OBJETIVO: Analisar a expressão imunoistoquímica do marcador CD34 e p27, como fator prognóstico em pacientes com neoplasia de próstata localizada. MÉTODOS: Análise de 100 casos de pacientes portadores de neoplasia prostática localizada submetida à cirurgia curativa. Realizou-se o preparo histológico habitual, seguido da reação imunoistoquímica para a detecção do acúmulo da proteína CD34 e p27 seguida de análise estatística. RESULTADOS: Na avaliação do marcador P27 e na correlação com as variáveis, observou-se diferença significativa no escore de Gleason com expressão positiva (P27 positivo) relacionada com PSA médio mais baixo (p=0,091), escore de Gleason mais baixo (p<0,0001) e menor área de tumor no CD34 (p=0,036). Correlacionando-se o marcador CD34 na área tumoral observou-se quanto menor o CD34 positivo menor é o valor do PSA (p<0,0001), e menor é o escore de Gleason (r=0,5726 ; p<0,0001) e quanto maior o CD34 positivo maior é o estadiamento (r=0,3305 ; p<0,0001) e a chance de recidiva (p=0,002). Os pacientes com estadiamento mais alto, também tinham maior área CD34 positivo (p<0,0001). CONCLUSÃO: Os marcadores P27 e CD34 estão associados com os eventos próprios ao câncer de próstata; contudo, apenas o CD34 foi capaz de determinar a possibilidade de recidiva bioquímica.

OBJECTIVE: to analyze the immunohistochemical expression of P27 and CD34 markers as prognostic factors in patients with localized prostate cancer. METHODS: analysis of 100 patients with localized prostate cancer submitted to curative surgery. We carried out the usual histological preparation, followed by immunohistochemistry to detect the accumulation of P27 and CD34 protein followed by statistical analysis. RESULTS: in the evaluation of P27 marker and on the correlation with the variables we found significant difference in Gleason score with positive expression (positive P27) related to lower mean PSA (p = 0.091), lower Gleason score (p < 0.0001) and smaller tumor area in CD34 (p = 0.036). Regarding the CD34 marker at the tumor area, it was observed that the smaller the positive CD34, the lower the PSA value (p < 0.0001) and lower the Gleason score (r = 0.5726, p < 0.0001), and the higher the positive CD34, the higher the staging (r = 0.3305, p <0.0001) and the chance of recurrence (p = 0.002). Patients with higher stage also displayed larger positive CD34 areas (p < 0.0001). CONCLUSION: the markers CD34 and P27 are associated with events specific to prostate cancer, however, only CD34 was able to determine the possibility of biochemical recurrence.

INTRODUÇÃO E OBJETIVO: Analisar a expressão imuno-histoquímica do marcador MIB-1 como fator prognóstico em pacientes com neoplasia de próstata localizada. MÉTODOS: Análise de cem casos de pacientes portadores de neoplasia prostática localizada submetida a cirurgia curativa no período de janeiro de 2000 a dezembro de 2006. Realizou-se o preparo histológico habitual seguido de reação imuno-histoquímica para a detecção do acúmulo da proteína MIB-1 e análise estatística. RESULTADOS: Obteve-se maior proporção de expressão negativa ao marcador MIB-1(63%, p < 0,0001). Os pacientes com expressão positiva (MIB1 positivo) apresentaram antígeno prostático específico (PSA) mais elevado (PSA > 10 ng/dl) (p = 0,01), escore de Gleason mais alto (> 7) (p = 0,0003) e estádio patológico pT2c (p = 0,001). Na comparação das variáveis observou-se que os pacientes com expressão positiva apresentaram PSA médio mais elevado (p = 0,031), escore de Gleason mais alto (p < 0,0001), maior tempo de seguimento (p = 0,037), maior área de proliferação vascular (p < 0,0001) e maior proporção de tumor em relação à área normal (p = 0,012). CONCLUSÃO: O MIB-1 mostrou-se um fator prognóstico comparável a PSA, Gleason e estádio.

