A 10-year experience with the Amatsu tracheoesophageal shunt

Introduction: Since 1991, we have done the tracheoesophageal shunt as described by Amatsu in candidates to a total laryngectomy. Our goal is to provide the patients a better speech rehabilitation that that obtained by the non-surgical techniques, and by doing so, lessen the oncological treatment impact on the patient's quality of life. Aim: This work revises the experience of our institution with the procedure during a 10 years period. Study design: Clinical retrospective. Material and method: We had 54 patients submitted to the procedure, 3 women e 51 men, with ages from 30 to 78 years old and a mean age of 59 years. All had scamous cell carcinoma, 10 from the piriform sinus, 2 from retrocricoide area, 6 from the supraglottis, 1 from the subglottis, 16 from the glottis and 19 were transglottic. According to the AJC staging system, 3 were stage II, 17 were stage III, 24 were stage IV and 10 were not staged. Previous radiotherapy as initial treatment had been done in 18 patients. During the laryngectomy, 33 patients had some type of neck dissection and in 15 of these patients the neck dissection was done bilaterally. A myocutaneous pectoralis major flap was needed in 5 cases and a deltopectoralis flap was used in one case. Postoperative radiotherapy was used in 20 patients. Local infections occurred in 36 percent of the cases, and all had a good outcome. One patient died in the early postoperative period. Results: Speech rehabilitation by the technique was successful in 70 percent of the cases. Aspiration occurred in 10 patients and, in 2 of these, the shunt had to be surgically closed. Conclusion: In conclusion, due to its low cost, good results with few complications, the Amatsu tracheoesophageal shunt continues in our service as the main technique for speech rehabilitation after laryngectomy

Aneurisma da artéria ilíaca interna: um problema a ser resolvido / Internal iliac artery aneurysm: a problem to be solved

O objetivo do presente trabalho é a divulgação da necessidade de diagnóstico precoce e tratamento do aneurisma da artéria ilíaca interna. São relatados 7 casos, que foram diagnosticados, alguns isoladamente, outros associados a aneurisma da artéria ilíaca comum e outros a aneurisma da aorta abdominal roto e operado eletivamente. Todos os pacientes foram submetidos a restauração vascular com sucesso. O aneurisma da artéria hipogástrica deve ser tratado precocemente para evitar sua ruptura e a circulação restaurada, sempre que possível, para evitarmos complicaçöes como isquemia mesentérica e glútea.

Producción de anticuerpos monoclonales ANTI-ZP3 humana / Production of monoclonal human antibodies anti-zp3

El propósito de este proyecto ha sido desarrollar anticuerpos monoclonales murinos dirigidos contra ZP3 humana, que permitan definir los epitopos de ZP3 que son exclusivos en la estimulación de células B. Esta información es fundamental para desarrollar una vacuna contraceptiva basada en ZP3. Se obtuvo un anticuerpo monoclonal (ACM) denominado SD10, que pertenece a la clase IgM, el cual mediante estudios de inmunofluorescencia indirecta con ZP humana, de hámster, de rata, mostró ser sólo reactivo con zona pelúcida humana (ZPH) y no con otras especies, demostrándose así que el ACM 3D10 reconoce en forma específica un antígeno de la ZPH y por lo tanto, podría ser una herramienta muy útil en el análisis de los mecanismos por los cuales este antígeno (ZPH) participa en las interacciones gaméticas para incrementar así los conocimientos acerca del fenómeno de la fertilización y su posible uso como un método anticonceptivo

Virus hepatitis C: resultados de detección en algunos grupos de riesgo en la X región de Chile / Hepatitis C virus: results on detection in some risk groups in X region of Chile

The aim of this study was to determine the prevalence of hepatitis C virus antibodies in high rosk patients coming from Valdivia, Osorno and Puerto Montt. Fiftysix patients in hemodialysis, 51 renal grafts recipients, 42 cirrhotic and 14 patients with acute non A non B hepatitis were studied. Antibodies were detected with a second generation ELISA technique and positive cases were confirmed with RIBA. All hemodialysis patients and renal grafts recipients were negative for hepatitis C virus antibodies. In one non alcoholic patient with cirrhosis, a positive ALISA was confirmed with RIBA. Six patients with acute hepatitis had a positive ALISA tests but none was confirmed with RIBA. It is concluded that the prevalence of hepatitis C virus antibodies in this region of Chile is very low

