PURPOSE:Compare two new methods with the traditional end-to-side neurorrhaphy. METHODS: Rats were divided into four groups. In A-L group the peroneal nerve was sectioned and the distal stump was connected to the lateral of the tibial nerve (donor) with two 10-0 nylon points. In A-R group two perineurium flaps embraced the donor nerve. In the B-R group a suture embraced the donor nerve. Group B-L was the control. After six months tibial cranial muscle mass and morphometry of the distal stump of the peroneal nerve were evaluated. RESULTS:Muscle mass in groups A-R, A-L and B-R were lower than B-L group (p<0.0001) an equal between themselves (p>0.05).Groups A-R, B-R and A-L had a lower number of nerve fibers when compared with B-L (p=0.0155, p=0.016, p=0.0021). CONCLUSION:The three types of neurorrhaphy showed no differences related to muscle mass and number of nerve fibers suggesting that the embracing with a single suture has great potential due its simplicity and usefulness in deep areas. CONCLUSÃO: Os três tipos de neurorrafia não apresentaram diferenças relacionadas à massa muscular e número de fibras nervosas sugerindo que a sutura abraçante com apenas um ponto apresente grande potencial em áreas cirúrgicas mais profundas.Descritores: Neurorrafia término-lateral. Sutura abraçante. Ratos. The embracing end-to-side neurorrhaphy in rats

Abstract. to evaluate the tumor response to neoadjuvant chemotherapy, 99m tc-sestamibi breast scintigraphy was proposed as a quantitative method. Fifty-five patients with ductal carcinoma were studied. they underwent breast scintigraphy before and after neoadjuvant chemotherapy, along with clinical assessment and surgical specimen analysis. the regions of interest on the lesion and contralateral breast were identified, and the pixel counts were used to evaluate lesion uptake in relation to background radiation. the ratio of these counts before to after neoadjuvant chemotherapy was assessed. the decrease in uptake rate due to chemotherapy characterized the scintigraphy tumor response. the Kruskal-Wallis test was used to compare the mean scintigraphic tumor response and histological type. Dunn's multiple comparison test was used to detect differences between histological types. the MannWhitney test was used to compare means between quantitative and qualitative variables: scintigraphic tumor response vs. clinical response and uptake before chemotherapy vs. scintigraphic tumor response. the spearman's test was used to correlate the quantitative variables of clinical reduction in tumor size and scintigraphic tumor response. All of the variables compared presented significant differences. The change in 99m tc-sestamibi uptake noted on breast scintigraphy, before to after neoadjuvant chemotherapy, may be used as an effective method for evaluating the response to neoadjuvant chemotherapy, since this quantification reflects the biological behavior of the tumor towards the chemotherapy regimen.Furthermore, additional analysis on the uptake rate before chemotherapy may accurately predict treatment response. IntroductionBreast cancer is the second most common type of cancer worldwide and the most common among women. It accounts for approximately 22% of new cancer cases among women each year (1), and the 5-year survival rate among the worldwide population is 61%. this high mortality rate is related to late diagnosis, with the presence of tumors of large dimensions and lymph node metastases.locally advanced breast cancer comprises tumors greater than 5 cm in diameter, with wall or skin invasion, metastases to fixed lymph nodes (2,3) and inflammatory carcinoma. treatment for this is multidisciplinary, consisting of preoperative chemotherapy, surgery, radiotherapy and postoperative chemotherapy (4-6).Preoperative or neoadjuvant chemotherapy is standard treatment for individuals with locally advanced breast cancer (7-10). It has been found to substantially improve the survival of these patients (6,11,12). It provides better local control over the disease, with increased likelihood that the breast surgery will be conservative (4,5,13). Moreover, this type of chemotherapy treats preexisting microscopic systemic disease and enables the evaluation of tumor resistance in vivo (14). reduction in tumor volume has been used as the standard criterion for response evaluation among solid tumors such as breast carcinoma (15). techniques tha...

