Arlete Hilbig

Immunohistochemical evaluation of the microvascular density through the expression of TGF-β (CD 105/endoglin) and CD 34 receptors and expression of the vascular endothelial growth factor (VEGF) in oligodendrogliomas

Angiogenesis has been proposed as essential for the growth of solid tumors. The determinants of this process, the growth factors and the vascular endothelial receptors have brought a potential in the tumor prognostic determination as well as perspectives of “targets” for antiangiogenic therapy. In oligodendrogliomas (OL), angiogenesis is little known and/or has generated conflicting results. In order to clarify angiogenesis in OL, we have evaluated the immunohistochemical expression of vascular endothelial growth factor (VEGF) and the microvascular density (MVD) through the expression of TGF‐β (CD105/endoglin) (MVD‐CD105) and CD34 (MVD‐CD34) receptors using the Chalkley point method in 30 OL. No significant immune reaction was found for the VEGF. There was expression in <10% of tumor cells and/or staining of weak intensity in 15 (50.0%), >10% of cells and moderate intensity staining in 1 (3.33%), and negative expression in 14 (46.67%). If present, the expression was restricted to tumor and endothelial cells. Our findings suggest that VEGF has little influence on OL angiogenesis. All specimens showed CD105 and CD34 expression in the intratumor vascular endothelium, suggesting involvement of CD105 in OL angiogenesis. The mean ± SD MVD‐CD105 and MVD‐CD34 were 10.83 ± 2.24 and 11.00 ± 2.76 in OL (P = 0.086; r = 0.319); 10.00 ± 2.00 and 10.40 ± 3.02 in OL grade II (n = 15) (P = 0.547; r = 0.105), and 11.67 ± 2.22 and 11.53 ± 2.45 in OL grade III (n = 15) (P = 0.817; r = 0.551), respectively. The absence of correlation between DMV‐CD105, DMV‐CD34 and tumor grades suggests that anti‐CD105 and anti‐CD34 antibodies have different vascular specificities. MVD‐CD105 was greater in OL grade III than in OL grade II (P = 0.0032), indicating an increase in the vascular neoformation, something which must be evaluated as a possible prognostic factor in OL. Both TGF‐β and CD105 bring perspectives as “targets” for antiangiogenic treatments in OL.

Immunohistochemical expression of markers Ki-67, neun, synaptophysin, p53 and HER2 in medulloblastoma and its correlation with clinicopathological parameters

Medulloblastoma (MB) is the most common malignant brain tumor in childhood. The alterations found include: presence of oncoproteins p53 and HER2, elevated mitotic index, and presence of neuronal differentiation. The aim of this study was to determine the immunohistochemical expression of markers Ki-67, NeuN, synaptophysin, HER2 and p53 in 40 MB samples and their correlation with clinicopathologic parameters and survival. In 29 patients (72.5%), >20% of cells were positive for Ki-67. Males showed greater ki-67 expression (p=0.02) and smaller survival rates (p=0.002). NeuN and synaptophysin were negative in 16 (40%) and 8 (20%) cases, respectively. P53 was positive in 18 (45%) cases, with 11 (61%) weakly positive and 7 (39%) strongly positive. HER2 was positive in 23 (57.5%) of the samples and did not show statistical association with survival (p=0.07).

Parkinson's disease and the heterozygous state for glucocerebrosidase mutations among Brazilians

We have read with interest the publication by Spitz et al. [1] regarding their results on the association study of glucocerebrosidase mutations and Parkinson’s disease (PD) among Brazilian patients. Before them, several publications confirmed the association between PD and the heterozygote state for glucocerebrosidase (GBA) mutations in patients from Israel, USA, Canada, Norway, Venezuela, Taiwan (for a review see Refs. [1,2]), and now S~ao Paulo, Brazil. Table 1 summarizes these results. We also investigated the association between PD and GBA mutations in Brazilians by recruiting patients with PD in Porto Alegre, in the south of Brazil. PD was diagnosed according to the clinical criteria proposed by Gelb et al. [3]. Patients participated in the study, which was approved by the local and national ethics committees, after giving informed consent. A single neurologist (MS) examined all cases and performed a full neurological examination and applied the Hoehn and Yahr (HY) modified scale as well as the Unified PD rating scale (UPDRS). The study patients were unrelated. All patients had their GBA activity measured in their peripheral leukocytes using the standard 4-methylumbelliferyl-b-Dglycopyranoside assay. Activities below 10 nmol/h/mg were considered to be associated with an increased risk for the carrier state if they were confirmed in a second blood specimen. Common GBA mutations L444P, N370S, and IVS2þ1 were analyzed by PCR-RFLP using NciI, XhoI and HphI, respectively; while 84GG was analyzed by ARMS-PCR. The clinical data of the 62 (37 male) study patients are shown in Table 2. Mean SD age at examination was 50.14 10 yr.; mean SD age at onset was 41.4 10 yr. Patients were of Brazilian origin with mixed ethnic backgrounds, including Portuguese, Spanish, Italian, German, Amerindian and African ancestry. There were two (3.5%) heterozygotes for GD as follows: one carrying the N370S mutation and the other carrying the L444P mutation. Five patients, that is, the L444P carrier plus four additional patients without common mutations, had a leukocyte GBA activity below 10 nmol/h/mg of protein.

