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Biomedical subjects

E A Da Silva

Publications and source records attributed to E A Da Silva.

16 recordsLinked to original sources
PubMed2002

Immunohistochemical detection of fibronectin and tenascin in incised human skin injuries.

Immunohistochemical detection of molecules involved in inflammatory reaction can be useful for the diagnosis of vitality in skin wounds. We studied the expression of fibronectin (FN) and tenascin (TN) in 58 human skin wounds (48 vital and 10 postmortem). The age of vital injuries ranged from 3 min to 8 h and postmortem specimens were collected after a postinfliction interval of 15-180 min. One hundred thirty-seven formalin-fixed paraffin-embedded sections (mean: 2.3 sections per case) were stained with each of two monoclonal antibodies against FN and TN using the streptABC technique. A reticular staining for FN in wound edge and dermis was observed in 50% of vital specimens versus 0% in postmortem cases. Immunoreactivity was reduced in 10 autolysed cases. FN positivity exclusively at the injury margin was observed in 39.4% of vital wounds and 10% of postmortem cases. TN was negative in all specimens. Vital and postmortem hemorrhage areas showed positivity for FN and TN. Due to its low sensitivity, immunohistochemical analysis of FN is useful for determining vitality only in a minority of cases. Different factors in everyday practice, including autolysis and technical problems often produce false negative reactions with the result that FN cannot be regarded as a reliable parameter of vitality. Positive reactions (network staining) are more valuable than negativity but are not pathognomonic. Both vital and postmortem hemorrhages show an enhanced positivity for FN and TN, thus impeding the diagnosis.

Adult↗
PubMed2002

Demonstration of apoptosis in human skin injuries as an indicator of vital reaction.

Demonstrating the vital character of an injury and estimation of the age are routine tasks in forensic pathology and although many different techniques have been applied to this problem none have been found to be completely satisfactory. Apoptosis, an active genetically controlled process, is the major mechanism by which homeostasis of a number of physiological systems in the body is regulated and changes in the rate following different kinds of stimuli have prompted us to test it as an indicator of vitality. We used an in situ end-labelling technique (Apop-Tag) in 30 human surgical skin injuries with age since injury ranging from 3 min to 8 h and found that apoptotic keratinocytes are found in over 50% of the cases with a post-infliction interval of at least 120 min. Apoptosis was not seen in injuries less than 120 min old or in normal skin, which was used as an external control. These results suggest that apoptosis could be a useful indicator for the intravital occurrence of injuries and could help to estimate the date of the skin injuries in some cases. The importance of strict technical control is stressed and the necessity of a complementary technique to confirm apoptosis is discussed.

Adult↗
PubMed2000

[Urethral substitution with synthetic material].

In spite of the numerous surgical techniques described, management of urethral stenosis continues to be an unresolved problem. Free graft urethroplasty is indicated in selected cases and several organic and synthetic materials have been described for this use. Our group reviews the synthetic alloplasts used for partial or total replacement of the male urethra. The search for an appropriate alloplast for urethral replacement has been rather frustrating. Complication rates are still too high to allow routine usage. The most encouraging results are those with new absorbable materials which cause minimal inflammatory reactions of a foreign body type. These are readily available and allow urethral replacement using tissues regenerated from removed ends.

Artificial Organs↗
PubMed1999

["Evanescent" prostate carcinoma].

Occurrence of prostatectomy sections with minimum or no tumour volume have been increasingly seen over the last few years in spite of a preoperative histology-based diagnosis of adenocarcinoma with a needle biopsy ("evanescent cancer phenomenon" ECP). Our group has reviewed 145 prostatectomies performed in our hospital between January 1988 and October 1997, and found 3 cases of ECP (2%). To explain this phenomenon patients must be divided into two groups. In those who receive preoperative hormonal blockade, treatment may result in a drastic reduction of tumoral volume as well as microscopic changes that make malignancy recognition more difficult. ECP occurs in less than 5% of these prostatectomies. In patients with no previous hormonal treatment, ECP is extremely rare and any explanation comes as a consequence of the extended use of screening methods that lead to the detection of very small tumours, probably of little clinical relevance, that are found in the needle biopsy. Subsequently, however, no residual neoplasia is seen in the section either due to technical limitations of the pathoanatomical methods or because of a true, complete ablation of the lesion through the biopsy.

Adenocarcinoma↗
PubMed1999

T1 GIII bladder cancer. Management with transurethral resection only.

