The association between hydration status and body composition in healthy children and adolescents.

OBJECTIVES: Children 10-20 years old in the US are currently obese, showing suboptimal hydration as 60% fail to meet the US Dietary Reference Intakes for water. Studies have shown a significant inverse association between hydration status and body composition in children, although most failed to use the Dual-X-Ray Absorptiometry Scan (DEXA), the gold standard for body composition. Limited studies used an objective marker to measure hydration, such as urine specific gravity (USG) from a 24-h urine collection. Therefore, this study aimed to examine the association between hydration status (measured from USG in a 24-h urine sample and assessed from three 24-h dietary recalls) and body fat % and lean mass (assessed from a DEXA scan) in children (10-13 years, n=34) and adolescents (18-20 years, n=34). METHODS: Body composition was measured using DEXA, total water intake (mL/d) was assessed from three 24-h dietary recalls and analyzed using the Nutrition Data System for Research (NDSR). Hydration status was objectively measured using USG via 24-h urine collection. RESULTS: Overall body fat % was 31.7 ± 7.31, total water intake was 1746 ± 762.0 mL/d, and USG score was 1.020 ± 0.011 uG. Linear regressions showed significance between total water intake and lean mass (B=12.2, p<0.05). Logistic regressions showed no significant association between body composition and USG and total water intake. CONCLUSIONS: Findings showed total water intake was significantly associated with lean mass. Future research should be conducted to explore other objective markers of hydration and with a larger sample.

Nuclear respiratory factor 1 transcriptomic signatures as prognostic indicators of recurring aggressive mesenchymal glioblastoma and resistance to therapy in White American females.

PURPOSE: The mechanisms contributing to recurrence of glioblastoma (GBM), an aggressive neuroepithelial brain tumor, remain unknown. We have recently shown that nuclear respiratory factor 1 (NRF1) is an oncogenic transcription factor and its transcriptional activity is associated with the progression and prognosis of GBM. Herein, we extend our efforts to (1) identify influential NRF1-driven gene and microRNA (miRNA) expression for the aggressiveness of mesenchymal GBM; and (2) understand the molecular basis for its poor response to therapy. METHODS: Clinical data and RNA-Seq from four independent GBM cohorts were analyzed by Bayesian Network Inference with Java Objects (BANJO) and Markov chain Monte Carlo (MCMC)-based gene order to identify molecular drivers of mesenchymal GBM as well as prognostic indicators of poor response to radiation and chemotherapy. RESULTS: We are the first to report sex-specific NRF1 motif enriched gene signatures showing increased susceptibility to GBM. Risk estimates for GBM were increased by greater than 100-fold with the joint effect of NRF1-driven gene signatures-CDK4, DUSP6, MSH2, NRF1, and PARK7 in female GBM patients and CDK4, CASP2, H6PD, and NRF1 in male GBM patients. NRF1-driven causal Bayesian network genes were predictive of poor survival and resistance to chemoradiation in IDH1 wild-type mesenchymal GBM patients. NRF1-regulatable miRNAs were also associated with poor response to chemoradiation therapy in female IDH1 wild-type mesenchymal GBM. Stable overexpression of NRF1 reprogramed human astrocytes into neural stem cell-like cells expressing SOX2 and nestin. These cells differentiated into neurons and form tumorospheroids. CONCLUSIONS: In summary, our novel discovery shows that NRF1-driven causal genes and miRNAs involved in cancer cell stemness and mesenchymal features contribute to cancer aggressiveness and recurrence of aggressive therapy-resistant glioblastoma.

Association of viral load and physical status of HPV-16 with survival of patients with head and neck cancer.

INTRODUCTION: Head and neck cancers (NHCs) are of multifaceted origins, and tobacco and alcohol are the primary risk factors. Currently, other factors associated with the genesis of these tumours are being considered, among these viral infections, especially human papillomavirus (HPV) infection. OBJECTIVE: The objective was to evaluate HPV infection, HPV-16 E6 load and its physical status in patients with squamous cell carcinoma in the head and neck and evaluate its effects in the survival of these patients. METHODOLOGY: A total of 80 fresh biopsies of HNC were evaluated. The genetic material was extracted using the commercial kit QIAGEN. The detection and classification of HPV were carried out using INNO-LiPA, whereas the quantification and analysis of integration of the viral genome into the host cell were carried out using real-time PCR. RESULTS: The average age of the patients included was 60.34 ± 14.48 years, with a predominance of the male gender. The most frequent HPV infection was genotype 16 (52.8%), with an average of 10 copies of the HPV-16 E6/ß-globin gene. Furthermore, an integration of the viral genome in the host cell was observed in 86% of cases with a statistically significant relationship between the location of the tumour and the viral load (p < 0.05). CONCLUSIONS: HPV-16 is the most common infection, and its physical status in the host cell is the determining factor in establishing response to treatment. However, more studies are needed to demonstrate the role of HPV infection in carcinogenesis.

