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Search Results: 1 - 10 of 76953 matches for " José Rafael; Fregnani "
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Anatomy of the Thoracic Wall, Axilla and Breast
Macéa,José Rafael; Fregnani,José Humberto Tavares Guerreiro;
International Journal of Morphology , 2006, DOI: 10.4067/S0717-95022006000500030
Abstract: for adequate treatment of patients with breast cancer, mastologists should have a complete understanding of the anatomy of the thoracic wall, axilla and breast. however, the classical anatomical descriptions in textbooks make it difficult to gain full mastery of this subject, because the books usually deal with its elements separately. in an endeavor to resolve this difficulty, the present authors have conducted an extensive review, to describe the muscles, blood vessels and nerves of the thoracic wall and in the axilla that are of interest to mastologists. the axilla was described in detail, with emphasis on its limits, walls and contents, and highlighting the lymph nodes in this region. finally, the anatomy of the breast and its topography, innervation, vascularization and lymph drainage were described, making correlations between the anatomy and the lymph node group classification routinely used by mastologists
Lymphatic Drainage of the Breast: from Theory to Surgical Practice
Fregnani,José Humberto Tavares Guerreiro; Macéa,José Rafael;
International Journal of Morphology , 2009, DOI: 10.4067/S0717-95022009000300038
Abstract: until recently, complete removal of axillary lymph nodes was performed as part of the treatment of breast cancer. sentinel lymph node biopsy (slnb) in selected cases has reduced the number of cases of wide axillary dissection and the related morbidity. knowledge of breast lymphatic drainage is essential for understanding the principles behind slnb and also for performing safe and correct axillary lymphonodectomy. this paper describes in detail the anatomical issues relating to breast lymphatic drainage and the correlated axillary and extra-axillary lymph nodes. in addition, it shows the application of this theoretical knowledge to surgical practice, especially with regard to slnb and lymphonodectomy. the surgical nomenclature is compared with the current international anatomical terminology.
Anatomy of the Thoracic Wall, Axilla and Breast Anatomía de la Pared Torácica, Axila y Mama
José Rafael Macéa,José Humberto Tavares Guerreiro Fregnani
International Journal of Morphology , 2006,
Abstract: For adequate treatment of patients with breast cancer, mastologists should have a complete understanding of the anatomy of the thoracic wall, axilla and breast. However, the classical anatomical descriptions in textbooks make it difficult to gain full mastery of this subject, because the books usually deal with its elements separately. In an endeavor to resolve this difficulty, the present authors have conducted an extensive review, to describe the muscles, blood vessels and nerves of the thoracic wall and in the axilla that are of interest to mastologists. The axilla was described in detail, with emphasis on its limits, walls and contents, and highlighting the lymph nodes in this region. Finally, the anatomy of the breast and its topography, innervation, vascularization and lymph drainage were described, making correlations between the anatomy and the lymph node group classification routinely used by mastologists Para un adecuado tratamiento de pacientes con cáncer de mama, los mastologistas deben tener un completo conocimiento de la anatomía de la pared torácica, axila y mama. Sin embargo, la descripción de la anatomía clásica se hace dificultosa en los libros para obtener una óptica visión sobre esta materia, debido a que los textos tratan estos elementos separadamente. Con el objetivo de resolver esta dificultad, los autores hacen una extensa revisión, describen los músculos, vasos sanguíneos y nervios de la pared torácica y de la axila, que son de interés para los mastologistas. Fue descrita la axila, dando énfasis a sus límites, pared y contenidos, y especialmente, a los linfonodos de la región. Finalmente, se describió la anatomía de la mama, su topografía, inervación, vascularización, y drenaje linfático haciendo una relación entre la anatomía y la clasificación rutinaria del grupo de linfonodos utilizada por los mastologistas
Lymphatic Drainage of the Breast: from Theory to Surgical Practice Drenaje Linfático de la Mama: desde la Teoría a la Práctica Quirúrgica
José Humberto Tavares Guerreiro Fregnani,José Rafael Macéa
International Journal of Morphology , 2009,
Abstract: Until recently, complete removal of axillary lymph nodes was performed as part of the treatment of breast cancer. Sentinel lymph node biopsy (SLNB) in selected cases has reduced the number of cases of wide axillary dissection and the related morbidity. Knowledge of breast lymphatic drainage is essential for understanding the principles behind SLNB and also for performing safe and correct axillary lymphonodectomy. This paper describes in detail the anatomical issues relating to breast lymphatic drainage and the correlated axillary and extra-axillary lymph nodes. In addition, it shows the application of this theoretical knowledge to surgical practice, especially with regard to SLNB and lymphonodectomy. The surgical nomenclature is compared with the current International Anatomical Terminology. Hasta hace poco, la eliminación completa de los linfondos axilares se realizaba como parte del tratamiento del cáncer de mama. En casos seleccionados la biopsia del linfonofo centinela ha reducido el número de casos de disección axilar y la morbilidad. El conocimiento del drenaje linfático de la mama es esencial para comprender los principios detrás del SNLB y también para la realización segura y correcta de la linfonodectomía axilar. Este trabajo describe en detalles los aspectos anatómicos en relación a la lactancia y correlaciona el drenaje linfático axilar y linfonofos extra-axilares. Además, se muestra la aplicación de estos conocimientos teóricos en la práctica quirúrgica, sobre todo con respecto al linfonofo centinela y la linfonodectomía. La nomenclatura quirúrgica es comparada con la actual Terminología Anatómica Internacional.
