Patient profiles as an aim to optimize selection in the second line setting: the role of aflibercept

Colorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient’s profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment (AU)

Using RNA-Seq SNP data to reveal potential causal mutations related to pig production traits and RNA editing.

RNA-Seq technology is widely used in quantitative gene expression studies and identification of non-annotated transcripts. However this technology also can be used for polymorphism detection and RNA editing in transcribed regions in an efficient and cost-effective way. This study used SNP data from an RNA-Seq assay to identify genes and mutations underlying production trait variations in an experimental pig population. The hypothalamic and hepatic transcriptomes of nine extreme animals for growth and fatness from an (Iberian × Landrace) × Landrace backcross were analyzed by RNA-Seq methodology, and SNP calling was conducted. More than 125 000 single nucleotide variants (SNVs) were identified in each tissue, and 78% were considered to be potential SNPs, those SNVs segregating in the context of this study. Potential informative SNPs were detected by considering those showing a homozygous or heterozygous genotype in one extreme group and the alternative genotype in the other group. In this way, 4396 and 1862 informative SNPs were detected in hypothalamus and liver respectively. Out of the 32 SNPs selected for validation, 25 (80%) were confirmed as actual SNPs. Association analyses for growth, fatness and premium cut yields with 19 selected SNPs were carried out, and four potential causal genes (RETSAT, COPA, RNMT and PALMD) were identified. Interestingly, new RNA editing modifications were detected and validated for the NR3C1:g.102797 (ss1985401074) and ACSM2B:g.13374 (ss1985401075) positions and for the COG3:g3.4525 (ss1985401087) modification previously identified across vertebrates, which could lead to phenotypic variation and should be further investigated.

Application of acute phase protein measurements in meat extract collected during routine veterinary inspection at abattoirs.

The possible application of acute phase protein measurements of meat extract in porcine carcass inspection at abattoir, under routine conditions, was studied. Concentrations of two acute phase proteins, C-reactive protein and haptoglobin, were quantified in 357 samples from carcasses subjected to official veterinary inspection at slaughterhouses. Carcasses were classified according to their sanitary status in five groups of animals ranging from healthy animals, without any organ alteration (group 1), to completely condemned carcasses with gross alteration in several organic systems (group 5). The concentration of both acute phase proteins appeared significantly higher in groups 2 to 5 in comparison to group 1. Sensitivity of these proteins to detect animals with organ alterations was 86% when the values of both proteins were taken into account. The quantification of the levels of acute phase proteins could be of help during routine veterinary meat inspection by offering an objective tool for active disease detection.

Pirfenidone prevents rat esophageal stricture formation.

BACKGROUND: Accidental ingestion of caustic substances induces esophageal injuries and stenosis formation. The main aim for acute phase treatment is to prevent esophageal stenosis. Pirfenidone (PFD) is a pyridone with antifibrotic and anti-inflammatory effects. Esophagus stenosis takes place after a strong inflammation process where proinflammatory and profibrogenic cytokines play an important role. The present study investigates the efficacy of PFD on the prevention of stricture development after esophageal caustic injuries in a rat model. MATERIAL AND METHODS: Caustic esophageal burn was produced by application of 32% of NaOH to the distal esophagus of healthy rats. PFD in the form of 8% gel was administered at a dose of 200 mg/kg/d. Animals were divided in three experimental groups as follows: healthy rats, animals injured with NaOH without PFD treatment, and rats injured with NaOH and treated with PFD. Efficacy of the treatment was assessed by measuring image esophagoscopy and esophagography with contrast barium at the 21st d. Histology staining with Sirius-red was performed to evaluate collagen deposition and stenosis area. Gene expression of transforming growth factor ß1, collagen-1, plasminogen activator inhibitor-1, connective tissue growth factor, and matrix metalloproteinase 2 were measured by quantitative reverse transcription polymerase chain reaction. RESULTS: There was significant difference in means of stenosis by esophagoscopy and esophagogram. Collagen deposition in the damaged area increased significantly when rats were burned with NaOH, and decreased notably in PFD treated group. Profibrogenic key molecules transforming growth factor ß1, collagen 1, plasminogen activator inhibitor-1 and connective tissue growth factor expression were significantly lower respect to control group without PFD treatment where matrix metalloproteinase 2 expression was no different in all groups. CONCLUSIONS: This study suggests that PFD reduces stenosis on caustic esophageal burn by decreasing profibrogenic genes expression and ameliorates fibrosis significantly in the chronic phase.

