Unraveling the peripheral and local role of inflammatory cytokines in glioblastoma survival.

Glioblastoma (GBM) is a life-threatening disease that presents high morbidity and mortality. The standardized treatment protocol results in a global survival of less than three years in the majority of cases. Immunotherapies have gained wide recognition in cancer treatment; however, GBM has an immunosuppressive microenvironment diminishing the possible effectiveness of this therapy. In this sense, investigating the inflammatory settings and the tumoral nature of GBM patients are an important goal to create an individual plan of treatment to improve overall survival rate and quality of life of these patients. Thirty-two patients who underwent surgical resection of GBM were included in this study. Tumor samples and 10 mL of peripheral blood were collected and immediately frozen. TNF-a, IL-1a and IL-4 were evaluated in the tumor and TNF-a, IL-1a and TGF-b in the plasma by Luminex assay. Immunohistochemistry analysis to determine immune celular profile was done, including immunohistochemistry for CD20, CD68 and CD3. Three cases were excluded. Tumor topography, tumor nature, and tumor volume reconstructions were accurately analyzed by T1-weighted, T2-weighted, and FLAIR magnetic resonance imaging. We found that GBM patients with below median peripheral levels of TNF-a and IL-1a had a decreased survival rate when compared to above median patients. On the other hand, patients with below median peripheral levels of TGF-b increased overall survival rate. Intratumoral IL-1a above median was associated with higher number of macrophages and fewer with B cells. Furthermore, plasmatic TNF-a levels were correlated with intratumoral TNF-a levels, suggesting that peripheral cytokines are related to the tumoral microenvironment. Even though tumor size has no difference regarding survival rate, we found a negative correlation between intratumoral IL-4 and tumor size, where larger tumors have less IL-4 expression. Nevertheless, the tumoral nature had a significant effect in overall survival rate, considering that infiltrative tumors showed decreased survival rate and intratumoral TNF-a. Moreover, expansive tumors revealed fewer macrophages and higher T cells. In multiple variation analyzes, we demonstrated that infiltrative tumors and below median peripheral IL-1a expression represent 3 times and 5 times hazard ratio, respectively, demonstrating a poor prognosis. Here we found that peripheral cytokines had a critical role as prognostic tools in a small cohort of GBM patients.

Nerve fibers in uterosacral ligaments of women with deep infiltrating endometriosis.

UNLABELLED: Endometriosis is a disease of high prevalence and enigmatic origin. One aspect not yet clarified is the relationship between endometriosis and nerve tissue. OBJECTIVE: To evaluate, by immunohistochemistry, the presence of sympathetic and parasympathetic nerve fibers in the uterosacral ligament and adjacent connective tissue in women with deep pelvic endometriosis and women without endometriosis. DESIGN: Cross-sectional study (Canadian Task Force II). SETTING: University Hospital. Obstetrics and Gynecology Department, Santa Casa Medical School, São Paulo, Brazil. METHODOLOGY: We selected 49 patients, 20 of them with deep endometriosis in the uterosacral ligament and 29 patients without endometriosis. Secondary antibodies to NSE (pan-neuronal marker), NPY (that identifies sympathetic nerve fibers), and VIP (that identifies parasympathetic nerve fibers) were used for the immunohistochemistry analyses. RESULTS: The immunohistochemical staining by the NSE antibody was positive in 40% of cases of women with endometriosis and in 20.7% of patients without endometriosis (non-significant). The immunohistochemical staining by the NPY antibody was positive in 60% of patients with endometriosis and in 20.7% of the control group (p=0.005), while staining by the VIP antibody was 60% in patients with endometriosis and 13.8% in patients without endometriosis (p=0.001). CONCLUSION: Immunoexpression of NPY (sympathetic fibers) and VIP (parasympathetic fibers) is higher in women with deep pelvic endometriosis than in women without endometriosis.

Ruptura de aneurismas das artérias gástrica esquerda e cólica média: causa de abdome agudo hemorrágico / Ruptured aneurysms of the gastric and colic arteries: causes of acuse intraabdominal hemorrhage

Säo descritos dois casos de aneurismas rotos de artérias esplâncnicas, um em artéria gástrica esquerda em doente de 62 anos e outro em artéria cólica média em doente de 58 anos, ambos do sexo masculino e que deram entrada em pronto-socorro com abdome agudo hemorrágico. O diagnóstico correto, no entanto, só foi possível após a laparotomia exploradora. O estudo anatomopatológico demonstrou tratar-se de aneurismas de etiologia arteriosclerótica. Poucas säo as descriçöes de anerismas rotos, praticamente näo se tendo encontrado citaçöes de rupturas de aneurismas em artérias gástrica esquerda ou cólica média na literatura nacional

Estudo histoquímico da musculatura esquelética em doentes desnutridos

Alguns trabalhos na literatura têm detectado alteraçöes significativas em músculo de animais desnutridos. No entanto, poucos säo os etudos que analisam as alteraçöes no músculo esquelético do homem. Foram estudados 24 pacientes com diferentes graus de desnutriçäo, 14 com neoplasias malignas e 10 com afecçöes näo neoplásicas. Os doentes foram submetidos à avaliaçäo nutricional e biópsia muscular, tendo por objetivo estudar as alteraçöes em músculo esquelético de desnutrido e correlacionar com graus de desnutriçäo. Neste grupo boservou-se amiotrofia neurogênica de graus variados em 23 e, em um, miosite paraneoplásica. Os resultados obtidos sugerem correlaçäo entre as alteraçöes morfológicas e histoquímicas com a desnutriçäo