Aesthetic oral rehabilitation of the upper-anterior sector with supra-nano filling resin in a patient with woolly hair syndrome: case report.

BACKGROUND: Woolly Hair Syndrome (WHS) is a rare birth condition that affects the structure of hair in non-black people. The pathogenesis is not yet defined. It is postulated that the hair follicle's desmosomes (specifically desmoplaquine, placoglobin and placofilin-1, which are cell structural proteins that keep the adhesion among close cells) would be altered in this pathology, leading to fragility in the cellular union. It is subdivided into two large groups: the localized or circumscribed variant and the generalized variant. From birth or first months of life, patients with WHS are clinically characterized by the presence of a portion or entire scalp area of very short frizzy hair, usually of a smaller diameter, brittle and lighter color. The most frequent skin manifestations are pilar keratosis and palmo-plantar keratodermia. The diagnosis is based on the clinical findings, and it is facilitated by trichotoscopic examination. However, a definitive diagnosis of WHS requires genetic testing. Oral agenesis, enamel defects (such as hypomineralization), atypical caries, dental inclusion, and malformed pin-shaped teeth may occur. OBJECTIVE: To describe an aesthetic alternative of oral rehabilitation using the mock-up technique in a patient with WHS. CLINICAL CASE: A 5-year-old female patient diagnosed with WHS from the National Institute of Child Health NIHCH: Breña, Lima, who was referred from the Genetic service to the Pediatric Dentistry service in order to screen outbreaks of infection associated with odontogenic origin and dental anomalies. At the ectoscopy, a patient with short capillary length, brittle and curly hair, dry skin, and nail dystrophy was observed. At the intraoral clinical examination, anterior pieces of 52, 51, 61, 62, and enamel hypomineralization were observed in all teeth. The radiographic examination showed agenesis of parts 41, 34, and 45. Integral dental treatment was performed in the operating room under general anesthesia due to the complexity of the case. Pulpectomy in pieces 52, 51, 61, 62, post of composite resin, and rehabilitation with supra-nanow filling resin using the mock-up technique were proposed as alternative treatments. CONCLUSION: The making of supra-nano filling resin-based crowns using the mock-up technique is an alternative treatment for aesthetic oral rehabilitation in deciduous dentition of patients with WHS. The aesthetic treatment was achieved using supra nano-filling resins. After 12 months of dental treatment, a favorable response was observed, improving the chewing, phonation and aesthetics of the patient.

Effectiveness of immediate dentine sealing and resin coating in reducing dental sensitivity in a child with idiopathic neuropathy and anterior dental attrition: Case report.

BACKGROUND: Idiopathic neuropathy is a peripheral nervous system disorder of unknown etiology. Patients with this disorder often suffer from bruxism problems. Bruxism is defined as an oral parafunction characterized by occlusal contacts resulting from non-physiological, repetitive, and involuntary masticatory motor activities. These events can trigger accentuated wear of the tooth structure leading to sensitivity. Tooth sensitivity is the pain arising from the exposed dentin in response to chemical, thermal, tactile, or osmotic stimuli that cannot be explained as the result of any other dental defect or disease. Sensitivity treatment using adhesive systems has a long-term or permanent effect. Therefore, this article is aimed at describing the management of dental sensitivity, through dentin sealing and resin coating techniques, during the dental restoration process of a child with idiopathic neuropathy and dental attrition in the anterior sector. All of this, with the consideration of using the minimal intervention philosophy. CASE PRESENTATION: A 6-year-old male patient diagnosed with idiopathic neuropathy and suffering from multiple dental attritions with dental sensitivity in the upper anterior teeth. With the clinical-radiographic evaluation, the family history, and the interconsultations with the neuropaediatrics service, the definitive diagnosis of dental sensitivity due to stage-3 moderate attrition was obtained, for which rehabilitation of the upper anterior sector was planned through the use of immediate dentin sealing (IDS) and resin coating (RC). CONCLUSION: The use of IDS and RC techniques shows acceptable sensitivity, which is why these techniques are recommended in cases of moderate attrition in early mixed dentition. The immediate rehabilitation along with the stamping technique improved the aesthetic and functional aspects. Therefore, it is advisable to use them immediately after dentin sealing.

Human Papillomavirus, Cytomegalovirus Infection and P16 Staining in Breast Tumors from Peruvian Women.

