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I Fonseca

Publications and source records attributed to I Fonseca.

At least 55 records · Page 3Linked to original sources
PubMed1993

Oncocytic tumors of salivary gland type: a study with emphasis on nuclear DNA ploidy.

We studied nine cases of oncocytic tumors of salivary gland type in order to evaluate their clinico-pathologic profiles and nuclear DNA patterns as criteria for the differential diagnosis between benign and malignant forms. The tumors were located at the parotid gland, palate, and orbit. The age of the patients ranged between 35 and 85 years and the sex ratio (F:M) was 1:0.8. Seven tumors were capsulated and had typical cytology: they were composed of polyhedrical cells with large, eosinophilic, and granular cytoplasm and dark nucleus. The remaining two tumors exhibited malignancy criteria for the oncocytic tumors: atypia, pleomorphism, and mitosis. The evaluation of the nuclear DNA content was also distinct: benign tumors had a DNA diploid pattern and the malignant neoplasms displayed a DNA aneuploid pattern. These observations point to DNA nuclear assessment as an additional criterion to discriminate neoplasms with divergent clinical behavior and prognosis.

Adenoma↗
PubMed1993

Adenoid cystic carcinoma: a study of nucleolar organizer regions (AgNOR) counts and their relation to prognosis.

We studied the AgNOR counts in 30 cases of adenoid cystic carcinoma from salivary glands (n = 18) and non-salivary sites (n = 12) in an attempt to correlate them with the evolution of the disease. AgNOR counts per nucleus varied between 1.96 and 6.12 (mean value 4.2 +/- 0.99) as compared with 1.21 +/- 1.4 in normal salivary tissue. There was no significant difference between cases that had an unfavourable clinical outcome (recurrence, metastases, and/or died of the disease) and cases without disease complications (4.31 vs. 4.03 AgNORs per nucleus). No difference was found between tumours located at salivary and non-salivary sites or between major and minor salivary glands. AgNOR counts also did not correlate with the grade of differentiation of the neoplasms. In adenoid cystic carcinoma, AgNOR counts do not seem to be a prognostic indicator, in contrast to the usefulness of this method in other tumour types.

Adult↗
PubMed1993

Epithelial-myoepithelial carcinoma of the salivary glands. A study of 22 cases.

Twenty-two cases of epithelial-myoepithelial carcinoma of major and minor salivary glands were studied retrospectively to define the clinico-pathological profile and to assess the value of DNA ploidy as a prognostic tool. Fifty-nine percent of the cases occurred in the major salivary glands, the patients being mostly females in their 5th to 8th decades. The clinical course was characterized by a high number of recurrences (in 50% of cases). Death due to the neoplastic disease was found in 40% of the patients. The only morphological feature found to be correlated to prognosis was the presence of nuclear atypia in more than 20% of the tumour cells. In 18 cases, cytophotometric DNA analysis was performed; 15 cases had a diploid DNA histogram and 3 an aneuploid one. All the cases that were DNA aneuploid were of the solid, predominantly clear-cell type and were associated with fatal outcome.

Adult↗
PubMed1993

Proliferating cell nuclear antigen immunohistochemistry in epithelial-myoepithelial carcinoma of the salivary glands.

Myoepithelial-type cells are largely predominant in the composition of aggressive recurrent epithelial-myoepithelial carcinoma, suggesting that such tumor cell lineage constitutes a highly proliferating neoplastic population. Thirteen cases of epithelial-myoepithelial carcinoma, seven of the solid type and six of the tubular-cribriform type, were immunostained with the anti-proliferating cell nuclear antigen PC10 antibody to evaluate the proliferative activity of the two tumor cell components. Positively stained nuclei were only observed in the myoepithelial cells. Only one of the 13 cases, of tubular architectural type, had a few but unequivocally positive ductlike cells. The percentage of cycling clear cells varied between 0.2% and 45.7%. Higher values were observed in the solid (11.2% to 45.7%) as compared with tubular-cribriform epithelial-myoepithelial carcinoma (0.2% to 6.3%) and were associated with a high recurrence rate of the neoplasm. No other relationship was found between proliferating cell nuclear antigen indexes and clinical evolution. These results point to epithelial-myoepithelial carcinoma growth being related to the proliferation of the myoepithelial cell component. The proliferating role of the duct cell population seems to be irrelevant, which points to these neoplastic cells being a "terminally differentiated" component with low potential dividing capacity.

