Global change and premature hatching of aquatic embryos.

Anthropogenically induced changes to the natural world are increasingly exposing organisms to stimuli and stress beyond that to which they are adapted. In aquatic systems, it is thought that certain life stages are more vulnerable than others, with embryos being flagged as highly susceptible to environmental stressors. Interestingly, evidence from across a wide range of taxa suggests that aquatic embryos can hatch prematurely, potentially as an adaptive response to external stressors, despite the potential for individual costs linked with underdeveloped behavioural and/or physiological functions. However, surprisingly little research has investigated the prevalence, causes and consequences of premature hatching, and no compilation of the literature exists. Here, we review what is known about premature hatching in aquatic embryos and discuss how this phenomenon is likely to become exacerbated with anthropogenically induced global change. Specifically, we (1) review the mechanisms of hatching, including triggers for premature hatching in experimental and natural systems; (2) discuss the potential implications of premature hatching at different levels of biological organisation from individuals to ecosystems; and (3) outline knowledge gaps and future research directions for understanding the drivers and consequences of premature hatching. We found evidence that aquatic embryos can hatch prematurely in response to a broad range of abiotic (i.e. temperature, oxygen, toxicants, light, pH, salinity) and biotic (i.e. predators, pathogens) stressors. We also provide empirical evidence that premature hatching appears to be a common response to rapid thermal ramping across fish species. We argue that premature hatching represents a fascinating yet untapped area of study, and the phenomenon may provide some additional resilience to aquatic communities in the face of ongoing global change.

Elevated carbon dioxide alters the plasma composition and behaviour of a shark.

Increased carbon emissions from fossil fuels are increasing the pCO2 of the ocean surface waters in a process called ocean acidification. Elevated water pCO2 can induce physiological and behavioural effects in teleost fishes, although there appear to be large differences in sensitivity between species. There is currently no information available on the possible responses to future ocean acidification in elasmobranch fishes. We exposed small-spotted catsharks (Scyliorhinus canicula) to either control conditions or a year 2100 scenario of 990 µatm pCO2 for four weeks. We did not detect treatment effects on growth, resting metabolic rate, aerobic scope, skin denticle ultrastructure or skin denticle morphology. However, we found that the elevated pCO2 group buffered internal acidosis via [Formula: see text] accumulation with an associated increase in Na(+), indicating that the blood chemistry remained altered despite the long acclimation period. The elevated pCO2 group also exhibited a shift in their nocturnal swimming pattern from a pattern of many starts and stops to more continuous swimming. Although CO2-exposed teleost fishes can display reduced behavioural asymmetry (lateralization), the CO2-exposed sharks showed increased lateralization. These behavioural effects may suggest that elasmobranch neurophysiology is affected by CO2, as in some teleosts, or that the sharks detect CO2 as a constant stressor, which leads to altered behaviour. The potential direct effects of ocean acidification should henceforth be considered when assessing future anthropogenic effects on sharks.

A decade of progress in marine evolutionary biology.

This article summarizes the Evolutionary Applications Special Issue, "A decade of progress in Marine Evolutionary Biology." The globally connected ocean, from its pelagic depths to its highly varied coastlines, inspired Charles Darwin to develop the theory of evolution during the voyage of the Beagle. As technology has developed, there has been a dramatic increase in our knowledge about life on our blue planet. This Special Issue, composed of 19 original papers and seven reviews, represents a small contribution to the larger picture of recent research in evolutionary biology, and how such advancements come about through the connection of researchers, their fields, and their knowledge. The first European network for marine evolutionary biology, the Linnaeus Centre for Marine Evolutionary Biology (CeMEB), was developed to study evolutionary processes in the marine environment under global change. Though hosted by the University of Gothenburg in Sweden, the network quickly grew to encompass researchers throughout Europe and beyond. Today, more than a decade after its foundation, CeMEB's focus on the evolutionary consequences of global change is more relevant than ever, and knowledge gained from marine evolution research is urgently needed in management and conservation. This Special Issue, organized and developed through the CeMEB network, contains contributions from all over the world and provides a snapshot of the current state of the field, thus forming an important basis for future research directions.

