Quantitative analysis of C cells in Hashimoto's thyroiditis

The objective of the present investigation was to study quantitatively C cells in Hashimoto's thyroiditis (HT) by analyzing 22 thyroids obtained at autopsy or thyroidectomy from 16 patients with thyroiditis and from 6 normal subjects. Six different areas were sampled on average and labeled with a monoclonal anticalcitonin antibody by immunohistochemistry using the avidin-biotin-peroxidase complex. Normal thyroids from adult patients with no thyroid disease were used as control. C cells were counted in 1 cm2 fields and the mean number of cells per field was calculated. Data were analyzed statistically by the Mann-Whitney test. The inflammatory process detected in cases of HT was usually moderate (50%) and the number of C cells ranged from 0 to 12.2 per 1 cm2 field. The number of C cells in normal thyroids ranged from 20 to 148 per 1 cm2 field, with a median of 35.2 cells per field. The results demonstrate a significant decrease in C cell number in HT compared with normal thyroids, indicating that the inflammatory process causes destruction of both follicular and C cells, which are replaced by fibrosis.

[Pseudo-tumoral schistosomiasis: case report]

The schistosomiasis is an endemic disease in Brazil. The most frequent forms are: intestinal, hepatosplenic and hepatointestinal. Rare forms also manifest such as pseudo-tumoral form. The objective of this paper is to report a 8 years-old boy, from Minas Gerais State, with pseudo-tumoral schistosomiasis. He was submitted an exploratory laparotomy and a biopsy from abdominal mass was made. The histologic studies showed a chronic inflammatory process, with a large number of S. mansoni eggs. The treatment was a single-dose of oxaminiquine (20 mg/kg), with a positive evolution, with non-sequel observed after two years of follow-up.

[Extraskeletal primary osteosarcoma of the frontal region]

BACKGROUND

Extraskeletal osteosarcoma (ESOS) in the head as a primary site has seldom been reported and none in the frontal region.

METHODS

A 78-year-old Italian man presented with one month history of a frontal soft tissue mass. A CT scan showed a mass of uneven density occupying the subcutaneous soft tissue and involving fascial planes. No primary bone tumor was found. The entire mass was excised. The mass was solid measuring 0.8 x 0.6 x 0.5 cm. Extraskeletal osteoblastic osteosarcoma was diagnosed by light microscopy. The tumor recurred four months after the diagnosis. The tumor was again ressected. The patient was also submitted to low penetration radiation therapy. Nine months after the first biopsy the patient had symptoms due to infiltration to the base of the cranium. He died 10 months after the first biopsy.

CONCLUSIONS

The first case with ESOS of the frontal region without a pre-existing condition or a history of irradiation is described.

[Daily circadian variations of deaths in a general hospital]

This work aims at determining the incidence of circadian daily variations of natural death at a general hospital.

METHODS

We have analyzed time of death in 502 individuals with natural death. Statistical analyses have been applied to determine the difference significance between proportions and averages. As a result, we have found out that the occurrence of natural death was similar in different periods of the day. However, values indicate an excess of lethality at 6 a.m. and from noon to 6 p.m. We have concluded that the observed results suggested that the natural death does not have a circadian pattern, despite the vespertine peak.

[Health education: some considerations and implications for nursing practice]

The article focuses on distincts approaches on Health Education, analyzing its implications for the nursing practice in the health work process. It emphasizes the importance of this theme for the health agents' education for a interdisciplinary work with social sciences. It also points out some implications of the social citizenship's developing approach for nursing practice and education.

Biologically active flavonoids and terpenoids from Egletes viscosa

The steam volatile components from the hexane extract of dried flower buds of Egletes viscosa were identified by gas chromatography-mass spectrometry as trans-carvyl acetate, cis-carvyl acetate, sabinyl acetate, verbenyl acetate, cyclopentaethylidene, geranyl acetate and 5-methylfuranone, and trans-pinocarvyl acetate (major component). From the non-volatile residue, centipedic acid and a novel clerodane diterpene, 12-acetoxy-hawtriwaic acid lactone, were isolated. From the ethanol extract, ternatin (4',5-dihidroxy-3,3',7,8-tetramethoxyflavone), was isolated. Ternatin showed anti-inflammatory, hepatoprotection and gastroprotection properties, and, according to the NCI protocols, it showed moderate activity against HIV. The diterpenes showed antispasmodic activity. Structure determination of these secondary metabolites was accomplished by spectrometric methods, including 2D NMR, chemical interconversion and X-ray crystallographic analysis.

