Gyl Henrique Albrecht Ramos

Allelic variants of XRCC1 and XRCC3 repair genes and susceptibility of oral cancer in Brazilian patients.

BACKGROUND The capacity for DNA repair is essential in maintaining cellular functions and homeostasis; however, this capacity can be altered based on DNA sequence variations in DNA repair genes, which may contribute to the onset of cancer. Many single-nucleotide polymorphisms (SNPs) in repair genes have been found to be associated with oral cancer. The aim of this study was to investigate the relationship between the presence of allelic variants Arg194Trp (rs:1799782) and Arg399Gln (rs: 25487) of XRCC1 gene and Thr241Met (rs: 861539) of XRCC3 gene and susceptibility to oral cancer. We also attempted to correlate the frequencies obtained for each of the SNPs to histopathological parameters. METHODS A case-control study was conducted with genomic DNA from 150 patients with oral squamous cell carcinomas and 150 controls. SNPs were genotyped by RFLP-PCR. RESULTS The presence of the polymorphic variants of the XRCC1 gene within codon 194 (OR 0.82, 95% CI: 0.44-1.51) and codon 399 (OR 0.94, 95% CI: 0.59-1.50) and within the XRCC3 gene (OR 0.72; 95% CI: 0.45-1.16) were not associated with an increased risk of oral cancer. A combinational analysis of SNPs in both genes indicated no association. The presence of the allelic variants of these two genes had no statistically significant effect on tumor differentiation, lymph node invasion or tumor size. CONCLUSIONS These results suggest that allelic variants of XRCC1 and XRCC3 are not suitable markers for susceptibility to carcinomas of the oral cavity and are also not related to the later stages of such tumors.

TOTAL THYROIDECTOMY WITH ULTRASONIC SCALPEL: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL

The ultrasonic scalpel is a recently introduced device in head and neck surgery. Total thyroidectomy is the most common endocrine procedure performed by surgeons.

Doença de Madelung

Doenca de Madelung ou lipomatose simetrica multipla e uma doenca rara, que e caracterizada por acumulo de gordura nao encapsulada, geralmente localizada simetricamente ao redor do pescoco e ombros. A etiologia e desconhecida, mas e frequentemente observada em pacientes com historia de alcoolismo cronico e e acompanhada por anormalidades metabolicas. Os autores apresentam um caso de lipomatose cervical associada a polineuropatia e alcoolismo. A remocao cirurgica do tecido adiposo por lipectomia ou lipoaspiracao e terapia paliativa, ja que ele nao e encapsulado, a recorrencia e comum.

Fístulas orocutâneas após cirurgia de câncer da cavidade oral: fatores de risco

OBJECTIVE To quantify the oral cutaneous fistulae after surgery and to identify possible risk factors. METHODS A retrospective study, interesting patients that were submitted to surgery, with a two years minimum post-operative follow up. The considered variables were: sex, concomitant diseases, tabacco and alcohol use, the anesthesic and pulmonary risks, clinical stage, cervical linphadenectomy, pre or postoperative radiotherapy, accidents during the surgery, wound infection and or hematoma, pulmonary infection, surgery and reconstruction extension. RESULTS In 159 patients, oral cutaneous fistulae occurred in 48 patients (30,3%): Patients stage T1 in 26,6 %,T2 in 1,8 %,T3 in 16%, and T4 in 40,3% (p=0,0138). The cases N+ developed fistulae in 22.9%, (N2c with 42,8%, (p=0,0136), those with preoperative radiotherapy in 63,6% (p=0,0346) Those with wound infection in 47,3% (p=0,0146), and those with wound deiscense in 53,7 % (p=0,0030). The fistulae rate was of 60% in the regional mucocutaneous flaps reconstruction cases, 39,2% in the myocutaneous ones and 12,5% of microsurgery ones (p=0,0286). CONCLUSION The general rate of oral cutaneous fistulae was 30,3%. The significant factors were: T stage, cervical linphadenectomy, pre or postoperative radiotherapy, wound infection and deiscense, and the use of flaps.

Incidence of second primary oral cancer tumors: a retrospective study

OBJETIVO: A maioria das neoplasias malignas de cabeca e pescoco e diagnosticada em estagios avancados. O alto risco de desenvolver um segundo tumor primario (STP) diminui a taxa de sobrevida dos pacientes. STP piora significativamente o prognostico e estudos sobre ele devem ser realizados para se descobrir seus fatores de risco e melhor forma de tratamento. O principal objetivo deste estudo foi analisar a ocorrencia de STP em pacientes com carcinoma epidermoide bucal (CEB) tratados no Hospital Erasto Gaertner (HEG), Curitiba, PRP, Brasil, num periodo de 16 anos. METODOLOGIA: Um estudo retrospectivo foi realizado a fim de revisar os pacientes com CEB que desenvolveram STP entre Janeiro de 1990 e Dezembro de 2005. Os dados demograficos e clinicos foram coletados atraves dos prontuarios medicos dos pacientes e foram analisados por estatistica descritiva. RESULTADOS: Neste periodo, 34.637 pacientes foram admitidos no HEG. Um total de 1637 (4,4%) pacientes recebeu diagnostico de CEB, dos quais 37 (2,7%) desenvolveram STP. Os pacientes que desenvolveram STP eram 29 (78,4%) homens e 8 (21,6%) mulheres, com media de idade de 58 anos. Os sitios anatomicos mais frequentes para o STP foram a boca, orofaringe e esofago; a taxa de sobrevivencia foi de 27%. CONCLUSAO: Pacientes tratados de CEB devem ser examinados cuidadosamente e monitorados regularmente por causa do alto risco de desenvolver um STP, especialmente aqueles que mantem os habitos de tabagismo e etilismo.