Experimental models of scald burns. A scope review.

PURPOSE: To conduct a scope review of the experimental model described by Walker and Mason, by identifying and analyzing the details of the method. METHODS: The authors searched Pubmed-Medline, Cochrane-Bireme and PEDro databases for articles published between January 2016 and December 2018, using the following search queries: burns, burn injuries, models animal, and animal experimentation. All articles whose authors used Walker and Mason's model - with or without changes to the method in Wistar rats - were included in this study. RESULTS: The search identified 45 mentions of Walker and Mason's model; however, after reading each summary, 20 were excluded (of which 5 due to duplicity). The inconsistencies observed after the scope review were: water temperature, length of time of exposure of the experimental model's skin to water, extent of the burnt area, and the description of the thickness/depth of the injury. CONCLUSIONS: Reproducibility of a scientific method is the basis to prove the veracity of the observed results. Thus, it is necessary to have a greater number of publications that adopt a reproducible scientific method, for this review found inconsistencies in the description of Walker and Mason's model.

Experimental models of scald burns. A scope review

Abstract Purpose: To conduct a scope review of the experimental model described by Walker and Mason, by identifying and analyzing the details of the method. Methods: The authors searched Pubmed-Medline, Cochrane-Bireme and PEDro databases for articles published between January 2016 and December 2018, using the following search queries: burns, burn injuries, models animal, and animal experimentation. All articles whose authors used Walker and Mason's model - with or without changes to the method in Wistar rats - were included in this study. Results: The search identified 45 mentions of Walker and Mason's model; however, after reading each summary, 20 were excluded (of which 5 due to duplicity). The inconsistencies observed after the scope review were: water temperature, length of time of exposure of the experimental model's skin to water, extent of the burnt area, and the description of the thickness/depth of the injury. Conclusions: Reproducibility of a scientific method is the basis to prove the veracity of the observed results. Thus, it is necessary to have a greater number of publications that adopt a reproducible scientific method, for this review found inconsistencies in the description of Walker and Mason's model.

Gestação e queimadura: experiência de unidade de queimaduras em Hospital Universitário / Pregnancy and burns: experience of a university hospital burn unit

Introdução: A incidência de queimaduras em gestantes não é bem estabelecida na literatura mundial, mas estima-se que varie entre 3% e 7%. Os cuidados da gestante queimada representam um grande desafio com impacto significante nos resultados e prognóstico materno-fetais. Relato de Caso: No presente estudo relatamos dois casos de gestantes vítimas de queimaduras que foram tratadas na unidade de tratamento de queimaduras na Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/UNIFESP), uma no primeiro trimestre e a outra no terceiro trimestre. Conclusão: Em ambos os casos, as gestantes receberam tratamento especializado para queimaduras em conjunto com acompanhamento clínico da equipe da obstetrícia, com boa evolução materno-fetal.

Introduction: The incidence of burns involving pregnant women is not well established in the literature, but is estimated to be between 3% and 7%. The management of burns in pregnancy represents a great challenge with significant impact on outcomes and maternal-fetal prognosis. Case Report: In the present study, we report two cases of pregnant burn victims who were treated in the burn unit in the Paulista School of Medicine, Federal University of São Paulo (EPM/UNIFESP). One patient was treated in the first trimester and the other in the third trimester. Conclusion: In both cases, the pregnant women received specialized treatment for burns in conjunction with clinical follow-up by the obstetrics team, with good maternal-fetal outcomes.

