrhosis when it is given simultaneously with CCl4. METHODOLOGY: Wistar rats were employed as experimental animals and divided into 6 groups: Group I received saline solution, Group II, saline solution and mineral oil; Group III, colchicine (10 micrograms/100 g) and mineral oil; Group IV, colchicine (10 micrograms/100 g) and CCl4; Group V, colchicine (5 micrograms/100 g) and CCl4; and, Group VI received saline solution and CCl4. The effect of colchicine was evaluated by liver function tests, serum total proteins, electrolytes and histological evaluation. RESULTS: The results demonstrated higher values of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin in groups IV and V when compared with group VI (p < 0.05). No difference between group VI and groups IV and V was observed in histological evaluation, serum total proteins and electrolytes (p < 0.05). CONCLUSIONS: Colchicine, as given in this study, did not have any protective effect in the prevention of cirrhosis induced by carbon tetrachloride.

Left ventricular function and endomyocardial biopsy in early and advanced dilated cardiomyopathy.

We evaluated left ventricular function and endomyocardial biopsy in 20 patients with early and advanced dilated cardiomyopathy, with the purpose of assessing the correlation between histologic variables and systolic and diastolic filling indexes. Group 1 included 10 patients with no clinical history of heart failure and left ventricular ejection fraction > or = 45% and group 2, 10 patients with a clinical history of heart failure and left ventricular ejection fraction <45%. Group 1 showed lower left ventricular end-systolic and end-diastolic volumes indexes (49+/-14 versus 86+/-23 ml/m2, P<0.001; 98+/-25 versus 127+/-35 ml/m2, P=0.049), higher left ventricular ejection fraction (50+/-4 versus 32+/-4%, P<0.001) and lower coefficient of variation of percentage shortening of left ventricular transverse hemiaxes (0.3+/-0.1 versus 0.5+/-0.1, P=0.001) compared with group 2. Group 1 had higher A wave peak velocity (78+/-18 versus 60+/-20 cm/s, P=0.048), lower E/A ratio (0.9+/-0.3 versus 1.5+/-0.6, P=0.02) and slower E wave deceleration time (204+/-51 versus 155+/-50 ms, P=0.047) compared with group 2. Semiquantitative histologic scores did not differ significantly between groups. There was no significant correlation between histologic variables and left ventricular systolic and diastolic indexes. Thus, dilated cardiomyopathy shows borderline to severe left ventricular systolic impairment and distinct left ventricular diastolic filling abnormalities, according to the clinical stage. This study suggests a marked dissociation between histologic findings and functional abnormalities in early and advanced dilated cardiomyopathy.

[Protective effect of colchicine on tissue damage caused by free radicals in hepatic cirrhosis: an experimental study in rats]. / Efeito protetor da colchicina no dano tecidual causado por radicais livres na cirrose hepática: um estudo experimental em ratos.

The present study was undertaken to evaluate the effect of colchicine on oxidative stress in cirrhosis assessed by lipid peroxidation products. Wistar rats were used and induced hepatic cirrhosis by carbon tetrachloride. After the cirrhosis-induced period colchicine was administrated daily during 90 days. Lipid peroxidation was evaluated by the thiobarbituric acid reactive substances method (TBARS) and chemiluminescence initiated by tert-butyl hydroperoxide. The liver was submitted to histological evaluation to check whether cirrhosis was present. The results demonstrated an higher increase in lipid peroxide levels in cirrhotic tissue when compared with normal tissue and it was decreased by colchicine treatment (P < 0.05). Observing this study, we can conclude that hepatic cirrhosis produce an higher oxidative stress than normal liver and it can be decreased by colchicine treatment.

[Pituitary adenomas: immunohistochemical study of 167 cases]. / Adenomas da hipófise: estudo imuno-histoquímico de 167 casos.

One hundred and sixty seven cases of pituitary adenoma were analysed using the immunocytochemical method of the Avidin-Biotin Complex (ABC), described by Hsu et al. (1981). Six pituitary anti-hormones were utilized: anti-prolactin (aPRL) at a 1:1,500 dilution; anti-growth hormone (aHGH) at a 1:4,000 dilution: anti-adrenocorticotrophic hormone (aACTH) at a 1:3,000 dilution; anti-thyrothrophic hormone (aTSH) at a 1:3,000 dilution; anti-luteinizing hormone (aLH) at a 1:1,000 dilution; and a anti-follicle-stimulating hormone (aFSH) at a 1:300 dilution. Incubation period was 14 to 16 hours at 4 degrees C. The survey of clinical, laboratory and radiological data of cases of pituitary adenomas was performed after reading the stained slides using the immunocytochemical method. Of the 167 cases of pituitary adenomas, 136 (81.4%) disclosed a positive immunoreaction to one or more anti-hormones, and the positivity index of neoplastic cells varied from 1 to 90%. The immunoreaction was positive exclusively to one anti-hormone in 80 cases (58.8%) and to two or more anti-hormones in 56 cases, and the association most frequently found was between both aPRL and aHGH. The positivity to the immunoreaction was distributed as follows: -100 cases were positive for aPRL, exclusively in 4 cases; -65 cases were positive for aHGH, exclusively in 22 cases; -31 cases were positive for aACTH, exclusively in 8 cases; -5 cases were positive for aTSH, exclusively in one case; -one patient presented an adenoma positive to aLH and another patient to aFSH.

