Case Report: Desmoid fibromatosis in the mediastinum of a 6-month-old toddler, what to do?

Desmoid fibromatosis is a rare, aggressive borderline lesion arising from soft tissues. Treatment will depend on the structures that the tumor has involved. Surgery with negative margins is the recommended strategy as it can usually achieve disease control; however, the tumor's location sometimes does not allow it. Therefore, a combination of medical therapies along with strict surveillance is crucial. We present the case of a 6-month-old boy with a chest mass. After further evaluation, a rapidly growing mediastinal mass involving the sternum and costal cartilage was detected. Desmoid fibromatosis was the final diagnosis.

Development of Films, Based on Oxidized Ipomea Batatas Starch, with Protein Encapsulation / Desarrollo de Películas, Basadas en Almidón Oxidado de Ipomea Batatas, con Encapsulación de Proteínas

ABSTRACT Dialdehyde starches (DAS) have been used as biomaterials due to their biocompatibility and biodegradability; nonetheless, sweet potato (Ipomea batatas L.) starch has not been researched. Films based on sweet potato DAS, mixed with native starch (NS), poly-vinyl alcohol (PVA) and glycerin have been developed with protein encapsulation, using central composite design (CCD) and response surface methodology (RSM). Input variables were oxidation degree, NS concentration and polymeric mixture volume, while output variables were film's thickness, equilibrium swelling and BSA (Bovine serum albumin) release. DAS was obtained through hydrogen peroxide (H2O2) oxidation, and the oxidation degree is referred to as H2O2 concentration. Films presented rough surfaces, and formulations containing 10% H2O2 DAS presented micropores. Water uptake was greater with higher DAS content. Film thickness depended on the volume of the polymeric suspension and influenced swelling capacity. According to RSM, the optimal formulation was DAS with 5% H2O2 and 35% NS. These results demonstrate that oxidized sweet potato starch has potential for protein encapsulation and delivery.

RESUMEN Almidones dialdehído (DAS) se han utilizado como biomateriales por su biocompatibilidad y biodegradabilidad; sin embargo, el almidón de camote (Ipomea batatas L.) no ha sido investigado. Se han desarrollado películas de DAS de camote, con almidón nativo (NS), alcohol polivinílico (PVA) y glicerina con encapsulación de proteínas, utilizando un diseño central compuesto (CCD) y metodología de superficie de respuesta (RSM). Las variables de entrada fueron: grado de oxidación, concentración de NS y volumen de la mezcla polimérica, mientras que las variables de salida fueron: espesor de la película, hinchamiento y liberación de BSA (Albúmina de Suero Bovino) en equilibrio. DAS se obtuvo mediante oxidación con peróxido de hidrógeno (H2O2), y el grado de oxidación se define como concentración de H2O2. Las películas presentaron superficies rugosas y las formulaciones con 10% H2O2 DAS presentaron microporos. La absorción de agua fue mayor con mayor contenido de DAS. El espesor de la película dependió del volumen de la mezcla polimérica e influyó en la capacidad de hinchamiento. Según RSM, la formulación óptima fue DAS con 5% H2O2 y 35% NS. Estos resultados demuestran que el almidón de camote oxidado tiene potencial para aplicaciones en la encapsulación y liberación de proteínas.

Anesthetic management for thoracic surgery in Rubinstein-Taybi syndrome.

Rubinstein-Taybi syndrome (RTS) is a chromosomopathy associated to molecular mutations or microdeletions of chromosome 16. It has an incidence of 1:125,000-700,000 live births. RTS patients present craniofacial and thoracic anomalies that lead to a probable difficult-to-manage airway and ventilation. They also present mental retardation and comorbidity, such as congenital cardiac defects, pulmonary structural anomalies and recurrent respiratory infections, which increase the risk of aspiration pneumonia. Cardiac arrhythmias have been reported after the use of certain drugs such as succinylcholine and atropine, in a higher incidence than in general population. There is an increased risk of postoperative apnea-hypopnea in these patients. We report the anesthetic management in a RTS patient undergoing emergent thoracic surgery due to oesophageal perforation and mediastinitis. Lung isolation was achieved with a bronchial blocker guided with a fiberoptic bronchoscope and one-lung ventilation was performed successfully.

