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1.
Int J Mol Sci ; 16(11): 26813-31, 2015 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-26569221

RESUMO

Cell therapy is a promising approach to improve cartilage healing. Adipose tissue is an abundant and readily accessible cell source. Previous studies have demonstrated good cartilage repair results with adipose tissue mesenchymal stem cells in small animal experiments. This study aimed to examine these cells in a large animal model. Thirty knees of adult sheep were randomly allocated to three treatment groups: CELLS (scaffold seeded with human adipose tissue mesenchymal stem cells), SCAFFOLD (scaffold without cells), or EMPTY (untreated lesions). A partial thickness defect was created in the medial femoral condyle. After six months, the knees were examined according to an adaptation of the International Cartilage Repair Society (ICRS 1) score, in addition to a new Partial Thickness Model scale and the ICRS macroscopic score. All of the animals completed the follow-up period. The CELLS group presented with the highest ICRS 1 score (8.3 ± 3.1), followed by the SCAFFOLD group (5.6 ± 2.2) and the EMPTY group (5.2 ± 2.4) (p = 0.033). Other scores were not significantly different. These results suggest that human adipose tissue mesenchymal stem cells promoted satisfactory cartilage repair in the ovine model.


Assuntos
Tecido Adiposo/citologia , Condrócitos/citologia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Regeneração/fisiologia , Tecido Adiposo/imunologia , Animais , Antígenos CD/genética , Antígenos CD/imunologia , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Diferenciação Celular , Condrócitos/imunologia , Feminino , Expressão Gênica , Antígenos HLA-DR/genética , Antígenos HLA-DR/imunologia , Humanos , Células-Tronco Mesenquimais/imunologia , Ovinos , Joelho de Quadrúpedes/lesões , Joelho de Quadrúpedes/cirurgia , Engenharia Tecidual , Alicerces Teciduais , Transplante Heterólogo , Resultado do Tratamento
2.
Braz. j. otorhinolaryngol. (Impr.) ; 81(1): 58-62, Jan-Feb/2015. tab
Artigo em Inglês | LILACS | ID: lil-741320

RESUMO

Introduction: Squamous cell carcinoma is the most common neoplasm of the larynx, and its evolution depends on tumor staging. Vascular endothelial growth factor is a marker of angiogenesis, and its expression may be related to increased tumor aggressiveness, as evidenced by the presence of cervical lymphatic metastases. Objectives: To evaluate the expression of the vascular endothelial growth factor marker in non-glottic advanced squamous cell carcinoma of the larynx (T3/T4) and correlate it with the presence of cervical lymph node metastases. Methods: Retrospective clinical study and immunohistochemical analysis of vascular endothelial growth factor through the German scale of immunoreactivity in products of non-glottic squamous cell carcinomas. Results: This study analyzed 15 cases of advanced non-glottic laryngeal tumors (T3/T4), four of which exhibited cervical lymphatic metastases. There was no correlation between vascular endothelial growth factor expression and the presence of cervical metastases. Conclusion: Although vascular endothelial growth factor was expressed in a few cases, there was no correlation with the spread of cervical lymph metastases. .


Introdução: O carcinoma de células escamosas é a neoplasia mais frequente da laringe e seu prognóstico depende do estadiamento. A progressão da doença está relacionada a fatores intrínsecos celulares do câncer, não conhecidos. O VEGF (vascular endothelial growth factor) é um marcador de angiogênese e sua expressão pode estar relacionada a uma maior agressividade tumoral, evidenciada pela presença de metástases linfáticas cervicais. Objetivos: Avaliar a expressão do marcador VEGF em carcinoma de células escamosas da laringe avançados (T3/T4), não glóticos e correlacionar quanto à presença de metástases linfáticas cervicais. Método: Estudo clínico retrospectivo de análise imunohistoquimica do VEGF através da escala Germânica de imunorreatividade em produtos de carcinomas epidermóides não glóticos. Resultados: Analisados 15 casos de tumores avançados de laringe (T3/T4) não glóticos, sendo sete com presença de metástases linfáticas cervicais. Não houve correlação entre a expressão do VEGF e a presença de metástases cervicais. Conclusão: O VEGF foi pouco expressado nos casos estudados e não foi observada sua correlação com a disseminação de metástase linfática cervical. .