Procedimentos no atendimento para queimaduras nas mãos na fase aguda / Procedures in the care of hand burns in the acute phase

Introdução: A mão representa 3% da superfície corporal total, porém seu envolvimento em trauma grave, como uma queimadura, pode levar a sequelas funcionais graves. O presente estudo descreve os procedimentos no atendimento de pacientes na fase aguda com queimaduras envolvendo as mãos. Métodos: 122 pacientes com queimaduras térmicas envolvendo uma ou ambas as mãos foram incluídos no estudo, entre agosto de 2011 a julho de 2014. No exame físico inicial, determinou-se a extensão e a profundidade da lesão; as queimaduras profundas e circulares, com sinais e sintomas de perfusão inadequada, tiveram escarotomias realizadas para evitar perda de extremidade. As queimaduras de espessura parcial profunda ou de espessura total no dorso das mãos foram submetidas à excisão tangencial até 5 dias após o trauma; e o enxerto de pele parcial foi realizado em todos os pacientes antes do 15º dia do trauma. Resultados: Os homens representaram a maioria (58% da casuística). Em relação ao agente das queimaduras, os líquidos inflamáveis corresponderam a 46,7% das internações. Em 50,8% dos casos, as queimaduras eram de espessura parcial profunda ou de espessura total e necessitaram de procedimento operatório. Não foi identificada perda de enxerto no grupo. As escarotomias foram realizadas em 12,3% dos pacientes. Conclusão: A mão queimada necessita de atenção e cuidados locais adequados, juntamente com excisão precoce e enxertia de pele.

Introduction: The hand represents 3% of total body surface, but its involvement in severe trauma, such as burns, can lead to serious functional sequelae. The present study describes procedures in the care of patients in the acute phase with burns involving the hands. Methods: 122 patients with thermal burns involving one or both hands were included in the study between August 2011 and July 2014. On initial physical examination, the extent and depth of the lesions were determined; deep and circular burns, with signs and symptoms of inadequate perfusion, had escharotomies performed to avoid the loss of extremity. Burns of partial deep thickness or full thickness on the back of the hands received tangential excision within 5 days after the trauma; partial skin grafting was performed on all patients before the 15th day of the trauma. Results: Men represented the majority of cases (58%). In relation to the burn agent, flammable liquids caused 46.7% of admissions. In 50.8% of the cases, the burns were of partial deep thickness or of total thickness and required an operative procedure. No graft loss was identified in the group. Escharotomies were performed in 12.3% of the patients. Conclusion: The burned hand needs proper local attention and care, along with early excision and skin grafting.

Development of experimental in vitro burn model.

PURPOSE: To propose an experimental burn model in NIH-3T3 cell line. METHODS: Induction of thermal injury in cultures of mouse fibroblast - NIH-3T3- cell line and determination of cell viability by MTT and immunofluorescence. RESULTS: The heating of the Petri dish increased proportionally to the temperature of the base and the time of exposure to microwave. In this in vitro burn model, using the cell line NIH-3T3 was observed drastic cellular injury with significant changes in cell viability and activity. It showed drastically modified cell morphology with altered membrane, cytoskeleton and nucleus, and low cellularity compared to the control group. CONCLUSION: The burn model in vitro using the cell line NIH-3T3 was reproductive and efficient. This burn model was possible to determine significant changes in cell activity and decreased viability, with drastic change in morphology, cell lysis and death.

Sentinel lymph node biopsy in rats. Comparison between paraffin and frozen section analysis.

PURPOSE: To simulate a lymph node metastasis in an animal model using activated carbon, assess their identification in frozen section analysis and compare with histopathological examination in paraffin. METHODS: Thirty two adult female rats were used. They received the carbon injection on its hind legs. Half of the rats was sacrificed on day one, and the other half after 21 days. Thus, 64 lymph nodes were dissected and split longitudinally. One half of the lymph node was sent immediately to frozen section analysis. The other half was fixed in 10% formaldehyde to be cut in paraffin. Slides were divided into quadrants and classified by the presence of carbon in these four quadrants_ They were also classified by the carbon staining intensity. RESULTS: Comparing the slides obtained in the first day and 21 days, there was a tendency of carbon to spread over time, but without statistical significance. The intensity did not alter over time. CONCLUSION: There was no concordance between the two methods of pathological analysis, however the actived carbon was seen in all lymph nodes.