Drug-induced alterations to gene and protein expression in intestinal epithelial cell 6 cells suggest a role for calpains in the gastrointestinal toxicity of nonsteroidal anti-inflammatory agents.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used extensively as therapeutic agents, despite their well documented gastrointestinal (GI) toxicity. At this time, the mechanisms responsible for NSAID-associated GI damage are incompletely understood. In this study, we used microarray analysis to generate a novel hypothesis about cellular mechanisms that underlie the GI toxicity of NSAIDs. Monolayers of intestinal epithelial cells (IEC-6) were treated with NSAIDs that either exhibit (indomethacin, NS-398 [N-[2-(cyclohexyloxy)-4-nitrophenyl]-methanesulfonamide]) or lack (SC-560 [5-(4-chlorphenyl)-1-(4-methoxyphenyl)-3-(trifluoromethyl)-1H-pyrazole]) inhibitory effects on IEC-6 migration. Bioinformatic analysis of array data identified the calpain cysteine proteases and their endogenous inhibitor calpastatin as potential targets of NSAIDs shown previously to retard IEC-6 migration. Accordingly, quantitative real-time reverse transcription polymerase chain reaction and immunoblotting were performed to assess the effects of NSAIDs on the expression of mRNA and protein for calpain 8, calpain 2, calpain 1, and calpastatin. In treated IEC-6 monolayers, NS-398 decreased the expression of mRNA for calpain 2 and calpain 8. Both NS-398 and indomethacin decreased the protein expression of calpains 8, 2, and 1. None of the NSAIDs affected expression of calpastatin mRNA or protein. The calpain inhibitors, N-acetyl-Leu-Leu-methioninal and N-acetyl-Leu-Leu-Nle-CHO, retarded IEC-6 cell migration in a concentration-dependant fashion, and these inhibitory effects were additive with those of indomethacin and NS-398. Our experimental results suggest that the altered expression of calpain proteins may contribute to the adverse effects of NSAIDs on intestinal epithelial restitution.

Depolarization and decreased surface expression of K+ channels contribute to NSAID-inhibition of intestinal restitution.

Non-steroidal anti-inflammatory drugs (NSAIDs) contribute to gastrointestinal ulcer formation by inhibiting epithelial cell migration and mucosal restitution; however, the drug-affected signaling pathways are poorly defined. We investigated whether NSAID inhibition of intestinal epithelial migration is associated with depletion of intracellular polyamines, depolarization of membrane potential (E(m)) and altered surface expression of K(+) channels. Epithelial cell migration in response to the wounding of confluent IEC-6 and IEC-Cdx2 monolayers was reduced by indomethacin (100 microM), phenylbutazone (100 microM) and NS-398 (100 microM) but not by SC-560 (1 microM). NSAID-inhibition of intestinal cell migration was not associated with depletion of intracellular polyamines. Treatment of IEC-6 and IEC-Cdx2 cells with indomethacin, phenylbutazone and NS-398 induced significant depolarization of E(m), whereas treatment with SC-560 had no effect on E(m). The E(m) of IEC-Cdx2 cells was: -38.5+/-1.8 mV under control conditions; -35.9+/-1.6 mV after treatment with SC-560; -18.8+/-1.2 mV after treatment with indomethacin; and -23.7+/-1.4 mV after treatment with NS-398. Whereas SC-560 had no significant effects on the total cellular expression of K(v)1.4 channel protein, indomethacin and NS-398 decreased not only the total cellular expression of K(v)1.4, but also the cell surface expression of both K(v)1.4 and K(v)1.6 channel subunits in IEC-Cdx2. Both K(v)1.4 and K(v)1.6 channel proteins were immunoprecipitated by K(v)1.4 antibody from IEC-Cdx2 lysates, indicating that these subunits co-assemble to form heteromeric K(v) channels. These results suggest that NSAID inhibition of epithelial cell migration is independent of polyamine-depletion, and is associated with depolarization of E(m) and decreased surface expression of heteromeric K(v)1 channels.