Costilla cervical en el diagnóstico diferencial de una masa supraclavicular / Cervical rib in the differential diagnosis of supraclavicular mass

La costilla cervical consiste en una costilla supernumeraria que surge de la séptima vértebra cervical y termina libremente en el tejido del cuello o se articula con la primera costilla. Puede ser asintomática y diagnosticarse como hallazgo casual en una radiografía de tórax, o bien presentarse con dolor en la región supraclavicular o como complicación en forma de síndrome del desfiladero torácico. A menudo plantea diagnóstico diferencial con masas tumorales malignas, por sus características en la exploración. El manejo suele ser conservador y la intervención quirúrgica se reserva para casos muy sintomáticos o complicados. Presentamos un caso clínico de costilla cervical sintomática y su abordaje desde Atención Primaria (AU)

Cervical rib is a supernumerary rib arising from the seventh cervical vertebra and ends freely in the tissue of the neck or articulates with the first rib. It can be diagnosed as an asymptomatic incidental finding on a chest radiograph or presented with supraclavicular pain or complications as thoracic outlet syndrome. The differential diagnosis often poses malignant tumor masses, because of their characteristics in the physical exam. The management is often conservative reserving surgical intervention for highly symptomatic or complicated cases. We report a case of symptomatic cervical rib and its approach from Primary Care (AU)

Generación in vitro de un sustituto de pared vesical humana obtenido mediante ingeniería tisular / In vitro generation of a human bladder wall substitute by tissue engineering

Objetivos. Numerosas patologías que afectan a la vejiga, de origen congénito (extrofia) o adquirido (traumatismos, tumores), requieren la reconstrucción de la pared vesical utilizando intestino delgado, sigma o estómago, los cuales no están exentos de complicaciones. Por ese motivo, en el presente trabajo pretendemos desarrollar un nuevo modelo de pared vesical humana mediante ingeniería tisular que pudiese tener una utilidad clínica. Material y métodos. En primer lugar, se procedió a generar cultivos primarios de células epiteliales y estromales de la mucosa vesical a partir de pequeñas biopsias de la pared vesical humana, utilizando para ello técnicas de digestión enzimática mediante tripsina-EDTA y colagenasa. Posteriormente, se generó un sustituto tridimensional de la mucosa vesical utilizando como soporte biomateriales de fibrina-agarosa. El análisis de las muestras se realizó a los 14 días mediante examen histológico de muestras teñidas con hematoxilina-eosina. Resultados. La aplicación de los métodos de digestión enzimática permitió generar eficientemente cultivos primarios de células epiteliales y estromales de la mucosa vesical humana, comprobándose que la tasa de proliferación de las células estromales era superior a la de las células epiteliales. Una vez generados los sustitutos de la pared vesical, se comprobó el adecuado nivel de biocompatibilidad del biomaterial y las células estromales y epiteliales. La estructura histológica de los sustitutos de pared vesical presentaba una gran analogía con la mucosa vesical humana nativa. Conclusiones. El tejido vesical generado por ingeniería tisular muestra importantes similitudes estructurales e histológicas con el tejido vesical nativo. Estos resultados sugieren que los tejidos generados mediante ingeniería tisular podrían tener utilidad terapéutica en el futuro (AU)

