Os efeitos da reestruturação econômica metropolitana na Baixada Fluminense: Apontamentos sobre o "novo" mercado imobiliário da região

Este estudo visa identificar o linfonodo sentinela por meio da injeção exclusiva de radiofármaco periareolar subdérmico em quatro pontos, independente da topografia do tumor. A biópsia do linfonodo sentinela diminui a morbidade no estadiamento da axila. Foram realizadas 57 biópsias do linfonodo sentinela, em pacientes com câncer de mama, prospectivamente, em dois grupos: grupo A (25 pacientes) e grupo B (32 pacientes). Realizamos a injeção do radiofármaco peritumoral no grupo A, e nova técnica periareolar em quatro pontos no grupo B. A biópsia do linfonodo sentinela foi estudada por "imprint" citológico e hematoxilina e eosina, seguida de linfadenectomia axilar no grupo A e nos casos positivos do grupo B. No grupo A foram identificados 88% (22/25) de linfonodos sentinelas, não houve falso-negativo, com sensibilidade e especificidade de 100%; no grupo B foram identificados 96% (31/32) de linfonodos sentinelas e valor preditivo positivo de 100%. O número de linfonodos sentinelas variou de 1 a 7, moda de 1 e média de 2,7, a área de maior captação variou de 10 a 100 vezes. A injeção periareolar em quatro pontos se apresenta como bom método no mapeamento linfático para identificação do linfonodo sentinela. A padronização deste sítio pode ser o de escolha para identificação do linfonodo sentinela, sendo necessário maior número de casos para confirmação destes achados.

the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.

CO2 injection is a well-known Enhanced Oil Recovery (EOR) technique that has been used for years to improve oil extraction from carbonate rock and other oil reservoirs. Optimal functioning of CO2 injection requires a thorough understanding of how this method affects the petrophysical properties of the rocks. We evaluated pore-scale changes in these properties, notably porosity and absolute permeability, following injection of CO2-saturated water in two coquina outcrop samples from the Morro do Chaves Formation in Brazil. The coquinas are close analogues of Pre-salt oil reservoirs off the coast of southern Brazil. The effects of carbonated water injection were evaluated using a series of experimental and numerical steps before and after coreflooding: cleaning, basic petrophysics, microtomography (microCT) imaging, nuclear magnetic resonance (NMR) analyses, and pore network modeling (PNM). Our study was motivated by an earlier experiment which did not show the development of a wormhole in the center of the sample, with a concomitant increase in permeability of the coquina as often noted in the literature. We instead observed a substantial decrease in the absolute permeability (between 71 and 77%), but with little effect on the porosity and no wormhole formation. While all tests were carried out on both samples, here we present a comprehensive analysis for one of the samples to illustrate changes at the pore network level. Different techniques were used for the pore-scale analyses, including pore network modeling using PoreStudio, and software developed by the authors to enable a statistical analysis of the pore network. Results provided much insight in how injected carbonated water affects the pore network of carbonate rocks.

RESUMOObjetivo: avaliar a eficiência da localização e exérese por cirurgia radioguiada de lesões ocultas mamárias utilizando radiofármaco injetado diretamente no interior das lesões ou até dois centímetros destas com posterior injeção de ar como controle radiológico. Métodos: vinte e nove pacientes com 32 lesões mamárias ocultas, detectadas por mamografia ou ultra-sonografia, classificadas como BI-RADS ® 3, 4 e 5 foram incluídas neste estudo observacional com resultados expressos em percentagens. O radiofármaco utilizado foi o macroagregado de albumina marcado com tecnécio-99m ( 99m Tc-MAA) injetado por orientação mamográfica ou guiado por ultra-sonografia. A injeção do radiofármaco foi seguida pela imediata administração de ar, através da agulha da estereotaxia, visando o controle radiológico da injeção do radiofármaco. A biopsia excisional foi feita com o auxílio do aparelho portátil gamma-probe (detector de radiação gama) e a remoção completa das lesões foi verificada pela radiografia das peças cirúrgicas ou por exame por congelação intra-operatório. Resultados: câncer de mama foi encontrado em 10% (1/10) das lesões BI-RADS ® 3, em 31,5% (6/19) das BI-RADS ® 4 e em 66,6% (2/3) das BI-RADS ® 5. As 29 pacientes corresponderam a 32 espécimes, cirúrgicos. O radiofármaco foi corretamente posicionado em 96,8% (31/32) dos espécimes permitindo remoção de 96,8% das lesões mamárias não palpáveis estudadas. A completa remoção da lesão foi demonstrada pela radiografia das peças em 23 casos (71,8%), pelo estudo intra-operatório por congelação em 21,8% (7/32) e por ambos os métodos em 6,2% (2/32). Conclusão: a cirurgia radioguiada é importante instrumento na remoção de lesões mamárias não palpáveis, tratando-se de método simples, rápido e exeqüível que pode ser implementado na rotina clínica dessas pacientes. PALAVRAS-CHAVE:Cirurgia assistida por computador; Doenças mamárias/cirurgia; Agregado de albumia marcado com tecnécio tc 99m; Neoplasias mamárias ABSTRACT Purpose: to asses the efficiency of the radioguided localization and removal of occult breast lesions using radiopharmaceuticals injected directly into the lesions or close to them with posterior air injection as a radiological control. Methods: twenty-nine consecutive patients with thirty-two occult breast lesions detected mammographically or by ultrasound, and categorized 3, 4 and 5 BI-RADS ®, were included in this observational study with results expressed in percentages. The radiopharmaceutical used was human serum albumin labeled with 99 mTc-HSA injected inside or close to the lesion using mammographic or ultrasonographic guidance. The injection of the radiopharmaceutical was followed immediately by air injection through the needle used for stereotaxis as a radiological control of the radiopharmaceutical placement. The excision biopsy was carried out with the aid of a hand-held gamma-detecting probe and the entire removal of the lesion was verified by X-ray of the surgical specimens or by intraoperative frozen section examination. Results: breast cancer was fou...

To analyze the feasibility, efficacy and results of the use of 125Iodine seeds for intra-operative localization of nonpalpable breast lesions. Method: Retrospective review of 284 patients, referred by various breast specialist surgeons, with radiologically detected but clinically nonpalpable microcalcifications or nodules, submitted to pre-operatory 125Iodine seed implant, between July 2012 and September 2016. A total of 338 seeds were implanted in ordinary radiologic departments, supported by ultrasonography or mammography exams, chosen according to the morphologic aspect of the lesion. Radioguided surgical procedure took place on the same day or few days after the implant of the seeds, with the help of a radiation detector called Gamaprobe, which directs the surgeons towards the radioactive seeds and to the lesion to be resected. Results: All implants were performed as outpatient procedures, with patients immediately returning to their daily activities. No complications such as pain, bleeding, infeccion and haematoma were recorded. Pathologists had no difficulty in preparing the surgical specimens for histopathologic analysis. Surgical safety margins were considered adequate in all pathologic reports, with no need for re-operations. The healing process was not jeopardized by radiation, and the surgeons were pleased with the improvement on intraoperative lesions localizations and shortening on operatory time. Cosmetic results were well accepted by the patients. Conclusion: The 125Iodine seed implant is an effective alternative method for intraoperative localization of radiologically detectable and clinically nonpalpable breast lesions.

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