[Palatine tonsil lymphoma in children with tonsillar asymmetry. Case report]. / Linfoma de amígdala en niño con asimetría tonsilar. caso clínico.

Tonsil malignancy is uncommon in children. Tonsillar asymmetry is usually secondary to a benign process, either inflammatory conditions, differences in the tonsillar fossa depth or anterior pillar asymmetry. However, it may indicate a serious underlying disorder such as lymphoma. Lymphoma is the most common childhood malignancy in the head and neck. Approximately, 15% of the cases affect the Waldeyer's ring. The most common clinical manifestations of palatine tonsils lymphoma are unilateral tonsillar hypertrophy, alteration in the appearance of the mucosa and ipsilateral cervical lymphadenopathy. Early diagnosis and appropriate treatment are of great importance in the prognosis. We present a case of palatine tonsil lymphoma in a child with tonsillar asymmetry and we emphasize the importance of the examination of the oral cavity and the neck to identify suspicious alterations compatible with tonsillar lymphoma.

Expression of CD44s and CD44 splice variants in human melanoma.

The ability of tumor cells to adhere and detach from extracellular matrix and endothelial cells, is a crucial step in the metastatic process and may alter the clinical prognosis of some human tumors such as melanomas. CD44, the major cell surface receptor for hyaluronate, has been implicated in cell adhesion and in tumor progression. We studied the expression of standard CD44 molecule (CD44s) and its variants v3 and v6 in 57 human primary melanoma biopsies, without previous treatment. We analyzed the association between CD44 expression and the principal clinicopathological features, including survival. Fifty-six of 57 tumors expressed CD44s, associated to the cytoplasmic membrane. No expression of CD44v3 or CD44v6 was detected. No association between CD44s expression and prognostic factors such as tumor thickness, growth type, stage or anatomic site of the lesion was found. However, a positive correlation between CD44s expression and Clark level (Spearman, p<0.001) was found. While only 33.3% of melanomas Clark I + II showed high expression of CD44s (more than 50% of positive cells), 82.6% of melanomas Clark IV + V did so. Kaplan-Meier analysis revelead that patients whose melanomas had high expression of CD44s showed a reduced relapse free survival (RFS) rate, though without statistical significance. No difference between the level of CD44 expression and overall survival (OS) was found. We conclude that melanomas only expressed CD44s, and that its level was associated with Clark's stage. CD44s seems not to be useful as a tumor marker, because it does not predict either RFS or OS.

[Prognostic value of the expression of MDR-1 in acute myeloid leukemia]. / Importancia pronóstica de la expresion de MDR-1 en la leucemia mieloblástica aguda.

An important number of patients with Acute Myeloid Leukemia (AML) experience relapse or resistance to chemotherapy. One of the mechanisms involved in this resistance is the presence of glycoprotein P170 (gp-P 170), which results of the MDR-1 gene in leukemic cells. The objective of this article is to assess the prognostic impact of the expression of MDR-1 in a group of patients treated for AML. The expression of MDR-1 was retrospectively assessed in a cohort of 55 patients with AML, older than 16 years old, who received chemotherapy from 1990 to 2000. The presence of MDR-1/gp-P170 was evaluated on bone marrow biopsy by immunohisto-chemistry. A ROC curve established that an expression of > 50% of MDR-1 on blastic cells was significant for the achievement of complete remission. The expression of MDR-1+ correlated with the presence of leucocytosis (p:0.002), expression of CD34+ cells (p:0.006), less achievement of complete remission (p:0.001), more rate of relapse (p:0.02) and of non-favorable cytogenetics (p:0.02). The event-free survival was of 21.2% SE:9.3 with a follow up of 22 months for the group of MDR-1+ versus 56.4% SE 12.5 with a follow-up of 78 months for the MDR-1-group (p:0.007). It can be concluded that the expression of MDR-1 is a prognostic factor of resistance to chemotherapy. These patients present a lower rate of complete remission, a higher rate of relapse with persistence of post treatment residual disease, which produces a shorter global survival.

Comparative effect of fucoxanthin and vitamin C on oxidative and functional parameters of human lymphocytes.

