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L Fonseca

Publications and source records attributed to L Fonseca.

At least 37 records · Page 2Linked to original sources
PubMed1993

Analysis of proliferative activity using anti-proliferating cell nuclear antigen antibody in gastric cancer tissue specimens obtained by endoscopic biopsy.

BACKGROUND: Proliferative activities of tumors are thought to be prognostic features of malignant tumors, but their value as measured by proliferating cell nuclear antigen (PCNA) labeling remains unclear in gastric cancer. METHODS: PCNA labeling rates (LR) were quantified in 121 paraffin-embedded biopsy specimens from primary tumors by immunocytochemistry. RESULTS: Immunohistochemical analyses have demonstrated that PCNA presents an intense staining in the nuclei of tumor cells and mucous neck cells of gastric glands. The PCNA LR ranged from 12% to 79% (mean +/- standard deviation), and a significant correlation was found between bromodeoxyuridine labeling indices and PCNA LR: PCNA LR were closely associated with tumor size, serosal invasion, and nodal involvement. The patients with tumors with high PCNA LR (greater than 40%) were dead significantly earlier than were those with tumors with low PCNA LR: When the PCNA LR and all the clinicopathologic parameters were entered into a Cox regression model, PCNA LR emerged as an independent prognostic factor. CONCLUSION: These results indicate that PCNA LR may be a potentially useful prognostic factor for gastric cancer.

Antibodies↗
PubMed1993

Histological evaluation of the intrahepatic biliary tree in intrahepatic cholesterol stones, including immunohistochemical staining against apolipoprotein A-1.

Apolipoprotein A-1 is known to be one of inhibiting factors of cholesterol nucleation in bile, and decreased activity of apolipoprotein A-1 is considered to predispose cholesterol-supersaturated bile to formation of cholesterol crystals. To study the pathogenesis of the intrahepatic formation of cholesterol stones, we examined surgically resected liver specimens from six patients with intrahepatic cholesterol stones and compared the characteristic histopathological features with those of intrahepatic calcium bilirubinate stones, using morphological examination and immunohistochemical staining against apolipoprotein A-1. Morphologically, in all six patients with cholesterol stones the severity of chronic proliferative cholangitis with proliferation of the mucus-producing glandular elements in the walls of the large bile duct or periductal tissues was less extensive than that seen with calcium bilirubinate stones, and cholesterol crystals had formed in the septal and interlobular bile ducts. Immunohistochemically, unlike the normal liver and calcium bilirubinate stone-containing lobes, the hepatocytes and the epithelial lining of the bile ducts and peribiliary glands of the cholesterol stone-containing lobes did not react completely (some of the epithelial cells reacted only faintly) with apolipoprotein A-1 antibody. These findings suggest that an abundance of mucous substance and bacterial infection of the biliary tree may not be necessary for the formation of cholesterol stones, compared with findings in cases of calcium bilirubinate stones. We suggest that cholesterol crystals may be produced in the septal and interlobular bile ducts in the microenvironment of cholesterol-supersaturated bile and decreased activity of apolipoprotein A-1.

Adult↗
PubMed1993

A case of serous cystadenoma of the pancreas with focal malignant changes.

We present a serous cystadenoma of the pancreas with focal malignant changes, and describe its characteristic histological features. On gross examination, a tumor was present on the anterior surface of the body of the pancreas and measured approx 25 x 25 x 20 mm. Microscopically, most tumor cells showed the typical histological features of serous cystadenoma, characterized by a microcystic architecture and glycogen-rich cells with a uniform and bland appearance. However, in some areas, a tendency to papillary structures with fibrovascular cores was noted. These papillary lesions were composed mainly of nonmucinous, glycogen-poor epithelial cells, the nuclei of which showed a mild atypia. In addition, vascular and perivascular invasion was focally observed. However, there was no clinical evidence of local or distant metastasis. From these findings, we diagnosed this lesion as a serous cystadenoma of the pancreas with focal malignant changes rather than a serous cystadenocarcinoma of the pancreas.

Blood Vessels↗
PubMed1993

Expression of argyrophilic nucleolar organizer regions in ductal adenocarcinoma of the pancreas and its relationship to prognosis.