OBJECTIVE: Transurethral resection (TUR) is the elective procedure in the treatment of superficial bladder tumor. The association of intravesical chemotherapy has no influence on survival and cause specific survival. This study was carried out to determine the evolution of T1 GIII bladder carcinoma treated with TUR only. PATIENTS AND METHODS: We retrospectively reviewed the records of 42 consecutive patients with T1 GIII bladder carcinoma. Follow-up was available for 34 patients. No patient received either adjuvant or neoadjuvant therapy. All the patients were treated with TUR only and followed for a median of 40 months. They were followed by cystoscopy, urinary cytology and intravenous urography. RESULTS: Forty-seven percent of patients had a solitary tumor while 53% had multiple tumors. Tumor recurrence occurred in 50% with a disease-free interval until the first relapse of 9.6 months. Progression of the primary tumor was observed in 23.5% of patients. The overall survival rate was 73.6% and the cancer-specific survival estimate was 88.2% at mean 36 months of follow-up. CONCLUSIONS: T1 GIII bladder carcinoma may be treated initially with transurethral resection only with acceptable recurrence and progression rates. This would avoid costs and complications of the adjuvant/neoadjuvant therapies.

Adult↗
PubMed1999

Pyelic metastasis from a renal cell carcinoma following partial nephrectomy.

The majority of ureteropelvic metastatic tumors are of non-urologic origin. A case of metastatic clear cell adenocarcinoma to the renal pelvis in a patient with a bilateral, asynchronous renal tumor is presented. Conservative surgical treatment involved open pyelotomy and local resection of the tumor. At the 12-month follow-up, the patient is alive, asymptomatic and not on dialysis. The hypothesis for the mechanisms of dissemination and the relevance of conservative treatment are discussed.

Aged↗
PubMed1999

[Traumatic unilateral testicular dislocation].

OBJECTIVE: To report a case of traumatic testicular dislocation, an unusual complication of pelvic trauma. METHODS/RESULTS: A case of traumatic testicular dislocation that had been diagnosed two months after the initial injury is presented. CT and color doppler US revealed a viable right testis displaced in the inguinal subcutaneous region. The testis was repositioned in the scrotum and orchidopexy was performed. Follow-up control evaluation at 6 months revealed a normal testis in the right hemiscrotum. CONCLUSIONS: Traumatic testicular dislocation is a rare complication that may be undetected at the time of the initial injury. Surgical reduction and repositioning achieve good results.

Adult↗
PubMed1999

[Use of the appendix in urology: analysis of findings and incidental appendicectomy in urological patients].

In spite of the long-standing use of the appendage in urological reconstructive surgery, it wasn't until the 80's that became popular. Anatomical and histological normality is the major consideration to allow use of the appendage in autografting. Over a 9-year period, performance of incidental appendicectomies in abdominal major surgery in adult patients was included as a surgical routine practice in our service. This paper describes the pathoanatomical findings of incidentally removed appendages, discussing the relevance of such findings in the incorporation of the appendage to the urinary tract.

Adult↗
PubMed1998

[Paratesticular sarcoma: apropos of a case with a 19-year evolution].

Presentation of one case report of paratesticular sarcoma in a 51-year old patient undergoing surgical treatment and adjuvant systemic radio- and chemo-therapy with 19 years follow-up, that evolved with local relapse of the disease but no distant spread. Analysis of the difficulties of the pathoanatomical diagnosis, currently improved by immunohistochemical methods and the value of the adjuvant treatment.

Aged↗
PubMedDate not supplied

[Chronic irritative urinary syndrome. Diagnostic value of cystoscopy, urinary cytology and biopsy].

Chronic irritative urinary syndrome (CIUS), is a diagnostic concern for urologists from the moment that it becomes chronic and there is no etiologic diagnostic available. The objective of this study is to find out the diagnostic value of Cystoscopy, Urinary cytology and Biopsy of the vesical mucosa. A prospective, descriptive study was conducted in 30 patients who developed CIUS. Cystoscopy showed visible damage in 7 patients (31.8%); urinary cytology, 22 patients with cytologic changes (73.3%); and vesical biopsy, 24 patients with histologic changes (80.0%). The authors conclude that CIUS occurs more frequently in females than in males, the age range with higher incidence are 43 and 45 years. The most common diagnosis are unspecific chronic inflammatory changes followed by metaplasia.

Adult↗
PubMedDate not supplied

[Retroperitoneal paraganglioma. Differential diagnosis with hypernephroma].

Paraganglioma are tumours that show embryological origin from the neural crest, and which derive from the paraganglia. They can be found in any location throughout the aorta and/or in association to the sympathetic chain. They can be either functioning or non-functioning based on hormone production. The authors present here a non-functioning retroperitoneal paraganglioma as an incidental finding in a 72-year old female patient. Pre-operative diagnosis was cystic hypernephroma, for which radical nephrectomy was performed. The extra-renal origin of the tumour was found subsequently on examining the piece. A discussion is included on the diagnosis, treatment, prognosis as well as a review of the literature.

Aged↗
PubMedDate not supplied

[Malignant endometriosis].

Presentation of two case reports of severe and multiple urinary tract involvement by endometriosis due to the low frequency of this disorder. Although this is a benign condition, the term "malignant" endometriosis has been used because of the significant consequences it may have for the urinary tract, since it may compromise both excretory systems with a likely vital risk.

Adult↗