Introduction. Certain urological congenital conditions, such as bladder exstrophy and acquired conditions such as trauma and tumors may require the use of different tissues like small bowel, sigmoid colon or stomach for bladder reconstruction. However, these tissues are often associated to important complications. The aim of this study is to develop a novel substitute of the human bladder wall by tissue engineering. Material and methods. We first generated primary cell cultures of epithelial and stromal bladder mucosa cells from small tissue biopsies of human bladder by using enzymatic methods based on trypsin-EDTA and collagenase I. Then, a three-dimensional substitute of the bladder mucosa was generated using fibrin-agarose biomaterials. The analysis of the tissue substitutes was carried out at day 14th of development by histological examination of samples stained with hematoxylin-eosin. Results. The use of enzymatic digestion methods allowed us to efficiently generate primary cell cultures of the human bladder epithelial and stromal cells. The proliferation rate was higher in stromal cells as compared to epithelial cells. Once the bladder mucosa substitutes were generated, a good biocompatibility of the stromal and epithelial cells into the biomaterial was found. The histological structure of the bladder wall substitutes was analogue to that of the native human bladder mucosa. Conclusions. The bladder mucosa substitute generated by tissue engineering showed structural and histological similarities with the native human bladder tissues and open the door to the future therapeutic use of these bioengineered tissues (AU)

[In vitro generation of a human bladder wall substitute by tissue engineering]. / Generación in vitro de un sustituto de pared vesical humana obtenido mediante ingeniería tisular.

INTRODUCTION: Certain urological congenital conditions, such as bladder exstrophy and acquired conditions such as trauma and tumors may require the use of different tissues like small bowel, sigmoid colon or stomach for bladder reconstruction. However, these tissues are often associated to important complications. The aim of this study is to develop a novel substitute of the human bladder wall by tissue engineering. MATERIAL AND METHODS: We first generated primary cell cultures of epithelial and stromal bladder mucosa cells from small tissue biopsies of human bladder by using enzymatic methods based on trypsin-EDTA and collagenase I. Then, a three-dimensional substitute of the bladder mucosa was generated using fibrin-agarose biomaterials. The analysis of the tissue substitutes was carried out at day 14th of development by histological examination of samples stained with hematoxylin-eosin. RESULTS: The use of enzymatic digestion methods allowed us to efficiently generate primary cell cultures of the human bladder epithelial and stromal cells. The proliferation rate was higher in stromal cells as compared to epithelial cells. Once the bladder mucosa substitutes were generated, a good biocompatibility of the stromal and epithelial cells into the biomaterial was found. The histological structure of the bladder wall substitutes was analogue to that of the native human bladder mucosa. CONCLUSIONS: The bladder mucosa substitute generated by tissue engineering showed structural and histological similarities with the native human bladder tissues and open the door to the future therapeutic use of these bioengineered tissues.

Generación de un sustituto de mucosa oral humana y comprobación de su viabilidad mediante ingeniería tisular / Generation of a substitute for human oral mucosa and verification of its viability by tissue-engineering

La reconstrucción de grandes defectos de mucosa oral a menudo es desafiante, por la escasez de mucosa oral sana para reemplazar tejidos dañados. De esta forma, las técnicas de ingeniería tisular pueden suponer una fuente de tejidos autólogos disponible para trasplantar a estos pacientes. En este trabajo hemos desarrollado un nuevo modelo de mucosa oral artificial generada mediante ingeniería tisular usando un soporte de fibrina-agarosa. Para ello, se han generado cultivos primarios de fibroblastos de la mucosa oral humana y queratinocitos a partir de pequeñas biopsias de mucosa oral normal y aplicándoles tratamiento senzimáticos. Después, se ha determinado la viabilidad de las células cultivadas mediante microanálisis por rayos-X, demostrando que la mayoría de las células de los cultivos primarios estaban vivas y tenían elevados K/Na ratios. Una vez que la viabilidad celular fue determinada, se usaron los fibroblastos y queratinocitos cultivados para desarrollar un constructo de mucosa oral sobre una matriz extracelular de (..) (AU)

