Effect of the problem-based learning method on student electroencephalograms and microcirculatory blood perfusion in the teaching of sports physiology / Efecto del método de aprendizaje basado en problemas en electroencefalogramas y perfusión sanguínea microcirculatoria de estudiantes en la enseñanza de la fisiología del deporte / Efeito do método de aprendizagem baseada em problemas em eletroencefalogramas e perfusão sanguínea microcirculatória de estudantes no ensino de fisiologia do esporte

ABSTRACT Introduction Applying the problem-based learning (PBL) method to the teaching of sports physiology. Objective This study explored the mechanism of the PBL method to improve the interest and learning effectiveness of students. Methods Twenty male students at the Physical Education College of Hubei Minzu University were randomly divided into a PBL group (10) and a traditional teaching method group (TTM). During the test, the subjects in the TTM group sat quietly listening to the experienced teacher, while the subjects in PBL group sat quietly and participated in a 20-minute group discussion under the guidance of the experienced teacher. Transcutaneous partial pressure of oxygen (TcPO2), microcirculatory blood perfusion (MBP), and alpha- and beta-band power were monitored at the beginning of and during the test. Results The mean of the PBL-group quiz score was significantly higher than that of the TTM group. In the PBL group, the alpha power of the students decreased statistically in the F3, T3, P3, and O1 channels and the beta power of the students increased statistically in the F7, F3, T3, C3, P3, and O1 as compared to the baseline values. Conclusion PBL can be an effective learning mechanism, since the students are actively engaged in the teaching of sports physiology. Level of Evidence I; Therapeutic studies - Investigating treatment results.

RESUMEN Introducción Aplicación del método de Aprendizaje Basado en Problemas (PBL), a la enseñanza de la fisiología del deporte. Objetivos Este estudio exploró el mecanismo del método PBL para ampliar el interés y la eficacia del aprendizaje de los estudiantes. Métodos Veinte estudiantes varones de la Facultad de Educación Física de la Universidad de Hubei Minzu fueron divididos aleatoriamente en el grupo PBL (10) y en un grupo de método de enseñanza tradicional (TTM). Durante la prueba, los participantes del grupo TTM permanecieron sentados y escuchando en silencio al profesor experimentado, mientras que los del grupo PBL permanecieron sentados y participaron en un debate de grupo de 20 minutos de acuerdo con la orientación del mismo profesor. La presión parcial de oxígeno transcutáneo (TcpO2), la perfusión sanguínea microcirculatoria (MBP) y la potencia de las bandas alfa y beta se monitorizaron al inicio y durante la prueba. Resultados La puntuación media del cuestionario del grupo PBL fue significativamente mayor que la del grupo TTM. En el grupo PBL, la potencia alfa de los estudiantes disminuyó estadísticamente en los canales F3, T3, P3 y O1 y la potencia beta de los estudiantes aumentó en los canales F7, F3, T3, C3, P3 y O1 en comparación con los valores de referencia. Conclusión El PBL puede ser un mecanismo de aprendizaje eficaz, ya que los estudiantes participan activamente en la enseñanza de la fisiología del deporte. Nivel de evidencia I; Estudios terapéuticos - Investigación de los resultados del tratamiento.

RESUMO Introdução Aplicação do método de aprendizagem baseada em problemas (PBL) ao ensino da fisiologia do esporte. Objetivos Este estudo explorou o mecanismo do método PBL para ampliar o interesse e a eficácia da aprendizagem dos estudantes. Métodos Vinte estudantes do sexo masculino da Faculdade de Educação Física da Universidade Hubei Minzu foram divididos randomicamente em um grupo PBL (10) e um grupo de método de ensino tradicional (TTM). Durante o teste, os participantes do grupo TTM ficaram sentados e em silêncio ouvindo o professor experiente, enquanto os do grupo PBL ficaram sentados e participaram de uma discussão em grupo de 20 minutos de acordo com a orientação do mesmo professor. A pressão parcial do oxigênio transcutâneo (TcPO2), a perfusão sanguínea microcirculatória (MPB) e a potência das bandas alfa e beta foram monitoradas no início e durante o teste. Resultados A média do escore do questionário do grupo PBL foi significativamente maior do que a do grupo TTM. No grupo PBL, o poder alfa dos estudantes diminuiu em termos estatísticos nos canais F3, T3, P3 e O1 e o poder beta dos estudantes aumentou nos canais F7, F3, T3, C3, P3 e O1 em comparação com os valores basais. Conclusão O PBL pode ser um mecanismo eficaz de aprendizagem, uma vez que os estudantes ficam ativamente engajados no ensino da fisiologia do esporte. Nível de Evidência I; Estudos terapêuticos - Investigação dos resultados do tratamento.