INTRODUCTION AND OBJECTIVE: To analyze the immuno-histochemical expression of MIB-1 marker as a prognostic factor in patients with localized prostate neoplasia. METHODS: Analysis of 100 cases of patients with localized prostate neoplasia who underwent curative surgery from January 2000 to December 2006. The customary histological preparation was carried out, followed by immunohistochemical reaction to detect MIB-1 protein accumulation and statistical analysis. RESULTS: There was a larger proportion of negative expression for MIB-1 marker (63.0%, p < 0.0001). Patients with positive expression (MIB-1 positive) had higher PSA (PSA > 10 ng/dl) (p = 0.010), higher Gleason score (> 7) (p = 0.0003) and pathological stage pT2c (p = 0.001). In the comparison of variables, it was noticed that patients with positive expression had a higher mean PSA (p = 0.031), higher Gleason score (p < 0.0001), longer follow-up (p = 0.037), larger area of vascular proliferation (p < 0.0001) and higher proportion of tumor in relation to normal area (p = 0.012). CONCLUSION: MIB-1 proved to be a prognostic factor comparable to PSA, Gleason and staging.

OBJETIVO: Avaliar a evolução e os fatores prognósticos da prostatectomia radical. MÉTODOS: Um total de 500 pacientes foi submetido à prostatectomia radical, entre 2000 e 2006. Estádio clínico, PSA pré-operatório e escore de Gleason foram avaliados em conjunto com o estádio patológico e margens cirúrgicas. O seguimento foi feito pela monitorização do PSA e correlação com diversos critérios. RESULTADOS: Dos 500 pacientes com doença clinicamente localizada tiveram seguimento médio de 36,7 ± 18,8 meses. O tempo operatório foi de 190 ± 45 minutos e o sangramento intra-operatório de 630 mL. O PSA pré-operatório médio foi de 7,8 ± 4,5 ng/dL, com maior proporção de escore de Gleason<6 (72%) e estádio TNM pT2c (65%). As complicações pós-operatórias foram incontinência em 2% pacientes e 46% com impotência sexual. CONCLUSÃO: A chance de recorrência esteve diretamente associada com PSA=10 ng/mL, escores de Gleason maiores e inversamente proporcionais à idade dos pacientes.

OBJECTIVE: Radical prostatectomy remains the standard treatment for early prostate cancer. This study was conducted to evaluate the outcome and prognostic factors of radical prostatectomy. METHODS: A total of 500 patients with prostate cancer underwent radical prostatectomy at Santa Rita hospital- Maringa-PR, between 2000 and 2006. Clinical staging, preoperative prostate-specific antigen (PSA) and Gleason score were evaluated with pathological stage and margin status. Follow-up PSA monitoring and survival were analyzed. RESULTS: Of 500 patients with clinical localized disease with a median follow up of 36,7±18,8 months. The average operative duration was 190± 45 minutes and the average intra-operative bleeding was 630 ml. The patients' preoperative serum PSA was 7,8 ± 4,5 ng/dl , with a higher proportion of Gleason Score < 6(72%) and The TNM stage pT2c (65%). For late postoperative complications: incontinence in 2% and 46 % with erectile dysfunction. CONCLUSION: Radical prostatectomy in men shows excellent results. The chance of recurrence was directly associated with PSA = 10 ng/ml, high Gleason score and inversely proportional to age.

Intravascular papillary endothelial hyperplasia is a benign and rare intravascular process thought to arise from an organizing thrombus. Involvement of the adrenal gland is extremely rare, with only one case reported in the literature. We report a case of this vascular lesion in the adrenal gland, treated with laparoscopic adrenalectomy.

Our objective is to report three patients with recurrent severe upper abdominal pain secondary to residual gallbladder. All patients had been subjected to cholecystectomy from 1 to 20 years before. The diagnosis was established after several episodes of severe upper abdominal pain by imaging exams: ultrasonography, tomography, or endoscopic retrograde cholangiography. Removal of the residual gallbladder led to complete resolution of symptoms. Partial removal of the gallbladder is a very rare cause of postcholecystectomy symptoms.

