Cisto coloide no terceiro ventrículo e morte súbita em jovem

Morte súbita de jovem, sexo masculino, 23 anos, assintomático, suscitou verificação de óbito. Antes queixou-se de cefaleia excruciante, em sala de aula, caindo sobre o computador. Encéfalo apresentou edema e congestão vascular. Sem herniações. Cortes coronais evidenciaram dilatação dos ventrículos laterais e nódulo aderido ao teto do terceiro ventrículo. À microscopia o diagnóstico foi cisto coloide do terceiro ventrículo. A ameaça de morte súbita em portadores de cisto coloide é sério problema diagnóstico na emergência médica. A relevância deste caso está em lembrar aos médicos que esta entidade deve permanecer como diagnóstico diferencial nas cefaleias em crianças, adolescentes e adultos jovens.

Monitorização vídeo-EEG prolongada em crises não epilépticas: semiologia clínica

O objetivo deste estudo foi mostrar a contribuição da monitorização vídeo-EEG prolongada (MVEP) no diagnóstico de crises não epilépticas (CNE) e estimar sua prevalência em um centro terciário de atendimento à Epilepsia (EP). Foram observados 47 pacientes com diagnóstico de CNE com crises espontâneas ou provocadas. Foram instituídos protocolos direcionados à história clínica e à semiologia das crises. A análise estatística baseou-se no teste de Fisher e na análise de cluster. Os resultados evidenciaram prevalência de 10% de CNE. Houve predominância do sexo feminino (63,8%); em 57% dos pacientes as crises foram espontâneas. A média de idade foi 32,5 ± 11anos. O sinal semiológico mais freqüente foi o sono aparente (87,2%). em 9% dos pacientes observaram-se tanto EP como CNE. Três agrupamentos resultaram da análise de cluster: CNE hipermotora das extremidades com alteração de tônus; CNE com automatismos e CNE axial com movimentos oculares. em conclusão, o estudo da semiologia clínica das CNE durante a MVEP contribui para o diagnóstico desta entidade nosológica e para o diagnóstico diferencial com EP; o teste provocativo auxilia na obtenção das crises.

Modelagem Matemática e Tecnologias de Informação e Comunicação: a realidade do mundo cibernético como um vetor de virtualização

Neste artigo construímos um entrelaçamento teórico-filosófico que tem como objetivo discutir a relação entre Modelagem Matemática e realidade do mundo cibernético. em particular, essa abrangência da realidade é evidenciada como um possível vetor de virtualização, isto é, como um aspecto que pode influenciar o modo como a problemática que envolve uma determinada situação ou entidade é compreendida. Para tanto, fazemos uma associação entre Modelagem Matemática e as transformações que envolvem os modos de ser denotados por real, possível, atual e virtual, tendo como base ilustrativa as quatro causas aristotélicas. Complementando essa associação, assumimos uma concepção de problema que permite uma consolidação entre as relações estabelecidas e, também, uma concepção de realidade que entende o mundo cibernético como uma de suas dimensões. Por fim, apresentamos um exemplo de Modelagem Matemática ocorrido em sala de aula, que visa caracterizar a realidade do mundo cibernético como um vetor de virtualização.

DUCTAL CARCINOMA IN-SITU OF THE BREAST - HISTOLOGIC CATEGORIZATION AND ITS RELATIONSHIP TO PLOIDY AND IMMUNOHISTOCHEMICAL EXPRESSION OF HORMONE RECEPTORS, P53, AND C-ERBB-2 PROTEIN

Background. Ductal carcinoma in situ (DCIS) of the breast has been diagnosed increasingly since the advent of mammography. However, the natural history of these lesions remains uncertain. Ductal carcinoma in situ of the breast does not represent a single entity but a heterogeneous group with histologic and clinical differences. The histologic subtype of DCIS seems to have an influence on its biologic behavior, but there are few studies correlating subtype with biologic markers.Methods. The authors studied a consecutive series of 40 cases of DCIS and after its histologic categorization verified its relationship with ploidy using image analysis and analyzing estrogen receptor (ER), progesterone receptor (PR), p53 and c-erbB-2 expression using immunohistochemistry.Results. The three groups proposed according to the grade of malignancy were correlated significantly with some of the additional parameters studied, including aneuploidy and c-erB-2 expression. Aneuploidy was detected in 77.5% of cases of DCIS mainly in high and intermediate grade subtypes (100% and 80% vs. 35.7% in low grade) whereas immunoreactivity for c-erbB-2 was detected in 45% of cases of DCIS mainly in the high grade group. Expression of ER and PR were observed frequently in this study (63.9% and 65.7% respectively), but without correlation with the histologic subtype of DCIS, although we found a somewhat significant association between high grade DCIS and lack of ER. p53 protein expression was detected in 36.8% of these cases, but no relationship between this expression and histologic subtype or grading of DCIS was found.Conclusions. These results provide further evidence for the morphologic and biologic heterogeneity of DCIS. Besides histologic classification and nuclear grading, some biologic markers such as aneuploidy and c-erbB-2 expression constitute additional criteria of high grade of malignancy.

