[Translated article] Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study.

Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.

Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study. / Características clínicas e histopatológicas de melanoma subungueal en 57 pacientes mexicanos: una cohorte de 5 años.

Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.

Tspan33 is Expressed in Transitional and Memory B Cells, but is not Responsible for High ADAM10 Expression.

Tetraspanins are a family of transmembrane proteins that form membrane microdomains. They play important roles in migration, adhesion and other cellular processes. TspanC8, a subfamily of tetraspanins, was found to associate and promote ADAM10 trafficking and cell surface localization. One of its members, Tspan33, is expressed in activated B cells. Using RT-PCR and flow cytometry, we analysed the pattern of expression of Tspan33 in B cells from healthy donors. We found Tspan33 expression in early and late stages of B cell development. However, Tspan33 expression did not correlate with ADAM10 surface expression. We also found expression of Tspan33 early in the activation process. Given its predominant expression in activated B cells and in several lymphomas, but not in naive B cells, we hypothesize that Tspan33 could be a potential target for therapeutic purposes.

Retención urinaria posparto: conducta clínica y modelos experimentales para su estudio / Postpartum urinary retention: clinical behavior and experimental models for study

Resumen ANTECEDENTES: puesto que la retención urinaria posparto no es un suceso que se considere grave, la información de su tratamiento en las unidades obstétricas es muy limitada, sobre todo en América Latina. MÉTODO: búsqueda de información publicada, en español e inglés, entre los años 2000 y 2016 relacionada con las medidas preventivas y tratamientos de la retención urinaria posparto en dos bases de datos de bibliografía biomédica: Pubmed y Scopus. RESULTADOS: se encontraron 31 artículos científicos en inglés relacionados con el tratamiento de la retención urinaria posparto y pocos estudios en modelos animales de retención urinaria aguda, ninguno en español. El diagnóstico de la retención urinaria posparto se establece con el auxilio de métodos invasivos y no invasivos: catéteres y ultrasonido. El tratamiento incluye acciones preventivas (reducción de problemas del parto mediante adiestramiento adecuado del personal de las unidades obstétricas o la aplicación de masaje en la región sacra) y posteriores al parto (uso de catéteres uretrales o suprapúbicos). CONCLUSIONES: la retención urinaria posparto es una complicación clínica que requiere entender que el diagnóstico y tratamiento tempranos contribuyen sustancialmente a disminuir la alta prevalencia de disfunciones vesicales femeninas. En esta revisión se evidenció la necesidad de estudios preclínicos que permitan conocer la repercusión a largo plazo de la retención urinaria y probar nuevos tratamientos.

Abstract BACKGROUND: since postpartum urinary retention is not a condition that is considered severe, information of its treatment in obstetrical units is very limited, especially in Latin America. METHOD: search of published information in Spanish and English, between 2000 and 2016 related to preventive measures and treatment of postpartum urinary retention in two data bases of biomedical bibliography: Pubmed and Scopus. RESULTS: 31 scientific articles in English related to the treatment of postpartum urinary retention were found as well as a few studies of acute urinary retention in animal models, none of them in Spanish. The diagnosis of postpartum urinary retention is established using invasive and non-invasive methods: catheters and ultrasound. Treatment includes preventive measures (reduction of delivery issues through appropriate training of obstetrical unis or the use of massage on the sacral region) and after delivery (use of urethral or suprapubic catheters). CONCLUSIONS: postpartum urinary retention is a clinical complication, thus we have to understand that early diagnosis and treatment substantially contribute to decreasing the high prevalence of female bladder dysfunctions. In this review, we proved the need for preclinical tests that allow us to recognize the long term repercussion of urinary retention and test new treatments.

Undifferentiated high-grade pleomorphic sarcoma in a California sea lion (Zalophus californianus).

A tumour located in the pectoral region and the left front flipper was observed in a 29-year-old female California sea lion (Zalophus californianus) that died following signs of respiratory disease and inappetence. Metastases were present in the lung and adrenal gland. The histological pattern of the tumour was variable. In some areas the tumour consisted of pleomorphic fibroblast-like cells arranged in a storiform pattern, while in other areas it comprised oval or polygonal cells with round to oval nuclei and some bizarre cells arranged in an alveolar pattern. Occasionally, multinucleated giant cells were observed. Immunohistochemically, the neoplastic cells only expressed vimentin. On the basis of the microscopical and immunohistochemical features the tumour was diagnosed as an undifferentiated high-grade pleomorphic sarcoma. This type of neoplasm with disseminated involvement of other organs is rare in all species and has never been reported in California sea lions.