Sensitivity to differential NRF1 gene signatures contributes to breast cancer disparities.

PURPOSE: Nuclear respiratory factor 1 (NRF1) drives estrogen-dependent breast tumorigenesis. Herein we examined the impact of NRF1 activity on the aggressiveness and disparate molecular signature of breast cancer in Black, White, Asian, and Hispanic women. METHODS: NRF1 activity by transcription factor target enrichment analysis and causal NRF1-target gene signatures by Bayesian Network Inference with Java Objects (BANJO) and Markov Chain Monte Carlo (MCMC)-based gene order were examined in The Cancer Genome Atlas (TCGA) breast cancer cohorts. RESULTS: We are the first to report increased NRF1 activity based on its differential effects on genome-wide transcription associated with luminal A and B, HER2+ and triple-negative (TN) molecular subtypes of breast cancer in women of different race/ethnicity. We observed disparate NRF1 motif-containing causal gene signatures unique to Black, White, Asian, and Hispanic women for luminal A breast cancer. Further gene order searches showed molecular heterogeneity of each subtype of breast cancer. Six different gene order sequences involving CDK1, HMMR, CCNB2, CCNB1, E2F1, CREB3L4, GTSE1, and LMNB1 with almost equal weight predicted the probability of luminal A breast cancer in whites. Three different gene order sequences consisting of CCNB1 and GTSE1, and CCNB1, LMNB1, CDK1 or CASP3 predicted almost 100% probability of luminal B breast cancer in whites; CCNB1 and LMNB1 or GTSE predicted 100% HER2+ breast cancer in whites. GTSE1 and TUBA1C combined together predicted 100% probability of developing TNBC in whites; NRF1, TUBA1B and BAX with EFNA4, and NRF1 and BTRC predicated 100% TNBC in blacks. High expressor NRF1 TN breast tumors showed unfavorable prognosis with a high risk of breast cancer death in white women. CONCLUSION: Our findings showed how sensitivity to high NRF1 transcriptional activity coupled with its target gene signatures contribute to racial differences in luminal A and TN breast cancer subtypes. This knowledge may be useful in personalized intervention to prevent and treat this clinically challenging problem.

Caffeine Intake and Its Association with Body Composition Measures and Macronutrient Intakes in People Living with HIV in the Miami Adult Studies on HIV Cohort.

Background: Caffeine acts as an anorexic agent, increases energy expenditures, and decreases total body fat mass, and could be detrimental to people living with HIV (PLWH). The objective of this study was to explore the relationship between caffeine consumption, body composition measures (fat mass, body mass index [BMI], and lean body mass [LBM]), nutrient intakes, CD4 counts, and HIV viral load in PLWH. Methods: A convenience sample of 130 PLWH was recruited and followed for 3 months. Caffeine intake, body composition measures, and nutrient intakes were collected using Modified Caffeine Consumption Questionnaire, bioimpedance analyses, and 24-hour dietary recalls. Linear regressions were used to analyze the baseline data for relationships between these variables. Linear mixed models (LMMs) were used to determine the overtime changes. Results: In baseline, linear regression analysis, higher caffeine consumption was associated with lower fat mass (ß = -0.994, p = 0.042). However, BMI and LBM did not show any significant association with caffeine intake. LMM analysis showed that the association between caffeine intake and fat mass strengthened overtime (ß = -1.987, p = 0.035). Baseline linear regression analysis showed that higher caffeine intake was significantly associated with lower caloric intakes from fat (ß = -1.902, p = 0.044) and lower total caloric intake (ß = -1.643, p = 0.042). However, LMM analysis showed that these associations diminished and lost significance overtime. There were no associations between body composition measures, nutrient intakes, CD4 counts, and HIV viral load. Conclusions: Caffeine intake adversely affected dietary intakes of macronutrients and total fat mass. Therefore, caffeine, a known anorectic, should be regulated in PLWH.

Effect of zinc intake on hepatic autophagy during acute alcohol intoxication.