DIFFERENTIATION OF DROSOPHILA-SERIDO (ISOFEMALE LINE A95F3) AND D-KOEPFERAE (ISOFEMALE LINE B20D2) - REPRODUCTIVE ISOLATION, DEVELOPMENT TIME AND POLYTENE CHROMOSOME-BANDING PATTERNS

Drosophila serido is considered to be a superspecies consisting of two species: D. serido, from Brazil and D. koepferae from Argentina and Bolivia. However this probably does not express the entire evolutionary complexity of its populations. Isofemale lines A95F3 (from Brazil) and B20D2 (from Argentina), at present representing, respectively, the first and second species, were analyzed for fertility and fecundity in pair-mating intracrosses and intercrosses, as well as for development time, banding patterns and asynapsis of polytene chromosomes in the isofemale lines and their hybrids.Although variations in experimental conditions resulted in some variability in the results, in general A95F3 fertility and fecundity were lower than in B20D2. Intercrosses of A95F3 females and B20D2 males showed lower fertility and fecundity than the reciprocal crosses, following more closely characteristics of the mother strains. This is in contrast to the results obtained by Fontdevilla et al. (An. Entomol. Soc. Amer. 81: 380-385, 1988) and may be due to the different geographic origin of D. serido strains they used in crosses to B20D2. This difference and others cited in the literature relative to aedeagus morphology, karyotype characteristics, inversion polymorphisms and reproductive isolation strongly indicate that A95F3 and D. serido from the State of Bahia, Brazil are not a single evolutionary entity, reinforcing the idea of greater complexity of the superspecies D. serido than is known today.The reproductive isolation mechanisms found operating between A95F3 and B20D2 were prezygotic and postzygotic, the latter included mortality at the larvae stage in both directions of crosses and sterility of male hybrids in intercrosses involving B20D2 females and A95F3 males. The two isofemale lines differed in egg-adult development time, which was also differently affected by culture medium composition.A95F3 and B20D2 also showed differences in the banding patterns of proximal regions of polytene chromosomes 2, 3 and X, a fixed inversion in chromosome 3 (here named 3t), apparently not described previously, and a high degree of asynapsis in hybrids.These observations, especially those related to reproductive isolation and chromosomal differentiation (including the karyotype, previously described, and the differentiation of banding patterns, described in this paper), as well as the extensive asynapsis observed in hybrids reinforces the distinct species status of A95F3 and B20D2 isofemale lines.

Criteria for the diagnosis of diffuse uterine myohypertrophy

Objectives: Diffuse uterine myohypertrophy (DUMH) is a condition clinically diagnosed by the presence of uterine bleeding, homogeneous and diffuse uterine enlargement, and absence of any myoendometrial cause of bleeding. Since the morphologic criteria for the diagnosis of this entity are still controversial, this study aimed to investigate the clinical presentation and the morphologic findings of the cases of DUMH presenting at the University Hospital of Botucatu, São Paulo, Brazil, Methods: We retrospectively studied 43 consecutive patients with DUMH submitted to hysterectomy (test group) and compared the findings with those obtained from 28 patients submitted to hysterectomy due to a prolapsed uterus (control group). There were no significant differences in age, weight or height between the two groups. Results: the uterine weight of the DUMH group (mean +/- S.D. 157.4 +/- 46.4 g) was significantly heavier than that of the control group (99.5 +/- 35.4 g) and myometrial thickness was significantly greater in the DUMH group (2.5 +/- 0.5 cm) than in the control group (1.9 +/- 0.4 cm). No positive correlation was observed between increased uterine weight and parity, but there was a positive correlation between uterine weight and myometrial thickness. on the basis of the present study, we suggest that the diagnosis of DUMH be made clinically and in cases of uterine weight greater than or equal to 120 g and myometrial thickness greater than or equal to 2.0 cm. In addition, 10 cases of each group were analyzed by morphometry to evaluate interstitial fibrosis and myometrial hypertrophy. The data showed that the increase in uterine weight in DUMH is caused by enlargement of individual myometrial fibers rather than accumulation of interstitial collagen. Conclusion: Discriminant analysis to estimate the diagnostic significance of a number of clinical and pathologic variables (age, parity, uterine weight and morphometric parameters) was able to differentiate cases of DUMH from controls in 100% of the patients.

