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Chromophobe renal cell carcinoma (CRCC) may be grossly and microscopically confused with oncocytoma. It is now believed that many, if not all, of the so-called malignant oncocytomas or oncocytomas with metastases reported in the literature were indeed chromophobe renal cell carcinomas. CRCC is characteristically positive for colloidal iron and shows cytoplasmic microvesicles in electron microscopy. This study of CRCC is thought to be the first one done in Latin America. Of a total of 106 renal epithelial neoplasms, 7 (6.6%) fulfilled the criteria for chromophobe renal cell carcinoma. This frequency in Brazil is similar to that in other parts of the world. There was no difference in age, sex, and race distribution of CRCC compared to usual renal epithelial tumors. Grossly, the CRCC ranged in size from 3.5 to 20 cm (average: 10.2 cm) in greatest dimension. Most frequently, the tumor was brown on the cut surface. The growth pattern showed compact areas in all tumors and, in most of the cases, both clear and eosinophilic cellular subtypes were seen. The electron microscopic findings favor an origin of the microvesicles from outpouchings of the outer membrane of mitochondria. The strong positivity for colloidal iron in spite of the destruction of the cytoplasmic vesicles in paraffin-embedded specimens seems to indicate that the acid mucopolysaccharides are not located inside the microvesicles. By the time of diagnosis, only one case had regional lymph node metastases and this particular case was the only one mixed (associated with the usual renal cell carcinoma). The follow-up examination after nephrectomy showed that prognosis seems to be favorable in CRCC, except when the tumor coexists with the usual renal cell carcinoma.

The existence of an association between autoimmune phenomena and lymphoproliferative neoplasms is well known. In Campinas at the University Hospital, seventy-seven adult patients with non-Hodgkin's lymphoma (NHL) were studied at diagnosis. The histological subgroup of NHL was performed using Kiel criteria and all patients were characterized by clinical and laboratory examinations according to the Ann Arbor staging. The results of the immunohaematological evaluation of our patients with NHL showed that: 28% presented erythrocyte autoantibodies (auto anti-I or auto-IgG without specificity) but only one developed haemolytic anaemia. There was a weak correlation between low-grade lymphoma and erythrocyte autoantibodies.

The crude latex of Crown-of-Thorns (Euphorbia milii var. hislopii) is a potent plant molluscicide and a promising alternative to the synthetic molluscicides used in schistosomiasis control. The present study was undertaken to investigate the embryofeto-toxic potential of E. milii latex. The study is part of a comprehensive safety evaluation of this plant molluscicide. Lyophilized latex (0, 125, 250 and 500 mg/kg body weight) in corn oil was given by gavage to Wistar rats (N = 100) from days 6 to 15 of pregnancy and cesarean sections were performed on day 21 of pregnancy. The numbers of implantation sites, living and dead fetuses, resorptions and corpora lutea were recorded. Fetuses were weighed, examined for external malformations, and fixed for visceral examination, or cleared and stained with Alizarin red S for skeleton evaluation. A reduction of body weight minus uterine weight at term indicated that E. milii latex was maternally toxic over the dose range tested. No latex-induced embryolethality was noted at the lowest dose (125 mg/kg) but the resorption rate was markedly increased at 250 mg/kg (62.5%) and 500 mg/kg (93.4%). A higher frequency of fetuses showing signs of delayed ossification (control: 17.4%; 125 mg/kg: 27.4% and 250 mg/kg: 62.8%; P < 0.05 vs control) indicated that fetal growth was retarded at doses > or = 125 mg latex/kg body weight. No increase in the proportion of fetuses with skeletal anomalies was observed at the lowest dose but the incidence of minor skeletal malformations was higher at 250 mg/kg body weight (control: 13.7%; 125 mg/kg: 14.8%; 250 mg/kg: 45.7%; P < 0.05 vs control). Since a higher frequency of minor malformations was noted only at very high doses of latex which are embryolethal and maternally toxic, it is reasonable to conclude that this plant molluscicide poses no teratogenic hazard or, at least, that this possibility is of a considerably low order of magnitude.