Reconstruction of large oral mucosa defects is often challenging, since the shortage of healthy oral mucosa to replace the excised tissues. This way, tissue ingineering techniques may provide a source of autologoustissues available for transplant in these patients. In this work, wehave developed a new model for artificial oral mucosa generated by tissue engineering using a fibrin-agarosa scaffold. For that purpose, we have generated primary cultures of human oral mucosa fibroblasts and keratinocytes from small biopsies of normal mucosa oral using enzymatic treatments. Then, we have determined the viability of cultured cells by electron probe quantitative X-ray microanalysis, and we have demonstrated that most of the cells in the primary cultures were alive and hd high K/Na ratios. Once cell viability was determined, we used cultured fibroblasts and keratinocytes to develop an artificial oral mucosaconstruct by using a fibrin-agarosa extracellular matrix and a sequential culture technique using porous culture inserts. Histological analysis of the artificial tissues showed high similarities with normal oral (..) (AU)

[Generation of a substitute for human oral mucosa and verification of its viability by tissue-engineering]. / Generación de un sustituto de mucosa oral humana y comprobación de su viabilidad mediante ingeniería tisular.

Reconstruction of large oral mucosa defects is often challenging, since the shortage of healthy oral mucosa to replace the excised tissues. This way, tissue ingineering techniques may provide a source of autologous tissues available for transplant in these patients. In this work, we have developed a new model for artificial oral mucosa generated by tissue engineering using a fibrin-agarosa scaffold. For that purpose, we have generated primary cultures of human oral mucosa fibroblasts and keratinocytes from small biopsies of normal mucosa oral using enzymatic treatments. Then, we have determined the viability of cultured cells by electron probe quantitative X-ray microanalysis, and we have demonstrated that most of the cells in the primary cultures were alive and hd high K/Na ratios. Once cell viability was determined, we used cultured fibroblasts and keratinocytes to develop an artificial oral mucosa construct by using a fibrin-agarosa extracellular matrix and a sequential culture technique using porous culture inserts. Histological analysis of the artificial tissues showed high similarities with normal oral mucosa controls. The epithelium of the oral substitutes had several layers, with desmosomes and apical microvilli and microplicae. Both the controls and de oral mucosa substitutes showed high suprabasal expression of cytokeratin 13 and low expression of cytokeratin 10. All these results suggest that our model of oral mucosa using fibrin-agarose scaffolds show several similarities with native human oral mucosa.

The normal electrocardiogram of the unanaesthetized competition "Spanish Pouler" pigeon (Columba livia gutturosa).

This investigation was carried out on 64 healthy adult competition pigeons (Spanish Poulers) to determine reference values of electrocardiographic parameters in standard lead II; a comparative study between males and females was also performed to find changes in the electrocardiographic patterns related to sex. P wave was positive and monophasic; PR segment depression was present in 64% of records; the QRS pattern obtained was in most cases of the rS type, followed by the QS configuration. ST slurring (absence of ST) was observed in 47% of records and the mean electrical axis was in all cases negative. Statistically significant differences related to sex were found for P-wave, R-wave and T-wave amplitudes, showing the males have greater amplitudes than females, associated with the increase of cardiac tissue mass. No sex-related differences were found in heart rate and mean electrical axis.

The normal electrocardiogram of the unanesthetized peregrine falcon (Falco peregrinus brookei).

The mean duration and amplitudes of the lead II electrocardiogram were determined in the peregrine falcon (Falco peregrinus brookei) using 10 birds ranging in age from 1 to 5 yr. Electrocardiograms were performed on unanesthetized falcons in order to avoid the anesthesia effect on the electrocardiogram, by a method which seems to induce a tonic immobility-like reaction. All the falcons had a normal sinus rhythm, with a mean heart rate of 268 beats per minute. Mean durations of PR, ST, QT, and RR intervals were higher (but not statistically significant) in females than in males, except for the ST segment, with similar values in both sexes. P-wave deflections were positive in I, II, III, aVL, and aVF and negative in aVR. The normal patterns of wave forms of the QRS complexes in all leads were of QS and rS types, except for aVR and aVL, which presented an R configuration. The mean electrical axis was negative, with an average of -99.9 degrees. T-wave deflections were positive in I, II, III, and aVF leads II and negative in aVR and aVL. The data collected in this study may serve as a guide for electrocardiographic monitoring of peregrine falcons.