The aim of this study was to evaluate the effects of FUCO alone or combined with vitamin C on different features of lymphocyte function related to ROS/RNS (reactive oxygen/nitrogen species) production. For this purpose we have evaluated the cytotoxicity of increasing concentrations of FUCO and vitamin C, the proliferative capacity of stimulated T- and B-lymphocytes, superoxide anion radicals (O(2)), hydrogen peroxide (H(2)O(2)) and nitric oxide (NO) production, antioxidant enzyme activities and the indexes of oxidative damage in proteins (carbonyl and thiol content). We have also evaluated the release of inflammatory cytokines and glucose-6-phosphate dehydrogenase (G6PDH) activity. Healthy human lymphocytes were acutely treated in vitro with FUCO (2 µM) with or without vitamin C (100 µM). Results revealed that human lymphocytes treated with FUCO at 2µM did not present any significant alteration in the proliferation of T- and B-lymphocytes at both resting and stimulated conditions. Moreover, FUCO used at low concentrations showed more pro-oxidant than antioxidant effects, which were recognized by the increased H(2)O(2) and increased NO production. Anti-inflammatory activity of FUCO was confirmed by significantly increased IL-10 and decreased TNF-α production. Vitamin C increased T-lymphocyte proliferation, whereas vitamin C plus FUCO promoted a reduction in the proliferation rate of these cells. All groups decreased pro-inflammatory cytokine TNF-α and increased anti-inflammatory IL-10 production although only vitamin C decreased IFN-γ either alone or when combined with FUCO. Overall, the combination of the antioxidants had more antioxidant and anti-inflammatory effects than when they were applied alone.

Glycolaldehyde impairs neutrophil biochemical parameters by an oxidative and calcium-dependent mechanism--protective role of antioxidants astaxanthin and vitamin C.

AIM: The present study examined the effects of glycolaldehyde (GC) on biochemical parameters of human neutrophils and whether the antioxidant astaxanthin associated with vitamin C can modulate these parameters. METHODS: Neutrophils from healthy subjects were treated with GC (1mM) followed or not by the antioxidants astaxanthin (2 µM) and vitamin C (100 µM). We examined the phagocytic capacity, hypochlorous acid, myeloperoxidase (MPO) and glucose-6-phosphate dehydrogenase (G6PDH) activities, cytokines and [Ca(2+)](i). Also, superoxide anion, hydrogen peroxide, nitric oxide production, antioxidant enzyme activities and glutathione-recycling system were evaluated. RESULTS: GC promoted a marked reduction on the phagocytic capacity, maximal G6PDH and MPO activities, hypochlorous acid production and release of IL-1ß, IL-6 and TNF-α cytokines. Some impairment in the neutrophils biochemical parameters appears to be mediated by oxidative stress through ROS/RNS production and calcium reduction. Oxidative stress was evidenced by reduction in the activities of the main antioxidant enzymes, GSH/GSSG ratio and in the increment of O(2)(-) and H(2)O(2) and NO. CONCLUSIONS: Treatment of cells with the combination of the antioxidants astaxanthin and vitamin C was able to restore some neutrophils function mainly by decreasing ROS/RNS production and improving the redox state. Overall, our findings demonstrate that GC modulates several neutrophils biochemical parameters in vitro.

Osteosclerosis asociada a mastocitosis sistémica / Osteosclerosis associated to systemic mastocytosis / Osteosclerose associada a mastocitose sistêmica

La mastocitosis es una enfermedad rara que se define por la expansión anormal de los mastocitos clonales y su acumulación en distintos tejidos. Esta enfermedad afecta el esqueleto en el 50-70% de los casos. Las anomalías radiológicas son generalmente difusas y afectan predominantemente al esqueleto axial. La forma más habitual es la osteopenia. La osteosclerosis y las formas mixtas son menos frecuentes. Se presenta el caso de un paciente varón de 74 años, con osteoesclerosis asociada a mastocitosis sistémica. Se observó un incremento de los marcadores de formación y resorción, con predominio de los primeros. La densitometría ósea presentó un notable incremento y en los estudios radiológicos se observó osteoesclerosis. La biopsia ósea transilíaca evidenció infiltrados multifocales de mastocitos y fibrosis de la médula ósea. La histomorfometría mostró un incremento en los parámetros de formación y en menor grado de la resorción ósea. Se indicó loratadina, corticoesteroides, interferón alfa, calcio y calcitriol. Se observó mejoría clínica, normalización de los marcadores de remodelación y disminución de la densidad mineral ósea 30 meses después de iniciado el tratamiento. Se destaca la importancia de considerar la mastocitosis sistémica en el diagnóstico diferencial de pacientes con osteoesclerosis u osteoporosis.

