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OBJECTIVE: To analyze the participation of glutathione-S-transferase (GST) M1 and T1 polymorphisms associated or not with protein p53 polymorphism at codon 72 and in the presence of HPV in the carcinogenesis of uterine cervix adenocarcinoma. METHODS: Forty-three samples of uterine cervix adenocarcinoma were studied and 86 samples of endocervical cells of women without tumors formed the control group. The presence of HPV was determined in order to genotype the isoforms of p53 at codon 72, GSTM1, GSTM1*0, GSTT1 and GSTT1*0 which were evaluated by the PCR method. RESULTS: HPV was present in 97.67% of the adenocarcinoma cases and in 31.40% of the control group. Statistical analysis showed differences (p = 0.001) and an OR of 113.3 (CI 95%: 13.67-947.14). GSTT1 and GSTT1*0 analysis showed a significant difference between the groups (p = 0.001) with an OR of 4.58 (CI 95%: 2.041-10.28) (p < 0.001) for the presence of GSTT1*0. When it was associated with HPV OR was 6.6 (CI 95%: 0.04-0.50). Analyses of p53 and GSTM1 and GSTM1*0 either alone or associated with HPV were not significant. CONCLUSION: The presence of GSTT1*0 increased the risk for uterine cervix adenocarcinoma development while the allele GSTT1 had a protective action. The other isoforms did not appear to participate in the carcinogenesis of uterine cervix adenocarcinoma.

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AIMS: Structural remodelling in acute and chronic idiopathic interstitial pneumonia (IIP) has been extensively investigated, but little attention has been directed to the elastic tissue in these situations. The aim of this study was to determine whether elastic deposition accompanies collagen deposition in the four major histological patterns of IIP: diffuse alveolar damage (DAD), organizing pneumonia (OP), non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). METHODS AND RESULTS: We measured, by image analysis, the content of fibres of the collagenous and elastic systems of the alveolar septum in histological slides of open lung biopsies, using the picrosirius-polarization method and Weigert's resorcin-fuchsin stain, respectively. Five groups were studied: 10 cases of DAD; nine cases of OP; nine cases of NSIP; and 10 cases of UIP. Four normal lungs were used for comparison. The content of collagen fibres was significantly higher in UIP when compared to DAD, NSIP, OP and normal lung. The content of elastic fibres was increased in comparison with normal lungs but this was not significantly different among the histological patterns. CONCLUSION: Acute and chronic IIP cause a similar increase in the collagen and elastic contents of the lungs, representing a process of 'fibroelastosis' rather than an exclusive process of fibrosis. A profibrogenic mechanism is responsible for the unparallelled collagen augmentation observed in UIP subjects, the nature of which is yet to be determined.

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Assuntos

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Among the possible techniques to obtain the pressure-volume (P x V) curve at the bedside the low constant flow (CF) is the easiest and quickest one. However, the best value for CF to perform a good semi-static P x V curve is still to be determined. The purpose of this study was to evaluate the influence of 4 different CFs (1, 2, 5, and 10 L/min) on determination of lower inflection point of the P x V curve (L-Pflex) and upper inflection point of the P x V curve (U-Pflex) on the maximum slope and on the inspiratory work of breathing (up to volume of 1.35 L; inspiratory work L/cm H2O), comparing the volume estimated from the CF with the measured volume obtained by the respiratory inductive plethysmograph. The design was a prospective study, and the setting was an adult medical intensive care unit of a university hospital. There were 7 acute respiratory distress syndrome (ARDS) patients, less than 5 days of installation, after the standardization of lung volume history received sequentially from 4 different low inspiratory CFs in 2 trials. The P x V curve lasted from 73 +/- 1.6 s (1 L/min) to 8.8 +/- 0.69 s (10 L/min). The L-Pflex differed in the 2 performed trials (p = 0.04). There was no difference of L-Pflex among the 4 CFs comparing the 3 methods (p = 0.072) used for its calculation as well as comparing the estimated and the measured volume (p = 0.456). The maximum slope decreased significantly while increasing the flow from 1 to 10 L/min just in the estimated volume (p = 0.03). The inspiratory work did not increase with the increment of the flow either in the estimated volume (p = 0.217) or in the measured volume (p = 0.149). The U-Pflex differed among the trials (p = 0.003) and the methods used for its calculation (p < 0.01). Constant flows from 1 to 10 L/min can equally determine L-Pflex in ARDS patients and is an easy and quick way to obtain the L-Pflex in order to optimize positive end expiratory pressure (PEEP) in ARDS patients.

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A headspace solid-phase microextraction (HS-SPME) method is developed for the determination of styrene in drinking water. Gas chromatography (GC)-mass spectrometry is utilized for qualitative analysis. A manual SPME holder with 85-microm polyacrylate coating is used to extract the styrene from water, which is determined to have good linearity (correlation coefficient r = 0.9999 for 1.00-100.00 microg/L range), a relative standard deviation of 1.9%, and a detection limit of 0.30 microg/L. This method is compared with a classical headspace GC method.

