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Made available in DSpace on 2022-04-29T08:44:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-01-01 Background: Oral squamous cell carcinoma (OSCC) is a frequent neoplasm, which is usually aggressive and has unpredictable biological behavior and unfavorable prognosis. The comprehension of the molecular basis of this variability should lead to the development of targeted therapies as well as to improvements in specificity and sensitivity of diagnosis. Results: Samples of primary OSCCs and their corresponding surgical margins were obtained from male patients during surgery and their gene expression profiles were screened using whole-genome microarray technology. Hierarchical clustering and Principal Components Analysis were used for data visualization and One-way Analysis of Variance was used to identify differentially expressed genes. Samples clustered mostly according to disease subsite, suggesting molecular heterogeneity within tumor stages. In order to corroborate our results, two publicly available datasets of microarray experiments were assessed. We found significant molecular differences between OSCC anatomic subsites concerning groups of genes presently or potentially important for drug development, including mRNA processing, cytoskeleton organization and biogenesis, metabolic process, cell cycle and apoptosis. Conclusion: Our results corroborate literature data on molecular heterogeneity of OSCCs. Differences between disease subsites and among samples belonging to the same TNM class highlight the importance of gene expression-based classification and challenge the development of targeted therapies. Centro de Pesquisa Experimental Instituto Israelita de Ensino e Pesquisa Albert Einstein Laboratório de Biologia Molecular Hospital Heliópolis Departamento de Cirurgia de Cabeça e Pescoço Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Departamento de Neurologia e Neurocirurgia Universidade Federal de São Paulo Departamento de Estomatologia Faculdade de Odontologia Universidade de São Paulo Departamento de Pediatria Faculdade de Medicina Universidade de São Paulo Departamento de Biologia Molecular Faculdade de Medicina de São José do Rio Preto Departamento de Genética e Biologia Evolutiva Instituto de Biociências Universidade de São Paulo Departamento de Patologia Faculdade de Medicina Hospital Heliópolis Departamento e Instituto de Psiquiatria Faculdade de Medicina USP Serviço de Cirurgia de Cabeça e Pescoço Faculdade de Medicina de Ribeirão Preto USP Serviço de Cirurgia de Cabeça e Pescoço Instituto do Câncer Arnaldo Vieira de Carvalho Departamento de Análises Clínicas Toxicológicas e Bromatológicas Faculdade de Ciências Farmacêuticas de Ribeirão Preto USP Departamento de Cirurgia de Cabeça e Pescoço Faculdade de Medicina USP Departamento de Pediatria Faculdade de Medicina USP Departamento de Biociências e Diagnóstico Bucal Faculdade de Odontologia UNESP Departamento de Estomatologia Faculdade de Odontologia USP Departamento de Neurologia e Neurocirurgia UNIFESP Departamento de Patologia Faculdade de Medicina de Ribeirão Preto USP Instituto de Ensino e Pesquisa Albert Einstein Departamento de Genética Faculdade de Medicina de Ribeirão Preto USP Ciências da Computação UNIVAP Departamento de Biologia Molecular Faculdade de Medicina Departamento de Epidemiologia Faculdade de Saúde Pública USP Departamento de Clínica Médica Faculdade de Medicina de Ribeirão Preto USP Departamento de Biociências e Diagnóstico Bucal Faculdade de Odontologia UNESP