Assuntos
Humanos , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/secundário , Neoplasias Laríngeas/patologia , Fator A de Crescimento do Endotélio Vascular/sangue , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/sangue , Imuno-Histoquímica , Metástase Linfática , Neoplasias Laríngeas/sangue , Estadiamento de Neoplasias , Estudos Retrospectivos
3.
Braz J Otorhinolaryngol ; 81(1): 58-62, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25595850

RESUMO

INTRODUCTION: Squamous cell carcinoma is the most common neoplasm of the larynx, and its evolution depends on tumor staging. Vascular endothelial growth factor is a marker of angiogenesis, and its expression may be related to increased tumor aggressiveness, as evidenced by the presence of cervical lymphatic metastases. OBJECTIVES: To evaluate the expression of the vascular endothelial growth factor marker in non-glottic advanced squamous cell carcinoma of the larynx (T3/T4) and correlate it with the presence of cervical lymph node metastases. METHODS: Retrospective clinical study and immunohistochemical analysis of vascular endothelial growth factor through the German scale of immunoreactivity in products of non-glottic squamous cell carcinomas. RESULTS: This study analyzed 15 cases of advanced non-glottic laryngeal tumors (T3/T4), four of which exhibited cervical lymphatic metastases. There was no correlation between vascular endothelial growth factor expression and the presence of cervical metastases. CONCLUSION: Although vascular endothelial growth factor was expressed in a few cases, there was no correlation with the spread of cervical lymph metastases.


Assuntos
Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/secundário , Neoplasias Laríngeas/patologia , Fator A de Crescimento do Endotélio Vascular/sangue , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/sangue , Humanos , Imuno-Histoquímica , Neoplasias Laríngeas/sangue , Metástase Linfática , Estadiamento de Neoplasias , Estudos Retrospectivos
4.
Clinics (Sao Paulo) ; 69(9): 579-84, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25318087

RESUMO

OBJECTIVE: Unplanned excision of soft tissue sarcomas is common because benign soft tissue lesions are very frequent. This study evaluated the impact of unplanned resections on overall survival, local recurrence and distant metastasis in patients with soft tissue sarcomas of the extremities. METHODS: In total, 52 patients who were diagnosed with soft tissue sarcomas between May 2001 and March 2011 were analyzed in a retrospective study. Of these patients, 29 (55.8%) had not undergone previous treatment and the remaining 23 (44.2%) patients had undergone prior resection of the tumor without oncological planning. All subsequent surgical procedures were performed at the same cancer referral center. The follow-up ranged from 6 to 122 months, with a mean of 39.89 months. Age, lesion size and depth, histological grade, surgical margins, overall survival, local and distant recurrence and adjuvant therapies were compared. RESULTS: Residual disease was observed in 91.3% of the re-resected specimens in the unplanned excision group, which exhibited greater numbers of superficial lesions, low histological grades and contaminated surgical margins compared with the re-resected specimens in the planned excision group. No differences were observed in local recurrence and 5-year overall survival between the groups, but distant metastases were significantly associated with planned excision after adjustment for the variables. CONCLUSIONS: There was no difference between patients undergoing unplanned excision and planned excision regarding local recurrence and overall survival. The planned excision group had a higher risk of distant metastasis, whereas there was a high rate of residual cancer in the unplanned excision group.


Assuntos
Extremidades/cirurgia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Análise Multivariada , Gradação de Tumores , Fatores de Risco , Sarcoma/mortalidade , Sarcoma/patologia , Neoplasias de Tecidos Moles/mortalidade , Neoplasias de Tecidos Moles/patologia , Resultado do Tratamento , Carga Tumoral , Adulto Jovem
5.
Braz J Otorhinolaryngol ; 80(4): 290-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25183178