The hemophagocytic syndrome (HS) is characterized by a clinical picture of fever, hepatosplenomegaly, lymphadenopathy and peripheral pancytopenia. The morphologic hallmark of this syndrome is the phagocytosis of hematopoietic elements by morphologically normal macrophages. HS is considered rare and may be a primary disease or associated to viral, infection, neoplasias or autoimmune diseases. Treatment is controversial and its evolution is often fatal. Anatomo-pathological evaluation shows the phenomenon of hemophagocytosis in several organs, especially the hematopoietic tissues. We describe a case of HS, discuss its possible causes, its clinical and pathologic features, its pathophysiology and therapeutic possibilities.

Mielodysplastic syndromes (MDS) are clonal disorders of the hemopoietic stem cell. About one third of the cases terminate in an acute leukemia, usually acute myeloblastic leukemia. However, few cases of transformation into acute lymphoblastic leukemia (ALL) have been described. We present a case of refractory anemia that transformed into ALL two months after diagnosis and was successfully treated with conventional chemotherapy. Two years later a hyperfibrotic form of MDS was detected in the patient, that soon after terminated in acute megakaryoblastic leukemia. The course of MDS in the present case provides evidence that MDS can involve a pluripotent stem cell, presenting clonal evolution, documented by successive changes in its clinical and hematological features.

In this work we have studied the respiratory burst and chemotaxis of polymorphonuclear leukocytes from 51 workers exposed to chlorinated compounds, which were compared with those of non-exposed, age- and sex-matched individuals. These two neutrophil functions were significantly reduced as compared to controls. No correlation was observed between the length of exposure, hexachlorobenzene (HCB) blood concentrations and neutrophil chemotaxis or the extent of nitroblue tetrazolium reduction.

Purpose: To determine the cumulative incidence and risk factors of in-hospital death due to acute myocardial infarction (AMI) in the thrombolytic era and to assess the degree of incorporation of new therapeutical interventions to the treatment of AMI in Salvador, Brazil., Methods: A retrospective study based on medical records of 388 patients hospitalized with an AMI in different hospitals between January 1993 and December 1994. The relative risk (RR) was used as a measure of association for the unadjusted analysis. To control for possible confoundears and to assess interactions, odds ratios (OR) were used to estimate the RR, by logistic regression models., Results: During the hospitalization period 50 (12.9%) patients died. The main predictors of hospital mortality in the unadjusted comparisons were older age (age > 60 years) (RR = 2.76; p < 0.01), female gender (RR = 2.08; p = 0.01), Killip class > 1 (RR = 5.73; p < 0.01), anterior wall AMI (RR = 1.92; p = 0.02), previous stroke (RR = 4.13; p < 0.01) and systemic disease (RR = 2.76; p < 0.01). In the multivariate analysis, older age (OR = 2.42; p = 0.02), Killip class > 1 (OR = 7.14; p < 0.01), anterior wall AMI (RR = 2.37; p = 0.02) and previous stroke (RR = 2.34; p = 0.04) were the main independent predictors of hospital death. Thrombolytic therapy was used in 143 patients (36.8%), aspirin in 322 (83%), beta blockers in 204 (52.6%) and heparin in 248 (63.9%). Cardiogenic shock was responsible for more than half of the death cases., Conclusion: Based on the data presented, older age, Killip class and anterior wall infarction are still important predictors of death due to AMI in the thrombolytic era, confirming other studies.