Sentinel lymph node biopsy in rats. Comparison between paraffin and frozen section analysis

PURPOSE: To simulate a lymph node metastasis in an animal model using activated carbon, assess their identification in frozen section analysis and compare with histopathological examination in paraffin. METHODS: Thirty two adult female rats were used. They received the carbon injection on its hind legs. Half of the rats was sacrificed on day one, and the other half after 21 days. Thus, 64 lymph nodes were dissected and split longitudinally. One half of the lymph node was sent immediately to frozen section analysis. The other half was fixed in 10% formaldehyde to be cut in paraffin. Slides were divided into quadrants and classified by the presence of carbon in these four quadrants_ They were also classified by the carbon staining intensity. RESULTS: Comparing the slides obtained in the first day and 21 days, there was a tendency of carbon to spread over time, but without statistical significance. The intensity did not alter over time. CONCLUSION: There was no concordance between the two methods of pathological analysis, however the actived carbon was seen in all lymph nodes. .

Development of experimental in vitro burn model

PURPOSE: To propose an experimental burn model in NIH-3T3 cell line. METHODS: Induction of thermal injury in cultures of mouse fibroblast - NIH-3T3- cell line and determination of cell viability by MTT and imunofluorescence. RESULTS: The heating of the Petri dish increased proportionally to the temperature of the base and the time of exposure to microwave. In this in vitro burn model, using the cell line NIH-3T3 was observed drastic cellular injury with significant changes in cell viability and activity. It showed drastically modified cell morphology with altered membrane, cytoskeleton and nucleus, and low cellularity compared to the control group. CONCLUSION: The burn model in vitro using the cell line NIH-3T3 was reproductive and efficient. This burn model was possible to determine significant changes in cell activity and decreased viability, with drastic change in morphology, cell lysis and death. .

Differential diagnosis in primary and metastatic cutaneous melanoma by FT-Raman spectroscopy / Diagnóstico diferencial no melanoma primário e metastático por espectroscopia FT-Raman

PURPOSE: To qualify the FT-Raman spectral data of primary and metastatic cutaneous melanoma in order to obtain a differential diagnosis. METHODS: Ten normal human skin samples without any clinical or histopathological alterations, ten cutaneous melanoma fragments, and nine lymph node metastasis samples were used; 105, 140 and 126 spectra were obtained respectively. Each sample was divided into 2 or 3 fragments of approximately 2 mm³ and positioned in the Raman spectrometer sample holder in order to obtain the spectra; a monochrome laser light Nd:YAG at 1064 nm was used to excite the inelastic effect. RESULTS: To differentiate the three histopathological groups according to their characteristics extracted from the spectra, data discriminative analysis was undertaken. Phenylalanine, DNA, and Amide-I spectral variables stood out in the differentiation of the three groups. The percentages of correctly classified groups based on Phenylalanine, DNA, and Amide-I spectral features was 93.1 percent. CONCLUSION: FT-Raman spectroscopy is capable of differentiating melanoma from its metastasis, as well as from normal skin.

OBJETIVO: Qualificar os dados espectrais FT-Raman do melanoma cutâneo primário e metastático e assim realizar o diagnóstico diferencial. MÉTODOS: Foram utilizadas amostras de 10 fragmentos de pele sem alterações clínicas ou histopatológicas, 10 de melanomas cutâneos e 9 de metástases linfonodais; 105, 140 and 126 espectros foram obtidos respectivamente. Cada amostra foi dividida em 2 ou 3 frações de 2 mm³ e posicionada no porta amostras do espectrômetro Raman para obtenção dos espectros, por meio da excitação do espalhamento inelástico pelo laser de Nd:YAG em 1064 nm incididos na amostra. RESULTADOS: Para diferenciar os três grupos formados de acordo com as características fornecidas pelos espectros, realizamos a análise discriminante dos dados. As variáveis espectrais Fenilalanina, DNA e Amida-I se destacaram na capacidade de diferenciação dos três grupos histológicos. A porcentagem de classificação correta utilizando estes critérios foi de 93,1 por cento; o que mostra a eficiência da análise realizada. CONCLUSÃO: A espectroscopia FT-Raman é capaz de diferenciar o melanoma de sua metástase, assim como da pele normal.