Adult↗
PubMed1992

[Peri-ungual capillaroscopy in atherosclerosis].

The pathology of the major vessels also affects microcirculation, making possible to evaluate at the distal sector the consequences of an ischaemia, due to an artery disease, for instance. This work had as its main aim to evaluate by peri-ungueal capillaroscopy (PUC) the lesions due to an atherosclerotic process and the prognosis and/or diagnosis value of this exam. We studied 210 patients with either risk factors for atherosclerosis or atherosclerotic disease, who were divided into groups according to the severity of the lesions seen in PUC. Finally, we were able to conclude that although the capillaroscopic lesions found are not specific, they appear very early in the process and are more serious in the more severe cases.

Adolescent↗
PubMed1992

Acinic cell carcinoma of the salivary glands. A long term follow-up study of 15 cases.

Fifteen cases of acinic cell carcinoma of the salivary glands were evaluated retrospectively with respect to histological and clinical data. DNA content assessment was carried out in six cases by cytophotometry. The majority of tumors were located in the parotid gland and were Stage I at presentation. There was a female predominance and the mean age at primary diagnosis was 51.2 years for females and 41.0 for males. The solid-acinar cell pattern was the most frequently observed and the tumors were 'diploid' in all the six cases studied. Surgery was the therapeutic modality in all cases (enucleation in seven, superficial parotidectomy in three and total parotidectomy in five) and, in four of them, was complemented with radiotherapy. The clinical course was characterized by recurrence in 10 cases, metastases occurred in three patients and one patient died of the tumor. Of the seven recurrent cases, six were treated by enucleation and one by superficial parotidectomy. The histological pattern showed no correlation with the clinical course or DNA content. Acinic cell carcinoma has a significant morbidity with a high recurrence rate which seems to be largely influenced by the type of surgery employed. Wide surgical excision of the neoplasia, which includes total parotidectomy in the parotid cases, is recommended in order to reduce the frequency of recurrence of the tumor.

Adult↗
PubMed1991

Synthesis and structural, conformational, and pharmacological study of some of esters derived from 3-phenethyl-3-azabicyclo[3.2.1]octan-8-beta-ol and the corresponding N-endo-methyl quaternary derivatives.

A series of 8-beta-acyloxy-3-phenethyl-3-azabicyclo[3.2.1]octane and its N-endo methiodides were synthesized and studied by 1H and 13C NMR spectroscopy, and the crystal structure of 8-beta-p-chlorobenzoyloxy-3-phenethyl-3-azabicyclo[3.2.1]octane methiodide (2c) was determined by X-ray diffraction. In CDCl3 solution, 1b-1e display the same preferred conformation. The cyclopentane and piperidine rings adopt an envelope conformation flattened at C-8 and a distorted chair conformation puckered at C-8 and flattened at N-3, respectively, with the N-substituent in the equatorial position with respect to the piperidine ring. In all cases, methylation takes place from the endo position. The ability of the title compounds to antagonize the acetylcholine-induced contraction of guinea pig ileum is also reported. An initial structure-activity relationship is proposed.

Animals↗
PubMed1991

Mucoepidermoid carcinoma of the salivary glands: a reappraisal of the influence of tumor differentiation on prognosis.