RESUMO

INTRODUCTION: Squamous cell carcinoma is the most common neoplasm of the larynx and glottis, and its prognosis depends on the size of the lesion, level of local invasion, cervical lymphatic spread, and presence of distant metastases. Ki-67 (MKI67) is a protein present in the core, whose function is related to cell proliferation. AIM: To evaluate the expression of marker Ki-67 in squamous cell carcinoma of the larynx and glottis and its correlation to pathological findings. METHODS: Experimental study with immunohistochemistry analysis of Ki-67, calculating the percentage of the cell proliferation index in glottic squamous cell carcinomas. RESULTS: Sixteen cases were analyzed, with six well-differentiated and 10 poorly/moderately differentiated tumors. There was a correlation between cell proliferation index and degree of cell differentiation, with higher proliferation in poorly/moderately differentiated tumors. CONCLUSION: The cell proliferation index, as measured by Ki-67, may be useful in the characterization of histological degree in glottic squamous cell tumors.


Assuntos
Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/patologia , Diferenciação Celular , Antígeno Ki-67/análise , Neoplasias Laríngeas/patologia , Adulto , Idoso , Proliferação de Células , Estudos de Coortes , Estudos Transversais , Feminino , Glote , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico
6.
Clinics ; 69(9): 579-584, 9/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-725406

RESUMO

OBJECTIVE: Unplanned excision of soft tissue sarcomas is common because benign soft tissue lesions are very frequent. This study evaluated the impact of unplanned resections on overall survival, local recurrence and distant metastasis in patients with soft tissue sarcomas of the extremities. METHODS: In total, 52 patients who were diagnosed with soft tissue sarcomas between May 2001 and March 2011 were analyzed in a retrospective study. Of these patients, 29 (55.8%) had not undergone previous treatment and the remaining 23 (44.2%) patients had undergone prior resection of the tumor without oncological planning. All subsequent surgical procedures were performed at the same cancer referral center. The follow-up ranged from 6 to 122 months, with a mean of 39.89 months. Age, lesion size and depth, histological grade, surgical margins, overall survival, local and distant recurrence and adjuvant therapies were compared. RESULTS: Residual disease was observed in 91.3% of the re-resected specimens in the unplanned excision group, which exhibited greater numbers of superficial lesions, low histological grades and contaminated surgical margins compared with the re-resected specimens in the planned excision group. No differences were observed in local recurrence and 5-year overall survival between the groups, but distant metastases were significantly associated with planned excision after adjustment for the variables. CONCLUSIONS: There was no difference between patients undergoing unplanned excision and planned excision regarding local recurrence and overall survival. The planned excision group had a higher risk of distant metastasis, whereas there was a high rate of residual cancer in the unplanned excision group. .


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Extremidades/cirurgia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Estimativa de Kaplan-Meier , Análise Multivariada , Gradação de Tumores , Fatores de Risco , Sarcoma/mortalidade , Sarcoma/patologia , Neoplasias de Tecidos Moles/mortalidade , Neoplasias de Tecidos Moles/patologia , Resultado do Tratamento , Carga Tumoral
7.
Braz. j. otorhinolaryngol. (Impr.) ; 80(4): 290-295, Jul-Aug/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-721413

RESUMO

INTRODUCTION: Squamous cell carcinoma is the most common neoplasm of the larynx and glottis, and its prognosis depends on the size of the lesion, level of local invasion, cervical lymphatic spread, and presence of distant metastases. Ki-67 (MKI67) is a protein present in the core, whose function is related to cell proliferation. AIM: To evaluate the expression of marker Ki-67 in squamous cell carcinoma of the larynx and glottis and its correlation to pathological findings. METHODS: Experimental study with immunohistochemistry analysis of Ki-67, calculating the percentage of the cell proliferation index in glottic squamous cell carcinomas. RESULTS: Sixteen cases were analyzed, with six well-differentiated and 10 poorly/moderately differentiated tumors. There was a correlation between cell proliferation index and degree of cell differentiation, with higher proliferation in poorly/moderately differentiated tumors. CONCLUSION: The cell proliferation index, as measured by Ki-67, may be useful in the characterization of histological degree in glottic squamous cell tumors. .