The aim of the present study was to investigate the relationship between Ag-NOR count levels and survival in 33 patients undergoing resection for ductal adenocarcinoma of the pancreas at Kanazawa University Hospital from 1985 to 1991. To determine the biologic behavior of invasive ductal adenocarcinoma of the pancreas, 33 tumors were classified into two groups according to the median value of Ag-NOR counts: Group 1, Ag-NOR count > or = 3.25 (higher Ag-NOR count group); Group 2, Ag-NOR count < 3.25 (lower Ag-NOR count group). As a result, we found that tumors with a higher Ag-NOR count were more likely to have liver or peritoneal metastasis than those with a lower Ag-NOR count, although the differences were not statistically significant. Tumors with lower Ag-NOR count levels were associated with favorable prognoses 2 and 3 yr after surgery, whereas those with higher Ag-NOR count levels were related to poor prognosis. Our results indicate that a Ag-NOR count level is a reliable prognostic parameter in resected pancreatic ductal adenocarcinoma.

Adult↗
PubMed1993

Prognostic significance of Helix pomatia lectin and c-erbB-2 oncoprotein in human breast cancer.

We investigated the prognostic significance of Helix pomatia lectin (HPA) staining on disease-free and overall survival in 120 primary breast carcinomas. HPA staining was present in 58 (48%) of these carcinomas. It was significantly associated with axillary lymph node metastases (P < 0.001) and c-erbB-2 expression (P < 0.01). A univariate study revealed that disease-free and overall survival were significantly correlated with clinical stage, tumour size, axillary lymph node metastases. HPA staining and c-erbB-2 expression. In a multivariate study, all previous prognostic indicators except HPA staining and c-erbB-2 expression were independent factors. However, stratifying the patients on the basis of HPA and c-erbB-2 status suggested that HPA +/c-erbB-2+ status was predictive of a higher incidence of axillary lymph node metastases (P = 0.000001) and a poorer overall (P < 0.0002) and a shorter disease-free (P < 0.000006) survival when compared with the other subgroups, although this combination did not provide any additional prognostic information for overall (P = 0.3544) or disease-free (P = 0.7152) survival by a multivariate analysis. For patients in whom axillary lymph node dissection has not been performed, therefore, HPA and c-erbB-2 status seems to be a powerful tool to discriminate subpopulations with a high recurrence risk and shorter survival who should undergo more aggressive therapy.

Adult↗
PubMed1993

Correlation of p53 expression and proliferative activity in gastric cancer.

We analyzed immunohistochemically the association between p53 tissue status and prognostic parameters of 357 gastric cancer patients, using endoscopically obtained biopsy materials, embedded in paraffin. Using PAb1801, an anti-p53 monoclonal antibody p53 immunoreactivity was detected in the nuclei of cancer cells in 113 cases (32%). The nuclear p53 immunoreaction was closely associated with positive lymph node metastasis, serosal invasion, and liver metastasis. For the estimation of proliferative activity, proliferating cell nuclear antigen (PCNA) labeling rates (LRs) of biopsy specimens were immunohistochemically measured. A significant positive correlation was found between PCNA LRs and p53 tissue status. In addition, a positive nuclear p53 immunoreaction was found to be significantly associated with shorter overall survival. Especially, in the group of patients with stages III and IV, the prognosis of patients with p53-positive tumours was significantly poorer than that of patients with p53-negative tumours. These results indicate that immunohistochemical staining for nuclear p53 in biopsied materials may be useful in deciding the therapeutic schedule of patients with gastric cancer, preoperatively.

Antibodies, Monoclonal↗
PubMed1993

Determination of the presence of spirochetes in the subgingival plaque of Brazilian children.

In the present study we investigated the presence of spirochetes in the subgingival plaque of 66 boys and girls aged 5 to 10 years. A total of 264 samples were removed from 4 different sites using wooden wedges held with hemostatic pliers and introduced into tubes containing 0.6 ml reduced transport fluid (RTF). After dispersal of the material, smears were prepared and stained by the Fontana-Tribondeau and Giemsa methods for spirochete visualization. Slides were examined under a binocular light microscope with a 100X objective and at least 200 microorganisms were counted, including spirochetes. Spirochetes were detected in 27.27% of the samples and were absent in 72.73% of them, i.e., 65.15% of the children harbored spirochetes in at least one of the sites studied. The relative frequency of percentage of spirochetes observed was quite low in 6-year old children (9.09%), and was higher in 7- and 10-year old children (41.76% and 36.62%, respectively) than in the remaining age groups studied. The spirochete-age correlation was statistically significant (P < 0.01).

