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Data on the occurrence and clinicopathological characteristics of actinic cheilitis (AC) and lip squamous cell carcinoma (LSCC) are well studied; however, they are based on studies limited to a single centre. Herein, we described the frequency of AC and LSCC submitted to microscopic examination from representative geographic regions of Brazil. A retrospective multicentre study was performed on biopsies obtained from 1953 to 2018 at 10 Brazilian oral and maxillofacial pathology centres. A total of 198,709 biopsy specimens were surveyed. Sociodemographic data and clinicopathologic characteristics were analysed. A total of 2017 cases of ACs (1.0%) and 850 cases of LSCCs (0.4%) were recorded. A strong fair-skinned (> 87%) male (> 70%) predilection was observed in both conditions. The mean age was 54.8 ± 18.7 for individuals with AC and 57.8 ± 19.0 for individuals with LSCC. The most commonly affected site was the lower lip (> 90%). This is a large multicentre study of AC and LSCC from Brazil. The frequency and clinicopathological features of AC and LSCC were similar to those described worldwide. This study provides robust and representative epidemiological data of these conditions for the scientific community.

Requirements engineering is a crucial stage for the success of any software, as it allows a better understanding of the needs and desires of the customers or future users. In software development for autistic users, inexperienced software engineers face difficulties in the requirements engineering stage, as there are few specific techniques and artifacts to gather requirements in such context. The challenges increase when considering low-functioning autistic people, who have the most severe limitations of the disorder. Considering the above, in this paper, we present two artifacts to support the elicitation of requirements in software projects for autistic users. We developed a set of interviewing questions based on the opinion of both software development practitioners and caregivers. Also, we have drawn inspiration in a commercial canvas model to synthesize relevant data obtained with the interviews. When validating the artifacts, we got indicators of the feasibility of applying the artifacts in an actual development project. By developing and integrating these artifacts, we intend to support the requirements engineering stage and continue their development and study in further contexts.

PURPOSE Adenocarcinoma is the most common histologic subtype of non–small-cell lung cancer, representing 40% of all diagnoses. Several biomarkers are currently used to determine patient eligibility for targeted treatments, including analysis of molecular alterations in EGFR and ALK, as well as programmed death-ligand 1 (PD-L1) protein expression. Epidemiologic data reporting the frequency of these biomarkers in Brazilian patients with lung adenocarcinoma (LUAD) are limited, and existing studies predominantly included patients from the southeast region of the country. MATERIALS AND METHODS The goal of this study was to investigate the frequency of somatic mutations in the EGFR, KRAS, NRAS, and BRAF genes, ALK, and PD-L1 expression in a series of Brazilian patients diagnosed with LUAD predominantly recruited from centers in southern Brazil. Molecular analysis of the EGFR, KRAS, NRAS, and BRAF genes was performed by next-generation sequencing using DNA extracted from tumor tissue. Immunohistochemistry was used to detect ALK and PD-L1 expression. RESULTS Analysis of 619 tumors identified KRAS mutations in 189 (30.2%), EGFR mutations in 120 (19.16%), and BRAF mutations in 19 (3%). Immunohistochemistry demonstrated ALK and PD-L1 expression in 4% and 35.1% of patients, respectively. CONCLUSION To our knowledge, this is the first study investigating the molecular epidemiology of patients with LUAD from southern Brazil and the largest assessing the frequency of multiple predictive biomarkers for this tumor in the country. The study also reveals a distinct mutation profile compared with data originating from other regions of Brazil.

Spasticity is one of the most important and residual signs after pyramidal and para-pyramidal catastrophic lesions after diverse neurological insults, including stroke, brain and spine trauma and post-radiation; infection and immunological diseases affecting nervous system, between others. Spasticity is normally a compensatory motor mechanism that could ameliorate the patients´ disability. Nevertheless, disastrous spasticity is described when the extremities force is diminished in the affected limbs, or when is impossible to wake o to take objects, maximum when hand or foot deformity is exposed. The objective of this chapter is centered in the neurosurgical treatment of spasticity, including brain lesions with specific targets and the spine with its different modalities. This review shows not only the basic aspects in these techniques, but also the option of infusion pumps and deep brain stimulation. To close, a proposal is stablished to determinate the possible path to treat the spasticity in the future.