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The bivalent chromomeres of maize were analyzed by means of enzymatic treatment with trypsin. The aim was to verify if the effect of swelling observed in human meiotic chromosomes also occurs in these bivalents, and if this morphological change allows a greater visual resolution of the chromomeric pattern. Bivalents treated with trypsin showed a structure with sequential and linear distribution of small rings. Comparisons between bivalent morphology, treated and non-treated, indicated a collinearity among the sequences of rings and the chromomeres. The results obtained were considered useful to analyze and to make a chromomere map. This treatment can also provide cytological evidence that may help to understand the pairing process. It was concluded that the ring-shape was caused by trypsin-induced "disjoining" just in the chromomeric but not in the interchromomeric regions.

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BACKGROUND: Malignant fibrous histiocytoma (MFH) arising primarily in the lungs is rare, and a preoperative diagnosis, as well as a surgical planning, is very important because of the tumor's propensity for vascular invasion and its low incidence of lymph node metastasis. The correct preoperative diagnosis of thoracic MFH is not easy to establish because the small fragments from needle and transbronchial biopsies are often inadequate for a conclusive histologic analysis. A preoperative bronchial brushing cytology suggestion of the diagnosis of primary MFH of the lungs may be helpful in such cases. CASE: A 37-year-old male presented with a large, irregular mass in the inferior and middle lobes on chest roentgenography as well as on computed tomography. Two bronchoscopies were performed, with the diagnosis of undifferentiated large cell carcinoma. After surgical resection a more sophisticated pathologic analysis, including immunohistochemical and ultrastructural studies, revealed a primary MFH of the lungs. Revision of the bronchial brushing cytology disclosed many spindle-shaped cells with a "comet" configuration, strongly suggestive of MFH. CONCLUSION: The bronchial brushing cytology features of spindle-shaped and bizarre, multinucleated giant cells with a comet appearance may be the key to the cytomorphologic diagnosis of MFH.

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AIM: To determine by morphometry if pleural biopsies with the histopathological diagnosis of "non-specific pleuritis", malignant, and tuberculous disease could be distinguished morphologically from those with truly non-specific disease. METHODS: Each pleural biopsy was reviewed taking into account three compartments of reference: the visceral/parietal mesothelial compartment, the submesothelial screen compartment, and the submesothelial adipose tissue compartment. Normal connective tissue, granulation tissue, fibrocellular proliferation, fibrin, polymorphonuclear cells, mononuclear cells, and mesothelial cells were measured using conventional point counting procedures in terms of the fractional area occupied by each parameter within each compartment of reference. Ranking was carried out on 164 patients, based on their diagnosis: chronic non-specific disease (n = 57), tuberculosis (n = 27), malignant disease (n = 58), and conditions associated with transudative effusions (n = 22). RESULTS: Stepwise discriminant analysis of the resulting data showed that biopsies from patients with tuberculosis, malignant disease, and chronic non-specific disease could be distinguished between themselves and normal cases. Statistical differences among the four groups were observed for eight morphometric parameters related to components of inflammation and extension throughout the three pleural anatomical compartments. A robust discriminant function permitted an adequate classification of the three groups of disease in 88.41% of the cases. Pleural biopsies with fibrin incorporated within granulation tissue on the submesothelial screen compartment showed 100% specificity for patients with tuberculosis, while mononuclear cells in a band-like infiltrate on the submesothelial adipose tissue compartment showed 93.1% specificity for patients with malignant disease. The truly non-specific pleuritis was characterised by deposits of fibrin in the subpleural compartment and discrete signs of chronic inflammation and reparatory fibrosis on the submesothelial screen. CONCLUSIONS: Morphometric analysis of pleural biopsies may be a useful supplementary histological procedure to support the diagnosis of pleural tuberculosis and malignant disease.

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Interstitial disease is a recognized form of lung involvement in primary Sjögren's syndrome in which frequency and severity have not yet been established. We studied 20 patients 61.2 +/- 36.4 mo after the first symptoms of the syndrome that fulfilled criteria for both xerostomia and xerophtalmia. Eighteen patients exhibited pulmonary symptoms; nine presented a restrictive functional pattern. The chest roentgenogram disclosed interstitial involvement in nine patients. Gallium-67 lung scan presented hypercaptation in 15 of 19 patients studied. Thirteen patients who submitted to bronchoalveolar lavage presented higher cell counts with increases of lymphocytes and/or polymorphonuclear cells. All patients had abnormal results in at least one of the above. Lung biopsy, undertaken in 12 patients, showed a whole spectrum of interstitial disease, from a follicular bronchiolitis to a lymphoid interstitial pneumonia and finally fibrosis with honeycombing. One patient presented with associated sarcoid granulomas. We treated 11 patients with an azathioprine-based regimen and found a significant improvement in the forced vital capacity (p < 0.05) after at least 6 mo when compared with nontreated patients. We conclude that the frequency of interstitial lung disease is high in Sjögren's syndrome and that an azathioprine-based treatment can favorably change the outcome in this population.

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