Leiomyosarcoma of the esophagus in a patient with chagasic megaesophagus: case report and literature review.

Leiomyosarcoma constitutes approximately 0.5% of the malignant neoplasias of the esophagus and its association with megaesophagus has not been described. We report on a case of a woman with dysphagia that was slowly progressive from the age of 19 due to chagasic megaesophagus. The woman was subjected to cardiomyotomy at the age of 49. She presented a rapid worsening of the dysphagia due to leiomyosarcoma at the age of 61, and was subjected to subtotal esophagectomy with cervical esophagogastroplasty. She developed pulmonary and hepatic metastases 14 months after surgery and died six months later.

[Metastasis of kidney carcinoma to thyroid gland seventeen years after resection of primary tumor]. / Metástase de carcinoma de rim para tireóide dezessete anos após a ressecção do tumor primário.

Renal cell carcinoma is an unpredictable tumor that can recur many years after the original diagnosis. Metastasis of this tumor to the thyroid is an uncommon occurrence that can cause clinical and pathologic problems in diagnosis. The authors report case that present clinically as a palpable thyroid nodule 17 years after the primary renal cell carcinoma had been resected. This lesion appeared a solitary "cold" nodule on iodine 131 scan and was misdiagnosed as primary thyroid neoplasm. The diagnosis was facilitated by the use of immunohistochemical study.

Hana Kai II: a 17-day dry saturation dive at 18.6 ATA. VII: Auditory, visual, and gustatory sensations.

Five divers were tested for alterations in auditory, visual, and gustatory functioning during a 17-day saturation exposure to He-O2 at 18.6 ATA. No evidence of permanent hearing loss was disclosed. Critical flicker fusion was not affected, but peripheral visual thresholds were significantly increased during the first two weeks at 18.6 ATA; this was interpreted to be evidence of severe psychological and physiological stress. Foveal vision was unaffected across testings. Magnitude estimation techniques disclosed changes in taste sensitivity, with sweet sensitivity increasing over time and sour sensitivity declining over the course of the dive. Subjects were more sensitive to bitter stimuli at maximum pressure than at sea level, and less sensitive to salt at maximum pressure. The results indicate that appreciable alterations in sensory functioning can occur during saturation exposures, although the sense modalities were differentially affected by such environmental stressors as pressure, psycho-social stress, fatigue, and perceptual deprivation.

Anticorpo anti-Trypanosoma cruzi como fator de reatividade cruzada na pesquisa de anticorpos anti-DNA por imunofluorescência indireta / Anti-Trypanosoma cruzi antibodies as a factor of cross-reactivity in the research of anti-DNA antibodies by indirect immunofluorescence

Na pesquisa de anticorpos anti-DNA podem ser utilizadas várias metodologias como a imunofluorescência indireta (IFI), enzimaimunoensaio (ELISA) ou radioimunoensaio (RIE) com DNA marcado com 14C, sendo que a IFI empregando Crithçidia luciliae como substrato é a mais utilizada. Sendo este um parasita flagelado da família dos tripanosomatídeos, apresenta estruturas antigênicas comuns ao Trypanosoma cruzi. Portanto, soros de pacientes com sorologia positiva para Doença de Chagas (DC) podem apresentar uma reatividade cruzada entre estes parasitas, constituindo um fator interferente na reação de IFI para pesquisa de anticorpos anti-DNA. Com o objetivo de verficar a freqüência com que esta inferência ocorre na rotina laboratorial, analisou-se os resultados obtidos na pesquisa de anti-DNA por IFI realizadas no período de junho de 1994 a julho de 1995 no Setor de Imunologia Clínica do Hospital Universitário Regional do Norte do Paraná, Londrina-Paraná. Das 927 reações realizadas, 60 (6,47%) foram reagentes, 832 (89,75%) não reagentes e 35 (3,77%) apresentaram um padrão inespecífico de fluorescência. Suspeitando-se de reatividade cruzada, foram realizadas reações sorológicas para DC (HAI e IFI) nestas amostras, sendo que 100% apresentaram resultados reagentes para ambas as reações. Estes dados confirmam a interferência dos anticorpos anti-Trypanosoma cruzi na pesquisa de anticorpos anti-DNA por IFI e alertam para a necessidade da confirmação de resultados falsos-positivos, principalmente em regiões onde a DC é endêmica.