Marcio lopes | Faculdade Pitágoras (original) (raw)

Papers by Marcio lopes

Journal of Neurosurgery, 1999

In this study the authors sought to estimate the frequency, seriousness, and delay of rebleeding ... more In this study the authors sought to estimate the frequency, seriousness, and delay of rebleeding in a homogeneous series of 20 patients whom they treated between May 1987 and May 1997 for arteriovenous fistulas (AVFs) that were revealed by intracranial hemorrhage (ICH). The natural history of intracranial dural AVFs remains obscure. In many studies attempts have been made to evaluate the risk of spontaneous hemorrhage, especially as a function of the pattern of venous drainage: a higher occurrence of bleeding was reported in AVFs with retrograde cortical venous drainage, with an overall estimated rate of 1.8% per year in the largest series in the literature. However, very few studies have been designed to establish the risk of rebleeding, an omission that the authors seek to remedy. Presenting symptoms in the 20 patients (17 men and three women, mean age 54 years) were acute headache in 12 patients (60%), acute neurological deficit in eight (40%), loss of consciousness in five (25%), and generalized seizures in one (5%). Results of the clinical examination were normal in five patients and demonstrated a neurological deficit in 12 and coma in three. Computerized tomography scanning revealed intracranial bleeding in all cases (15 intraparenchymal hematomas, three subarachnoid hemorrhages, and two subdural hematomas). A diagnosis of AVF was made with the aid of angiographic studies in 19 patients, whereas it was a perioperative discovery in the remaining patient. There were 12 Type III and eight Type IV AVFs according to the revised classification of Djindjian and Merland, which meant that all AVFs in this study had retrograde cortical venous drainage. The mean duration between the first hemorrhage and treatment was 20 days. Seven patients (35%) presented with acute worsening during this delay due to radiologically proven early rebleeding. Treatment consisted of surgery alone in 10 patients, combined embolization and surgery in eight, embolization only in one, and stereotactic radiosurgery in one. Three patients died, one worsened, and in 16 (80%) neurological status improved, with 15 of 16 AVFs totally occluded on repeated angiographic studies (median follow up 10 months). The authors found that AVFs with retrograde cortical venous drainage present a high risk of early rebleeding (35% within 2 weeks after the first hemorrhage), with graver consequences than the first hemorrhage. They therefore advocate complete and early treatment in all cases of AVF with cortical venous drainage revealed by an ICH.

Dental Materials, 2001

Purpose: To compare the adhesive capability of the new adhesive Prompt L-Pop (ESPE) with that of ... more Purpose: To compare the adhesive capability of the new adhesive Prompt L-Pop (ESPE) with that of two total-etch adhesive systemsÐ EBS Multi (ESPE) and Prime&Bond NT (Dentsply).

Dental Materials, 2000

It has been suggested that the hybrid layer (HL) does not play any important role in the mechanis... more It has been suggested that the hybrid layer (HL) does not play any important role in the mechanism of adhesion to dentin. To substantiate this hypothetical insignificance of the HL, sodium hypochlorite (NaOCl) has been used to remove collagen from etched dentin prior to bonding.

International Journal of Cancer, 2002

There is strong evidence that nonsteroidal antiinflammatory drug (NSAID) sulindac may exert a sig... more There is strong evidence that nonsteroidal antiinflammatory drug (NSAID) sulindac may exert a significant antineoplastic effect. The purpose of our study was to explore the effects of sulindac on human oral squamous cell carcinoma (SCCa) cells and to elucidate the underlying molecular mechanisms. The changes that sulindac treatment induced on growth, apoptosis and cell cycle distribution of human oral SCCa cell lines were assessed by cell growth and flow cytometry experiments. Utilizing quantitative RT-PCR and immunocytochemistry, we determined the effect of sulindac treatment on mRNA and protein expression of different sulindac's targets. Also, PPARγ expression was selectively targeted by antisense oligonucleotide treatment. Both sulfide and sulfone metabolites of sulindac, which differ in the ability to cause COX-2 inhibition, induced a significant dose- and time-dependent cell growth reduction accompanied by increase in apoptosis without concomitant cell cycle arrest. Sulindac treatment also caused upregulation of the protein and mRNA expression levels of COX-2 and PPARs. Treatment with antisense PPARγ oligonucleotides abolished sulindac's growth inhibitory effect. Our results are consistent with a significant growth inhibitory effect of NSAID sulindac on human oral SCCa cells, which is mediated, at least partially, through induction of apoptosis. We suggest that upregulation of PPARγ expression and activation may be, at least partially, responsible for sulindac's antiproliferative effect. © 2002 Wiley-Liss, Inc.

