Conjunctival leiomyosarcoma.

Purpose: Leiomyosarcoma (LMS) is a mesenchymal neoplasm with smooth muscle differentiation, being considered one of the most common soft tissue sarcomas. However, it rarely affects the eye, and when it does, it is usually located in the orbit, being extremely rare in the conjunctiva. Observations: We report a case of a 45 years old male patient, with a recurrent rapid growing conjunctival mass on the temporal limbus of his left eye, which was excised, and the anatomopathological report was suggestive of a grade 1 leiomyosarcoma. Since the lesion was recurrent, we decided to perform an extended enucleation for treating this condition. Nevertheless, the patient is being followed up to 30 months, with systemic metastasis screening, showing no other lesions or recurrences. Conclusions and importance: Conjunctival leiomyosarcoma is an extremely rare ocular tumor, which can be clinically indistinguishable from other conditions such as squamous cell carcinoma, so, biopsy is essential. Albeit there is no standard treatment, complete surgical removal with safety margins is mandatory.

Morphological, comparative and qualitative tissue reaction analysis due to the implantation of alloplant™ to the eyelid and subcutaneous of rabbits / Análise morfológica comparativa e qualitativa da reação tecidual à colocação do alloplant™ (aloimplante) em pálpebra e dorso de coelhos

Purpose:To compare by optical microscopy, tissue reaction caused by the Alloplant ™ to conjunctiva and backs of 24 rabbits.Methods:All rabbits underwent implantation of Alloplant ™ on the inner third of the lower eyelid, replacing the tarsal conjunctiva of one eye. After thirty days six rabbits (Group I) were sacrificed and lower eyelids of both sides and a back fragment (control) routed to optical microscopy. After sixty days six rabbits (group II) were sacrificed and their eyelids and a back fragment (control) sent for microscopic examination. That day were also performed surgical implantation of Alloplant ™ on the back of the twelve remaining rabbits. They were sacrificed ninety days (group III) and one hundred and twenty days (group IV) after the first surgery of the eyelids and microscopic study backs.Results:The “Alloplant™” (aloimplante), caused an intense inflammatory reaction, mixed exudative and proliferative with a predominance of lymphocytes, macrophages and formation of foreign body granulomas in both locations, which evolved with the replacement of the implant by dense fibrous connective tissue.Conclusion:eyelid inflammatory reaction was more intense and more prolonged in the eyelid than in the back. In the back the formation of fibrosis was more intense, what is not suitable for eyelid surgery.

Objetivo:Analisar comparativamente através da microscopia óptica, a reação tecidual causada pelo Alloplant Ô na conjuntiva e dorso de 24 coelhos.Métodos:Todos os coelhos foram submetidos a implantação do AlloplantÔ no terço interno da pálpebra inferior, em substituição à conjuntiva tarsal de um dos olhos. Após trinta dias seis coelhos (grupo I) foram sacrificados e as pálpebras inferiores dos dois lados e um fragmento do dorso (controle) foram encaminhados para a microscopia óptica. Após sessenta dias foram sacrificados mais seis coelhos (grupo II) e suas pálpebras um fragmento do dorso (controle) foram encaminhados para estudo microscópico. Nesse dia também foram realizadas implantações cirúrgicas do aloimplanteÔ no dorso dos doze coelhos restantes, os quais foram sacrificados noventa (grupo III) e cento e vinte (grupo IV) dias após a primeira cirurgia para estudo microscópico das pálpebras e dorsos.Resultados:O “Alloplant Ԕ (aloimplante), causou intensa reação inflamatória mista exsudativa e proliferativa com predominância de linfócitos, macrófagos e formação de granulomas de corpo estranho nas duas localizações, que evoluiu com a substituição do implante por tecido conjuntivo fibroso denso.Conclusão:na pálpebra a reação inflamatória foi mais intensa e mais prolongada do que no dorso e no dorso a formação de fibrose foi mais intensa, mostrando inadequação ao uso cirúrgico.

