Prevalence of vascular-endothelial growth factor, matrix metalloproteinases and tissue inhibitors of metalloproteinases in primary breast cancer

Our objective was to determine the presence of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2) and MMP-9 and specific tissue inhibitors of matrix metalloproteinase (TIMP-1 and TIMP-2) in tumor samples obtained from patients with primary breast cancer. We attempted to correlate these findings with the status of the sentinel lymph node (SLN) and clinical-pathological characteristics such as age, tumor size, histological type, histological grade, and vascular invasion. Tumor samples from 88 patients with primary breast cancer were analyzed. The immunoreactivity of VEGF, MMP-2, MMP-9, TIMP-1, and TIMP-2 in tumors was correlated with clinical and pathological features, as well as SLN status. Nonparametric, Mann-Whittney, Kruskal-Wallis, and Spearmann tests were used. Categorical variables were analyzed by the Pearson test. No statistically significant correlation was found between the amount of VEGF, MMP-2, MMP-9, TIMP-1, and TIMP-2 and the presence of tumor cells in the SLN. However, larger tumor diameter (P < 0.01) and the presence of vascular invasion (P < 0.01) were correlated positively with a positive SLN. A significant correlation of higher VEGF levels (P = 0.04) and lower TIMP-1 levels (P = 0.04) with ductal histology was also observed. Furthermore, lower TIMP-2 levels showed a statistically significant correlation with younger age (<50 years) and larger tumor diameter (2.0-5.0 cm). A positive SLN correlated significantly with a larger tumor diameter and the presence of vascular invasion. Higher VEGF and lower TIMP-1 levels were observed in patients with ductal tumors, while higher TIMP-1 levels were observed in lobular tumors.

Postangioplasty restenosis: a practical model in the porcine carotid artery

Transluminal coronary angioplasty is a routine therapeutic intervention in coronary heart disease. Despite the high rate of primary success, restenosis continues to be its major limitation. Porcine models have been considered to be the most adequate experimental models for studying restenosis. One limitation of porcine models is the need for radiological guidance and the expenses involved. The objective of the present study was to adapt an experimental model of angioplasty in the porcine carotid artery that does not require radiological equipment. Eight animals were used to develop the technique of balloon injury to the common carotid artery by dissection without radiological guidance. This technique was then employed in six other animals. Under anesthesia, the left common carotid artery was dissected and incised at the carotid sinus for insertion of an over-the-wire angioplasty balloon towards the aorta. Overstretch injury of the carotid artery was performed under direct visualization. After 30 days, the arteries were excised and pressure-fixated. Uninjured carotid arteries from 3 additional animals were used as controls. A decreased luminal area associated with intimal hyperplasia and medial reaction was observed in all injured arteries. Immunohistochemistry identified the intimal hyperplastic cells as smooth muscle cells. Computerized morphometry of the ballooned segments revealed the following mean areas: lumen 2.12mm2 (+ 1.09), intima 0.22mm2 (+ 0.08), media 3.47mm2 (+ 0.67), and adventitia 1.11mm2 (+ 0.34). Our experimental model of porcine carotid angioplasty without radiological guidance induced a vascular wall reaction and permitted the quantification of this response. This porcine model may facilitate the study of vascular injury and its response to pharmacological interventions.

O aspecto prpeventivo da psicanalise em conexao com sua dimensao socio-cultural. / Preventive aspects of psychoanalysis in relation to socio-cultural dimension

O autor acentua o aspecto social da reflexao psicanalitica ja na obra de Freud, assumindo grande importancia no pensamento de autores neopsicanalistas. Refere-se as relacoes entre psicanalise e sociologia na obra de psicologos e sociologos, acentuando que devem ser delimitados os campos de ambas as ciencias, posto haja fenomenos de acolamento sobretudo no campo do transcultural. Conclui insistindo sobre a necessidade de uma perspectiva sociodinamica em psicanalise para fins de prevencao, o que enriquece o campo de saude mental

Psicoterapia e realidade brasileira / Psychotherapy and Brazilian reality

O autor faz um estudo evolutivo das varias correntes psicoterapicas acompanhando a evolucao da psiquiatria na realidade brasileira. Refere-se as varias formas de psicoterapia assistematica, demasiado empiricas, assinalando o prograsso trazido pela obras de Freud. Refere-se as varias modalidades psicoterapicas inspiradas no pensamento psicanalitico inclusive a moderna medicina psicossomatica, para concluir que o pensamento e a pratica psicoterapicos no Brasil vem realizando notaveis progressos