Efficacy of sodium hypochlorite in overcoming antimicrobial resistance and eradicating biofilms in clinical pathogens from pressure ulcers.

Sodium hypochlorite (NaOCl) is widely recognized for its broad-spectrum antimicrobial efficacy in skin wound care. This study investigates the effectiveness of NaOCl against a range of bacterial and fungal isolates from pressure ulcer (PU) patients. We analyzed 20 bacterial isolates from PU patients, comprising carbapenem-resistant Klebsiella pneumoniae (CRKP), multidrug-resistant Acinetobacter baumannii (MDRAB), methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus aureus (MSSA), along with 5 Candida albicans isolates. Antibiotic resistance profiles were determined using standard susceptibility testing. Whole-genome sequencing (WGS) was employed to identify antimicrobial resistance genes (ARGs) and disinfectant resistance genes (DRGs). Genetic determinants of biofilm formation were also assessed. The antimicrobial activity of NaOCl was evaluated by determining the minimum inhibitory concentration (MIC) and the minimal biofilm eradication concentration (MBEC) for both planktonic and biofilm-associated cells. CRKP and MDRAB showed resistance to fluoroquinolones and carbapenems, while MRSA exhibited resistance to ß-lactams and levofloxacin. MSSA displayed a comparatively lower resistance profile. WGS identified significant numbers of ARGs in CRKP and MDRAB, with fewer DRGs compared to MRSA and MSSA. All isolates possessed genes associated with fimbriae production and adhesion, correlating with pronounced biofilm biomass production. NaOCl demonstrated substantial antimicrobial activity against both planktonic cells and biofilms. The MIC90 for planktonic bacterial cells was 0.125 mg/mL, and the MBEC90 ranged from 0.225 to 0.5 mg/mL. For planktonic C. albicans, the MIC90 was 0.150 mg/mL, and the MBEC90 was 0.250 mg/mL. These results highlight the challenge in treating biofilm-associated infections and underscore the potential of NaOCl as a robust antimicrobial agent against difficult-to-treat biofilm infections at concentrations lower than those typically found in commercial disinfectants.

Match Injuries in the Spanish Rugby Union Division de Honor.

OBJECTIVE: To describe the injury rate, severity, cause, anatomical location (tissue damaged), recurrence, place and time during matches throughout a season in the Spanish Rugby Union Division de Honor. METHODS: Observational, prospective and descriptive study conducted in the competition of the Spanish División de Honor de Rugby with 258 players. The data were reported by the medical services of the previously formed clubs. RESULTS: Total exposure was 4100 h, during which 220 injuries occurred. The average number of sick days was 36.8. The total injury rate was 53.6 injuries/1000 h of exposure. Three quarters suffered 93 injuries and the forwards sustained a total of 127 injuries, with a total of 48.6 and 58.1 injuries/1000 h of exposure, respectively. Moderate injuries were the most frequent. Specifically, ligament injury was the most frequent, and dislocation was the injury that caused the most sick days. The most injuries occurred in the third quarter of the match, and the most serious injuries occurred in the second quarter. CONCLUSIONS: The injury rate of Spanish rugby competitors is 53.6 injuries/1000 match hours, with an average of 36.8 sick days. Contact injuries are the most frequent, taking place especially when tackling or being tackled.

The Epidemiology of Injuries in Spanish Rugby Union División de Honor.

BACKGROUND: We describe and analyze injury incidence, severity, cause of injury, anatomical location, damaged tissue, injury recurrence, and the time and place at which injuries occur over the course of a season. METHODS: An observational, descriptive, prospective, nomothetic, and multidimensional study was conducted during the 2018-2019 season with 258 players of the top semiprofessional rugby league in Spain (División de Honor de Rugby). Data were reported by the clubs' medical services. Reported time-loss injuries were collected. RESULTS: Overall exposure was 4100 h (137 matches), over 35 weeks of competition. A total of 288 injuries were reported, with three of these leading to withdrawal from the sport. A total average of 35.63 days was lost to injury. Overall time-loss injury incidence was 3.41 injuries/1000 h of exposure. Backs suffered 119 injuries corresponding to 3.80 injuries/1000 h of exposure, whilst forwards suffered 169 injuries with 4.27 injuries/1000 h of exposure. Severe injuries were the most frequent injury type. CONCLUSIONS: Outcomes confirm that more injuries take place during competition, with these also being more severe in nature. Contact injuries were most frequently suffered, above all, due to tackling or being tackled.