Empathizing with the software’s future users allows knowledge of their willingness and needs, enabling interfaces more attractive. Similarly, empathizing with autistic users is, above all, understanding their limitations and try to see things and people from their perspective. Despite the importance of the empathizing process, traditional requirements survey methods do not allow this for the autistic audience, mainly for those considered low-functioning. A low-functioning autistic users have a more significant impairment of their skills. Thereby, there is a need for methods that consider their difficulties and support the software requirements elicitation process for autistic users. Therefore, this paper proposes the ACF (Autistic’s Characterization Form), composed of sections representing the four areas of impairment of an autistic person. With the ACF, we provide a set of characteristics representing enough information to support generating empathy between a designer and an autistic person during the requirements gathering phase. We also present a graph called AOG (Autistic’s Overview Graph), which shows the disability rate of the autistic person in each area of limitation of the disorder. Through this work, we intend to support interface designers willing to build empathy during the user interfaces’ requirements elicitation and creation processes.

When developing software for autistic people, the design techniques have to ensure that the physical and cognitive conditions do not prevent the interaction with the software. Empathy Map is an important tool for most of interface projects. However, the tool's components related to "Listen", "Think and Feel", "See", and "Say" may be problematic for autistic users with low/medium degree of functioning, therefore requiring adaptation. This is due to cognitive impairment and limitations caused by this disorder on verbal communication. To address these issues, this work presents the initial proposal of EmpathyAut which is based on the traditional Empathy Map model, but has sections that are more compatible with the reality of autistic people. The main EpathyAut goal is to improve empathy between the interface designers and autistic users. The EmpathyAut covers the autistic people's main affected areas, namely interaction, communication, behavior, and cognition.

Personas has been an important support mechanism in interfaces design. They represent, hypothetically, behavior synthesis, main characteristics, motivations and expectations of real users. Through Personas, empathy can be generated between interface designers and future software end-users. However, when these end users are autistic, this challenge is even bigger due to the lack of specific knowledge of some designers / developers on the autism subject. Another reason is the fact that low functioning autistic users (the audience selected for this research) have difficulty expressing themselves verbally. This work presents the PersonAut, which is a specific Personas Model for autistic individuals. Our goal is to support the designer / developer in the interface design activity so that they can create empathy in order to meet the needs of the autistic users. The main contribution of the PersonAut is to make the personas design faster and easier, in the context of software development for autistic people, through the use of diverse and specialized data sources for autistic individuals.

Pneumonia is highly dangerous for children and is the disease that most kill for those under 5 years. For rapid diagnosis, it is common to require chest x-ray, which is a difficult image for reading and interpret, requiring an expert physician. It is important to provide computational methods to help exam interpretation or enhance important information. This paper proposes an approach of transfer learning to automatic semantic segmentation of lungs in a pediatric chest x-ray image based on knowledge acquire in other datasets. The results are promising and reaches 0.917 of Dice using U-Net combined with InceptionV3 in a chest x-ray dataset without lung annotation.