Outcomes of oesophageal cancer treated with neoadjuvant compared with definitive chemoradiotherapy

INTRODUCTION@#We report outcomes of patients with oesophageal cancer treated with neoadjuvant chemoradiotherapy (NACRT) plus surgery or definitive chemoradiotherapy (chemoRT) at our institution.@*METHODS@#We retrospectively reviewed patients who underwent chemoRT from 2005 to 2017. The primary outcome was overall survival (OS). Secondary outcomes were disease-free survival (DFS) and toxicities.@*RESULTS@#We identified 96 patients with median age of 64 years and squamous cell carcinoma in 82.3%. Twenty-nine patients (30.2%) received NACRT plus surgery, 67 patients (69.8%) received definitive chemoRT. Median follow-up was 13.5 months. The 3/5-year OS were 26.4%/13.4%, and 59.6%/51.6% in the definitive chemoRT and NACRT plus surgery groups, respectively. The 3/5-year DFS were 19.3%/12.3%, and 55.7%/37.2% in the definitive chemoRT and NACRT plus surgery groups, respectively. NACRT plus surgery significantly improved OS (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.22-0.72, @*CONCLUSION@#NACRT plus surgery improved OS and DFS. However, in view of treatment-related complications, careful selection of patients is warranted. With the predominant histology of our cohort being squamous cell carcinoma (SCC), our results may be more relevant for those with SCC.

Effect of 12 week aerobic exercise on microcirculation function of sedentary college students / 中国学校卫生

Objective@#To investigate the effects of different doses of aerobic exercise on the microvascular function of habitually sedentary college students.@*Methods@#A total of 69 students from Hubei Minzu University were recruited and divided into sports group A, sports group B and control group, with 23 students in each group (12 boys and 11 girls). The exercise group received 12 weeks of aerobic exercise intervention, in which group A exercised 1-2 times a week, group B exercised≥3 times a week, and the control group did not carry out any systematic sports. Microvascular response, Transcutaneous partial pressure of oxygen(TcpO 2), Nitric oxide, Nitric oxide synthase (NOS) and En dothelin-1 (ET-1) were measured before and after the test.@*Results@#After the test, the microvascular reactivity showed group and time interaction( P <0.01), in which exercise group B was greater than that of control group and exercise group A ( P <0.01). There was no significant difference between exercise group A and control group ( P >0.05), but the percutaneous partial pressure of oxygen ( P =0.53) had no time interaction with other groups; NO( F =6.32) and NOS( F =7.91) had group and time interaction, in which exercise group B was greater than control group and exercise group A ( P <0.01), and there was no significant difference between exercise group A and control group ( P >0.05).@*Conclusion@#There is a "dose effect" relationship between aerobic exercise and microcirculatory blood perfusion and endogenous NO. Continuous aerobic exercise ≥3 times a week for 12 weeks improved microcirculatory blood perfusion and promoted endogenous NO production in sedentary college students, but doing aerobic exercise for 1-2 times a week had no significant effect on microcirculatory blood perfusion and endogenous NO.