Mastocytosis is a rare disease defined by abnormal clonal mast-cell expansion and accumulation in various tissues. The disease affects the skeleton in 60-70% of cases. Radiological abnormalities are usually diffuse and the lesions mainly involve the axial skeleton. Osteopenia is the most frequent form, but it can also occur as osteosclerosis or a combination of both disease expressions. In this report, a 74-year old male patient with osteosclerosis associated to systemic mastocytosis is presented. Laboratory tests showed an elevation in bone turnover markers with a greater increase in bone formation markers. Bone densitometry depicted a marked increase in mineral density and X-rays showed osteoesclerosis. A trans-iliac bone biopsy described the presence of dense, multifocal infiltrates of mast cells and bone marrow fibrosis. Bone histomorphometry showed a marked increase in bone formation and resorption parameters. Treatment with loratadine, corticosteroids, á interferon, calcium and calcitriol was initiated. The patient improved, bone turnover markers normalized and bone mineral density decreased after 30 months. The importance of considering systemic mastocytosis in the differential diagnosis of patients with osteosclerosis or osteoporosis.

A mastocitose é uma doença rara que se define pela expansão anormal dos mastócitos clonais e sua acumulação em diferentes tecidos. Esta doença afeta o esqueleto em 50-70% dos casos. As anomalias radiológicas geralmente são difusas e afetam predominantemente o esqueleto axial. A forma mais habitual é a osteopenia. A osteosclerose e as formas mistas são menos frequentes. Apresenta-se o caso de um paciente masculino de 74 anos, com osteosclerose associada a mastocitose sistêmica. Foi observado um incremento dos marcadores de formação e reabsorção, com predomínio dos primeiros. A densitometria óssea apresentou importante incremento e nos estudos radiológicos foi observada osteosclerose. A biópsia óssea transilíaca evidenciou infiltrados multifocais de mastócitos e fibrose da medula óssea. A histomorfometria mostrou um aumento nos parâmetros de formação e, em menor grau, da reabsorção óssea. Indicou-se loratadina, corticoesteroides, interferón-alfa, cálcio e calcitriol. Foi observada a melhoria clínica, normalização dos marcadores de remodelação e diminuição da densidade mineral óssea 30 meses depois de iniciado o tratamento. Destaca-se a importância de considerar a mastocitose sistêmica no diagnóstico diferencial de pacientes com osteosclerose ou osteoporose.

Linfoma de amígdala en niño con asimetría tonsilar. caso clínico / Palatine tonsil lymphoma in children with tonsillar asymmetry. Case report

El tumor maligno de amígdalas es poco frecuente en niños. La asimetría amigdalina es, generalmente, secundaria a un proceso benigno, ya sea patología inflamatoria, diferencia en la profundidad de la fosa tonsilar o asimetría del pilar anterior. Sin embargo, puede indicar un trastorno subyacente grave, como el linfoma. El linfoma es el tumor maligno infantil más común en la cabeza y el cuello. En el 15% de los casos, afecta al anillo de Waldeyer. Las manifestaciones clínicas más comunes del linfoma de la amígdala palatina son la hipertrofia amigdalina unilateral, la alteración en la apariencia de la mucosa y la adenopatía cervical ipsilateral. El diagnóstico precoz y el tratamiento adecuado son de gran importancia en el pronóstico. Presentamos un caso de linfoma amigdalino en un niño con asimetría amigdalina y destacamos la importancia del examen de la cavidad oral y del cuello para identificar alteraciones sospechosas de linfoma tonsilar.