Autophagy is a conserved mechanism that plays a housekeeping role by eliminating protein aggregates and damaged organelles. Recent studies have demonstrated that acute ethanol intoxication induces hepatic autophagy in mice. The effect of dietary zinc intake on hepatic autophagic flux during ethanol intoxication has not been evaluated using animal models. Herein, we investigated whether zinc deficiency and excess can affect autophagic flux in the liver in mice and in human hepatoma cells acutely exposed to ethanol. A mouse model of binge ethanol feeding was utilized to analyze the effect of low, adequate, and high zinc intake on hepatic autophagic flux during ethanol intoxication. Autophagic flux was inferred by analyzing LC3II/LC3I ratio, protein levels of p62/SQSTM1, Beclin1 and Atg7, and phosphorylation of 4EBP1. In addition, the degradation of the fusion protein LC3-GFP and the formation of autophagosomes and autolysosomes were evaluated in cells. Ethanol treatment stimulated autophagy in mice and cells. High zinc intake resulted in enhanced autophagy in mice exposed to ethanol. Conversely, zinc deficiency was consistently associated with impaired ethanol-induced autophagy in mice and cells. Zinc-deficient mice exhibited a high degree of ethanol-driven steatosis. Furthermore, zinc depletion increased apoptosis in cells exposed to ethanol. The results of this study suggest that adequate zinc intake is necessary for proper stimulation of autophagy by ethanol. Poor zinc status is commonly found among alcoholics and could likely contribute to faulty autophagy.

Soft-tissue sarcomas in the head and neck: 25 years of experience.

Sarcomas are infrequent and heterogeneous tumours. They represent 1-2% of all malignant neoplasms in adults and between 4% and 10% of head and neck cancers. METHODS: The research was retrospective, descriptive, and cross-sectional. RESULTS: A study population of 62 patients with a mean age of 44 years was obtained; the most frequent location was the soft tissues of the neck (25.3%) and the mean tumour size was 7.1 cm; the most frequent diagnosis was undifferentiated pleomorphic sarcoma (25.5%) and the majority were stage III (41.4%). The lowest survival rates were associated with T2a and T2b tumours (p = 0.014), the presence of lymph node metastasis (p = 0.001), advanced stages (p = 0.003), and invasion of bone, blood vessels and/or nerves (p = 0.008). CONCLUSIONS: Late diagnosis is the main factor associated with decreased survival in patients with head and neck sarcomas.

Prevalence of HPV and EBV infection andtheir relationship with the p53 and PCNA expression in oral carcinoma patients

Introduction: Infection caused by potentially oncogenic viruses, such as HPV and EBV, favors the role of certain oncoproteins that can induce dysplasias and malignant lesions. Objective: To evaluate the prevalence of HPV and EBV and their relation with the expression of p53 and PCNA in patients with oral carcinoma. Methodology: Twenty-seven oral squamous cell carcinomas (OSCC) were evaluated; DNA extraction was conducted using the QIAamp DNA mini kit; viral detection was obtained using the INNO-LiPA kit for HPV, and nested PCR was used for EBV. The evaluation of molecular markers was performed through immunohistochemical staining. Results: The mean age of the patients was 60.55 +/- 13.94 years, and 52 percent of these were female. Of the patients, 59 percent were tobacco users and 63 percent were alcohol consumers. HPV was detected in 70 percent of the patients with the predominance of genotype 16 (60 percent). As for EBV infection, it was observed in 59 percent of cases. p53 and PCNA immunopositivity corresponded to 44 percent and 59 percent, respectively. The tongue was the anatomical location with highest positivity for both viruses as well as for the expression of molecular markers. The 48 percent of the cases presented infection by both viruses. Conclusion: HPV and EBV infection together with the expression of p53 and PCNA were more frequently observed in advanced stages of the disease, suggesting a more relevant role in the progression than in tumor genesis.

Human papillomavirus detection in head and neck squamous cell carcinoma.

