Pointing to potential reference areas to assess soil mutagenicity.

Several have been performed to evaluate the mutagenicity of soil samples in urban and industrial areas. The use of uncontaminated reference areas has been an obstacle to the study of environmental mutagenesis. The study aimed to indicate a methodology to define reference areas in studies of environmental contamination based on "Ambient Background Concentration" of metallic elements associated with the Salmonella/microsome assay. We looked at three potential reference areas, two of them close by the industrial sources of contamination (São Jerônimo reference, near the coal-fired power plant, and Triunfo reference, near the wood preservative plant), but not directly influenced by them and an area located inside a protected area (Itapuã reference). We also carried out chemical analyses of some metals to plot the metal profile of these potential reference areas and define basal levels of these metals in the soils. After examining the mutagenicity of the inorganic extracts using strains TA98, TA97a, and TA100, in the presence and absence of S9 mix, we indicated the São Jerônimo reference and the Itapuã reference as two sites that could be used in future studies of mutagenicity of soils in southern Brazil. The association between a mutagenicity bioassay and the "Ambient Background Concentration" seems to be a useful method to indicate the reference areas in studies of contamination by environmental mutagens, where these results were corroborated by canonical correspondence analysis.

Schwannoma of the cervical sympathetic chain: it's not a carotid body tumor.

Schwannoma of the cervical sympathetic chain is a rare nerve tumor with fewer than 40 confirmed cases in the English literature. These lesions typically present as an asymptomatic neck mass and are easily mistaken for a carotid body tumor during the initial workup. We report a case of schwannoma of the cervical sympathetic chain in a 35-year-old man followed by a review of the current literature.

Bilateral recurrent nerve paralysis associated with multinodular substernal goiter: a case report.

Substernal goiter is an infrequent occurrence and is found in two to five per cent of all patients undergoing thyroid surgery. These lesions are well known to cause respiratory symptoms and alterations in phonation due to direct compression of airway structures. Infrequently, unilateral recurrent nerve palsy has been reported in patients with substernal goiter. We report a case of bilateral recurrent nerve palsy associated with multinodular substernal goiter in an 89-year-old female who presented in respiratory distress.

Cryosurgical ablation of unresectable hepatic metastases.

BACKGROUND AND OBJECTIVES: Recent advancements in the technology of cryosurgery along with the development and refinement of intraoperative ultrasound have led to a feasible alternative for some patients with unresectable hepatic malignancy. This paper reports our first year's experience with cryosurgical ablation of unresectable hepatic malignancies. METHODS: From May 1996 to July 1997, 12 patients with colorectal hepatic metastases underwent exploration for possible resection and/or cryosurgery. At surgery, three patients had extensive disease and were not candidates for any surgical treatment, three underwent formal right hepatic lobectomy, five underwent a combination of resection and cryoablation, while one underwent cryoablation alone. RESULTS: In the six patients who received cryosurgery, the mean number of metastatic lesions was four (range 1-6). The mean number of lesions frozen was two (range 1-4) with a mean size of 2.5 cm. (range 1-5 cm). There were no intraoperative deaths and no major postoperative complications. All patients were discharged home in stable condition with a mean hospital stay of eight days (range 5-14 days). At a mean follow-up of 17.3 months (range 10-22) three patients were alive with disease and three were disease free. CONCLUSIONS: Cryosurgical ablation is a safe method of treating unresectable hepatic malignancies and it may extend survival in carefully selected patients.

Myelolipoma of the adrenal gland: a case report.

Adrenal myelolipomas are rare benign neoplasms composed of mature fat and bone marrow elements. Most are asymptomatic tumors found incidentally at postmortem examinations. We report the natural history of an adrenal myelolipoma in a middle-aged man over a 6-year interval.