Molecular, behavioural and morphological comparisons of sperm adaptations in a fish with alternative reproductive tactics.

In species with alternative reproductive tactics, there is much empirical support that parasitically spawning males have larger testes and greater sperm numbers as an evolved response to a higher degree of sperm competition, but support for higher sperm performance (motility, longevity and speed) by such males is inconsistent. We used the sand goby (Pomatoschistus minutus) to test whether sperm performance differed between breeding-coloured males (small testes, large mucus-filled sperm-duct glands; build nests lined with sperm-containing mucus, provide care) and parasitic sneaker-morph males (no breeding colouration, large testes, rudimentary sperm-duct glands; no nest, no care). We compared motility (per cent motile sperm), velocity, longevity of sperm, gene expression of testes and sperm morphometrics between the two morphs. We also tested if sperm-duct gland contents affected sperm performance. We found a clear difference in gene expression of testes between the male morphs with 109 transcripts differentially expressed between the morphs. Notably, several mucin genes were upregulated in breeding-coloured males and two ATP-related genes were upregulated in sneaker-morph males. There was a partial evidence of higher sperm velocity in sneaker-morph males, but no difference in sperm motility. Presence of sperm-duct gland contents significantly increased sperm velocity, and nonsignificantly tended to increase sperm motility, but equally so for the two morphs. The sand goby has remarkably long-lived sperm, with only small or no decline in motility and velocity over time (5 min vs. 22 h), but again, this was equally true for both morphs. Sperm length (head, flagella, total and flagella-to-head ratio) did not differ between morphs and did not correlate with sperm velocity for either morph. Thus, other than a clear difference in testes gene expression, we found only modest differences between the two male morphs, confirming previous findings that increased sperm performance as an adaptation to sperm competition is not a primary target of evolution.

A novel method for measuring acute thermal tolerance in fish embryos.

Aquatic ectotherms are vulnerable to thermal stress, with embryos predicted to be more sensitive than juveniles and adults. When examining the vulnerability of species and life stages to warming, comparable methodology must be used to obtain robust conclusions. Critical thermal methodology is commonly used to characterize acute thermal tolerances in fishes, with critical thermal maximum (CTmax) referring to the acute upper thermal tolerance limit. At this temperature, fish exhibit loss of controlled locomotion due to a temperature-induced collapse of vital physiological functions. While it is relatively easy to monitor behavioural responses and measure CTmax in larval and adult fish, this is more challenging in embryos, leading to a lack of data on this life stage, or that studies rely on potentially incomparable metrics. Here, we present a novel method for measuring CTmax in fish embryos, defined by the temperature at which embryos stop moving. Additionally, we compare this measurement with the temperature of the embryos' last heartbeat, which has previously been proposed as a method for measuring embryonic CTmax. We found that, like other life stages, late-stage embryos exhibited a period of increased activity, peaking approximately 2-3°C before CTmax. Measurements of CTmax based on last movement are more conservative and easier to record in later developmental stages than measurements based on last heartbeat, and they also work well with large and small embryos. Importantly, CTmax measurements based on last movement in embryos are similar to measurements from larvae and adults based on loss of locomotory control. Using last heartbeat as CTmax in embryos likely overestimates acute thermal tolerance, as the heart is still beating when loss of response/equilibrium is reached in larvae/adults. The last movement technique described here allows for comparisons of acute thermal tolerance of embryos between species and across life stages, and as a response variable to treatments.

Invader at the edge - Genomic origins and physiological differences of round gobies across a steep urban salinity gradient.