Thirty-nine cases of mucoepidermoid carcinoma of the salivary glands were reviewed for a reappraisal of the influence of the grade of differentiation on the outcome of the disease. The age of the patients ranged between 7 and 84 years. Fifteen patients were females and 24 males. The tumors were located at the parotid gland (n = 30), the submaxillary gland (n = 1), the soft palate (n = 5) and the oral mucosa NOS (n = 3). At presentation 4 tumors were intraglandular and 35 extraglandular; three patients had lymph node metastases and one patient lung metastases. The grade of differentiation was assessed using the criteria of Healey et al. Twelve tumors were classified as grade I, 17 as grade II, and 10 as grade III. Follow-up information was obtained with a duration of 5-144 months (mean 44.7 months). Six cases recurred locally and 5 developed metastases. Five years cumulative survival was 100% for grade I, 70.1% for grade II, and 47.2% for grade III. The results point to the usefulness of the assessment of the grade of differentiation as a guide to anticipate the outcome of the disease.

Actuarial Analysis↗
PubMed1991

Epithelial salivary gland tumors of children and adolescents in southern Portugal. A clinicopathologic study of twenty-four cases.

During a 30-year period 24 epithelial salivary gland tumors were diagnosed in children and adolescents less than 18 years of age. The cases were retrieved from a series of 759 consecutive cases of salivary gland tumors (3.2%) from the area corresponding to southern Portugal during the same period of time. The mean age of the patients was 13.4 years, and one case was congenital. There was a slight female predominance (male/female ratio 1:1.7). The parotid gland was affected in most cases (70.8%). Seventeen neoplasms were benign, and the remaining seven were malignant. As in the adult group, pleomorphic adenoma was the most frequent benign tumor (66.6%), with similar histologic findings and clinical course. Mucoepidermoid carcinoma was the prevalent malignant tumor (20.8%), had a high grade of differentiation, and had a favorable outcome. The histologic pattern of the congenital neoplasm was similar to that of adult epithelial-myoepithelial carcinoma.

Adenoma, Pleomorphic↗
PubMed1991

Submandibular endodermal sinus (yolk sac) tumor in a female infant. A case report.

A submandibular endodermal sinus (yolk sac) tumor (EST-YST) is reported. The patient was a 1.5-year-old girl exhibiting a rapidly growing tumor in the submandibular region. The lesion showed the typical microscopic features including Schiller-Duval bodies and colloid bodies. Alpha-fetoprotein immunoreactivity was expressed by most tumor cells. There was no clinical or radiological evidence of the presence of this tumor elsewhere in the body.

Basement Membrane↗
PubMed1991

Prognostic implications of image cytometric assessments of nuclear DNA distribution pattern of neoplastic cells in thyroid medullary carcinoma. A retrospective study using disaggregated, formalin-fixed, paraffin-embedded specimens.

A modified technique for cytometric analysis of the nuclear DNA distribution pattern of neoplastic cells has been applied on archival histopathological specimens originating from 42 patients who had undergone thyroidectomy for medullary carcinoma of the thyroid gland. Five of the cases were of familial type. The DNA cytometric assessments were made by means of computerized image analysis techniques on Feulgen-stained, intact, cytodiagnostically identified neoplastic nuclei obtained from histopathologically selected areas of paraffin blocks. The nuclei were enriched by means of a cytospin technique after deparaffinization of pronase-induced disaggregation of 50 microns thick sections. Only seven of the tumours were found to consist of neoplastic cells where the nuclei showed a DNA distribution pattern of "aneuploid" type; six of these patients had a rapidly progressive neoplastic disease, but the seventh patient did not. Among all the patients whose tumour cell nuclei showed a cytometric DNA ploidy pattern of "euploid" type, not less than about half had a rapidly progressive neoplastic disease. Thus, even when a refined cytometric technique is used, the value of the nuclear DNA ploidy pattern of the neoplastic cells as a prognostic variable in MTC is limited.

Adolescent↗
PubMed1989

A case of lymphomatoid papulosis and Hodgkin's disease.