A prospective study was undertaken to elucidate the clinical and laboratory differences between de novo acute myeloid leukemia (AML) and AML with trilineage myelodysplasia (AML-TMDS). One hundred and seven patients with AML were diagnosed at the University Hospital between January 1987 and July 1992, and were followed until July 1995. TMDS was identified in 17 of them (16%). With regard to age and sex distribution no difference was found between AML patients with and without TMDS (p = 0.43, p = 0.54, respectively). The duration of symptoms at presentation in AML-TMDS was similar to those observed in de novo AML (p = 0.29). Hemoglobin values and platelet counts were similar in both groups of patients (p = 0.45, p = 0.44, respectively). However, peripheral white blood cell and neutrophil counts, as well as blast counts in AML-TMDS patients were lower than those observed in AML without TMDS patients (p < 0.001 for all of them). Bone marrow blast counts in de novo AML were higher than the values observed in AML-TMDS patients (p < 0.001). TMDS occurred predominantly in M2 and M6 FAB types, and was absent in the M3 type. Bone marrow histology showed no particular feature that could be of diagnostic relevance. The remission rates were similar in both groups of patients (p = 0.55). The same was true for the probability of disease-free survival and overall survival during the period of study (p = 0.50, p = 0.33, respectively). These results suggest that: 1) in AML-TMDS patients, leukemia transformation occurs in a more undifferentiated pluripotent stem cell, leading to a dysplastic residual hemopoiesis besides the blast proliferation; 2) the incidence of TMDS in our group of patients did not influence the clinical outcome after treatment of the disease.

Health surveillance for hazardous situations due to chemical exposure, in particular those which are carcinogenic, requires sensitive monitoring tests. Although experimental studies have shown the genotoxic and carcinogenic effect of several organochlorides, the lack of epidemiologic studies prevents their classification as carcinogenic to human beings. In this context, genotoxicity tests of short duration in human cells gain importance. The relation between the clastogenic effects (chromosome breaks) and cancer induction is already known to the scientific literature. The micronucleus test has been proposed as a good indicator of clastogenesis. In the present study, we evaluated, by means of the micronucleus test, 41 workers of a chemical industry in the state of São Paulo, southeast region of Brazil, who had been exposed to a mixture of chlorinated solvents (carbon tetrachloride, perchloroethylene, and hexachlorobenzene) and 28 workers who had not been exposed. Peripheral lymphocytes stimulated by phytohemagglutinin and with cytokinesis blocked by cytochalasin B were used. The results showed that the exposed workers presented a statistically significant higher frequency of micronuclei than the group which had not been exposed.

Neurofilaments subunits (NF-H, NF-M, NF-L) and glial fibrillary acidic protein (GFAP) were investigated in the hippocampus of rats after distinct periods of reperfusion (1 to 15 days) following 20 min of transient global forebrain ischemia in the rat. In vitro [14Ca]leucine incorporation was not altered until 48 h after the ischemic insult, however concentration of intermediate filament subunits significantly decreased in this period. Three days after the insult, leucine incorporation significantly increased while the concentration NF-H, NF-M, and NF-L were still diminished after 15 days of reperfusion. In vitro incorporation of 32P into NF-M and NF-L suffered immediately after ischemia, but returned to control values after two days of reperfusion. GFAP levels decreased immediately after ischemia but quickly recovered and significantly peaked from 7 to 10 days after the insult. These results suggest that transient ischemia followed by reperfusion causes proteolysis of intermediate filaments in the hippocampus, and the proteolysis could be facilitated by diminished phosphorylation levels of NF-M and NF-L.

alpha-Terpinene (1-isopropyl-4-methyl-1,3-cyclohexadiene) (TER) is a monoterpene found in the essential oils of a large variety of useful plants. Despite the widespread use of plants and essential oils containing TER in folk medicine potions and cosmetics, and as a flavouring food additive, toxicity studies of this monoterpene are scarce. The present study was undertaken to provide data on the embryofoetotoxic potential of TER in the rat. TER (30, 60, 125 and 250 mg/kg body weight) in corn oil was given by gavage to female Wistar rats from day 6 to 15 of pregnancy. Caesarean sections were performed on day 21 of pregnancy. The number of implantation sites, living and dead foetuses, resorptions and corpora lutea were recorded. All foetuses were weighed, examined for externally visible malformations, numbered with a marker pen and fixed in 5% formalin solution. One-third of the foetuses of each litter, chosen at random, were evaluated for visceral anomalies by a microsectioning technique. Heart, lungs, thymus, liver, spleen and kidneys of foetuses that were microdissected were also weighed. The remaining foetuses were examined for skeletal malformations after clearing with potassium hydroxide and staining with Alizarin Red S. A reduction in body weight minus uterine weight at term indicated that the two highest doses tested [125 and 250 mg TER/kg body weight orally] were maternally toxic. No increase in the ratio of resorptions/implantations was observed over the dose range tested. The highest dose of TER (250 mg/kg body weight) reduced the ratio of pregnant/treated female. A decrease in foetal body weight and an increase in foetal kidney weights were noted at 250 mg TER/kg body weight. Signs of delayed ossification (poorly ossified and not ossified bones as well as irregular spongy bones) and a higher incidence of minor skeletal malformations were observed at doses of 60 mg/kg body weight or more. These findings indicate that the no-observed-adverse-effect level for TER-induced embryofoetotoxicity can be set at 30 mg/kg body weight by the oral route.