INTRODUCTION: Human Papillomavirus (HPV) has been associated with benign and malignant lesions in different epitheliums. The relationship between specific genotypes of high-risk HPV and some human cancers is well established. The aim of this work was to detect the HPV genotypes present in head and neck squamous cell carcinoma (HNSCC). METHODS: We evaluated 71 samples of patients with histopathological diagnosis of HNSCC. The DNA extraction was conducted with the QIAGEN commercial kit. HPV detection and genotyping were performed by reverse hybridisation (INNO-LiPA) following the commercial specifications. RESULTS: The mean age of the patients evaluated was 60.7 ± 13.11 years. The distribution of the lesions included 25 (35.20%) cases of squamous cell carcinoma (SCC) of the oral cavity, 23 (32.39%) of larynx, 16 (22.50%) of the oropharynx, 4 (5.63%) of paranasal sinus, and 2 (2. 80%) cases of SCC of the nostril. Of the patients, 78.9% were males, and of these 76% were tobacco users and 67.6% were alcohol consumers. The viral DNA was detected in 67.6% of the samples. The oral cavity and the larynx were the highest HPV-positivity sites with 35.40% and 29.10% respectively. The most frequent genotype was 16 as single infection (18.70%), or in combination with another HPV types. In the oral cavity and larynx the genotypes 16 or the combination 6 and 51 were present in 11.76% and 14.28%, respectively; and in the oropharynx the most frequent genotype was 16 in 22.50% of the cases, and in the paranasal sinus 50% presented infection with HPV-6. We observed that tumours with most advanced size and stage presented greater HPV positivity. CONCLUSIONS: This study shows a high percentage of HPV positivity in SCC is mainly associated with high-risk HPV. It is important to highlight that viral infection, especially HPV-16, could be a risk factor in HNSCC progression.

Cambios moleculares en los márgenes de resección en el carcinoma de células escamosas de cavidad oral / Molecular changes in the resections borders in squamous cell cancer of oral cavity

Evaluación molecular de márgenes de resección en pacientes con carcinoma de células escamosas de cavidad oral sometidos a cirugía. 16 pacientes con carcinoma escamoso de cavidad oral, en cualquiera de sus localizaciones, sin tratamientos previos, intervenidos quirúrgicamente en el 2011. La pieza operatoria fue procesada por anatomía patológica a través del método tradicional, realizándose cortes adicionales que incluían: tumor y 0,5 cm de margen no tumoral. Se realizó hematoxilina-eosina y complementó con inmunomarcaje para p53, PCNA, Ki-67, factor de crecimiento epidérmico y receptor de crecimiento endotelial vascular. De los 16 pacientes en estudio la mayoría eran del género masculino, la edad promedio fue cercana a los 60 años, la mayoría eran pacientes consumidores de tabaco y alcohol. La lengua fue la localización más frecuente y los tumores se encontraban en un estadio avanzado (estadio III y IV). Estudio molecular: todos los marcadores evaluados se encontraban positivos en los márgenes de resección en el 93,75% de los pacientes. Los marcadores de proliferación celular como el PCNA y Ki-67 así como el p-53 se encontraban positivos entre 1,5 cm a 2 cm del tumor con un marcaje intenso. Por el contrario, el factor de crecimiento epidérmico el receptor de crecimiento endotelial vascular se encontraban positivos hasta 1,5 cm pero con menor intensidad. En el cáncer oral podemos observar con frecuencia cambios moleculares en el tejido aparentemente sano que rodea el tumor hasta por lo menos 15 mm.

The molecular evaluation of resection margins in patients with squamous cell carcinoma of oral cavity who underwent surgery. Field of cancerization concept. We included 16 patients with oral cavity squamous cell carcinoma in any of their locations,without pre treatment, surgically treated in our hospital in the 2011 year. The surgical specimen was processed by the pathology department of our institution, through the traditional method, additional sectioned including the tumor and at least 0.5 cm margin non tumorigenic. Study was performed hematoxylin eosin and was supplemented with immunostaining for p53, PCNA, Ki-67, epidermal growth factor receptor and vascular endothelial growth factor receptor. The most important features of the 16 patients studied were: The majorities were male, the average age was around 60 years old; most of them were tobacco and alcohol consumers. The tongue was the most frequent location and most of the tumors were in an advanced stage (stage III y IV). In molecular evaluation all the markers were positive in the resection margins in 93.75% of all patients. The cell proliferation markers suchas PCNA and Ki-67 and the p-53 were positive 1.5 cm to2 cm tumor with intense staining. Conversely, epidermal receptor grow factors and vascular endothelial grow factor receptor were positive up to 1.5 cm but with less intensity. In oral cancer can often observe molecular changes in the apparently healthy tissue surrounding the tumor to at least 15 mm.

Regulation of hepatic suppressor of cytokine signaling 3 by zinc.

