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Objective: The aim of this in vitro study was to determine the effects of barium sulfate addition in two dental impression materials previously proved as radiolucent. Materials and Methods: An irreversible hydrocolloid (IH) and polyether (PE) were tested for optical density, linear dimension stability and detail reproduction. Statistical Analysis Used: The optical density data were submitted to Kolmogorov-Smirnov normality test and compared with two-way ANOVA and Tukey (alpha=0.05). Results: The results of optical density (pixel) were: IH control 45.24 f (±7.6), PE control 54.93 e (±4.45), PE 5Wt% 60.43 d (±6.27), IH 1Wt% 61.54 cd (±5.3), PE 1Wt% 66.9 bc (±5.05), IH 5Wt% 67.17 b (±6.01), PE 10Wt% 84.55 a (±5.14), IH 10Wt% 85.33 a (±5.53). On detail reproduction, polyether control was able to copy the 6 μm line. Adding 1 or 5Wt% of barium sulfate have not change this characteristic. For the irreversible hydrocolloid, the control group was able to copy a line with 14 μm, however, adding 1Wt% barium sulfate, the capability decreased to 22 μm. Adding barium sulfate in the polyether promoted an increase in between the copied lines, for the control, the average distance was 931.6 μm, 936 μm to 1Wt% and 954.5 μm to 5 Wt%. For the IH, the control presented 975 μm in comparison to 987.25 μm for 1 Wt% samples. Conclusion: The addition of barium sulfate was capable of increasing significantly the optical density of tested material, have changed the linear dimension stability, however, have not interfered in detail reproduction only for PE.

OBJETIVO: Analisar a tendência temporal da mortalidade infantil no Brasil em um período recente (1980 a 1998) de crise econômica. MÉTODOS: Estudo de série temporal tendo o Sistema de Informações de Mortalidade do Ministério da Saúde, Fundação IBGE e Fundação Nacional de Saúde como fontes de dados. Pela modelagem Autoregressive integrated moving average (ARIMA) descreveram-se parâmetros da série e, com coeficientes de correlação de Spearman, avaliou-se a associação entre coeficiente de mortalidade infantil e alguns determinantes. RESULTADOS A mortalidade infantil apresentou tendência decrescente (-59,3%) e forte correlação com a maioria dos indicadores analisados. Todavia, apenas as correlações entre coeficiente de mortalidade infantil e taxa de fecundidade total (e taxa de natalidade) diferiram significantemente de uma década para outra. CONCLUSÕES: A variação da fecundidade foi a principal responsável pela persistência do declínio da mortalidade infantil nos anos oitenta. No período seguinte, aqueles relacionados às condições de vida, principalmente, à atenção à saúde, talvez tenham sido mais importantes.

Hepatitis B virus (HBV) serological markers were investigated in 40 incident cases of hepatocellular carcinoma (HCC) and in two age and sex matched control groups, comprising 40 patients with other cancers and 80 healthy individuals, resident in Bahia, Brazil. Serologic tests were done by radioimmunoassay. The study observed high proportion of seropositivity to HBsAg (42.5%) and of those presenting HBsAg or antiHBc (65.0%) among HCC cases, higher in men than women and in those aged 17 to 30 years old. HBsAg seropositivity among HCC patients was greater than in the control group with other cancers (7.5%) and in healthy controls (2.5%), corresponding to odds ratio estimates of 15.0 (95% CI 3.29, 68.30) and 33.0 (95% CI 9.13, 119.28), both statistically significant. HBeAg was not observed and antiHBe was present in 41.2% of cases, suggesting the absence of viral replication, possibly with viral DNA intergration into the hepatocyte genome. The presence of cirrhosis was associated with HBsAg seropositivity among HCC cases. A history of chronic alcoholism is shown to be more frequently related to those cases with cirrhosis. This study highlights the relevant association between HCC and HBV in Northeast Brazil, particularly for young individuals, and the high risk of development of HCC for HBsAg carriers.

