Histopathological Characterization and Whole Exome Sequencing of Ectopic Thyroid: Fetal Architecture in a Functional Ectopic Gland from Adult Patient

Ectopic thyroid results from a migration defect of the developing gland during embryogenesis causing congenital hypothyroidism. But it has also been detected in asymptomatic individuals. This study aimed to investigate the histopathological, functional, and genetic features of human ectopic thyroids. Six samples were histologically examined, and the expression of the specific thyroid proteins was assessed by immunohistochemistry. Two samples were submitted to whole exome sequencing. An oropharynx sample showed immature fetal architecture tissue with clusters or cords of oval thyrocytes and small folliclesone sample exhibited a normal thyroid pattern while four showed colloid goiter. All ectopic thyroids expressed the specific thyroid genes and T4 at similar locations to those observed in normal thyroid. No somatic mutations associated with ectopic thyroid were found. This is the first immature thyroid fetal tissue observed in an ectopic thyroid due to the arrest of structural differentiation early in the colloid stage of development that proved able to synthesize thyroid hormone but not to respond to TSH. Despite the ability of all ectopic thyroids to synthetize specific thyroid proteins and T4, at some point in life, it may be insufficient to support body growth leading to hypothyroidism, as observed in some of the patients.FAPESP Grant [2009/53840-0]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), Sao Paulo, Brazil [2010/12005-9, 2014/24549-4]Instituto da TiroideUniv Sao Paulo FMUSP, Fac Med, Cellular & Mol Endocrine Lab, Thyroid Unit,LIM 25, Ave Doutor Arnaldo 455, BR-01246904 Sao Paulo, SP, BrazilSao Paulo Publ Hlth Serv, Adolfo Lutz Inst, Av Dr Arnaldo 355, BR-01246000 Sao Paulo, SP, BrazilHead & Neck Surg Santa Catarina Hosp, Av Paulista 200, BR-01310000 Sao Paulo, SP, BrazilUNESP, Botucatu Sch Med, Dept Internal Med, Av Prof Montenegro,S-N Dist Rubiao Jr, BR-18618687 Botucatu, SP, BrazilHosp Pediat Dr Juan Garrahan, Serv Endocrinol, Combate Pozos 1881,C1245AAM, Buenos Aires, DF, ArgentinaUniv Estadual Campinas, Fac Ciencias Med, Dept Cirurgia, Disciplina Cirurgia Cabeca & Pescoco, R Tessalia Vieira Camargo 126, BR-13083887 Campinas, SP, BrazilUniv Fortaleza Unifor, Med Sch, Av Washington Soares 1321, BR-60811905 Fortaleza, CE, BrazilUniv Fed Sao Paulo UNIFESP, Postgrad Program Biotechnol, Pedro Toledo 669, BR-04039903 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Postgrad Programs Biotechnol & Struct & Funct Bio, Dept Ciencias Biol, Thyroid Mol Sci Lab,UNIFESP, Pedro Toledo 669, BR-04039903 Sao Paulo, SP, BrazilHosp Sirio Libanes, Mol Oncol Ctr, Rua Prof Daher Cutait 69, BR-01308060 Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Postgrad Program Biotechnol, Pedro Toledo 669, BR-04039903 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Postgrad Programs Biotechnol & Struct & Funct Bio, Dept Ciencias Biol, Thyroid Mol Sci Lab,UNIFESP, Pedro Toledo 669, BR-04039903 Sao Paulo, SP, BrazilFAPESP [2009/53840-0]FAPESP[2010/12005-9, 2014/24549-4]Web of Scienc

Maca Hospitalar Com Sistema De Freios Para Dirigibilidade

MACA HOSPITALAR COM SISTEMA DE FREIOS PARA DIRIGIBILIDADE. Macas são meios de transporte, geralmente em ambientes hospitalares, a indivíduos com algum tipo de enfermidade. As mesmas são conduzidas em espaços estreitos e necessitam fazer curvas e manobras. A colisão com obstáculos é muitas vezes inevitável. Além do que o condutor antevendo isto necessita fazer esforço para sua manobra. No intuito de facilitar a condução, diminuir o esforço do condutor e causar mais conforto ao transportado, foi desenvolvido um sistema de freios independentes adaptados nos pés anteriores giratórios das macas, para evitar os transtornos mencionados. Este sistema é de fácil execução e até de adaptação nas macas já existentes, além de ter custos muito acessíveis.BRMU9100859 (U2)A61G1/04BR2011MU00859UA61G1/0