Promoter analysis of the family of suppressors of cytokine signaling (SOCS) revealed that the human SOCS3 gene contains four binding sites for the metal regulatory transcription factor 1 (MTF-1) located within 1600 bp relative to the transcription start site. A series of experiments were carried out with human hepatoma cells (HepG2) and C57BL/6 mice to examine the effect of zinc on the regulation of SOCS3. In addition, we tested the role of MTF-1 in the regulation of SOCS3 expression using EMSA, chromatin immunoprecipitation assay and siRNA. Lastly, the role of the zinc transporter SLC39A14 on the basal expression of SOCS3 was evaluated. Results indicate that SOCS3 expression is regulated by zinc through an MTF-1-dependent mechanism. In addition, results from siRNA experiments suggest that SLC39A14 is required for basal expression of SOCS3. Further studies are needed to determine whether zinc status affects SOCS3 function.

Zip14 is a complex broad-scope metal-ion transporter whose functional properties support roles in the cellular uptake of zinc and nontransferrin-bound iron.

Recent studies have shown that overexpression of the transmembrane protein Zrt- and Irt-like protein 14 (Zip14) stimulates the cellular uptake of zinc and nontransferrin-bound iron (NTBI). Here, we directly tested the hypothesis that Zip14 transports free zinc, iron, and other metal ions by using the Xenopus laevis oocyte heterologous expression system, and use of this approach also allowed us to characterize the functional properties of Zip14. Expression of mouse Zip14 in RNA-injected oocytes stimulated the uptake of (55)Fe in the presence of l-ascorbate but not nitrilotriacetic acid, indicating that Zip14 is an iron transporter specific for ferrous ion (Fe(2+)) over ferric ion (Fe(3+)). Zip14-mediated (55)Fe(2+) uptake was saturable (K(0.5) ≈ 2 µM), temperature-dependent (apparent activation energy, E(a) = 15 kcal/mol), pH-sensitive, Ca(2+)-dependent, and inhibited by Co(2+), Mn(2+), and Zn(2+). HCO(3)(-) stimulated (55)Fe(2+) transport. These properties are in close agreement with those of NTBI uptake in the perfused rat liver and in isolated hepatocytes reported in the literature. Zip14 also mediated the uptake of (109)Cd(2+), (54)Mn(2+), and (65)Zn(2+) but not (64)Cu (I or II). (65)Zn(2+) uptake also was saturable (K(0.5) ≈ 2 µM) but, notably, the metal-ion inhibition profile and Ca(2+) dependence of Zn(2+) transport differed from those of Fe(2+) transport, and we propose a model to account for these observations. Our data reveal that Zip14 is a complex, broad-scope metal-ion transporter. Whereas zinc appears to be a preferred substrate under normal conditions, we found that Zip14 is capable of mediating cellular uptake of NTBI characteristic of iron-overload conditions.

Efecto del consumo de dietas con avena y caraotas negras sobre el perfil lipídico en un modelo experimental en rata / Effect of consumption of diets with oats and black beans on the lipid profile of an experimental model in rat

El consumo de alimentos ricos en fibra dietética (FD) soluble e insoluble, afecta favorablemente el perfil de lípidos séricos al reducir las concentraciones de colesterol total, colesterol- LDL y triglicéridos (TG). El objetivo de este trabajo, fue comparar el efecto del consumo de dietas con avena (Avena sa tiva) y con caraotas negras (Phaseolus vulgaris ) sobre el perfil lipídico de ratas. Quince ratas machos, cepa Sprague Dawley, fueron alimentadas ad libitum por 18 días, con tres tipos de dietas: un con trol, una conteniendo caraotas negras (15% p/p) y otra con avena (15% p/p). La concentración del colesterol total sérico disminuyo 50,56% en el grupo alimentado con avena y 40,52% en el alimentado con caraotas. Así mismo, se observó una disminución de colesterol-LDL de 49,21% en el grupo alimentado con avena y un 42,93% en el grupo alimentado con caraotas. Hubo una reducción de 52,47% del colesterol-HDL en el grupo alimentado con avena y 31,29% para el grupo alimentado con caraotas; esta reducción no es beneficiosa. La concentración de TG séricos fue significativamente menor, un 50,20% para el grupo alimentado con avena y de 51,8% para el grupo alimentado con caraota. La disminución de los lípidos séricos debido a la dieta, con avena o con caraotas, mostró diferencias significativas respecto al control, pero, no entre ellas. La consideración de estos resultados en el caso de la salud humana es bien importante, particularmente en la disminución de la prevalencia de enfermedades cardiovasculares. El efecto de FD sobre los niveles de colesterol-HDL, son hasta los momentos, contradictorios.