Purpose: To determine the rate of utilization and reasons for exclusion from thrombolytic therapy in acute myocardial infarction (AMI) in the setting of Intensive Care Unit (ICU) Salvador-BA., Methods: Retrospective cohort study recording patients admitted with suspected AMI in six ICU in Salvador-BA between January/93 and December/94 were reviewed., Results: Three hundred and eighty-eight of confirmed cases of AMI were analysed, 165 (42.0%) were admitted at public hospitals and 225 (58.0%) at private hospitals. Thrombolytic therapy was indicated in 143 (36.8%) patients. The thrombolysis was more frequently performed in men (PR = 1.96 IC 95% 1.39-2.77), in patients less than 60 years of age (PR = 4.46 CI 95% 2.17-9.19) and in those with Killip class I (PR = 2.62 CI 95% 1.60-4.31). The major reasons for excluding from thrombolytic therapy were late arrival, old age and lack of ST elevation. Thirty three percent of patients were excluded for more than one reasons. Multivariate analysis showed that female gender was associated with a reduced indication for thrombolytic therapy, independent of the clinical findings on admission., Conclusion: The frequency of the use and reasons for excluding patients from thrombolytic therapy in AMI in Salvador-BA were similar to those of other clinical studies. The recent recommendations of the Thrombolysis Brazilian Consensus will enhance the utilization of this therapy, as it expands its utilization to elderly patients and to those who arrive late to the hospital.

The anonymous seroprevalence of HIV and syphilis was studied by collecting umbilical cord blood samples from 5,815 women who gave birth in Campinas' hospitals throughout a six-month period. ELISA and Western blot were used for HIV, and VDRL and TPHA for Treponema pallidum screening. While maintaining the anonymity of the women, information was recorded on the hospital of origin, divided into university (public) and private hospitals, as well as on the form of payment (social security, private insurance or direct payment), age, marital status, education, employment and place of residence. Seroprevalence was 0.42 percent for HIV and 1.16 percent for syphilis. There was a significant correlation between a positive reaction to the two infections (p = 0.02). After univariate and logistic regression analysis, only university hospitals were shown to be associated with seropositivity for HIV, whereas the same variable and an older age were associated with syphilis. All positive reactions were found either in public hospitals or among social security patients treated at private institutions. The conclusion was that HIV infection is becoming almost as prevalent as syphilis among this population, and affects primarily the lower socio-economic strata. This suggests that routine, voluntary HIV serology should be considered and discussed with patients during prenatal or delivery care whenever a population shows a seroprevalence close to or greater than 1 percent.

Allogeneic blood stem cell (BSC) transplantation has been performed experimentally in some patients with success. Wider application of this therapeutic modality has been hampered ultimately by many factors, mainly the concern that infusion of large numbers of donor T cells could result in an increased incidence and severity of graft-versus-host disease (GVHD). We report the short-term results of 17 allogeneic BSC transplants in patients with hematologic malignancies. When compared to standard BMT results, BSC transplants showed the advantages of faster engraftment, shorter hospital stay and fewer antibiotic needs. The incidence and severity of GVHD, as well as the general BMT-associated morbidity, was comparable between the two groups. BSC collection by apheresis was well tolerated and associated with less morbidity for donors, probably reducing the cost of the treatment. The collection of BSC was a single apheresis procedure and yielded adequate numbers of stem cells to ensure engraftment. Although this was not a prospective randomized study, the data obtained are encouraging and warrant more prospective and controlled studies.