[A safety study of retinal toxicity after serial intravitreal injections of infliximab in rabbits eyes]. / Estudo de toxicidade retiniana após injeções intravítreas seriadas de infliximabe em olhos de coelhos.

PURPOSE: To determine retinal and choroid toxicity levels of two and three infliximab intravitreous injections in albino rabbits by means of electroretinographic, histological and ophthalmological clinical tests. METHODS: 12 albino rabbits were used in the study. Each eye was given two (n=10 eyes) or three (n=10 eyes) serial intravitreous 2 mg infliximab injections dissolved in 0.06 ml of saline, at monthly intervals. A separate group of rabbits (n=4 eyes) served as a control group. Ninety days after the study had begun, the rabbits underwent clinical and electroretinographic tests, and after being enucleated, the eyes were examined for histological changes. RESULTS: Slit-lamp biomicroscopy and fundoscopic examination did not reveal any significant retinal abnormalities in the eyes injected with infliximab and control eyes or in pre- and post-treated eyes. The histological change that was noted was the presence of rare lymphocytes and eosinophils in the posterior vitreous of some of the rabbits subjected to two or three injections, but it was not considered clinically significant. A severe inflammatory reaction with vitreous exudates and ganglion cell edema in a single rabbit was clinically significant. The electroretinographic tests showed amplitudes that were on the average 12-13% smaller than those obtained before the treatment, however, there were no statistically significant differences when comparing the amplitude or the implicit time between pre- and post-treatment electroretinographic findings. CONCLUSION: Two and three intravitreous 2 mg infliximab injections in rabbits at monthly intervals did not cause any changes after a 90-day follow-up, according to histological and electroretinographic tests and after clinical evaluation. Differently from prior studies that have investigated potential retinotoxicity effects after single administrations, this study investigated the possibility of retinotoxicity after multiple injections. Clinical studies in humans should be conducted to better evaluate the safety of this drug in the treatment of certain diseases affecting the retina and the choroid.

Estudo de toxicidade retiniana após injeções intravítreas seriadas de infliximabe em olhos de coelhos / A safety study of retinal toxicity after serial intravitreal injections of infliximab in rabbits eyes

OBJETIVO: Determinar os níveis de toxicidade de duas e três aplicações intravítreas de infliximabe na retina de coelhos albinos, por meio de exames clínicos oftalmológicos, eletrorretinográficos e histológicos. MÉTODOS: Foram utilizados doze coelhos albinos divididos em dois grupos. No primeiro grupo de 10 coelhos, cada olho recebeu duas (n=10 olhos) ou três injeções (n=10 olhos) intravítreas de 2 mg de infliximabe dissolvidos em 0,06 ml de solução salina, em intervalos mensais. Um segundo grupo de dois coelhos, que serviu como grupo controle (n=4 olhos), foram submetidos a duas e três aplicações intravítreas de BSS. Noventa dias após, os coelhos foram novamente submetidos a exame oftalmológico (biomicroscopia, oftalmoscopia e tonometria), eletrorretinográfico e, após enucleados, a exame histológico. RESULTADOS: O exame biomicroscópico e oftalmoscópico não revelou anormalidades retinianas nos olhos injetados com infliximabe e no grupo controle. Alteração histológica notada foi a presença de raros linfócitos e eosinófilos no vítreo posterior em quatro e em seis olhos submetidos a duas e três aplicações de infliximabe sem significado clínico. A única alteração clinicamente significante foi uma reação inflamatória severa com presença de exsudatos vítreos na interface vítreo retiniana e discreto edema de células ganglionares nos dois olhos de um único coelho, sem alterações no vítreo posterior. Os exames eletrorretinográficos mostraram amplitudes em média 12-13 por cento menores daquelas obtidas antes do tratamento, contudo não houve nenhuma diferença estatisticamente significante quando comparamos as amplitudes e a latencia entre os achados electrorretinográficos pré e pós-tratamento. CONCLUSÃO: Duas e três aplicações intravítreas de infliximabe em olhos de coelhos em intervalos mensais, na dosagem de 2 mg, não provocam alterações significantes após um seguimento de noventa dias, quer no exame histológico, na eletrorretinografia e na avaliação clínica oftalmológica. Conclui-se que doses seriadas de infliximabe por via intravítrea é um procedimento seguro. Estudos clínicos em humanos devem ser realizados para melhor avaliação da segurança do seu uso no tratamento de determinadas doenças que acometem a retina e a coroide.