Species invasions are a global problem of increasing concern, especially in highly connected aquatic environments. Despite this, salinity conditions can pose physiological barriers to their spread, and understanding them is important for management. In Scandinavia's largest cargo port, the invasive round goby (Neogobius melanostomus) is established across a steep salinity gradient. We used 12,937 SNPs to identify the genetic origin and diversity of three sites along the salinity gradient and round goby from western, central and northern Baltic Sea, as well as north European rivers. Fish from two sites from the extreme ends of the gradient were also acclimated to freshwater and seawater, and tested for respiratory and osmoregulatory physiology. Fish from the high-salinity environment in the outer port showed higher genetic diversity, and closer relatedness to the other regions, compared to fish from lower salinity upstream the river. Fish from the high-salinity site also had higher maximum metabolic rate, fewer blood cells and lower blood Ca2+. Despite these genotypic and phenotypic differences, salinity acclimation affected fish from both sites in the same way: seawater increased the blood osmolality and Na+ levels, and freshwater increased the levels of the stress hormone cortisol. Our results show genotypic and phenotypic differences over short spatial scales across this steep salinity gradient. These patterns of the physiologically robust round goby are likely driven by multiple introductions into the high-salinity site, and a process of sorting, likely based on behaviour or selection, along the gradient. This euryhaline fish risks spreading from this area, and seascape genomics and phenotypic characterization can inform management strategies even within an area as small as a coastal harbour inlet.

Ancestral Sperm Ecotypes Reveal Multiple Invasions of a Non-Native Fish in Northern Europe.

For externally fertilising organisms in the aquatic environment, the abiotic fertilisation medium can be a strong selecting force. Among bony fishes, sperm are adapted to function in a narrow salinity range. A notable exception is the family Gobiidae, where several species reproduce across a wide salinity range. The family also contains several wide-spread invasive species. To better understand how these fishes tolerate such varying conditions, we measured sperm performance in relation to salinity from a freshwater and a brackish population within their ancestral Ponto-Caspian region of the round goby, Neogobius melanostomus. These two ancestral populations were then compared to nine additional invaded sites across northern Europe, both in terms of their sperm traits and by using genomic SNP markers. Our results show clear patterns of ancestral adaptations to freshwater and brackish salinities in their sperm performance. Population genomic analyses show that the ancestral ecotypes have generally established themselves in environments that fit their sperm adaptations. Sites close to ports with intense shipping show that both outbreeding and admixture can affect the sperm performance of a population in a given salinity. Rapid adaptation to local conditions is also supported at some sites. Historical and contemporary evolution in the traits of the round goby sperm cells is tightly linked to the population and seascape genomics as well as biogeographic processes in these invasive fishes. Since the risk of a population establishing in an area is related to the genotype by environment match, port connectivity and the ancestry of the round goby population can likely be useful for predicting the species spread.

Evidence of rapid adaptive trait change to local salinity in the sperm of an invasive fish.

Invasive species may quickly colonize novel environments, which could be attributed to both phenotypic plasticity and an ability to locally adapt. Reproductive traits are expected to be under strong selection when the new environment limits reproductive success of the invading species. This may be especially important for external fertilizers, which release sperm and eggs into the new environment. Despite adult tolerance to high salinity, the invasive fish Neogobius melanostomus (round goby) is absent from fully marine regions of the Baltic Sea, raising the possibility that its distribution is limited by tolerance during earlier life stages. Here, we investigate the hypothesis that the spread of N. melanostomus is limited by sperm function in novel salinities. We sampled sperm from two invasion fronts with higher and lower salinities in the Baltic Sea and tested them across a range of salinity levels. We found that sperm velocity and percentage of motile sperm declined in salinity levels higher and lower than those currently experienced by the Baltic Sea populations, with different performance curves for the two fronts. Sperm velocity also peaked closer to the home salinity conditions in each respective invasion front, with older localities showing an increased fit to local conditions. By calculating how the sperm velocity has changed over generations, we show this phenotypic shift to be in the range of other fish species under strong selection, indicating ongoing local adaptation or epigenetic acclimation to their novel environment. These results show that while immigrant reproductive dysfunction appears to at least partly limit the distribution of invasive N. melanostomus in the Baltic Sea, local adaptation to novel environments could enable future spread beyond their current boundaries.

Alternative reproductive tactics are associated with sperm performance in invasive round goby from two different salinity environments.