Two cases of peritonitis caused by Acremonium kiliense in patients receiving a continuous ambulatory peritoneal dialysis treatment are reported. Diagnosis was established by direct examination and cultures of dialysis effluent, secretion of catheter-exit-site and from the tip of the catheter. Management of fungal peritonitis includes catheter removal, since in this infection the result of systemic antifungal therapy is inconsistent.

Misoprostol (MSP) is a synthetic prostaglandin E1 methyl analogue indicated for the prevention of gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs). Because of its abortifacient properties, MSP has been extensively misused for abortion induction in Brazil. Since abortion induction with MSP very often fails and pregnancy continues to term, there has been increasing concern regarding the potential teratogenicity of this PGE1 analogue in humans. The objective of the present study was to evaluate the embryotoxicity of MSP in mice. A single dose of MSP (20 or 30 mg/kg body weight) was administered to Han:NMRI mice (ca 60 days old) by gavage on day 10 of pregnancy. The number of treated mice was as follows: control, 19; MSP 20 mg/kg, 10; MSP 30 mg/kg, 28. Cesarean sections were performed on day 18 of pregnancy and the number of resorptions and implantation sites were recorded. Fetuses were weighed, examined for external malformations, fixed, cleared and stained with Alizarin Red S for skeleton evaluation. No evidence of embryotoxicity was found at the lower dose tested. A slight and reversible deficit in pregnancy weight gain (day 10-11: control, 1.3 +/- 0.3 g; MSP 20 mg/kg, -0.9 +/- 0.9 g; MSP 30 mg/kg, -1.7 +/- 0.6 g) was the only sign of maternal toxicity noted in both groups of mice treated with misoprostol.(ABSTRACT TRUNCATED AT 250 WORDS)

Citral, 3,7-dimethyl-2,6-octadien-1-al, found in the essential oils of a large variety of useful plants, is used as a scenting agent in household products, as a fragrance in cosmetics, and as a food flavouring additive. This study was undertaken to investigate the embryofeto-toxic potential of citral in the rat. Citral (60; 125; 250; 500 and 1000 mg/kg) in corn oil was given orally to Wistar rats from day 6 to 15 of pregnancy. Caesarean sections were carried out on day 21 of pregnancy, and the number of resorptions and implantation sites were recorded. Fetuses were weighed, examined for external malformations, and fixed for visceral examination, or cleared and stained with Alizarin Red S for skeleton evaluation. A transient decrease in weight gain from days 6 to 11 of gestation at the lowest doses, and a reduction in body weight minus uterine weight at term at the highest doses, indicated that citral was maternally toxic over the dose range tested. A slight but statistically significant increase in the ratio of resorptions per implantations was observed with 60 and 125 mg/kg body weight. Doses higher than 125 mg/kg reduced dose-dependently the ratio of pregnant per mated female. Signs of fetal growth retardation and a higher incidence of minor skeletal abnormalities were found in doses higher than 60 mg/kg. No increase in the frequency of visceral anomalies was found at any dose level, but an increase in fetal spleen weight was observed in doses higher than 125 mg/kg. Therefore, data presented in this paper indicate that the no-observed adverse effect level for embryofeto-toxicity is lower than 60 mg citral/kg body weight p.o.

1. The objective of the present study was to investigate whether maternal protein-energy malnutrition alters methanol-induced embryotoxic effects in rats. 2. On day 0 of pregnancy, dams were assigned at random to one of the following treatment groups: well-nourished methanol (WNM), well-nourished control (WNC), malnourished methanol (MNM) and malnourished control (MNC). Malnourished animals received half of the well-nourished food intake (ca 12 g/day) throughout pregnancy. Methanol was administered by gavage (2.5 g/kg body weight) from gestation day 6 to 15. 3. Rats were weighed on days 0, 6 to 15, and 21 of pregnancy. On day 21 rats were submitted to cesarean section. The number of implantations, living and dead fetuses, resorptions and corpora lutea was recorded. All fetuses were weighed, examined for externally visible malformations, fixed, and examined for skeletal anomalies after clearing and staining with Alizarin Red S. 4. An increased proportion of fetuses with skeletal malformations, particularly cervical extra ribs, was found in the methanol-treated groups (fetuses with skeletal malformations: WNC = 5.6%, WNM = 45.4%, MNC = 3.8%, and MNM = 38.8%). Malnutrition produced fetal growth retardation, but did not cause any increase in the occurrence of gross structural malformations. The methanol-induced increase in the proportion of fetuses with extra ribs was not altered by malnutrition, but methanol potentiated the malnutrition-induced increase in the proportion of fetuses with signs of delayed ossification (WNC = 18.6%, WNM = 25.4%, MNC = 39.7%, and MNM = 78.4%). 5. These findings suggest that methanol-induced gross structural malformations are not affected by maternal malnutrition, but the delay in ossification caused by malnutrition is aggravated by treatment with methanol.