Influence of long term aerobic exercise sports on microcirculation function and maximum oxygen uptake on the lower limbs of college students / 中国学校卫生

Objective@#To explore the effect of long term aerobic exercise on microcirculation function and VO 2max of college students, and to explore the relationship between microcirculation function and VO 2max .@*Methods@#Seventy sports major college students were selected as the exercise group, 70 sedentary non sports major students were selected as the control group. PF6000 dual channel laser Doppler blood flow detector was used to assess the skin microcirculation function on the quadriceps femoris muscle of the subjects right lower limbs.The PFT Ergo cardiopulmonary function test system and the equipped power bicycle were used to measure the VO 2max of the subjects.@*Results@#The baseline value of MBP in the exercise group was significantly lower than that in the control group (6.5±1.8 vs. 8.1±2.5), but the microvascular reactivity(1 666.3±588.6 vs. 1 165.2±407.1) was significantly higher than that in the control group(t =-3.42，4.46， P <0.01). The absolute value of VO 2max (2 684.8±451.1 vs. 2 474.4±423.5) and relative value (42.7±4.3 vs. 35.1±4.8) in exercise group were significantly higher than those in control group( t =2.16，3.25， P < 0.01 ). Multiple regression showed that there was a positive correlation between microvascular reactivity and VO 2max (relative value) ( β = 0.40 , P =0.03), but no significant correlation between percutaneous oxygen partial pressure and VO 2max (relative value) ( β= 0.23 , P =0.19).@*Conclusion@#Long term physical exercise can decrease microcirculation perfusion volume, improve microvascular reactivity, percutaneous oxygen partial pressure among college students. Improvement of the microvascular reactivity may be a sport improving VO 2max (relative) one of the most important peripheral physiological mechanism.

Influence of applying fast-track surgery to optimize the process in perioperative period of cardiac intervention on rehabilitation of patients with radial artery stenting surgery: A randomized controlled trial / 中国胸心血管外科临床杂志

@#Objective To explore the influence of applying the fast-track surgery (FTS) to optimize the process in the perioperative period of cardiac intervention on the rehabilitation of patients with radial artery stenting surgery. Methods A total of 190 patients with radial artery stenting surgery in the Department of Cardiology, West China Hospital from June 2017 to May 2018 were enrolled. They were randomized into a control group (n=95) and a FTS group (n=95) by random umber table. There were 60 males and 35 females aged 35-88 (65.2±9.6) years in the control group as well as 62 males and 33 females aged 34-86 (61.5±11.3) years in the FTS group. Patients in the control group received routine perioperative care, but patients in the FTS group received individual precision interventions by applying the FTS concept to optimize the process of perioperative care, including individual care management before being admitted into hospital, during hospital, and after discharge from hospital. Duration of hospital stay, satisfaction scores, number of comorbidities after surgery, disease self-management ability, and readmission rates were compared between the two groups. Results Compared to the control group, the FTS group had significantly shorter duration of hospital stay, less comorbidities, higher satisfaction scores and disease self-management ability, and lower readmission rate to hospital (P<0.05). Conclusion Applying FTS into the perioperative period of cardiac interventions to optimize its process can help patients recover from radial artery stenting surgery, increase patients’ self-management abilities, shorten duration of hospital stay and decrease comorbidities and cardiac adverse events.

Outcomes of neoadjuvant chemoradiotherapy followed by total mesorectal excision surgery for locally advanced rectal cancer: a single-institution experience

<p><b>INTRODUCTION</b>Neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision (TME) surgery for locally advanced rectal cancer has been shown to improve local control and reduce toxicity, as compared to adjuvant CRT. We reported the outcomes of our patients with locally advanced rectal cancer treated at National University Hospital, Singapore.</p><p><b>METHODS</b>From April 2002 to December 2014, 117 patients with T3/4, N0/+, M0 rectal cancer received neoadjuvant CRT followed by TME surgery. The treatment regimen comprised a total radiotherapy dose of 50.4 Gy in 28 daily fractions delivered concurrently with 5-fluorouracil or capecitabine chemotherapy over 5.5 weeks. All patients were planned for TME surgery. Local control, disease-free survival, overall survival and treatment toxicities were analysed.</p><p><b>RESULTS</b>Median follow-up was 34 (range 2-122) months. 11.5% (13/113) of patients achieved a pathological complete response (pCR) and 72.6% (85/117) had either tumour or nodal downstaging following neoadjuvant CRT. 5.2% (5/96) of patients had Grade 3 acute toxicities (dermatitis and diarrhoea) and 3.1% (3/96) had Grade 3 late toxicities (fistula and stricture). There was no Grade 4 toxicity noted. The five-year local recurrence, disease-free survival and overall survival rates were 4.5%, 65.7% and 80.6%, respectively. Multivariate analysis showed that nodal positivity was a predictor of poor disease-free survival and poor overall survival. Tumour downstaging and pCR did not improve outcomes.</p><p><b>CONCLUSION</b>Our outcomes were comparable to internationally published data, and this treatment regimen remains the standard of care for locally advanced rectal cancer in our local population.</p>