INTRODUÇÃO: O carcinoma de células escamosas é a neoplasia mais frequente da laringe e da região glótica, seu prognóstico depende do tamanho da lesão, do nível de invasão local, disseminação cervical linfática e da existência de metástases à distância. Ki-67 (MKI67) é uma proteína presente no núcleo, cuja função está relacionada com a proliferação celular. OBJETIVOS: Avaliar a expressão do marcador Ki-67 em carcinoma de células escamosas da laringe glóticos e correlacionar sua expressão com os achados anatomopatológicos. MÉTODO: Trabalho experimental de análise imunohistoquímica do Ki 67 através do cálculo percentual do índice de proliferação celular em produtos de carcinomas epidermóides glóticos. RESULTADOS: Dezesseis casos foram analisados, sendo seis bem diferenciados e dez pouco/moderadamente diferenciados. Houve correlação entre o índice de proliferação celular e o grau de diferenciação celular, sendo a proliferação maior nos pouco/moderadamente diferenciados. CONCLUSÃO: O índice de proliferação celular, medido pelo Ki-67 pode ser útil na caracterização do grau histológico em tumores glóticos de células escamosas. .


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diferenciação Celular , Carcinoma de Células Escamosas/patologia , /análise , Neoplasias Laríngeas/patologia , Biomarcadores Tumorais/análise , Proliferação de Células , Estudos de Coortes , Estudos Transversais , Glote , Imuno-Histoquímica , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico
8.
Appl Immunohistochem Mol Morphol ; 22(8): 600-5, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24897071

RESUMO

INTRODUCTION: Although cartilaginous tumors have low microvascular density, vessels are important for the provision of nutrition so that the tumor can grow and generate metastasis. The aim of this study was to assess the value of the vascular pattern classification as a prognostic tool in chondrosarcomas (CSs) and its relation with vascular endothelial growth factor (VEGF) expression. MATERIALS AND METHODS: This was a retrospective study of 21 enchondromas and 57 conventional CSs. Clinical data and outcome were retrieved from medical files. CSs histologic grades (on a scale of 1 to 3) were determined according to the World Health Organization classification. The vascular pattern (on a scale of A to C) was assessed through CD34, according to Kalinski. CD105 and VEGF were also evaluated. RESULTS: Poor outcome was significantly associated with vascular pattern groups B and C. Higher vascular pattern were 6.5 times more frequent in moderate-grade and high-grade CSs than in grade 1 CS. On multivariate analysis, a clear correlation was found between VEGF overexpression and B/C vascular patterns. Only 18 (benign and malignant) tumors stained for CD105. DISCUSSION: The results point to the use of the vascular pattern classification as a prognostic tool in CSs and to differentiate low-grade from moderate-grade/high-grade CSs. Vascular pattern might be also used to complement histologic grade, VEGF immunostaining, and microvascular density, for indicating a patient's prognosis. Low-grade CSs develop under low neoangiogenesis, which conforms to the slow growth rate of these tumors.


Assuntos
Neoplasias Ósseas/irrigação sanguínea , Condroma/irrigação sanguínea , Condrossarcoma/irrigação sanguínea , Adulto , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Condroma/metabolismo , Condroma/patologia , Condrossarcoma/metabolismo , Condrossarcoma/patologia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Estudos Retrospectivos
9.
Nucl Med Commun ; 35(3): 252-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24300379

RESUMO

PURPOSE OF THE REPORT: Although MRI is utilized for planning the resection of soft-tissue tumors, it is not always capable of differentiating benign from malignant lesions. The risk of local recurrence of soft-tissue sarcomas is increased when biopsies are performed before resection and by inadequate resections. PET associated with computed tomography using fluorodeoxyglucose labeled with fluorine-18 ((18)F-FDG PET/CT) may help differentiate between benign and malignant tumors, thus avoiding inadequate resections and making prior biopsies unnecessary. The purpose of this study was to evaluate the usefulness of (18)F-FDG PET/CT in differentiating benign from malignant solid soft-tissue lesions. MATERIALS AND METHODS: Patients with solid lesions of the limbs or abdominal wall detected by MRI were submitted to (18)F-FDG PET/CT. The maximum standardized uptake value (SUVmax) cutoff was determined to differentiate malignant from benign tumors. Regardless of the (18)F-FDG PET/CT results all patients underwent biopsy and surgery. RESULTS: MRI was performed in 54 patients, and 10 patients were excluded because of purely lipomatose or cystic lesions. (18)F-FDG PET/CT was performed in the remaining 44 patients. Histopathology revealed 26 (59%) benign and 18 (41%) malignant soft-tissue lesions. A significant difference in SUVmax was observed between benign and malignant soft-tissue lesions. The SUVmax cutoff of 3.0 differentiated malignant from benign lesions with 100% sensitivity, 83.3% specificity, 89.6% accuracy, 78.3% positive predictive value, and 100% negative predictive value. CONCLUSION: (18)F-FDG PET/CT seems to be able to differentiate benign from malignant soft-tissue lesions with good accuracy and very high negative predictive value. Incorporating (18)F-FDG PET/CT into the diagnostic algorithm of these patients may prevent inadequate resections and unnecessary biopsies.