Lymphomatoid papulosis is a unique paradoxic entity characterized by recurrent self-healing papulonodular lesions with histologic features of malignancy. Usually the disease has a protracted benign course; however, it can be associated with or evolve to a lymphoproliferative disorder. Thus "lymphoma-associated papulosis" represents the malignant end of a wide spectrum. We describe a case of a patient with lymphomatoid papulosis who developed Hodgkin's disease 8 years after the onset of skin lesions. Systemic chemotherapy achieved complete remission of Hodgkin's disease, but recurrent papulonodular lesions continued to form in the subsequent 18 months.

Adult↗
PubMedDate not supplied

Immunosuppression with antithymocyte globulin in renal transplantation: better long-term graft survival.

We analyzed the impact of antithymocyte globulin (ATG) in renal transplantation. We retrospectively studied 1217 recipients performed from July 83 to December 03. ATG-Fresenius-S (ATG-F) was used for induction therapy in 492 patients (40.4%; group I) and compared with group II, 725 patients (59.6%), without antilymphocyte induction. Groups were comparable in terms of recipient gender and race distribution; time on dialysis; cause of renal disease; number of human leukocyte antigen (HLA) mismatches; donor age, gender, and creatinine; and cold ischemia time. Patients with ATG-F were younger (35.8 +/- 13.8 vs 38.9 +/- 12.5 years, P < .001), more frequently hypersensitized (10% vs 3%, P < .001), and had more second transplants (15.7% vs 5.8%, P < .001). The incidence of acute rejection episodes was lower among ATG-F patients (23.6% vs 32.1%, P = .004). Admission time and incidence of delayed graft function (DGF) were similar in the two groups. Graft survival at 1, 5, 10, and 15 years was 88.9%, 80.7%, 71.3%, and 64.9% in group I and 86.4%, 77.4%, 60.7%, and 48.4% in group II (P = .003). The difference in patient survival over the same follow-up did not reach statistical significance. Multivariate analysis showed that the risk of graft failure was higher for those who did not receive ATG-F (HR = 1.51; 95% CI, 1.14 to 2.00; P = .004). Donor age and DGF were also independent predictors of graft failure. Our results showed a better long-term graft survival among patients who received ATG-F, despite their higher immunological risk. The absence of induction with ATG-F, donor age, and DGF were independent risk factors for graft failure.

Antilymphocyte Serum↗
PubMedDate not supplied

Impact of homocysteinemia on long-term renal transplant survival.

AIM: We prospectively followed a cohort of 202 renal transplant recipients for 5 years to examine the impact of fasting homocysteinemia on long-term patient and renal allograft survival. METHODS: Cox proportional hazards regression analysis was used to identify independent predictors of all-cause mortality and graft loss. RESULTS: Hyperhomocysteinemia (tHcy >15 micromol/L) was present in 48.7% of the 202 patients, predominantly among men (55.8%) as opposed to women (37.1%). At the end of the follow-up period, 13 (6.4%) patients had died including 10 from cardiovascular disease, and 23 had (11.4%) had lost their grafts. Patient death with a functioning allograft was the most prevalent cause of graft loss (13 recipients). Levels of tHcy were higher among patients who died than among survivors (median 23.9 vs 14.3 micromol/L; P = .005). Median tHcy concentration was also higher among the patients who had lost their allografts than those who did not (median 19.0 vs 14.1 micromol/L; P = .001). In a Cox regression model including gender, serum creatinine concentration, transplant duration, traditional cardiovascular risk factors, and associated conditions, such as past cardiovascular disease, only tHcy concentration (ln) (HR = 5.50; 95% CI, 1.56 to 19.36; P = .008) and age at transplantation (HR = 1.07; 95% CI, 1.02 to 1.13; P = .01) were independent predictors of patient survival. After censoring data for patient death, tHcy concentration was not a risk factor for graft loss. CONCLUSIONS: This prospective study shows that tHcy concentration is a significant predictor of mortality, but not of graft loss, after censoring data for patient death.

Adult↗