Histopathological and immunohistochemical characteristics of two canine lipid-rich mammary carcinomas.

Clinicopathological and immunohistochemical findings of two uncommon canine lipid-rich mammary carcinomas are described. The predominant histological feature in both tumours was the presence of at least 80% of cells with intracytoplasmic vacuoles which stained positively with Sudan IV but not with alcian-blue periodic acid-schiff method. In both tumours, small groups of non-vacuolated cells were identified among the vacuolated cells. However, histological and immunohistochemical differences were also found between these tumours. Thus, one of them was composed of tumour cells with a large and single vacuole, which were arranged in lobular pattern, while the other neoplasm showed an intraductal growth of tumour cells with a fine vacuolated cytoplasm. Immunohistochemically, in the first tumour most vacuolated cells were positive for CK (cytokeratin)8-7, indicating a secretory epithelial immunophenotype while CK5 and CK8-7-expressing non-vacuolated cells were associated with luminal duct immunophenotype. However, in the second tumour the expression of CK14 in most of vacuolated cells and alpha-smooth muscle actin (alpha-SMA) in non-vacuolated cells, alone or in combination with CK5 suggested a myoepithelial immunophenotype for both cell types. These results suggest heterogeneity of the cell type and growth pattern for this type of canine tumour as has been described in women but not in dogs.

Biological characterization of ovarian granulosa cell tumours of slaughtered cattle: assessment of cell proliferation and oestrogen receptors.

Of 1489 slaughtered cattle, 11 had ovarian granulosa cell tumours (GCTs). These GCTs were examined immunohistochemically for proliferating cell nuclear antigen (PCNA) and oestrogen receptor (ER) in relation to histopathological features (growth pattern, nuclear atypia and mitotic count). On the basis of nuclear atypia and mitotic count, the prognosis for GCTs with a diffuse growth pattern appeared less favourable than that for GCTs with a follicular or trabecular pattern. Increased PCNA expression was significantly associated with nuclear atypia but not with histological growth pattern or mitotic count. A novel finding was the presence of ERbeta but not ERalpha in bovine ovarian GCTs. However, ERbeta expression did not appear to be related to the histopathological features examined. The results indicate that PCNA expression may be of value in establishing the biological behaviour of bovine GCTs. However, a larger series of bovine GCTs should be examinated to assess the prognostic significance of ERbeta.

Expression of cytokeratins and vimentin in normal and neoplastic tissue from the bovine female reproductive tract.

The distribution of cytokeratins (CKs) and vimentin in the normal genital tract of calves and cows at different stages of the oestrous cycle and in epithelial tumours of the tract was studied immunohistochemically. Few differences in CK and vimentin immunolabelling were detected in relation to age or stage of the oestrous cycle. Coexpression of CKs in simple epithelia and in basal cells of stratified epithelia was detected in the oviduct and endocervix; this coexpression was different from that previously described in women. The demonstration of CKs but not vimentin in the neoplastic cells of a serous superficial ovarian papilloma suggested an origin from the ovarian surface epithelium, while the coexpression of CKs and vimentin in serous papillary and mucinous cystadenomas pointed to a possible origin from the rete ovarii. Studies on three uterine adenocarcinomas and the ovarian metastases from two of these showed an endometrial-CK phenotype. The intermediate filament profile of normal endometrium, conserved in uterine adenocarcinomas and their ovarian metastases, may be useful in discriminating between ovarian metastases from endometrial carcinomas and those originating from primary carcinomas in other organs.

Effects of retinoic acid exposure in utero on mouse vibrissal follicle development.

It is known that topical all-trans-retinoic acid (RA) modulates growth and differentiation of skin and its cutaneous appendages. To examine whether a pre-natal exposure to a potentially non-teratogenic dosage of all-trans-RA had any effect on vibrissal follicle development, the histologic and immunohistochemical responses to RA during its morphogenesis in NMRI mouse were investigated. After a single oral dose of 30 mg/kg body weight of all-trans-RA on day 11.5 of gestation, no fetal malformations were detected and the histological features and the distribution of keratin (K) proteins in comparable stages of vibrissal development were similar for the untreated, vehicle-treated and RA-treated mice. The absence of teratogenic response and of adverse effects on the vibrissae under the experimental conditions indicates that this protocol may be useful for investigation of the effects of pre-natal exposure to RA on the post-natal development of experimental tumours in the mouse skin.