Pediatric Chronic Sclerosing Sialadenitis: Kuttner Tumor

Chronic sclerosing sialadenitis is an uncommon cause of salivary gland enlargement mainly occurring in the fifth and seventh decade of life. In the Western population, chronic sclerosing sialadenitis has been characterized as an IgG4-related disease. Although rare, this lesion occurs in children. To increase awareness about this entity in the pediatric age group, we report the case of an 11-year-old boy with a hard, 4.0-cm circumscribed mass in the right submandibular gland. Histologically there was marked distortion of the gland architecture by a dense lymphocytic infiltrate and extensive fibrosis with septa that crossed and distorted the gland, leaving atrophic acini and dilated, irregular ducts. The lymphoid infiltrate formed multiple follicles with active germinal centers, numerous plasma cells, and areas with diffuse arrangement. Immunophenotyping showed abundant CD20- and CD3-positive lymphocytes; cytokeratin AE1/AE3 highlighted the distorted architectural pattern; IgG staining showed large numbers of positive cells infiltrating the interstitium and surrounding the atrophic acini and ducts. IgG4 staining revealed a large proportion of positive infiltrating elements. Kuttner tumor belongs to the group of IgG4-related sclerosing diseases. The differential diagnosis includes pleomorphic adenoma and other salivary gland neoplasms. Its recognition in children is important clinically because this entity is amenable to steroid treatment, and additional work up and follow up is warranted to stave off other IgG4-related diseases/complications.

Litíase intrahepática primária. Relato de caso e revisão da literatura.

Primary intrahepatic lithiasis is an entity defined by intrahepatic stones exclusively located in the IH ducts above the emergence of the common bile duct. The disease is classified in two types: Eastern type (stones formed primarily in intrahepatic ducts; frequent in Japan) and Western type (stones formed in the extrahepatic bile system, usually in gallbladder, which migrate up to the intra-hepatic ducts). The mechanisms of lithogenesis in the entity are as yet not fully understood; multiple factors seem to operate synergistically: anatomical changes of the intrahepatic ducts, metabolic disorders, infections, idiopathic alteration. All these factors may facilitate biliary stasis leading ultimately to stone formation. We report on a case of and review the literature on primary intrahepatic lithiasis, which is a rare occurrence in the West and a disease of difficult surgical approach and high mortality.

Polyradiculoneuropathy and neurocysticercosis: Case report

Report of a patient with the hydrocephalic and meningoencephalitic form of neurocysticercosis who simultaneously developed polyradiculoneuropathy and intracranial hypertension syndrome during the first week of treatment with albendazole. Etiologic agents associated with polyradiculoneuropathy related in the literature are cited. Some comments about the possible physiopathogeny of this entity in the presence of cysticercosis are also done. It is mentioned another case who presented polyradiculoneuropathy as the only manifestation of a probable cysticercosis of the nervous system. In this presented case, including the neurocysticercosis and even a mere coincidence of facts, some factors can have a relationship with the appearance of polyradiculoneuropathy as the surgical stress, the stress due to the severity of the clinical picture and the possible side effect of albendazole.

Factor V Leiden and factor II G20210A mutations in patients with recurrent abortion

Recurrent abortion (RA) represents an intriguing problem in obstetric practice in which genetic and acquired factors may play a role. In the present investigation we sought to assess the possibility that inherited thrombophilia might determine the risk of RA. We therefore investigated the prevalence of two genetic abnormalities frequently associated with venous thrombosis [factor V Leiden (FVL) and factor II G20210A] in 56 patients with primary or secondary abortion and in 384 healthy control women. Polymerase chain reaction amplification followed by digestion with the restriction enzymes MnlI and HindIII was used to define the FVL and FII G20210A genotypes respectively. FVL was found in 4/56 patients (7.1%) and in 6/384 controls (1.6%), yielding an odds ratio (OR) for RA related to FVL of 4.9 [95% confidence interval (CI): 1.3-17.8]. FII G20210A was detected in 2/56 (3.6%) patients and in 4/384 (1%) controls (OR for RA: 3.5, CI: 0.6-19.7). In conclusion, FVL and FII G20210A mutations in patients with RA were more prevalent in comparison with controls. These data support a role for both mutations as determinants of the risk of RA and strengthen the notion that thrombophilia plays a role in this clinical entity.