Differential diagnosis in primary and metastatic cutaneous melanoma by FT-Raman spectroscopy.

PURPOSE: To qualify the FT-Raman spectral data of primary and metastatic cutaneous melanoma in order to obtain a differential diagnosis. METHODS: Ten normal human skin samples without any clinical or histopathological alterations, ten cutaneous melanoma fragments, and nine lymph node metastasis samples were used; 105, 140 and 126 spectra were obtained respectively. Each sample was divided into 2 or 3 fragments of approximately 2 mm³ and positioned in the Raman spectrometer sample holder in order to obtain the spectra; a monochrome laser light Nd:YAG at 1064 nm was used to excite the inelastic effect. RESULTS: To differentiate the three histopathological groups according to their characteristics extracted from the spectra, data discriminative analysis was undertaken. Phenylalanine, DNA, and Amide-I spectral variables stood out in the differentiation of the three groups. The percentages of correctly classified groups based on Phenylalanine, DNA, and Amide-I spectral features was 93.1%. CONCLUSION: FT-Raman spectroscopy is capable of differentiating melanoma from its metastasis, as well as from normal skin.

Estudo epidemiológico da Unidade de Tratamento de Queimaduras da Universidade Federal de São Paulo / Epidemiological study of the Federal University of São Paulo Burn Unit

Introdução: Queimadura é um grave trauma, com repercussões sociais, econômicas e de saúde pública, que tem seu tratamento custeado basicamente pelo poder público, e necessita de dados epidemiológicos para a correta gestão pública e para campanhas de prevenção. Objetivo: Traçar o perfil epidemiológico dos pacientes atendidos na unidade de tratamento de queimaduras (UTQ) da Universidade Federal de São Paulo (UNIFESP). Método: Os dados foram coletados nos 12 primeiros meses de funcionamento, de julho de 2009 a junho de 2010. O estudo analisou o total de internações por mês; tipo de internação; sexo; idade; procedência; agente da queimadura; classificação quanto à extensão, gravidade do caso; SCQ; taxa de ocupação; período de internação; média mensal de cirurgias; tentativa de suicídio; lesão inalatória; taxa de mortalidade; solicitação de vagas e atendimento ambulatorial. Resultados: Dos 101 pacientes internados nesse período, 69,3% foram do sexo masculino, com média de internação mensal de 8,3 dias. A média da idade foi de 33,7 anos (11 meses a 90 anos). Líquido inflamável (40,6%) foi o mais frequente, álcool líquido (31,3%), seguido de líquido aquecido (25,7%). Pequeno queimado em 61,4%, com SCQ média de 11,3% (1 a 77,5%). A média mensal de cirurgias foi de 9,1, sendo que foram realizadas precocemente, entre 3 e 5 dias após a queimadura; 4,95% foram causadas por tentativa de suicídio, 10,9% apresentavam lesão inalatória na internação e 5,94% de taxa de mortalidade. Conclusão: Houve predomínio do sexo masculino, das queimaduras de segundo grau misto e de menor extensão. A mortalidade foi relacionada à presença da lesão inalatória.

Background: Burns is a serious trauma, affecting social, economic and public health, which has basically funded their treatment by the government, and needs of epidemiological data for the correct management and publishing for prevention. Purpose: Describe the epidemiological profile of patients treated at the UNIFESP burn care unit. Methods: Data were collected from July 2009 to June 2010. The study evaluated the total number of admissions per month, type of admission, sex, age, origin of the patient, burn agent, ranking as the extent, severity of the case, body surface total area burned, occupancy rate, hospital stay, mean of surgery, self extermination, inhalation injury, mortality rate, hospital bed request and outpatient care. Results: Of the 101 patients admitted during this period, 69.3% were male, mean hospital stay of 8.3 days monthly. The median age was 33.7 years old (11 months to 90 years.) Flammable liquid (40.6%) was the most frequent, liquid alcohol (31.3%), followed by heated liquid (25.7%). Small burned in 61.4%, with an average of 11.3% TBSA (1 to 77.5%). The monthly mean of surgeries was 9.1 and they were made precociously, between 3 to 5 days post burn. 4.95% were caused by self extermination, 10.9% had inhalation injury and 5.94% mortality rate. Conclusion: There was male, of second degree burns mixed and less extensive predominance. The mortality was related to the presence of inhalation injury.