Oral Oncology, 2002

Leiomyosarcoma of the oral cavity is a very rare tumor that is associated with aggressive clinica... more Leiomyosarcoma of the oral cavity is a very rare tumor that is associated with aggressive clinical behavior and low survival. In this paper, we report two new cases of leiomyosarcoma affecting the mandibular gingiva and mandible of a 35-year-old male and the mandible of a 51-year-old female. Given the difficulty in the histopathologic discrimination between benign and malignant smooth muscle tumors and the absence of reliable histologic parameters for prognostication of leiomyosarcomas, we evaluated the diagnostic and prognostic value of various immunohistochemical and molecular markers. By means of immunohistochemistry and quantitative real-time PCR analysis, we detected protein expression of PCNA, bcl-2, CDK4, p53 and MDM2 in both our cases and MDM2 amplification in our second case. The literature, pertinent to oral leiomyosarcoma and to molecular analysis of smooth muscle tumors, is reviewed. #

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2001

Although liposarcoma is one of the most common soft tissue sarcomas, its location in the oral cav... more Although liposarcoma is one of the most common soft tissue sarcomas, its location in the oral cavity is very rare. To our knowledge, only 43 cases of liposarcoma originating in the oral tissues have been reported in the English-language literature. In this article, we report a case of well-differentiated liposarcoma affecting the cheek of a 28-year-old man and review the oral liposarcoma literature. Immunohistochemical analysis of the tumor revealed an MDM2+/CDK4+/p53+ immunophenotype that is consistent with the immunohistochemical profile of well-differentiated liposarcoma originating in other areas of the body. Quantitative polymerase chain reaction analysis of the DNA levels of the MDM2 (human homologue of the murine double-minute type 2), CDK4 (cyclin-dependent kinase 4), and SAS (sarcoma amplified sequence), genes was performed, revealing only SAS gene amplification. The possibility of misdiagnosis of oral liposarcoma because of its sometimes inconspicuous clinical and microscopic features is emphasized. Careful pathologic examination of liposarcoma is essential for discrimination from benign adipose tissue neoplasms and for precise histologic classification, both of major prognostic significance. Possible implications of molecular and cytogenetic analysis for unraveling the pathogenesis and determining the prognosis of liposarcoma are discussed.

Oral Oncology, 2001

Overexpression and ampli®cation of several genes (MDM2, CDK4 and SAS) located on chromosome 12q13... more Overexpression and ampli®cation of several genes (MDM2, CDK4 and SAS) located on chromosome 12q13-15 have been noted to occur in various human sarcomas. As a result, two major growth regulation pathways may be inhibited. MDM2 may down regulate the p53-mediated growth control and CDK4 may aect pRB-mediated events. To determine the frequency of alterations in these genes and their correlation with clinicopathologic features, we analyzed the MDM2 and CDK4 protein levels by immunohistochemistry and assessed MDM2, CDK4 and SAS ampli®cation by real-time PCR in nine osteosarcomas of the jaws. Positive staining for CDK4 and MDM2 was observed in eight cases (88.8%) and ®ve cases (55.5%), respectively. Intense CDK4 staining was noted in four cases (two high grade, one intermediate grade and one low grade). Intense MDM2 staining was observed in the same four previous cases, as well as, one additional high-grade tumor. Individual DNA ampli®cation for CDK4, MDM2 and SAS was observed in six cases for each gene. Co-ampli®cation was observed in ®ve cases that showed CDK4 and MDM2 concomitant ampli®cation and four cases that displayed ampli®cation for all of the genes. In addition, among the ®ve cases that presented CDK4 and MDM2 ampli®cation, strong overexpression of CDK4 and MDM2 was observed in three and in four cases, respectively (three high grade and one intermediate grade). These results suggest that 12q13-15 genes are involved in neoplastic disease and concurrent ampli®cation and overexpression of these genes might help to de®ne high-grade tumors. #