PURPOSE: To determine retinal and choroid toxicity levels of two and three infliximab intravitreous injections in albino rabbits by means of electroretinographic, histological and ophthalmological clinical tests. METHODS: 12 albino rabbits were used in the study. Each eye was given two (n=10 eyes) or three (n=10 eyes) serial intravitreous 2 mg infliximab injections dissolved in 0.06 ml of saline, at monthly intervals. A separate group of rabbits (n=4 eyes) served as a control group. Ninety days after the study had begun, the rabbits underwent clinical and electroretinographic tests, and after being enucleated, the eyes were examined for histological changes. RESULTS: Slit-lamp biomicroscopy and fundoscopic examination did not reveal any significant retinal abnormalities in the eyes injected with infliximab and control eyes or in pre- and post-treated eyes. The histological change that was noted was the presence of rare lymphocytes and eosinophils in the posterior vitreous of some of the rabbits subjected to two or three injections, but it was not considered clinically significant. A severe inflammatory reaction with vitreous exudates and ganglion cell edema in a single rabbit was clinically significant. The electroretinographic tests showed amplitudes that were on the average 12-13 percent smaller than those obtained before the treatment, however, there were no statistically significant differences when comparing the amplitude or the implicit time between pre- and post-treatment electroretinographic findings. CONCLUSION: Two and three intravitreous 2 mg infliximab injections in rabbits at monthly intervals did not cause any changes after a 90-day follow-up, according to histological and electroretinographic tests and after clinical evaluation. Differently from prior studies that have investigated potential retinotoxicity effects after single administrations, this study investigated the possibility of retinotoxicity after multiple injections. Clinical studies in humans should be conducted to better evaluate the safety of this drug in the treatment of certain diseases affecting the retina and the choroid.

Avaliação histopatológica dos efeitos colaterais do uso intraestromal de biguanida em córnea de coelhos / Histopathological assessment of side effects of the use of corneal intrastromal biguanide in rabbits

OBJETIVO: Observar os efeitos da injeção intraestromal de biguanida a 0,02%, 0,1% e 0,5% em córnea de coelhos. MÉTODOS: Experimento prospectivo duplo cego. Foram utilizados 8 coelhos, identificados aleatoreamente e divididos em 4 grupos de 2 coelhos cada, ocorrendo a administração intraestromal de 0,2ml do fármaco na córnea do olho direito. O primeiro grupo recebeu biguanida na concentração de 0,02%, o segundo grupo a 0,1%, o terceiro a 0,5% e o quarto grupo (controle) recebeu a injeção de placebo - Soro Fisiológico 0,9%. Um dos coelhos de cada grupo foi sacrificado no terceiro dia e o outro no décimo dia após a injeção da droga e tiveram os olhos direitos enucleados e submetidos a exame histopatológico. RESULTADOS: Os coelhos que receberam placebo e biguanida a 0,02% apresentaram tanto no terceiro quanto no décimo dia da aplicação, reação inflamatória muito discreta. O coelho sacrificado no terceiro dia após a injeção da droga a 0,1% apresentou infiltrado inflamatório discreto com neutrófilos e eosinófilos, porém no décimo dia houve necrose estromal, vascularização e infiltrado intenso. O terceiro grupo apresentou necrose estromal, infiltrado moderado de leucócitos e atrofia endotelial com leucócitos na câmara anterior ao terceiro dia, evoluindo com necrose estromal extensa, infiltrado moderado e atrofia endotelial e epitelial no décimo dia. CONCLUSÃO: A biguanida quando utilizada via estromal nas concentrações de 0,1% e 0,5% pode causar efeitos indesejáveis na córnea de coelho, o que nos desperta para a necessidade de estudos posteriores com amostra maior para a confirmação dos achados.

