[Transcient ischemic attack, a rare manifestation of Eagle syndrome]. / Accident ischémique transitoire, une manifestation rare du syndrome d'Eagle.

INTRODUCTION: Clinical presentation of Eagle syndrome (ES) is very variable and non-specific, making its diagnosis difficult. It is usually limited to pain. Transient neurological manifestations are exceptional. We report one case in which the diagnosis of ES has been made based on neurological events occurring during left anterolateral head bending, without pain. OBSERVATION: A 47-year-old man presented with transient neurological events progressing since two years, half-right body paresthesia and reduced field of vision on the left side type, triggered by left anterolateral head flexion and regressive in neutral position. Transcranial Doppler and CT angiography of the supra-aortic trunks were performed in neutral position and in right and left head rotation that showed a disruption of the left sylvian flow and an extrinsic compression of the left internal carotid artery, due to a musculoskeletal impediment involving the lower end of the temporal styloid process. Complete recovering was achieved after surgical resection of this process. A control CT angiography confirmed the cessation of the compression. DISCUSSION: ES has non-specific and highly variable clinical manifestations making diagnosis difficult or leading to misdiagnosis. ES should be considered in any transient neurological deficit, especially when occurring during head rotation. Treatment relies on surgical resection of the excessively long styloid process.

Development of high-temperature strain instrumentation for in situ SEM evaluation of ductility dip cracking.

Nowadays, the implementation of sophisticated in situ electron microscopy tests is providing new insights in several areas. In this work, an in situ high-temperature strain test into a scanning electron microscope was developed. This setup was used to study the grain boundary sliding mechanism and its effect on the ductility dip cracking. This methodology was applied to study the mechanical behaviour of Ni-base filler metal alloys ERNiCrFe-7 and ERNiCr-3, which were evaluated between 700°C and 1000°C. The ductility dip cracking susceptibility (threshold strain; εmin) for both alloys was quantified. The εmin of ERNiCrFe-7 and ERNiCr-3 alloys were 7.5% and 16.5%, respectively, confirming a better resistance of ERNiCr-3 to ductility dip cracking. Furthermore, two separate components of grain boundary sliding, pure sliding (Sp) and deformation sliding (Sd), were identified and quantified. A direct and quantitative link between grain boundary tortuosity, grain boundary sliding and ductility dip cracking resistance has been established for the ERNiCrFe-7 and ERNiCr-3 alloys.

[Adverse reactions to insulin]. / Reacciones adversas a la insulina.

The prevalence of allergic reactions to insuline has decreased during the last few years. Probably this is due to the use of the newly-developed recombinant human insuline. At present, adverse reactions to insuline occur in 5-10% of patients on therapy with insuline. Adverse reactions may be local (more frequent) or systemic (rare). Insuline resistance consists in a different type of immunological reaction. Diagnosis of allergy to insuline is based on clinical history and cutaneous and serological tests. Treatment depends upon the severity of the reaction. When insuline is indispensable despite a previous allergic reaction, a desensitization protocol may be implemented.

Hormonal receptors in mammary carcinoma: comparison between quantitative and qualitative methods.

Alternatives to the traditional hormone receptor dosages for prognostic evaluation and clinical approach to breast cancer have been proposed for immunohistochemical determinations. For correlation purposes, such procedures were compared in 37 patients presenting 5 to 15 years of survival. Considering 30 fm/mg as the positivity index, the disagreement between both methods reached 35.1% with estrogen and 48.5% with progesterone receptors. When the positiveness level was changed to 20 fm/mg, the discrepancies were reduced to 32% with ER and increased to 57% with PgR. This study leads us to not recommend the immunohistochemical method applied to paraffin sections as an alternative procedure to the dextran-charcoal dosage for prognosis and therapeutic management of mammary carcinoma.

[Occult cancer as a special form of breast carcinoma]. / Câncer oculto como forma especial dos carcinomas mamários.

Occult carcinoma of the breast is characterized as a diagnosis made when the finding of axillary metastasis precedes the identification of the primary mammary lesion. This concept must be distinguished from subclinical breast cancer, in which a non-palpable tumor is discovered through radiological image. In 1975, a 56 years old patient presented an axillary metastatic lesion not detected by a conventional mammogram, but revealed by specialized equipment. After a modified radical mastectomy performed at that time, she has remained asymptomatic for 14 years. In 1985, a 51 years old patient, had an axillary clearance after a diagnosis of a malignant lymph node without the identification of the primary lesion on her homolateral breast, in spite of several tests. After 40 months, during her frequent follow-up, a small lump was identified by mammography. The patient underwent a quadrantectomy followed by radiotherapy and is asymptomatic after 2 years. These 2 cases, added to others mentioned in international literature, allow us to consider occult breast carcinoma as a particular type belonging to the special category of Unknown Primary Tumors (UPT), in which the biologic aspects and prognostic index authorize a less aggressive management than is usually accepted for the UPTs.

Analise de 3.134 mamografias realizadas em uma clinica de mastologia. / Analysis of 3,134 mammographies performed in a breast clinic

Em um periodo de cinco anos, foram realizadas em nosso servico 3.134 mamografias em 2.854 pacientes (18 do sexo masculino e 2.836 do sexo feminino) que apresentavam sintomas mamarios e que procuraram tratamento especializado. Destes exames, 231 (7,3%) foram rejeitados por varios motivos para este estudo. Nas pacientes do sexo feminino, foram verificadas alteracoes benignas da mama em 1.502 (52%) dos casos.Os outros resultados foram os seguintes: mamas normais 926 (31,9%), sinais de malignidade 253 (8,7%), diagnostico a esclarecer 90 (3,1%) estudos da mama oposta 78 (2,7%), protese nove (0,3%), cistosarcoma filodes oito (0,2%), anomalias congenitas sete (0,2%) e mama pos-irradiacao sete (0,2%). Nos pacientes do sexo masculino os diagnosticos foram: ginecomastia 16, lipoma um e diagnostico radiologico duvidoso um

Experiencia com mamografias em uma clinica de mastologia. / Experience with mammography in a mastology clinics

Estudadas 3.134 mamografias, considera-se o valor da radiografia da mama como metodo propedeutico simples, de alta precisao, onde muitos aspectos definem o estado maligno ou benigno; indica sinais de malignidade em mamas assintomaticas e constitui o melhor meio para diagnostico precoce de neoformacoes