Evaluation of Merkel Cell Polyomavirus DNA in Tissue Samples from Italian Patients with Diagnosis of MCC.

Because the incidence of Merkel cell carcinoma (MCC) has increased significantly during the last 10 years and it is recognized that Merkel cell polyomavirus (MCPyV) and ultraviolet (UV) radiation represent two different etiological inputs sharing clinical, histopathological, and prognostic similar features, although with different prognosis, this study investigated the detection of MCPyV in skin and lymph nodes with histological diagnosis of MCC. Formalin-fixed paraffin-embedded tissue (FFPE) were retrieved from archived specimens and MCPyV non-coding control region (NCCR) and viral capsid protein 1 (VP1) sequences were amplified and sequenced. Results provide an interesting observation concerning the discrepancy between the MCPyV DNA status in primary and metastatic sites: in fact, in all cases in which primary and metastatic lesions were investigated, MCPyV DNA was detected only in the primary lesions. Our data further support the "hit-and-run" theory, also proposed by other authors, and may lead to speculation that in some MCCs the virus is only necessary for the process of tumor initiation and that further mutations may render the tumor independent from the virus. Few point mutations were detected in the NCCR and only silent mutations were observed in the VP1 sequence compared to the MCPyV MCC350 isolate. To unequivocally establish a role of MCPyV in malignancies, additional well-controlled investigations are required, and larger cohorts should be examined.

Structural Analysis of Merkel Cell Polyomavirus (MCPyV) Viral Capsid Protein 1 (VP1) in HIV-1 Infected Individuals.

Merkel cell polyomavirus (MCPyV) viral protein 1 (VP1) is the capsid protein that mediates virus attachment to host cell receptors and is the major immune target. Given the limited data on MCPyV VP1 mutations, the VP1 genetic variability was examined in 100 plasma and 100 urine samples from 100 HIV+ individuals. Sequencing of VP1 DNA in 17 urine and 17 plasma specimens, simultaneously MCPyV DNA positive, revealed that 27 samples displayed sequences identical to VP1 of MCC350 strain. VP1 from two urine specimens had either Thr47Ser or Ile115Phe substitution, whereas VP1 of one plasma contained Asp69Val and Ser251Phe substitutions plus deletion (∆) of Tyr79. VP1 DNA in the remaining samples had mutations encoding truncated protein. Three-dimensional prediction models revealed that Asp69Val, Ser251Phe, and Ile115Phe caused neutral effects while Thr47Ser and Tyr79∆ produced a deleterious effect reducing VP1 stability. A549 cells infected with urine or plasma samples containing full-length VP1 variants with substitutions, sustained viral DNA replication and VP1 expression. Moreover, medium harvested from these cells was able to infect new A549 cells. In cells infected by samples with truncated VP1, MCPyV replication was hampered. In conclusion, MCPyV strains with unique mutations in the VP1 gene are circulating in HIV+ patients. These strains display altered replication efficiency compared to the MCC350 prototype strain in A549 cells.

Merkel Cell Polyomavirus (MCPyV) in the Context of Immunosuppression: Genetic Analysis of Noncoding Control Region (NCCR) Variability among a HIV-1-Positive Population.