Comparative Study of Longbie Capsules and Bone Marrow Mesenchymal Stem Cell Transplantation in Repairing Damaged Cartilage of Knee Osteoarthritis Rats / 广州中医药大学学报

Objective To compare the actions of Longbie Capsules and bone marrow mesenchymal stem cell (BMSC)transplantation in repairing the damaged cartilage of knee osteoarthritis(KOA)rats. Methods Thirty-six rats aged 4-6 weeks old were induced into KOA model(bilateral knees)by collagenase injection method. All of the modeled rats were randomly divided into model group(intragastric administration of normal saline), BMSC transplantation group(giving tail vein injection of 1 ×106 of BMSCs per time, 2 times every week), and Chinese medicine group (intragastric administration of Longbie Capsules of 7.5 g·kg-1·d-1),12 rats in each group. Six weeks later,the cartilage of rat bilateral knees was taken out. The pathological changes of cartilage were observed by hematoxylin-eosin(HE) staining method, and the protein and mRNA expression levels of Col2a1, X-linkedinhibitor of apoptosis protein (XIAP), HuR in rat knee cartilage were detected by immunohistochemistry and real-time quantitative polymerase chain reaction (qPCR), respectively. Results The HE staining results showed that the cartilage tissue surface was rough with more cracks, and the cartilage cells gathered with the cytoplasm collapsed and arranging disorderly in the model group. The number of chondrocytes was increased and cell surface was flat,and the cracks of the cartilage were decreased with the chondrocytes arranging uniformly in Chinese medicine group and BMSC transplantation group compared with the model group. The results of immunohistochemistry and qPCR detection showed that in Chinese medicine dosage group and BMSC transplantation group, the protein and mRNA expression levels of Col2a1,XIAP and HuR were significantly higher than those in the model group (P<0.05 or P<0.0001), but there was no significant difference between the two medication groups(P>0.05). Conclusion Longbie Capsules and BMSC transplantation can promote the secretion of Col2a1 in the cartilage tissue of KOA rats,improve cartilage, and their mechanism may be related with up-regulating apoptosis-related proteins HuR and XIAP.

Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study / Bloqueio contínuo do nervo femoral guiado por ultrassom e estimulador de nervo para analgesia após artroplastia total de joelho: estudo multicêntrico, randomizado e controlado / Bloqueo continuo del nervio femoral guiado por ultrasonido y estimulador de nervio para analgesia posterior a la artroplastia total de rodilla: estudio multicéntrico, aleatorizado y controlado

BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty. METHODS: 46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group); in 24 patients, epidural analgesia was done (PCEA group). The analgesic effects, side effects, articular recovery and complications were compared between two groups. RESULTS: At 6 h and 12 h after surgery, the knee pain score (VAS score) during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48 h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group. CONCLUSION: Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6 h and 12 h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition. .