Objetivo: determinar a expressão de neurotrofinas e seus receptores tirosina quinases em pacientes com osteossarcoma (OS) e sua correlação com desfechos clínicos. Métodos: biópsias de tumores primários de pacientes com OS tratados em uma única instituição, consecutivamente, entre 2002 e 2015, foram analisados através de imuno-histoquímica para expressão de receptores de tirosina quinase A e B (TrKA e TrKB), fator de crescimento neural (NGF) e fator neurotrófico derivado do cérebro (BDNF). De forma independente, dois patologistas classificaram os marcadores de imuno-histoquímica como negativos (negativos e focais fracos) ou positivos (moderado focal/difuso ou forte focal/difuso). Resultados: foram analisados dados de 19 pacientes (10 do sexo feminino e 9 do masculino) com mediana de idade de 12 anos (5 a 17,3 anos). Dos tumores, 83,3% estavam localizados em membros inferiores e 63,2% dos pacientes eram metastáticos ao diagnóstico. A sobrevida global em cinco anos foi de 55,3%. BDNF foi positivo em 16 pacientes (84%) e NGF em 14 pacientes (73%). TrKA e TrKB apresentaram coloração positiva em quatro (21,1%) e oito (42,1%) pacientes, respectivamente. A análise de sobrevida não demonstrou diferença significativa entre receptores TrK e neurotrofinas. Conclusão: amostras de OS primário expressam neurotrofinas e receptores TrK através de imuno-histoquímica. Estudos futuros podem auxiliar na identificação do papel das mesmas na patogênese do OS e determinar se há possível correlação prognóstica. Objective: to determine the expression of neurotrophins and their tyrosine-kinase receptors in patients with osteosarcoma (OS) and their correlation with clinical outcomes. Methods: we applied immunohistochemistry to biopsy specimens of patients consecutively treated for primary OS at a single institution between 2002 and 2015, analyzing them for expression receptors of tyrosine kinase A and B (TrKA and TrKB), neural growth factor (NGF) and brain derived neurotrophic factor (BDNF). Independently, two pathologists classified the immunohistochemical markers as negative (negative or weak focal) or positive (moderate focal/diffuse or strong focal/diffuse). Results: we analyzed data from 19 patients (10 females and 9 males), with median age of 12 years (5 to 17.3). Tumors’ location were 83.3% in the lower limbs, and 63.2% of patients had metastases at diagnosis. Five-year overall survival was 55.3%. BDNF was positive in 16 patients (84%) and NGF in 14 (73%). TrKA and TrKB presented positive staining in four (21,1%) and eight (42,1%) patients, respectively. Survival analysis showed no significant difference between TrK receptors and neurotrophins. Conclusion: primary OS samples express neurotrophins and TrK receptors by immunohistochemistry. Future studies should explore their role in OS pathogenesis and determine their prognostic significance in larger cohorts.

Objective The objective of this study was to describe the clinicopathological, molecular, and prognostic features of oral/oropharyngeal diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma. Study Design All cases were retrieved from 7 Brazilian institutions. Immunohistochemical reactions were performed to confirm the diagnoses and to categorize the tumors. In situ hybridization was used to detect Epstein-Barr virus (EBV) and fluorescence in situ hybridization was used to identify gene rearrangements. Results Most cases involved the oral cavity (76.8%). Males and females, with a mean age of 60 years, were evenly affected. Tumors mostly presented as painful swellings. Forty cases represented germinal center B-cell type (58%). Five cases presented double-hit translocation and 3 harbored rearrangement for MYC/BCL2/BCL6. EBV was detected in 3 cases (4.3%). The 5-year overall survival was 44.4%. Female sex, presence of pain and ulcer, microscopic “starry sky pattern” and necrosis, co-expression of c-Myc/Bcl2, and translocation of MYC were associated with a lower survival in univariate analysis (P = .05, P = .01, P = .01, P = .03, P = .05, P = .006, P = .05, respectively). Conclusion Patients affected by oral/oropharyngeal DLBCL have a low survival rate. High-grade B-cell lymphoma (17.7%) and EBV‐positive DLBCL, not otherwise specified (4.3%) account for a small number of cases.

Osteosarcoma is the most common primary neoplasm of the bone, typically affecting the metaphysis of femur or tibia in children or young adults. Metastasis of osteosarcoma in the oral cavity is rare. An 18-year-old male presented gingiva swelling with 1-month duration. Medical history revealed osteosarcoma in femur diagnosed in 2016 with metastasis in lung, mediastinum, and tibia. Intraorally, a lobulated nodule with ulcerative surface, measuring 2.0 x 2.0 cm was observed in left buccal and lingual attached gingiva surrounding teeth 37 and 38. The diagnostic hypothesis included non-neoplastic reactive lesions and metastasis of osteosarcoma. An incisional biopsy was performed, and histopathological diagnosis was compatible with osteosarcoma. The patient maintained palliative chemotherapy; however, he died 2 months after the metastasis diagnosis due to osteosarcoma complications.