BACKGROUND: Since limited data are available about the prevalence of Merkel cell polyomavirus (MCPyV) and the genetic variability of its noncoding control region (NCCR) in the context of immunosuppression, this study aimed to investigate the distribution of MCPyV in anatomical sites other than the skin and the behavior of NCCR among an HIV-1-positive population. METHODS: Urine, plasma, and rectal swabs specimens from a cohort of 66 HIV-1-positive patients were collected and subjected to quantitative real-time polymerase chain reaction (qPCR) for MCPyV DNA detection. MCPyV-positive samples were amplified by nested PCR targeting the NCCR, and NCCRs alignment was carried out to evaluate the occurrence of mutations and to identify putative binding sites for cellular factors. RESULTS: MCPyV DNA was detected in 10/66 urine, in 7/66 plasma, and in 23/66 rectal samples, with a median value of 5 × 102 copies/mL, 1.5 × 102 copies/mL, and 2.3 × 103 copies/mL, respectively. NCCR sequence analysis revealed a high degree of homology with the MCC350 reference strain in urine, whereas transitions, transversions, and single or double deletions were observed in plasma and rectal swabs. In these latter samples, representative GTT and GTTGA insertions were also observed. Search for putative binding sites of cellular transcription factors showed that in several strains, deletions, insertions, or single base substitutions altered the NCCR canonical configuration. CONCLUSIONS: Sequencing analysis revealed the presence of numerous mutations in the NCCR, including insertions and deletions. Whether these mutations may have an impact on the pathogenic features of the virus remains to be determined. qPCR measured on average a low viral load in the specimens analyzed, with the exception of those with the GTTGA insertion.

Polyomaviruses shedding in stool of patients with hematological disorders: detection analysis and study of the non-coding control region's genetic variability.

Fragmented data are available on the human polyomaviruses (HPyVs) prevalence in the gastrointestinal tract. Rearrangements in the non-coding control region (NCCR) of JCPyV and BKPyV have been extensively studied and correlated to clinical outcome; instead, little information is available for KIPyV, WUPyV and MCPyV NCCRs. To get insights into the role of HPyVs in the gastrointestinal tract, we investigated JCPyV, BKPyV, KIPyV, WUPyV and MCPyV distribution among hematological patients in concomitance with gastrointestinal symptoms. In addition, NCCRs and VP1 sequences were examined to characterize the strains circulating among the enrolled patients. DNA was extracted from 62 stool samples and qPCR was carried out to detect and quantify JCPyV, BKPyV, KIPyV, WUPyV and MCPyV genomes. Positive samples were subsequently amplified and sequenced for NCCR and VP1 regions. A phylogenetic tree was constructed aligning the obtained VP1 sequences to a set of reference sequences. qPCR revealed low viral loads for all HPyVs searched. Mono and co-infections were detected. A significant correlation was found between gastrointestinal complications and KIPyV infection. Archetype-like NCCRs were found for JCPyV and BKPyV, and a high degree of NCCRs stability was observed for KIPyV, WUPyV and MCPyV. Analysis of the VP1 sequences revealed a 99% identity with the VP1 reference sequences. The study adds important information on HPyVs prevalence and persistence in the gastrointestinal tract. Gastrointestinal signs were correlated with the presence of KIPyV, although definitive conclusions cannot be drawn. HPyVs NCCRs showed a high degree of sequence stability, suggesting that sequence rearrangements are rare in this anatomical site.

Fluoxetine Treatment in Rats Increases the Rate of Taurine Transport in Mononuclear Cells.