OBJECTIVE: To evaluate the frequency distribution of viral infections in Peruvian Breast Cancer (BC) lesions and its association with clinicopathological features. Additionally, a prospective evaluation of p16 and Tumor-infiltrating lymphocytes (TIL) levels were performed for developing a comprehensive analysis. METHODS: Detection of high risk- human papillomavirus (HR- HPV) through qPCR was performed in 447 BC and 79 non-cancer frozen samples. Paired paraffin samples from 238 BC were stained with Human cytomegalovirus (HCMV) and p16 immunohistochemistry. TIL was calculated in 397 BC cases. RESULTS: HCMV was positive in 72.5%. HR- HPV was detected in 2.9% of BC and 1.3% of non-malignant samples. P16+ was found in 28.15% and median TIL percentage was 30. HR- HPV infection was associated with non-ductal histology (p=0.003) and p16+ (p=0.017). Positive P16+ was associated with higher T stage (p=0.022), grade (p=0.009), TIL level (p=0.002), and triple-negative phenotype (p=0.021). CONCLUSION: HCMV is frequent, but HR- HPV infection is unusual in Peruvian BC. P16+ is associated with HR- PVH infection, high TIL and aggressive features.

Association between PIK3CA Mutations in Blood and Tumor-Infiltrating Lymphocytes in Peruvian Breast Cancer Patients.

OBJECTIVE: To evaluate the relationship between circulating tumor DNA (ctDNA) presence and tumor features including tumor-infiltrating lymphocyte (TIL) levels in Peruvian breast cancer patients. MATERIALS AND METHODS: This was a prospective study conducted at the Instituto Nacional de Enfemedades Neoplasicas, Peru. We evaluated level of TIL and PIK3CA mutations in ctDNA. Clinical characteristics, including outcome data, were collected from the patient file. Survival was calculated from the date of blood sample drawn to the event time. Data collected were analyzed using SPSS software version 25. RESULTS: We analyzed plasma samples from 183 breast cancer patients. most cases were of Luminal-B (44.8%) phenotype and stage II (41.5%), and median stromal TIL was 30%. PIK3CA mutation in ctDNA was detected in 35% cases (most with E545K) and was associated with lower TIL level (p=0.04). PIK3CA in ctDNA tended to be associated with advanced stages (p=0.09) in the whole series and with higher recurrence rates (p=0.053) in the non-metastatic setting. Patients with presence of PIK3CA in ctDNA tended to have shorter survival (p=0.083). CONCLUSION: Presence of PIK3CA mutation in ctDNA was frequently found in our Peruvian breast cancer series, was associated with lower TIL levels and tended to predict poor outcomes.

[Metastatic primary gastric adenocarcinoma in amigdala]. / Adenocarcinoma metastásico de amígdala de primario gástrico.

We report the case of a 79 years old female patient, with a one year history of dysphagia, presence of a tumor in the right palatine tonsil and cervical lymph node involvement. A biopsy of the palatine tonsil tumor informed as an adenocarcinoma was performed followed by a gastroscopy that reported a lesion in gastric body and antrum whose histologycal diagnosis was a moderately differentiated tubular adenocarcinoma. The patient received chemotherapy with 5FU. We present this case due to the unusual presentation of metastasis to the palatine tonsil and also for being the first manifestation of a gastric cancer.

PIK3CA mutation in non-metastatic triple-negative breast cancer as a potential biomarker of early relapse: A case report.

BACKGROUND: Currently, the detection of PIK3CA mutations is of special interest in personalized medicine because it is frequently found in triple-negative breast cancer (TNBC). The PI3KCA mutation is an independent negative prognostic factor for survival in metastatic breast cancer, and its prognostic value in liquid biopsy as a biomarker of treatment and early relapse is under investigation, both for metastatic disease and neoadjuvant scenario with curative intent. CASE SUMMARY: A 54-year-old female patient with TNBC clinical stage IIIA, who, after receiving neoadjuvant chemotherapy (based on anthracyclines and taxanes), surgery, radiotherapy, and adjuvant capecitabine, was detected with a PI3KCA mutation in tissue and peripheral blood (ctDNA in liquid biopsy). After 10 mo, the patient had disease relapse of left cervical node disease. CONCLUSION: The detection of PIK3CA mutation in TNBC after neoadjuvant treatment might be associated with early relapse or rapid disease progression.

A biomarker study in Peruvian males with breast cancer.