Dynamical modelling of an activated sludge system of a petrochemical plant operating at high temperatures.

The Mexican petrochemical industry, Morelos S.A. de C.V., is one of the biggest and more important petroleum industries in Mexico and Latin America. It has an activated sludge system to treat its wastewater flow, which is approximately 7,000 m3/d. The wastewater contains volatile organic carbon substances classified as toxics. The old surface aeration system was changed for fine bubble diffusers; however, one major drawback of the new aeration system is that the temperature in the bioreactor has increased due to the compression of the air, which at the compressor exit reaches 85 degrees C. This effect results in the temperature in the bioreactor attaining 32 degrees C during the fall, whereas in the spring and summer, the bioreactor temperature reaches higher values than 40 degrees C. The high temperatures reduce the microorganism activity and cause a higher volatilisation rate of volatile compounds, among other effects, which affect the performance of the biological treatment. This work was performed to obtain a better modelling of the wastewater treatment from the petrochemical industry. The model describes the effect of the temperature on the performance of the biological treatment. The model was obtained from tests that were carried out in laboratory reactors with 14 L capacity, which were operated at different temperatures (from 30 to 45 degrees C), with the same wastewater and conditions as the actual system.

Differential expression of the CD10 antigen (neutral endopeptidase) in primary versus metastatic malignant melanomas of the skin.

The CD10 antigen is a neutral endopeptidase expressed by a variety of mesenchymal tumours (haemopoietic or not), including a subset of malignant melanomas. We investigated the expression of CD10 in formalin-fixed, paraffin-embedded tissue specimens of 72 cutaneous melanomas (28 primary, 26 metastatic to the skin and 18 lymph node metastases). The CD10 antigen was expressed by 18 of the 26 (69%) and 11 of the 18 (61%) melanomas metastatic to the skin or lymph nodes, respectively; in contrast, only six of the 28 primary melanomas (21.4%) expressed appreciable CD10 reactivity, and expression was usually lower (in terms of the percentage of immunoreactive cells) than that found in metastatic tumours. The sensitivity, specificity, and positive and negative predictive values of CD10 positivity for metastatic malignant melanoma were calculated to be 0.66, 0.79, 0.83 and 0.6, respectively. Our results suggest that the CD10 antigen is upregulated during the process of metastasis in melanomas. From a diagnostic point of view, the expression of CD10 appears to be an additional feature for the histological differential diagnosis between primary and metastatic melanomas.

Programa nacional de protocolos farmacoterapéuticos / It programs national of protocols farmacoterapéuticos

Presenta Programa nacional de protocolos farmacoterapéuticos. Los protocolos terapéuticos, la formación y actualización de los profesionales a partir del programa de prescripción basada en problemas y la instauración de comités farmacoterapéutico son algunos de los objetivos esperados. El Programa de Modernización del Sector Salud (PMSS) específicamente del Proyecto Sistema Alternativo de Abastecimiento de Suministros (SAAS) a través de uno de sus módulos pretende la implantación y la cultura de protocolización en las unidades de salud

Oxygen isotopes and emerald trade routes since antiquity

Oxygen isotopic compositions of historical emerald artifacts from the Gallo-Roman period to the 18th century indicate that during historical times, artisans worked emeralds originating from deposits supposedly discovered in the 20th century. In antiquity, Pakistani and Egyptian emeralds were traded by way of the Silk Route. Together with Austrian stones, they were the only source of gem-quality emeralds. Immediately after the discovery of the Colombian mines by Spaniards in the 16th century, a new trade route was established, first via Spain to Europe and India and then directly via the Philippines to India. Since then, Colombian emeralds have dominated the emerald trade, and most of the high-quality emeralds cut in the 18th century in India originated from Colombia.

Individual moral judgment and cultural ideologies.