Fluoxetine, a selective serotonin reuptake inhibitor antidepressant, modulates the mitogen-induced proliferation of lymphocytes. Lymphocytes contain taurine and express taurine transporter (TauT). Among the effects of taurine on lymphocytes are protection against oxidants and regulation of the inflammatory aspects of the immune response. Our aim was to determine the influence of fluoxetine treatment on taurine transport, and to determine the presence of TauT in the mononuclear cells of rats. METHODS: Male adult Sprague-Dawley rats were treated with fluoxetine 10 mg/kg i.p. for 1, 2, and 3 weeks. The cells were obtained by density gradients. [3H]Taurine was used for transport assays. Amino acid levels were determined by high-performance liquid chromatography. Immunolabeling of CD4+, CD8+, and TauT was performed. The mRNA of TauT was evaluated by RT-PCR. Controls were included for each protocol. RESULTS: The transport of taurine, after 1 week of treatment, was significantly augmented compared to controls. The affinity significantly increased at 1 and 2 weeks. While the percentage of CD4+ cells decreased and that of CD8+ cells increased, the percentage of TauT in CD4+ and CD8+ cells was not affected. Reduction of levels of aspartic acid, glutamic acid, threonine, alanine, glycine, and arginine occurred at 1 and 2 weeks. The taurine concentration significantly decreased after 2 and 3 weeks of treatment. The estimation of mRNA of TauT was not different. CONCLUSION: Taurine transport increases with fluoxetine treatment, and so this could be related to an immunomodulatory role of fluoxetine through TauT. Inhibition of serotonin reuptake might be involved in the regulation of taurine transport in mononuclear cells.

Neurites outgrowth and amino acids levels in goldfish retina under hypo-osmotic or hyper-osmotic conditions.

Amino acids are known to play relevant roles as osmolytes in various tissues, including the retina. Taurine is one of these active molecules. In addition, taurine stimulates outgrowth from the goldfish retina by mechanisms that include extracellular matrix, calcium fluxes and protein phosphorylation. The present report aims to explore the effect of medium osmolarity on goldfish retinal outgrowth and the possible modifications produced by changing eye osmolarity on amino acid levels in the retina. Goldfish retinal explants were obtained 10 days after crush of the optic nerve and cultured under iso-, hypo- or hyper-osmotic conditions. Hypo-osmotic medium was prepared by diluting the solutions 10% twice, preserving fetal calf serum concentration. Hyper-osmotic medium was done by adding 50 or 100 mM urea or mannitol. Evaluation of length and density of neurites was performed 5 days after plating. Outgrowth was reduced in hypo- and in hyper-osmotic conditions. Taurine, 4 mM, increased length and density of neurites in iso-osmotic, and produced stimulatory effects under both hyper-osmotic conditions. The in vivo modification of osmolarity by intraocular injection of water or 100 mM urea modified levels of free amino acids in the retina. Taurine and aspartate retinal levels increased in a time-dependent manner after hypo- and hyper-osmotic solution injections. Serine, threonine, arginine, γ-aminobutyric acid, alanine and tyrosine were elevated in hyper-osmotic conditions. Outgrowth in vitro, after in vivo osmolarity changes, was higher in the absence of taurine, but did not increase in the presence of the amino acid. The fact that certain outgrowth took place in these conditions support that the impairment was not due to tissue damage. Rather, the effects might be related to the cascade of kinase events described during osmolarity variations. The time course under these conditions produced adjustments in ganglion cells probably related to taurine transporter, and phosphorylation of specific proteins.

Gastrectomía longitudinal en manga: abordaje laparoscópico a través de tres portales / Sleeve gastrectomy: laparoscopic approach three portals

El procedimiento bariátrico conocido como "manga gástrica" o gastrectomía longitudinal es una intervención que cada día gana más adeptos dentro del mundo quirúrgico bariátrico debido a su simplicidad técnica, ya que sólo involucra una resección subtotal del fundus y del cuerpo gástrico para crear un conducto gástrico de aspecto tubular a lo de la curva menor del estómago. La laparoscopia tradicional ha demostrado que disminuye el dolor postoperatorio, la estancia hospitalaria y el paciente reinicia más rápido de sus actividades laborales. Tradicionalmente la realización de la manga gástrica requiere la utilización de 5 a 6 portales A manera de puente entre la laparoscopia tradicional y el abordaje endoscópico con una sola incisión se plantea la realización esta operación a través de tres portales, con una incisión oculta en la cicatriz umbilical y dos incisiones de 5mm en el abdomen. Mostrar la técnica quirúrgica de las "gastrectomía longitudinal en manga" a través de tres portales. Un total de 5 pacientes (todos femeninos), con IMC promedio de 35,4, fueron intervenidos con esta técnica. Se usaron tres portales, uno de 12 mm colocado en la cicatriz umbilical y 2 de 5 mm en línea medio clavicular en ambos hipocondrios. Se utilizó una óptica de 5mm y 30° HD. La maquina de autosutura fue utilizada por el portal umbilical. El tiempo quirúrgico promedio fue de 43 minutos. En un caso hubo subengrapado, lo que conllevo a fuga de la línea de grapas. Fue diagnósticada precozmente y resuelta quirúrgicamente. Es factible reproducir esta técnica y se logran tiempos quirúrgicos equiparables a la laparoscopia tradicional y sustancialmente menor al abordaje endoscópico de una sola incisión.