Quantitative Study of Brunner's Glands in the Human Duodenal Submucosa
Marcondes Macéa,Maria Inez; Macéa,José Rafael; Tavares Guerreiro Fregnani,José Humberto;
International Journal of Morphology , 2006, DOI: 10.4067/S0717-95022006000100002
Abstract: the existence of brunner's glands (bgs) in the duodenal submucosa is uncontestable, but their exact distribution along the full extent of the duodenal wall is unknown. objective: to verify the bgs distribution along the human duodenum. material and method: twenty normal duodenums were examined. two samples were removed from each of the four anatomical portions of the duodenum using a scalpel, in such a way that the whole circumference of each portion was excised. sections were prepared and stained with hematoxylin-eosin. twelve microscope fields were examined on each duodenal section. the mean numbers of glandular points per field were computed and compared, for the 12 microscope fields of each duodenal section examined. results: the first duodenal portion presented large quantities of bgs in all of the fields examined. the second duodenal portion also showed the presence of bgs in all the fields examined, albeit in smaller quantities than in the first portion. in the third duodenal portion, bgs were present in six of the duodenums examined. in the fourth duodenal portion, there was a minimal quantity of glands, all located in only ten of the duodenums studied. conclusions: bgs are present in the submucosa of all duodenal portions, with the greatest concentration in the first portion. their concentration decreases significantly in the second portion of the duodenum. furthermore, they become even fewer in number in the third portion and are minimally present in the fourth portion
Quantitative Study of Brunner's Glands in the Human Duodenal Submucosa Estudio cuantitativo de las Glándulas de Brunner en la Submucosa Duodenal Humana
Maria Inez Marcondes Macéa,José Rafael Macéa,José Humberto Tavares Guerreiro Fregnani
International Journal of Morphology , 2006,
Abstract: The existence of Brunner's glands (BGs) in the duodenal submucosa is uncontestable, but their exact distribution along the full extent of the duodenal wall is unknown. Objective: To verify the BGs distribution along the human duodenum. Material and method: Twenty normal duodenums were examined. Two samples were removed from each of the four anatomical portions of the duodenum using a scalpel, in such a way that the whole circumference of each portion was excised. Sections were prepared and stained with hematoxylin-eosin. Twelve microscope fields were examined on each duodenal section. The mean numbers of glandular points per field were computed and compared, for the 12 microscope fields of each duodenal section examined. Results: The first duodenal portion presented large quantities of BGs in all of the fields examined. The second duodenal portion also showed the presence of BGs in all the fields examined, albeit in smaller quantities than in the first portion. In the third duodenal portion, BGs were present in six of the duodenums examined. In the fourth duodenal portion, there was a minimal quantity of glands, all located in only ten of the duodenums studied. Conclusions: BGs are present in the submucosa of all duodenal portions, with the greatest concentration in the first portion. Their concentration decreases significantly in the second portion of the duodenum. Furthermore, they become even fewer in number in the third portion and are minimally present in the fourth portion La presencia de las glándulas de Brunner en la submucosa duodenal es innegable, pero se desconoce su exacta distribución a lo largo de toda la extensión de la pared duodenal. El objetivo del presente estudio fue analizar la distribución de las glándulas duodenales de Brunner (GDB) en la submucosa de duodenos humanos. Para ello, se examinaron 20 duodenos normales en los que fueron seccionados 22cm de cada porción duodenal, retirados con bisturí, de forma tal, que toda la circunferencia de cada segmento fuese extraída. Cada porción seleccionada fue preparada, te ida con hematoxilina-eosina y observada en 12 campos microscópicos diferentes. Las medias de los puntos glandulares por campo fueron computadas y comparadas para 12 campos microscópicos de cada porción del duodeno examinado. El primer segmento duodenal presenta un gran número de GDB en todos los campos microscópicos examinados. El segundo segmento también mostró la presencia de GDB, aunque el número encontrado fue menor. En el tercer segmento GDB fueron encontradas en 6 de los duodenos estudiados. En el cuarto segmento, el
Cardia: at the End of the Day, what is it? Cardia: al Fin de Cuentas Qué es?