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:20:14Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:45:08Z : No. of bitstreams: 1 2-s2.0-0034939110.pdf: 46197 bytes, checksum: c2ed280ee57bb49ed5584b9edb9515dd (MD5) Made available in DSpace on 2014-05-27T11:20:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2001-01-01 Objectives: To verify prostate cancer prevalence in non-symptomatic men between 50 and 70 years old as well as cancer characteristics. Material and Methods: 2815 non-symptomatic men had total PSA and digital rectal examination performed between March 1998 and April 1998. Racial distribution was: 2331 Caucasians (83.9%), 373 Blacks (13.4%) and 75 Asiatic (2.7%). PSA was normal in 2554 (91.4%), 4 to 10 in 177 (6.3%) and greater than 10 in 64 (2.3%). DRE was normal in 2419 (86.3%), suspicious in 347 (12.4%) and characteristic for cancer in 37 (1.3%). Men with abnormal DRE and/or PSA had transrectal prostate biopsy indicated. Results: 461 biopsies were done and 78 tumors was detected (prevalence = 2.8%). Prevalence was progressively higher with age (p < 0.001), PSA level (p < 0.0001) and DRE findings (p = 0.0216). Cancer prevalence in Blacks was 1.65 times higher than in Caucasians (p > 0.05) and 94.9% of detected tumors were moderately or poorly differentiated. Sensibility, specificity, positive predictive value, negative predictive value and total accuracy for PSA were respectively: 66.6%; 89.7%; 51.7%; 94.2% and 86.5%. For DRE, the respective values were: 49.1%; 79.4%; 50.9%; 78.3% and 70.3%. Conclusions: prostate cancer prevalence in the studied population (2.8%) was similar to that of other countries populations. Cancer prevalence in blacks was 1.65 times higher than in Caucasians (difference was not statistically significant). Cancer prevalence becomes higher with aging. The association of DRE and PSA is of paramount importance for cancer diagnosis. The great majority of detected tumors (94.9%) was moderately and poorly differentiated. Brazil probably needs regional studies to better characterize prostate cancer epidemiology due to population heterogeneity. Division of Urology School of Medicine State Univ. of de São Paulo, Rua Jaraguá 192, São Paulo SP 01129-000

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:20:14Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:29:17Z : No. of bitstreams: 1 2-s2.0-0034841905.pdf: 22175 bytes, checksum: fe0fde8c0c3938616a68ac005b68fe00 (MD5) Made available in DSpace on 2014-05-27T11:20:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2001-01-01 Objectives: To evaluate the laparoscopic technique as a diagnostic and therapeutic tool in the management of patients with impalpable testis. Material and Methods: Fifty-nine patients with mean age of 6.3 years underwent laparoscopy to evaluate 85 impalpable testes that were classified as absent, canalicular and intra-abdominal. In the case of testicular absence, the procedure was terminated. In the case of canalicular testis, open inguinal exploration was performed. In intra-abdominal testis, either laparoscopic orchiopexy or orchiectomy was performed. According to the length of the vascular pedicle, orchipexy was performed either with or without vascular ligature. Post-operatively, the treated testes were evaluated according to size and location in the scrotum. Results: Seventeen (20%) of the 85 impalpable testes were diagnosed as absent, 21 (24.7%) as canalicular and 47 (55.3%) as intra-abdominal. Of the canalicular testes, 20 were explored by inguinotomy and one by laparoscopy. All the intra-abdominal testes were treated initially by laparoscopy, four being removed due to atrophy, 31 submitted to vascular ligature and 12 to primary orchipexy. Of those submitted to vascular ligature, 22 underwent a second stage orchipexy, of which 18 laparoscopically and 4 by inguinotomy. Of the 18 testes brought to the scrotum by staged laparoscopic orchipexy, 15 (83.3%) presented normal characteristics in the late follow-up, while of the 12 submitted to primary laparoscopic orchipexy, 8 (66.6%) were normal. There were no perioperative or late complications. Conclusions: Laparoscopy is a minimally invasive procedure with low morbidity that enables precise diagnosis of the impalpable testes. When intra-abdominal testes are found, either immediate laparoscopic orchiectomy, or primary and staged orchipexy are possible, with results equivalent to open procedures, with the advantage of smaller surgical incisions and shorter postoperative recovery. Unit of Pediatric Urology Division of Urology State University of São Paulo, Rua Curuzú 114, São Paulo, SP 05084-020

Made available in DSpace on 2022-04-28T18:54:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2001-01-01 Objective: To determine the incidence and which type of human papillomavirus (HPV) was more prevalent in penile epidermoid carcinoma. To determine the influence of HPV in the biological behavior of the tumor in relation to the following variables: coilocitosis, clinical and pathological staging and histological grading. Prognostic factors like survival curve and death risk from the tumor are also studied in relation to the presence of HPV. Material and Methods: Fifty-five patients with penile epidermoid carcinoma, surgically treated between 1979 and 1995, were retrospectively studied. The mean follow-up was 31.6 months. The presence of HPV was studied by polymerase chain reaction (PCR) on the most representative surgical specimens of the primary tumor and metastasis. The patients whose tumors had HPV type-16 were placed into groups separated from those uninfected by the virus and those infected by any other viral type. Results: Patients having HPV type-16 in their tumors were submitted to major surgical procedures to remove the primary tumor (p = 0.04). The relative risk of death for patients with HPV type-16 was 7.59 times greater than that for the virus negative group. Also, patients presenting HPV type-16 in the tumor presented a lower tendency for survival (without statistical significance). Coilocitosis was detected in 12 patients, presenting a significant correlation with the presence of HPV type-16 (p = 0.026). Conclusion: The infection by HPV was strongly associated with penile epidermoid carcinoma (30.9%). Also, the presence of coilocitosis is strongly associated with viral infection. The presence of HPV type-16 in the tumors was associated with increased tumor-related mortality. Division of Urology General Hospital State University of Sao Paulo USP, Rua Cotoxó 611/105, São Paulo, SP 05021-000

