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Our aim was to retrospectively evaluate the influence of gemistocytic astrocytes, cellular proliferation indices, immunoexpression of proteins p53 and bcl-2 in the clinical outcome of 39 patients with WHO grade II and III astrocytomas with the presence of gemistocytes. The mean proportion of gemistocytes was 18.7% and the mean proliferative index was 3.3%. Immunoexpression of p53 was detected in 29 cases (74.4%) and all cases (100%) were positive for bcl-2. The median overall survival was 97.2 months and the progression-free survival was 43.1 months. Estimated 1-, 5- and 10-year overall survival rates were 94.3%, 69.5% and 46.4%; 1-, 5- and 10-year progression-free survival rates were 91.1%, 26.1% and 13.1%. Out of 24 who presented clinical and neuroimaging worsening, characterized as tumor progression or recurrence, 16 had histological confirmation and were also analyzed. We could not detect significant differences when comparing all the indices between WHO grade II and III and also between the first and second biopsies. We also could not detect significant differences in progression-free and overall survival when analyzing the gemistocyte index and the immunohistochemical labeling indices p53, bcl-2 and MIB-1, as well as patientsa9 age (median value, up to 34 vs. over 34 years) and histological grade (II or III). Our finding confirms recent reports that question the role of gemistocytes as a prognostic factor in diffuse astrocytomas. The significance and role of gemistocytes in astrocytomas has yet to be defined and warrants further study.

PURPOSE: The aim of this study was to investigate whether the hind limbs or intestinal tract is the most important initiator of the inflammatory response secondary aortic clamping and hind limb ischemia/reperfusion injury. METHODS: Blood samples of Wistar rats obtained from posterior cava vein, portal vein, and heart cavity during either laparotomy (control group, n=8) or laparotomy + 2 h of aortic clamping and bilateral hind limb ischemia (ischemia group, n=8), or 2 h after ischemia and 2 h of reperfusion (ischemia-reperfusion group, n=8) were assayed for interleukin 6 (IL-6) and C-reactive protein (CRP). RESULTS: Serum IL-6 at the heart (223.6±197.9 [10-832] pg/mL) was higher (p<0.001) than at both portal (133.08±108.52 [4-372] pg/mL) and posterior cava veins (127.58±109.15 [8-388] pg/mL). CRP was not significant different among groups. CONCLUSION: The splanchnic region is also a source of inflammatory response secondary to ischemia and reperfusion of the hind limbs.

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RESUMO -Foram estudados, retrospectivamente, 22 pacientes com diagnóstico de astrocitomas grau II (n=17) e III (n=5), OMS, no período de 1990 a 1998, cujos laudos histopatológicos descreviam a presença gemistocitos com o objetivo de determinar o índice de astrócitos gemistocíticos, investigar a imuno-expressão da proteína p53 e confrontá-los com o intervalo até a recorrência da neoplasia. O índice de astrócitos gemistocíticos, em cada caso, foi calculado a partir da razão entre o número de gemistocitos e o número total de células neoplásicas contadas, no mínimo 1000. Imuno-expressão nuclear da proteína p53 foi avaliada em astrócitos e gemistocitos neoplásicos; tanto a freqüência (7/22), como o índice de imuno-expressão positiva da p53 em gemistocitos, independentemente do grau histológico da neoplasia, foram inferiores aos relatados na literatura. Não se observou correlação entre o índice de astrócitos gemistocíticos e a imuno-expressão positiva da p53.PALAVRAS-CHAVE: gemistocito, p53, astrocitoma, glioma. Fraction of gemistocytic astrocytes and immunoexpression of p53 protein in astrocytomas grade II and III (WHO)ABSCTRACT -Twenty-two patients with astrocytomas, grade II or III WHO, were studied from 1990 to 1998. In all cases, histopathology showed that the astrocytomas had a gemistocytic component. The aims of this study were to establish the fraction of gemistocytic astrocytes, to investigate p53 protein immunoexpression and to evaluate correlations between these two parameters with the tumour outcome. Tumor cells were quantified at high-power magnification (x400). At least 1000 neoplastic cells (small neoplastic astrocytes plus gemistocytes) were counted in each specimen. The percentage of gemistocytes was defined as the gemistocytic index. Nuclear expression of p53 protein was evaluated in neoplastic astrocytes and gemistocytes. Both the frequency (7/22) as well the p53 immunoexpression indices in gemistocytes, regardless of the grade of the astrocytomas, were inferior from those reported in the literature. No correlation was found between the gemistocytic indices and the p53 immunoexpression.KEY WORDS: gemistocytes, p53, astrocytoma, glioma. Astrocitomas difusos abrangem grande espectro de neoplasias desde lesões que crescem lentamente, até tumores altamente agressivos e fatais. Uma característica importante desse grupo de neoplasias é a tendência à recorrência, frequentemente acompanhada da progressão para fenótipos mais malignos, o que é um aspecto particular dos astrocitomas gemistocíticos. Gemistocitos não são observados no tecido cerebral normal ou durante a embriogênese 1-3 . Entretanto, sua presença em neoplasias tem sido considerada um fator de pior prognóstico 4 . Vários estudos têm mostrado que a evolução dos astrocitomas para graus maiores de anaplasia, reflete aquisição seqüencial de alterações genéticas [5][6][7] . Como nos astrocitomas de baixo grau, mutações no gene p53 são as alterações genéticas mais comuns e estão presentes em freqüências semelhantes nos astrocitomas anaplásicos e gliobl...