Meningiomas and hormonal receptors: immunohistochemical study in typical and non-typical tumors

The authors assessed 116 cases of meningiomas classified as typical, atypical and anaplastic and they used an immunohistochemical technique for estrogen and progesterone receptors attempting to determine if there is any difference between typical and non-typical tumors in relation to hormone receptors. The immunohistochemical technique to estrogen receptors was negative in all meningiomas studied. Progesterone receptors were detected in 58.3% of typical, and in 48.2% of non-typical meningiomas. This difference was not statistically significant. However, individually considering the criteria used for selection of non-typical tumours, those that concurrently displayed brain invasion and increased mitotic activity or necrosis, as well as the summation of those three features, were predominantly negative for progesterone receptors (respectively p = 0.038; p = 0.001; and p = 0.044). The authors conclude that estrogen receptors were not present in meningiomas; that progresterone receptors in isolation are not enough to predict a higher tumoral malignancy but can be useful associated with other histological features.

Expression of nestin and vimentin in gliomatosis cerebri

Gliomatosis cerebri (GC) is a rare form of CNS neoplasia in which there is diffuse involvement of the nervous tissue with or without the presence of tumor mass. The origin of the tumor is unknown, nor whether it represents a disease with diffuse onset or infiltration from a neoplastic focus. Here we studied the histopathologic characteristics of 6 cases with a diagnosis of GC and performed an immunohistochemical analysis using glial fibrillary acidic protein (GFAP), synaptophysin, nestin and vimentin. Most tumor cells were negative for GFAP, even though there were foci of positivity for this marker in all cases. We detected the presence of many positive cells for nestin and vimentin in all studied samples. The presence of these cells may indicate origin of the tumor from undifferentiated cells with a high degree of mobility.

Neuropatologia das epilepsias de difícil controle: estudo de 300 casos consecutivos

We report histopathological findings in 300 consecutive surgical specimens from epilepsy surgery during 6 years. Our material was mainly from temporal lobe epilepsy (70.33%). In 44% the diagnosis was hippocampal sclerosis. There were tumors in 15% of cases and neuronal migration disorders in 10%. The most common tumors were gangliogliomas (42.22%) and dysembryoplastic neuroepithelial tumors (20%). We review the more frequent diagnosis in epilepsy surgery based on this series and comparing with literature.We report histopathological findings in 300 consecutive surgical specimens from epilepsy surgery during 6 years. Our material was mainly from temporal lobe epilepsy (70.33%). In 44% the diagnosis was hippocampal sclerosis. There were tumors in 15% of cases and neuronal migration disorders in 10%. The most common tumors were gangliogliomas (42.22%) and dysembryoplastic neuroepithelial tumors (20%). We review the more frequent diagnosis in epilepsy surgery based on this series and comparing with literature.

Corpora amylacea in temporal lobe epilepsy associated with hippocampal sclerosis

UNLABELLED Hippocampal sclerosis (HS) is the commonest pathology in epileptic patients undergoing temporal lobe epilepsy surgery. Beside, there are an increased density of corpora amylacea (CA) founded in 6 to 63% of those cases. OBJECTIVE verify the presence of CA and the clinical correlates of their occurrence in a consecutive series of patients undergoing temporal surgery with diagnosis of HS. METHOD We reviewed 72 hippocampus specimens from January 1997 to July 2000. Students t test for independent, samples, ANOVA and Tukey test were performed for statistical analysis. RESULTS CA were found in 35 patients (49%), whose mean epilepsy duration (28.7 years) was significantly longer than that group of patients without CA (19.5 years, p=0.001). Besides, when CA were found, duration was also significantly correlated with distribution within hippocampus: 28.7 years with diffuse distribution of CA, 15.4 with exclusively subpial and 17.4 years with distribution subpial plus perivascular (p=0.001). CONCLUSION Our findings corroborate the presence of CA in patients with HS and suggest that a longer duration of epilepsy correlate with a more distribution of CA in hippocampus.

Evaluation of body image and self-concept and their correlation with depressive symptoms in Parkinson's disease

OBJECTIVE To identify characteristics of body image and self-concept in individuals over fifty years of age with Parkinsons disease (PD). The secondary objectives are to analyze whether body image and self-concept are influenced by the severity of PD and to verify if there is correlation between depression, self-concept and body image in cases of PD. METHOD Participating in the study were 48 individuals, being 26 with PD and 22 Controls. The instruments used were: The Mini Exam of Mental State, The My Body Image Test, The Factorial Self-concept Test, The Beck Depression Inventory, the motor section of The Unified Parkinsons Disease Rating Scale and The Modified Hoehn and Yahr Scale. RESULTS In PD the perception of body image and self-concept demonstrated significantly reduced values p<0.001 and p=0.012 respectively, and the presence of depression symptomatology was significantly more (p=0.002). CONCLUSION Individuals with PD present alteration of body image and self-concept and also present lower personal confidence and lower social receptivity, correlated with depressive symptoms.

Erratum to “Evaluation of the Expression of C-Kit (CD117) in Ependymomas and Oligodendrogliomas”

We came through this erratum and declare that we are aware that the author Ligia Maria Barbosa Coutinho, Professor at the Graduate Program in Pathology of Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA), Brazil, was a part of the implementation of this paper, and, by our mistake, was absent from the list of authors. We would like to add Ligia Maria Barbosa Coutinho as a coauthor.

Meningeomas: aspectos histopatológicos e recidiva

The authors assessed 246 cases of meningiomas that were classified as typical, atypical, anaplastic and papillary, according to previously defined criteria. Among the criteria used to define non-typical tumours, brain invasion was predominant in 62.3%. Meningiomas were typical in 75.22%, atypical in 19.1 %, anaplastic in 5.68% of the cases. There was recurrence in 3.78% of typical, 42.55% of atypical and 45.45% of anaplastic. The authors conclusion was that the criteria used to define typical and non-typical were adequate to predict a higher chance to tumour recurrence.