Moacyr Pezati Rigueiro

Experimental lamellar corneal graft in dogs using preserved equine pericardium

The purpose of this paper was to study the preserved equine pericardium as a corneal lamellar graft of the dog. We performed in twelve adults, male and female mongrel dogs a superficial keratotomy 5 mm square and a fragment of equine pericardium of the same shape was sutured in place with multiple 7-0 nylon simple interrupted sutures. Each five animals were sacrificed in days 7, 15, 30 and 100 after surgery. The clinical and histological exams permitted us to assert that this membrane is a useful tissue to be used as a corneal lamellar graft of the dog.

Correlação da infiltração das células Natural Killer (NK) CD 57+ no prognóstico do adenocarcinoma gástrico

Background - To evaluate the concentration of Natural Killer cells (NK) cells in adenocarcinoma of the stomach, and its correlation with prognostic factors and survival. Methods - Seventy-two patients with gastric adenocarcinoma who underwent gastric resection surgery and D2 lymphadenectomy in the period 1997-2007 were analyzed. The concentration of NK cells was evaluated by immunohistochemistry technique with the reagent CD57. Patients were divided into two groups: high concentration (n = 32) (more than 15 cells per 10 high power field) and low concentration (less or equal than 15 cells per 10 high power field). These two groups were compared with several prognostic factors such as: gender, age, tumor location, tumor differentiation, Lauren classification, stage, lymph nodes involvement, distant metastases and survival. The Kaplan-Meier curve was applied to evaluate survival and multivariate analysis of prognostic factors for evaluation. Results - There was no relationship of NK cells with the several variables studied, except to the tumor stage (p<0.02) with high concentration in more advanced stages. Survival was better (p = 0.0025) in the group of high concentration of NK. The survival analysis in advanced stage shown that the group with high concentration had higher survival (p<0.0001). In multivariate analysis, the concentration of NK cells was an independent prognostic factor (p = 0.0027, Hazard Ratio = 0343). Conclusions - The concentration of NK cells did not differ among the prognostic variables, with the exception of the staging. Patients with high concentration of NK cells showed a higher survival rate when compared to the low concentration, especially in the advanced stage.AIM To evaluate the concentration of Natural Killer cells (NK) cells in adenocarcinoma of the stomach, and its correlation with prognostic factors and survival. METHODS Seventy-two patients with gastric adenocarcinoma who underwent gastric resection surgery and D2 lymphadenectomy in the period 1997-2007 were analyzed. The concentration of NK cells was evaluated by immunohistochemistry technique with the reagent CD57. Patients were divided into two groups: high concentration (n = 32) (more than 15 cells per 10 high power field) and low concentration (less or equal than 15 cells per 10 high power field). These two groups were compared with several prognostic factors such as: gender, age, tumor location, tumor differentiation, Lauren classification, stage, lymph nodes involvement, distant metastases and survival. The Kaplan-Meier curve was applied to evaluate survival and multivariate analysis of prognostic factors for evaluation. RESULTS There was no relationship of NK cells with the several variables studied, except to the tumor stage (p<0.02) with high concentration in more advanced stages. Survival was better (p = 0.0025) in the group of high concentration of NK. The survival analysis in advanced stage shown that the group with high concentration had higher survival (p<0.0001). In multivariate analysis, the concentration of NK cells was an independent prognostic factor (p = 0.0027, Hazard Ratio = 0343). CONCLUSIONS The concentration of NK cells did not differ among the prognostic variables, with the exception of the staging. Patients with high concentration of NK cells showed a higher survival rate when compared to the low concentration, especially in the advanced stage.

Rosai-Dorfman disease manifesting as an epibulbar ocular tumour.

The authors report a rare case of extranodal Rosai–Dorfman disease without systemic involvement. A 14‐year‐old girl presented with a slowly progressive, non‐tender, well‐circumscribed, perilimbal nodule in the right eye. Excisional biopsy was performed and histopathologic and immunohistochemical analysis established the diagnosis. Systemic evaluation revealed no other masses. After complete excision of the epibulbar lesion, the patient is asymptomatic and remains on regular follow up with no signs of recurrence. Rosai–Dorfman disease is an infrequent, benign histiocytic disorder that can rarely manifest as an exclusive extranodal mass. We report a case of solitary epibulbar Rosai–Dorfman disease, successfully treated with complete surgical excision of the lesion.

Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia

BACKGROUND/AIMS: In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS: Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Lauren and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS: The mean age was 61 years (median: 63). There was predominance of the male gender (72.5%), diffuse histological type (55%) and infiltrative histological type (72.5%), and the more advanced stages (III and IV: 67.5%). There was no association with intestinal metaplasia and/or H. pylori. No epithelial dysplasia was detected in adjacent mucosa in any of the cases. The mean apoptotic index was 7.05 in 10 high power fields and 11.40 in 500 cells (2.28%). The mean positivity to PCNA was 275.05 cells in ten high power fields and 409.33 in 500 cells (81.9%). There was a positive correlation between the cell proliferative and apoptotic indices. There was a positive correlation for intestinal histological type with PCNA and apoptotic indices, in 10 high power fields. The mean survival was 28.41 months. Age over 63 and apoptotic index over 7.05 showed a negative correlation with survival, in multivariate analysis. CONCLUSIONS: Adenocarcinoma of the cardia predominated in male adults of mean age 61 years, and the predominant type was diffuse in more advanced stages. There was a correlation between apoptosis and tumoral cell proliferation. Survival in cases of adenocarcinoma of the cardia is still low. Both age and apoptosis were independent prognostic factors in cancer of the cardia.