During male-male competition, evolution can favor alternative reproductive tactics. This often results in a dominant morph that holds a resource, such as a nest for egg laying, which competes with a smaller sneaker morph that reproduces by stealing fertilizations. The salinity environment can influence male growth rates, for example, via osmoregulatory costs, which in turn may influence the use of sneaker tactics for small males competing for mating opportunities. Salinity can also affect sperm directly; however, little is known of how salinity influences sneaker tactics through sperm performance. We sampled males of the invasive round goby (Neogobius melanostomus) from two environments, a freshwater river and a brackish estuary. This fish has two male morphs: nest-holding dark males and non-nest-holding light males. We examined the role of water salinity of 0, 8, and 16 on sperm performance and found that for estuarine males, a salinity of 0 reduced sperm velocity compared to a salinity of 8 and 16. Riverine males had low velocity in all salinities. Sperm viability also decreased by over 30% in 0 salinity, compared to 8 and 16, for fish from both environments. Gobies produce ejaculate contents in specialized glands that could in theory shield sperm in an adverse environment. However, gland contents did not improve sperm performance in our tests. Body mass and age estimates indicate that riverine males invested more in somatic growth compared to estuarine males. Estuarine light morph males had a high enough gonadosomatic index to indicate sneaker tactics. We propose that when sperm performance is low, such as for the riverine males, sneaker tactics are ineffective and will be selected against or phenotypically suppressed. Instead, we interpret the increased investment in somatic growth found in riverine males as a life-history decision that is advantageous when defending a nest in the next reproductive season.

Sperm-duct gland content increases sperm velocity in the sand goby.

Sperm performance is often tightly linked to male reproductive success. In many demersal gobiid fishes, the male attaches sperm embedded in a mucus produced by sperm-duct glands to the nest substrate before spawning takes place. Sperm are activated as the mucus and embedded gland content dissolve into the water. To test the importance of gland content on sperm function in Pomatoschistus minutus, a marine fish with external fertilization, we used a paired experimental design, with spermatozoa tested with and without sperm-duct gland content mixed into seawater. We measured sperm velocity, percentage of motile sperm and sperm viability over time. Sperm were found to swim 7.3% faster when gland content was mixed in the seawater. Percentage motile sperm was unaffected by the gland content. Sperm viability in seawater exceeded 24 h, but was unaffected by the gland content. An increase in sperm velocity of similar magnitude as found here has been shown by others to increase fertilization success. Since velocity-boosting properties of sperm-duct gland content have now been found in three distantly related goby species, this trait appears to be conserved across the Gobiidae family and may aid in reproduction across a range of species and environments.This article has an associated First Person interview with the first author of the paper.

A study of the immediate effects of glycerine-filled insoles, contoured prefabricated orthoses and flat insoles on single-leg balance, gait patterns and perceived comfort in healthy adults.

BACKGROUND: Footwear interventions are often prescribed to assist with the management of lower limb pain, injury and disease. Commercially available shoe insoles and orthoses are increasingly incorporating novel design features to alleviate foot and lower limb symptoms, but this may be at a cost to optimal functional performance. This study compared the immediate effects of wearing glycerine-filled insoles, contoured prefabricated orthoses, and flat insoles, on balance and gait measures. METHODS: Thirty healthy adults (17 men, 13 women; mean [SD] age: 24.3 [2.5] years) performed tests of single-leg standing with eyes open (Kistler force platform), star excursion balance test, and level-ground walking (GAITRite® walkway system), under three randomised conditions: wearing glycerine-filled insoles, prefabricated orthoses, and flat (control) insoles, within their own footwear. Centre of pressure movement (anterior-posterior and mediolateral range and standard deviation, total path velocity), star excursion balance test reach distance, and temporospatial gait variables were collected. Perceived comfort of the inserts was scored immediately after use on a 100 mm visual analogue rating scale. After trialling all inserts each participant ranked their level of comfort from least to most. RESULTS: Centre of pressure measures, star excursion balance test reach distance, or temporospatial gait variables did not differ between the three inserts (all P values >0.088). Significant between-condition differences were reported for comfort ranking (P = 0.031), but not rating scores (P = 0.638). Weak to moderate negative correlations (r values ranged between -0.368 and -0.406) were observed between visual analogue scale comfort rating for the flat insoles and prefabricated orthoses, star excursion balance test and gait measures. CONCLUSIONS: Single-leg standing balance, star excursion balance test performance, and level-ground walking patterns in asymptomatic adults do not appear to differ when wearing glycerine-filled insoles, contoured prefabricated orthoses, or flat insoles. Perceived comfort may be related to the biomechanical or clinical effectiveness of novel footwear interventions, and requires further investigation. Importantly, these findings are specific to a healthy population and further research is needed to determine the long-term effects of glycerine-filled insoles in patients with known balance impairments.