Adenosquamous carcinoma of the liver is a rare type of hepatic tumor first described in 1975. It is characterized by both glandular and squamous compounds. We describe a case of adenosquamous carcinoma of the liver. It was discovered in a 42-yr-old female with a 2-month history of vomiting, weight loss (7 kg). A left hepatic lobectomy disclosed an 11 x 9 x 7,5 cm tumor located at I, II, III, IV segments. This tumor is rare entity and is a variant of cholangiocarcinoma whose etiology and prognostic are not well known.

O objetivo do presente estudo é avaliar os efeitos do transplante hepático bem sucedido nas alterações dos ciclos menstruais e da fertilidade observadas em mulheres com hepatopatia crônica. Doze mulheres com idade de 17 a 54 anos submetidas a transplante hepático foram avaliadas. As seguintes variáveis foram analisadas: idade, etiologia da hepatopatia, padrão da menstruação, período de amenorréia, antes e após o transplante, e ocorrência de gravidez após o transplante. A idade média das pacientes foi de 36 ± 12,6 anos. Pacientes com cirrose biliar primária não apresentavam amenorréia antes do transplante. Os demais pacientes apresentavam amenorréia por 3 meses a 11 anos antes do transplante. Recuperação rápida da menstruação ocorreu em todos pacientes após o transplante (3,1 ± 1,2 meses). Duas pacientes engravidaram um e três anos após o transplante. Conclui-se deste estudo que a maioria das mulheres que apresenta amenorréia secundária à doença hepática avançada, volta a ter ciclos menstruais normais aproximadamente três meses após o transplante hepático e podem engravidar.

The objective of the present study is to evaluate the effects of successful liver transplantation on menstrual cycles abnormalities and on reproductive function of women with chronic liver disease. Twelve women with age between 17 and 54 years who underwent liver transplantation were evaluated. The following variables were analyzed: age, etiology of chronic liver disease, pattern of menstrual function and period of amenorrhea before and after transplantation, and occurrence of pregnancy after transplantation. The mean age of patients was 36 ± 12.6 years. Patients with primary biliary cirrhosis did not have menstrual abnormalities before transplantation. The other patients presented amenorrhea for 3 months to 11 years before the transplantation. Rapid recovery of menstrual function was observed in all patients after the transplantation (3.1 ± 1.2 months). Two patients became pregnant one and three years after the transplantation. It is concluded from this study that most women who present amenorrhea secondary to chronic liver disease have normal menstrual cycles in approximately three months following liver transplantation and they may become pregnant.

The objective of the present study is to report a sucessful pregnancy in a 28 year-old female who underwent an orthotopic liver transplantation two years ago due to type I auto immune he patitis. Patient was taking cyclosporin, prednisone and azathioprine for maintenance immunossupression and had good graft function during all the pregnancy. The liver function tests were normal during the pregnancy. Fetal growth was monitored by ultrasonographic examination and showed normal development. At the end of the third trimester, she was subjected to a cesarean bearing a healthy girl weighting 2,320 kg. She was discharged with normal liver functions tests and no complications.

The aim of this paper is to present a case of a 37-year-old female patient with a benign tumor of the Ampulla of Vater and a brief review of the literature. The patient presented with progressive obstructive jaundice and weigth loss due to the presence of two adenomas of the second portion of duodenum. Laboratory tests confirmed the presence of obstruction of the biliary tree. Ultrasound and CT scan of the abdomen revealed bile duct dilatation. ERCP showed a tumor at the site of the Ampulla of Vater. The biopsies revealed tubular adenoma. She was submitted to local resection of the tumors and sphincteroplasty, since the frozen biopsy at the time of surgery showed no malignancy. During the post-operative follow-up she presented recurrence of symptoms. An upper GI endoscopy revealed a tumor at the Ampulla of Vater. She was then submitted to Whipple procedure with an uneventful recovery.