International Journal of Oral and Maxillofacial Surgery, 2006

Low-grade myofibroblastic sarcoma was recently described as representing malignant mesenchymal tu... more Low-grade myofibroblastic sarcoma was recently described as representing malignant mesenchymal tumours that show myofibroblastic differentiation; few cases have been reported. Here, a low-grade myofibroblastic sarcoma of the parapharyngeal space is described. A 42-year-old man presented with swelling on the right side of the temporal bone. Based on histological and immunohistochemical features, the diagnosis of low-grade myofibroblastic sarcoma was established. The tumour had invaded the orbit and the brain, and therefore surgical excision was not possible. There are thought to have been no cases affecting this region reported previously in the English-language literature.

International Journal of Oral and Maxillofacial Surgery, 2002

The aim of this study is to report on five cases of intraoral pleomorphic adenoma (PA) in patient... more The aim of this study is to report on five cases of intraoral pleomorphic adenoma (PA) in patients under 18 years of age and to review the literature. Intraoral salivary gland tumours were reviewed in two Brazilian institutions and five cases of PA in patients under 18 years of age were found. Clinical data were obtained from the medical records and paraffin-embedded tissues were sectioned for proliferating cell nuclear antigen (PCNA) and p53 immunohistochemical analysis. Four patients were female and one was male; two cases affected the palate, two the upper lip and one the tongue. All five patients were treated surgically and after long follow-up periods no recurrences were observed. Tumour cells were weakly positive for PCNA and negative for p53. PA should be considered in the differential diagnosis of submucosal nodules in young patients. In youngsters, PA seems to have similar biological characteristics as in adults, with low recurrence rates after surgical resection.

Journal of Oral Pathology & Medicine, 2007

We present a retrospective study of 196 patients with intraoral minor salivary gland tumours, 128... more We present a retrospective study of 196 patients with intraoral minor salivary gland tumours, 128 malignant and 68 benign, diagnosed from 1954 to 1993 in the A.C. Camargo Hospital, São Paulo, Brazil. Sixty-five percent of the cases occurred in the palate, followed by tongue (9.7%) and retromolar area (6.1%). Pleomorphic adenoma was the most common benign tumour, and mucoepidermoid carcinoma was predominant among the malignant tumours. Surgery was the main treatment method and postoperative radiotherapy and radiotherapy alone were used in 40 and 15 patients, respectively. Local recurrence was observed in two patients with pleomorphic adenoma and in eight patients with malignant tumours. Regional lymph node metastases occurred in four cases and distant metastases in five. Forty-six of 47 patients with benigh tumours who were followed up from 1 to 7 years were alive without disease. Twenty-four of 79 patients with malignant tumours who were followed up for at least 5 years died due to the tumour and 47 were alive without disease.

International Journal of Oral and Maxillofacial Surgery, 2003

Central mucoepidermoid carcinoma (CMC) is an uncommon tumor, comprising 2-3 % of all mucoepidermo... more Central mucoepidermoid carcinoma (CMC) is an uncommon tumor, comprising 2-3 % of all mucoepidermoid carcinomas reported. The majority of cases occurring in the 4th and 5th decades of life and they are histologically low-grade malignant neoplasm usually affecting the mandible. The case presented is a 41 year old woman with central mucoepidermoid carcinoma at the left posterior of the mandible as a swelling with purulent discharge since last year. Radiographic examination showed a radiolucent lesion with well-defined borders in distal area of ┌8.

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2005

Teratomas are embryonal tumors composed of tissues from all 3 germinal layers with variable level... more Teratomas are embryonal tumors composed of tissues from all 3 germinal layers with variable levels of maturity. Teratomas are rare in the head and neck region, representing less than 5% of all cases. In the head and neck the most common involved sites are the nasopharynx and cervical regions. Oral teratomas are extremely uncommon, and we found only 21 cases published in the English-language literature. We describe an unusual case of oral teratoma on the right buccal mucosa of a 9-year-old girl.