JUSTIFICATIVA E OBJETIVOS: Analgesia pós-operatória é fundamental para o exercício funcional precoce logo após a artroplastia total de joelho. O objetivo foi investigar a eficácia clínica do bloqueio contínuo do nervo femoral guiado por ultrassom e estimulador de nervo em analgesia após artroplastia total do joelho. MÉTODOS: Receberam analgesia pós-operatória, de outubro de 2012 a janeiro de 2013, 46 pacientes, estado físico ASA I-III, submetidos à artroplastia total de joelho. Em 22 pacientes, o bloqueio femoral contínuo foi guiado por ultrassom e estimulador de nervo para analgesia (grupo BFC); em 24 pacientes, analgesia foi administrada por via epidural (grupo ACP). Os efeitos analgésicos, efeitos colaterais, a recuperação articular e as complicações foram comparados entre os dois grupos. RESULTADOS: Às seis e 12 horas após a cirurgia, os escores de dor no joelho (escore EVA) durante os testes funcionais após exercício ativo e passivo foram significativamente menores no grupo BFC do que no grupo ACP. A quantidade usada de parecoxib nos pacientes do grupo BFC foi significativamente menor em comparação com o grupo ACP. Quarenta e oito horas após a cirurgia, o grau de força muscular no grupo BFC foi significativamente maior e o tempo de atividade ambulatória foi menor do que no grupo ACP. A incidência de náusea e vômito em pacientes do grupo BFC foi significativamente menor em comparação com o grupo ACP. CONCLUSÃO: O bloqueio femoral contínuo guiado por ultrassom e estimulador do nervo proporcionou melhor analgesia às seis e 12 horas, demonstrada por EVA-R e EVA-P. A quantidade de parecoxib também foi menor, a incidência de náusea e vômito diminuiu, a influência sobre a força muscular é comprometida e os pacientes podem fazer atividade ambulatorial sob essa condição. .

JUSTIFICACIÓN Y OBJETIVOS: La analgesia postoperatoria es fundamental para el ejercicio funcional precoz posteriormente a la artroplastia total de rodilla. El objetivo fue investigar la eficacia clínica del bloqueo continuo del nervio femoral guiado por ultrasonido y estimulador de nervio en analgesia después de la artroplastia total de la rodilla. MÉTODOS: Cuarenta y seis pacientes, con estado físico ASA I-III, sometidos a artroplastia total de rodilla recibieron analgesia postoperatoria de octubre de 2012 a enero de 2013. En 22 pacientes, el bloqueo femoral continuo fue guiado por ultrasonido y estimulador de nervio para analgesia (grupo BFC); en 24 pacientes, la analgesia fue administrada por vía epidural (grupo ACP). Los efectos analgésicos, efectos colaterales, recuperación articular y las complicaciones fueron comparados entre los 2 grupos. RESULTADOS: A las 6 y 12 h después de la operación, las puntuaciones de dolor en la rodilla (puntuación EVA) durante los test funcionales después del ejercicio activo y pasivo fueron significativamente menores en el grupo BFC que en el grupo ACP. La cantidad usada de parecoxib en los pacientes del grupo BFC fue significativamente menor en comparación con el grupo ACP. Cuarenta y ocho horas después de la operación, el grado de fuerza muscular en el grupo BFC fue significativamente mayor y el tiempo de actividad ambulatoria fue menor que en el grupo ACP. La incidencia de náuseas y vómitos en pacientes del grupo BFC fue significativamente menor en comparación con el grupo ACP. CONCLUSIÓN: El bloqueo femoral continuo guiado por ultrasonido y estimulador del nervio proporcionaron una mejor analgesia a las 6 y 12 horas, lo que quedó demostrado por EVA-R y EVA-P. La cantidad de parecoxib también fue menor, la incidencia de náuseas y vómito disminuyó, la influencia sobre la fuerza muscular está comprometida y los pacientes pueden realizar una actividad ambulatoria bajo esa condición. .

A rare case of intratesticular leiomyoma

A 47-year-old man presented with a scrotal swelling. Ultrasonography of the testes showed that it was an extratesticular swelling. However, the swelling was intraoperatively found to be intratesticular. Histology showed an intratesticular leiomyoma, which is extremely rare.