Desde os mais remotos tempos pesquisam-se incessantemente drogas que acelerem o processo cicatricial normal. No Hospital de Clínicas da UFPr preconiza-se a limpeza de feridas limpas com solução salina de NaCl a 0,9%. Alguns serviços têm utilizado empiricamente o Agarol® e o Trigliceril® na confecção do curativo após este procedimento. Este estudo objetivou avaliar experimentalmente a evolução de feridas cutâneas, em ratos, produzidas por incisão cirúrgica tratadas com solução de NaCl a 0,9%, Agarol® e Trigliceril® . Utilizou-se 24 ratos, divididos em três grupos: C, controle, submetido à troca diária de curativo após limpeza com solução de NaCl a 0,9%; grupo A com aplicação de Agarol® e grupo T com aplicação de Trigliceril®. Verificou-se que no terceiro e décimo quarto dias de pós-operatório o Agarol<FONT FACE="Symbol">â</FONT> e o Trigliceril<FONT FACE="Symbol">â</FONT> não influenciaram o processo cicatricial. No sétimo dia de pós-operatório verificou-se houve aumento da quantidade de tecido de granulação nos grupos tratados com Agarol<FONT FACE="Symbol">â</FONT> e diminuição da neovascularização no grupo Trigliceril<FONT FACE="Symbol">â</FONT> .

For centuries, mankind has been incessantly researching with drugs that could accelerate the normal wound healing process. In the Hospital de Clinicas da Universidade Federal do Paraná, it has been recommended that the cleansing of clean wounds with saline solution of 0.9% sodium chloride, followed by a cover of dry dressing. However, some services have empirically used Agarol and Trigliceril in the confection of dressings after cleansing. This study aimed to evaluate the evolution of cutaneous wounds treated with normal saline, Agarol and Trigliceril in rats. A group of twenty-four rats were submitted to three skin circular incisions of 1.2 cm in diameter on their backs which exposed the subcutaneous tissue. The wounds were cleaned daily with normal saline solution. This group was distributed at random within three groups: Group C, control, received a clean and dry dressing after cleansing; groups A and T received dressings with Agarol and Trigliceril respectively. The evaluation of the wounds was done on the 3rd, 7th and 14th postoperative days by histological and macroscopic studies. The results showed that on the 3rd and 14th days, no evident influence of the drugs on the healing wound was noticed. On 7th postoperative day, Agarol demonstrated to increase the amount of granulation tissue, while Trigliceril appears to decrease the neovasculature during the healing process.

Desde o século XIX o omento maior vem sendo utilizado em diferentes procedimentos cirúrgicos. O objetivo desse estudo foi avaliar os efeitos da omentoplastia na cicatrização de anastomoses colônicas em ratos. Utilizaram-se 64 ratos machos, que foram divididos em 4 grupos (A,AN,B,C). Realizou-se uma anastomose colônica situada há 5 cm da borda anal, de três maneiras diferentes: para os grupos A e AN , anastomose padrão com 8 pontos seromusculares; para o grupo B, anastomose isquêmica e, para o grupo C uma anastomose deficiente com apenas 4 pontos. Na metade dos animais de cada grupo a anastomose foi recoberta com o omento e desta forma obteve-se os subgrupos AO, ANO, BO, CO. No grupo AN e ANO utilizou-se tinta nanquim para avaliar a neovascularizção. Todos os animais foram submetidos a eutanásia no 7o dia de pós-operatório. Concluiu-se que a utilização da omentoplastia promoveu, uma neovascularização na área de anastomose, aumentou a presença de colágeno e levou a uma diminuição da presença de aderências próximo da linha de sutura.

Since the XIX century the greater omentum has been used for different purposes in the surgical practice. The aim of the present study is to determine the effects of the omental wrapping on the healing of colonic anastomoses in rats. Sixty four, Wistar male rats were used. The animals were divided in four groups (A,AN,B,C). A colonic anastomoses located 5 cm from the anal verge was performed in three different ways: for A and AN groups the anastomoses was done in one layer with 8 nylon interrupted propylene(prolene) slitches, for B group an ischemic anastomose was created and for group C a deficient anastomose was performed .Half of animals in each group had this anastomose protected by omental wrapping (AO, ANO, BO, CO). All the animals were sacrificed on the 7th P.O. In the AN and ANO groups just before the sacrifice a dye (China ink) was injected in order to evaluate the neovascularity of the anastomoses. We concluded that the omental wrapping increased the vascularity in the colonic anastomoses improving its healing and decreasing the adhesions on the anastomotic line.