Malignant fibrous histiocytoma (giant cell type) associated with a malignant mixed tumor in the salivary gland of a dog.

A 12-year-old male Boxer dog presented with a 5 x 5 x 7-cm partially encapsulated mass in the right mandibular salivary gland. Histologically, the mass was composed of neoplastic epithelial and mesenchymal cells. The mesenchymal component consisted of two cell populations arranged in different patterns: coalescing nodules of neoplastic mononuclear cells with rare osteoid and numerous osteoclastlike giant cells; and sheets of neoplastic spindle cells intermingled with neoplastic epithelial cells and containing osteoid and well-formed bone trabeculae lined by osteoblasts and few osteoclastlike giant cells. On the basis of these histological features, two malignant salivary tumors were diagnosed: a malignant fibrous histiocytoma (giant cell type) and a malignant mixed tumor. Immunohistochemical studies demonstrated keratin 5 and 8 expression by the neoplastic epithelial cells, indicating a probable salivary ductal origin, and vimentin expression by all mesenchymal elements, suggesting a fibroblastic line of differentiation.

Histopathological and immunohistochemical study of lambs experimentally infected with Fasciola hepatica and Schistosoma bovis.

The aim of this study was to investigate the cross-resistance between Fasciola hepatica and Schistosoma bovis in lambs assessing parasitologic, gross pathologic, histopathologic and immunohistochemical changes in liver and small intestine. Thirty Castellana breed lambs were divided into five comparable groups and exposed to F. hepatical S. bovis (group F/S), S. bovis/F. hepatica (group S/F), S. bovis (group S) or F. hepatica (group F) and six unexposed lambs were used as non-infected controls (group C). Primary patent infection with F. hepatica induced a lower number of schistosome eggs and a higher number of lymphocytes in intestinal and liver schistosome egg-induced granulomas in group F/S than in the groups S/F and S, liver damage being mainly attributed to F. hepatica. S. bovis infection followed by challenge with F. hepatica particularly increased the severity of the most significant liver alterations (cholangiohepatitis by F. hepatica and mesoendophlebitis by S. bovis) and F. hepatica seemed not to have an influence on established S. bovis infection. In addition, immunohistochemical results suggested that the predominant local immune response in both double-infected groups was different, being mainly a cell-mediated immune response in group F/S and a mucosal response in group S/F.

Extra-laryngeal head and neck tuberculosis.

OBJECTIVE: Extra-laryngeal head and neck tuberculosis is exceptional. Therefore, a retrospective multicenter study in patients with head and neck tuberculosis, excluding solitary lymphadenitis and laryngeal locations was carried out. METHODS: We reviewed the patients with these features and tuberculosis confirmation by culture and/or histologic granuloma with presence of acid-fast bacilli (AFB). RESULTS: We found 16 patients with the following locations: eight in oral cavity and/or pharynx, four in ear, two in salivary glands, one in nose and one in frontal sinuses. The average duration of symptoms was 11.5 months. Purified protein derivative (PPD) was positive (> 10 mm) in all but one patient in whom it was performed (six of seven). Except tuberculous otitis, which occured without reactive lymphadenitis, this was present in 50% of the rest (six of the 12). In all cases a biopsy was required for diagnosis. Only in four patients, all with pharyngeal locations, was coincident pulmonary tuberculosis confirmed. One patient with tuberculous otitis developed meningitis and died; three additional patients (two with otitis) were cured but with sequelae; the evolution of the remaining patients was satisfactory with medical therapy. CONCLUSIONS: Extra-laryngeal head and neck tuberculosis has a slow course. The diagnosis is difficult due to the common absence of lung involvement and the usual requirements for biopsy procedures. The outcome is usually favorable with antituberculous drugs alone although in tuberculous otitis there are possibilities of complications.

[Nasopharyngeal cysts. Report of four cases and literature review]. / Quistes nasofaríngeos: descripción de cuatro casos y revisión de la literatura.

Nasopharyngeal cysts although common are not completely understood. They are classified according to their localization and pathogenesis in congenital or acquired and medial or lateral. We report 4 cases: a branchiogenic causing serious otitis, a Tornwaldt's cyst also producing otitis serosa, another asymptomatic Tornwaldt's cyst and a retention cyst which produce an obstructive apnea syndrome. All but the asymptomatic one were operated on transoral, by grasping the cyst and its implantation site. They all remain till now asymptomatic. We review the chapter of nasopharyngeal cysts, discussing their clinicopathological classification, their diagnosis and treatment.