BACKGROUND: Breast cancer (BC) frequency in males is extremely low and tumor features vary from its female counterpart. Breast cancer clinical and pathological features differ by race in women. Tumor infiltrating lymphocyte (TIL) levels, mismatch repair (MMR) protein loss, androgen receptor (AR) expression, and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC. There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC. AIM: To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population. METHODS: This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018. Standard pathological features, TIL levels, MMR proteins, AR immunohistochemistry staining, and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material. Percentage of AR and estrogen receptor (ER) positive cells was additionally calculated by software after slide scanning. Statistical analyses included association tests, intraclass correlation test and Kaplan Meier overall survival curves. RESULTS: The median age was 63 years and most cases were ER-positive (85.7%), HER2 negative (87.2%), Luminal-A phenotype (60%) and clinical stage II (41.5%) among our male breast tumors. Median TIL was 10% and higher levels tended to be associated with Luminal-B phenotype and higher grade. AR-positive was found in 85.3% and was correlated with ER (intraclass index of 0.835, P < 0.001). Loss of MMR proteins was found in 15.4% and PIK3CA mutation (H1047R) in 14.3% (belonged to the Luminal-A phenotype). Loss of MMR proteins was associated with AR-negative (P = 0.018) but not with ER (P = 0.43) or TIL (P = 0.84). Early stages (P < 0.001) and lower grade (P = 0.006) were associated with longer overall survival. ER status, phenotype, AR status, TIL level, MMR protein loss nor PIK3CA mutation was not associated with survival (P > 0.05). CONCLUSION: Male BC is usually ER and AR positive, and Luminal-A. MMR loss and PIK3CA mutations are infrequent. Stage and grade predicted overall survival in our South American country population.

Level of tumor-infiltrating lymphocytes and density of infiltrating immune cells in different malignancies.

Aim: To correlate levels of tumor-infiltrating lymphocytes (TIL) evaluated using the International Immuno-Oncology Biomarker Working Group methodology, and both density of tumor-infiltrating immune cell and clinicopathological features in different malignancies. Methods: 209 pathological samples from gastric cancer, cervical cancer (CC), non-small-lung cancer, cutaneous melanoma (CM) and glioblastoma were tested for TIL in hematoxylin eosin, and density of CD3+, CD4+, CD8+, CD20+, CD68+ and CD163+ cells by digital analysis. Results: TIL levels were higher in invasive margin compartments (IMC). TIL in IMC, intratumoral and stromal compartments predicted survival. CC and gastric cancer had higher TIL in intratumoral; CC and CM had higher TIL in stromal compartment and IMC. CM had the highest density of lymphocyte and macrophage populations. CD20 density was associated with survival in the whole series. Conclusion: Standardized evaluation of TIL levels may provide valuable prognostic information in a spectrum of different malignancies.

Radicales libres y sistema antioxidante

Los radicales libres son compuestos caracterizados por tener un electrón desapareado en su orbital externo, condición que los torna altamente reactivos, es decir, tienen la propiedad de interactuar a través de reacciones controladas por difusión con proteínas, lípidos y ácidos nucleicos. También se les ha designado como especies reactivas de oxígeno (ERO), especies reactivas de nitrógeno (ERN) o especies reactivas de azufre (ERA). En el organismo humano se generan, principalmente, en la cadena transportadora de electrones mitocondrial, donde específicamente participan los complejos respiratorios I y III que tienen la propiedad de reducir al oxígeno y convertirlo en anión superóxido; así mismo, pueden formarse haciendo uso de una gran diversidad de reacciones enzimáticas y no enzimáticas en las que intervienen sustancias que la célula sintetiza o que se ingieren con los alimentos y algunos medicamentos. El ser humano dispone de un sistema antioxidante, que es de naturaleza enzimática y no enzimática, el cual tiene como función proteger al organismo de la acción nociva de los radicales libres; comprende enzimas -como catalasa, superóxido dismutasa, tiorredoxina, etc.- y compuestos no enzimáticos -como glutatión, ferritina, mioglobina, etc.-, pero no son lo suficientemente eficientes para protegerlo, por lo que es necesaria la ingesta de alimentos que contengan en su composición sustancias con propiedades antioxidantes cuya acción protectora dependerá de su reactividad química, así como de su concentración; estos compuestos antioxidantes se encuentran principalmente en las frutas y verduras, habiéndose identificado polifenoles, flavonoides, carotenoides, vitamina C, vitamina E, etc. Un número considerable de evidencias sugiere que la ingesta de sustancias antioxidantes protege al organismo del efecto dañino de los radicales libres, pero cuando prevalece la acción oxidante sobre la antioxidante puede conducirse al estrés oxidativo, condición que está estrechamente vinculada con una gran diversidad de enfermedades crónicas no transmisibles como cáncer, diabetes mellitus, obesidad, psoriasis, aterosclerosis, entre otras. Todo ello parece indicar que el término "estado estable redox celular" describe de manera apropiada la constante adaptación a una situación de rápido recambio químico, y sugiere que las sustancias implicadas en este proceso se designen como "especies biológicamente reactivas" en razón de la existencia de compuestos nocivos como el peróxido de hidrógeno, peroxinitrito, etc., que no son propiamente radicales libres, pero ejercen efectos dañinos a las células.