Adenomas da hipófise: estudo imuno-histoquímico de 167 casos / Pituitary adenomas: immunohistochemical study of 167 cases

Foram analisados 167 casos de adenomas da hipófise pelo método imuno-histoquímico utilizando o Complexo da Avidina Biotina (ABC) descrito por HSU e col. (1981). Foram usados 6 anti-hormônios hipofisários: anti-prolactina (aPRL), na diluiçäo de 1:1.500, anti-hormônio do crescimento (aHGH), na diluiçäo de 1:4.000, anti-hormônio adrenocorticotrófico (aACTH), na diluiçäo de 1:3.000, anti-hormônio tireotrófico (aTSH), na diluiçäo de trófico (aACTH), na diluiçäo de 1:3.000, anti-hormônio tireotrófico (aTSH), na diluiçäo de 1:3.000, anti-hormônio luteinizante (aLH), na diluiçäo de 1:1.000, anti-hormônio folículo estimulante (a(FSH), na diluiçäo de 1;3.000. O período de incubaçäo foi de 14 a 16 horas a 4-C. Foi realizada também a coloraçäo pelo Orange G-PAS. O levantamento dos dados clínicos, laboratoriais, e radiológicos dos casos de adenomas de hipófise foi realizado após leitura das lâminas pelo método imuno-histoquímico. Dos 167 casos de adenomas da hipófise, 136 (81,4%) mostraram imuno-reaçäo positiva a um ou mais anti-hormônios, variando o índice de positividade entre 1 e 90% das células neoplásicas. A imuno-reaçäo foi positiva exclusivamente a um anti-hormônio em 80 casos (58,8%) e para dois ou mais anti-hormônios nos 56 casos restantes (41,2%), sendo a associaçäo mais freqüentemente encontrada aquela em que a positividade ocorreu para o aPRL e o aHGH. A positividade a reaçäo imuno-histoquímica distribuiu-se da seguinte forma: 100 casos foram positivos para o aPRL, em 49 pacientes de forma isolada; 65 casos foram positivos para o aHGH, em 22 pacientes de forma isolada; 31 casos foram positivos para o aACTH, em 8 pacientes de forma isolada; 5 casos foram positivos ao aTSH, em um paciente de forma isolada; um paciente apresentou adenoma positivo ao aLH; um caso foi positivo ao aFSH

Estudo citologico em nodulos da tiroide por biopsia de aspiracao. / Cytological study in thyroid nodules using aspiration biopsy

Os autores fazem um estudo comparativo entre os resultados dos exames citopatologicos de material obtido por puncao aspirativa, em 105 casos de nodulos isolados da tireoide, com os resultados dos exames anatomopatologicos por inclusao em parafina

Pneumonia congenita por Pneumocystis carinii. / Congenital pneumonia by Pneumocystis carinii

Estudo de raro caso de autopsia de feto com pneumonia congenita por Pneumocystis carinii, possivelmente por transmissao transplacentar

Agenesia de vesicula biliar e ducto cistico: apresentacao de um caso e revisao da literatura. / Agenesis of the gallbladder and cystic duct: report of a case and review of the literature

A agenesia de vesicula biliar e do ducto cistico e uma malformacao pouco frequente, devida a uma anomalia do desenvolvimento da porcao caudal presente no embriao de 3 mm: apenas 181 casos em 1.352.000 necropsias.Em grande numero de casos ela e asintomatica, mas os casos que vao a cirurgia sao levados por sintomas que simulam colecistite ou colelitiase, o que ocorre com maior frequencia no sexo feminino (2:1) e entre os 40 e 50 anos. O caso apresentado preenche todos os criterios adotados para uma comprovacao transoperatoria de tal raridade, e ainda foi seguida no pos-operatorio de ecografia hepatica, recurso indispensavel para excluir existencia de vesicula biliar intra-hepatica (por si tambem pouco frequente). Relata-se na literatura a existencia de outras malformacoes congenitas associadas, sendo que a paciente aqui descrita tinha uma anomalia da veia porta