Etude epidemiologique de l'onchocercose dans la vallee de la Bini (Adamaoua) Cameroun : prevalence de l'infestation et charge parasitaire

L'Enquete epidemiologique effectuee dans la vallee de la Bini montre que l'onchocercose touche l'ensemble de la population urbaine. Les resultats obtenus dans les villages sont sensiblement identiques. On note en effet que la prevalence parasitaire est de 57;3pour les hommes et de 50;3pour les femmes. Cette difference entre les sexes est encore accentuee par le calcul du nombre moyen de microfilaires par biopsie entamee. Celui-ci est de 55 pour les hommes et de 22 pour les femmes

Immunodetection of acrosin during the acrosome reaction of hamster, guinea-pig and human spermatozoa

Mammalian sperm acrosomes contain a trypsin-like protease called acrosin which causes limited and specific hydrolysis of the extracellular matrix of the mammalian egg, the zona pellucida. Acrosin was localized on hamster, guinea-pig and human sperm using monoclonal and polyclonal antibodies to human acrosin labelled with colloidal gold. This was visualized directly with transmission electron microscopy, and with light and scanning microscopy after silver enhancement of the colloidal gold probe. Four distinct labelling patterns were found during capacitation and the acrosome reaction in hamster and guinea-pig spermatozoa, and three patterns were found in human spermatozoa. In the hamster, acrosin was not detected on the inner acrosomal surface after the completion of the acrosome reaction, thus correlating with the observation that hamster spermatozoa lose the ability to penetrate the zona after the acrosome reaction. With guinea-pig and human spermatozoa, acrosin was still detected after the completion of the acrosome reaction, thus correlating with the observation that acrosome reacted guinea-pig spermatozoa bind to and penetrate the zona pellucida

Nefropatía por IgA (enfermedad de Berger): experiencia en 78 casos / Ig-A nephropathy

We studied 78 patients with a diagnosis of IgA nephropathy. Renal biopsy was indicated in 69 patients by the presence of macroscopic hematuria (52%), microhematuria or renal failure (14%) or hephritic syndrome (1%). Nine were healthy subjects being studied as live kidney donors. An association with IgG and/or IgM was present in 92% of patients. Serum IgA was elevated in 36% of patients. Hypertension was present in 30% and decreased renal function in 29%. Patients with serum creatinine above 1,5 mg/dl tended to be older (33.8 vs 28.7 years) and to have hypertension (52% vs 19%). among 25 pátients followed for more than 12 months renal function remained stable in 44%, deteriorated in 20% and 36% developed renal failure. the latter was associated to older age, hypertension, abscense of macroscopic hematuria and nephrotic syndrome. The 9 live donors had no clinical manifestations of renal disease. Thus, IgA nephropathy is a highly variable clinical manifestations and its prognosis. An asymptomatic course is demonstrated in some subjects

Fatores maternos associados ao lactocrito de leite humano. / Maternal factors associated with the crematocrit of human milk

O lactocrito (ou crematocrito) traduz a porcentagem de creme do leite humano: e um micrometodo que mede suas calorias com facilidade, sensibilidade e fidelidade. E de execucao rapida e demanda baixo custo. Pode ser utilizado na pratica clinica, em pesquisa e em estudos epidemiologicos. O leite estudado proveio de maes indias e nao-indias do Amazonas (regiao do Alto Solimoes). Foram analisados nas maes os seguintes fatores: idade, cor, paridade, historia de tabagismo, dias pos-parto, hora da coleta, tipo de alimentacao fornecida ao lactente, quantidade coletada e tempo entre o fim da ultima mamada e o inicio da coleta do leite para exame. Foram coletadas 77 amostras de leite pelas maes. Pode-se constatar que diferencas estatisticamente significativas ocorreram nos seguintes fatores: numero de dias pos-parto, hora de coleta e quantidade coletada