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:20:14Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:29:11Z : No. of bitstreams: 1 2-s2.0-0035075237.pdf: 15962 bytes, checksum: ba8c8e74cc3170b87505fd0fdc6c347d (MD5) Made available in DSpace on 2014-05-27T11:20:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2001-01-01 Objectives: Penile fracture is a rare injury, usually resulting from direct trauma to the erect penis during sexual intercourse. Our goal was to evaluate the best diagnostic methods and the late complications following surgical treatment of penile fracture. Material and Methods: We studied retrospectively 11 patients with penile fracture in a period of 10 years (1985-1995). Results: In 55% of the cases, the injury occurred during sexual intercourse. All patients presented with a very suggestive clinical picture (pain, detumescence and hematoma) and only 2 were submitted to further investigation (ultrasonography) to confirm the diagnosis. Only one patient had urethral bleeding and therefore was submitted to retrograde urethrogram, which confirmed urethral injury. All patients were treated by immediate surgery, through a circular subcoronal incision and degloving of the penis to allow a thorough exploration. All patients had a tunica albuginea tear that was promptly repaired, and 2 patients (18%) had associated urethral injury (one had no symptoms) that was also repaired. All patients did very well after surgery and only one had a mild curvature, which did not hinder intercourse during follow-up (18 months). Conclusions: Penile fracture has very typical clinical signs and, therefore, further investigation is usually unnecessary. Early surgical treatment is associated with a low incidence of late complications. Divisão Clín. Urol. School of Medicine State Univ. of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, São Paulo, SP 05422-970

OBJETIVO: Para determinar o acerto obtido pelos diagnósticos efetuados em uma unidade de transplante renal, foram analisados 40 episódios de disfunção renal aguda que ocorreram no período pós-transplante. MÉTODOS: Os pacientes foram submetidos a biópsia renal por ocasião do episódio de insuficiência renal ao mesmo tempo em que o diagnóstico clínico era realizado pelos membros da equipe. RESULTADOS: Foram realizados 19 diagnósticos de necrose tubular aguda (NTA), 18 de rejeição celular aguda (RCA), dois de rejeição humoral (RH) e um de nefrotoxicidade (NTX) pela ciclosporina A (CyA). O diagnóstico de NTA foi confirmado pela histologia em 84,21%, o de RCA, em 83,33%, o de RH em 100% e o único diagnóstico de NTX realizado se apresentou como NTA à biópsia. No total, a clínica foi concordante com a histologia em 82,5% das vezes. CONCLUSÃO: Os autores concluíram que existe uma boa acurácia nos diagnósticos clínicos de RCA, NTA e RH realizados em um centro experiente em transplante renal. PURPOSE: To assess the agreement between clinical and histopathological diagnosis in a renal transplantation center, 40 episodes of acute renal failure were studied. METHODS: Kidney biopsies were performed at the moment that a clinical diagnosis was made by the staff. RESULTS: Nineteen episodes of acute tubular necrosis (ATN), eighteen episodes of acute cellular rejection (ACR), 2 humoral rejections and 1 acute cyclosporin nephrotoxicity episodes were diagnosed. ATN episodes were confirmed by renal biopsy in 84.21%, ACR episodes in 83.33%, humoral rejections in 100%. Renal biopsy showed ATN in the occurrence of clinical cyclosporin nephrotoxicity. Total agreement was 82.5%. CONCLUSION: There is a good relationship between clinical and histopathological diagnosis in the post-transplantation period. Diagnostic mistakes occurred mainly when oliguria was present.