Moral judgment cannot be reduced to cultural ideology, or vice versa. But when each construct is measured separately, then combined, the product predicts powerfully to moral thinking. In Study 1, 2 churches (N = 96) were selected for their differences on religious ideology, political identity, and moral judgment. By combining these 3 variables, a multiple correlation of .79 predicted to members' moral thinking (opinions on human rights issues). Study 2 replicated this finding in a secular sample, with the formula established in Study 1 (R = .77). Individual conceptual development in moral judgment and socialization into cultural ideology co-occur, simultaneously and reciprocally, in parallel, and not serially. Individual development in moral judgment provides the epistemological categories for cultural ideology, which in turn influences the course of moral judgment, to produce moral thinking (e.g., opinions about abortion, free speech).

Comparative nuclear morphometric analysis of aggressive and non-aggressive squamous cell carcinomas of the skin.

Squamous cell carcinomas (SCC) are the most frequent tumours complicating organ transplantation. Whereas most SCC can be successfully treated with conventional surgery, other lesions show an aggressive course with recurrence and metastases. We assessed the value of nuclear morphometry in detecting tumours with an ab initio potential for aggressive course. Nuclear perimeter, area, feret X and feret Y were calculated semi-automatically on an image analyzer on histological sections of 15 non-aggressive, 15 aggressive and 6 recurrent SCC developed in seven organ graft recipients. We found statistically significant differences for all the parameters studied between recurrent and initially aggressive SCC, and, to a lesser extent, between non-aggressive and aggressive SCC. These results suggest that some SCC have ab initio a potential for more aggressive evolution; morphometry can be a useful adjunct in order to better study these lesions.

Immunohistochemical study of CD34-positive dendritic cells of human dermis.

The human dermis contains a heterogeneous network of cells with a dendritic morphology, including factor XIIIa+ dermal dendrocytes and CD34+ dendritic cells located around epidermal adnexae. Whereas dermal dendrocytes have been immunohistochemically studied, CD34+ dermal cells have not yet been well characterized. We studied by simple and double immunolabeling techniques on tissue sections of normal human skin the phenotype of these cells and found them to express vimentin and Te7 but none of the remaining markers sought (factor XIIIa, von Willebrand factor, CD1a, CD3, CD4, CD8, CD14, CD25, CD36, CD45, CD54, CD56, LFA-1, EGF-R, S-100 protein, Mac 387, and muscle-specific actin). Rare CD34+ cells of the interstitial dermis expressed human leukocyte antigen (HLA)-DR antigens, but this was not the case for periadnexal CD34+ cells. These results show that CD34+ dendritic cells of human dermis are mesenchymal cells bearing a unique immunophenotype different from that of (myo)fibroblasts, monocytes-macrophages, Langerhans cells, and factor XIIIa+ dermal dendrocytes. Whereas the involvement of CD34+ cells in some cutaneous tumors is well known, their physiologic role in normal skin remains to be established. On the basis of our results, we speculate that these cells could represent uncommitted mesenchymal cells, unique by virtue of CD34 antigen expression.

Expression of the CD34 antigen distinguishes Kaposi's sarcoma from pseudo-Kaposi's sarcoma (acroangiodermatitis).

The differential diagnosis between Kaposi's sarcoma and the so-called 'pseudo-Kaposi's sarcoma' or acroangiodermatitis of the feet is often fraught with difficulty, not only on clinical but also on histological grounds. The aim of this study was to assess whether immunolabelling for the CD34 antigen, a marker of Kaposi's sarcoma cells, could be of value in the distinction between these two angioproliferative disorders. We comparatively examined 16 biopsy specimens from cases of Kaposi's sarcoma and seven biopsies from patients with pseudo-Kaposi's sarcoma, by a streptavidin-biotin-peroxidase method, using a monoclonal antibody to the CD34 antigen. All cases of Kaposi's sarcoma showed CD34 labelling both on endothelial cells and on the characteristic spindle-shaped, perivascular cells. Biopsies of pseudo-Kaposi's sarcoma showed a strong labelling of endothelial cells of hyperplastic vessels. However, in sharp contrast with Kaposi's sarcoma, a complete absence of perivascular CD34 expression was noted. It seems therefore that immunolabelling for the CD34 antigen appears to be a valuable tool in the differential diagnosis between Kaposi's sarcoma and pseudo-Kaposi's sarcoma.