Resultados de la timectomía máxima en miastenia gravis. Experiencia de 20 años en el Servicio de Neumología y Cirugía de Tórax en el Hospital General de México: Influencia de la timectomía en dosis de piridostigmina y tres variables espirométricas en miastenia gravis / Results of maximal thymectomy in myasthenia gravis. A 20 year experience at The Pulmonology and Thoracic Surgery Department of Mexico's General Hospital: The influence of thymectomy over the dose of pyridostigmine and three spirometric variables in myasthenia gravis

La miastenia gravis (MG) es una enfermedad de la placa neuromuscular, caracterizada por debilidad y fatiga muscular. Puede estar relacionada con casos de timoma y más frecuentemente con hiperplasia del timo. La MG se trata con medicamentos como la piridostigmina; cuando no se controla a pesar de altas dosis, o aparecen efectos secundarios indeseables, se indica la timectomía que permite disminuir o suspender la medicación. En este trabajo se presenta la experiencia de 20 años en 126 pacientes con MG que han sido sometidos a timectomía máxima; hubo una defunción postoperatoria inmediata y otra tardía, ambas relacionadas con falta de recuperación de fuerza muscular. Después de la timectomía máxima se observó disminución postoperatoria en las dosis de piridostigmina y mejoría de las pruebas de función respiratoria, con valores estadísticamente significativos.

Myasthenia gravis (MG) is a disease of the neuromuscular plaque characterized by weakness and fatigue. It can be related to thymic tumors or hyperplasia of the gland. MG is treated with pyridostigmine; if medical control can not be achieved or unpleasant symptoms appear, thymectomy is indicated. We present our 20 year experience with 126 cases of transternal maximal thymectomy for the treatment of MG; there were two postoperative deaths related to respiratory muscle weakness. Statistically significant improvements in pyridostigmine dosage, tidal volume, vital capacity and maximal inspiratory force were seen after surgery.

Metástasis pulmonar por sarcoma de tejidos blandos: once años de experiencia en el Instituto Nacional de Cancerología / Pulmonary netastases of soft tissue sarcoma: eleven years of experience at the National Cancerology Institute

Antecedentes: Aunque los sarcomas de tejidos blandos son tumores raros, inducen metástasis al pulmón hasta en un 70 por ciento de los casos. En población mexicana no se ha descrito la frecuencia y distribución de metástasis por este tipo de sarcoma, por lo que en este trabajo se describen dichas variables en pacientes del Instituto Nacional de Cancerología. Métodos: Se revisaron los expedientes de pacientes con sarcoma de tejidos blandos registrados entre 1986 y 1996. Se recabó información demográfica, la histología del tumor y el tiempo de desarrollo de la metástasis pulmonar. Resultados: Se incluyeron en el estudio 247 casos. De éstos, 69 (28 por ciento) desarrollaron metástasis pulmonar, 111 (45 por ciento) fueron hombres y 136 (55 por ciento) mujeres. Se observó una mediana de edad de 35 años. En cuanto a la histología del tumor destacan: 73 (30 por ciento) liposarcomas, 13 (18 por ciento) desarrollaron metástasis pulmonar, 61 (25 por ciento) sarcomas sinoviales, 28 (45 por ciento) con metástasis, y 31 (12 por ciento) rabdomiosarcomas, 11 (35 por ciento) desarrollaron metástasis. Considerando la fecha de ingreso, se observaron medianas de tiempo de desarrollo de metástasis de hasta 24 meses. Los pacientes con sarcoma sinovial, angiosarcoma y liposarcoma y metástasis pulmonar tuvieron una supervivencia a 60 meses inferior al 20 por ciento, significativamente menor a la registrada en cada caso sin metástasis pulmonar (p= 0.0006, p= 0.038 y p= 0.01, respectivamente). Conclusiones: Se encontró una frecuencia del 28 por ciento de metástasis pulmonar. El sarcoma sinovial, el angiosarcoma y el rabdomiosarcoma fueron los principales inductores de metástasis.