Free radicals are compounds characterized by having an unpaired electron in their outer orbit, a condition that makes them highly reactive, i.e., they interact through diffusion-controlled reactions with proteins, lipids and nucleic acids. They have also been referred to as reactive oxygen species (ROS), reactive nitrogen species (RNS) or reactive sulfur species (RSS). In the human organism, they are mainly produced in the mitochondrial electron transport chain, where respiratory complexes I and III specifically participate and reduce oxygen by converting it into superoxide anion. Likewise, they can be formed through a wide variety of enzymatic and non-enzymatic reactions involving substances that are synthesized by cells or are ingested with food and some medicines. Human beings have an antioxidant system which is both enzymatic and non-enzymatic in nature and whose function is to protect the organism from the harmful action of free radicals. This system includes enzymes-such as catalase, superoxide dismutase, thioredoxin, etc.-and non-enzymatic compounds- such as glutathione, ferritin, myoglobin, etc. However, they are not efficient enough to protect it, so it is necessary to eat foods that contain substances with antioxidant properties whose protective action will depend on their chemical reactivity and their concentration. These antioxidant compounds are mainly found in fruits and vegetables, where polyphenols, flavonoids, carotenoids, vitamin C, vitamin E, etc. have been identified. A significant amount of evidence suggests that the intake of antioxidant substances protects the body from the damaging effect of free radicals, but when the oxidative action prevails over the antioxidant action, it can lead to oxidative stress, a condition that is closely linked to a wide variety of chronic non-communicable diseases including cancer, diabetes mellitus, obesity, psoriasis, atherosclerosis, among others. All this seems to indicate that the term "cellular redox steady state" more appropriately describes the constant adaptation to a situation of rapid chemical turnover and suggests that the substances involved in this process be designated as "biologically reactive species" due to the existence of harmful compounds such as hydrogen peroxide, peroxynitrite, etc., which are not-strictly speaking-free radicals but have toxic effects on cells.

Clinicopathological predictors of long-term benefit in breast cancer treated with neoadjuvant chemotherapy.

AIM: To investigate the survival impact of clinicopathological factors, including pathological complete response (pCR) and tumor-infiltrating lymphocytes (sTIL) levels according to subtypes, in breast cancer (BC) patients who received neo-adjuvant chemotherapy (NAC). METHODS: We evaluated 435 BC patients who presented and received NAC at the Instituto Nacional de Enfermedades Neoplasicas from 2003 to 2014. sTIL was analyzed as the proportion of tumor stroma occupied by lymphocytes, and was prospectively evaluated on hematoxylin and eosin-stained sections of the preNAC core biopsy. pCR was considered in the absence of infiltrating cancer cells in primary tumor and axillary lymph nodes. Analysis of statistical association between clinical pathological features, sTIL, pCR and survival were carried out using SPSSvs19. RESULTS: Median age was 49 years (range 24-84 years) and the most frequent clinical stage was IIIB (58.3%). Luminal A, Luminal B, HER2-enriched and (triple-negative) TN phenotype was found in 24.6%, 37.9%, 17.7% and 19.8%, respectively. pCR was observed in 11% and median percentage of sTIL was 40% (2%-95%) in the whole population. pCR was associated to Ct1-2 (P = 0.045) and to high sTIL (P = 0.029) in the whole population. There was a slight trend towards significance for sTIL (P = 0.054) in Luminal A. sTIL was associated with grade III (P < 0.001), no-Luminal A subtype (P < 0.001), RE-negative (P < 0.001), PgR-negative (P < 0.001), HER2-positive (P = 0.002) and pCR (P = 0.029) in the whole population. Longer disease-free survival was associated with grade I-II (P = 0.006), cN0 (P < 0.001), clinical stage II (P = 0.004), ER-positive (P < 0.001), PgR-positive (P < 0.001), luminal A (P < 0.001) and pCR (P = 0.002). Longer disease-free survival was associated with grade I-II in Luminal A (P < 0.001), N0-1 in Luminal A (P = 0.045) and TNBC (P = 0.01), clinical stage II in Luminal A (P = 0.003) and TNBC (P = 0.038), and pCR in TNBC (P < 0.001). Longer overall survival was associated with grade I-II (P < 0.001), ER-positive (P < 0.001), PgR-positive (P < 0.001), Luminal A (P < 0.001), cN0 (P = 0.002) and pCR (P = 0.002) in the whole population. Overall survival was associated with clinical stage II (P = 0.017) in Luminal A, older age (P = 0.042) in Luminal B, and pCR in TNBC (P = 0.005). CONCLUSION: Predictive and prognostic values of clinicopathological features, like pCR and sTIL, differ depending on the evaluated molecular subtype.