Tonsil malignancy is uncommon in children. Tonsillar asymmetry is usually secondary to a benign process, either inflammatory conditions, differences in the tonsillar fossa depth or anterior pillar asymmetry. However, it may indicate a serious underlying disorder such as lymphoma. Lymphoma is the most common childhood malignancy in the head and neck. Approximately, 15% of the cases affect the Waldeyer's ring. The most common clinical manifestations of palatine tonsils lymphoma are unilateral tonsillar hypertrophy, alteration in the appearance of the mucosa and ipsilateral cervical lymphadenopathy. Early diagnosis and appropriate treatment are of great importance in the prognosis. We present a case of palatine tonsil lymphoma in a child with tonsillar asymmetry and we emphasize the importance of the examination of the oral cavity and the neck to identify suspicious alterations compatible with tonsillar lymphoma.

PKC Delta (PKCdelta) promotes tumoral progression of human ductal pancreatic cancer.

OBJECTIVE: Our objective was to study the role of protein kinase C delta (PKCdelta) in the progression of human pancreatic carcinoma. METHODS: Protein kinase C delta expression in human ductal carcinoma (n = 22) was studied by immunohistochemistry. We analyzed the effect of PKCdelta overexpression on in vivo and in vitro properties of human ductal carcinoma cell line PANC1. RESULTS: Human ductal carcinomas showed PKCdelta overexpression compared with normal counterparts. In addition, in vitro PKCdelta-PANC1 cells showed increased anchorage-independent growth and higher resistance to serum starvation and to treatment with cytotoxic drugs. Using pharmacological inhibitors, we determined that phosphatidylinositol-3-kinase and extracellular receptor kinase pathways were involved in the proliferation of PKCdelta-PANC1. Interestingly, PKCdelta-PANC1 cells showed a less in vitro invasive ability and an impairment in their ability to migrate and to secrete the proteolytic enzyme matrix metalloproteinase-2. In vivo experiments indicated that PKCdelta-PANC1 cells were more tumorigenic, as they developed tumors with a significantly lower latency and a higher growth rate with respect to the tumors generated with control cells. Besides, only PKCdelta-PANC1 cells developed lung metastasis. CONCLUSION: Our results showed that the overexpression of PKCdelta in PANC1 cells induced a more malignant phenotype in vivo, probably through the modulation of cell proliferation and survival, involving phosphatidylinositol-3-kinase and extracellular receptor kinase signaling pathways.

Association between mast cells of different phenotypes and angiogenesis in colorectal cancer.

It is known that mast cells proliferate in solid tumours and increase tumour angiogenesis. Nevertheless, there is no consensus regarding their role in colorectal cancer (CRC). In this study, we aimed to clarify the relationship of mast cells positive for tryptase (MCts) and tryptase-chymase (MCtcs) with microvessel density (MVD) in the intratumoral zone and the invasive edge of 80 CRC patient tumours. We evaluated these parameters and associated their expression with clinicopathological parameters, including survival rate. Tumour sections from each patient were immunostained for tryptase to evaluate MCts, chymase to evaluate MCtcs, and CD34 to evaluate microvessel counts under x100 microscopy. The number of MCs of both phenotypes and the MVD counts were higher in the invasive edge than in the intratumoral zone (p<0.001). MCt numbers were higher than those of MCtcs in all Astler-Coller stages in both regions. A positive correlation between MVD and MCts or MCtcs was observed (Pearson's test p<0.001). Neither the number of MCs nor MVD was associated with overall survival (log rank test). However, only 8.3% of patients with low numbers of MCtcs in the invasive edge succumbed to the disease, compared to 32% with high numbers of MCtcs. Our results indicate that angiogenesis and MC hyperplasia are events which appear early during CRC development. The correlation of MC phenotypes with MVD is in agreement with the role attributed to MCs, that of angiogenesis enhancement. Collectively, these findings suggest that screening during the early malignization of CRC can provide valuable clinical information.

Frozen sections of samples taken intraoperatively for diagnosis of infection in revision hip surgery.