Evidências no tratamento de queimaduras / Evidence-Based Medicine in burns treatment

Introdução: A Medicina Baseada em Evidências luta para que todos os médicos façam uso consciencioso, explícito e judicioso da melhor evidência atual, quando tomam decisões em seu trabalho de cuidado individual dos pacientes, no caso, pacientes vítimas de queimaduras. Objetivo: Realizar levantamento de artigos sobre revisão sistemática e meta-análise sobre o tema queimaduras, analisar, divulgar esse conhecimento científico na Sociedade Brasileira de Queimaduras, apresentando as conclusões desses estudos, as evidências presentes e sugerir inovações no atendimento desses pacientes. Método: O descritor utilizado foi burn/burns ou queimadura na Cochrane Library, usando o termo limitante reviews e classificando por record title. O mesmo descritor foi utilizado também para pesquisa nas bases de dados MEDLINE/PUBMED, LILACS e EMBASE. Resultados: Apenas 21 revisões sistemáticas com meta-análise foram encontradas, todas na língua inglesa. Os temas escolhidos são relevantes e vão desde prevenção até suporte nutricional e tratamento das cicatrizes, passando pelo tratamento cirúrgico e controle da dor. Vários assuntos importantes ainda não foram abordados. Existem cinco trabalhos protocolados, ou seja, não concluídos. Conclusão: É necessário maior número de publicações com qualidade científica, ou seja, estudos clínicos randomizados controlados, de preferência multicêntricos, com o objetivo de num futuro próximo sejam realizadas revisões sistemáticas com meta-análise para obtermos a melhor evidência atual, para o fortalecimento da política de atendimento do paciente com queimadura, além do avanço na qualidade das pesquisas desenvolvidas e na sua aplicabilidade.

Background: The Evidence-Based Medicine struggles to which all doctors, conscientiously, explicitly and judiciously applies for current best evidence when taking decisions in their work of caring for patients, in this case, burn patients. Purpose: Raise systematic review articles and meta-analysis articles about burn issue, analyze and spread this scientific knowledge in Brazilian Burn Society, presenting the conclusions of these studies, the current evidences and suggesting innovations in treatment of burn patient. Methods: The key word was burn/burns searched at Cochrane Library, using the limiting term reviews and sorted by record title. The same key word was applied in MEDLINE, LILACS and EMBASE. Results: Only 21 systematic reviews with meta-analysis were found, all in English language. The chosen issues are relevant and go from prevention to nutritional support, comprehending surgery treatment and pain control. Many important issues were not covered yet. There are 5 protocols, articles not concluded. Conclusion: Scientific quality studies - multicentre controlled randomized trials - are necessary to get the best current evidence in burn care and improve their applicability.

Cutaneous melanoma and telomerase

There are cells that suffer uncontrolled growth with loss of contact inhibition and alterations in the nucleus, affecting the maintenance of telomeres in the chromosomes, forming a tumor. Telomeres have a tendency to merge, making repairs of DNA impracticable, taking the loss of genetic information and producing chromosomal aberrations. In relation to telomeres, there is a protein known as telomerase, hyperactive in several neoplasms, such as melanoma. The integrity and stability of chromosomes is one of the key factors that must be maintained for good functioning and propagation of an organism. In this revision, only aspects related to melanoma, telomeres and telomerase are addressed, pointing to the contribution of genetic and mutagenic environmental factors for carcinogenic development.