Bone mineral density changes in coal workers' pneumoconiosis in Two and Triple stages with increasing ages / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the bone mineral density changes in coal workers' pneumoconiosis in Two and Triple stages with increasing ages.</p><p><b>METHODS</b>Chose 70 cases of coal workers pneumoconiosis in Two and Triple stages in Jincheng Coal Mining Group, all of workers were male, of 55-years old-80 years old, an average of 67 years old. 10 years of ages to grouping, whole body bone mineral densities were measured by body dual-energy X-ray absorptiometry. We analyzed the BMD changes bone loss, osteoporosis occurrence.</p><p><b>RESULTS</b>Chest bone, pelvis, spine bone mineral densities of coal workers pneumoconiosis in Two and Triple stages were significantly decreased. We found that the rate of Pelvic BMD decline of coal workers' pneumoconiosis patients in Two stage was significantly faster after 65 years of age. In Different age groups of coal workers' pneumoconiosis patients in Two and Triple stages, incidence of bone loss and osteoporosis were significantly increased.</p><p><b>CONCLUSION</b>With the age increasing, Coal workers' pneumoconiosis in Two and Triple stages significantly accelerated the speed of the rate of BMD decline. This phenomenon was most obvious in the chest bone, pelvis, and spine.</p>

Bone mineral density changes in coal workers' pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the bone mineral density changes of coal workers' pneumoconiosis.</p><p><b>METHODS</b>We chose 150 cases of One-Triple coal workers pneumoconiosis in Jincheng Coal Mining Group, all of workers were male, of 55-years old-80 years old, an average of 67 years old. 10 years of age to grouping, Whole body bone mineral density and T value were measured by body dual-energy X-ray absorptiometry. We analyzed the BMD changes bone loss, osteoporosis occurrence.</p><p><b>RESULTS</b>The BMD of six parts were not declined obviously in One stage of coal workers' pneumoconiosis; the BMD of Chest bone, pelvis and spine were declined obviously in two stage of coal workers' pneumoconiosis; the BMD of six parts were declined obviously in Triple stage of coal workers' pneumoconiosis; The occurrence rate of bone loss was significantly higher in Two and Triple coal workers pneumoconiosis. The occurrence rate of osteoporosis was significantly higher in Triple coal workers pneumoconiosis.</p><p><b>CONCLUSION</b>With the increase in the severity of coal workers' pneumoconiosis, the BMD of six parts were declined, The occurrence rate of bone loss osteoporosis was significantly higher.</p>

Germline genetic testing to predict drug response and toxicity in oncology--reality or fiction?

In addition to 6-mercaptopurine, 5-fluorouracil and irinotecan, the United States Food and Drug Administration (US FDA) has recently recommended label change for tamoxifen, to include pharmacogenetic information on treatment outcome. With the increasing availability of pharmacogenetic testing, on germline as well as somatic mutations, oncologists are now able to identify individuals at risk of severe treatment toxicity or poor treatment response. However, there are still knowledge gaps to fill before rationalised therapy based on pharmacogenetics can be fully integrated into clinical practice. This review provides an overview on the application of pharmacogenetic testing for germ line mutations in oncology to predict response and toxicity.

Localização radioguiada de lesões mamárias não-palpáveis, exame anatomopatológico e biópsia de linfonodo sentinela no mesmo ato operatório / Radioguided localization of non-palpable breast lesions, intraoperative anatomopathological analysis and sentinel lymph node biopsy at the same surgery

O objetivo deste estudo foi apresentar uma nova estratégia para o manejo de lesões mamárias suspeitas de malignidade, a qual combina a localização radioguiada (ROLL), mapeamento de linfonodo sentinela (LS), exame de congelação e, se necessário, ressecção segmentar da mama e biópsia linfonodal. Foram estudados 115 casos (101 lesões mamárias não-palpáveis suspeitas de malignidade e 14 cânceres não-palpáveis descobertos por mamotomia prévia). Na véspera da cirurgia foi injetada no centro da lesão (ou na área do clipe pós-mamotomia) uma solução contendo 0,2 ml de dextram e 15 MBq de 99mTc, por orientação ultrasonográfica ou estereotáxica. No dia seguinte, todas as pacientes foram submetidas à biópsia cirúrgica orientada por probe detector de radiação gama, radiografia da peça cirúrgica e exame de congelação. A taxa de confirmação de remoção das lesões foi de 100 por cento, sendo que o LS foi mapeado por linfacintilografia em 97,4 por cento (112/115). O exame anatomopatológico intra-operatório revelou 29 carcinomas infiltrativos, 13 carcinomas ductais in situ, 11 hiperplasias atípicas, 42 alterações fibrocísticas e 6 resultados inconclusivos. Na comparação com os resultados verificados no exame definitivo ou parafina notaram-se 3 (2,9 por cento) resultados falsos-negativos e nenhum falso-positivo. O LS foi imediatamente biopsiado 50 casos de malignidade, dos quais 3 estiveram comprometidos pelo exame citológico na hora e mereceram dissecção axilar completa. Em conclusão, ROLL e biópsia de LS podem ser empregados simultaneamente mediante uma injeção única de 99mTc ligada a dextram. Esta técnica possibilita exame de congelação, cirurgia conservadora, biópsia de LS e dissecção axilar total se necessário.