Ectopia ureteral como causa de incontinencia urinaria en niñas / Ureteral ectopia as a cause urinary incontinence in girls

La ectopia ureteral se presenta con una baja prevalencia y por lo general se asocia con duplicidad pieloureteral. En estos casos es frecuente la aparición de incontinencia. Se presentan los casos clínicos de 5 pacientes tratadas en el Hospital Materno-Infantil Virgen de las Nieves por presentar incontinencia urinaria secundaria a ectopia ureteral asociada a duplicidad. En tres de ellas el uréter ectópico desembocaba en el útero y en las otras dos en la vagina. Se eligió la heminefroureterectomía por ser este segmento hipofuncionante o displásico. La incontinencia desapareció tras la intervención quirúrgica (AU)

Dilatación segmentaria de íleon / Segmental dilatation of the ileum

La dilatación segmentaria del intestino delgado es una malformación poco frecuente que puede provocar episodios de oclusión o suboclusión intestinal.La etiología de esta entidad es desconocida, existiendo diversas teorías para explicar su origen. Presentamos los casos de dos pacientes varones de 1 y 2 años de edad que presentaban dilatación segmentaria de íleon, asociándose uno de ellos a un divertículo de Meckel. Se discute el posible origen vascular de esta enfermedad (AU)

Demanda urgente en cirugía infantil. Estudio de utilización inapropiada / Appropriateness utilization of a pediatric surgery emergency service

Introducción. Diversos estudios han demostrado que, entre uno y dos tercios de los casos, la demanda urgente de atención es considerada inapropiada. Esta situación conlleva un aumento de los costes sanitarios y supone para el usuario una atención médica fragmentada. En el ámbito de la especialidad de Cirugía Pediátrica no hemos encontrado ningún trabajo realizado a tal efecto. Objetivos. 1. Cuantificar el grado de inadecuación de la demanda urgente en Cirugía Pediátrica. 2. Conocer los factores asociados a la demanda inadecuada. Pacientes y métodos. Diseño: estudio de observación transversal. Ambito: pacientes visitados por cirujano pediatra en Servicio de Urgencias Pediátrica* de un hospital universitario. Muestra: aleatoria (a: 0,05; precisión: 0,05) de los pacientes atendidos durante 1998. Variables de estudio: dependiente: inadecuación; independientes: edad, género, distancia desde el domicilio, diagnóstico, nivel de estudios de los padres, asistencia previa y si acude por iniciativa propia. Mediante entrevista: motivos que inducen a la demanda. Unidad de análisis: se consideró urgencia hospitalaria, siguiendo los criterios de la OMS, cuando se trata de emergencia vital o cuando existe necesidad de usar medios diagnósticos o terapéuticos no disponibles en un nivel de atención inferior. Análisis: el tratamiento estadístico consistió en un análisis de frecuencias relativas, prueba x2 para comparar frecuencias y 't' de Student para comparar medias. Resultados. De los 2.226 pacientes atendidos en urgencias, se han estudiado 441 (edad: 5,54 años; 63 por ciento varones). Los diagnósticos más frecuentes han sido: heridas y pequeños traumatismos (39,7 por ciento), dolor abdominal (22,2 por ciento), quemaduras (3,6 por ciento), apendicitis (3,2 por ciento) y hernias (3,2 por ciento). El 86,2 por ciento acudieron por iniciativa propia. La proximidad (19,9 por ciento), la alarma por los síntomas (13,1 °Io) y el desconocimiento de la existencia de otros niveles de atención (10 por ciento) han sido las causas argüidas por los padres para la demanda de atención. El 63,9 por ciento de las visitas se consideraron inapropiadas. Se ha encontrado relación estadística entre uso inapropiado y edad superior a un año (p < 0,02), distancia domicilio-hospital (p < 0,003), acudir por iniciativa propia (p < 0,001) y expectativa de los padres (p < 0,02). No existe relación con el género o el nivel de estudios de los padres. Conclusiones. En los Servicios de Urgencias existe un elevado número de consultas inadecuadas. La accesibilidad, la disponibilidad de medios, la rapidez de la atención .y quién toma la decisión de acudir son variables predictoras de la sobreutilización (AU)

