José Germano Ferraz de Arruda

Quantification of fractal dimension and Shannon’s entropy in histological diagnosis of prostate cancer

BackgroundProstate cancer is a serious public health problem that affects quality of life and has a significant mortality rate. The aim of the present study was to quantify the fractal dimension and Shannon’s entropy in the histological diagnosis of prostate cancer.MethodsThirty-four patients with prostate cancer aged 50 to 75 years having been submitted to radical prostatectomy participated in the study. Histological slides of normal (N), hyperplastic (H) and tumor (T) areas of the prostate were digitally photographed with three different magnifications (40x, 100x and 400x) and analyzed. The fractal dimension (FD), Shannon’s entropy (SE) and number of cell nuclei (NCN) in these areas were compared.ResultsFD analysis demonstrated the following significant differences between groups: T vs. N and H vs. N groups (p < 0.05) at a magnification of 40x; T vs. N (p < 0.01) at 100x and H vs. N (p < 0.01) at 400x. SE analysis revealed the following significant differences groups: T vs. H and T vs. N (p < 0.05) at 100x; and T vs. H and T vs. N (p < 0.001) at 400x. NCN analysis demonstrated the following significant differences between groups: T vs. H and T vs. N (p < 0.05) at 40x; T vs. H and T vs. N (p < 0.0001) at 100x; and T vs. H and T vs. N (p < 0.01) at 400x.ConclusionsThe quantification of the FD and SE, together with the number of cell nuclei, has potential clinical applications in the histological diagnosis of prostate cancer.

Effect of Sodium Cyclamate on the Rat Fetal Liver: A Karyometric and Stereological Study

El ciclamato, es una substancia derivada del acido N-ciclo-hexil-sulfamico, bastante usada como edulcorante no calorica en alimentos y bebidas, asi como en la industria farmaceutica. El objetivo del trabajo fue evaluar los efectos del ciclamato de sodio en higados de fetos de ratas, considerandose las alteraciones cariometricas y estereologicas. Fueron utilizadas 10 ratas adultas (Rattus norvegicus) variedad Wistar, con peso medio de 240 g, siendo 5 el grupo control y 5 tratadas con ciclamato de sodio. Entre el 10 y 14 dia de la prenez, 5 ratas recibieron una inyeccion diaria intraperitoneal de 60mg/Kg/dia de ciclamato de sodio durante 5 dias. En el 20 dia, los animales fueron sacrificados y los fetos fijados en solucion de Alfac, incluidos en parafina, cortados a 6 µm y tenidos com H-E. Hubo aumento estadisticamente significativo en siete parametros cariometricos (diametros mayor, menor y medio, volumen, area, perimetro y relacion area/volumen) en el grupo tratado con ciclamato de sodio comparado con el grupo control. Parametros estereologicos mostraron aumento significativo en los volumenes citoplasmatico y celular y disminucion significativa en la relacion nucleo/citoplasma y densidad numerica celular. Los resultados mostraron que el uso del ciclamato de sodio en las ratas prenadas causo retardo en el desarrollo fetal e hipertrofia celular hepatica en los fetos, sugerente de toxicidad en el higado fetal de las ratas

Ciclamato de sódio e rim fetal

Cyclamate is used as an artificial non-caloric sweetener in a variety of foods and beverages, being 30 times as sweet as sugar without the bitter after-taste of saccharin. It is present in the formula of products such as sodium and calcium cyclamates and cyclamic acid. Cyclamate and cyclohexylamine, its principal metabolite, can cross the human placenta exposing the fetus. It has been demonstrated in rats that the kidney may be adversely affected by high doses of cyclamate. Studies on the effects of sodium cyclamate in the human species are necessary, because in addition to replacing saccharose - harmful in individuals with diabetes or patients in whom weight reduction and control are essential for health - it does not cause dental caries.

EFFECTS OF SODIUM CYCLAMATE IN KIDNEYS OF RATS FETUSES: A MORPHOMETRIC STUDY

El ciclamato es usado como edulcorante no calorico en muchos alimentos y bebidas y es 30 veces mas dulce que la sacarosa, sin el gusto amargo de la sacarina. Aparecen en su composicion, los productos como ciclamato de sodio, ciclamato de calcio y acido ciclamico. El objetivo del trabajo fue evaluar los efectos del ciclamato de sodio en rinones de fetos de ratas, considerandose las alteraciones morfometricas en glomerulo, tubulos contornados proximal y distal y conducto coletor. Fueron utilizadas 10 ratas adultas (Rattus norvegicus) variedad Wistar, con peso medio de 238 g, 5 ratas para el grupo control y 5 ratas tratadas con ciclamato de sodio. Entre el 10 y 14 dia de la prenez, 5 ratas recibieron una inyeccion diaria intraperitoneal de 60mg/Kg/dia de ciclamato de sodio durante 5 dias. En el 20 dia, los animales fueron sacrificados y los fetos fijados en solucion de Alfac, incluidos en parafina, cortados y tenidos com H-E. El metodo utilizado fue la morfometria por la tecnica cariometrica. Hubo disminucion significativa en los pesos de los fetos y de la placenta en el grupo tratado con ciclamato de sodio (p= 0,004) comparado con el grupo control. En el volumen glomerular y tamano nuclear de las celulas de los tubulos contornados proximal, distal y conducto colector del rinon fetal de las ratas tratadas con ciclamato de sodio, hubo aumento estadisticamente significativo. Los resultados mostraron que el uso del ciclamato de sodio produjo la reduccion del peso de los fetos, placenta y longitud del cordon umbilical. Hubo aumento significativo en el volumen glomerular y en el tamano nuclear de las celulas de los tubulos contornados proximal, distal y conducto colector, sugerente de nefrotoxicidad