Known as "gastric sleeve" or longitudinal gastrectomy bariatric procedure, is an intervention every day earning more adherents in the surgical bariatric world due to its technical simplicity, because it involves only the fundus and the gastric body subtotal resection to crease a gastric conduit of tubular appearance along the curve less tham the stomach. Traditional laparoscopy has show that it reduces postoperative pain, hospital stay and patients restarts faster their occupational activities. The realization of the gastric sleeve traditionally requires the use of 5 to 6 portals. A bridge the between the traditional laparoscopic and endoscopic approach with a single incision, arises the realization this operation through three portals with a hidden in the umbical scar incisión and two 5 mm abdominal incisions. Show the surgical technique of the "longitudinal sleeve gastrectomy" through three portals. A total of 5 patients (all female), with an average BMI of 35.4, were operated with this technique. Three portals, one of 12 mm placed in the umbilical SCAR and 2 of 5 mm on midclavicular line in both hypochondri were used. We used a lens of 5mm and 30° HD. The surgical stapler machine was used by the umbilical portal. The average surgical time was 43 minutes . In one case there was a sub stapled, which led to the staple line leak. It was diagnosed early and resolved surgically. It is possible to reproduce this technique and get surgical times comparable to traditional laparoscopy and substantially less that the endoscopic approach of a single incision.

Taurine and proliferation of lymphocytes in physically restrained rats.

BACKGROUND: Taurine is present in lymphocytes and seems to modulate certain immune cell functions. Among the effects of taurine on these cells are protection against antioxidants and regulation of inflammatory aspects of the immune response. Stress affects antigen presentation, traffic and proliferation of leukocytes, as well as antibody and cytokine secretion. The purposes of this study were to explore the possible direct effects of taurine concentrations on lymphoproliferation and interleukins levels in control and in physical restrained rats. METHODS: Lymphocytes of male Sprague-Dawley rats, stressed by physical restrain and controls (5 h per day for 5 days) were isolated from blood by Histopaque (1077 g/l) and differential adhesion to plastic, and then cultured (72 h) in the presence of different concentrations of taurine (0.5-50 mM), beta-alanine (0.5-50 mM), or both, without or with the T cells mitogen, concanavalin A. Plasma and lymphocytes levels of pro-inflammatory interleukin-1beta and anti-inflammatory interleukin-10 were respectively measured by Pierce Endogen rat ELISA Kits. Taurine in plasma and in lymphocytes were determined by HPLC. RESULTS: Lymphoproliferation of resting cells significantly decreased in the presence of 3 and 6 mM taurine and increased up to control level at 12 mM taurine. In concanavalin A-activated lymphocytes, the effect of taurine was greater. beta-alanine increased lymphoproliferation in a bell shaped dose-dependent manner and decreased it in activated lymphocytes but in a lower magnitude. In combination, beta-alanine impaired the effect of taurine at 3 and 6 mM. After restriction, no change in lymphoproliferation was observed at different concentrations of the amino acids without or with concanavalin A, although pro-inflammatory interleukin and taurine in plasma and in lymphocytes significantly increased. CONCLUSIONS: Taurine affects lymphoproliferation in control rats, following a dose-dependent manner, an effect that might involve its transport into the cells. Elevation of interleukin-1beta produced in stressed rats by physical restrain could seriously affect the immune balance, whereas taurine increase might be protective. These results suggest that taurine and taurine transport play a role in lymphoproliferation. In addition, modifications of taurine system in lymphocytes take place during restriction stress.