1. Newborn and old individuals are more susceptible to infection. In this study vascular permeability as well as the migration of neutrophils and mononuclear cells were determined in male Wistar rats aged 3, 8 and 16 weeks (N = 5-7 animals per group). The increase in vascular permeability induced by the ip injection of carrageenin in 3-week old rats was 2-fold lower than observed for 8- or 16-week old animals. 2. The migration of neutrophils and mononuclear cells into the peritoneal cavity induced by carrageenin and thioglycollate was lower in 3-week old rats (1.4 +/- 0.4 x 10(6) and 1.22 +/- 0.27 x 10(6)) compared to 8-week (4.5 +/- 0.25 x 10(6) and 4.16 +/- 0.38 x 10(6)) and 16-week old animals (5.75 +/- 1.0 x 10(6) and 5.5 +/- 0.5 x 10(6)), respectively. The number of resident cells in the peritoneal cavity of 3-week old rats was also only 15% of that observed for the older rats. The reduced cell migration in younger rats was not the result of leucopenia since the white cell counts of these animals were significantly higher than that of animals aged 8 or 16 weeks (15 +/- 2 x 10(6) vs 8 +/- 1 x 10(6) and 7 +/- 1 x 10(6)/ml of blood, respectively). 3. Although the chemotactic response was lower in 3-week old rats compared to 16-week old animals, the ability of both neutrophils and macrophages from young rats to phagocytose zymosan was similar to that of older animals (60-80%).(ABSTRACT TRUNCATED AT 250 WORDS)

The authors present the histological and cytological features of bone marrow (BM) in 152 employees from the steel plant of Cubatão (S. Paulo-Brazil) who presented with neutropenia, due to chronic exposure to benzene and its homologues. All patients were male. Mean age was 35 years. At the time of this study, all patients were removed from risk areas because of the hematological abnormality. BM morphology was characterized by a hypocellular hemopoiesis (82%). Decrease of the granulocytic precursors (86%) was the most outstanding feature. Erythroid and megakaryocytic series were diminished in 40% and 57% of the cases, respectively. Eosinophilia in BM was observed in 71% of the cases. Cell atypias and stromal changes (necrosis, increase in reticulin fibres) were frequent.

The authors report one case of granulocytic sarcoma infiltrating the larynx and cervical lymph nodes in a 50-year-old smoking patient. At the time of diagnosis there was no clinical and laboratory evidence of acute myeloid leukemia or chronic myeloproliferative disease. Four months after diagnosis, bone marrow morphology was consistent with chronic myeloid leukemia, accelerated phase. Cytogenetic abnormalities (Ph 1 chromosome, t(1; 12) (p36; p13), and trisomy of chromosome 20) were also found in hemopoetic cells. Granulocytic sarcoma preceding installation of chronic myeloid leukemia, as described here, seems to be a rare clinical event.