Age Distribution↗
PubMed1993

The role of 16,16-dimethyl prostaglandin E2 on the intrahepatic biliary branches in dogs.

We studied the effects of the oral administration of a stable prostaglandin E2 analog, 16,16-dimethyl prostaglandin E2, on the intrahepatic biliary branches in a canine model. Obstructive cholestasis with a bacterial infection was induced surgically in two liver lobes in healthy mongrel dogs, and 16,16-dimethyl prostaglandin E2 was administered orally. We examined the morphological changes in the intrahepatic biliary branches and quantitatively estimated density of mucus-producing glandular elements in the ductal wall by counting these glands per unit area. Dogs treated with 16,16-dimethyl prostaglandin E2 (group 1) demonstrated fibrous thickening of the ductal wall, moderate infiltration by inflammatory cells and severe adenomatous hyperplasia of the bile duct epithelium, including striking proliferation of the mucous glands. The mean number of these mucous glands per unit area (4 mm2) was 43.0 +/- 9.0 (mean +/- S.D.; range = 36 to 56). In contrast, in a control group whose members did not receive 16,16-dimethyl prostaglandin E2 (group 2), the mean number of mucous glands per unit area was 19.4 +/- 8.0 (range = 10 to 29), significantly lower than that in group 1, although histological examination revealed chronic inflammation in the region of the large bile duct similar to that in group 1. These findings suggest that the increase in the number of mucous glands that typically occur in the setting of bile stasis and biliary infection is enhanced by 16,16-dimethyl prostaglandin E2.

16,16-Dimethylprostaglandin E2↗
PubMed1992

Gallbladder cancer in Chile. A report on 54 potentially resectable tumors.

Fifty-four patients with potentially resectable gallbladder tumors, chosen from 205 cases diagnosed at the Pathologic Unit of the authors' institution, were included in a prospective protocol of management. Of the potentially resectable tumors, only four were indicated before cholecystectomy (7.4%). Inconspicuous tumors were frequently observed, explaining in part the poor results of ultrasonogram for diagnosis. Poorly differentiated tumors were related to a greater rate of metastasis and shorter survival. Likewise, younger patients were associated with a worse prognosis. Patients with tumor confined to the mucosal layer were followed-up only during their postoperative courses. Patients with tumor involvement of the subserosa or muscular layer were offered treatment of a second operation, which included a lymphadenectomy and a liver wedge resection. For patients with serosal involvement, a more aggressive approach was proposed. Metastatic lymph node involvement was found in 9 of the 25 (36%) patients in whom dissection was performed. However, tumor invasion of the liver was seen in 10 of the 24 (41.6%) patients who underwent a liver resection. Patients who had a curative resection had a significantly longer survival in comparison with those who had a palliative resection or simple cholecystectomy.

Adenocarcinoma↗
PubMed1992

Influence of age on the reactivity of the BANA test among Brazilian children.

Three hundred and twenty samples of subgingival plaque were obtained from 80 caucasian girls, ranging from 10 to 13 years of age. The samples were analyzed to verify the influence of age upon colonization of the gingival sulcus by microorganisms potentially pathogenic to the periodontal tissues. The gingival and plaque status were evaluated through the gingival index (GI) and plaque index (PlI) and the microflora was assessed by the enzymatic method benzoyl-arginine-naphthylamide (BANA). The results of the BANA test were positive for 62.50% of the tested individuals and 40% of the examined sites. The influence of age was statistically significant on BANA reactivity, and the number of positive sites was greater at 11 (57.5%) than at 12 years (28.8%).

Adolescent↗
PubMed1991

Pilonidal disease: 25 cases treated by the Dufourmentel technique.