Adherencia a la suplementación con gomitas que contienen hierro hemo en niños de 6 a 8 años en el distrito de Ate-Lima

Objetivo: Determinar la adherencia a la suplementación con gomitas que contienen hierro hemo en niños de 6 a 8 años en el distrito de Ate en Lima. Materiales y métodos: Se realizó un muestreo no probabilístico de tipo intencional de 50 niños de 6 a 8 años de ambos sexos registrados en el municipio de Ate. Se incluyó a niños sin anemia, con anemia leve y anemia moderada. El nivel de hemoglobina se determinó al inicio y al término de la intervención. Cada niño ingirió una gomita con hierro hemo (9 mg de hierro elemental) durante 4 meses. Resultados: La adherencia al consumo fue del 100 %; ninguno de los niños manifestó haber sufrido efectos secundarios y a todos les agradó el sabor de las gomitas. Los niños con anemia moderada tuvieron una concentración de hemoglobina de 10,48 ± 0,48 g/dL al iniciar la intervención y 11,43 ± 0,38 g/dL al finalizar; los niños con anemia leve, 11,21 ± 0,14 g/dL al inicio y 12,17 ± 0,51 g/dL al finalizar la intervención, y los niños sin anemia, 11,68 ± 0,13 g/dL al inicio y 12,57 ± 0,53 g/dL al finalizar; el valor p en todos los grupos fue estadísticamente significativo (p = 0,000). El 94,74 % de los niños con anemia leve consiguieron normalizar sus niveles de hemoglobina. Conclusiones: Se observó una completa adherencia de los niños al consumo de las gomitas con hierro hemo y los niveles de hemoglobina se elevaron en todos los grupos.

Objective: To determine the adherence to heme iron gummy supplementation among children 6 to 8 years of age in the district of Ate, Lima. Materials and methods: A purposive non-probability sampling of 50 children 6 to 8 years of age, of both sexes, registered in the municipality of Ate. The study included children with no anemia, mild anemia and moderate anemia. The hemoglobin level was determined at the beginning and end of the intervention. Each child ingested a heme iron gummy (9 mg elemental iron) for four months. Results: Adherence to heme iron gummies consumption was 100 %; none of the children reported side effects and all of them liked the taste of the gummies. Children with moderate anemia, mild anemia and no anemia had a hemoglobin concentration of 10.48 ± 0.48 g/dL and 11.43 ± 0.38 g/dL, 11.21 ± 0.14 g/dL and 12.17 ± 0.51 g/dL, and 11.68 ± 0.13 g/dL and 12.57 ± 0.53 g/dL at the beginning and end of the intervention, respectively. The p value in all groups was statistically significant (p = 0.000). Out of the children with mild anemia, 94.74 % achieved normal hemoglobin levels. Conclusions: All age groups had good adherence to heme iron gummies consumption and increased their hemoglobin levels.

Tumor infiltrating lymphocytes in triple negative breast cancer receiving neoadjuvant chemotherapy.

AIM: To determine influence of neoadjuvant-chemotherapy (NAC) over tumor-infiltrating-lymphocytes (TIL) in triple-negative-breast-cancer (TNBC). METHODS: TILs were evaluated in 98 TNBC cases who came to Instituto Nacional de Enfermedades Neoplasicas from 2005 to 2010. Immunohistochemistry staining for CD3, CD4, CD8 and FOXP3 was performed in tissue microarrays (TMA) sections. Evaluation of H/E in full-face and immunohistochemistry in TMA sections was performed in pre and post-NAC samples. STATA software was used and P value < 0.05 was considered statistically significant. RESULTS: Higher TIL evaluated in full-face sections from pre-NAC tumors was associated to pathologic-complete-response (pCR) (P = 0.0251) and outcome (P = 0.0334). TIL evaluated in TMA sections showed low level of agreement with full-face sections (ICC = 0.017-0.20) and was not associated to pCR or outcome. TIL in post-NAC samples were not associated to response or outcome. Post-NAC lesions with pCR had similar TIL levels than those without pCR (P = 0.6331). NAC produced a TIL decrease in full-face sections (P < 0.0001). Percentage of TIL subpopulations was correlated with their absolute counts. Higher counts of CD3, CD4, CD8 and FOXP3 in pre-NAC samples had longer disease-free-survival (DFS). Higher counts of CD3 in pre-NAC samples had longer overall-survival. Higher ratio of CD8/CD4 counts in pre-NAC was associated with pCR. Higher ratio of CD4/FOXP3 counts in pre-NAC was associated with longer DFS. Higher counts of CD4 in post-NAC samples were associated with pCR. CONCLUSION: TIL in pre-NAC full-face sections in TNBC are correlated to longer survival. TIL in full-face differ from TMA sections, absolute count and percentage analysis of TIL subpopulation closely related.