Assuntos
Fluordesoxiglucose F18 , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Neoplasias de Tecidos Moles/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
10.
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-686915

RESUMO

Introdução: Os mixomas odontogênicos são tumores benignos,raros, de origem mesenquimal, que acometem principalmentea mandíbula. Esses tumores apresentam um comportamentolocal agressivo e tendem a recorrer. Seus principais diagnósticosdiferenciais incluem os tumores queratocísticos, odontomas,ameloblastomas, entre outros. Por serem resistentes àquimioterapia ou radioterapia, devem ser tratados cirurgicamente,por curetagem da lesão para lesões menores ou cirurgia comexérese total e ressecção óssea, entretanto a primeira opção estárelacionada a altas taxas de recorrência (acima de 25%). Relatode caso: Apresentamos o caso de uma paciente do sexo feminino,de 31 anos, diagnosticada com um mixoma odontogênico centralem região de maxila, submetida à cirurgia de maxilectomia, comressecção da porção infraestrutural, com exérese total da lesão(margens livres) e colocação de prótese no transoperatório.


Assuntos
Humanos , Feminino , Adulto , Maxila , Mixoma , Cabeça , Pescoço
11.
Arq. gastroenterol ; 47(4): 373-378, Oct.-Dec. 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-570525

RESUMO

CONTEXT: Desmoid tumors constitute one of the most important extraintestinal manifestations of familial adenomatous polyposis. The development of desmoids is responsible for increasing morbidity and mortality rates in cases of familial adenomatous polyposis. OBJECTIVES: To evaluate the occurrence of desmoid tumors in familial adenomatous polyposis cases following prophylactic colectomy and to present patient outcome. METHODS: Between 1984 and 2008, 68 patients underwent colectomy for familial adenomatous polyposis at the School of Medical Sciences Teaching Hospital, University of Campinas, SP, Brazil. Desmoid tumors were found in nine (13.2 percent) of these patients, who were studied retrospectively by consulting their medical charts with respect to clinical and surgical data. RESULTS: Of nine patients, seven (77.8 percent) were submitted to laparotomy for tumor resection. Median age at the time of surgery was 33.9 years (range 22-51 years). Desmoid tumors were found in the abdominal wall in 3/9 cases (33.3 percent) and in an intra-abdominal site in the remaining six cases (66.7 percent). Median time elapsed between ileal pouch-anal anastomosis and diagnosis of desmoid tumor was 37.5 months (range 14-60 months), while the median time between colectomy with ileorectal anastomosis and diagnosis was 63.7 months (range 25-116 months). In 6/9 (66.7 percent) patients with desmoid tumors, the disease was either under control or there was no evidence of tumor recurrence at a follow-up visit made a mean of 63.1 months later (range 12-240 months). CONCLUSIONS: Desmoid tumors were found in 13.2 percent of cases of familial adenomatous polyposis following colectomy; therefore, familial adenomatous polyposis patients should be followed-up and surveillance should include abdominal examination to detect signs and symptoms. Treatment options include surgery and clinical management with antiestrogens, antiinflammatory drugs or chemotherapy.


