Resumo: Propósito: Investigar a efetividade da descompressão no tratamento inicial de ameloblastomas e os efeitos desse tipo de tratamento conservador nas características histopatológicas e de proliferação celular do tumor. Materiais e Métodos: Foram estudados retrospectivamente 8 pacientes portadores de ameloblastoma de mandíbula procedentes da Faculdade de Odontologia de Araçatuba-UNESP e do Hospital das Clínicas da FMUSP, sendo 4 ameloblastomas unicísticos e 4 multicísticos que tiveram como tratamento inicial pré-cirúrgico a descompressão. Foram avaliados o dados clínicos e imaginológicos antes e depois da descompressão. Foram definidos critérios para a indicação da descompressão. Fez-se também o estudo comparativo histopatológico antes e depois da descompressão. Os efeitos da descompressão sobre a proliferação celular do tumor foram investigados por meio da contagem de AgNORs e avaliação da expressão de PCNA e Ki-67. Resultados: Em todos os casos a descompressão foi efetiva promovendo considerável redução do tumor. O caráter cístico do tumor foi comprovado por punção aspirativa prévia em todos os pacientes. Aspecto radiográfico unilocular foi visto em 5 casos e multilocular com grande loja radiolúcida em 2. O período de descompressão foi de 5 a 12 meses e a técnica mostrou ser bem aceita pelo paciente, de baixo custo e de fácil execução. A avaliação comparativa histopatológica revelou que em alguns casos a descompresssão pode modificar o clássico padrão do epitélio odontogênico do ameloblastoma para um epitélio do tipo ameloblastomatoso com abrandamento dos critérios de Vickers & Gorlin. Não observamos significativa diferença na contagem do AgNOR e na expressão do PCNA e do Ki-67 do epitélio tumoral antes e depois da descompressão. Conclusão: Nossos resultados indicam que a descompressão é um valioso método no tratamento inicial de... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Purpose: To investigate the effectiveness of decompression in ameloblastoma initial treatment and its action on histopathologic characteristics and cellular proliferation of the tumor. Materials e Methods: A retrospective study of 4 unicystic and 4 multicystic mandible ameloblastoma submitted to decompression was realized with. Clinical and radiologic informations before and after decompression were obtained from the records of the Faculty of Dentistry of Araçatuba, UNESP and of the Hospital das Clínicas of the School of Medicine, USP. Criterions for decompression indication were determined and a histopathologic comparative study before and after decompression was realized. The effect of decompression on cellular proliferation was investigated by AgNOR count and expression of PCNA and Ki-67 evaluation. Results: Decompression was effective in all the studied cases presenting a considerable decrease of the tumor. The cystic aspect was confirmed by previous aspirate punction. Unilocular radiologic aspect was observed in 5 cases and multilocular with great radiolucent region in 2 cases. The decompression period lasted from 5 to 12 months and the technique was well accepted by the patients, with low cost and easy accomplishment. In some cases the histopathological comparative evaluation showed an alteration of the classical odontogenic epithelium pattern of the ameloblastoma to an ameloblastomatous epithelium with lightening of Vickers & Gorlin criterions. Significative difference in the cellular proliferation to the tumoral epithelium was not observed between before and after the decompression. Conclusion: Our results consider decompression as a valuable method for initial treatment of unicystic and multicystic ameloblastoma with great cystic degeneration. It decreases the tumor size and increases the bone support reducing the necessity of mandibulectomy... (Complete abstract, click electronic address below) / Orientador: Norberto Perri Moraes / Coorientador: Marcelo Macedo Crivelini / Banca: Idelmo Rangel Garcia Júnior / Banca: Antônio Francisco Durighetto Júnior / Banca: Norberto Perri Moraes / Mestre