Efeito imunossupressor da ciclosporina intra-muscular administrada em diferentes períodos pós-operatórios em um modelo de transplante penetrante de córnea em ratos

Objetivo: Avaliar o efeito imunossupressor da ciclosporina intramuscular (I.M.), administrada por tempo limitado em diferentes periodos do pos-operatorio, no transplante penetrante de cornea em um modelo experimental em rato, por meio de avaliacao clinica e anatomo-patologica do enxerto corneano. Metodo: Foram utilizados ratos isogenicos Fischer como doadores e Lewis como receptores, em um modelo ortotopico de transplante de cornea. A administracao de ciclosporina I.M. 10 mg/kg/dia foi iniciada em diferentes periodos nos grupos estudados: no pos-operatorio imediato, no 7o dia pos-operatorio e no 9o dia pos-operatorio. A ciclosporina quando iniciada foi administrada ate o 30o dia pos-operatorio. Um grupo controle nao recebeu a ciclosporina I.M. Os enxertos corneanos foram avaliadas clinica e histologicamente. Resultados: Rejeicao foi observada nas primeiras tres semanas do pos-operatorio em 100% dos casos no grupo controle (n = 5) que nao recebeu a ciclosporina. Os ratos tratados com ciclosporina (n = 15) apresentaram rejeicao em apenas um caso, que teve curta evolucao e poucos sinais clinicos. Os estudos histologicos confirmaram as avaliacoes clinicas. O grupo controle apresentou infiltrado no enxerto corneal com predominio de linfocitos sobre neutrofilos com mais neovasos, com mais fibrose e com infiltrado inflamatorio mais intenso do que os grupos tratados com ciclosporina. Conclusao: Os dados obtidos indicam que a ciclosporina I.M., pode ter efeito benefico sobre o controle da rejeicao do transplante de cornea, mesmo na sua fase ativa.

Estudo de toxicidade retiniana após injeções intravítreas seriadas de infliximabe em olhos de coelhos

PURPOSE To determine retinal and choroid toxicity levels of two and three infliximab intravitreous injections in albino rabbits by means of electroretinographic, histological and ophthalmological clinical tests. METHODS 12 albino rabbits were used in the study. Each eye was given two (n=10 eyes) or three (n=10 eyes) serial intravitreous 2 mg infliximab injections dissolved in 0.06 ml of saline, at monthly intervals. A separate group of rabbits (n=4 eyes) served as a control group. Ninety days after the study had begun, the rabbits underwent clinical and electroretinographic tests, and after being enucleated, the eyes were examined for histological changes. RESULTS Slit-lamp biomicroscopy and fundoscopic examination did not reveal any significant retinal abnormalities in the eyes injected with infliximab and control eyes or in pre- and post-treated eyes. The histological change that was noted was the presence of rare lymphocytes and eosinophils in the posterior vitreous of some of the rabbits subjected to two or three injections, but it was not considered clinically significant. A severe inflammatory reaction with vitreous exudates and ganglion cell edema in a single rabbit was clinically significant. The electroretinographic tests showed amplitudes that were on the average 12-13% smaller than those obtained before the treatment, however, there were no statistically significant differences when comparing the amplitude or the implicit time between pre- and post-treatment electroretinographic findings. CONCLUSION Two and three intravitreous 2 mg infliximab injections in rabbits at monthly intervals did not cause any changes after a 90-day follow-up, according to histological and electroretinographic tests and after clinical evaluation. Differently from prior studies that have investigated potential retinotoxicity effects after single administrations, this study investigated the possibility of retinotoxicity after multiple injections. Clinical studies in humans should be conducted to better evaluate the safety of this drug in the treatment of certain diseases affecting the retina and the choroid.

Ossificação pulmonar dendriforme

Diffuse pulmonary ossification is a rare condition of unknown pathogenesis in which mature bone is found in the pulmonary parenchyma. It is almost invariably discovered as an incidental finding at autopsy. Most commonly, it affects middle-aged men and is asymptomatic. We present the case of a 75-year-old man in which the chest X-ray showed diffuse interstitial infiltrate. Diagnosis was based on histopathological examination by open-lung biopsy, which revealed interstitial fibrosis with pulmonary ossification.

Eyelid swelling as the only manifestation of ocular sarcoidosis.

Purpose: To describe a case of eyelid sarcoidosis without systemic manifestations with a three-year follow-up. Methods: A 73-year-old woman presented complaining of a one-year history of swelling and hyperemia in the right upper eyelid. To confirm the diagnosis, we performed an incisional biopsy of the eyelid. Results: Histopathological examination showed a non-caseating granulomatous process suggestive of sarcoidosis. After three years, the patient was asymptomatic and physical and laboratory examination showed no signs of systemic sarcoidosis. Conclusion: The histopathological exam was fundamental for the diagnosis.

Ceratoconjuntivite cicatricial bilateral associada a líquen plano: relato de caso

Descrevemos um caso de ceratoconjuntivite cicatricial bilateral em uma paciente portadora de liquen plano e apresentamos revisao da literatura mundial sobre esse assunto. Cicatrizacao conjuntival, com formacao de simblefaro, olho seco, infiltracao corneana, neovascularizacao e afinamento foram os sinais observados. Diagnostico foi baseado nos achados clinicos e biopsia, apos exclusao das causas tipicas de ceratoconjuntivite cicatricial.

Dendriform pulmonary ossification

Diffuse pulmonary ossification is a rare condition of unknown pathogenesis in which mature bone is found in the pulmonary parenchyma. It is almost invariably discovered as an incidental finding at autopsy. Most commonly, it affects middle-aged men and is asymptomatic. We present the case of a 75-year-old man in which the chest X-ray showed diffuse interstitial infiltrate. Diagnosis was based on histopathological examination by open-lung biopsy, which revealed interstitial fibrosis with pulmonary ossification.