PURPOSE: Observe the effects of corneal intrastromal injection of biguanide at 0.02%, 0.1% and 0.5% in rabbits' eyes. METHODS: Doble blind prospective study. 8 rabbits were used, randomly identified and divided into 4 groups, with 2 rabbits each, with the administration of 0.2 ml of the drug via intrastromal, in the right eye. The first group received biguanide at a concentration of 0.02%, the second one at 0.1%, the third at 0.5% and the fourth group (control) was given a placebo injection - saline solution at 0.9%. One rabbit from each group was sacrificed on the third day and the remaining rabbits on the tenth day after the drug injection and had its right eyes enucleated and submitted to histopathological analysis. RESULTS: The rabbits that received placebo and biguanide at 0.02% presented, both on the third and the tenth day of the application, mild inflammation response. The rabbit sacrificed on the third day after the drug injection at 0.1% presented mild inflammatory infiltrate with neutrophils and eosinophils, although on the tenth day there was stromal necrosis, vascularization and intense infiltrate. The third group presented stromal necrosis, moderate infiltrate of leukocytes and endothelial atrophy with leukocytes in the anterior chamber on the third day, developing extensive stromal necrosis, moderate infiltrate and endothelial and epithelial atrophy on the t enth day. CONCLUSION: Biguanide when used at concentrations of 0.1% and 0.5% may cause adverse reactions in the rabbit's cornea, which arouses the necessity of further studies with a larger sample to confirm the findings.

Bronchial glomus tumor with right upper lobe atelectasis.

Glomus tumors are uncommon benign soft tissue neoplasms. We report the case of a 32-year-old male who presented with right upper lobe atelectasis due to an endobronchial tumor. The patient underwent right upper lobectomy and wedge bronchoplasty. The pathological diagnosis was bronchial glomus tumor. To our knowledge, this presentation (with right upper lobe atelectasis) has never before been reported. Glomus tumor should be considered in the differential diagnosis of endobronchial lesions causing lobar atelectasis.

Tumor glômico endobrônquico com atelectasia de lobo superior direito / Bronchial glomus tumor with right upper lobe atelectasis

Tumores glômicos são raras neoplasias benignas de tecidos moles. Relatamos o caso de um paciente de 32 anos de idade que apresentava atelectasia em lobo superior direito devido a um tumor endobrônquico. O paciente foi submetido a lobectomia superior direita e broncoplastia em cunha. O diagnóstico patológico foi de tumor glômico endobrônquico. Até onde sabemos, essa apresentação com atelectasia em lobo superior direito nunca foi relatada. O tumor glômico deve ser considerado no diagnóstico diferencial de lesões endobrônquicas que causam atelectasia lobar.

Glomus tumors are uncommon benign soft tissue neoplasms. We report the case of a 32-year-old male who presented with right upper lobe atelectasis due to an endobronchial tumor. The patient underwent right upper lobectomy and wedge bronchoplasty. The pathological diagnosis was bronchial glomus tumor. To our knowledge, this presentation (with right upper lobe atelectasis) has never before been reported. Glomus tumor should be considered in the differential diagnosis of endobronchial lesions causing lobar atelectasis.

Meduloblastoma nodular: achados de imagem de uma rara variante: relato de caso / Medulloblastoma with extensive nodularity: imaging findings of a rare variant: a case report

Meduloblastoma é o tumor maligno do sistema nervoso central mais comum na faixa etária pediátrica, bem como o tumor primário mais comum na fossa posterior em crianças, apresentando-segeralmente entre 5 e 12 anos de idade. O quadro clínico é caracterizado principalmente por hipertensãointracraniana e ataxia. O meduloblastoma nodular, relatado a seguir, é um raro subtipo que acomete crianças mais jovens, habitualmente menores de três anos, porém com melhor prognóstico. Apresenta-se tipicamente como lesão cística em fossa posterior, com componentes sólidosnodulares que realçam ao contraste, agregados em ôcacho de uvaõ. Este achado de imagem pode sugerir o diagnóstico pré-operatório correto.

