Gastric metastasis of melanoma

We present a case of gastric metastasis, leading to chronic bleeding in a patient already submitted to surgery for a malignant melanoma of the lip. In view of the good clinical conditions, a subtotal gastrectomy as palliative treatment was performed. We discuss the diagnostic and therapeutic aspects of this rare clinical situation

Prognostic value of the histopathologic private characteristics of breast cancer in patients with no axillary lymph node involvement.

The biological behavior of breast cancer supports the impression that it is often a systemic disease which can recur many years after the treatment of the local lesion. Since 35% of patients without axillary nodal metastasis will have recurrence of the disease after mastectomy, prognostic indicators are necessary to identify the high-risk patients to allow a more rational adjuvant therapy. We studied the prognostic value of fatty tissue invasion, perineural involvement and lymphatic and venous peritumoral embolization in T2NOMO primary breast carcinomas. Fifty-three patients were studied after initial treatment (only Halsted mastectomy). They were divided into two groups: A (control), with 25 patients with 15 years of survival without clinical and laboratory evidence of metastasis, and group B, with 28 patients who developed metastasis after initial treatment. The results were analysed by the chi-square test (p < 0.05). The fatty tissue invasion was identified in 56.0% and 78.5% in the A and B groups respectively, while venous embolization was only detected in 8.0% of the group A tumors and in 10.7% of those in group B. Neither showed significant variation when analyzed according to the chi-square test. Lymphatic embolization and perineural involvement were found respectively in 36.0% and 40.0% in the group A tumors and in 67.8% and 71.4% of those in group B, exhibiting a significant statistical variation. When analysing the histopathological characteristics in the pre- and post-menopausal patients, the chi-square test disclosed that lymphatic embolization and perineural involvement had a significantly higher incidence only in premenopausal patients in group B.

Pharmacology of lemongrass (Cymbopogon citratus Stapf). II. Effects of daily two month administration in male and female rats and in offspring exposed "in utero".

An infusion (abafado) prepared from leaves of lemongrass (Cymbopogon citratus Stapf) administered orally to adult rats for 2 months, in doses up to 20 times larger than the estimated corresponding human dosage, did not induce any effect which could be taken as evidence of toxicity. An absence of effects was also noted in male and female rats and in their offspring when the abafado was administered prior to mating or during pregnancy. These data strongly suggest that lemongrass, as used in Brazilian folk medicine, has no toxic properties.

Acao de pressao positiva expiratoria (PPE) no edema pulmonar por aumento da permeabilidade microvascular. / The effect of positive end expiratory pressure on lung edema due to increased microvascular permeability

Com o objetivo de analisar o papel da pressao positiva expiratoria (PPE) sobre o edema pulmonar por aumento de permeabilidade microvascular foram estudados 18 caes divididos em tres grupos. No grupo I, os caes eram ventilados com respirador a volume a apos 30 minutos instalavamos PPE de 5 cmH2O. No grupo II, os caes eram ventilados com respirador a volume e provocava-se edema pulmonar por injecao endovenosa de aloxana de 90 mg/kg, e, no grupo III, procediamos como no grupo II e apos 30 minutos instalavamos 5 cmH2O de PPE.Apos 120 minutos os pulmoes foram retirados.Para avaliarmos o edema ocorrido utilizamos o pulmao esquerdo para calcularmos a relacao peso unico/peso seco (PU/PS) foi, no grupo I 4,01 +/- 0,69, grupo II 8,78 +/- 2,29, e no grupo III 8,18 +/- 2,33: os grupos II e III apresentaram aumento significante desta relacao quando comparado ao grupo I. A microscopia revelou ausencia de edema no grupo I e intenso edema em iguais proporcoes nos grupos II e III. Pudemos concluir que: a aplicacao de 5 cmH2O de PPE nao provocou edema pulmonar: e que a quantificacao do edema pulmonar decorrente de aumento de permeabilidade microvascular nao se modificou com a utilizacao de ventilacao com PPE de 5 cmH2O

Alteracoes da estrutura pulmonar no edema por aumento da permebilidade microvascular. Estudo experimental em caes. / Changes of the pulmonary structure in edema due to the increase of microvascular permeability. Experiemental study in dogs

Foram estudados 10 caes mantidos em respiracao mecanica e em que se provocou edema pulmonar por administracao de aloxana.Este edema foi quantificado para relacao entre peso do pulmao umido e peso do pulmao seco O valor medio desta relacao foi de 5,94, denotando a presenca de edema. A histopatologia demonstrou a presenca de edema perivascular intersticial e alveolar. A analise destes dados permitiu que se concluisse que o edema iniciou-se na regiao perivascular e peribronquica, atingindo posteriormente o septo e finalmente o alveolo. A microscopia eletronica demonstrou a presenca de liquido de edema no intersticio e espaco alveolar, rico em proteinas confirmando o aumento de permeabilidade microvascular. Edema celular, alteracao na morfologia das mitocondrias e vesiculas de pinocitose foram outros achados morfologicos

Tumor mesodermico misto, heterologo do corpo do utero. / Mixed mesodermic heterologous tumor of the uterine corpus

Os autores analisam um exemplo de tumor mesodermico misto, heterologo do corpo do utero, em paciente de 69 anos de idade. Apresentava, entre as manifestacoes clinicas, hemorragia genital com duracao de um ano e crescimento do abdome ha dois meses. Os exames clinico e ginecologico revelaram abdome abaulado, tenso com sinais de ascite e presenca de uma volumosa massa tumoral, ocupando todo abdome. A citologia oncotica cervico-vaginal e endometrial eram positivas e compativeis com neoplasia do corpo do utero. Foi submetida, inicialmente, a curetagem uterina fracionada, que revelou tratar-se de tumor mesedermico misto, heterologo, maligno, do corpo do utero A ulterior laparotomia mostrou carcinomatose difusa, generalizada, sendo realizada apenas biopsia das massas tumorais. Por esse fato, constituiu a terapeutica na quimioterapia intraperitoneal e sistemica e na hormonioterapia (progestogenioterapia). A evolucao foi insatisfatoria, tendo o obito ocorrido cinco meses apos a cirurgia

[Alkaline reflux gastritis. Surgical treatment]. / Gastrite alcalina de refluxo. Tratamento cirúrgico.

The authors present the results of 35 patients with alcaline gastritis submitted to truncal vagotomy and jejunostomy by Roux in technic. Preoperative diagnosis was founded in clinical symptoms and endoscopy with histopathology. In a follow-up of 84,8% of the patients, clinical results were excellent or good in 92,8%, showing relief of pain and vomits, gastric endoscopy almost normal and on histopathology.

[Reflux alkaline gastritis. Clinical, endoscopic and histopathologic results of surgical treatment]. / Gastritis alcalina de reflujo. Resultados Clínicos, endoscópicos e histopatológicos del tratamiento quirúrgico.

Reflux alcaline gastritis is submitted to analysis on 35 operated patients. Diagnosis is based on anamnesis and improved by endoscopy and histopathology. Troncular vagotomy and Y de Roux is considered the operation of choice and 84.8% of the patients were reevaluated clinically, endoscopically and histopathologically. Results were considered excellent in 92.8%.