American tegumentary leishmaniasis (ATL) is the most common form of leishmaniasis that promote cutaneous and mucosal lesions. It represents a parasitic disease caused by protozoa of the genus Leishmania sp., transmitted by the bite of naturally infected sandflies of the genus Lutzomyia. A 51-year-old male patient attended the medical service reporting weight loss, hoarseness, hemoptysis, dysphagia, and dyspnea. Clinical and videolaryngoscopic examination revealed an ulcerated, granulomatous, friable lesion, extending to the soft palate, nasopharynx, and supraglottic larynx. Patient reported 1-year evolution, with no response to previous antifungal treatment. In medical history, patient described having had leishmaniasis 30 years ago. The hypotheses of diagnosis were fungal/parasitic infection, malignant neoplasm, and autoimmune disease. Incisional biopsy was performed, with the presence of extra and intracellular Leishmania parasites in the microscopic analysis. Fungi and bacteria analysis were negative. Treatment with liposomal Amphotericin B was proposed; however, patient refused treatment and requested hospital discharge.

A 23-year-old man presented with facial asymmetry without symptoms. The panoramic radiographic revealed a unilocular radiolucent area in the jaw associated tooth elements floating inside the lesion without root resorption. Tomographic examination presented cortical reabsorption. Diagnostic hypotheses were keratocyst odontogenic (KO), ameloblastoma or other odontogenic tumor. Partial biopsy was performed because of extensive lesion. During the surgery, macroscopy appearance was friable capsule with an elastic, yellow, and consisted mass. The histologic analysis show presence of cystic cavity coated by orthokeratinized stratified squamous epithelium with prominent granular layer in addition to the presence of dense fibrous connective tissue capsule. Histologic diagnosis was orthokeratinized odontogenic cyst (OOC). For a long time OOC was defined as an uncommon variant of the KO and just in 2005, the World Health Organization considered distinct pathologic entities because of molecular differences, biological behavior, and relapse rates.

e22081 Background: Targeting the hedgehog (HH) protein family pathway has consistently shown activity in locally advanced and metastatic BCC. Itraconazole is an affordable agent with known toxicity profile that demonstrates in vitro HH signaling inhibition, suggesting a possible role in BCC treatment. Initial results of a phase 2 study designed to investigate efficacy of Itraconazole as neoadjuvant treatment in patients with resectable BCC are reported. Methods: Eligible pts had biopsy-proven resectable BCC, ECOG PS 0-3, adequate organ function and measurable disease. Dosing of I consisted of 200mg twice daily for 60 days followed by surgery. Simon two-stage design was used to test a null rate of 5% vs. 20% (power = 0.80; α = 0.05, unilateral). If ≥1 of 13 pts in stage 1 have objective response (OR) according to RECIST 1.1 criteria, 14 more pts will be enrolled. If ≥4 of 27 pts have OR, the treatment is worthy of further study. Secondary endpoints include safety and change in Ki-67 and Gli1. Results: Thirteen pts with 14 measurable lesions enrolled from Jan/2018 to Feb/2019; 1 pt was not evaluable, but was included in safety analysis. Demographics and outcomes are summarized in Table. After 60 days of treatment, all patients had R0 resection as primary planned and 1 (8.3%) PR was observed. There were no progressions during the study. OR rate was 8.3%. No grade 3 AE or SAE were reported. 6 pts had grade 1 or 2 AEs at least possibly related to I including depression, headache, GPT elevation, diarrhea, abdominal pain and bilirubin elevation. Conclusions: Itraconazole showed initial anti-tumor activity in pts with resectable BCC, no safety concerns were observed. Study will proceed to Simon’s second stage. Clinical Trial Information: NCT03972748 , 47011715.0.0000.5327 . [Table: see text]

A 45-year-old man presented with an extensive gingival growing disseminated in the jaws, leading to limitations with eating, talking, and mouth closure. The diagnostic hypothesis was lymphoma. A test for human immunodeficiency virus (HIV) was positive. An incisional biopsy was performed and histopathologic analysis was compatible with lymphocytic malignant neoplasm (unspecified). At subsequent immunohistochemical analysis, a diagnosis of diffuse large B-cell lymphoma was rendered. The patient was referred to a hematologist and started on chemotherapy. Initially, a significant clinical improvement was seen and the patient remains under treatment. The patient is in clinical and radiographic control, without mouth lesions. The World Health Organization classifies lymphomas into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Based on morphologic aspects and immunohistochemistry, these tumors may be classified as B-cell, T-cell, and natural killer cell type. The B-cell origin comprises about of 85% of lymphomas and presents immunoreactivity for markers like CD20 and CD79a.