Oxidative dissolution of chalcopyrite by Thiobacillus ferrooxidans

The oxidative dissolution of research-grade chalcopyrite was characterized in respirometric and growth experiments with Thiobacillus ferrooxidans. In respirometric experiments with chalcopyrite, the pH of mineral salts medium increased to values that inhibited the oxygen uptake activity of T. ferrooxidans. In glycine-H 2SO 4 buffered medium the pH remained stable and oxygen uptake was not inhibited. In cultures growing with chalcopyrite as the sole source of energy, pH changes were only minor during the incubation. The redox potential values increased to about 600 mV during the bacterial oxidation of chalcopyrite in the presence and absence of additional Fe 2+, while they remained at about 350 mV in abiotic control flasks. Iron in chalcopyrite was solubilized and oxidized to Fe 3+ by T. ferrooxidans. In the abiotic controls, by comparison, less iron was solubilized and it remained as Fe 2+. Jarosite was a major solid- phase product in T. ferrooxidans cultures. The solub'flization of copper from chalcopyrite in inoculated flasks was enhanced in the presence of additional Fe 2+.Accumulation of S 0, reflecting partial oxidation of the S-entity of chalcopyrite, was apparent from the x-ray diffraction analysis of solid residues from the inoculated flasks as well the abiotic controls. © 1997 Elsevier B.V. All rights reserved.

Synthesis and spectroscopic characterization of a novel coordination polymer of palladium(II) with pyrazole and azido ligands

The one-dimensional coordination polymer of palladium(II) with pyrazolato (Pz -) and azide (N 3 -) as bridging ligands, of formula [Pd 3(μ-N 3)(μ-Pz) 5] n, has been prepared. From IR and Raman studies it was evidenced the exobidentate nature of pyrazole ligands as well the μ-1,1-bridging coordination of azido groups. NMR experiments showed two sets of broadened signals with different intensities indicating the presence of pyrazolato groups in distinct chemical environments. The proposed structure of [Pd 3(μ-N 3)(μ-Pz) 5] n consists of a zigzag ribbon in which each (Pz) 2Pd(Pz) 2 entity is bound to two stacked planar units [Pd(μ-Pz)(μ-N 3)Pd core] with very weak Pd-Pd interaction, based on UV-Vis spectroscopy.

Transformación de leucoplasia verrugosa proliferativa en carcinoma oral: diez años de seguimiento

The authors present a case of proliferative verrucous leukoplakia (PVL) in a 78-year-old man. It was initially presented as leukoplakia on the tongue but a microscopic investigation in 1991 revealed it to be a mild epithelial dysplasia. After 5 years of follow-up, the lesion presented changes in size and location, and a recidivant behavior. In 1996, a red granular and indurated area that appeared on the tongue was found to be a microinvasive squamous cell carcinoma when microscopically investigated. After a review of the clinicopathologic behavior of this entity, the authors concluded that it was a typical PVL, whose diagnosis is difficult and retrospective, as indicated by others. The authors emphasize the importance of periodic detailed clinical and histological examination of this type of lesions in order to detect early signs of malignancy.

De Sitter relativity and quantum physics

In the presence of a cosmological constant, interpreted as a purely geometric entity, absence of matter is represented by a de Sitter spacetime. As a consequence, ordinary Poincaré special relativity is no longer valid and must be replaced by a de Sitter special relativity. By considering the kinematics of a spinless particle in a de Sitter spacetime, we study the geodesics of this spacetime, the ensuing definitions of canonical momenta, and explore possible implications for quantum mechanics. © 2007 American Institute of Physics.

Oftalmomiíase externa causada por cochliomyia hominivorax

The purpose of this study was to report a case of external ophthalmomyiasis caused by Cochliomyia hominivorax in a 10 years-old child, which presented acute preseptal celulitis and had 17 worms removed from the lacrimal canaliculus and conjunctival cul de sac, bilaterally, with resolution. The authors discuss the diagnosis and treatment of this nosological entity.