[Demand of emergency pediatric surgery. Study of inappropriate utilization]. / Demanda urgente en cirugía infantil. Estudio de utilización inapropiada.

BACKGROUND: Several studies have demonstrated that, between 30-60% of the cases, the urgent attention demand is considered inappropriate. This situation causes an increase in the sanitary costs and supposes for the patient a partial medical care. In the area of the Pediatric Surgery we have not found any work accomplished to such effect. DESIGN: Transverse observational study. SETTING: Emergency Service of a University Hospital. PATIENTS: a sample random (alpha: 0.05; precision: 0.05) of the patients attended during 1998. MAIN OUTCOME MEASURES: Dependent: appropriateness. Independent: age, gender, proximity, diagnostic, studies of the parents, previous assistance, if attends by own initiative and motives that induce to demand. It was considered hospital emergency, continuing the criteria of the WHO, when it is considered vital emergency or when there is using of therapeutic or diagnostic means nor available in an primary level of health care. The statistic treatment consisted of a relative frequencies analysis, test x2 and t Student. RESULTS: Of 2,226 cases attended in emergency service, they have 441 reviewed (age: 5.54 years; 63% male). The most frequent diagnoses have been: injuries and small traumatisms (39.7%), abdominal pain (22.2%), burns (3.6%), appendicitis (3.2%) and hernias (3.2%); 86.2% attended by own initiative. The proximity (19.9%), the alarm by the symptoms (13.1%) and the ignorance of the existence of other level of health care (10%) have been the causes by the parents for attention demand. The 63.9% of the visits were considered inappropriate. It has been found relationship between inappropriate use and age (p < 0.02), proximity (p < 0.003), to attend by own initiative (p < 0.001), and expectation of the parents (p < 0.02). It does not exist relationship to the gender or the studies level of the parents. CONCLUSIONS: These data suggest that in the Emergency Services exists a high appropriateness. The accessibility, the availability of means, the rapidity of the attention and who takes the decision of attending are variable associated to the appropriateness.

[The use of resources. Unnecessary stays in pediatric surgical services]. / Utilización de recursos. Estancias innecesarias en un servicio de cirugía infantil.

BACKGROUND: There is wide-spread consensus that a part of the use of hospital resources is inadequate in the sense that the patients receive services that do not provide them with any significant benefits, or that could be more beneficial, or less costly, with a lower care standard. OBJECTIVE: The main aim of this work is to determine the percentage of inadequate stays in a pediatric surgery service and to identify the causes that provoke them. METHOD: It was a concurrent study in pediatric patients entered, at least 24 hours, by different disease for surgery, observation or study. Revising trained applied the pediatric version of the Appropriateness Evaluation Protocol on the medical records of these patients. It has been measured if the stay was appropriated or not, and the cause. RESULTS: The studied patients (279) caused a total of 1,001 stays of those which 373 (37.3%) were deemed to be unnecessary. The diseases with greater number of inappropriate stays were cryptorchidia (97.3%), hernia (88.9%), hypertrophic pyloric stenosis (50%), and soft tissues surgery (43.1%). A 68.2% of the unnecessary stays were responsibility of the hospital-service-surgeon, a 22.6% to the associated environment-familiar, and a 9.2% to the lack of alternative resources to the hospital. CONCLUSIONS: A meaningful proportion by day of hospital stay would be avoided. The unnecessary stays search facilitates the weak points identification on those which to develop improvement actions.