BACKGROUND: The diagnosis of a suspected infected prosthesis is often difficult, but is important for the choice of treatment. Even at surgery, it is not easy to assess whether the prosthesis is infected or not--even though this may be important for the choice of surgical procedure. PATIENTS AND METHODS: We assessed the sensitivity, specificity, predictive value, and reliability of the results of the analysis of frozen sections from samples of tissues taken during revision hip surgery of 136 probably infected prostheses. Samples of tissues were taken to be analyzed immediately from frozen sections, to be processed on a routine basis later, and to be referred for bacteriological cultures. A finding of 5 or more polymorphonuclear leukocytes per field at a magnification of 400x was considered positive for infection. RESULTS: The analysis of frozen sections for infection was in agreement with the results of routine histopathology in 134 of 136 cases. Comparison with the results of culture showed a sensitivity of 85%, a specificity of 87%, a PPV of 79%, an NPV of 91%, and a Kendall's tau correlation coefficient of 0.72. INTERPRETATION: We believe that the method we have tested is of value in revision surgery when infection cannot be ruled out.

Prognostic value of E-cadherin, beta-catenin, MMPs (7 and 9), and TIMPs (1 and 2) in patients with colorectal carcinoma.

BACKGROUND AND OBJECTIVES: Therapy of colorectal tumors (CRC) based on histology and clinical factors is insufficient to predict the evolution of each patient. The finding of molecular abnormalities able to differentiate subgroups of patients with bad prognosis will improve our ability to treat them successfully. Our purpose was to analyze retrospectively the prognostic input of E-cadherin, beta-catenin, metalloproteinases (MMPs) (7 and 9), and tissue inhibitors of metalloproteinases (TIMPs) (1 and 2) in patients with a follow-up period of 5 years. METHODS: Antigen expression was analyzed by immunohistochemistry. Prognostic evaluation was performed with the multivariate proportional hazards model. RESULTS: We demonstrated a concomitant loss of E-cadherin and beta-catenin at membranous level and an abnormal accumulation of nuclear beta-catenin. Besides, we found that all MMPs and TIMPs studied were overexpressed in CRC tissue. There was no association between the expression of any of these molecules and the known clinical-pathological parameters employed in CRC pathology. A multivariate analysis demonstrated that the overall survival could be independently predicted by the loss of E-cadherin and the overexpression of TIMP-2. CONCLUSIONS: The expression of E-cadherin and TIMP-2 could be relevant in determining the prognosis of CRC patients and providing a more accurate mechanism for their classification.

Incorporation of vancomycin-supplemented bone incorporation of vancomycin-supplemented bone allografts: radiographical, histopathological and immunohistochemical study in pigs.

We compared the incorporation of bone allografts with or without vancomycin in tibial defects of 18 pigs. High-quality radiographs, histological examination, immunological expression of metalloproteinase-13 (MMP-13) and transforming growth factor-beta 2 (TGFbeta2) indicated that there was no significant difference in bone allograft incorporation between up to 220 times the MIC (minimum inhibitory concentration) in bone allografts with 1 g of vancomycin in each 300 g of allograft or without this supplement.

Breast cancer stromal myxoid changes are associated with tumor invasion and metastasis: a central role for hyaluronan.

The interplay between a tumor and its environment is exemplified by the morphological changes observed in the stroma of human breast cancer. These changes are evident as stromal myxoid changes. Hyaluronan, an extracellular polysaccharide that has been implicated in invasion, is one of the major constituents of the stromal myxoid changes. This study evaluated the association of these stromal changes with axillary node status, tumor grade, and mortality. The prognostic value of the stromal myxoid changes was evaluated in patients with negative axillary nodes with 10 years of follow-up. Our results showed a high level of reproducibility of our stromal myxoid changes grading system (overall kappa = 0.68). Image analysis semiquantification showed marked correlation of a strong stromal hyaluronan signal with high-grade stromal myxoid changes. In a multiple logistic regression analysis, positive nodes were associated with stromal myxoid changes, tumor size, desmoplasia, lymphocytic infiltration, high tumor grade, tumor emboli, and multifocality. Stromal myxoid changes were also associated with young age and lymphatic embolizations (P <.001). Overall, there is a weak correlation between mortality and stromal myxoid changes (P <.01). Mortality was more evident with high stromal myxoid changes grades and tumor size >2 cm (P <.008). However Cox multivariate analysis fail to show stromal myxoid changes as an independent prognostic factor. In conclusion, stromal myxoid changes with high hyaluronan concentration are strongly associated with positive nodes, tumor grade, and lymphatic emboli, thereby identifying high-risk group and reinforcing the role of hyaluronan in invasion and metastasis.