Ganglio centinela en cáncer gástrico: descripción de la técnica laparoscópica / Technique of laparoscopic sentinel node biopsy in gastric cancer

El estudio del ganglio centinela es un procedimiento actualmente aceptado en el melanoma, cáncer de pene y de mama. Su indicación y utilidad en el cáncer gástrico es aún controvertida. El objetivo del presente trabajo es describir la técnica de la biopsia laparoscópica del ganglio centinela en el cáncer gástrico y la posibilidad de su realización en el Hospital Universitario de Caracas. Se incluyeron dos pacientes durante el período comprendido entre enero y noviembre del 2008 con diagnóstico de carcinoma gástrico en estadio inicial. Se utilizó la técnica combinada con azul patente y tecnecio (Tc99). Una vez identificado el ganglio centinela se procedio a la cirugía habitual. El ganglio se evaluo posteriormente por anatomía patológica en conjunto con el espécimen quirúrgico. El porcentaje de detección del ganglio centinela fue del 50 por ciento. El ganglio centinela detectado fue positivo para metástasis. No hubo morbilidad asociada. La identificación del ganglio centinela por laparoscopia es aplicable en pacientes con cáncer gástrico en estadios iniciales y representa una opción en el abordaje terapéutico minimamente invasivo de dicha patología.

Taurine transporter in lymphocytes of patients with major depression treated with venlafaxine plus psychotherapy.

The taurine transporter and taurine are present in lymphocytes, where taurine functions as an antioxidant and an anti-inflammatory agent. Taurine levels are elevated in lymphocytes of subjects with major depression, but returns to control levels after treatment with the antidepressant mirtazapine. Patients (40) were diagnosed using the Diagnostic and Statistical Manual IV of the American Psychiatric Association, and the severity of their condition was determined by the Hamilton Scale of Depression. One group of patients was treated with venlafaxine and the other with venlafaxine plus Neuro-Linguistic Programming. Lymphocytes were isolated from the peripheral blood by Ficoll/Hypaque. The coexistence of the taurine transporter with a subpopulation of CD4+ and CD8+ lymphocytes was measured by immunofluorescence. The levels of the pro-inflammatory, IL-2, and the anti-inflammatory, IL-4, cytokines were determined by ELISA while plasma amino acid levels were determined by HPLC. The percentage of CD4+ cells significantly decreased after both treatments, whereas the levels of CD8+ cells remained unchanged. The taurine transporter of CD4+ and CD8+ cells decreased after integrate treatment. No differences were found in the levels of IL-2 while IL-4 levels increased after integrate treatment. The observed effects of treatment on the taurine transporter and IL-4 content might modify lymphocyte activity during depression.

Effect of medium osmolarity and taurine on neuritic outgrowth from goldfish retinal explants.

Taurine stimulates outgrowth of goldfish retinal explants in a concentration- and time-dependent manner, an effect related to calcium movement and protein phosphorylation. Since taurine is an osmoregulator in the central nervous system, and osmolality might influence regeneration, the purpose of this work was to evaluate the possible effect of hypo-osmolality on basal outgrowth and on the trophic action of the amino acid. Accordingly, goldfish retinal explants obtained after crushing the optic nerve were cultured in iso- and hypo-osmotic medium, the latter achieved by diluting the medium 10% 24 and 72 h after plating. The length and density of the neurites, measured after 5 days in culture, were significantly lower in the hypo- than in the iso-osmotic medium. Taurine stimulated the outgrowth under both conditions, but the percentage of increase was greater in iso-osmotic medium. Taurine concentration, determined by HPLC, did not significantly change in explants. Co-administration of beta-alanine and taurine impaired the trophic effect of taurine to a greater extent in the iso- than in hypo-osmotic medium, indicating a possible differential interaction with the taurine transporter which could be altered by osmotic stress. The exact mechanism of outgrowth regulation by hypotonicity requires further clarification, taking into considering possible modification of the taurine transporter.

