Purpose: The mechanism of larynx oncogenesis is complex and controlled by various factors, most of them involved in cell proliferation and apoptosis. In this study, we evaluated the levels of two suppressor proteins (pRb and p53) and two oncogenic proteins (c-Myc and Bcl-2), as well as the apoptotic levels and the presence of human papillomavirus (HPV) in both tumor types. Experimental Design: Low-or high-risk HPV viral DNA was determined by PCR and in situ PCR; the level of cellular proteins was examined by immunohistochemistry; the presence of apoptotic cells was evaluated by in situ cell death detection. Results: Most laryngeal papillomatosis samples contained low-risk HPV determined by both techniques. However, 25% of laryngeal carcinoma samples were positive for HPV employing PCR or in situ PCR. In papillomatosis, pRb and p53 levels were higher than in normal larynxes, whereas laryngeal cancer presented the lowest levels. c-Myc oncogene expression was very low in normal and cancer tissues but highly increased in papillomatosis. Bcl-2 expression was low and showed no significant difference between laryngeal papillomatosis and normal larynxes. By contrast, Bcl-2 was clearly up-regulated in cancer. Normal larynx samples and those from laryngeal papillomatosis exhibited similar relatively high numbers of apoptotic cells, whereas in malignant tumors, these cells were scarce. Conclusion: Our results suggest that HPV is an important risk factor in papillomatosis and in some malignant larynx tumors with a strong participation of cellular genes, specifically involved in proliferation and apoptosis. In benign papillomatosis lesions but not in larynx cancer, high p53 activity might preserve the apoptosis process. In larynx cancer, low p53 levels and high bcl-2 expression may be playing an important role to block apoptosis.Laryngeal carcinoma is a common malignant tumor of the head and neck (1). Besides well-established risk factors like smoking and alcohol abuse (1, 2), the development of laryngeal carcinoma is associated with human papillomavirus (HPV) infection (2, 3). On the other hand, mother-to-child transmission is probably responsible for recurrent laryngeal and pulmonary papillomatosis in infants (4), and actually laryngeal papillomatosis is the most common benign tumor of the larynx in children (5, 6). Laryngeal papillomatosis is induced by low-risk HPV, especially types 6 and 11, and is characterized by recurrence (5, 6). The clinical course is unpredictable but regression may occur following some treatments (7 -9). However, in other cases, the disease has a more aggressive course, recurs more frequently, and can extend well into adult life, requiring repeated surgical procedures. In a small number of patients, laryngeal papillomatosis may develop into squamous cell carcinoma (7 -9).HPV-16 is the most common high-risk virus. Its contribution to neoplastic progression is predominantly through the action of the viral oncoproteins E6 and E7 (10 -14). Expression of these proteins is sufficient for the i...

Pericallosal artery aneurysms should have a better prognosis than the aneurysms located in the other parts of the circle of Willis. Complications are related to the patients" age. If possible, these aneurysms should always be clipped due to potential risk of bleeding and difficulty of embolization.

Background: Gliomas are aggressive and resilient tumors. Progression to advanced stages of malignancy, characterized by cell anaplasia, necrosis, and reduced response to conventional surgery or therapeutic adjuvant, are critical challenges in glioma therapy. Relapse of the disease poses a considerable challenge for management. Hence, new compounds are required to improve therapeutic response. As hydrolyzed rutin (HR), a compound modified via rutin deglycosylation, as well as some flavonoids demonstrated antiproliferative effect for glioblastoma, these are considered potential epigenetic drugs. Objective: The purpose of this study was to determine the antitumor activity and evaluate the potential for modifying tumor aggressivity of rutin hydrolysates for treating both primary and relapsed glioblastoma. Methods: The glioblastoma cell line, U251, was used for analyzing cell cycle inhibition and apoptosis and for establishing the GBM mouse model. Mice with GBM were treated with HR to verify antitumor activity. Histological analysis was used to evaluate HR interference in aggressive behavior and glioma grade. Immunohistochemistry, comet assay, and thiobarbituric acid reactive substance (TBARS) values were used to evaluate the mechanism of HR action. Results: HR is an antiproliferative and antitumoral compound that inhibits the cell cycle via a p53- independent pathway. HR reduces tumor growth and aggression, mainly by decreasing mitosis and necrosis rates without genotoxicity, which is suggestive of epigenetic modulation. Conclusion: HR possesses antitumor activity and decreases anaplasia in glioblastoma, inhibiting progression to malignant stages of the disease. HR can improve the effectiveness of response to conventional therapy, which has a crucial role in recurrent glioma.

RESUMO Introdução:A dor lombar constitui causa frequente de morbidade e incapacidade, sendo a senescência patológica das facetas articulares da coluna vertebral uma das principais causas de lombalgia. Objetivo: Relatar os resultados obtidos no tratamento de pacientes idosos com lombalgia crônica através de analgesia peridural associada a rizotomia química percutânea de faceta. Método: O critério de inclusão neste estudo foi pacientes com presença de lombalgia crônica, sendo aplicada escala numérica de dor (END) para análise da dor pré-e pós-operatória no seguimento ambulatorial. Os pacientes foram submetidos a analgesia peridural seguida de rizotomia química percutânea de facetas articulares bilateralmente sob radioscopia intra-operatória. Resultados: Este estudo foi constituído de 19 pacientes. A pontuação média na END no pré e pós-operatório foi 8,2 e 1,9 pontos, respectivamente, com tempo médio de seguimento de 50 meses. Não houve óbitos ou complicações durante e após o ato cirúrgico, e os pacientes receberam alta hospitalar no mesmo dia da internação. Conclusão: São pontos favoráveis desta terapêutica: o menor tempo de internação hospitalar, segurança e baixo custo para execução. Esta associação de técnicas neurocirúrgicas apresenta-se como opção terapêutica promissora. Palavras-chave: Lombalgia; Manejo da Dor; Procedimentos Neurocirúrgicos; Idoso.ABSTRACT Introduction: Low back pain is a frequent cause of morbidity and incapacity and the spine facet joint dysfunction is one of the main causes. Objective: This paper aims to report the results obtained in the treatment of the elderly who suffer from chronic low back pain with epidural anesthesia associated to percutaneous chemical rhizotomy of facet joint. Methods: Inclusion criteria was patients who suffer from low back pain. The numerical scale of pain (NSP) was applied to analysis in the preoperative and postoperative pain in outpatients. The patients were submitted to epidural anesthesia associated to percutaneous chemical rhizotomy of facet joint bilaterally with intraoperative radioscopy aid. Results: This paper consisted of 19 patients. Mean scores were 8.2 and 1.8 points in the preoperative and postoperative period, respectively. The average follow-up was 50 months. There was no death or complication during and after the procedure, and patients were discharged on the day of admission. Conclusion: The shorter hospitalization stay, safety and low cost are favorable points of this therapy. This neurosurgical techniques association is presented as a promising therapeutic option for low back pain. IntroduçãoA dor lombar ou lombalgia é definida como uma condição clínica de dor regional moderada ou intensa, anatomicamente distribuída entre o último arco costal e a prega glútea. Frequentemente é acompanhada de limitações de movimento com etiologia variada podendo ser desencadeada por fatores de risco biológicos, mecânicos e cognitivos 21,50,57 . A lombalgia constitui causa frequente de morbidade e 274 Original Pacheco CC, Camporeze B, Estevão IA, Mariano PM, J...