Twenty-five patients with pilonidal disease were treated by the Dufourmentel technique between 1984 and 1989. In this series, 18 patients (72 percent) were women and 7 (28 percent) were men (mean age, 24 years); hospital stay averaged 4 days. There were no recurrences and no reports of surgical wound infection. Diagnosis was confirmed histologically in all cases.

Adolescent↗
PubMed1991

Sjogren's syndrome: a comparative study of impression cytology of the conjunctiva and buccal mucosa, and salivary gland biopsy.

The diagnosis of Sjogren's syndrome (SJ) as an underlying disease of keratoconjunctivitis sicca is important because of the many ocular and systemic complications. We compared the results of impression cytology of conjunctiva (ICC) and the results of labial salivary gland biopsy (LSB) with impression cytology of buccal mucosa (ICB) in 33 patients with SJ. LSB, ICC, and ICB were considered positive in all patients. Moderate to severe changes were graded in 85% of the biopsy specimens, 94% of the conjunctival specimens, and 76% of the buccal mucosa specimens. The rate of agreement between LSB and ICB was 97%. The use of ICB in the clinical ophthalmological examination may be helpful in patients with consistent history, and clinical and ocular findings, before the biopsy procedure.

Adolescent↗
PubMed1991

[Inapparent cancer of the gallbladder].

Gallbladder cancer is the most common cancer in the Chilean female population. A prospective histological mapping of cholecystectomy pieces allowed the detection of 37 tumors not evident to the surgeon. Tumoral invasion engaged the mucous membrane in 7, the muscular layer in 8, the subserous layer in 12, the serous membrane in 5 and the surrounding adipose tissue of the gallbladder in 5 cases. 18 pts were reoperated on for resective oncological surgery. In 5 of these cases the ganglia, and in 6 the hepatic tissue behind the gallbladder were involved. Actuarial survival at 38 months was 48% (10 pts have died by the time of this publication). The prognosis of the disease was directly related to histological differentiation and to the degree of tumoral invasion. Gallbladder cancer has a poor prognosis even if the surgeon has no suspicion of the disease and a simple cholecystectomy is by no means a healing therapy.

Adult↗
PubMed1991

Experience in the surgical treatment of 331 patients with pulmonary hydatidosis.

Echinococcus disease is prevalent in Chile, with a rate of occurrence of 8.2 per 100,000. During a 15-year-period (1970 to 1985) we operated on 331 patients for pulmonary hydatidosis. Chest roentgenography was the main method of diagnosis. Among the total of 508 surgical procedures performed, pulmonary cystectomy was the most common (61.4%), whereas pulmonary resection was used in 31.4% of patients. The arc 5 test was used to confirm the diagnosis. Results were positive in 85% of the patients in whom it was done. There were 12.9% immediate postoperative complications in 12.9%, with late complications occurring in 4.10% and an overall mortality rate of 4.21%. These data suggest that hydatid cyst is still a common disease in our country, causing an important number of hospital admissions and a high percentage of complications.

Echinococcosis, Pulmonary↗
PubMed1991

Pancreatojejunostomy.

Pancreatoduodenectomy is a complex procedure associated with considerable mortality and morbidity. Pancreatojejunostomy is probably the main cause of morbidity, and controversy concerning the best type of reconstruction still exists. In this report the technique of pancreatojejunostomy is demonstrated. An end-to-side pancreatojejunostomy is performed on all patients. For patients with a pancreatic duct of less than 4 mm in diameter, the top of the pancreatic duct is inserted into a stab-wound of jejunum. It is secured with a purse-string suture. Furthermore, two layers of reinforcement are done. By using this technique, an end-to-side anastomosis was done on patients with soft glands and small ducts. In patients with a pancreatic duct greater than 4 mm, a three-layer anastomosis is done between pancreas and jejunum. This is a technique that allows the performance of an end-to-side anastomosis regardless of the pancreas consistency or pancreatic duct diameter.

Anastomosis, Surgical↗
PubMed1990

[Association of gallbladder and Vater's ampulla neoplasms. Report of a case].

A 54 year old female was operated on for ampullary carcinoma diagnosed by retrograde cholangiography. Histologic study of the gallbladder resected at operation revealed another carcinoma at that location. Pancreato-duodenectomy plus a double segmental resection of liver was performed. The patient remains in good condition 11 months after operation.

Adenocarcinoma↗