CONTEXTO: Os tumores desmóides representam uma das manifestações extraintestinais mais importantes na síndrome da polipose adenomatosa familiar. O aparecimento desta neoplasia está relacionada ao aumento da morbimortalidade nos doentes com polipose adenomatosa familiar. OBJETIVOS: Avaliar a ocorrência dos tumores desmóides nos casos de polipose adenomatosa familiar submetidos a colectomia profilática e avaliar o seguimento em ambulatório. MÉTODOS: Entre 1984 e 2008, 68 pacientes foram submetidos a colectomia por polipose adenomatosa familiar no Hospital das Clínicas da Faculdade de Ciências Médicas da Universidade de Campinas, SP. Os tumores desmóides ocorreram em nove pacientes (13.2 por cento), que foram estudados retrospectivamente, por meio da análise de prontuários, buscando dados clínicos e cirúrgicos. RESULTADOS: Dos nove pacientes, sete (77,8 por cento) foram submetidos a laparotomia para ressecção do tumor. A média de idade no momento da cirurgia foi de 33,9 anos (variando 22-51 anos). Os tumores desmóides da parede abdominal ocorreram em 3/9 casos (33.3 por cento) e os intra-abdominais em seis casos (66,7 por cento). O tempo médio entre a cirurgia do reservatório ileal e o diagnóstico do tumor desmóide foi de 37,5 meses (variando 14-60 meses), enquanto o tempo médio entre a cirurgia de colectomia com anastomose íleorretal e o diagnóstico foi de 63,7 meses (variando 25-116 meses). Em 6/9 (66,7 por cento) pacientes com tumor desmóide, a doença estava controlada ou não havia evidência de recidiva do tumor em 63,1 meses (variando de 12 a 240 meses) de tempo médio de seguimento. CONCLUSÃO: Os tumores desmóides ocorreram em 13,2 por cento dos casos de polipose adenomatosa familiar após a cirurgia do cólon; desta maneira, os pacientes com polipose adenomatosa familiar devem manter seguimento em ambulatório e o rastreamento deve incluir o exame abdominal minucioso a fim de identificar sinais e sintomas que possam conduzir ao diagnóstico de tumor desmóide. As opções de tratamento incluem cirurgia e manejo clínico com antiestrogênios, anti-inflamatórios ou quimioterapia.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias Abdominais/cirurgia , Colectomia , Fibromatose Abdominal/cirurgia , Fibromatose Agressiva/cirurgia , Anastomose Cirúrgica , Neoplasias Abdominais/patologia , Neoplasias Abdominais/prevenção & controle , Parede Abdominal/cirurgia , Seguimentos , Fibromatose Abdominal/patologia , Fibromatose Abdominal/prevenção & controle , Fibromatose Agressiva/patologia , Fibromatose Agressiva/prevenção & controle , Resultado do Tratamento
12.
Arq Gastroenterol ; 47(4): 373-8, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21225148

RESUMO

CONTEXT: Desmoid tumors constitute one of the most important extraintestinal manifestations of familial adenomatous polyposis. The development of desmoids is responsible for increasing morbidity and mortality rates in cases of familial adenomatous polyposis. OBJECTIVES: To evaluate the occurrence of desmoid tumors in familial adenomatous polyposis cases following prophylactic colectomy and to present patient outcome. METHODS: Between 1984 and 2008, 68 patients underwent colectomy for familial adenomatous polyposis at the School of Medical Sciences Teaching Hospital, University of Campinas, SP, Brazil. Desmoid tumors were found in nine (13.2%) of these patients, who were studied retrospectively by consulting their medical charts with respect to clinical and surgical data. RESULTS: Of nine patients, seven (77.8%) were submitted to laparotomy for tumor resection. Median age at the time of surgery was 33.9 years (range 22-51 years). Desmoid tumors were found in the abdominal wall in 3/9 cases (33.3%) and in an intra-abdominal site in the remaining six cases (66.7%). Median time elapsed between ileal pouch-anal anastomosis and diagnosis of desmoid tumor was 37.5 months (range 14-60 months), while the median time between colectomy with ileorectal anastomosis and diagnosis was 63.7 months (range 25-116 months). In 6/9 (66.7%) patients with desmoid tumors, the disease was either under control or there was no evidence of tumor recurrence at a follow-up visit made a mean of 63.1 months later (range 12-240 months). CONCLUSIONS: Desmoid tumors were found in 13.2% of cases of familial adenomatous polyposis following colectomy; therefore, familial adenomatous polyposis patients should be followed-up and surveillance should include abdominal examination to detect signs and symptoms. Treatment options include surgery and clinical management with antiestrogens, antiinflammatory drugs or chemotherapy.