The consumption of foods rich in soluble and insoluble dietary fiber (DF) favorably affects the serum lipid profile by lowering total cholesterol, LDL-cholesterol and triglycerides (TG). The objective of this work was to compare the effect of consumption of diets with oats (Avena sativa) and black beans (Pha seo lus vulgaris) on the lipid profile of rats. Fifteen male rats, Spra gue Dawley strain were fed ad libitum for 18 days, with three different diets: a control, one containing black beans (15% w / w) and another with oats (15% w / w). The serum total cholesterol concentration decreased 50.56% in the group fed with oats and 40.52% in the group fed with beans. Also a de crease of LDL-cholesterol 49.21% in the group fed with oats and 42.93% in the group fed with beans was observed. There was 52.47% reduction of HDLcho lesterol in the group fed with oats and 31.29% for the group fed with beans, this is not a be neficial reduction. The serum TG concentration was significantly lower, 50.20% for the group fed with oats and 51.8% for the group fed with beans. The decrease of these lipids due to diet containing oats or beans, was significantly different from control but not between them. Consideration of these results for human health is very important, particularly in reducing the prevalence of cardiovascular disease. The FD effect on HDL-cholesterol levels, are until now contradictory.

STAT5-glucocorticoid receptor interaction and MTF-1 regulate the expression of ZnT2 (Slc30a2) in pancreatic acinar cells.

The exocrine pancreas plays an important role in endogenous zinc loss by regulating excretion into the intestinal tract and hence influences the dietary zinc requirement. The present experiments show that the zinc transporter ZnT2 (Slc30a2) is localized to the zymogen granules and that dietary zinc restriction in mice decreased the zinc concentration of zymogen granules and ZnT2 expression. Excess zinc given orally increased ZnT2 expression and was associated with increased pancreatic zinc accumulation. Rat AR42J acinar cells when induced into a secretory phenotype, using the glucocorticoid analog dexamethasone (DEX), exhibited increased ZnT2 expression and labile zinc as measured with a fluorophore. DEX administrated to mice also induced ZnT2 expression that accompanied a reduction of the pancreatic zinc content. ZnT2 promoter analyses identified elements required for responsiveness to zinc and DEX. Zinc regulation was traced to a MRE located downstream from the ZnT2 transcription start site. Responsiveness to DEX is produced by two upstream STAT5 binding sites that require the glucocorticoid receptor for activation. ZnT2 knockdown in the AR42J cells using siRNA resulted in increased cytoplasmic zinc and decreased zymogen granule zinc that further demonstrated that ZnT2 may mediate the sequestration of zinc into zymogen granules. We conclude, based upon experiments with intact mice and pancreatic acinar cells in culture, that ZnT2 participates in zinc transport into pancreatic zymogen granules through a glucocorticoid pathway requiring glucocorticoid receptor and STAT5, and zinc-regulated signaling pathways requiring MTF-1. The ZnT2 transporter appears to function in a physiologically responsive manner involving entero-pancreatic zinc trafficking.

Tumor neuroectodérmico primitivo renal: sarcoma de Ewing extraóseo: presentación de un caso / Primitive neuroectodermal renal tumor: Ewing sarcoma extra osseous: presentation of a case

El sarcoma de Ewing o también llamado tumor neuroectodérmico primitivo es una entidad muy rara, cuyo diagnóstico se realiza con la utilización de estudios de inmunohistoquímica, su comportamiento es muy agresivo con una supervivencia limitada. Se presenta el caso de un paciente masculino de 18 años de edad que consultó por presentar un tumor renal, se le realizó nefrectomía radical con diagnóstico definitivo de sarcoma de Ewing extra esquelético. Esta es una patología quirúrgica poco frecuente, lo que nos motivó a su presentación y a la revisión de la literatura.

The Ewing sarcoma is also denominated primitive neuroectodermic tumor and is considered how a rare entity, the diagnostic is realize with the utilization of immunohistochemestry study’s, his clinical curse is very aggressive with a limite superlife. We presented and study a clinical case of a sex male patient of 18 years old which consult us for present a renal tumor. He underwent a radical nefrectomy with a definitive diagnostic of extra osseous Ewing sarcoma. This is a less frequent surgical pathology, we motive us to present and review the literature.