Abstract. Scintimammography using 99m tc-sestamibi is a noninvasive and painless diagnostic imaging method that is used to detect breast cancer when mammography is inconclusive. Because of the advantages of labeling with 99m Tc-sestamibi and its high efficiency in detecting carcinomas, it is the most widespread agent for this purpose. its accumulation in the tumor has multifactorial causes and does not depend on the presence of architectural distortion or local or diffuse density variation in the breast. the objective of this study was to evaluate the accuracy of scintimammography for detecting breast cancer. One hundred and fifty-seven patients presenting 158 palpable and non-palpable breast nodules were evaluated. three patients were male and 154 were female, aged between 14 and 81 years. all patients underwent scintimammography, and the nodule was subjected to cytological or histological study, i.e., the gold standard for diagnosing cancer. One hundred and eleven malignant and 47 benign nodules were detected, with predominance of ductal carcinomas (n=94) and fibroadenoma/fibrocystic condition (n=11/n=11), respectively. The mean size was 3.11 cm (7-10 cm) among the malignant nodules and 2.07 cm among the benign nodules (0.5-10 cm). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 89, 89, 95, 78 and 89%, respectively. analysis on the histological types showed that the technique was more effective on tumors that were more aggressive, such as ductal carcinoma. in this study, 99m tc-sestamibi scintimammography was shown to be an important tool for diagnosing breast cancer when mammography was inconclusive.Introduction mammography is the safest method for breast cancer screening (1-3). It presents good sensitivity for detecting palpable and non-palpable lesions and low specificity for distinguishing between benign and malignant processes (4). hence, a biopsy is often required for diagnostic confirmation (5). It also presents limitations in relation to detection of lesions in dense breasts (6-8). mann et al demonstrated that false negative mammograms cause delays in undertaking biopsies among patients with cancer (9). the high rates of unnecessary biopsies in cases of benign lesions (10) have encouraged research on non-invasive techniques with greater precision. ultrasound, magnetic resonance imaging, positron emission tomography and scintigraphy are important aids for detecting cancer when mammography is indeterminate (11). high-risk patients (e.g., family antecedents, atypical proliferative lesions and previous cancer subjected to tumorectomy or radiotherapy) have benefited from combined use of these methods (11). Scintigraphy is a noninvasive imaging examination that uses small doses of radiation (12). it is painless, its cost and availability are reasonable and it enables functional or metabolic evaluation of various organs or structures. its advantage is unequivocal, especially when analysis using other methods is limited, and it stands out as a diagnostic eva...

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Neste trabalho apresentamos um caso de hiperplasia nodular focal que foi diagnosticado aos seis anos de idade e que está sendo acompanhado até o momento presente. Para o diagnóstico foram imprescindíveis as técnicas de imagem, tendo importância de realce a cintilografia hepatoesplênica e a tomografia computadorizada. Apresentamos, também, revisão da literatura sobre o assunto.

The objective of this paper was to evaluate the hepatobiliary function of patients with pulmonary tuberculosis under triple treatment, using the technetium-99m-DISIDA (99mTc-DISIDA) hepatobiliary scintigraphy. Ten men and three women with pulmonary tuberculosis were subjected to hepatobiliary scintigraphy at the beginning of triple treatment (M1) and two months after it (M2). Patients were from the urban area, of low socioeconomic level, malnourished, and chronic alcohol and/or tobacco users. Ten normal individuals were evaluated as controls. Radiotracer images were acquired on a computerized gamma camera (Orbiter-Siemens) and T1/2 uptake and excretion values were calculated. Nutritional status and serum hepatic enzyme levels for each patient were evaluated at M1 and M2. None presented clinical or laboratory antecedent of hepatobiliary disease. At M1, there were no hepatic serum or kinetic alterations of the 99mTc-DISIDA. At M2, patients presented better nutritional conditions than at M1; there was increased serum aspartate aminotransferase (AST) and reduced excretion time for 99mTc-DISIDA, which was interpreted as a more adaptive than toxic phenomenon, yet not all alterations were significant and none manifested clinically. Apparently, triple treatment acted on the liver inducing the P450 cytochrome enzymatic system, accelerating radiotracer excretion, which follows the same path as the bilirubins

Paracoccidioides sp.—Herpes simplex virus (HSV) co-infection was not reported until now and malabsorption syndrome is a rare complication of the acute/subacute form (AF) of paracoccidioidomycosis (PCM), characterized by life-threatening abnormalities, such as fat and protein loss, lymphopenia, ascites, and intense immunosuppression. A 21-year-old woman presented the PCM AF with intense involvement of the abdominal and intestinal lymphoid organs, which leads to the malabsorption syndrome and severe immunosuppression. This patient developed a fatal-disseminated HSV infection associated with the paracoccidioidal disease. This case demonstrates that, in addition to the antigen-specific immunosuppression, some PCM patients can present a generalized cell-mediated immune depression and endogenous infection of latent microorganisms. On the best of our knowledge, this is the first report of an association between PCM and HSV infection.

Lymph node involvement is very frequent in paracoccidioidomycosis (PBM) mainly in its juvenile form. PBM also affects the lymphatic system of patients with the chronic form as it was confirmed by bipedal lymphangiography and autopsy.