[Nursing education and professional practice: what is the relationship?]

This paper focuses on the relation between nurse's education and professional practice, through the experiences of nurses that were graduated at the same School of Nursing and that were working in hospitals in Porto Alegre. The discussion of the aspects that are involved in the categories of analysis give elements for nursing education, emphasizing the fact that it is disconnected of the reality of the professional practice, which characterizes dissociation between theory and practice.

Limb-girdle syndrome: a genetic study of 22 large Brazilian families. Comparison with X-linked Duchenne and Becker dystrophies

The differential clinical diagnosis between the X-linked muscular dystrophies (DMD and BMD) and autosomal recessive limb-girdle muscular dystrophy (LGMD), which is extremely important for genetic counseling, may be very difficult. The aim of the present report is to describe clinical and laboratory findings in patients from large families, with AR inheritance, in an attempt to characterize better cases which have been diagnosed as LGMD compared with the X-linked forms. The main features analysed are: age of onset and of confinement to a wheelchair, reproductive performance, serum enzymes (CK and PK) and dystrophin assessment (through immunohistochemistry and Western blot). Twenty-two families, with 62 affected patients diagnosed as limb-girdle muscular dystrophy, were included in this report. In 19 families, the patients had a milder clinical course, while in the remaining 3, the progression of the disease was continuous and clinically similar to X-linked DMD ("DMD-like"). A high consanguinity rate was observed among the parents of the affected patients (77%). No major clinical difference was observed between the X-linked and the AR forms. However, muscle dystrophin was found qualitatively and quantitatively normal in the autosomal forms but absent or abnormal in the X-linked ones. The reproductive performance was significantly higher for male than female patients. In addition, a surprising finding was the significantly greater fitness estimated for male LGMD cases as compared with Becker patients of comparable age studied in our center. The implications of such findings are discussed.

[Program of quality control in gynecologic cytology at the Adolfo Lutz Institute: strategies and critical analysis of results of its pilot implementation]

The Quality Control in the Gynecological Cytology Program, Instituto Adolfo Lutz, was designed to assure a high-standard of laboratory analysis for the Gynecological Cancer Detection and Prevention System in the São Paulo State Public Health Service. This study presents strategies for intra-laboratorial quality control as well as preliminary results on 32,018 cases. The methods applied for the selection of cases to be reviewed were based on clinical and cytological conditions that could mean higher risk of development of neoplasia and/or conditions that might induce difficulties of interpretation. The classification and analysis of the discrepancies found in this initial experience are the highlight points of this Program. Out of the 492 cases submitted to review, 45 had received underscored initial interpretation, although none of them fit international criteria for "false-negative". Overscores were found in 51 cases, with only three cases fitting the criteria for "false-positive". Based on this initial experience, the Quality Control Program will be applied to the other laboratories of the Public Health Service. This intra-laboratory model of control will be coupled with external supervision by Instituto Adolfo Lutz.

Serum and pleural adenosine deaminase. Correlation with lymphocytic populations

This study attempts to correlate levels of ADA in tuberculous and neoplastic pleural exudates with the different immunologic cellular expressions that follow these clinical situations. Seventy-three patients with pleural effusion were studied in order to assess ADA activity (pleural and serum); in 25 of them, a study of delayed cellular immunity (pleural and sanguineous) was performed through B, CD3, CD4, and CD8 lymphocytic populations. The activity of ADA was determined, and the study of lymphocytic populations was made through the use of monoclonal antibodies. The data obtained showed the following: levels of ADA were significantly (p less than 0.0005) higher in the pleural fluid and the serum of tuberculous effusions compared to neoplastic effusions; percentages of CD3 and CD4 T-cells were significantly (p less than 0.05 and p less than 0.0005, respectively) greater in tuberculous effusions. The statistical study of the levels of ADA activity and the percentage of CD4 T-cells in pleural exudates produced a significant regression curve (r = 0.612 and p less than 0.0001) which showed a positive correlation between these two parameters. The pathogenic implications of these results suggest the possibility that ADA could be a new marker of cell-mediated immune activity.