José HumbertoTavares Guerreiro Fregnani,José Rafael Macea,Mirna Duarte Barros,Bianca Maria Liquidato
International Journal of Morphology , 2007,
Abstract: There is no consensus about the precise definition of what the cardia is. Although this term is often utilized in the medical literature, it takes on a variety of meanings, depending on the context. For histologists and endoscopists, the cardia is a region of the stomach immediately below the gastroesophageal junction. However, the concepts of gastroesophageal junction used by histologists and endoscopists are not the same as used by anatomists. This junction is histologically defined as the abrupt transition from the nonkeratinized stratified squamous epithelium of the esophagus to simple columnar epithelium and corresponds to the endoscopically defined Z-line. Nevertheless, this epithelial change does not occur exactly in the anatomical transition between the esophagus and stomach, but is situated in the esophagus, 1 or 2 cm above the anatomical transition. Surgeons usually use the term cardia as synonymous with lower esophageal sphincter. From a strictly oncological point of view, the cardia is the region that includes the most distal 5 cm of the esophagus and the most proximal 5 cm of the stomach. Thus, it is easy to see that there is no uniform concept of the cardia. The term cardia needs to be revised as a matter of urgency No existe concenso sobre una definición precisa de lo que es el cardia. Aunque este término es a menudo utilizado en la literatura médica ha tomado una variedad de significados dependiendo del contexto. Para histólogos y endoscopistas, el cardia es una región del estómago inmediatamente bajo la unión gastroesofágica. Sin embargo, los conceptos de unión gastroesofágica usado por éstos es diferente al de los anatomistas. Esta unión es histológicamente definida como la abrupta transición del epitelio escamoso estratificado no queratinizada del esófago, a un epitelio columnar simple y corresponde a lo que endoscópicamente se define como línea Z. Sin embargo, este cambio epitelial no ocurre exactamente en la transición anatómica entre el esófago y el estómago, pero está situado en el esófago, 1 a 2 cm por encima de la transición anatómica. Generalmente, los cirujanos usan el término cardia como sinónimo de esfínter esofágico inferior. Desde un estricto punto de vista oncológico, el cardia es la región que incluye los más distales 5 cm del esófago y los más proximales 5 cm del estómago. Así, es fácil afirmar que no hay un concepto uniforme del cardia. El término necesita ser urgentemente revisado
Evaluation of prognostic factors in stage IIA breast tumors and their correlation with mortality risk
Carvalho, Solange Torchia;Stiepcich, Monica Maria;Fregnani, José Humberto;Nonogaki, Sueli;Rocha, Rafael;Soares, Fernando Augusto;
Clinics , 2011, DOI: 10.1590/S1807-59322011000400014
Abstract: breast tumors exhibit extensive molecular and clinical heterogeneity. one of the most utilized breast carcinoma classifications is based on its molecular aspects and subdivides breast cancer into five major groups based on the expression of certain genes. in this study, we evaluated which factors are important in determining a prognosis after 5 years of follow-up for patients with clinical stage iia breast tumors. we took into consideration the different phenotypes (luminal a luminal b her-2 overexpression, basal and triple-negative), various epithelial-mesenchymal (emt) molecular markers and adhesion molecules (e-cadherin, p-cadherin, n-cadherin, vimentin, twist snail and slug) and nos-2, in addition to clinical and demographic data, tumor characteristics and treatment types. methods: the study population consisted of 82 patients with breast cancer. we analyzed eight molecular markers by immunohistochemistry on tissue microarrays containing breast tumor specimens from patients with ten years of follow-up, and we classified each tumor according to its estrogen