Gustavo Rubino de Azevedo Focchi

Immunohistochemical expression of p16(INK4A) in normal uterine cervix, nonneoplastic epithelial lesions, and low-grade squamous intraepithelial lesions.

Objectives. In this study, the authors analyzed the immunoexpression of p16 in high-risk human papillomavirus DNA-negative normal and nonneoplastic cervical epithelia, in low-grade cervical intraepithelial neoplasia (CIN), high-grade CIN, and squamous cell carcinoma. Materials and Methods. A retrospective study, in which 58 normal cervical hysterectomy samples, 56 nonneoplastic cervical biopsies, 88 CIN 1, 33 CIN 2, 32 CIN 3, and 47 invasive squamous cell carcinoma biopsies, were evaluated for p16 immunoexpression. Human papillomavirus tests were also performed. Results. p16 immunohistochemistry seems to reveal possible different biological subgroups of lesions among morphologically similar mildly dysplastic cervical epithelia. Conclusion. Distribution patterns of p16 protein might be useful to predict different outcomes in CIN 1.

Histologic Studies of the Effects of Circulating Hot Saline on the Uterus Before Hysterectomy

STUDY OBJECTIVE To evaluate a new device for endometrial ablation. DESIGN (Canadian Task Force classification II-1). SETTING University-affiliated hospital. PATIENTS Thirty-two women scheduled for hysterectomy. INTERVENTIONS Endometrial ablation and hysterectomy. MEASUREMENTS AND MAIN RESULTS The new device for endometrial ablation was evaluated by studying depth of necrosis after staining for the oxidative enzyme NADH. Uniform endomyometrial necrosis was achieved at a depth of 2 to 4 mm with 90 degrees C saline circulated for 10 minutes. CONCLUSION The procedure was successful in all patients, and there were no adverse clinical sequelae. (J Am Assoc Gynecol Laparosc 6(3):269-273, 1999)

Evaluation of Hydro ThermAblator for endometrial destruction in patients with menorrhagia.

OBJECTIVE To describe endometrial destruction with the Hydro ThermAblator. DESIGN (Canadian Task Force classification II-1). SETTING University-affiliated hospital. PATIENTS Twenty-six women with uncontrolled menorrhagia. INTERVENTION Endometrial ablation with saline heated to 90 degrees C and circulated in the uterine cavity for 10 minutes under hysteroscopic control. MEASUREMENTS AND MAIN RESULTS All patients tolerated the procedure well, all but one was satisfied with the results, and there were no significant side effects or complications. Seventy-seven percent of women were either amenorrheic or hypomenorrheic after 6 months, and 88% were amenorrheic or hypomenorrheic after 1 year, including one patient who was treated a second time; 87.5% were amenorrheic or hypomenorrheic at 18 months. One woman had persistent menorrhagia and was treated by hysterectomy. CONCLUSION In this study, endometrial ablation was performed successfully with the Hydro ThermAblator in 25 of 26 women. (J Am Assoc Gynecol Laparosc 6(3):275-278, 1999)

Expression of COX-2 in Stomach Carcinogenesis

BackgroundsGastric cancer is a frequent cause of cancer in Brazil. The understanding of gastric carcinogenesis is not completely known but the progress of the molecular biology has provided that the initiation and progression of gastric cancer process is a consequence of a cumulative series of multiple gene alterations.AimThe aim of the study is to investigate the relationship among cytoplasmatic COX-1 and COX-2, Bcl-2 and nuclear P53 in chronic gastritis, metaplasia, and intestinal and gastric cancer.Patients and MethodsCOX-1, COX-2, P53, and Bcl-2 were evaluated by immunohistochemistry in 34 gastric adenocarcinoma (GA) tissues obtained from gastric resection, 21 tissues of patients with chronic gastritis (CG), and 34 with intestinal metaplasia (IM) obtained from endoscopic biopsies.ResultsCOX-1 and COX-2 were expressed in more than 85% of the tissues. A correlation between COX-1 and COX-2 were observed (r = 0.66). P53 was positive in 29% CG, 20% of IM and in 59 % of GA. Bcl-2 was negative in all the CG, in 88% of IM, and in 85% of GA. P53 staining was expressed more frequently in gastric cancer when compared to CG (p = 0.05) or IM (p = 0.003). The expression of Bcl-2 was also higher in gastric cancer (p = 0.002) and in intestinal metaplasia (p = 0.04) when compared to CG. There were no difference between metaplasia and chronic gastritis for P53 or Bcl-2. The imunoreactivity of COX-2 in gastric cancer was higher in the intestinal type (58%) than in diffuse type. A higher expression of COX-2 was found in advanced gastric cancer (p = 0.019). P53 was also more frequent in node positive cancer (p = 0.04).ConclusionCOX-2 is probably involved in gastric carcinogenesis, being an early alteration in cancer. Although we observed in this study a correlation between COX-2 and depth of cancer, this association as a prognostic marker is not well defined. P53 and Bcl-2 was expressed mainly in gastric cancer, being probably a latest alteration in gastric development.

Ultrastructural aspects of the remodeling process of the Corpus albicans in the recent postmenopausal period

To study the cytophysiology of the corpus albicans in the recent postmenopausal period, the authors analyzed the ovarian ultrastructure of ten patients submitted to oophorectomy due to non-malignant gynecological diseases. Evidence of a remodeling process with connective tissue substitution of the corpora albicantia was observed. The remodeling process appears to depend on the activity of three essential cell types; the fibroblasts, which provide collagen synthesis; the macrophages, which phagocytize the flaky material; and the myofibroblasts, mainly located in the peripheral region of the corpora albicantia, which may have a retracting action on the remodeling site of the corpus albicans.