Abstract Background Vertical facial pattern may be related to the direction of pull of the masticatory muscles, yet its effect on occlusal force and elastic deformation of the mandible still is unclear. This study tested whether the variation in vertical facial pattern is related to the variation in maximum occlusal force (MOF) and medial mandibular flexure (MMF) in 51 fully-dentate adults. Methods Data from cephalometric analysis according to the method of Ricketts were used to divide the subjects into three groups: Dolichofacial (n = 6), Mesofacial (n = 10) and Brachyfacial (n = 35). Bilateral MOF was measured using a cross-arch force transducer placed in the first molar region. For MMF, impressions of the mandibular occlusal surface were made in rest (R) and in maximum opening (O) positions. The impressions were scanned, and reference points were selected on the occlusal surface of the contralateral first molars. MMF was calculated by subtracting the intermolar distance in O from the intermolar distance in R. Data were analysed by ANCOVA (fixed factors: facial pattern, sex; covariate: body mass index (BMI); alpha = 0.05). Results No significant difference of MOF or MMF was found among the three facial patterns (P = 0.62 and P = 0.72, respectively). BMI was not a significant covariate for MOF or MMF (P > 0.05). Sex was a significant factor only for MOF (P = 0.007); males had higher MOF values than females. Conclusion These results suggest that MOF and MMF did not vary as a function of vertical facial pattern in this Brazilian sample.

Background: Early gastric cancers are associated with lymph node metastasis (LNM) in 15% of cases. Risk factors for LNM are well established in Eastern countries. Less invasive treatments, such as endoscopic or surgical laparoscopic resection, are well accepted in Eastern countries and a matter of intense debate in the West, were indications for such treatments are still contested The objective of the study is to determine risk factors related to LNM and to validate endoscopic resection indications., Methods: The study was a retrospective cohort of 178 patients with early gastric cancer who underwent gastrectomy. Clinical and pathological factors were analyzed. The new rules of ER from JGCA were applied to the studied cohort., Results: LNM was present in 13.48% of the cases, 3.96% (3/76) in T1a tumors and 20.58% (21/102) in T1b tumors. In univariate analysis ulceration (p = 0.04), differentiation grade (p = 0.04), submucosal invasion (p = 0.001), lymphatic invasion (p < 0.001), and vascular invasion (p < 0.001) were associated with LNM. In multivariate analysis, differentiation grade (p = 0.005) and submucosal invasion (p = 0.005) were independent risk factors. One patient classified in the expanded criteria group and seven from the relative criteria group had LNM. There were no LNM for undifferentiated mucosal lesions without ulceration., Conclusions: Undifferentiated tumors and submucosal invasion are risks factors associated with LNM in early gastric cancer in our study. Endoscopic Resection or less invasive and radical surgical treatments are an option to be carefully considered.

Objective: To evaluate the prognostic value of positive peritoneal lavage in patients with gastric cancer without signs of peritoneal or hematogenous spread., Methods: We evaluated patients with gastric adenocarcinoma treated with curative intent operation. The peritoneal lavage was classified as positive or negative for neoplastic cells. We obtained demographics, performance status, histology and type of surgery. The results were statistically compared and were considered significant for values of p <0.05., Results: We included 72 patients with gastric adenocarcinoma. During a mean follow up of 26 months (one to 39 months) we observed 20 local or distant recurrences and 21 deaths. Only the presence of lymph node metastases and the need for resection of adjacent organs were associated with a significant reduction in relapse-free survival. There was a significant reduction in overall survival in patients with angio-lymphatic invasion, lymph node metastasis, requiring resection of multiple organs, need for total gastrectomy and greater invasion of the gastric wall. The presence of tumor cells in the peritoneal cavity was associated with worse overall survival, but without statistical significance., Conclusion: There was no statistically significant associations between positive peritoneal citology and recurrence-free survival or overall survival among patients with resectable gastric cancer.