Journal of Periodontal Research, 1995

The continuous growth of the rat incisor is associated with renovation of the junctional epitheli... more The continuous growth of the rat incisor is associated with renovation of the junctional epithelium and resorption of the periodontal ligament. The circumdental papilla separates the connective tissue suffering resorption from the rest of the gingiva. Laminin and collagen IV were detected by the immunoperoxidase technique on the basement membrane of all regions of the gingival epithelium of the rat incisor, except the internal basal lamina and the internal surface of the circumdental papilla. The internal basal lamina is formed by a granular electron-dense material, without the organization of a typical basal lamina. Areas of the internal surface of the circumdental papilla, negative for laminin and collagen IV, lack the basal lamina. These data suggest that these molecules are not components of the dento-epithelial junction of the distal surface of the rat incisor. In addition, the basal lamina is absent or fragmented on the internal surface of the circumdental papilla, adjacent to the areas of the connective tissue undergoing resorption.

Oral Diseases, 2002

We describe two additional cases of solitary fibrous tumour (SFT) affecting the mouth. SFT is ver... more We describe two additional cases of solitary fibrous tumour (SFT) affecting the mouth. SFT is very uncommon in the oral cavity and we found only 14 cases reported in the literature. Our two cases were well circumscribed, slow growing tumours that, after surgical removal, did not recur. Case 1 was a 3 cm nodule on the right cheek. Hypo and hypercellular adjacent areas were mainly patternless, and the stroma was formed by thin collagen fibrils. Case 2 was a 4.8 cm mass in the anterior portion of the tongue. Microscopically it was formed by spindle cells embedded in a vascularized sclerotic collagen matrix. Some areas were hypercellular with scarce collagen fibrils. The immunohistochemical findings were similar in both cases, with strong immunoreactivity for vimentin, CD34, bcl-2, focal positivity for Ki-67 and negativity for other immunomarkers. Based on these clinical, microscopical and immunohistochemical features the final diagnosis of these two cases was SFT. Diagnosis of SFT is difficult and, although uncommon, it should be considered in the differential diagnosis of oral soft tissue tumours.

Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 1998

Minor salivary gland carcinomas are uncommon tumors of the oral cavity. The decision regarding tr... more Minor salivary gland carcinomas are uncommon tumors of the oral cavity. The decision regarding treatment remains controversial. The main objective of this paper is to report on the survival results of 128 patients treated in a single institution. Tumor sites were: hard palate (62 cases), tongue (16 cases), buccal mucosa (13 cases), soft palate (12 cases), and other sites (25 cases). The most common histology was mucoepidermoid carcinoma (76 cases). Clinically metastatic lymph nodes were palpable in 21 patients. Cox regression technique was used to construct the mathematical-statistical models, aiming to predict the risks of recurrence and of death as functions of the different variables under study. The 5-year overall survival rates were, respectively, 85.9% and 87.7% in the groups of patients treated by surgery or combined therapy. There were significant differences in survival rates according to N stage, bone involvement, tumor histology, sex, and type of surgery. Most of the recurrences were at the site of primary tumor; neck metastases were rare at presentation and after initial treatment. Prognosis involves several factors related to stage, histology, and treatment.

International Journal of Oral and Maxillofacial Surgery, 2005

RHCFAP/3105 VARGAS PA et al. -Salivary gland tumors in a Brazilian population: a retrospective st... more RHCFAP/3105 VARGAS PA et al. -Salivary gland tumors in a Brazilian population: a retrospective study of 124 cases. Rev. Hosp. Clín. Fac. Med. S. Paulo 57(6):271-276, 2002.

Journal of Oral Rehabilitation, 2002

SUMMARY Denture stomatitis (DS) is frequently associated with high levels of Candida in saliva a... more SUMMARY Denture stomatitis (DS) is frequently associated with high levels of Candida in saliva and deficient denture hygiene. In order to analyse the incidence of DS and its pre-disposing factors, we evaluated 77 edentulous patients before and 6 months after the placement of new complete dentures. Denture stomatitis was observed in 50·6 and 18·2% of the patients at the first and second evaluation, respectively. Salivary flow, Candida counts in saliva and Candida species were similar in both evaluations. Denture stomatitis and Candida in saliva were more common in females. Our results showed that denture replacement and denture hygiene improvement were useful for DS resolution, particularly types I and II. However, oral and denture hygiene must be continuous, inasmuch as salivary Candida counts remained high and it is considered an important pre-disposing factor for DS.