Estudio histopatológico de los efectos de la administración de hierro hemo y sulfato ferroso con vitamina C en cerebro e hígado de rata / Histopathological study of the effects of administering heme iron and ferrous sulfate with vitamin C in rat liver and brain

Objetivo: Determinar el efecto que ejerce la administración de hierro hemo y la de sulfato ferroso con vitamina C en hígado y cerebro de rata. Materiales y métodos: Se utilizaron ratas albinas Holtzman mantenidas en un bioterio con temperatura de 22 ± 2° C, humedad entre 50 y 70 % y 12 horas de luz y 12 horas de oscuridad, que recibieron 4,0 mg de hierro elemental/kg p.c. bajo la forma de hierro hemo o como sulfato ferroso + 10 mg de vitamina C durante siete días, a cuyo término se sacrificaron y se les extrajo sangre, hígado y cerebro. Se hicieron los cortes histológicos que se trataron con hematoxilina-eosina para la observación microscópica y en el suero se midió la capacidad antioxidante.Resultados: Los cerebros de las ratas que recibieron tratamiento con hierro hemo y sulfato ferroso + vitamina C no sufrieron alteraciones significativas, mientras que los cortes histológicos de hígado de ratas tratadas con hierro hemo mostraron un parénquima sin distribución polar, algunos núcleos carentes de citoplasma y numerosas células de Küpffer a nivel del sinusoide. En cambio, las ratas que fueron tratadas con sulfato ferroso + vitamina C presentaron un parénquima hepático deteriorado notablemente, algunas áreas con núcleos sueltos sin citoplasma y otras con citoplasma cuya membrana había desaparecido. Además, en algunas zonas, el parénquima hepático se encontraba homogenizado.Conclusiones: Los cerebros de las ratas tratadas con hierro hemo y las que recibieron sulfato ferroso + vitamina C prácticamente no sufrieron modificación alguna, en cambio, el hígado de las ratas tratadas con sulfato ferroso + vitamina C presentaron mayor daño hepático que las tratadas con hierro hemo.

Objective: To determine the effect exerted by the administration of heme iron and ferrous sulfate with vitamin C in rat liver and brain. Materials and methods:The study used Holtzman albino rats housed in a bioterium with a temperature of 22 ± 2 °C, humidity between 50 and 70 %, and 12 hours of light and 12 hours of darkness. They received elemental iron 4.0 mg/kg b.w. as heme iron or ferrous sulfate + vitamin C 10 mg for seven days, at which time they were sacrificed, and blood, liver and brain were extracted. Histological sections were made and treated with hematoxylin-eosin for microscopic observation, and serum antioxidant capacity was measured.Results: The brains of the rats treated with heme iron and ferrous sulfate + vitamin C did not undergo significant changes, while the histological sections of the livers of the rats treated with heme iron showed a parenchyma without polar distribution, some nuclei lacking cytoplasm and numerous Küpffer cells at the sinusoidal level. In contrast, the rats treated with ferrous sulfate + vitamin C had a significantly deteriorated hepatic parenchyma, some areas with loose nuclei without cytoplasm and others with disappeared cytoplasmic membranes. In addition, in some areas, the liver parenchyma was homogenized. Conclusions: The brains of the rats treated with heme iron and those with ferrous sulfate + vitamin C did not practically undergo any change. In contrast, the liver of the rats treated with ferrous sulfate + vitamin C had greater liver damage than those treated with heme iron.