Perfusão isolada de membro com hipertermia na trataento das metástases em trânsito do melanoma cutâneo / Hyperthermic isolated limb perfusion in the treatment of in-transit melanoma metastases

OBJETIVO: Avaliar a casuística do Setor de Tumores Cutâneos da Disciplina de Cirurgia Plástica da Escola Paulista de Medicina/ Universidade Federal de São Paulo em relação à Perfusão Isolada de Membro (PIM) para o tratamento das metástases em trânsito do melanoma cutâneo, bem como os resultados conseqüentes, comparando-os com a literatura internacional. MÉTODO: De maio de 1993 a abril de 2007, 41 pacientes portadores de metástases em trânsito do melanoma cutâneo submeteram-se a 44 PIM. Por meio da observação de seus prontuários, foram avaliados quanto à toxicidade regional e sistêmica, e resposta tumoral após a PIM. Após a coleta dos resultados, procedeu-se a comparação com a literatura internacional e as posteriores conclusões. RESULTADOS: Houve 43,2 por cento de respostas completas, 36,4 por cento de respostas parciais e 20,4 por cento sem resposta ao tratamento proposto. A toxicidade regional aguda descrita foi, de modo geral, restrita a edema e eritema discretos, não havendo nenhum caso de complicação sistêmica grave. CONCLUSÃO: Os dados obtidos nessa casuística corroboram os descritos pela literatura internacional, demonstrando a importância e a possibilidade da PIM para o controle locoregional das metástases em trânsito do melanoma cutâneo também na realidade brasileira.

BACKGROUND: To evaluate our cases at the Skin Tumors Sector of Plastic Surgery Division at Federal University of São Paulo in relation to Isolated Limb Perfusion (ILP) for the treatment of in transit melanoma metastases, as well as the results, comparing them with international literature. METHODS: From May 1993 until April 2007, 41 patients with in transit metastases of skin melanoma were submitted to 44 ILP. Medical registry observations were evaluated in terms of regional and systemic toxicity and tumoral response after ILP. The obtained results were compared with international literature and posterior conclusions were done. RESULTS: We observed 43.2 percent of complete responses, 36.4 percent of partial responses and 20.4 percent of no responses after the procedures. Acute regional toxicity was in general restricted to slight erythema or edema, and there was no single case of serious systemic complication. CONCLUSION: The obtained data are in accordance with international literature demonstrating the importance and the possibility of ILP for locoregional control of in transit metastases of skin melanoma also in Brazilian reality.

Sentinel lymph node biopsy in cutaneous melanoma.

PURPOSE: To assess the importance of sentinel lymph node biopsy in patients with cutaneous melanoma. METHODS: Ninety consecutive non-randomized patients with stages I and II melanoma who underwent sentinel lymph node biopsy were followed up prospectively for six years. RESULTS: Patients were followed up for a mean period of 30 months. Their mean age was 53.3 years, ranging from 12 to 83 years. Thirty patients were male (37.5%) and 50, female (62.5%). Sentinel lymph node was positive in 32.5% and negative in 67.5%. It was found that the thicker the tumor, the greater the incidence of positive sentinel lymph nodes. In the group of patients with positive sentinel lymph nodes, recurrence occurred in 43.5%, but in those with negative sentinel lymph nodes, in only 7%, what points out to the association of tumor recurrence and positive sentinel lymph nodes. There were no major postoperative complications. CONCLUSION: Sentinel lymph node biopsy was demonstrated to be a safe method for selecting patients who need therapeutic lymphadenectomy.

Sentinel lymph node biopsy in cutaneous melanoma

PURPOSE: To assess the importance of sentinel lymph node biopsy in patients with cutaneous melanoma. METHODS: Ninety consecutive non-randomized patients with stages I and II melanoma who underwent sentinel lymph node biopsy were followed up prospectively for six years. RESULTS: Patients were followed up for a mean period of 30 months. Their mean age was 53.3 years, ranging from 12 to 83 years. Thirty patients were male (37.5 percent) and 50, female (62.5 percent). Sentinel lymph node was positive in 32.5 percent and negative in 67.5 percent. It was found that the thicker the tumor, the greater the incidence of positive sentinel lymph nodes. In the group of patients with positive sentinel lymph nodes, recurrence occurred in 43.5 percent, but in those with negative sentinel lymph nodes, in only 7 percent, what points out to the association of tumor recurrence and positive sentinel lymph nodes. There were no major postoperative complications. CONCLUSION: Sentinel lymph node biopsy was demonstrated to be a safe method for selecting patients who need therapeutic lymphadenectomy.