Medulloblastoma is the most common malignant central nervous system tumor in pediatric patients and the most common primary tumor in the posterior fossa in children, most manifest in patients 5-12 years of age. Clinical features are mainly characterized byintracranial hypertension and ataxia. The authors present a case of medulloblastoma with extensive nodularity, a rare variant which affects younger age usually under three years, with more favorable prognosis. It is typically a cystic lesion in the posterior fossa with solid nodular components that enhance after contrast, like ôbunchof grapesõ clusters. Preoperative diagnosis could be suggested by this finding.

Ceratoconjuntivite cicatricial bilateral associada a líquen plano: relato de caso / Lichen planus leading to bilateral cicatrizing keratoconjunctivitis: case report

Descrevemos um caso de ceratoconjuntivite cicatricial bilateral em uma paciente portadora de líquen plano e apresentamos revisão da literatura mundial sobre esse assunto. Cicatrização conjuntival, com formação de simbléfaro, olho seco, infiltração corneana, neovascularização e afinamento foram os sinais observados. Diagnóstico foi baseado nos achados clínicos e biópsia, após exclusão das causas típicas de ceratoconjuntivite cicatricial.

To describe a case of bilateral cicatrizing keratoconjunctivitis in a patient with lichen planus and review the literature. Conjunctiva cicatrization with symblepharon formation, dry eye, corneal infiltration and neovascularization and thinning were the most observed prominent signs. Diagnosis was based on clinical findings and biopsy, after exclusion of typical causes of cicatricial keratoconjuntivitis.

Porcine pericardium as glaucoma implant tube coverage--an experimental study.

PURPOSE: To evaluate the inflammatory response associated with the use of processed porcine pericardium and glycerin-preserved homologous sclera as silicone glaucoma drainage device coverage in a rabbit experimental model. METHODS: Eight New Zealand white rabbits' eyes received an equal-sized glycerin-preserved homologous scleral patch or a double-layered processed porcine pericardium that was sutured to the bare sclera covering a silicone tube. Conjunctival hyperemia was graded using the double-blind method during the immediate postoperative period and during the first, third, and seventh postoperative weeks. After the seventh week, the enucleated eyes were histopathologically examined. They were also evaluated for signs of patch graft melting, tube erosion and chemosis. RESULTS: There was no occurrence of graft melting or tube exposure, although porcine pericardium was associated with greater inflammation through clinical observation. Light microscopy revealed marked inflammation surrounding the porcine pericardium with foreign body granuloma formation. On the other hand, the sclera group presented milder inflammation with foreign body granulomas only around the sutures. CONCLUSIONS: Porcine pericardium is associated with significant inflammation when used as tube coverage in a rabbit model, at both histopathologic and clinical levels, when compared to glycerin-preserved homologous sclera during the seven-week follow-up period.

Porcine pericardium as glaucoma implant tube coverage: an experimental study / Uso de pericárdio suíno no recobrimento de implantes de drenagem de glaucoma: um estudo experimental

PURPOSE: To evaluate the inflammatory response associated with the use of processed porcine pericardium and glycerin-preserved homologous sclera as silicone glaucoma drainage device coverage in a rabbit experimental model. METHODS: Eight New Zealand white rabbits' eyes received an equal-sized glycerin-preserved homologous scleral patch or a double-layered processed porcine pericardium that was sutured to the bare sclera covering a silicone tube. Conjunctival hyperemia was graded using the double-blind method during the immediate postoperative period and during the first, third, and seventh postoperative weeks. After the seventh week, the enucleated eyes were histopathologically examined. They were also evaluated for signs of patch graft melting, tube erosion and chemosis. RESULTS: There was no occurrence of graft melting or tube exposure, although porcine pericardium was associated with greater inflammation through clinical observation. Light microscopy revealed marked inflammation surrounding the porcine pericardium with foreign body granuloma formation. On the other hand, the sclera group presented milder inflammation with foreign body granulomas only around the sutures. CONCLUSIONS: Porcine pericardium is associated with significant inflammation when used as tube coverage in a rabbit model, at both histopathologic and clinical levels, when compared to glycerin-preserved homologous sclera during the seven-week follow-up period.

