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We report a patient with longstanding Behçet disease who presented sudden onset of headache and facial paresis. The magnetic resonance imaging (MRI) showed a mass in the right thalamus, extending to the lentiform nucleus, subthalamic area, right cerebral peduncle and deep subcortical white matter. Stereotactic brain biopsy disclosed gliosis with no signs of malignancy. The diagnosis of a pseudotumoral form of neuro-Behçet disease was done and she was treated with pulse methylpredinisolone and intravenous cyclophosphamide. After 8 weeks she had improved and a new MRI showed disappearance of the tumor-like lesion. The differential diagnosis, especially with central nervous system tumor is emphasized.

ResumoA densidade da madeira é a propriedade que mais se correlaciona com as outras propriedades físicas e mecânicas, sendo usada para definir o uso apropriado da madeira industrialmente. Diversas ferramentas computacionais e matemáticas são utilizadas para modelar a densidade básica dos povoamentos, destacando-se as Redes Neurais Artificiais (RNA). Os dados foram provenientes de 2247 árvores de 20 clones de Eucalyptus ssp.. em 6 arranjos espaciais, com idades variando entre 3 e 6 anos. As RNA foram treinadas visando a estimação da densidade na idade de corte (6 anos), com variáveis de entrada como idade (anos), área basal (m²/ha), incremento médio anual (m³/ha/ano) na idade de medição, altura total (m), diâmetro a 1,3 m da superfície do solo (Dap) (cm), número de fustes por hectare (n/ha) e a razão entre dap, altura total e interação entre as variáveis. Os algoritmos de treinamento foram error backpropagation, resilient propagation, Manhattan update rule, scaled conjugate gradient, levenberg marquardt, quick propagation, simulated annealing, e algoritmos genéticos. As estimativas foram avaliadas com base nos coeficientes de correlação com os valores observados, raiz quadrada do erro médio percentual (RMSE), análise gráfica dos resíduos (erros percentuais) e histograma de frequência percentual dos erros percentuais. As melhores configurações foram a de 4 neurônios de camada oculta e função de ativação tangente hiperbólica na camada oculta e sigmoide na camada de saída e a com 8 neurônios na camada oculta, com função de ativação tangente hiperbólica na camada oculta e sigmoide na camada de saída. Palavras-chave:Parametrização, algoritmos, planejamento operacional. AbstractThe Wood density is the property which correlates most closely with the other physical and mechanical properties and is used to set the appropriate use of wood industrially. Several computational and mathematical tools are used to model the basic density of stands, highlighting the Artificial Neural Networks (ANN). Data came from 2247 trees of 20 clones of Eucalyptus spp. in 6 spatial arrangements, aged between 3 and 6 years. The RNA's were trained in order to estimate the density at the cutting age (6 years), with input variables such as age (years), basal area (m² / ha), mean annual increment (m³ / ha / year) of measuring age , total height (m), diameter at 1.3 m from the soil surface (Dap) (cm), stems number per hectare (n / ha) and the ratio of dbh, total height and interaction between variables. Training algorithms were: error backpropagation, resilient propagation, Manhattan update rule, scaled conjugate gradient, Levenberg Marquardt, quick propagation, simulated annealing, and genetic algorithms. The estimates were evaluated

Pilonidal cysts and sinuses are described as dermoid cysts which contain follicles of hairs and sebaceous glands. They clinically present as a classic case of inflammation which comes with pain, local infection and redness. The origin of pilonidal disease remains controverse. There are many hypothesis as lack of hygiene on the affected area and a penetration and growth of a hair in the subcutaneous tissue caused by constant friction or direct trauma on the damaged area. The option for clinical treatment is very frequent. However, taking into consideration the incidence and the possibility of recidive, surgical treatment is presently recommended. Complications include cellulitis and abscess formation. Pilonidal cysts are mostly found on the sacral region. In the literature is found description of pilonidal cysts on the penis, interdigital region on the hands as well as on the cervical region. We present a case of pilonidal cyst located on the vault biparietal region, without malignant degeneration.

