Enfermedad de paget mamaria. presentación de un caso / Mammary paget disease. case report

RESUMEN: La enfermedad de Paget mamaria es una patología poco común de la mama que tiene una gran importancia por su alta asociación a carcinoma mamario y por requerir de un alto índice de sospecha para arribar a su diagnóstico. Se presenta el caso de una mujer de 65 años de edad, con diagnóstico de enfermedad de Paget mamaria asociada a carcinoma ductal infiltrante de mama izquierda con compromiso ganglionar axilar homolateral. Se realizó la revisión bibliográfica de esta patología, con especial énfasis en la clínica, diagnóstico, estadificación, tratamientoy pronóstico.

ABSTRACT: Paget's disease of the breast is a rare pathology in the breast, however, it is very important because of its high association with mammary carcinoma and because it requires a high index of suspicion. We present the case of a 65-year-old woman with Paget's disease of the breast associated with an infiltrating ductal carcinoma of the left breast with homolateral axillary lymph node involvement. A bibliographic review of this pathology was carried out, with special emphasis on the clinic, diagnosis, staging, treatment and prognosis.

Nucleolar organizer regions as a marker of incipient transformation in a model of experimental carcinogenesis.

Nucleolar organizer regions stained selectively with a silver colloid technique (AgNOR) were evaluated during the process of tumour promotion in the skin of mice. Tumour promotion and control skin samples were processed for identification of AgNOR by light microscopy and submitted to a morphometric study of the following AgNOR-related variables: nuclear area (V.NUC); AgNOR number per nucleus (N.NOR); single AgNOR area (V.NOR); total AgNOR area per nucleus (TV.NOR) and proportion of nucleus occupied by AgNOR (TV.NOR/V.NUC). N.NOR exhibited significant differences between control and tumour tissue, but in the promotion period, N.NOR did not exhibit a significant rise until week 24. V.NOR and TV.NOR rose significantly as early as 2 weeks after the onset of promotion when the cells fail to exhibit unusual microscopic features. The significant increase in AgNOR material at the beginning of the promotion period reveals the potential value of the variables assessed in the early quantitative evaluation of cellular alterations which could be linked to the probability of tumour development. Rise in AgNOR material would indicate transcriptional activation leading to an increase in protein synthesis and, ultimately, to the expression of an altered phenotype.

Mast cell phenotypic changes in skin of mice during benzoyl peroxide-induced tumor promotion.

The behavior of the mast cell population was analyzed during the sequential changes that normal mice skin undergoes during experimental two-stage carcinogenesis. Our study reveals that the number of mast cells increased during the promotion period but that this alteration is confined to the 30-microns-wide strip below the epidermis. A different mast cell phenotype appeared in this area, compatible with an MMC-like phenotype. During the carcinogenesis process, the mast cell population is comprised of two distinct subpopulations that appeared simultaneously in the same tissue, i.e. connective tissue mast cells, normally found in the skin of mice, and the newly formed mucosal mast cell-like cells, currently found in gastrointestinal mucosa.

Inhibition of benzoyl peroxide-induced tumor promotion and progression by copper(II)(3,5-diisopropylsalicylate)2.

The ability of a biomimetic superoxide dismutase agent, copper(II)(3,5-diisopropylsalicylate)2 (CuDIPS), to modulate benzoyl peroxide (BzPo)-induced tumor promotion and progression in mouse skin multistage carcinogenesis was evaluated. The results showed a significant inhibition of tumor incidence by CuDIPS pretreatment during promotion-progression. Different types of tumors were developed: papillomas, keratoacanthomas and squamous cell carcinomas. There was a significant increase in the keratoacanthoma-papilloma ratio when the period of treatment with BzPo was prolonged, which was inhibited by CuDIPS pretreatment. CuDIPS induced a significant inhibition of malignant conversion. Our results suggest that reactive oxygen species could be important in BzPo-induced promotion and progression.