receptor, progesterone receptor and her-2 expression. we then placed the tumor into one of the above categories. results: the presence of several clinical and demographic factors, various histopathologies, treatment forms and several immunohistochemical markers were not associated with a worse prognosis for group iia patients. the factors that were associated with a mortality risk were the triple-negative (odds ratio (or) = 11.8, 95% confident interval (ci) = 2.0-70.3, p = 0.007) and basal (or =18.4, 95% ci = 1.8-184.7, p= 0.013) phenotypic patterns. conclusions: the emt markers and nos-2 were not mortality risk factors. basal and triple-negative phenotypic patterns were related to a higher mortality risk in patients with stage iia tumors.
Histological analysis of the distribution pattern of glandular tissue in normal inferior nasal turbinates
Millas, Ieda;Liquidato, Bianca Maria;Dolci, José Eduardo Lutaif;Fregnani, José Humberto Tavares Guerreiro;Macéa, José Rafael;
Brazilian Journal of Otorhinolaryngology , 2009, DOI: 10.1590/S1808-86942009000400007
Abstract: nasal turbinates play an important role in nasal physiology. these functions include the important function of particle filtration by the mucocilliary system. many nasal mucosal diseases, such as rhinitis and rhinosinusitis, are directly related with structural alterations of the mucosal lining of the turbinates. aim: to study the distribution pattern of the glandular epithelium of the lamina propria in the normal lower nasal turbinate mucosa of the anterior, medium and posterior portions. material and method: a prospective study in which small linear fragment of the lower nasal turbinate was removed from ten patients undergoing aesthetic nose surgery. the slides were hematoxilin-eosin stained, examined histologically and photographed. glandular epithelium was delimited individually, the total area of the lamina propria on the anterior, medium and posterior portions of nasal turbinates was calculated (μm2). results: there was no statistically significant difference in the distribution pattern of the glandular epithelium of the lamina propria. conclusion: this study showed no predominance of glandular epithelium distribution in anterior and posterior portions of lower nasal turbinates in normal subjects.
Inmunohistochemical Evaluation of Estrogen Receptors Alpha and Beta in Normal Inferior Turbinate Mucosa
Millas,Ieda; Liquidato,Bianca Maria; Dolci,José Eduardo Lutaif; Macéa,José Rafael; Fregnani,José Humberto Tavares Guerreiro; Meceles,Lenira Rocha;
International Journal of Morphology , 2010, DOI: 10.4067/S0717-95022010000100020
Abstract: it has been postulated that the nasal mucosa, like other human tissues, is affected by a complex interactive network of neuropeptides, cytokines, allergic and inflammatory mediators and hormones such as estrogen, in which associations between symptoms (e.g. nasal stuffiness and coryza) and hormonal variations deriving from pregnancy, use of hormonal contraceptives and menstrual cycle phases are observed. the objective is evaluating the presence of specific estrogen receptors (types alpha and beta) in inferior turbinate mucosa in healthy subjects without nasal symptoms. samples of nasal inferior turbinate were removed from patients undergoing aesthetic nasal surgery, and analyzed using hematoxylin-eosin staining, followed by immunohistochemical preparations on paraffin-embedded sections from the material sample, to detect estrogen receptors alpha and beta. positive immunohistochemical reactions for both beta and alpha receptors were found in various regions of the inferior nasal turbinate. in conclusion both alpha and beta receptors were found, though the expression of beta was greater and more intense in the anterior portion of the inferior turbinate. no difference was found between male and female patients regarding the intensity of expression of receptors in the inferior turbinate.
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