Laparoscopia na prenhez tubaria integra. / Laparoscopy in intact tubal pregnancy

A utilidade da laparoscopia em pacientes com suspeita de prenhez tubaria integra e discutida. Sao analizadas 28 laparoscopias com diagnostico clinico de prenhez tubaria integra, de um total de 846 realizadas no Instituto de Ginecologia da Universidade Federal do Rio de Janeiro entre novembro de 1973 e marco de 1982. A terceira decada foi a faixa etaria em que mais houve suspeita da patologia (67,9%), a laparoscopia concordou com o diagnostico clinico em 57,2% dos casos,a tuba esquerda foi a mais acometida (68,8%) e o diagnostico laparoscopico foi confirmado pela laparotomia e exame histopatologico em sua totalidade.Nao houve casos de prenhez tubaria bilateral ou gemelar, prenhez combinada, nem casos de falso-positivo. Conclui-se que o exame laparoscopico permitiu o diagnostico oportuno da prenhez tubaria, possibilitando uma intervencao imediata, e evitou os riscos de laparotomia quando aquela foi afastada

Estudo comparativo entre histerossapingografia e laparoscopia na ivestigacao do fator tubario em pacientes esteries. / Comparative study between hysterosalpingography and lapatoscopy in the investigation of tubal factor in sterile patients

Estudo comparativo entre histerosalpingografia (HSG) e laparoscopia no diganostico do fator tubario foi realizado em 228 pacientes portadoras de esterilidade, procedentes do Setor de Esterilidade do Instituto de Ginecologia da Universidade Federal do Rio de Janeiro, entre novembro de 1973 e marco de 1982. A HSG revelou mais tubas normais (14,5%) e menos aderencia peritubarias (10,9%), enquanto a laparoscopia detectou menos tubas normais (11,8%) e mais aderencias peritubarias (45,6%).Juntos, os procedimentos mostraram tubas normais em 6,1% e anormalidades tubarias semelhantes em 40,0% dos casos. Completa concordancia foi verificada em 46,1% das pacientes. A HSG revelou 5,7% de falsos-positivos e 8,3% de falsos-negativos.Aderencia peritubaria foi a patologia menos diagnosticada pela HSG.Concluem que a HSG, embora limitada, tem importancia lugar na investigacao do fator tubario, devendo ser o exame inicial. A laparoscopia e mais informativa e mais conclusiva que aquela e imprescindivel quando pretende-se realizar operacao corretiva das tubas

Terapeutica no adenocarcinoma do endometrio. Analise de 195 casos. / Therapeutics of adenocarcinoma of the endometrium.Analysis of 195 cases

Os autores estudaram 195 casos de adenocarcinoma do endometrio tratados no Instituto de Ginecologia da Universidade Federal do Rio de Janeiro. Analisaram os principais metodos terapeuticos, e baseados nesta experiencia opinam sobre a melhor conduta em cada caso. Acham a radiumterapia previa ao tratamento cirurgico desnecessaria. Os melhores resultados foram obtidos com tratamento cirurgico exclusivo, quando comparados a terapeutica combinada pela radiumterapia pre-operatoria nos estadios IA e IB. A operacao mais usada foi a histerectomia abdominal total com anexectomia bilateral e exerese de 1/3 cranial de vagina (80%). A operacao ideal para os estadios I e II e a histerocolpectomia alargada com linfadenectomia pelvica.Foi realizada em apenas 6% dos casos em virtude do alto risco cirurgico apresentado pelas portadoras dessa neoplasia, tornando proibitiva tal conduta sistematica.Utilizamos a hormonioterapia adjuvante com a medroxiprogesterona em todos os casos

Sindrome de Meigs. Apresentacao de caso. / Meigs' syndrome. Report of a case

A syndrome de Meigs e pouco frequente.No Instituto de Ginecologia da Universidade Federal do Rio de Janeiro, apos minuciosa revisao encontramos apenas dois casos em 40 anos.O mais recente e proposito deste trabalho.O mecanismo da ascite e do hidrotorax que acompanha o tumor ovariano caracterizando a sindrome nao e satisfatoriamente explicado. Doencas do coracao, do rim, do figado e do pancreas sao capazes de produzir liquido no abdome e torax entretanto jamais desapareceram com o tratamento exclusivo da causa. Na sindrome de Meigs, a simples extirpacao do tumor faz regredir tais derrames