Background: The standard treatment of gastric cancer still has high morbidity and mortality in western populations. Groups of patients with negligible risk of lymph node metastasis may benefit from less invasive treatments. Data regarding the frequency and predictive factors related to lymphatic metastasis in early gastric cancer are rare., Aim: To perform the analysis of frequency and predictive factors related to lymphatic metastasis in patients with early gastric cancer treated in a tertiary center in Brazil., Methods: Nine hundred and twenty three patients underwent gastrectomy for gastric adenocarcinoma at the hospital. Of these, 126 had early tumors and were included in the analysis. Clinical and pathological related findings and lymphatic metastasis were evaluated., Results: Lymph node metastases were observed in 7.8% of patients with mucosal tumors and 22.6% of submucosal tumors. The presence of ulceration, Lauren histologic type, tumors larger than 50 mm, submucosal invasion, and presence of lymphatic or vascular invasion were significant factors in univariate analysis. The presence of ulceration, lesions larger than 50 mm, infiltration of the submucosal layer and lymphatic invasion were factors independently related to lymphatic metastasis in multivariate analysis., Conclusion: Ulceration, lesions larger than 50 mm, infiltration of the submucosal layer and lymphatic invasion are independent risk factors related to lymphatic metastasis in early gastric cancer.

Mucoepidermoid cancer (MEC) is the most malignant neoplasm of minor salivary glands. The aim of this study was to compare the expression of Ki-67 and MUC1 and clinicopathological data of mucoepidermoid carcinoma (MEC) in minor salivary glands of young and adult patients. The MEC cases in patients under 25 years old (n=8) and over 26 year old (n=8) were matched by gender, location and TNM staging. Immunohistochemical analysis of Ki-67 and MUC1 was carried out and correlated with clinicopathological data. The expression of Ki-67 and MUC1 was similar between the groups, although a tendency towards higher Ki-67 and MUC1 expression was observed in the younger group. Despite no significant differences, survival time was shorter in adults (71.37±17.44 months) compared to the younger group (97.62±25.81). While no patient deaths or tumor recurrences were found in the younger patient group, the adult group presented recurrence in 25% of cases and one patient died. In conclusion, our findings showed that age can be an important factor in MEC prognosis., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: Endoscopic resection is an adequate treatment for subgroups of patients with early gastric cancer. Endoscopic submucosal dissection (ESD) represents a recent advance and leads to good results when adequately indicated. There is great experience with this technique in Japan and it is gaining acceptance among Western endoscopists. We present the first gastric ESD series performed in Brazil., Methods: Patients with well-differentiated adenocarcinomas macroscopically classified as early cancer, less than 30 mm with no ulcer or scar, were included. ESD was performed with an insulated-tip knife and electrosurgical unit with endocut mode. Clinicopathological aspects and morbidity were evaluated. The study was approved by the local ethics committee and informed consent was obtained from all participant subjects., Results: From October 2005 to July 2007, 160 patients received surgical treatment for gastric cancer; 44 patients (27.5%) had early gastric cancer. In this latter group, 15 procedures (ESD) were performed in 12 patients. The mean size of the lesions was 16.8 mm. Almost half of the lesions were located in the proximal third of the stomach and the mean elapsed time for the procedure was 140 min. In 80% of the cases resection was en bloc and 80% of the resections were considered curative. We had three perforations, which were managed clinically, and no bleeding., Conclusion: When adequately indicated, ESD is a safe and feasible technique.