Gemcitabine in advanced non-small cell lung cancer: a phase II study

Gemcitabina es un agente activo en el tratamiento del cáncer de pulmón (CPCNP). El tratamiento semanal con gemcitabina, como agente único, ha mostrado respuestas del 20 al 26 por ciento. Este estudio fase 2 fue realizado para determinar la eficacia y seguridad de gemcitabina 1000 mg/m2, administrado semanalmente. Por tres semanas, seguido de una de descanso (ciclos de 28 días): los pacientes requirieron tener evidencia histológica de CPCNP y enfermedad avanzada; estado de desempeño de Zubrod de 0 a 2 y enfermedad medible. No se permitió que hubieran recibido tratamiento previo. Veinte pacientes, diez hombres y diez mujeres con una edad promedio de 60 años fueron incluidos en el estudio. La mayor parte de los pacientes (doce pacientes, 60 por ciento) tuvieron EC IIIb y, diagnóstico de adenocarcinoma (trece pacientes, 65 por ciento). Cuatro pacientes (20 por ciento) tuvieron EC IIIa y otros cuatro (20 por ciento) tuvieron EC IV, siete pacientes (35 por ciento) tuvieron variedad histológica epidermoide. Los pacientes recibieron un total de 62 ciclos y un promedio de 3.1 ciclos de terapia con gemcitabina. De los dieciocho pacientes que se incluyeron para evaluar eficacia, en seis se obtuvo respuesta parcial con un porcentaje de respuesta del 33.3 por ciento. La supervivencia media fue de siete meses (dos a 15 meses) con un tiempo medio libre de enfermedad de 3.5 m (1-15 meses) y un año de supervivencia del 22.2 por ciento. Toxicidad hematológica grado 3 y 4 de la Organización Mundial de la Salud (OMS) fue observada en menos del 2 por ciento de todos los ciclos. La toxicidad más común grado 3 y 4 no hematológica fue náusea y vómito observada en menos del 5 por ciento de los ciclos. Elevación transitoria de transaminasas se observó en menos del 4 por ciento de los ciclos. Un paciente presentó hepatitis fulminante y rash generalizado que, a consideración de los investigadores, se debió a una reacción de hipersensibilidad por toxicidad de la gemcitabina. En conclusión, gemcitabina como agente único en administración semanal de 1000 mg/m2 es segura y efectiva en el tratamiento del CPCNP avanzado.

Presencia selectiva de trombina en pulmones de pacientes con metástasis pulmonar / Selective presence of thrombin in the lungs of patients with pulmonar metastasis

La trombina, componente clave de la cascada de la coagulación, podría participar en el desarrollo de la metástasis pulmonar, al incrementar la adhesión: plaquetas-células tumorales in vitro y el número de metástasis in vivo. Se midieron cromogénicamente (Sustrato específico de trombina, S-2238) las concentraciones de trombina en lavados broncoalveolares de 20 pacientes con metástasis pulmonares y se compararon con lavados broncoalveolares de 20 pacientes con cáncer de pulmón y 20 testigos. La mediana de la concentració de trombina en los lavados broncoalveolares de los pacientes con metástasis pulmonar fue 5.4 x 10-9 M 82.5 x 10-9 M-13 x 10-9 M). Esto representó un aumento de 10 y 100 veces en las concentraciones de trombina, en comparación con los de los lavados de pacientes con cáncer de pulmón (0.6 x 10-9 M; 0.2 x 10-9 M-2.2 x 10-9 M) y los testigos (0.6 x 10-9 M; 0.02 x 10-9 M-0.4 x 10-9 M) respectivamente (p<0.02). Estos resultados demuestran que la trombina está presente, en forma selectiva, en los pulmones de pacientes con metástasis pulmonar, y que podría estar involucrada en su desarrollo

La trombina: ¿Un nuevo factor útil en el diagnóstico temprano de metástasis pulmonar? / The trombin: Anew useful factor in the early diagnosis of pulmonary metastasis?