Prognostic value of Mdm2, p53 and p16 in patients with astrocytomas.

Surgical cure of gliomas infiltrating into the brain is practically impossible and their clinical course is primarily determined by the biological behavior of the tumor cell. The purpose of this study was to analyze retrospectively prognostic input of p53, Mouse double minute-2 (Mdm2) and p16 in 103 uniformly treated patients with astrocytic tumors. The expression of these molecules was measured by immunohistochemical procedure. Prognostic evaluation was performed with the multivariate proportional hazards model. The follow-up period lasted 19 (5-122) months for the survivors. We observed that 66% of gliomas showed mutated p53, while only 17% overexpressed Mdm2, the p53-regulatory molecule. Besides, almost 50% of gliomas lost p16 immunopositivity. Only p53 labeling showed a positive correlation with the grade of malignancy, according with the WHO classification. The association between mutated p53 and histological grade remained when prognostic variables were considered in a multivariate analysis. No association between p53 status and overall survival was found. On the other hand, Mdm2 overexpression and, unexpectedly, p16 immunopositivity were associated with a shorter survival in an univariate analysis. However, Cox-regression analysis showed that only Mdm2 in female patients was an independent prognostic factor, associated with shorter survival. In conclusion, our results suggest that Mdm2 could be a relevant marker in determining the evolution of glioma patients and could provide a more objective way to classify astrocytomas.

CD44 expression in human gliomas.

BACKGROUND AND OBJECTIVES: Glioma invasiveness involves the attachment of tumor cells to the brain extracellular matrix, rich in hyaluronic acid (HA). CD44, the principal receptor for HA is found as a standard molecule (CD44s) or as variants (CD44v). We undertook a retrospective study to evaluate the expression pattern of CD44s, the isoforms CD44v3, v4/5 and v6 and to correlate their expression with clinical-anatomopathological parameters and survival rate. METHODS: The expression of these molecules was evaluated immunohistochemically in 84 gliomas. RESULTS: No expression of CD44v was detected in any tumors. CD44s staining of tumor cells was found in 70 of 84 (83.3%) of the gliomas. In 23 of 39 (59.0%) of the GBM more than the 70% of the cells were stained, while only 2 of 21 (9.5%) of LGA showed high expression. The association between CD44 and histological grade remained when the prognostic variables were considered in a multivariate analysis. Higher expression of CD44 was associated with worse overall survival rate; however, the Cox analysis indicated that survival was not associated with CD44. CONCLUSIONS: Our results suggest that overexpression of CD44s could be relevant in determining the highly invasive behaviour of gliomas, though it does not behave as an independent prognostic factor for survival.

Syphilitic meningitis in HIV-patients with meningeal syndrome: report of two cases and review

Few patients with symptomatic neurosyphilis present with signs and symptoms of acute meningitis. Here we report cases of syphilitic meningitis diagnosed in HIV patients with meningeal syndrome. The first case, a 30-year-old black bisexxual male, had concurrent meningeal and ocular syphilis with persistent unusually low CSF glucose levels. He responded well to 21 days of intravenous penicillin therapy. The second case was a 55-year-old female with epilepsy, depression, behavioral disorder and confusion. The diagnosis of HIV infection was made after onset of the syphilitic meningitis. She was treated with 21 days i.v. penicillin with improvement in her clinical condition. The clinical aspects of combined neurosyphilis and HIV infection, plus special features of diagnosis and treatment are discussed.