Association of Hypertension With Erectile Function in Chronic Peripheral Arterial Insufficiency Patients

Background Risk factors may influence the improvement or worsening of erectile dysfunction (ED). The aim of the current study was to evaluate the effect of systemic hypertension on ED in patients with peripheral arterial disease. Methods The effect of hypertension on ED was assessed in 125 consecutive patients in a cross-sectional quantitative study. The ages of the patients ranged from 19 to 88 years old (mean: 59.82 ± 10.48 years). The only exclusion criterion was the amputation of one or both legs. The ankle-arm index was assessed and the international index of ED questionnaire was applied to all participants in the study. Results Of the 125 patients, 22 (17.6%) had mild (grade 1), 50 (40.0%) had moderate (grade 2) and 53 (42.4%) had severe (grade 3) ED. Hypertensive patients have more ED, with ED in hypertensive patients being associated to chronic arterial disease. However, in comparison with normotensive patients, hypertension exerts an immediate protective effect on erectile function. Conclusions In conclusion, although erectile function is initially protected by systemic arterial hypertension in patients with chronic arterial disease, both chronic arterial disease and ED deteriorate over the long term in hypertensive patients.

Penile Replantation After Five Hours of Warm Ischemia

Although a rare occurrence, this event may occur as a result of self-mutilation among individuals with psychiatric disturbances or due to work-related accidents, iatrogenic injuries or the actions of individuals motivated by jealously, rage and feelings of betrayal. In western societies, most penile amputations are the result of self-aggression during a psychotic episode, the treatment of victims involves resuscitation, stabilization and immediate psychiatric support. The amputated tissue must be preserved under hypothermic conditions. Micro-surgery is currently the most widely employed method for penile replantation. This paper describes a successful case of penile replantation following 5 hours of warm ischemia.

Prostatic paracoccidioidomycosis with a fatal outcome: a case report

IntroductionParacoccidioidomycosis is a systemic mycosis in Latin America that can affect various organs. Few case reports of paracoccidioidomycosis affecting the prostate are found in the literature.Case presentationWe present the case of a 79-year-old Caucasian man with a six-month history of irritative symptoms of the prostate (urgency, frequency and nocturia) and difficulty initiating urination that progressed to urinary retention and the use of a urinary catheter. The anatomopathological analysis of the transurethral resection of the prostate revealed chronic granulomatous prostatitis of fungal etiology (paracoccidioidomycosis) with extensive necrosis. The patient began treatment with itraconazole at a dose of 100mg/day for six months. Radiography of the thorax revealed bilaterally diffuse nodular reticular interstitial lesions. The patient progressed to respiratory failure and was sent to the intensive care unit, but suffered a cardiopulmonary arrest and was pronounced dead.ConclusionsDue to the high incidence of paracoccidioidomycosis in countries like Brazil, urologists should suspect blastomycosis in all patients with symptoms of lower urinary obstruction with chronic abacterial prostatitis. Considering that paracoccidioidomycosis has the potential to affect various organs, following diagnosis, the treatment must be initiated as soon as possible.

Incidental finding of retrocaval ureter in a patient without hydronephrosis

Retrocaval or circuncaval ureters are rare congenital anomaly, in which the ureter is located posterior to the inferior vena cava (IVC). Usually, patients present symptoms in the 3rd or 4th decade of life due to compression of the ureter by the IVC, with obstruction of the urinary flow and consequent hydronephrosis. Herein we report the case of a 62-year-old patient who underwent ultrasonography to investigate abdominal pain. The patient had bilateral renal lithiasis associated with urinary tract dilation with no obvious obstruction. Computed tomography of the abdomen demonstrated a retrocaval ureter without hydronephrosis.

Inguinal hernia with ureter in patient with single kidney

Inguinal hernias are a common disease in adults, but involvement of extraperitoneal structures is rare. This condition is usually asymptomatic and an incidental finding during the surgical correction of inguinal hernias, often resulting in iatrogenic damage. We present a rare case of left renal agenesis and right inguinal hernia, with the ureter being the only organ protruding as an inguinal hernia, diagnosed in the preoperative period.

Clinical Treatment of Penile Fibrosis After Penoscrotal Lymphedema

Genital lymphedema in men can affect the penis and/or scrotum, causing deformity and causing sexual limitations, social isolation, poor quality of life and recurrent subcutaneous infections due to difficulties in hygiene. There are few studies in the literature emphasizing the treatment of penile fibrosis after penoscrotal lymphedema. The purpose of this report is to describe a case of penile fibrosis treated using a new compression method.