Assuntos
Neoplasias Abdominais/cirurgia , Colectomia , Fibromatose Abdominal/cirurgia , Fibromatose Agressiva/cirurgia , Neoplasias Abdominais/patologia , Neoplasias Abdominais/prevenção & controle , Parede Abdominal/cirurgia , Adulto , Anastomose Cirúrgica , Feminino , Fibromatose Abdominal/patologia , Fibromatose Abdominal/prevenção & controle , Fibromatose Agressiva/patologia , Fibromatose Agressiva/prevenção & controle , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
13.
J Rheumatol ; 36(6): 1230-4, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19369464

RESUMO

OBJECTIVE: To determine HLA-G expression in skin biopsies from patients with systemic sclerosis (SSc), and its association with epidemiological, clinical, and laboratory variables and survival. METHODS: Paraffin-embedded skin biopsies obtained from 21 SSc patients (14 limited SSc, 7 diffuse SSc) and from 28 healthy controls were studied. HLA-G expression was evaluated by immunohistochemistry. RESULTS: HLA-G molecules were detected in 57% of skin biopsies from patients with SSc (9 from limited SSc, 3 from diffuse SSc), whereas no control sample expressed HLA-G (p=0.000004). In patients, HLA-G molecules were consistently observed within epidermal and some dermal cells. HLA-G expression was associated with a lower frequency of vascular cutaneous ulcers (p=0.0004), telangiectasias (p=0.008), and inflammatory polyarthralgia (p=0.02). After a 15-year followup, SSc patients who exhibited HLA-G survived longer than patients who did not. CONCLUSION: HLA-G is expressed in skin biopsies from patients with SSc, and this is associated with a better disease prognosis. This suggests a modulatory role of HLA-G in SSc, as observed in other skin disorders.


Assuntos
Antígenos HLA/metabolismo , Antígenos de Histocompatibilidade Classe I/metabolismo , Escleroderma Sistêmico/metabolismo , Pele/metabolismo , Biomarcadores/metabolismo , Brasil/epidemiologia , Feminino , Antígenos HLA-G , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Prognóstico , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/mortalidade , Escleroderma Sistêmico/patologia , Pele/irrigação sanguínea , Pele/patologia , Úlcera Cutânea/etiologia , Úlcera Cutânea/metabolismo , Úlcera Cutânea/patologia , Taxa de Sobrevida , Telangiectasia/etiologia , Telangiectasia/metabolismo , Telangiectasia/patologia
14.
Ann Plast Surg ; 58(6): 645-51, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17522488

RESUMO

Cherubism is an autosomal-dominant syndrome characterized by excessive bilateral maxillomandibular bony degeneration followed by fibrous tissue hyperplasia. Eight patients (age, 6-15 years; mean, 11 years) with severe cherubism were treated with a 2-stage operation by the same senior surgeon (C.M.R.-A.) over an 18-year period, 1987 through 2005. Severity was based on a modified Motamedi classification system. The diagnosis was established clinically, radiographically, and histologically. Postoperative follow up ranged from 2 to 18 years (mean, 5.1 years). All patients underwent 2-stage surgical treatment. In the first stage, the anterior wall of the maxilla was osteotomized and removed (n = 5). The cherubic lesion was curetted from the maxilla and orbits. The maxilla was recontoured on the back table and then fixed orthotopically with wires. Alternatively, cortical bone windows were created, the maxillary and orbital lesions were curetted, and the maxilla was infractured and recontoured in situ with manual pressure (n = 3). Six months after the maxillary/orbital procedure, all patients underwent second-stage curettage and recontouring of the mandible using bony access windows and manual infracture. Satisfactory esthetic results were achieved in all patients. The patients remained clinically and radiographically disease-free throughout the follow-up period. The most profoundly affected patient sustained bilateral lower eyelid ectropion that resolved with full-thickness skin grafting. Although cherubism tends to abate by the fourth decade of life, early 2-stage surgical curettage provides a simple and reliable treatment that not only delivers immediate results, but also seems to arrest the growth of any remaining cherubic tissue.