Generación de radicales libres por efecto de vitamina C sobre un jarabe antianémico de sulfato ferroso / Generation of free radicals by the effect of vitamin C on a ferrous sulfate antianemic syrup

Objetivo: Determinar el efecto que ejerce la vitamina C sobre el sulfato ferroso, principio activo de un jarabe antianémico. Materiales y métodos: La reacción que se produce entre el sulfato ferroso de un jarabe antianémico y la vitamina C se determinó al aplicar la técnica de descomposición de la desoxirribosa, que evalúa la formación de malondialdehído por acción de radicales libres. Resultados: En un medio de ensayo constituido por tampón fosfato 50 mM (pH 7,4), el jarabe antianémico de sulfato ferroso a una concentración 1,080 mM reaccionó con la vitamina C en concentraciones comprendidas entre 5,0 x 10-6 mM y 0,5 mM, generando radicales libres que disminuyen cuando se utiliza una concentración de vitamina C de 5,0 x 10-2 mM mientras que a una concentración 0,5 mM, se eleva. Cuando se usa sulfato ferroso en condiciones similares se aprecia un incremento de la generación de radicales libres que alcanza un valor máximo a una concentración de vitamina C de 5,0 x 10-6 mM que se mantiene invariable a concentraciones de dos órdenes de magnitud mayor y, ulteriormente, decrece a concentraciones más elevadas. La vitamina C a una concentración 1,0 mM reacciona con el sulfato ferroso utilizado en concentraciones comprendidas entre 0,270 y 2,160 mM describiendo una curva de tipo hiperbólica. En cambio, el jarabe de sulfato ferroso, utilizado en las mismas concentraciones, mostró un elevado incremento a bajas concentraciones de tipo no lineal pero que tuvo una respuesta lineal a partir de la concentración 0,540 mM del jarabe, respuesta que fue mayor a la alcanzada por el sulfato ferroso disuelto en agua destilada. Conclusiones: La vitamina C reacciona con el jarabe de sulfato ferroso y genera radicales libres, esta respuesta depende de las concentraciones relativas de sulfato ferroso, vitamina C y de los excipientes del jarabe.

Objective: To determine the effect of vitamin C on ferrous sulfate, the active ingredient of an antianemic syrup. Materials and methods: The reaction between the ferrous sulfate contained in an antianemic syrup and vitamin C was determined using the decomposition technique of deoxyribose, which evaluates the formation of malondialdehyde by the action of free radicals. Results: In an assay medium consisting of 50 mM phosphate buffer (pH 7.4), the ferrous sulfate antianemic syrup at a concentration of 1.080 mM reacted with vitamin C at concentrations between 5.0 x 10-6 mM and 0.5 mM, generating levels of free radicals that decrease when vitamin C is used at a concentration of 5.0 x 10-2 mM, and increase at a concentration of 0.5 mM. When ferrous sulfate is used under similar conditions, an increase in the generation of free radicals is observed, which reaches a maximum value with vitamin C at a concentration of 5.0 x 10-6 mM, remains unchanged at concentrations of two orders of magnitude higher, and subsequently decreases at higher concentrations. Vitamin C at a concentration of 1.0 mM reacts with ferrous sulfate used at concentrations between 0.270 and 2.160 mM, describing a hyperbolic curve. In contrast, ferrous sulfate syrup used at the same concentrations showed a high increase at low non-linear concentrations, but a linear response from the 0.540 mM concentration of the syrup, a response that was higher than that reached by the ferrous sulfate dissolved in distilled water. Conclusions: Vitamin C reacts with ferrous sulfate syrup generating free radicals. This response depends on the relative concentrations of ferrous sulfate, vitamin C and syrup excipients.

Adenocarcinoma Metastásico de Amígdala de Primario Gástrico / Metastatic primary gastric adenocarcinoma in amigdala

Reportamos el caso de una paciente mujer de 79 años, con historia de 1 año de enfermedad caracterizado por disfagia y tumoración en amígdala derecha y adenopatía cervical. Se le realiza biopsia de tumoración amigdalina que fue diagnosticada como Adenocarcinoma, realizándose posteriormente una gastroscopia encontrándose una lesión en cuerpo y antro con estudio histopatológico de Adenocarcinoma Tubular infiltrante moderadamente diferenciado. La paciente recibió posteriormente quimioterapia con 5FU. Presentamos el caso debido a lo inusual que es encontrar metástasis amigdalina, siendo ésta además la primera manifestación de un cáncer gástrico.

