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São José do Rio Preto, Brazil

Kramer C.K.,Federal University of Rio Grande do Sul | Ferreira N.,Servico de Neurocirurgia | Silveiro S.P.,Federal University of Rio Grande do Sul | Gross J.L.,Federal University of Rio Grande do Sul | And 2 more authors.
Arquivos Brasileiros de Endocrinologia e Metabologia | Year: 2010

Metastatic tumors involving the pituitary gland are an uncommon finding and occur in up to 1% of all pituitary tumor resections. A 74-year-old man had progressive vision deterioration, over the 30 days prior to consultation. He did not complain of headache or polyuria, but referred to intestinal constipation. Five years ago, he underwent a right radical nephrectomy for renal cell carcinoma, followed by chemotherapy and radiotherapy for lung and parotid metastases. On ophthalmologic examination, there was a left abducens nerve palsy and bitemporal hemianopia. Magnetic resonance imaging demonstrated a sellar mass with suprasellar cistern extension compressing the optic chiasm. Endocrinological evaluation revealed central adrenal and gonadal insufficiencies. The patient underwent a transsphenoidal tumor resection that revealed renal cell carcinoma. This case illustrates that metastatic pituitary lesions can mimic typical symptoms and signs of pituitary macroadenoma. Furthermore, clinical diabetes insipidus, a common finding of pituitary metastases, can be absent. Copyright© ABE&M todos os direitos reservados.

Rubino G.,Unidade de Infecciologia e Servico de Urgencia | Correia A.,Servico de Neurocirurgia | Rodrigues F.,Unidade de Infecciologia e Servico de Urgencia
Acta Medica Portuguesa | Year: 2012

Capnocytophaga spp. are part of the oral flora of humans and animals, being responsible for skin and soft tissues infections and invasive infections. Microbiological identification can be difficult due to its slow growth. We present a case of infection caused by this bacteria in the form of an extracerebral intracranial abscess, presenting as a frontal mass that posed some diagnostic challenges. A surgical drainage was performed together with antibiotic therapy with favourable outcome. This microorganism was identified in the second week of treatment and then a careful history revealed a dog bite days prior to the initial symptoms. This could have been the site of entry to a posterior focalization.

The case of a 76-year-old male with a large chronic subdural hematoma that showed total regression with the mere suspension of aspirin, its only apparent causal factor, and that of an 81 year-old male on aspirin and clopidogrel with a chronic subdural hematoma who succumbed after burr holes due to two simultaneous severe hemorrhagic complications (cerebellar hemorrhage and ipsilateral acute subdural hematoma) are presented. The cases may provide support for the following management strategies: (i) if conservative management and drug suspension are feasible, they may well be worth trying and lead to a favorable outcome; (ii) if a patient is at risk of developing a chronic subdural hematoma, namely because of a minor acute subdural hematoma, withdrawal of antiplatelet agents should be considered; (iii) if surgery is necessary, its delay allows for the metabolization of the drug and platelet renewal, thereby minimizing the risk of hemorrhage; (iv) if urgent burr holes are indicated, measures to improve platelet function should be undertaken. © 2011 Elsevier Masson SAS.

Bernas M.J.,University of Arizona | Cardoso F.L.,University of Lisbon | Daley S.K.,University of Arizona | Weinand M.E.,University of Arizona | And 8 more authors.
Nature Protocols | Year: 2010

We describe a method for generating primary cultures of human brain microvascular endothelial cells (HBMVECs). HBMVECs are derived from microvessels isolated from temporal tissue removed during operative treatment of epilepsy. The tissue is mechanically fragmented and size filtered using polyester meshes. The resulting microvessel fragments are placed onto type I collagen-coated flasks to allow HBMVECs to migrate and proliferate. The overall process takes less than 3 h and does not require specialized equipment or enzymatic processes. HBMVECs are typically cultured for approximately 1 month until confluent. Cultures are highly pure (97% endothelial cells; 3% pericytes), are reproducible, and show characteristic brain endothelial markers (von Willebrand factor, glucose transporter-1) and robust expression of tight and adherens junction proteins as well as caveolin-1 and efflux protein P-glycoprotein. Monolayers of HBMVECs show characteristically high transendothelial electric resistance and have proven useful in multiple functional studies for in vitro modeling of the human blood-brain barrier. © 2010 Nature America, Inc. All rights reserved.

Queijo L.,Polytechnic Institute of Braganca | Rocha J.,Polytechnic Institute of Braganca | Barreira L.,Polytechnic Institute of Braganca | Barbosa T.,Polytechnic Institute of Braganca | And 2 more authors.
Innovative Developments in Design and Manufacturing - Advanced Research in Virtual and Rapid Prototyping | Year: 2010

The use of rapid prototyping has increasingly begun to reveal itself as a tool of great value in supporting medical activity. From two-dimensional medical images from Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) it is possible to obtain three-dimensional models. The models produced by rapid prototyping technologies are useful both in educational and medical-surgical environments. It can simplify the diagnosis of certain diseases, the development of complex surgical procedures, the prostheses and medical devices manufacture and the visualization of anatomical structures in educational environment. © 2010 Taylor & Francis Group.

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