Assuntos
Querubismo/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Criança , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Maxila/cirurgia , Órbita/cirurgia , Índice de Gravidade de Doença , Resultado do Tratamento
17.
Int J Surg Pathol ; 14(2): 119-26, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16703172

RESUMO

Chondromatous hamartoma of the chest wall is an extremely rare, benign lesion that usually occurs in early infancy. It typically arises in the rib cage and produces a large mass. It is composed of a varying admixture of hyaline cartilage that has features resembling growth plate cartilage, fascicles of spindle cells, woven bone, and hemorrhagic cysts. Treatment consists mainly of surgical excision, which is usually curative. We present 3 new cases, which demonstrated interesting findings, including multicentricity, involvement of the sternum, and local recurrence, and we discuss these findings in the context of a literature review.


Assuntos
Doenças das Cartilagens/patologia , Hamartoma/patologia , Parede Torácica/patologia , Doenças das Cartilagens/cirurgia , Criança , Condroma/patologia , Diagnóstico Diferencial , Feminino , Hamartoma/cirurgia , Humanos , Cartilagem Hialina/patologia , Cartilagem Hialina/cirurgia , Imuno-Histoquímica , Lactente , Masculino , Costelas/patologia , Parede Torácica/cirurgia
18.
Rev. bras. ortop ; 32(11): 891-3, nov. 1997. ilus
Artigo em Português | LILACS | ID: lil-209279

RESUMO

Os autores mostram um caso de schwannoma benigno intramuscular da coxa. É uma entidade nao usual de diagnóstico clínico difícil, principalmente pela baixa sintomatologia e localizaçäo anômala. Sao enfatizados os métodos para melhor acurácia diagnóstica e tecidas conclusöes.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Musculares/diagnóstico , Neurilemoma/diagnóstico , Coxa da Perna
19.
Rev. bras. ortop ; 31(11): 931-5, nov. 1996. ilus
Artigo em Português | LILACS | ID: lil-209828

RESUMO

O trabalho teve por objetivo criar um modelo biológico experimental de regeneraçao óssea espontânea nas metáfises proximais de tíbias e distais de fêmures de caes. Esses segmentos ósseos foram perfurados com broca de 5,55mm de diâmetro e estudados, do ponto de vista histológico, nos 2§ e 5§ dias e nas 2ª, 3ª, 4ª, 6ª, 8ª, 10ª e 12ª semanas de pós-operatório. A cicatrizaçao, tanto no fêmur como na tíbia, se fez de forma centrípeta. Inicialmente, a cavidade foi preenchida por tecido de granulaçao e em seguida por proliferaçao óssea e, ao final de 12 semanas, a regeneraçao foi total.


Assuntos
Animais , Masculino , Cães , Regeneração Óssea , Fêmur/cirurgia , Modelos Biológicos , Tíbia/cirurgia , Cicatrização , Fêmur/patologia , Tíbia/patologia
20.
Rev. bras. reumatol ; 30(3): 100-2, maio-jun. 1990. ilus
Artigo em Português | LILACS | ID: lil-129275

RESUMO

Os autores descrevem um caso de poliarterite nodosa (PAN) evoluindo com abdome agudo e óbito por necrose e perfuraçäo de alça intestinal. Paciente do sexo masculino, com manifestaçöes clínicas iniciais de febre, emagrecimento e fraqueza muscular, foi diagnosticado como polimiosite (PM). Após dois anos de evoluçäo, apresentou manifestaçöes de abdome agudo por necrose segmentar de alça intestinal, cujo histopatológico foi compatível com PAN. Os autores discutem as diversas manifestaçöes clínicas da PAN, enfatizando o comprometimento muscular e gastrintestinal, neste com mortalidade de 75 a 100 por cento dos casos


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Perfuração Intestinal/etiologia , Poliarterite Nodosa/complicações , Perfuração Intestinal/patologia , Poliarterite Nodosa/patologia
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