We report the case of a 79 years old female patient, with a one year history of dysphagia, presence of a tumor in the right palatine tonsil and cervical lymph node involvement. A biopsy of the palatine tonsil tumor informed as an adenocarcinoma was performed followed by a gastroscopy that reported a lesion in gastric body and antrum whose histologycal diagnosis was a moderately differentiated tubular adenocarcinoma. The patient received chemotherapy with 5FU. We present this case due to the unusual presentation of metastasis to the palatine tonsil and also for being the first manifestation of a gastric cancer.

Perfil genómico PVH-VEB y proteómica celular en los carcinomas nasofaringeo y nasosinusal / Profile genomic HPV-EBVand proteomic cell carcinoma and sinonasal nasopharyngeal

La neoplasia de la cabeza y el cuello ha sido reportada como una enfermedad que emerge de células transformadas que se encuentran sometidas a cambios genéticos a nivel de oncogenes y genes supresores de tumores y a factores virales. Objetivo: Determinar el perfil genómico de los PVH y VEB y la proteómica de los genes celulares p53, bcl2 y pcna en los carcinoma nasofaríngeo (CNF) y nasosinusal (CNS). Material y métodos: 41 muestras (10 CNF y 31 CNS) de tejido parafinado fueron investigadas para las secuencias genómicas de los tipos 6, 11, 16 y 18 de papilomavirus humano (PVH) y los tipos 1 y 2 del virus Epstein Barr (VEB) con PCR por inmunohistoquímica se determinó sobre expresión de P53, Bcl 2 y Pcna. Resultados: ADN - PVH fue detectado en 24/41 (58%) y ADN-VEB en 13/41(32%). En CNF, 5 fueron VEB+, 3 PVH+ & VEB+ y 2 negativos para ambos virus. En CNS, 18 fueron PVH+, 2 VEB+, 3 PVH & VEB y 8 negativos para ambos virus. Los tipos de PVH y EBV más frecuentes fueron, tipo 16 (54%) y tipo 1 (27%). Infección simple observada en 21/41, infección doble en 4/41 e infección mixta (PVH & VEB) en 8/41. P53, Bcl-2 y Pcna sobre-expresadas en 66%, 41% y 76% respectivamente (CNF: 7, 7 y 10, y CNS: 20, 10 y 21). En CNF sobre-expresaron P53, Bcl-2 y Pcna en 3/5, 3/5 y 5/5 en casos con VEB, y expresaron los tres marcadores 3/3 en casos con PVH & VEB. En CNS sobre-expresaron P53, Bcl-2 y Pcna en 2/2, 1/2 y 2/2 en casos con VEB; 12/18, 7/18 y 12/18 en casos con PVH+, y expresaron P53 y Pcna en 2/3 casos con PVH+ & VEB. Conclusiones: El VEB 1 es el marcador genómico viral fuertemente asociado a los CNF y el PVH tipo 16 asociado a los CNS en esta serie de pacientes peruanos.

Objective: to determine the HPV and EBV genomic profile and P53, Bcl2 and Pcna proteomic in nasopharyngeal (CNF) and nasosinusal carcinoma (CNS). Material and methods: 41 samples (10 CNF y 31 CNS) embedded paraffin tissue were studied for HPV types 6, 11, 16 and 18 (PVH) and EBV types 1 and 2 (VEB) with PCR. By immunohistochemestry was determined the over expression of P53, Bcl2 and Pcna. Results: HPV DNA was found in 24/41 (58%) and EBV ADN in 13/41(32%). In CNF, 5 were EVB+, 3 HPV+ & EBV+ and 2 negatives for both virus. In CNS, 18 were PVH+, 2 EBV+, 3 HPV & VEB y 8 negatives for both viruses. The types HPV and EBV more frequently were type 16 (54%) and type 1 (27%). Simple infection was observed in 21/41, double infection in 4/41 and mixed infection (HPV & EBV) in 6/41. p53, bcl-2 y PCNA were over expressed in 66%, 41% and 76% respectively (CNF: 7, 7 and 10, and CNS: 20, 10 and 21). In CNF over expressed P53, Bcl-2 and Pcna in 3/5, 3/5 and 5/5 cases with EBV, and expressed the markers 3/3 in cases with HPV & EBV. In CNS over expresed P53, Bcl-2 y PCNA in 2/2, 1/2 and 2/2 in cases with EBV; 12/18, 7/18 and 12/18 in cases with PVH+, and expressed P53 y pcna in 2/3 cases with HPV+ & EBV. Conclutions: the viral genomic marker strongly associated to CNF is EBV 1 and in CNS is HPV 16. Proteomic profile P53+, Bcl-2+, Pcna+ and P53+, Bcl 2-, Pcna+, in CNF and CNS associated with survival / recurrence and progression respectively.