beta-Myrcene (MYR) and essential oils containing this monoterpene have been widely used as scenting agents in cosmetics, detergents, soaps, and as flavouring additives in food and beverages. Recently, MYR was reported to be an analgesic substance and the active principle of lemongrass tea. Despite the importance of human exposure to MYR, its toxicological profile has not been comprehensively studied. The aim of this study was to provide data on the peri- and postnatal developmental toxicity of this terpene. MYR (0.25, 0.5, 1.0 and 1.5 g/kg) in corn oil was given by gavage to female Wistar rats from day 15 of pregnancy, parturition and throughout the period of lactation up to weaning (postnatal day 21). The progeny were examined at birth and subsequently to weaning. Mortality, weight gain and physical signs of postnatal development (ear unfolding, incisor eruption, fur development and eye opening) were evaluated. When the exposed offspring reached maturity (120 days) their reproductive capacity was assessed. No adverse effects on the offspring were seen with the lowest dose tested, but 0.5 g/kg and higher doses decreased birth weight, increased perinatal mortality and delayed the day of appearance of landmarks of postnatal development. Moreover, fertility was impaired in female offspring exposed to the two highest doses of MYR. From the data presented in this paper the no-observed-adverse-effect level for peri- and postnatal developmental toxicity could be set at 0.25 g beta-myrcene/kg body weight.

A study was carried out into the hematological abnormalities of peripheral blood bone marrow in patients chronically exposed to benzene. The metabolic biotransformation and the mechanisms involved in toxicity are described. Hematological data are described and discussed. Macrocytosis and lymphopenia are the earliest hematological signs of benzene toxicity. Bone marrow abnormalities are demonstrated by the complementary methods of cytology and histology. Global hypocellularity was mainly due to the granulocytic series. Mastocytosis, eosinophilia and magakariocytic abnormalities are also presented. Inflammatory abnormalities and signs of dismyelopoiese could also be observed. The importance of peripheral blood abnormalities and the need for a critical approach to this important public health problem are emphasized.

Among 29833 donors evaluated we have found a prevalence of 1.52% for HBsAg and 11% for anti-HBc. The co-positivity anti-HBc/anti-HBs in 2783 donors HBsAg negative/anti-HBc positive was 81.9%. The prevalence for HBsAg is low among Campinas donors, while anti-HBc presents high prevalence when compared to that of other countries. The anti-HCV detection in blood donors of Campinas has shown a positivity of 2.6% which is much higher than that of USA and Europe. About 36% of the anti-HCV positive donors are anti-HBc reagent, leading to the conclusion that these two "viruses" infect simultaneous or sequentially Brazilian blood donors.

Five cases of megakaryoblastic leukemia, presenting as "de novo" acute leukemias are reported. They represented 7.2% of all cases of adult acute non-lymphoblastic leukemias (ANLL) seen in our Hematology Service during the past 30 months. These cases showed features of predominantly blast proliferation with a marked increase of reticulin fibres in the bone marrow. One case had features of acute leukemia with trilineage myelodysplasia and one had a more chronic evolution with splenomegaly initially resembling a myeloproliferative syndrome. In all cases, the definitive diagnosis was made on bone marrow histology as cytology was poor and the blast cells were positive for factor VIII with the immunoperoxidase technique. The importance of bone marrow histology is emphasized.

The methodology used by a project being carried out at the Institute of Social Medicine, Rio de Janeiro, concerning the epidemiology of the elderly and the stages of the community survey are presented. The sampling methods and the steps of the enumerator process are also detailed.

The present study was performed to determine the effect of an intravenous injection of the macrophage-derived neutrophil chemotactic factor (MNCF) (Cunha & Ferreira 1986) on neutrophil migration to rat peritoneal cavities, which were challenged with chemotactic stimuli. Macrophage monolayers stimulated by LPS release a factor (MW greater than 10,000 D) which, when injected intravenously, blocked neutrophil migration in carrageenin-induced peritonitis. This inhibition was dependent on dose and lasted more than 2 h. It was not due to neutropaenia, hypotension or LPS contamination. Neutrophil migration induced by LPS, MNCF, the Gram-negative bacterium Pseudomonas aeruginosa was also blocked by intravenous administration of the factor. Intravenous injection of recombinant interleukin 1 beta or tumour necrosis factor-alpha, present in the samples of the factor, failed to reproduce the described inhibitory effect on neutrophil migration. The release of this factor by LPS-stimulated macrophage monolayers was inhibited by dexamethasone but not by indomethacin. It is suggested that the failure of neutrophils to migrate during septicaemia may be the result of a continuous release of chemotactic factors in the circulation, particularly of the macrophage-derived neutrophil chemotactic factor(s).