OBJETIVO: Avaliar a resposta inflamatória associada com o uso de pericárdio suíno processado e esclera homóloga preservada em glicerina no recobrimento de tubo de drenagem de silicone utilizado em cirurgia de glaucoma em modelo experimental. MÉTODOS: Oito olhos de 8 coelhos albinos da raça Nova Zelândia receberam enxertos do mesmo tamanho de esclera homóloga, preservada em glicerina ou pericárdio suíno processado, suturados à esclera recobrindo um tubo de silicone. Os olhos foram avaliados quanto à hiperemia conjuntival de modo mascarado na primeira, terceira e sétima semanas de pós-operatório. Após a sétima semana os olhos foram enucleados e submetidos a estudo histopatológico. Os olhos também foram avaliados quanto à presença de afinamento do enxerto, exposição do tubo e quemose. RESULTADOS: Não ocorreram casos de afinamento do enxerto ou exposição do tubo, porém o pericárdio suíno esteve associado clinicamente a uma maior inflamação. Achados à microscopia óptica incluíram intensa reação inflamatória em torno do enxerto de pericárdio com formação de granuloma do tipo corpo estranho. Por outro lado, no grupo que recebeu esclera, ocorreu formação de granulomas apenas em torno dos fios de sutura. CONCLUSÃO: O pericárdio suíno esteve associado a maior inflamação tanto à histopatologia quanto clinicamente, quando usado no recobrimento de tubo de silicone, em comparação à esclera homóloga preservada em glicerina, durante o período de acompanhamento de sete semanas.

[Lichen planus leading to bilateral cicatrizing keratoconjunctivitis: case report]. / Ceratoconjuntivite cicatricial bilateral associada a líquen plano: relato de caso.

To describe a case of bilateral cicatrizing keratoconjunctivitis in a patient with lichen planus and review the literature. Conjunctiva cicatrization with symblepharon formation, dry eye, corneal infiltration and neovascularization and thinning were the most observed prominent signs. Diagnosis was based on clinical findings and biopsy, after exclusion of typical causes of cicatricial keratoconjunctivitis.

[Analysis of clinicopathological, tumor cell proliferation and apoptosis parameters in adenocarcinoma of the gastric cardia]. / Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia.

BACKGROUND/AIMS: In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS: Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Laurén and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS: The mean age was 61 years (median: 63). There was predominance of the male gender (72.5%), diffuse histological type (55%) and infiltrative histological type (72.5%), and the more advanced stages (III and IV: 67.5%). There was no association with intestinal metaplasia and/or H. pylori. No epithelial dysplasia was detected in adjacent mucosa in any of the cases. The mean apoptotic index was 7.05 in 10 high power fields and 11.40 in 500 cells (2.28%). The mean positivity to PCNA was 275.05 cells in ten high power fields and 409.33 in 500 cells (81.9%). There was a positive correlation between the cell proliferative and apoptotic indices. There was a positive correlation for intestinal histological type with PCNA and apoptotic indices, in 10 high power fields. The mean survival was 28.41 months. Age over 63 and apoptotic index over 7.05 showed a negative correlation with survival, in multivariate analysis. CONCLUSIONS: Adenocarcinoma of the cardia predominated in male adults of mean age 61 years, and the predominant type was diffuse in more advanced stages. There was a correlation between apoptosis and tumoral cell proliferation. Survival in cases of adenocarcinoma of the cardia is still low. Both age and apoptosis were independent prognostic factors in cancer of the cardia.

Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia / Analysis of clinicopathological, tumor cell proliferation and apoptosis parameters in adenocarcinoma of the gastric cardia / Analysis of clinicopathological, tumor cell proliferation and apoptosis parameters in adenocarcinoma of the gastric cardia

RACIONAL/OBJETIVO: Em vista do aumento na incidência do carcinoma da cárdia nos últimos anos, este trabalho visa estudar os aspectos clínico-patológicos, da proliferação celular e da apoptose tumorais, suas correlações e eventuais influências no seu prognóstico. MATERIAL E MÉTODO: Estudaram-se 40 doentes submetidos a gastrectomia total por carcinoma da cárdia, no período de 1988 a 2001, com seguimento clínico de no mínimo 3 anos. Excluíram-se aqueles com tratamento químio ou radioterápico prévio, neoplasia precoce, óbito no intra-operatório ou por outras causas não relacionadas ao câncer. Analisou-se sexo, idade, tipo histológico de Laurén, padrão de crescimento tumoral de Ming, estádio e presença ou ausência de metaplasia intestinal e/ou Helicobacter pylori na mucosa adjacente. O índice apoptótico foi avaliado por cortes histológicos corados pela hematoxilina-eosina. O índice de proliferação celular foi avaliado por meio da imunoexpressão ao PCNA, sendo a técnica imunoistoquímica utilizada a da estreptoavidina-biotina-peroxidase. Para análise da sobrevida, excluíram-se os casos com metástase à distância ao diagnóstico. Foram utilizados testes t de Student, de Mann-Whitney, curvas de Kaplan-Meier e modelo de regressão de Cox. O nível de significância adotado foi menor de 0,05. RESULTADOS: A idade média foi de 61 anos (mediana: 63); houve predomínio do sexo masculino (72,5 por cento), tipo histológico difuso (55 por cento) e infiltrativo (72,5 por cento) e de estádios mais avançados (III e IV: 67,5 por cento). Não houve associação com metaplasia intestinal e/ou H. pylori. O índice apoptótico médio foi de 7,05 em 10 campos consecutivos de grande aumento e de 11,40 em 500 células (2,28 por cento). A positividade média ao PCNA foi de 275,05 células em 10 campos consecutivos de grande aumento e de 409,33 em 500 células (81,9 por cento). Houve correlação positiva do tipo histológico intestinal com PCNA e com a apoptose em 10 campos consecutivos de grande aumento e de ...

BACKGROUND/AIMS: In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS: Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Laurén and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS: The mean age was 61 years (median: 63). There was predominance of the male gender (72.5 percent), diffuse histological type (55 percent) and infiltrative histological type (72.5 percent), and the more advanced stages (III and IV: 67.5 percent). There was no association with intestinal metaplasia and/or H. pylori. No epithelial dysplasia was detected in adjacent mucosa in any of the cases. The mean apoptotic index was 7.05 in 10 high power fields and 11.40 in 500 cells (2.28 percent). The mean positivity to PCNA was 275.05 cells in ten high power fields and 409.33 in 500 cells (81.9 percent). There was a positive correlation between the cell proliferative and apoptotic indices. There was a positive correlation for intestinal ...

Ossificação pulmonar dendriforme / Dendriform pulmonary ossification

A ossificação pulmonar difusa é uma condição rara, de etiologia desconhecida, na qual osso maduro é encontrado no parênquima pulmonar. É quase sempre descoberta como um achado incidental de autópsias. Freqüentemente afeta homens de meia-idade e é assintomática. Relata-se o caso de um paciente de 75 anos, que apresentou uma radiografia torácica com comprometimento pulmonar difuso e cujo diagnóstico foi baseado no exame histopatológico de fragmento pulmonar obtido através da biópsia a céu aberto, o qual demonstrou fibrose intersticial acentuada com ossificação do parênquima pulmonar.

Diffuse pulmonary ossification is a rare condition of unknown pathogenesis in which mature bone is found in the pulmonary parenchyma. It is almost invariably discovered as an incidental finding at autopsy. Most commonly, it affects middle-aged men and is asymptomatic. We present the case of a 75-year-old man in which the chest X-ray showed diffuse interstitial infiltrate. Diagnosis was based on histopathological examination by open-lung biopsy, which revealed interstitial fibrosis with pulmonary ossification.

Dendriform pulmonary ossification.