Device For Draining Pleural Fluids And Drainage System Using Same

The present invention discloses a device for draining gaseous or liquid fluids present in the chest due to the occurrence of a direct injury to the chest or to an organ directly related to the lungs, said device comprising a cone-shaped rigid support (2) with a first enlarged end (4) and a second cylindrical end (5). An additional cover device (3) in its upper outer upper end has a central duct (7) for attaching a flexible collection tube (8), the drain, and a lower inner end has a perfect fitting for a one-way sealing valve (9).WO2008074109 (A3); WO2008074109 (A2)WO2007BR0033

Is specialized ophthalmologic evaluation necessary after orbital fractures? A prospective 64-case study

Introduction and objective The objective of this study was to determine whether there is a need for ophthalmologists to perform a specialized assessment after the occurrence of orbital fractures. Materials and methods Sixty-three patients (64 orbits) diagnosed with orbital fractures were evaluated preoperatively (up to 24 h after the trauma) and in 90-day postoperative period. Results Eight injuries required either specialized clinical or surgical ophthalmologic intervention. Of these patients, four required emergency eye surgery: two patients with corneal lacerations had lesions larger than 2 mm. Two patients had extensive ocular lesions after multiple traumas with uveal exposure and without light perception. Another four patients (iridodialysis associated with lens subluxation, anterior uveitis, direct lesion on the optic nerve, and chorioretinitis sclopetaria) received conservative management. Conclusion This study concluded that a specialized ophthalmologic examination as soon as possible is important, particularly in cases in which the signs and symptoms of severity are associated. The non-ophthalmologist surgeon must have the basic medical knowledge required to provide basic primary ophthalmologic care and to discern the severity of the injury23332532

The increased PDGF-A, PDGF-B and FGF-2 expression in recurrence of salivary gland pleomorphic adenoma

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background Pleomorphic adenoma (PA) is the most common salivary gland tumour. Although classified as benign, it has a tendency to recur (recurrent pleomorphic adenomas (RPA)), as well as the ability to undergo malignant transformation. It has been suggested that mutations in various families of growth factors and growth factor receptions are involved in the autonomous growth of tumour cells. The aim of the present study was to investigate the participation of platelet-derived growth factor (PDGF)-A, PDGF-B, PDGF-R alpha, fibroblast growth factor (FGF)-2, Flg and BEK in PA, RPA and recurrent pleomorphic adenoma with malignant transformation (TRPA). Methods 18 cases of PA, 16 cases of RPA and two cases of RPA with focal malignant transformation (TRPA) were analysed for growth factor expression utilising immunohistochemical techniques via tissue microarray. Results There was a significant difference in PDGF-A, PDGF-B, PDGF-R alpha, FGF-2, Flg and BEK expression in all groups. When comparing non-recurrent with recurrent tumours, PDGF-A, PDGF-B, PDGF-R alpha, FGF-2, Flg and BEK reactivity in RPA was stronger than that observed in PA. All proteins were highly expressed in TRPA. Conclusions This research suggests that PDGF-A, PDGF-B, PDGF-R alpha, FGF-2, BEK and Flg can be related to the recurrence of PA. In addition, this study shows that TRPA cells overexpress all growth factors, which has been reported in association with the malignant transformation.653272277Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

mRNA BRAF expression helps to identify papillary thyroid carcinomas in thyroid nodules independently of the presence of BRAFV600E mutation

