Assuntos
Imunidade Celular/fisiologia , Hanseníase/imunologia , Hanseníase/patologia , Biópsia por Agulha , Doença Crônica , Feminino , Humanos , Imuno-Histoquímica , Controle de Infecções , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Hanseníase/metabolismo , Masculino , PrognósticoAssuntos
Dermatoses do Pé/etiologia , Dermatoses da Mão/etiologia , Ceratose/etiologia , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/patologia , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/patologia , Humanos , Ceratose/diagnóstico , Ceratose/patologia , Masculino , Pessoa de Meia-Idade , SíndromeRESUMO
OBJECTIVE: To evaluate if the heterogeneous distribution of tumor blood supply affects the response to chemotherapy in patients with head and neck cancer. METHODS: We treated 25 stage III/IV patients with an intraarterial cisplatinum-bleomycin regimen. Prior to treatment, a blue dye was injected directly to tumors through the catheter. Well-stained areas were considered as profusely perfused areas whereas poorly stained areas were considered as poorly perfused areas. Biopsies of both areas of each tumor were taken prior to and after the treatment and the histopathological response was evaluated with the following grading: I, tumor disappearance; II, destruction of some tumor nests; III, no changes. RESULTS: Grade I responses were attained in 13/25 (52%) of profusely perfused areas against 1/25 (4%) of poorly perfused areas (p < 0.001). Moreover, there were significant differences (p < 0.001) in the overall responses: 21/25 (84%) in the profusely perfused areas versus 7/25 (28%) in the poorly perfused areas; and in grade III responses (4/25, 16% vs. 18/25, 72%). To determine a possible correlation between the histopathological responses obtained in profusely perfused and in poorly perfused areas of each tumor, we then calculated the Kendall's tau-b statistics, obtaining a tau value of 0.279 (p = 0.145). This data indicated that histopathological responses to chemotherapy of profusely perfused and poorly perfused areas were independent in each tumor. CONCLUSIONS: Heterogeneity in the distribution of tumor blood supply affects the response to chemotherapy by influencing the intratumoral delivery of therapeutic agents. After the administration of effective doses of anticancer drugs to a tumor, cells in profusely perfused areas receive enough to destroy them while cells in the poorly perfused areas are exposed to lower drug concentrations and, therefore, survive. This phenomenon could explain in part the difficulty in the treatment of human solid tumors.
Assuntos
Neoplasias de Cabeça e Pescoço/irrigação sanguínea , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Bleomicina/uso terapêutico , Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Cisplatino/uso terapêutico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Injeções Intra-Arteriais , Corantes de RosanilinaRESUMO
BACKGROUND: In 1967, Badham used the term angina bullosa hemorrhagica (ABH) to describe an entity we already knew as traumatic oral hemophlyctenosis (TOH) (1933) and later renamed recurrent oral hemophlyctenosis (ROH) (1971). OBJECTIVES: The objective of this study was to review and discuss the literature, and to report 54 new cases seen between 1989 and 1996. MATERIALS AND METHODS: Fifty-four patients were thoroughly assessed to determine the clinical features, histology, etiology, pathogenesis, differential diagnosis, and therapy. RESULTS: In 35 patients (64.8%), the lesions predominated on the palate and in nine (16.6%) on the oral mucosa. The incidence was similar in both sexes (women, 52%; men, 48%) and the condition affected mostly the 51-70-year age group. ABH was never documented in children under 10 years of age. In 24 cases (44.4%), diabetes mellitus, hyperglycemia, and/or a family history of diabetes was found. CONCLUSIONS: ABH is a disorder more common than the literature would suggest. Although the causes may be multiple (mucosal trauma, inhaled corticosteroids), the available data indicate that, in these patients, the presence of an alteration in glucose metabolism should be considered.
Assuntos
Vesícula/patologia , Hemorragia Bucal/patologia , Idoso , Ácido Ascórbico/uso terapêutico , Vesícula/etiologia , Vesícula/terapia , Clorexidina/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/uso terapêutico , Hemorragia Bucal/etiologia , Hemorragia Bucal/terapiaRESUMO
We describe several members of a family with Van der Woude syndrome, a genetic and congenital malformation syndrome with autosomal dominant inheritance and 70% to 80% penetrance with variable expressivity. It is characterized by clinical signs localized to the face, such as bilateral or unilateral pits on conical elevations in babies or extensive depressions in adults, both in the vermilion border of the lower lip, with cleft lip, with or without cleft palate and uvula. Small accessory or heterotopic salivary glands empty into sinuses or fistulas in the lips. This eight member family had various clinical signs of the condition. All had cleft lip and palate. We studied the major characteristics of the eight patients and describe histopathologic and immunohistochemical features.
Assuntos
Fenda Labial/genética , Doenças em Gêmeos , Lábio/anormalidades , Feminino , Humanos , Lactente , Lábio/patologia , Linhagem , SíndromeAssuntos
Neoplasias Palpebrais/secundário , Biópsia , Neoplasias da Mama/patologia , Carcinoma/patologia , Neoplasias Palpebrais/patologia , Pálpebras/patologia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Peritoneais/secundário , Neoplasias da Coluna Vertebral/secundário , Fatores de TempoRESUMO
BACKGROUND: Nevus spilus is found with relative frequency. It is observed as as tan to brown macule serving as base to a speckle of smaller and darker maculo-papular elements. On rare occasions it turns into a malignant melanoma. PURPOSES: To describe one case with some characteristics different from routine observations and to revise the cases published reporting nevus spilus that turned into malignant melanoma, in order to point out the most frequent aspects. RESULTS: The 17 patients with nevus spilus and melanomas, including ours, were white, with ages between 35 and 56 years. Most of the cases were localized in the dorsal region. Five patients were men. Almost all nevus were congenital and their size ranged between 2 and 10 cm in diameter. Histologically, the speckled spots were junctional nevus, and few of them had dysplastic characteristics. Melanomas corresponded to the extensive superficial type MES; one of them was nodular. Some had systemic ganglial metastases and three of the patients are known to have died. Our patient had an intradermal cellular nevus on the man spot, and terminal hairs could be observed on it. The speckled elements were junctional nevus with dysplastic cells. CONCLUSIONS: Nevus spilus must be closely monitored, because it may turn into a malignant melanoma.