The Immunoexpression of Heparanase 2 in Normal Epithelium, Intraepithelial, and Invasive Squamous Neoplasia of the Cervix

Objective Heparanase 2 (HPSE2) is expressed in various tissues, including the brain, intestine, prostate, breast, and endometrium. The aim of this study was to investigate the role of HPSE2 in cervical carcinogenesis, which has not been clarified to date. Materials and Methods The immunoexpression of HPSE2 in normal and neoplastic cervical squamous epithelia was determined using a semiquantitative (SQ) method and an index of expression (IE) method, using Image Lab Software. A total of 230 cervical tissue samples were analyzed and segregated into the following diagnostic groups: normal (27.4%), cervical intraepithelial neoplasia 1 (CIN 1, 15.2%), CIN 2 (16.5%), CIN 3 (15.2%), and invasive neoplasia (25.7%). The mean HPSE2 expression in the normal group was significantly lower than that of the other groups individually or combined (p < .001, for all combinations). The immunoexpression via the SQ method was significantly greater in the CIN 3 group compared with that in the CIN 1 group (p = .02). The mean immunoexpression of the high-grade squamous intraepithelial lesion groups was significantly greater than those of the normal and low-grade squamous intraepithelial lesion groups (p < .001) and lower compared with that of the invasive neoplasia group (p < .001). There were no statistically significant differences in the immunoexpression of HPSE2 among the different clinical states within the invasive neoplasia group. Conclusions The SQ method produced a greater sensitivity and specificity than did the index of expression method. There was a progressive increase in the mean HPSE2 immunoexpression according to the severity of the cervical lesion from the low-grade squamous intraepithelial lesion group to the invasive neoplasm group, whereas the normal group displayed the lowest level of expression. This is a novel study concerning HPSE2 in the cervix and cervical cancer carcinogenesis.

Morphologic and morphometric aspects of the endometrium of postmenopausal women before and after cyclic oestrogen replacement treatment.

OBJECTIVE The aim of the study is to observe the morphology and morphometry of the endometrium of postmenopausal women treated with cyclic conjugated oestrogens. STUDY DESIGN Three groups of nine postmenopausal women received cyclic conjugated oestrogens for 21 days (with a seven-day pause) during six months. The endometrial specimens were obtained using a modified Novak suction curet, in the second or third day of the period of drug washout. The slides were stained with haematoxylin and eosin (H.E.) in order to measure epithelial height and determine the gland/stroma ratio. RESULTS Morphologic examination showed that single daily doses of 0.3 mg of conjugated oestrogens caused discrete endometrial proliferation after three and six months of treatment. However, a more intense effect was observed in women receiving doses of 0.625 and 1.25 mg/day of the hormone, in the same period. Morphometric study revealed significant increases both in epithelial thickness and in the gland-stroma ratio, specially in women receiving higher doses of the conjugated oestrogen (0.625 and 1.25 mg/day). CONCLUSIONS We concluded that there were marked proliferative alterations without atypias in the endometrium of women that received 0.625 and 1.25 mg of conjugated oestrogens during six months.

Morphological and biochemical action of dipyrone on rat placenta

1. The morphological and biochemical action of dipyrone (N-[2,3-dimethyl-5-oxo-1-phenyl-3-pyrazolin-4-yl]-methylamino methanesulfonate, sodium monohydrate) on the placenta of albino rats was studied by means of karyometry of trophoblastic giant cells and by determinations of DNA, RNA and total protein contents. 2. The animals were treated with a single daily dose of 50 mg/kg body weight during 5 different periods: from the 9th to the 12th, 11th to the 14th, 13th to the 16th, 15th to the 18th or 17th to the 20th day of pregnancy. 3. Karyometric results showed that the nuclear volumes of placental cells in rats treated with dipyrone during the first 3 periods were significantly greater than in control animals and that, closer to term, no differences were observed in this regard. Only the animals treated from the 9th to the 12th day of pregnancy had higher placental contents of DNA, RNA and protein than the corresponding controls. 4. Our results showed that dipyrone had a blocking effect on placental cell division which occurs mainly in the initial steps of placental development.

Fibroma de Vulva (Molluscum Pendulum): Relato de Caso

A vulvar fibroma, of the molluscum pendulum type, was present in a 20-year-old patient. The tumor began to develop slowly after her menarche, when she was 14 years of age. The physical examination revealed a mass with considerable volume, painless, located at the upper third of the greator left lip, elastic consistency, greater diameter at its distal portion measuring 12 cm by 23 cm in length. The treatment was exeresis from the base of the pedicle, under local anesthesia. The tumor weighed 950 g. A literature review is included.

Premature ovarian failure: morphological and ultrastructural aspects

The authors documented by means of light and transmission electron microscopy that the ovaries of women with premature ovarian failure (POF) displayed dense connective tissue and rare corpora albicantia. Eight of the ten studied cases did not present ovarian follicles; in two cases, it was verified the presence of ovarian follicles, atypical primordial follicles and in one case, a corpus luteum was identified (after stimulation with exogenous gonadotrophin). Regarding the ultrastructural analysis, it was noted that the fibroblasts were united one to each other by cellular prolongations that formed a woof, constituting a cellular syncicius.