Importancia pronostica de la expresion de MDR-1 en la leucemia mieloblastica aguda / Prognostic value of the expression of MDR-1 in acute myeloid leukemia

An important number of patients with Acute Myeloid Leukemia (AML) experience relapse or resistance to chemotherapy. One of the mechanisms involved in this resistance is the presence of glycoprotein P170 (gp-P 170), which results of the MDR-1 gene in leukemic cells. The objective of this article is to assess the prognostic impact of the expression of MDR-1 in a group of patients treated for AML. The expression of MDR-1 was retrospectively assessed in a cohort of 55 patients with AML, older than 16 years old, who received chemotherapy from 1990 to 2000. The presence of MDR-1/gp-P170 was evaluated on bone marrow biopsy by immunohisto-chemistry. A ROC curve established that an expression of > 50 of MDR-1 on blastic cells was significant for the achievement of complete remission. The expression of MDR-1+ correlated with the presence of leucocytosis (p:0.002), expression of CD34+ cells (p:0.006), less achievement of complete remission (p:0.001), more rate of relapse (p:0.02) and of non-favorable cytogenetics (p:0.02). The event-free survival was of 21.2 SE:9.3 with a follow up of 22 months for the group of MDR-1+ versus 56.4 porcento SE 12.5 with a follow-up of 78 months for the MDR-1-group (p:0.007). It can be concluded that the expression of MDR-1 is a prognostic factor of resistance to chemotherapy. These patients present a lower rate of complete remission, a higher rate of relapse with persistence of post treatment residual disease, which produces a shorter global survival

Cirugía Conservadora en el tratamiento de los tumores benignos / Conservative surgery in the treatment of benign testicular tumors in childhood

El tratamiento clásico de los tumores testiculares ha sido la orquidectomía radical.En los últimos años esta conducta se ha modificado mediante un tratamiento más conservador:la tumorectomía con conservación de parénquima sano.Esta terapeútica está basada en datos preoperatorios,como la ecografía de alta definición,el dosaje negativo de marcadores serológicos y fundamentalmente,en la anatomía patológica intraoperatoria(congelación)dato esencial para decidir una conducta conservadora.En esta revisión presentamos la experiencia de nuestro servicio en 4 niños con tumores testiculares benignos,que fueron tratados con conservación de la gónada

Gradación histológica del adenocarcinoma de próstata según el sistema de Gleason: seminario interactivo, presentación de dos casos problema / Histological grading of prostatic adenocarcinoma: Gleason system

Existen numerosos sistemas de gradación para la evaluación del adenocarcinoma de próstata. El grupo de trabajo del cáncer de próstata que opera supervisado por el Instituto Nacional del Cáncer de Estados Unidos recomienda el sistema de Gleason, que se basa exclusivamente en patrones arquitecturales, el cual puede ser combinado con otros sistemas de gradación. Dos adenocarcinomas de próstata (de una serie de 514 casos) son discutidos. Los materiales fueron obtenidos por punción transrectal de próstata bajo control ecográfico y por resección transuretral. La gradación de la biopsia por punción determinó discrepancias entre los patólogos, lo que revela la fragilidad del sistema de Gleason y la utilidad de la punción transrectal con aguja fina como método diagnóstico

Diagnóstico de los tumores del conducto raquídeo por Resonancia Nuclear Magnética: experiencia sobre 84 pacientes / Diagnosis of the endorachidian tumors for Magnetic Resonance Imaging: experience on 14 patients

De 6.500 pacientes examinados con RNM entre julio de 1987 y julio de 1990, el 46 por ciento habían concurrido por enfermedades de la columna. De entre éstos, se seleccionaron 84 pacientes portadores de lesiones del conducto raquídeo, que fueron clasificados de acuerdo a las patologías halladas, los espacios y niveles comprometidos, sexo, edad, diagnóstico anatomopatológico y la correlación entre los diagnósticos RNM y anatomopatológico. Ochenta y un pacientes tenían tumores endorraquídeos y 3 eran portadores de hernias discales que constituyeron falsos positivos. Se concluye que la RNM, particularmente con inyección endovenosa de Gadolinio, constituye un método de elección para el diagnóstico de los tumores endorraquídeos