A 32-year-old white woman was referred for evaluation of palate lesion with 3 months’ duration. Medical history included recent investigation for tuberculosis due to the presence of nodules detected on chest radiograph and previous treatment for syphilis. The patient exam revealed nasal obstruction, cough, secretion drainage, and weight loss. Extraoral examination showed erythema and edema in the face. Moreover, erosive lesions, crusts and purulent drainage were observed in the nasal area. Intraorally, an extensive necrotic lesion with bone destruction and exposure, midline palatal perforation was detected. Differential diagnosis included tertiary syphilis, leishmaniosis, tuberculosis, deep mycosis, Wegener granulomatosis, maxillary sinus carcinoma, and T-cell/natural killer (T/NK) lymphoma. Hematologic tests were negative for infectious diseases. Incisional biopsy followed by histopathologic examination revealed an unspecified malignant neoplasm. Epstein-Barr virus (EBV) was positive in the sample. T/NK lymphoma diagnosis was supported by morphologic aspects and immunohistochemical profile. Treatment comprised radiotherapy, and a partial remission was observed. The patient remains under follow-up care.

A 63-year-old white male presented with maxillary gingival swelling for a 6-month duration. Medical history revealed diabetes and hypertension. Extraoral examination was noncontributory. Intraoral exam showed a red bleeding lobulated nodule measuring 5.0 × 3.0 cm in the left maxillary gingiva. The presumptive diagnosis was nonneoplastic reactive lesion. An incisional biopsy was performed and histopathologic diagnosis was unspecific malignant neoplasm. The initial immunohistochemical panel was inconclusive. The panoramic radiography showed extensive bone destruction in the left maxilla. Abdominal and chest computed tomography (CT) revealed lesions in the liver, kidney, and lung. Magnetic resonance imaging (MRI) of the central nervous system (CNS) showed nodules in left parietal lobe. An ultrasound-guided biopsy of the right kidney confirmed the diagnosis of clear cell renal carcinoma, with metastasis to the liver, lung, CNS, and oral cavity. The treatment combined surgery, palliative chemotherapy, and radiotherapy with partial remission of the lesions. The patient remains under treatment.

A 23-year-old woman was referred with maxillary swelling for a 6-month duration. In her medical history, the patient revealed a surgery for ameloblastoma 8 years earlier. Extraoral examination revealed a swelling over the right side of face, lifting her lip and nose. Intraorally, a firm, reddish, nodular swelling involving the right maxilla was observed. Computed tomography (CT) showed a hypodense image invading the right maxilla, maxillary sinus, and nasal fossa. An incisional biopsy was performed, followed by histopathologic examination and immunohistochemical panel, which led to the diagnosis of ameloblastic carcinoma. The patient underwent a total resection of the lesion and an immediate obturator prosthesis was placed. Four months after the surgery, the patient was rehabilitated with a temporary obturator and no recurrence was detected.

Background: The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) published, in Nov/2013, the interpretive guidelines for HER2 testing of breast cancer patients. This aimed to improve the accuracy of HER2 testing and its utility as a predictive marker in invasive breast cancer. The former version of these criteria was written in 2007. Objectives: to compare the HER2 immunohistochemical (IHC) analysis using the 2007 versus 2013 algorithms in a cohort of breast cancer cases diagnosed in a single institution in Southern Brazil. The cases were previously classified as HER2 1+ or 2+, using the 2007 criteria. Methods: the sample included 100 invasive breast cancer cases. The HercepTest (Dako, Denmark) was used for determination of HER2 expression. The HER2 testing was analyzed independently by two pathologists. The FISH analysis was done using a HER2/D17Z1 probe set. Preliminary Results: The HER2 IHC interpretation changed in 11/69 (15.9%) cases: 8.7% negative or equivocal cases by the 2007 guidelines were positive by the 2013 classification and 7.2% of HER2 1+ cases became equivocal (p Citation Format: Juliana Giacomazzi, Carolina R Hartmann, Diego D Paskulin, Luis Fernando Rivero, Maira Caleffi, Alessandro C Pasqualotto, Marcia S Graudenz, Daniela D Rosa. The ASCO/CAP guideline update for HER2 testing increases the number of breast cancer patients eligible for HER2-targeted therapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-15-22.

