Strongyloides stercoralis is an endemic nematode to tropical and subtropical regions of the globe. The parasite is capable of autoinfection, which is limited by an intact immune response. In immunocompromised hosts, hyperinfection and dissemination can occur and have a high index of mortality. A hyperinfection syndrome with dissemination is frequently associated with corticosteroid administration and other conditions (malignancies and organ transplantation). Interestingly, although strongyloidiasis is common among AIDS patients in endemic areas, the hyperinfection syndrome is rarely noted. We report here on a rare manifestation of fulminant gastrointestinal hemorrhage due to hyperinfection of strongyloidiasis in a female drug-abusing, alcoholic HIV/AIDS patient.

The aim of the present study was to evaluate histologically the pulp response of anionic lyophilized collagen matrix with or without hydroxyapatite as a biomaterial pulp-capping agent in pulpotomy of dogs' teeth. Sixty pre-molar roots from three dogs were used. After pulpotomy, the remaining pulp tissue was capped with one of the following materials: Group I (20 roots): anionic lyophilized collagen matrix; Group II (20 roots): anionic lyophilized collagen matrix associated with hydroxyapatite; Group III (10 roots): calcium hydroxide (p.a.) paste in saline; Group IV (10 roots): zinc oxide eugenol cement. After 90 days the animals were killed by anesthetic overdose and the teeth were removed and submitted to histological processing. According to the histopathological results, we concluded that the zinc oxide eugenol cement and anionic lyophilized collagen matrix with or without hydroxyapatite did not present satisfactory pulp response and that calcium hydroxide is the suitable material for pulpotomy.

CONTEXTO: Carcinoma da mama é a neoplasia maligna mais importante nas mulheres adultas e sua incidência apresenta crescimento em todo o mundo. O estroma tumoral é um compartimento morfológico muito importante na modulação do crescimento e invasão tumorais. As relações entre as células epiteliais e o respectivo estroma não são ainda completamente entendidas. Carcinoma esquirroso é uma variante do carcinoma ductal infiltrante usual da mama, caracterizado pelo extenso componente desmoplásico, e sua importância como tipo histológico especial é ainda motivo de debate na literatura. OBJETIVO: Comparar o grau de reação desmoplásica com a expressão de marcadores biológicos como os receptores de estrógeno e progesterona, oncoproteínas c-erbB-2 e p53, com o objetivo de estudar as inter-relações entre o estroma tumoral e as células epiteliais neoplásicas. TIPO DE ESTUDO: Estudo retrospectivo. LOCAL: Hospital do Câncer A C Camargo e Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil. AMOSTRA: 107 casos de mulheres adultas operadas do carcinoma ductal infiltrante da mama. Os casos foram separados em quatro grupos de acordo com a reação desmoplásica: grupo 1 -- menos do que 15% do tumor era constituído por estroma; grupo 2 -- estroma entre 15-50% de estroma; grupo 3 -- entre 50-85% de fibrose; e grupo 4, com mais de 85% de fibrose. O grau de fibrose foi determinado utilizando-se a coloração de picrus-sirius vermelho e quantificado com ocular estequiométrica. Reações imuno-histoquímicas foram utilizadas para determinar a expressão dos receptores de estrógeno e progesterona e as oncoproteínas c-erbB-2 e p53. VARIÁVEIS ESTUDADAS: Grau de reação desmoplásica versus expressão imuno-histoquímica de receptores de estrógeno, progesterona e oncoproteínas c-erbB-2 e p53. RESULTADOS: Os resultados mostraram que os carcinomas esquirrosos superexpressam oncoproteína p53 mais freqüentemente do que todos os demais grupos de menor reação desmoplásica. Não houve diferenças com os demais marcadores biológicos CONCLUSÃO: A reação estromal desmoplásica pode ser reguladora da expressão da proteína p53 em carcinomas ductais infiltrantes da mama. Investigações futuras devem ser conduzidas para determinar como essa expressão diferenciada pode influir no índice proliferativo, e se esta superexpressão é decorrente da mutação de gene p53 ou devido a modulação por outros fatores embebidos no estroma neoplásico.

CONTEXT: Breast cancer is the most important neoplasm in adult women, and its worldwide incidence is growing. The tumoral stroma is very important for modulating the growth and invasion of the tumor itself. The relationship between these two components is not completely understood. Schirrous carcinoma is a variant of ductal invasive carcinoma in which the stroma is very desmoplastic, and the importance of this finding still a motive for debate in the literature. OBJECTIVE: To compare the desmoplastic reactions against biological markers, such as estrogen and progesterone receptors, oncoprotein c-erbB-2 and oncoprotein p53, with the objective of studying the relationship between the tumoral stroma and epithelial cancer cells. TYPE OF STUDY: Retrospective study. SETTING: Cancer Hospital A C Camargo and Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. SAMPLE: 107 adult women operated because of ductal invasive carcinoma. The cases were separated into 4 groups according to the desmoplastic reaction -- less than 15%, between 15-50%, 51-85%, and more than 85% fibrosis. The grade of fibrosis was determined by picrus-sirius staining and quantified by using a microscope with a stereo-imaging grid. Immunohistochemical methods were used to determine the expression of the hormonal receptors and c-erbB-2/p53 oncoprotein. MAIN MEASUREMENTS: Extent of desmoplastic reaction versus expression of estrogen and progesterone receptors, oncoprotein c-erbB-2, and oncoprotein p53. RESULTS: The results showed that schirrous carcinoma expresses oncoprotein p53 more frequently than other carcinomas with less extensive desmoplastic reaction. There were no differences between the grade of fibrosis and the other biological markers. CONCLUSION: The intense stromatous reaction in invasive ductal carcinoma may modulate the expression of p53. Further investigations should be made with the aim of understanding how this expression determines the proliferative activity in schirrous carcinoma, and whether this overexpression is secondary to mutation of the p53 gene or due to modulation of other molecules of the stroma.