OBJETIVO: Avaliar a importância da biópsia do linfonodo sentinela em pacientes com melanoma cutâneo MÉTODOS: Noventa pacientes com estadiamento I e II foram acompanhados prospectivamente no período de seis anos, de forma consecutiva e não randomizada e submetidos a biópsia do linfonodo sentinela. RESULTADOS: Os pacientes foram acompanhados durante tempo médio de 30 meses. A média de idade dos pacientes foi de 53,3 anos, variando de 12 a 83. Quanto ao sexo, foram avaliados 30 pacientes do sexo masculino (37,5 por cento) e 50 do sexo feminino (62,5 por cento).32,5 por cento dos pacientes apresentaram linfonodo sentinela positivo e 67,5 por cento linfonodo sentinela negativos. Comparando-se a espessura tumoral com a positividade do LS, verificou-se que quanto maior a espessura, maior a incidência de positividade do linfonodo sentinela. No grupo de pacientes com LS positivo a recorrência surgiu em 43,5 por cento dos casos, mostrando a relação entre a recorrência e a positividade do LS. Não houve complicações no pós-operatório. CONCLUSÃO: A biópsia do linfonodo sentinela mostrou-se um método seguro para selecionar os pacientes que necessitam de linfadenectomia terapêutica.

Modelo experimental de cultura primária de melanoma metastático por punção aspirativa de agulha fina / Experimental model of primary cultured metastatic melanoma by fine needle aspiration

OBJETIVO: Estabelecer um modelo experimental de cultura primária de melanoma metastático por punção aspirativa por agulha fina (PAAF). MÉTODOS: Duas culturas primárias de células de melanoma metastático através de PAAF foram desenvolvidas a partir de pacientes submetidos à excisão de lesões metastáticas e identificadas por imunohistoquímica utilizando os marcadores S-100 e MB-45, específicos para melanoma. RESULTADOS: O diagnóstico da cultura foi confirmado através da imunohistoquímica. A técnica oferece vantagens como pequena morbidade e invasibilidade, além do mais, a mesma lesão pode ser puncionada seqüencialmente durante o tratamento do doente. CONCLUSÃO: O estabelecimento de cultura primária de melanoma metastático a partir de punção aspirativa por agulha fina mostrou-se uma técnica viável.

[Experimental model of primary cultured metastatic melanoma by fine needle aspiration]. / Modelo experimental de cultura primária de melanoma metastático por punção aspirativa de agulha fina.

PURPOSE: Establish an experimental model of metastatic melanoma primary culture cells from fine-needle aspiration biopsies (FNAB). METHODS: Two metastatic melanoma primary culture cells from (FNAB) have been developed from patients who had been submitted to excision of metastatic lesions and they were identified by immunohistochemical analyses using S-100 and MB-45 melanoma markers. RESULTS: The culture diagnostic was confirmed by immunohistochemical. The technique of FNAB offers the advantage of providing a sequential analysis of the same tumor nodules throughout treatment, and is a minimally invasive procedure with almost no associated morbidity. CONCLUSION: The establishment of metastatic melanoma primary culture from FNAB samples showed a viable technique.

Perfuração espontânea de colédoco em adolescente / Spontaneous perforation of the common duct in a teenager

Spontaneous perforation of the common bile duct is rare. It happens predominantly in children and it is related to obstructive disease of the biliary tract. We present a case of an 18 year-old male patient, with ulcerative rectocolitis associated with malignant tumor of the head of pancreas. The patient developed an acute abdomen syndrome and laparotomy, a spontaneous perforation of common bile duct was evidenced. The authors make a revision of the clinical aspects of that pathology