Autistic people belong to a group with heterogenic conditions that are considerable dynamic. There are several applications specific for autistic users to support their treatment. However, several works do not describe the process for choosing the interface elements to differentiate the specific aspects for such audience. These aspects are important, since an interface containing attractive elements for autistic people can provide a better interaction. This paper presents a study to identify the preferences of autistic children with regards to the interface components. The study was divided in two stages: (a) regarding the view of practitioners that deal directly with the children and with the presence of the researchers; and (b) with the presence of the practitioners, but without the presence of the researchers. This paper also presents the identified aspects, developing a collaborative repository to store recommendations that support the design of interfaces that are specific for autistic children.

Objective: To perform a prospective analysis on the effects of unilateral lesion versus unilateral electrical stimulation (ES) of the globus pallidus internus (Gpi) in the treatment of bilateral Parkinson’s disease (PD). Materials and Methods: We studied 18 patients with stages III–V on the Hoehn and Yahr (H-Y) scale having prominent rigidity, bradykinesia and gait disturbances. Nine patients were treated with lesions and 9 patients with ES. Both groups were evaluated using the New York Parkinson’s Disease Scale, the Unified Parkinson’s Disease Rating Scale part III, and the H-Y scale and with specific items of tremor, rigidity and bradykinesia independently on each side. Both lesions and electrodes for ES were placed stereotactically in the Gpi as confirmed by postoperative magnetic resonance images. Significance of changes was evaluated with the Wilcoxon test after 3 and 6 months. Significance of intergroup differences was evaluated using the Mann-Whitney U test. Results: Lesions and ES significantly decreased rigidity (p < 0.01) and bradykinesia (p < 0.005) in the contralateral extremities. ES significantly decreased tremor in the contralateral extremities (p < 0.01) and rigidity and bradykinesia ipsilaterally (p < 0.01) at 3 months. There were no significant intergroup differences. The H-Y scale score showed improvement in self-sufficiency. L-DOPA dose was decreased by 31%. Conclusions: ES was a safer procedure and more efficient in controlling PD symptoms. Unilateral lesions and ES may improve bilateral symptoms to the point of making patients self-sufficient.

Ninety-one Helicobacter pylori-positive patients with nonulcer dyspepsia were randomized to receive either lansoprazole, amoxicillin, and clarithromycin or lansoprazole and placebo. A validated questionnaire assessed dyspeptic symptoms at baseline and at 3, 6, and 12 months. Endoscopies and biopsies were performed at baseline and at 3 and 12 months. There was an overall trend, although not statistically significant, for a benefit of H. pylori eradication. Of the patients in the antibiotics group, 16 of 46 (35%) had symptomatic improvement, versus 9 of 43 (21%) in the control group (P = 0.164). In a secondary analysis, it was found that of the patients without endoscopic gastric erosions, 15 of 34 (44%) in the antibiotics group and 5 of 33 (15%) of controls had symptomatic improvement (P = 0.015). Helicobacter pylori eradication did not prove to be clinically beneficial, although a tendency to symptomatic benefit was detected. Further studies are necessary to confirm the implications of endoscopic gastric erosions in these patients.

Web flow is an optimal perceived user experience which improves the user orientation and navigational behaviors towards Web applications. In order for Web applications to achieve Web flow in terms of navigation, it is necessary to enhance their degree of user interaction. However, despite their importance, user interaction features that can improve ease of use and navigation are mostly evaluated late in development. This paper presents practical findings from applying proposed Design Usability Evaluation (DUE) technologies. Such technologies allow the usability inspection of Web applications mockups to reduce the cost of identifying and fixing navigation and ease of use problems early in the development process. We planned an empirical study to evaluate: (a) the capability of applying these technologies without training, and (b) the perceived ease of use and utility of the technologies, using the Technology Acceptance Model. The results show that the DUE technologies could be used without training to find problems affecting navigation and ease of use of Web applications. Also, practitioners agreed that using the DUE technologies could enhance their performance during an inspection. Finally, we provide a list of some of the identified user interaction problems that, if avoided, could aid in the improvement of Web flow.