Los eventos celulares tempranos que inducen una metástasis pulmonar son desconocidos. La trombina, componente clave de las cascada de la coagulación, podría estar involucrada en el desarrollo de este padecimiento, ya que incrementa la adhesión plaquetas-células tumorales in vitro y el número de metástasis in vivo. Para evaluar si la trombina podría ser considerada como un marcador en su diagnóstico, mediamos los niveles de trombina en elevados broncoalveolares (LBA) de 20 pacientes con dicho padecimiento y los comparamos frente a los de 20 pacientes con cáncer de pulmón y 20 controles. La mediana de la concentración de trombina en los lavados de los pacientes con metástasis fue 5.4 x 10-9 M (2.5 x 10-9 M - 13 x 10-9 M). Esto presentó un incremento de 10 y 100 vece en los niveles de trombina, en comparación con los encontrados en los lavados de pacientes con cáncer de pulmón (0.6 x 10-9 M; 0.2 x 10-9 M-2.2 x 10-9 M) y los controles (0.06 x 10-9 M; 0.02 x 10-9 M - 0.4 x 10-9 M), respectivamente (p < 0.02). Lavados de pacientes con metástasis y cáncer de pulmón incrementaron la proliferación celular en un 34.9 por ciento (1.5 - 58.3 por ciento) (p< 0.02). La hurudina, un inhibidor de la trombina, disminuyó únicamente la proliferación inducida por los lavados brincoalveolares de pacientes con metástasis en un 63.8 por ciento (p < 0.05). Estos resultados demuestran que la trombina está presente en forma selectiva en los pulmones de pacientes con metástasis pulmonar, y que podría estar involucrada en el desarrollo de este padecimiento

Cisplatino y vinorelbina en cáncer avanzado de células no pequeñas de pulmón. Experiencia en el Instituto Nacional de Cancerología / Treatment with cisplatin and vinorelbine in advanced no-small cell lung carcinoma

Para determinar la eficacia y seguridad de un régimen de quimioterapia a base de cisplatino y vinorelbina con o sin radioterapia en cáncer de células no pequeñas de pulmón, revisamos retrospectivamente 16 expedientes clínicos (nueve hombres y siete mujeres; edad media de 53 años; dos en etapa clínica IIIA, 11 en IIIB y tres en IV). Distinguimos tres modalidades de tratamiento: quimioterapia sola (cinco casos), quimioterapia y radioterapia concomitantes (dos pacientes) y quimioterapia de induccción seguida de quimioterapia y radioterapia concomitantes (nueve enfermos). La respuesta global fue 68.7 por ciento (18.7 por ciento completas y 50 por ciento parciales). La mediana de supervivencia global fue 13 meses y la de supervivencia libre de progresión 12 meses. La tasa de supervivencia a un año fue 75 por ciento. Se observó una tendencia a mayor supervivencia global, supervivencia libre de progresión, respuestas globales y supervivencia a un año en quienes recibieron alguna modalidad de radioterapia agregada. La toxicicdad grado 3-4 se distribuyó así hematológica (neutropenia) en seis pacientes, ninguno de los cuales requirió hospitalización ni antibióticos; y no hematológica (náuses y vómitos) en siete enfermos. Hubo neuropatía periférica grado 1-2 en cinco sujetos. No observamos mayor toxicidad asociada a tratamiento combinados. Cisplatino y vinorelbina con o sin radioterapia es un régimen eficaz y bien tolerado

Leiomioma del esófago: diagnóstico diferencial de tumoración mediatinal en la radiografía del tórax / Leiomyoma of the esophagus: differential diagnosis of mediastinal tumor in thorax radiography

Informamos un caso de Leiomioma del Esófago que se presentó como masa en el mediastino posterior. Se discute la frecuencia de presentación así como los signos que puedan orientar la sospecha radiológica