Ten independent mutants resistant to 2-deoxygalactose and without any detectable galactokinase activity (null-galactokinase mutations) were isolated from mutagenized Chinese hamster somatic cells. They were analyzed for the presence of serologically cross-reacting material (CRM) with antiserum generated against highly purified Chinese hamster galactokinase. All 10 mutants contain cross-reacting material (i.e., were CRM+), indicating that all the mutations affect the correct expression of a product of the galactokinase structural gene. Complementation analysis among them shows that the 10 mutations fall in one functional genetic unit.

This paper offers a quantitative evaluation of the scientific information produced in Brazil on several endemic diseases: Chagas' disease, schistosomiasis, leishmaniasis, leprosy, malaria and filariasis. The source of data was the Index Medicus Latino Americano (IMLA), and the published scientific information was analyzed in general and specifically, by type of disease and year of publication. The indexed production of articles on the material of the Latin American countries as a whole increased from 3,506 articles in 1978 to 5,528 in 1982 (for an increase of 52.7%), whereas that of Brazil alone rose from 1,781 to 2,531 (an increase of 42.1%) during the same period. The output of articles on endemic diseases totaled 703 papers (6.3% of the total indexed production). Of this total, 441 (62.7%) was on applied research and 262 (37.3%) were on basic research, and these proportions held relatively constant. Chagas' disease and schistosomiasis accounted for 75.2% of that total over the period considered. The production of papers on the diseases of interest grew 79.2%, at the same rate as that of all biomedical information published in Brazil over the period. An equilibrium was reached between the numbers of basic and applied papers. The analysis also identified the core of Brazilian periodicals that most frequently publish information on those endemics. It was also found that a large proportion of articles by Brazilian authors are published in journals of international circulation, and the foreign journals that publish papers by researchers in Brazil were identified.

The association of Schistosoma mansoni infection and proteinuria was investigated by measuring quantitative urinary protein in a defined population in an endemic area in northeastern Brazil. Persons with schistosomiasis had higher mean urinary protein than those without. Two of 162 persons with schistosomiasis had clear evidence of renal disease (pathologic proteinuria, abnormal urinary sediment). These results seemed to be related neither to the intensity of S. mansoni infection as measured by fecal egg excretion nor to the presence of hepatic and splenic enlargement in schistosomiasis.

The number of Brazilian periodicals listed in the Index Medicus dropped from 70 in 1964 to 15 in 1983, or 78%, while the total number of listed periodicals from other countries fell only 11%. The total number of articles published in Brazil on Chagas' disease, schistosomiasis, leishmaniasis, leprosy, malaria, and filariasis, and listed in the Index Medicus did not change significantly between 1965 and 1982, because, with the exception of the journal O Hospital, the Brazilian periodicals that published 74% of all articles on those diseases remained listed throughout the period considered. The predominant subjects in articles on endemic diseases were Chagas' disease and schistosomiasis, and in the later years there was a tendency to index more articles on basic than on applied research. The number of articles on Chagas' disease published by Brazilian authors directly in foreign journals increased considerably during the latter decade. Analysis of all the data together suggests that the developed countries select a specific portion of the Brazilian output of biomedical literature--which is kept listed in secondary and international publications or published directly in foreign journals--while another portion of the same output gradually loses visibility on the international scene.

Cytological and histological features of the bone marrow in Philadelphia-positive chronic myelogenous leukaemia (CML) at diagnosis were analysed in a prospective study. Formerly described (Frisch et al, 1984) subtypes GRAN and GRAN/MEG were found, and myelofibrosis and incipient blast crisis could also be detected. A more or less continuous spectrum of number and degree of atypias in megakaryocytes was found. Biopsy and imprint were complementary in making differential diagnosis of both subtypes. Cytologically, type GRAN/MEG was characterized by a mixed proliferation of neutrophil, eosinophil and basophil series, besides proliferation of megakaryocytes. Type GRAN showed a predominantly neutrophilic proliferation. The importance of performing bone marrow analysis in evaluation of CML patients is discussed.