Tumor de cavidad oral: como primera manifestación de adenocarcinoma gástrico metastásico / Oral tumor cavity: how first manifestation of metastasic gastric adenocarcinoma

La cavidad oral es un blanco raro pero ocasional para lesiones metastásicas. Las metástasis orales han sido descritas principalmente en cáncer de pulmón, mama y rinón. En nuestro trabajo se describe un caso poco común de una metástasis en mucosa gingival proveniente de un carcinoma gástrico sin otros síntomas, fue diagnosticada y tratada como adenocarcinoma de glándulas salivares menores. El exámen histopatológico de la biopsia reportó un adenocarcinoma pobremente diferenciado. En endoscopia digestiva superior realizada posteriormente se evidenció un tumor gastrico, cuya biopsia demostró la presencia de un adenocarcinoma. El paciente recibió tratamiento con quimioterapia pero falleció por falla renal. En conclusión, un carcinoma oculto gástrico puede presentarse con metástasis a la cavidad oral, pudiendo ser ésta la primera y única manifestación.

The oral cavity is a rare but occasional target for metastases lesions. Oral metastatic lesions have been principal described in lung, breast and kidney carcinomas. In our work we describe an uncommon case of gingival mucosa metastases from a gastric carcinoma without other symptoms that was diagnosed and treated as a minor salivary gland adenocarcinoma. Histopathological examination of the lesion revealed a poor differentiated cell adenocarcinoma. A subsequent upper endoscopy revealed a gastric tumour; the biopsy practiced of the tumour reported the presence of one adenocarcinoma. The patient underwent to chemotherapy but died of renal failure. In conclusion, an occult carcinoma of the stomach may rarely be present how metastasize to the oral cavity even as a first and exclusive clinical manifestation.

Detección de VPH y expresión: de p53 en carcinoma de cabeza y cuello / HPV detection and expression: of p53 in head and neck carcinoma

El cáncer de cabeza y cuello ha sido frecuentemente asociado al abuso en el consumo del alcohol y tabaco, aunque existe un bajo porcentaje de casos que no presenta una historia de alcohol y/o tabaco conocida. Esto ha llevado a considerar la exposición a otros factores de riesgo como por ejemplo el virus de papiloma humano. Actualmente los oncólogos evalúan distintos marcadores oncogénicos, entre ellos la proteína p53, lo cual les permite realizar el pronóstico y diagnóstico más preciso. El objetivo de este estudio fue evaluar la infección de virus de papiloma humano en pacientes con carcinoma de células escamosas de cabeza y cuello mediante reacción de cadena polimerasa, así como la detección de p53 por inmunohistoquímica. De 30 muestras evaluadas, 12 (40 por ciento) resultaron positivas para la detección viral, de éstas el 58 por ciento correspondía virus de papiloma humano tipo 11 (de bajo riesgo oncogénico), siendo la cavidad bucal la localización anatómica más afectada por la presencia del genoma viral. El p53 fue encontrado en 50 por ciento, siendo la orofaringe la localización anatómica con mayor positividad para dicho marcador.

The head and neck cancer has been frequently associated with the alcohol and tobacco abuse consume, although there are a low percents of cases that have not an alcohol and tobacco history know. This has made to consider another risks exposure factors how for example, the human papilloma virus. At present the oncologist evaluate different oncogenic markers inside them like the p53, this permit to them realize a better prediction and the prognostic. The objective of this study was evaluating the human papilloma virus infection in the patients with diagnostic of head and neck carcinoma using the polymerase reaction chain, such as the detection of the p53 by the immunohistochemistry procedure. Of the 30 evaluated samples 12 (40 %) of them result positive to the human papilloma viral detection, of these the 58 % correspond to the human papilloma virus type 11 (low oncogenic risk), been the oral cavity the anatomic localization most affected by the viral genome presence. The p53 has been finding in the 50 %, the orofaringe was the anatomic localization who has most positive to the marker.

Aberrant expression of zinc transporter ZIP4 (SLC39A4) significantly contributes to human pancreatic cancer pathogenesis and progression.