[Gonadal, hormonal and spermatic function in patients treated for cryptorchidism]. / Función gonadal hormonal y espermática en pacientes tratados por criptorquidia.

This paper studies the gonadal-hormonal and spermatic function of 48 adults (over 18 years old) who were treated in childhood for cryptorchidism by medical, surgical or both treatments. We measure plasmatic levels of FSH, LH, testosterone and prolactin of 34 patients and sperm samples of 31 patients. The testicular hormonal function was not disturbed except in four patients with high levels of prolactin (> 20 ng/ml) without symptoms. The spermatic function was disturbed in bilateral cryptorchidism mainly. The better sperm quality and testicular volume were at patients treated with hormonal treatment before surgical treatment.

Immunocytochemical localization of melatonin in the harderian gland of Syrian hamster.

BACKGROUND: The Harderian gland (HG) is a tubulo-alveolar gland found within the ocular orbit of animals which present a nictitating membrane. The Harderian gland is regarded as an extrapineal melatonin producing organ and both, photoperiod and melatonin have been shown to exert an important role in the metabolism and morphological features of such a gland. Our results seem to support the presence of melatonin in the nuclei of the HG cells, although our studies have not definitively proved such presence. METHODS: An Immunocytochemical anti-melatonin technique was done over free sections of Bouin fixed material obtained from Syrian hamsters. Some of the sections were embedded in an epoxy resin and studied under electron microscope. RESULTS: The presence of positive immunoreaction was observed at the level of the nuclear membranes and in close relation to chromatin. No differences were observed between males and females nor between pinealectomized animals and control ones. CONCLUSIONS: Our results suggest the binding of melatonin to the cell nucleus in all cell types of the gland. These observations are in accord with the binding studies performed by Acuña-Castroviejo in purified cell nuclei of rat liver (Acuña-Castroviejo et al., 1994. J. Pineal Res., 16:100-112) and the earlier one by Menéndez-Peláez et al. (1993a,b, J. Pineal Res., 15:59-69; J. Cell Biochem., 53:373-3*2) using the light microscope. Our results seem to support the idea of a nuclear action of melatonin and they agree with the observations of Carlberg and Wiesenberg (1995, J. Pineal Res., 18:171-178) about the activation of some orphan receptors by melatonin.

[Ovarian cysts in childhood]. / Quistes de ovario en la infancia.

It's perform a descriptive study about a series of events with the purpose of discover the own characteristics of ovarian cysts and which characteristics determine its treatment. In the 41 patients (10 newborn, 14 prepubertal females and 17 post-menarchal females) we analyzed their symptoms, pathological findings, ecographics details, treatment, diagnostic and follow-up. The predominant symptom has been the abdominal pain (18 patients). In 8 newborn the cyst was find before born by prenatal sonography. The cyst was palped like abdominal mass in 22 patients and it was like a picture of acute abdomen in 11. It was found in the right ovary in 24 patients and bilaterally in 7. By pelvic ultrasonography was observed a superior size of 5 cm of diameter in 28 occasions, in 17 there were imagine of complex and in 3 there were hemorrhagic. In 16 patients the suspicion diagnostic was of torsion and in 5 of appendicitis. The torsion was confirmed in 11. In 16 patients it was a follicular cyst, in 9 was a dermoidal and in 9 hemorrhagic. Was realized a surgical treatment (cystectomy or ooforectomy in 36 girls, in 4 was realized a puncture and evacuation (bigger of 5 cm with clear liquid) and in 7 was hope the spontaneous evolution (clear liquid and infer size of 5 cm). There were not relapses. The clinic manifestations are presents with own characteristics depending of the cyst affected to newborn, premenarchal or menarchal females. The indications of surgery are: symptoms which are not resolved after a observation time (24-49 hours) and cysts of big volume associated a complications.(ABSTRACT TRUNCATED AT 250 WORDS)