Hibernoma de la región anterolateral del muslo / Hibernoma of the anterolateral thigh

Exponer nuestra experiencia en el manejo de 1 caso de hibernoma, en el Servicio de Cirugía 2 del Hospital Universitario de Caracas (HUC). Revisión de literatura. Se realizó el estudio clínico, imagenológico y anatomopatológico de una tumoración de partes blandas en el muslo derecho de un paciente masculino de 23 años de edad, de aproximadamente 10 meses de evolución. Ante los hallazgos de estudios por imágenes (imágenes por resonancia magnética y ultrasonido con efecto Doppler), así como el resultado de la biopsia percutánea, por trucut, se decidió realizar su exéresis. El estudio anatomopatológico de la pieza quirúrgica reportó hibernoma. Una lesión benigna, poco frecuente, sin proceso de malignización reportado hasta la fecha. La evaluación clínica, imagenológica y la realización de biopsias percutáneas previo al acto quirúrgico son de suma importancia para las lesiones de partes blandas. El reporte de casos de presentación inusual, como el hibernoma, nutre nuestra gama de diagnósticos diferenciales a tener en cuenta al momento de evaluar lesiones de este tipo.

Laparoscopic gastric bypass for morbid obesity-a randomized controlled trial comparing two gastrojejunal anastomosis techniques.

OBJECTIVES: We present a randomized controlled trial of laparoscopic gastric bypass comparing 2 techniques of gastrojejunostomy in patients with morbid obesity. METHODS: Eighty consecutive patients underwent laparoscopic Roux-en-Y gastric bypass between September 2005 and August 2006. Patients were randomly assigned to 2 groups by the use of sealed envelopes. In group A, the gastrojejunal anastomosis was performed with a 21-mm circular-stapler, and in group B, this anastomosis was performed with a 45-mm linear-stapler. The rest of the procedure was identical in both groups. Variables evaluated were complications involving the gastrojejunostomy, operative time, length of stay, and percentage of excess weight loss. RESULTS: Both groups were similar in age and body mass index. No patients experienced leakage or gastrojejunal anastomosis fistula, but group A patients had a more frequent stricture rate (P<0.05). Operative time and hospital stay were comparable in both groups (P>0.05). Percentage excess weight loss at one year following surgery was satisfactory in both groups, without a statistically significant difference (P>0.05). CONCLUSION: Gastrojejunal anastomosis does not seem to be a critical factor in excess weight loss for morbidly obese patients who underwent laparoscopic gastric bypass. The 2 techniques used in this experience are safe and effective; however, the 45-mm liner-stapler is preferable because it has a lower stricture rate.

Metástasis intestinal de melanoma: a propósito de un caso / Melanoma intestinal metastasis: a porpuse case

Presentamos el caso de un paciente masculino de mediana edad, piel morena, con lesión primaria en los dedos del pie derecho de seis meses de evolución, quien durante su hospitalización presentó episodio de obstrucción intestinal. Se realizó laparotomía con los hallazgos de metástasis en asas delgadas y mesenterio que condicionaban intususcepción de un segmento de yeyuno. Manifestación poco común del melanoma metastásico.

We present a case of male brown patient with primary injury in right foot fingers with six months of evolution. During hospitalization did episode of intestinal obstruction, he was taken to operating room by finds of metastasis in thin handles and mesentery that they were determining intussusception of a segment of jejune. Slightly common manifestation of the dissemination of the melanoma.