Zinc is an essential trace element and catalytic/structural component used by many metalloenzymes and transcription factors. Recent studies indicate a possible correlation of zinc levels with the cancer risk; however, the exact role of zinc and zinc transporters in cancer progression is unknown. We have observed that a zinc transporter, ZIP4 (SLC39A4), was substantially overexpressed in 16 of 17 (94%) clinical pancreatic adenocarcinoma specimens compared with the surrounding normal tissues, and ZIP4 mRNA expression was significantly higher in human pancreatic cancer cells than human pancreatic ductal epithelium (HPDE) cells. This indicates that aberrant ZIP4 up-regulation may contribute to the pancreatic cancer pathogenesis and progression. We studied the effects of ZIP4 overexpression in pancreatic cancer cell proliferation in vitro and pancreatic cancer progression in vivo. We found that forced expression of ZIP4 increased intracellular zinc levels, increased cell proliferation by 2-fold in vitro, and significantly increased tumor volume by 13-fold in the nude mice model with s.c. xenograft compared with the control cells. In the orthotopic nude mice model, overexpression of ZIP4 not only increased the primary tumor weight (7.2-fold), it also increased the peritoneal dissemination and ascites incidence. Moreover, increased cell proliferation and higher zinc content were also observed in the tumor tissues that overexpressed ZIP4. These data reveal an important outcome of aberrant ZIP4 expression in contributing to pancreatic cancer pathogenesis and progression. It may suggest a therapeutic strategy whereby ZIP4 is targeted to control pancreatic cancer growth.

Resección craneofacial de ameloblastoma recidivante, reconstrucción con colgajo libre de recto abdominal / Craneofacial resection of recidivant ameloblastoma and reconstruction with free abdominal rectum flap

La resección craneofacial es el tratamiento de elección de lesiones que comprometen huesos de la supraestructura, la fosa orbitaria y fosa craneal anterior. El ameloblastoma multiquístico es un tumor odontogénico benigno, localmente agresivo, que constituye 1 por ciento de los tumores maxilares. Su alta tasa de recidiva local, la invasión más allá del límite radiológico exigen su resección en bloque con importante impacto estético para el paciente. Estudio descriptivo de caso clínico y revisión de la literatura de paciente del servicio de cirugía I “Hospital Vargas” de Caracas. Paciente de 43 años portadora de ameloblastoma multiquístico recidivado en antro maxilar derecho tratado con resección craneofacial con márgenes oncológicos y reconstruidos con rotación de colgajo microquirúrgico de recto abdominal. La resección craneofacial es el tratamiento de elección para lesiones tumorales localizadas por encima de la línea de Ohngren´s. Una resección adecuada debe incluir piso de la fosa craneal anterior, paredes medial, superior de la órbita y usualmente contenido orbitario. En la mayoría de las instancias el ojo debe ser sacrificado. Los ameloblastomas son tumores odontogénicos benignos localmente agresivos en un 15 por ciento 20 por ciento se localizan en el maxilar superior, teniendo esta localización peor pronóstico por un mayor índice de recidivas posquirúrgicas, invasión tejidos vecinos y porcentaje de malignización, requiriendo resección en bloque, con unimpacto estético importante para el paciente. La rotación de colgajo microquirúrgico de recto abdominal es una opción versátil para la reconstrucción de estos pacientes.

Tipificación del virus del papiloma humano en carcinoma de células escamosas de cabeza y cuello / Typification of Human papillomavirus in squamous carcinoma of the head and neck

El cáncer de cabeza y cuello es atribuido al consumo de tabaco, alcohol, el virus del papiloma humano representa un riesgo potencial para estos tumores. Se evaluaron 29 muestras de pacientes con carcinoma de células escamosas histológicamente confirmados en el servicio de cabeza y cuello del Hospital Oncológico “Padre Machado”. Se les realizó una toma de muestra del tumor la cual fue inicialmente congelada a - 80º C luego procesada a través de reacción en cadena de polimerasa, se determinó el tipo de virus que infectaba al tejido muestreado. Se documentó sobre datos demográficos: edad, sexo, uso de tabaco, alcohol, localización, estadio y grado tumoral, se realizó análisis estadístico con “t” de Student. El 34,48 por ciento resultó positivo para ADN del virus, siendo los de bajo riesgo los implicados. Factor asociado a presencia del virus papiloma fue significativo el hábito tabáquico, si era en la actualidad, y la localización del tumor en cavidad oral. Sexo, edad, consumo de alcohol, grado tumoral, tamaño, estado ganglionar y estadio clínico no fueron estadísticamente significativos. La mayoría de trabajos de cáncer de cabeza y cuello han enfocado el estudio de virus de alto grado como 16 y 18 en etiología de tumores. Tipos como l6 y 11 no han sido identificados en muchas lesiones malignas. Nuestro principal hallazgo sugiere que los virus 6 y 11 pueden estar involucrados en la génesis del carcinoma de células escamosas de cabeza y cuello.