The objective of this study was to verify the frequency of p53 and BCL-2 immunohistochemical expression in patients with endometrial carcinoma and to correlate it with histological factors (histological type, tumor grade, depth of myometrial invasion, lymph node involvement and surgical staging) and survival. Forty-eight patients with endometrial carcinoma who were submitted to primary surgical treatment were assessed. p53 and BCL-2 immunohistochemical expression was determined using paraffin blocks containing the tumor area. p53 and BCL-2 expression was detected in 39.6% and 58.3% of the tumors, respectively. No significant difference was found regarding the frequency of p53 expression when analyzing histological type (33.3% in endometrioid tumors, 58.3% in non-endometrioid tumors; p = 0.176), depth of myometrial invasion (p = 0.632) and surgical staging (I—11.1%, II—66.7%, III—57.1%; p = 0.061). p53 expression was significantly more frequent in undifferentiated tumors (p = 0.007) and in those showing lymph node involvement (p = 0.030). Univariate analysis showed a positive association with death (RR, 3.358; CI, 1.386–8.134; p = 0.005) and short-term survival. The present study did not reveal any correlation between BCL-2 expression and histopathologic markers or survival. In conclusion, this study showed that p53 expression is directly correlated with undifferentiated tumors, lymph-node involvement and risk of death. On the other hand, BCL-2 expression was not correlated with any known histological factors.

Summary Background : The protective role of Helicobacter pylori in gastro-oesophageal reflux disease has been widely discussed. Aim : To assess the risk of reflux oesophagitis in patients with functional dyspepsia after treatment for H. pylori infection. Methods : A randomized, placebo-controlled, investigator-blinded trial was carried out on 157 functional dyspeptic patients. Patients were randomized to receive lansoprazole, amoxicillin and clarithromycin (antibiotic group) or lansoprazole and identical antibiotic placebos (control group). Upper gastrointestinal endoscopy was performed at baseline, 3 and 12 months after randomization. The primary aim was to detect the presence of reflux oesophagitis. Analyses were performed on an intention-to-treat basis. Results : A total of 147 patients (94%) and 133 (85%) completed 3 months and 12 months follow-up, respectively. The eradication rate of H. pylori was 90% in the antibiotic group (74 of 82) and 1% (one of 75) in the control group. At 3 months, reflux oesophagitis was diagnosed in 3.7% (three of 82) in the antibiotic group and 4% (three of 75) in the control group (P > 0.2). At 12 months, diagnosis was established in five new cases within the first group and in four within the second (P > 0.2). No difference was found in heartburn symptoms. Conclusions : H. pylori eradication does not cause reflux oesophagitis in this western population of functional dyspeptic patients.

Pleuropulmonary blastoma (PPB) is a rare and aggressive malignant tumor of the lung. Approximately 80 cases of PPB have been published, and in only three cases high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) was applied. A 5-year-old girl presenting with cough, fever, and shortness of breath was referred to the authors in March 1999. A computed tomography scan of the chest showed a tumor mass in the left hemithorax. The lesion was biopsied and the histopathologic report suggested the diagnosis of PPB. The patient received chemotherapy comprising vincristine, actinomycin D, and cyclophosphamide with only a minor response, and treatment was switched to ifosfamide, carboplatin, and etoposide, which produced a partial response. Tumor resection was performed, but margins were positive for PPB. Due to the high risk of recurrence, the authors elected to administrate high-dose chemotherapy using melphalan, etoposide, and carboplatin, followed by autologous HSCT. The patient achieved complete hematologic recovery, and reimaging after HSCT showed no evidence of disease. She relapsed 4 months later and died about 9 months after the completion of high-dose therapy. The role of high-dose chemotherapy and autologous HSCT is likely to be limited in PPB.