Small bowel carcinomas in celiac or Crohn's disease: Distinctive histophenotypic, molecular and histogenetic patterns

Non-familial small bowel carcinomas are relatively rare and have a poor prognosis. Two small bowel carcinoma subsets may arise in distinct immune-inflammatory diseases (celiac disease and Crohn's disease) and have been recently suggested to differ in prognosis, celiac disease-associated carcinoma cases showing a better outcome, possibly due to their higher DNA microsatellite instability and tumor-infiltrating T lymphocytes. In this study, we investigated the histological structure (glandular vs diffuse/poorly cohesive, mixed or solid), cell phenotype (intestinal vs gastric/pancreatobiliary duct type) and Wnt signaling activation (β-catenin and/or SOX-9 nuclear expression) in a series of 26 celiac disease-associated small bowel carcinoma, 25 Crohn's disease-associated small bowel carcinoma and 25 sporadic small bowel carcinoma cases, searching for new prognostic parameters. In addition, non-tumor mucosa of celiac and Crohn's disease patients was investigated for epithelial precursor changes (hyperplastic, metaplastic or dysplastic) to help clarify carcinoma histogenesis. When compared with non-glandular structure and non-intestinal phenotype, both glandular structure and intestinal phenotype were associated with a more favorable outcome at univariable or stage- and microsatellite instability/tumor-infiltrating lymphocyte-inclusive multivariable analysis. The prognostic power of histological structure was independent of the clinical groups while the non-intestinal phenotype, associated with poor outcome, was dominant among Crohn's disease-associated carcinoma. Both nuclear β-catenin and SOX-9 were preferably expressed among celiac disease-associated carcinomas; however, they were devoid, per se, of prognostic value. We obtained findings supporting an origin of celiac disease-associated carcinoma in SOX-9-positive immature hyperplastic crypts, partly through flat β-catenin-positive dysplasia, and of Crohn's disease-associated carcinoma in a metaplastic (gastric and/or pancreatobiliary-type) mucosa, often through dysplastic polypoid growths of metaplastic phenotype. In conclusion, despite their common origin in a chronically inflamed mucosa, celiac disease-associated and Crohn's disease-associated small bowel carcinomas differ substantially in histological structure, phenotype, microsatellite instability/tumor-infiltrating lymphocyte status, Wnt pathway activation, mucosal precursor lesions and prognosis

[pt] CRIANÇAS E TELEVISÃO: UM ESTUDO DE AUDIÊNCIA INFANTIL E DE FATORES INTERVENIENTES

Esta dissertação traça o perfil sócio-econômico das crianças que participaram da pesquisa O que penso da tevê? realizada pelo Grupo de Pesquisa em Educação e Mídia, e analisa, descritivamente, o consumo cultural dessas crianças, o tempo dedicado por elas à tevê, modos de interação com o veículo e níveis e formas de atuação da escola e da família como fatores intervenientes dessa relação. Os dados que sustentam o estudo foram construídos a partir de um questionário auto-administrável, respondido por 718 crianças, com idades entre 8 e 12 anos, estudantes de oito escolas públicas e três particulares dos estados do Rio de Janeiro e de Minas Gerais e foram feitas análises de fatores e análises bivariadas. As variáveis que foram objeto destas análises são: impacto da televisão na vida das crianças - correlacionada ao tempo dedicado à prática de ver tevê e às atividades que as crianças deixam de fazer em função disso; padrão de consumo cultural das crianças; diálogo familiar; expertise ou telefilia, relacionada ao conhecimento que as crianças têm sobre a televisão; relação escola/televisão e família/televisão; nível econômico delas. Como referências teórico- metodológicas foram utilizadas pesquisas de audiência infantil realizadas na Inglaterra por Livingstone; na Espanha, por Bailén e Aguaded; em Portugal, por Matos; os estudos de Ortigão e Aguiar sobre os conceitos de Coleman de capital econômico e social orientaram a análise e a descrição do perfil econômico das crianças, de seu consumo cultural e de seu diálogo familiar; a Teoria das Multimediações, desenvolvida por Guillermo Orozco-Gomez, orientou a análise dos dados relativos à atuação da família e da escola na relação das crianças com a tevê. Os resultados indicam que: 1) essas crianças têm um consumo de televisão muito intenso no que diz respeito ao tempo - mais de três horas diárias, todos os dias da semana - e ao conhecimento adquirido acerca do veículo e de sua linguagem - são experts no assunto; 2) têm clara preferência por narrativas de ficção (telenovelas, filmes e seriados) e sentem imenso prazer em se relacionar com elas; 3) vêem seus programas prediletos quase sempre acompanhadas por adultos, o que sugere presença da família como importante fonte de mediação; 4) a escola tem participação significativa na relação das crianças com o conteúdo televisivo.This dissertation defines the socio-economic profile of the children who participated in the poll What do I think about TV? carried out by the Education and Media Research Group (Grupo de Pesquisa em Educação e Mídia) and analyses on a descriptive manner, the cultural consumption of these children, the time they dedicate to watching TV, the ways they interact with the vehicle and levels and ways schools and families act as intervening factors. The data supporting this research were built based on factorial and bivariate analysis of the responses 718 children with ages varying between 8 as 12, students of eight public schools and three private schools in the states of Rio de Janeiro and Minas Gerais, gave answering a self administered questionnaire. The variables which were analyzed are the following: impact of TV in the children´s lives - related to the time they dedicate to watching TV and the activities they end up not doing as a result of that; the children´s standard of cultural consumption; their family dialogue; their knowledge about TV; the school/television and family/television relationships; and their economic standards. As theoretical methodological references, infantile audience researches carries out in the UK by Livingstone; in Spain by Bailén and Aguaded and in Portugal by Matos were used. The studies of Ortigão and Aguiar about Coleman´s concepts of economic and social capital oriented the analysis and description of the children´s economic profile, cultural consumption and family dialogue. The Theory of Multimediations developed by Guillermo Orozco-Gómez, oriented the analysis of data related to the roles of family and school in the children´s relationship with TV. The results indicate that: 1) these children have very intense television consumption time wise - more than three hours per day every day of the week - and with respect to the knowledge about TV and its languages - they are experts in the area; 2) they have a clear preference for fictional programs (soap operas, movies and series) and have immense pleasure in watching these programs;; 3) they almost always watch their preferred TV shows with adults, what suggests that the presence of the family is an important mediation source; 4) the school has an significant role in the children´s relationship with television

Breast Carcinomatous Lymphangitis as an Unusual Presentation of Ovarian Cancer.

We describe the case of a 45-year-old woman with an unusual presentation of metastatic ovarian cancer. The patient presented to the oncological clinic with a three-week history of skin rash on the right breast. She underwent a chest and abdomen CT scan, which showed skin thickening of the right breast, right pleural effusion and bilateral cystic ovarian masses. Biopsy of a left ovarian lesion by diagnostic laparoscopy revealed the presence of ovarian serous carcinoma. Biopsy of the breast skin lesion revealed the presence of carcinomatous lymphangitis and immunohistochemistry documented the ovarian origin