Made available in DSpace on 2014-06-11T19:25:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-12-21Bitstream added on 2014-06-13T20:13:37Z : No. of bitstreams: 1 bernabe_dg_me_araca.pdf: 7019228 bytes, checksum: e0f61885765ce32b3656f184e94c9a2b (MD5) / Universidade Estadual Paulista (UNESP) / Propósito: Investigar a efetividade da descompressão no tratamento inicial de ameloblastomas e os efeitos desse tipo de tratamento conservador nas características histopatológicas e de proliferação celular do tumor. Materiais e Métodos: Foram estudados retrospectivamente 8 pacientes portadores de ameloblastoma de mandíbula procedentes da Faculdade de Odontologia de Araçatuba-UNESP e do Hospital das Clínicas da FMUSP, sendo 4 ameloblastomas unicísticos e 4 multicísticos que tiveram como tratamento inicial pré-cirúrgico a descompressão. Foram avaliados o dados clínicos e imaginológicos antes e depois da descompressão. Foram definidos critérios para a indicação da descompressão. Fez-se também o estudo comparativo histopatológico antes e depois da descompressão. Os efeitos da descompressão sobre a proliferação celular do tumor foram investigados por meio da contagem de AgNORs e avaliação da expressão de PCNA e Ki-67. Resultados: Em todos os casos a descompressão foi efetiva promovendo considerável redução do tumor. O caráter cístico do tumor foi comprovado por punção aspirativa prévia em todos os pacientes. Aspecto radiográfico unilocular foi visto em 5 casos e multilocular com grande loja radiolúcida em 2. O período de descompressão foi de 5 a 12 meses e a técnica mostrou ser bem aceita pelo paciente, de baixo custo e de fácil execução. A avaliação comparativa histopatológica revelou que em alguns casos a descompresssão pode modificar o clássico padrão do epitélio odontogênico do ameloblastoma para um epitélio do tipo ameloblastomatoso com abrandamento dos critérios de Vickers & Gorlin. Não observamos significativa diferença na contagem do AgNOR e na expressão do PCNA e do Ki-67 do epitélio tumoral antes e depois da descompressão. Conclusão: Nossos resultados indicam que a descompressão é um valioso método no tratamento inicial de... / Purpose: To investigate the effectiveness of decompression in ameloblastoma initial treatment and its action on histopathologic characteristics and cellular proliferation of the tumor. Materials e Methods: A retrospective study of 4 unicystic and 4 multicystic mandible ameloblastoma submitted to decompression was realized with. Clinical and radiologic informations before and after decompression were obtained from the records of the Faculty of Dentistry of Araçatuba, UNESP and of the Hospital das Clínicas of the School of Medicine, USP. Criterions for decompression indication were determined and a histopathologic comparative study before and after decompression was realized. The effect of decompression on cellular proliferation was investigated by AgNOR count and expression of PCNA and Ki-67 evaluation. Results: Decompression was effective in all the studied cases presenting a considerable decrease of the tumor. The cystic aspect was confirmed by previous aspirate punction. Unilocular radiologic aspect was observed in 5 cases and multilocular with great radiolucent region in 2 cases. The decompression period lasted from 5 to 12 months and the technique was well accepted by the patients, with low cost and easy accomplishment. In some cases the histopathological comparative evaluation showed an alteration of the classical odontogenic epithelium pattern of the ameloblastoma to an ameloblastomatous epithelium with lightening of Vickers & Gorlin criterions. Significative difference in the cellular proliferation to the tumoral epithelium was not observed between before and after the decompression. Conclusion: Our results consider decompression as a valuable method for initial treatment of unicystic and multicystic ameloblastoma with great cystic degeneration. It decreases the tumor size and increases the bone support reducing the necessity of mandibulectomy... (Complete abstract, click electronic address below)

Based on contemporary theoretical knowledge in this prospective study we outline the relationship between a chosen surgical approach (anterior or posterior approach) as it relates to the localization of spinal cord lesion (anterior or posterior spinal pathways) assessed by the use of evoked potentials (SEP, MEP) and the effect of this approach on the postoperative state of patients with cervical spondylotic myelopathy. Furthermore we evaluate clinical outcome of these patients according to several aspects of their MRI and X-ray findings. The study, from 2006 to 2010, comprised 65 patients with clinical signs of cervical myelopathy. These patients had been indicated for surgery, which subsequently was performed by using either the front (anterior - a) or back (posterior - p) approach. The patients were assessed using Nurick and mJOA scores before surgery, then at 12 months, and finally 24 months after surgery. In addition, they were preoperatively examined with a battery of evoked potentials (EP) - somatosensory evoked potential (SEP) and motor evoked potential (MEP) tests. Based on EP, principal spinal cord disability was determined: A - anterior (maximum changes in MEP), P - posterior - maximum change in SEP). The entire group was, on the basis of EP partitioning and the surgical approach used, divided...

Based on contemporary theoretical knowledge in this prospective study we outline the relationship between a chosen surgical approach (anterior or posterior approach) as it relates to the localization of spinal cord lesion (anterior or posterior spinal pathways) assessed by the use of evoked potentials (SEP, MEP) and the effect of this approach on the postoperative state of patients with cervical spondylotic myelopathy. Furthermore we evaluate clinical outcome of these patients according to several aspects of their MRI and X-ray findings. The study, from 2006 to 2010, comprised 65 patients with clinical signs of cervical myelopathy. These patients had been indicated for surgery, which subsequently was performed by using either the front (anterior - a) or back (posterior - p) approach. The patients were assessed using Nurick and mJOA scores before surgery, then at 12 months, and finally 24 months after surgery. In addition, they were preoperatively examined with a battery of evoked potentials (EP) - somatosensory evoked potential (SEP) and motor evoked potential (MEP) tests. Based on EP, principal spinal cord disability was determined: A - anterior (maximum changes in MEP), P - posterior - maximum change in SEP). The entire group was, on the basis of EP partitioning and the surgical approach used, divided...