Differential oxidative stress induced by two different types of skin tumor promoters, benzoyl peroxide and 12-O-tetradecanoylphorbol-13-acetate.

The oxidative stress induced in vivo by benzoyl peroxide (BzPo) or 12-O-tetradecanoylphorbol-13-acetate (TPA) was evaluated in terms of chemiluminescence (CL) emitted by SENCAR mouse skin, a non-invasive method that allows an estimation of overall oxidative stress. The ability of a biomimetic superoxide dismutase, copper(II)(3,5-diisopropylsalicylate)2 (CuDIPS), to inhibit that response was also evaluated. A single application of BzPo to mouse skin resulted in a dose-dependent increase in CL up to 0.083 mumol. Sequential treatment with BzPo in a dose used for tumor promotion resulted in a fall in CL induced by the second topical application. There were no differences between initiated and non-initiated mice in their responses to BzPo-induced CL. CuDIPS, an inhibitor of tumor promotion, was an effective inhibitor of CL in all the protocols evaluated. Conversely, ZnDIPS and DIPS did not inhibit CL. Phenolic antioxidants induced partial inhibition of CL. Unlike BzPo treatment, a single application of TPA up to 105 nmol did not induce an increase in CL, but the second topical application with TPA in a dose used for tumor promotion resulted in a small but significant increase in CL. However, these values of CL were much smaller than the CL induced by BzPo. Our results show a differential response of the skin in terms of the oxidative stress induced by BzPo or TPA.

Rehidratación oral en SDA del lactante con solución Na 75 y Na 90 / Oral rehidration in infant acute diarrhea syndrome with Na 75 and Na 90 solution

Se analizan comparativamente 2 soluciones para la hidratación del lactante hospitalizado por Síndrome Diarréico Agudo (SDA) en la Unidad de Lactantes, Hospital Regional de Temuco, Enero-Marzo 1987. Se someten al estudio 39 pacientes divididos en 2 grupos randomizados y con sistema de doble ciego. En 17 se usó la solución glucoelectrolítica con 75 meq/L de Na y en 22 lactantes se utilizó la solución OMS de 90 meq/L de Na. Ambas soluciones fueron suficientes para hidratar y corregir acidosis metabólica en todos los pacientes. Ninguno presentó hipernatremia en su evolución. A partir de esta experiencia se propone el uso normado de la solución OMS en la terapia de hidratación oral del lactante hospitalizado por SDA con deshidratación moderada a grave, con el consiguiente menor costo de tratamiento, ahorro de días de hospitalización y el subsecuente menor riesgo de deshidratación y/o infección cruzada

Simultaneous analysis of skin response to the different L.E.T. regions of a 55 MeV helium ion beam.

Rat tail epidermis was used to analyze the in vivo response of a biological system to heavy particle irradiation. The conical configuration of the rat tail gives rise to a variable energy degradation of the beam thus yielding information on the damage elicited by 2 different L.E.T. regions of the helium beam at different sites on the same sample. Cytochrome oxidase activity and epidermal thickness were used to analyze the metabolic and structural radioinduced response. Quantitative evaluation of radiation damage revealed marked variations within a few micrometers of tissue.

Cytotoxic effect of uranium dioxide on rat alveolar macrophages.

Alveolar macrophages obtained by bronchial lavage were used to assess the response of these cells to cultivation in media containing increasing concentrations of particulate UO2. The characteristic time course of uranium effects on alveolar macrophages was determined by analyzing cell viability and incorporation of uranium particles. This study reveals the ability of alveolar macrophages to phagocytize uranium particles despite the high toxicity the metal exerts on cell membranes. However, lethal effects soon become evident. Ultrastructural analysis showed uranium particles confined within membrane bound vacuoles or free in the cytoplasm. Marked ultrastructural alterations consistent with cell death were frequently observed. The elimination of the first biological barrier hinders the scavenging of particulate contaminants in alveolar spaces, thus favoring the translocation to target organs.