Diffuse pulmonary ossification is a rare condition of unknown pathogenesis in which mature bone is found in the pulmonary parenchyma. It is almost invariably discovered as an incidental finding at autopsy. Most commonly, it affects middle-aged men and is asymptomatic. We present the case of a 75-year-old man in which the chest X-ray showed diffuse interstitial infiltrate. Diagnosis was based on histopathological examination by open-lung biopsy, which revealed interstitial fibrosis with pulmonary ossification.

Primary hyperparathyroidism simulating motor neuron disease: case report.

We report a case of a 26-year-old man who presented a lower motor neuron syndrome due to hyperparathyroidism. Electromyography showed neurogenic features with normal nerve conduction studies. Hypercalcemia led to the discovery of a primary hyperparathyroidism with gland hyperplasia. Following parathyroid surgery there was recovery of the neurological symptoms.

Primary hyperparathyroidism simulating motor neuron disease: case report

Descrevemos o caso de homem de 26 anos que apresentou síndrome do neurônio motor inferior devido a hiperparatiroidismo. A eletromiografia mostrou aspecto neurogênico com estudos da condução normal. Hipercalcemia levou à descoberta de hiperparatiroidismo primário com hiperplasia da glândula. Após a cirurgia de ressecção da paratiróide, houve regressão dos sintomas neurológicos.

Eyelid swelling as the only manifestation of ocular sarcoidosis.

PURPOSE: To describe a case of eyelid sarcoidosis without systemic manifestations with a three-year follow-up. METHODS: A 73-year-old woman presented complaining of a one-year history of swelling and hyperemia in the right upper eyelid. To confirm the diagnosis, we performed an incisional biopsy of the eyelid. RESULTS: Histopathological examination showed a non-caseating granulomatous process suggestive of sarcoidosis. After three years, the patient was asymptomatic and physical and laboratory examination showed no signs of systemic sarcoidosis. CONCLUSION: The histopathological exam was fundamental for the diagnosis.

Toxicidade córneo-conjuntival do colírio de iodo-povidona: estudo experimental / Corneal and conjunctival toxicity of povidone-iodine eye drops: experimental study

OBJETIVO: Avaliar a toxicidade ocular do colírio de iodo-povidona a 2,5 por cento e a 0,5 por cento sobre a superfície ocular, na regeneração do epitélio corneal e as alterações histopatológicas da córnea. MÉTODOS: Realizaram-se estudos experimentais consecutivos em coelhos albinos, nos quais se fez a ablação do epitélio de uma área circular central da córnea de 6,5 mm de diâmetro. Em cada experimento foram utilizados 20 animais (40 olhos), sendo que no olho direito foi instilado o colírio de iodo-povidona (caso) e no olho esquerdo água destilada (controle), em intervalos de uma hora, durante três dias consecutivos. Durante o experimento, os animais foram submetidos a exames biomicroscópicos diários para avaliação da superfície córneo-conjuntival e realização de fotografias seriadas da área sem epitélio, corada com fluoresceína, para medida da área projetada da lesão com auxílio de analisador de imagem computadorizado. No final do experimento, os animais foram sacrificados para avaliação histopatológica das córneas. RESULTADOS: O colírio de iodo-povidona a 2,5 por cento comprometeu a regeneração epitelial, causou conjuntivite em 100 por cento dos olhos, com produção de secreção de aspecto mucoso em 80 por cento, ceratite ponteada em 40 por cento e edema estrômico leve em 10 por cento dos casos. Os achados histopatológicos foram úlcera de córnea, degeneração hidrópica das células endoteliais e infiltrado inflamatório com predomínio de eosinófilos em 100 por cento dos casos. Nos olhos em que se instilou iodo-povidona a 0,5 por cento, assim como nos controles, observou-se completa regeneração da lesão epitelial (p<0,001) após 72 horas do início do experimento. Do ponto de vista histopatológico, epitelização normal em todos os casos e controles, em apenas um caso observou-se discreto infiltrado de leucócitos perilímbicos. CONCLUSÃO: A toxicidade ocular do colírio de iodo-povidona é dependente da concentração da solução, sendo que o colírio a 2,5 por cento mostrou-se inadequado para utilização em intervalos de uma hora e a 0,5 por cento não causou toxicidade significante.