Literature has consistently shown associations of BRAFV600E mutation with papillary thyroid cancer clinical features. However, the clinical utility of BRAF expression has not been clinically explored so far. We studied 67 thyroid nodules (32 benign nodules and 35 PTC cases). BRAF mRNA expression levels measured by a quantitative real-time PCR and a PCR-RFLP were used to identify BRAFV600E mutation. BRAF mRNA expression was significantly higher in malignant (198.2 +/- 373.9 AU) than in benign (4.1 +/- 6.9 AU) nodules (p < 0.0001). BRAF expression identified malignancy with a sensitivity of 80.6%, specificity of 77.1%, positive predictive value of 75.8%, and negative predictive value of 81.8%. A cut-point of 4.712, identified by the ROC curve, was able to sort out malignant nodules with an accuracy of 78.8%. Although we did not find any correlation between the presence of BRAF V600E mutation and clinical or tumor features such as age (p = 0.309), gender (p = 0.5453), ethnicity (p = 0.9820), tumor size (p = 1.000), multifocality (p = 0.2530) or mRNA levels (p = 0.7510), the study power for BRAF expression and diagnosis (99%; FPRP = 0.85) indicated that data is noteworthy despite the relative small number of patients investigated. We concluded that BRAF mRNA expression may help to identify PTC among thyroid nodules independently of the presence of BRAFV600E mutation. (C) 2012 Elsevier GmbH. All rights reserved.208848949

Pattern of intraoperative parathyroid hormone and calcium in the treatment of tertiary hyperparathyroidism

Tertiary hyperparathyroidism, an autonomous hyperproduction of parathyroid hormone (PTH), has a challenge in its treatment. This study asked whether the intraoperative PTH and calcium drop can confirm the resection of all parathyroid tissues. Case series with planned data collection. Tertiary referral medical center. The study assessed patients with tertiary hyperparathyroidism who were treated at the Hospital of the State University of Campinas from 2007 to 2015. All patients underwent total parathyroidectomy with autotransplantation of parathyroid fragments. PTH and calcium were collected during the preoperative period; at 10, 20, and 240 minutes after resection of the glands; and at 1 year after the procedure. Data were analyzed by analysis of variance and logistic regression analysis with statistical values of P < .05. Thirty-five patients were assessed: 17 women (48.57%) and 18 men (51.43%). The percentage of PTH drop was statistically significant at all times, unlike the calcium analysis, but only PTH collected at 20 minutes was able to confirm the removal of all parathyroid tissues (P = .029). Based on the receiver operating characteristic curve, the 71.2% drop obtained high sensitivity and specificity (P = .028). Treatment success can be predicted by analyzing the decrease of intraoperative PTH and not by calcium. The 71.2% PTH drop at 20 minutes after parathyroidectomy had high sensitivity and specificity to predict surgical cure161695495

Loss of expression of Plag1 in malignant transformation from pleomorphic adenoma to carcinoma ex pleomorphic adenoma

PLAG1 (pleomorphic adenoma gene 1) is frequently activated in pleomorphic adenoma (PA). Carcinoma ex pleomorphic adenoma (CXPA) arises in PA, and PLAG1 expression is believed to be maintained from PA to CXPA, as it can contribute to the carcinogenesis process. To evaluate if PLAG1 is a good marker of malignant transformation from PA to CXPA as well as to evaluate if PLAG1 expression is associated with progression and histopathologic subtype of CXPA. Forty PAs, 21 residual PAs (without malignant transformation), and 40 CXPAs were analyzed by immunohistochemistry with PLAG1 antibody. The proportion of positive neoplastic cells was assessed according to a 2-tiered scale: >10% to 50%, and >50% positive cells. The CXPA group was classified according to histopathologic subtype and invasiveness degree. Thirty-seven PAs (92.5%), 15 residual PAs (71%), and 14 CXPAs (35%) were positive for PLAG1. In relation to the CXPA group, among the intracapsular cases, myoepithelial carcinoma and epithelial-myoepithelial carcinoma showed the highest level of PLAG1 expression. PLAG1 expression is lost when PA undergoes malignant transformation, possibly due to other pathway activation and different clone cells. In addition, PLAG1 expression seems to be present mainly in low-grade carcinomas and in cases with early phase of invasion, due to its regulation of oncogene-induced cell senescence. In CXPA, PLAG1 expression was most associated with myoepithelial differentiation. This way, loss of PLAG1 expression can be considered a hallmark of CXPA carcinogenesis, mainly when there is only epithelial differentiation57152159FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2014/18312-1; 2011/23366-5; 2011/23204-