Background: When performed in carefully selected cases, the endoscopic treatment of early gastric cancer yields results which are comparable to the conventional surgical treatment, but with lower morbidity and mortality and better quality of life. Several technical options to perform endoscopic mucosal resection have been described and there is a large amount of accumulated experience with this procedure in eastern countries. In western countries, particularly in Brazil, technical limitations associated with the small number of cases of early gastric cancer reflect the little experience with this therapeutic mode., Aim: This study was carried out in order to assess the indications, pathological results and morbidity of a series of endoscopic mucosal resections using two technical variants in addition to investigating the safety and feasibility of the method., Methods: Individuals with well-differentiated early gastric adenocarcinomas with up to 30 mm in diameter without scar or ulcer underwent endoscopic treatment. Two variants of the strip biopsy technique were used. The pathological study assessed the depth of the vertical invasion, lateral and basal margins as well as angio-lymphatic invasion., Results: Thirteen tumors in 12 patients were resected between June 2002 and August 2005. The most common macroscopic types were IIa and IIa + IIc. Tumor size ranged from 10 to 30 mm (mean = 16.5 mm). En bloc resection was carried out in nine patients. Angio-lymphatic invasion was not observed; however, submucosal invasion was found in two cases. In four cases, the lateral margin was involved. Perforation occurred in two patients who then received conservative treatment., Conclusion: The relatively small series presented here suggests that the method is safe and feasible. Appropriate patient selection is the most important criteria. Long follow-up is required after treatment due to the risk of relapse.

Purpose: We evaluated the influence of koilocytosis, and other clinical and pathological variables in the risk of groin metastasis and death in penile cancer patients., Materials and Methods: From January 1994 to January 2004, 172 patients with squamous cell carcinoma of the penis were treated at a single cancer center. Of these patients 144 were retrospectively studied to analyze prognostic factors and establish the role of koilocytosis in penile cancer. Univariate and multivariate analyses were performed, and Kaplan-Meier survival curves were generated., Results: A total of 102 patients (71%) underwent groin dissection, of whom 84 (58.3%) had inguinal metastasis. Koilocytosis was present in 91 patients (63.1%) and it was associated with low and moderate primary tumor grade on univariate analysis (p = 0.0005). Although koilocytosis statistically correlated with Jackson stage (p = 0.017) and tumor grade (p = 0.002), it had no impact on disease specific survival (p = 0.912). Metastatic inguinal disease correlated with patient age, Jackson and disease specific survival. Only Jackson stage and inguinal relapse after groin dissection influenced overall survival on multivariate analysis (each p = 0.001)., Conclusions: According to all studied variables only patient age and Jackson stage correlated with an increased risk of groin disease. Koilocytosis was rarely found in high grade penile tumors and it did not correlate with a high risk of metastatic groin disease or death.

Seminal vesicle tumor is a rare disease with unclear origin. Generally, it is presented as a pelvic mass that can be detected by sonography and digital rectal exam. The authors report a 25-year-old patient with a pelvic mass which the magnetic resonance and surgical specimen reveal a seminal vesicle tumor. Immunohistochemical findings favored a primitive neuroectodermal tumor of the seminal vesicle. Herein, the treatment, histological and histochemical findings of this entity are discussed.

Background: Metastases in the stomach are rare. The increased use of esophagogastroduodenoscopy (EGD), associated with better treatment results for malignancies, requires them to be acknowledged. The aim of this study was to describe a series of cases of metastasis to the stomach, their primary sites, clinical and endoscopic features, treatment, and results., Methods: Twenty cases were diagnosed between December 1999 and January 2004. Their analysis included symptomatology, macroscopic presentation, time from diagnosis of the primary tumor to the detection of the gastric metastasis, treatment approach, and survival., Results: The primary sites were the esophagus, skin, lung, cervix, breast, sigmoid colon, and testis. The symptom most frequently requiring EGD was upper gastrointestinal bleeding. Ten patients showed concomitant metastases to other organs. The mean time between diagnosis of the primary tumor and diagnosis of gastric metastasis was 16 months (range, 0 to 56 months). Only seven patients were given some form of treatment after diagnosis of the gastric metastasis. The median survival was 4.75 months. Overall survival during the first year was 20% and survival was nil at 2 years., Conclusions: Gastric metastasis marks advanced disease and the prognosis is poor. New advances in diagnosis and treatment are required for better results.