Bypass gástrico por laparoscopia para la obesidad mórbida: técnica y resultados en 150 pacientes con seguimiento de 3 a 48 meses / Laparoscopic gastric bypass for morbid obesity: technical and results in 150 patients with pursuit of 3 a 48 menses

Se presenta una serie prospectiva de 150 pacientes sometidos a bypass gástrico por laparoscopia debido a obesidad mórbida. En 98 mujeres y 52 hombres con índice de masa corporal promedio de 43,3 kg/m² se realizó un bypass gástrico en "Y" de Roux antecólico, con dos técnicas de anastomosis gastroyeyunal. La morbilidad temprana (< 1 mes) fue de 5,3 por ciento representada principalmente por hemorragia intraabdominal, mientras que la tardía (> 1 mes) fue de 13,8 por ciento, debida en la mayoría de los casos a estenosis de la gastroyeyunoanastomosis. No hubo mortalidad en la serie. Con un seguimiento del 70 por ciento, encontramos pérdidas de exceso de peso del 84 por ciento al año de posoperatorio (valor promedio), con mejoría de comorbilidades de 92,5 por ciento en hipertensión arterial y 59,9 por ciento en diabetes. Se concluye que la técnica de bypass gástrico por laparoscopia, representa una alternativa factible, segura y efectiva para los pacientes con obesidad mórbida.

A prospective series of 150 patients submitted to laparoscopic gastric bypass for morbid obesity is presented. In 92 women and 58 men with a median body mass index of 43.3 kg/m² an antecolic Roux en Y gastric bypass was performed using two techniques of gastrojejunostomy. The early morbidity (< 1 month) was of 5.3 percent mainly represented by intraabdominal bleeding, while the late morbidity (> 1 month) was of 13.8 percent, and in most cases due to stenosis of the gastrojejunal anastomosis. No mortality occurred in the series. With a 70 percent follow up, we found an excess weight loss of 84 percent at first postoperative year (mean value), with co-morbidities improvement of 92.5 percent on hypertension and 59.9 percent on diabetes. We concluded that the technique of laparoscopic gastric bypass is a feasible, safe, and effective alternative for patients with morbid obesity.

Taurine concentration in human gliomas and meningiomas: tumoral, peritumoral, and extratumoral tissue.

Taurine concentrations were determined in gliomas from 16 patients and in meningiomas from 15 patients. After imaging analysis and clinical evaluation to consider the level of functional deterioration by the scale of Karnosky, tissue was obtained by surgery. Tumoral, peritumoral and extratumoral samples were taken and analyzed by HPLC with fluorescence detector. The concentration of taurine (nmol/mg protein) was higher in tumoral and peritumoral tissues than in the extratumoral samples for gliomas. In the case of meningiomas, the taurine concentration was higher in tumoral than in peritumoral and extratumoral samples. These modifications might be due to specific functions of this amino acid, being either protective or involved in the proliferation of cells. The differential distribution in the two types of tumors could be related to the malignancy of them, which is higher in gliomas than in meningiomas.

Neuritic outgrowth from goldfish retinal explants, interaction of taurine and zinc.

Various studies provide evidence for an interaction between taurine and zinc during development, affecting the morphology and function of the retina. The objectives of the present work were to determine taurine and zinc levels in the retina of goldfish during regeneration and to investigate the effect of the intracellular zinc chelator N,N,N,N-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN) on the trophic role of taurine on outgrowth from post-crush goldfish retinal explants. Taurine was determined by HPLC (nmol/mg protein) and zinc by spectrophotometry ICP (microg/mg protein) at various days post-crushing the optic nerve. The levels of taurine were significantly increased at 72 h and the zinc levels at 24 h. Explants from retinas, 10 days post-crush, were cultured for 5 days in the presence of various concentrations and combinations of TPEN and taurine. TPEN, 1 nM, decreased the outgrowth but simultaneously with taurine (1-8 mM) there was an increase. These results demonstrate that zinc was necessary for normal outgrowth of retinal fibers and that taurine counteracted the chelator effect.