Torção hepática e obstrução de cólon transverso: relato de um caso e revisão da literatura / Hepatic torsion with colonic obstruction: a case report and review of the literature

Os autores relatam o caso de uma paciente de 20 anos de idade, sem antecedentes patológicos, que apresentou quadro de abdome agudo obstrutivo. Realizou exames radiológicos, ultra-som e tomografia computadorizada, seguidos de laparotomia explorada, sendo constatadas: a) rotação hepática completa para o hipocôndrio esquerdo; b) hipotensão severa por compressão da veia cava inferior; c) malformação congênita dos ligamentos falciforme e coronários; d) obstrução do cólon transverso por bridas constritivas congênitas; e) importante distensão gasosa de alças cólicas no hipocôndrio direito. Foram ressecadas as bandas pericólicas, com redução imediata da dilatação no hemiabdome direito, havendo retorno espontâneo do fígado à posição anatômica. Esta condiçãoímpar, o os outros três casos similares já descritos na literatura mundial, são comentados neste trabalho.

Síndrome de Peutz-Jeghers e intussuscepçäo: relato de um caso e revisäo da literatura

Resumo: Os autores relatam um caso de uma mulher, de 28 anos de idade, com intussuscepçäo ileocecocólica associada à síndrome de Peutz-Jeghers, uma doença autossômica dominante caracterizada por pópolis harmartomatosos no trato gastrointestinal e pigmentaçäo mucocutânea. Esta patologia apresenta complicaçäo frequêntes, tais como obstruçäo intestinal por intussuscepçäo e hemorragia. No caso aqui apresentado, o diagnóstico da invaginaçäo foi pré-operaatório, por meio de exames de imagem. A paciente foi submetida a laparotomia, durante a qual foi realizada hemicolectomia direta. Na peça cirúrgica foram encontrados três pólipos de grandes dimensöes, interpretados como sendo a causa da intussuscepçäo

Apendicite aguda associada ao bário / Acute appendicitis associated with barium

Os autores relatam um caso em que apendicite aguda ocorreu após enema opaco baritado.A relaçäo causl é discutida.

Correlaçäo radioanatomopatológica de lesöes mamárias näo palpáveis / Nonpalpable breast lesions: pathological-radiological correlations

Existem evidências conclusivas de que ocorre reduçäo significativa na mortalidade por câncer de mama como resultado de rastreamento mamográfico de grandes populaçöes de mulheres. Após rastreamento e estudos diagnósticos, substancialmente mais pacientes estäo sendo encaminhadas aos cirurgiöes, principalmente aquelas portadoras de lesöes näo palpáveis. A lesäo oculta näo palpável é entidade clínica que, geralmente, requer localizaçäo com agulha e biópsia para o diagnóstico. Esta técnica, amplamente usada, envolve um esforço coordenado entre o radiologista, o patologista, o cirurgiäo e a paciente. Apenas 10 a 30 por cento das biópsias mamárias com o emprego dessa conduta säo malignas, indicando alto grau de falso-positivo. Este trabalho estudou 81 pacientes com lesöes

Apendicite aguda gangrenosa com abscesso / Acute gangrenous appendicitis with abscess

Apresenta-se um caso de apendicite aguda gangrenosa com grande abscesso pélvico-abdominal e säo abordados alguns comentários sobre o diagnóstico clínico, radiológico e ultrassonográfico