-Whipple´s disease (WD) is an uncommon multisystem condition caused by the bacillus Tropheryma whipplei. Central nervous system involvement is a classical feature of the disease observed in 20 to 40% of the patients. We report the case of a 62 yeards old man with WD that developed neurological manifestations during its course, and discuss the most usual signs and symptoms focusing on recent diagnostic criteria and novel treatment regimens.KEY WORDS: Whipple´s disease, inflammatory bowel disease, dementia, polyneuropathy. Doença de Whipple com manifestações neurológicas: relato de casoRESUMO -A doença de Whipple (DW) é distúrbio multissistêmico raro causado pelo bacilo Tropheryma whipplei. O envolvimento do sistema nervoso central é um aspecto clássico da doença, sendo observado em 20 a 40% dos pacientes. Relatamos o caso de homem de 62 anos com DW que desenvolveu manifestações neurológicas durante sua evolução, com o objetivo de discutir os sinais e sintomas mais comuns e destacar os critérios diagnósticos e propostas terapêuticas mais recentes. PALAVRAS-CHAVE: doença de Whipple, doença inflamatória intestinal, demência, polineuropatiaWhipple´s disease (WD) or intestinal lypodystrophy was first described in 1907 1 . It is a relatively rare multisystem disorder caused by the gram-positive bacillus Tropheryma whipplei.The usual presenting complaints include pronounced weight loss, mal-absorptive diarrhea (sometimes accompanied by abdominal cramping and bloody stool), recurrent non-deforming polyarthritis and longstanding low grade fever 2 . Cutaneous hyperpigmentation and lymphadenopathy are also common clinical signs. Central nervous system (CNS) involvement is a classical feature of WD observed in 20 to 40% of cases. CNS manifestations are myriad and usually develop in later stages of the illness 3 , often with cranial nerve and cognitive complaints. Approximately 5% of the patients follow an unusual presentation with isolated CNS symptoms 4 . Available data on CNS WD are scant, consisting basically of isolated case reports. Gerard et al. 3 found only 122 reported cases in the literature since 1960, most of them in Europe and North America. To our knowledge, the following case is the first to be reported in Brazil. CASEA 62-year-old white man, retired electrician, came to our Gastroenterologic Clinic in 1989 complaining of increased stool frequency and liquidity, associated with pronounced weight loss (20 Kg) in the last 2 years. Subsequent investigation disclosed a mal-absorptive syndrome, steatorrhoea and hepatosplenomegaly. Six months later, he developed bilateral knee arthritis which subsided spontaneously in two weeks. In 1990, an upper digestive endoscopy combined with multiple gastric and duodenal biopsies was performed. Histologic examination of the bowel specimens revealed flattened villi, small intestinal mucosa laden with distended foamy macrophages in the lamina propria and intracellular periodic acid Schiff (PAS) positive granules ( Figure 1A -1B). Acid-fast bacilli were not identified in Z...

We report a 56-year old man with prolonged focal motor status epilepticus as the first clinical manifestation of paracoccidioidomycosis (PCM) and discuss this unusual presentation. We emphasize the need for a comprehensive work-up and increased awareness for central nervous system involvement in PCM, particularly in endemic areas.

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-There are few papers devoted to geriatric Guillain-Barré (GBS) and many related issues re m a i n u n a n s w e re d . Objective: To describe clinical, electrophysiological and therapeutic features in this age. Method: Clinico-epidemiological data and therapy of GBS patients older than 60 years were reviewed. Hughes scores were used to quantify neurological deficit and define outcome. Results: Among 18 patients (mean age 64.8 years), 9 had evident pro d rome and 80% noticed initially sensory-motor deficit. Demyelinating GBS was found in 8 and axonal in 6 subjects. There was one Miller-Fisher and 3 unclassified cases. Plasmapheresis (PFX) was single therapy in 12 patients and intravenous immunoglobulin (IVIg) in 2. Disability scores just before therapy were similar in both groups, so as short and long term outcome. C o n c l usion: Axonal GBS seems to be more frequent in the elderly and this may have prognostic implications. PFX and IVIg were suitable options, but complications were noticed with PFX. Prospective studies are needed to better understand and manage GBS in the elderly.KEY WORDS: Guillain-Barré syndrome, plasmapheresis, intravenous immunoglobulin, elderly.S í n d rome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e pro g n ó stico RESUMO -Publicações sobre a síndrome de Guillain-Barré (SGB) no idoso são escassas e várias questões s o b re o tema estão abert a s . O b j e t i v o :D e s c rever aspectos clínico-eletrofisiológicos, terapêuticos e pro g n ó stico no idoso. Método: Revisamos os prontuários de pacientes acima de 60 anos com SGB. A escala de Hughes foi usada para quantificar os déficits iniciais e finais. Resultados: No total de 18 pacientes (média de idade 64,8 anos), 50% tiveram pródromo e 80% tiveram déficit sensitivo-motor no início. SGB desmielinizante foi encontrada em 8 pacientes, axonal em 6 e uma síndrome de Miller-F i s h e r. Três casos não puderam ser classificados. Plasmaférese (PFX) foi empregada isoladamente em 12 pacientes e imunoglobulina endovenosa (IVIg) em 2. A disfunção inicial nos dois grupos tratados era semelhante, assim como a evolução a curto e longo prazo. Conclusão: A forma axonal da SGB parece ser mais freqüente no idoso e isto pode ter implicações prognósticas. PFX e IVIg foram eficazes, mas complicações ocorreram apenas no gru p o tratado com PFX. Estudos prospectivos são necessários para um melhor entendimento e manejo da SGB no idoso. PALAVRAS-CHAVE: síndrome de Guillain-Barré, plasmaférese, imunoglobulina endovenosa, idosos.