A pathological study of experimental long-standing Schistosoma bovis infection in sheep.

The pathological response of sheep to two dose levels (400 or 10,000 cercariae) of Schistosoma bovis was evaluated 24 weeks after infection. The results confirmed that a single low or high dose causes lesions in the liver and intestine, and that the lungs, lymph nodes, pancreas and abomasum are affected in sheep given a single high dose. In addition, the study showed that pathological changes (mainly a granulomatous inflammatory reaction) were induced not only by eggs but also by adult worms, and that their severity was in general related to the dose of S. bovis. Hoeppli reaction product, observed on the surface of adult schistosomes in some parasitic granulomas, showed no immunoreaction for IgG, IgA or IgM.

Optimization of the immunohistochemical demonstration of keratins in paraffin wax-embedded mouse skin.

The purpose of this study was to develop an immunoperoxidase technique for the detection of cytokeratins in samples of paraffin wax-embedded adult and fetal skin from NMRI mice, with various antibodies (Troma-1, LL001, 8.60, MCK5, MCK6, AF129) that have been tested mainly on fresh-frozen sections. Each antibody was tested with three different fixatives (10% neutral buffered formalin, Bouin's fluid, and 70% ethanol) and two distinct pretreatments (enzymatic digestion with trypsin, or heat treatment). The best results, in terms of non-specific background labelling, morphological preservation and intensity of specific labelling, were obtained (1) for adult skin, by the use of Bouin's fluid, heat pretreatment and antibodies LL001, MCK5, MCK6 or AF129, and (2) for fetal skin, by the use of 70% ethanol, heat pretreatment and antibody Troma-1. Monoclonal antibody 8.60 gave the best results when the use of 70% ethanol was combined with either enzymatic digestion or heat pretreatment.

[Laryngeal tuberculosis and laryngeal cancer]. / Tuberculosis laríngea y cáncer de laringe.

Account of 2 synchronic cases of tuberculosis and laryngeal carcinoma. Apart from bacteriostatic drugs one of them underwent a cordectomy the other one a total laryngectomy and neck dissection. Despite the great majority of laryngeal cancer it is compulsory to take in account the differential diagnosis with the tuberculosis, because of its possible coexistence. Perusal of national and international literature, having found only 11 of similar instances reported.

[Osteoplastic frontal sinus flap. Study of 47 cases]. / Colgajo osteoplástico del seno frontal. Estudio de 47 casos.

Osteoplastic flap of the frontal sinus, described by Macbeth over 40 years ago, still is the best surgical approach for the diagnosis and definitive treatment of chronic disease. Forty-seven patients were treated with this technique between 1978 and 1995. The conditions treated were, by order of frequency: 16 fronto-ethmoidal mucocele, 12 osteoma, 12 hypertrophic sinusitis, and less frequent disorders, such as osteomyelitis (2), fibrous histiocytoma (2), tuberculosis (1), frontal fracture (1) and dilated pneumosinus (1). The surgical approach was coronal in 28 patients, brow in 18 and hemicoronal in 3. In some cases, other approaches were associated: 13 lateral rhinotomy, 6 sublabial and 1 intranasal. Nasofrontal duct obstruction was found in 89% of cases and erosion of one or more sinus walls in 70%. Intraoperative complications included 4 small dural tears, 1 with leakage of cerebrospinal fluid. Postoperative complications included 4 frontal deformity, 2 persistent frontal anesthesia, 1 supraorbital nerve neuralgia, 1 post-anticoagulant epistaxis and 1 death from pulmonary embolism.

Spontaneous mouse mammary tumours: incidence and cytokeratin expression.

The purpose of this study was to advance our knowledge of the histogenesis of spontaneous mammary tumours in laboratory mice. Normal mammary tissue and 19 spontaneous mammary tumours from adult female mice were examined using monoclonal and polyclonal antibodies differing in their recognition of various cytokeratin intermediate filament proteins (CKs). All neoplasms were intraductal and were invasive carcinomas with a tubular, papillary, cystic or solid growth pattern. CK8-positive reactions were detected in the normal alveolar and ductal epithelia and CK5- and CK14-positive reactions were seen in myoepithelial cells of nonlactating mammary glands. Positive staining for CK5 and CK8 was detected in all tumours and CK14 was expressed in those with a papillary pattern. Comparisons between non-lactating glands and tumours indicated that the neoplasms were well or moderately differentiated, there was no squamoid differentiation and that they arose from the alveoli and duct system, not the myoepithelial cells.