Stromal tumors of the digestive tract. Prognostic value of mitotic index.

OBJECTIVE: We analyzed the prognostic factors and evaluated the usefulness of mitotic index to predict the behavior of gastrointestinal stromal tumors (GIST). PATIENTS AND METHODS: Fifty three patients operated on for stromal tumors of the digestive tract were studied retrospectively. Mean follow-up was 6 years. The number of mitosis/10 high power fields was the definitive criterion for classification, regardless of their inmunohistologic differentiation. Twelve tumors had 0 mitoses, 34 from 1 to 9 mitoses, and 7 had > or = 10 mitoses. The survival rate was analyzed and the morphological characteristics and evolution were correlated according to mitotic index. RESULTS: The incidence of advanced illness was related to the number of mitoses: 29% in the group with 1 to 9 mitoses, and 86% when there were > or = 10 mitoses. The recurrence intervals were 44 and 8 months respectively. No tumor with 0 mitoses evolved aggressively. The survival rate was significantly related (p < 0.001), to the mitotic index. The group with 0 mitoses had a survival rate of 100% after 10 years, those with 1 to 9 mitoses 69% and those with > or = 10 mitoses 14%. The other factors which influenced the prognosis (location, size, local invasion and resection) depended, as well, on the mitotic index. CONCLUSION: The classification of digestive tract stromal tumors by mitotic index is an efficient method because it distinguishes 3 entities with different biological behavior in the long term.

Octreotide: effects in experimental severe acute pancreatitis. Analysis of survival, biochemical findings and histomorphometry.

OBJECTIVE: The effect of octreotide in acute experimental pancreatitis was examined. EXPERIMENTAL DESIGN: Acute pancreatitis was induced in 70 male Wistar rats by retrograde injection of 5% sodium taurocholate into the pancreatic duct. Octreotide (50 micrograms = 0.5 ml) or isotonic saline was administered subcutaneously every six hours for 24 hours, beginning at the time of induction of pancreatitis (groups 1 and 2) or 12 hours later (groups 3 and 4). Six hours after the last dose of octreotide or saline, the rats were sacrificed. Ten additional rats were used for basal biochemical determination. For the analysis of survival, another 10 rats were included. The survival rate, serum concentrations of amylase, lipase and lactate dehydrogenase (LDH) and morphometric studies (total area of the pancreas and percentage necrosis) were examined. Statistical analysis involved Student's t test, ANOVA and the Mantel-Haenszel test. RESULTS: No significant differences existed among the groups with respect to survival, morphometric analysis or biochemical determinations, except for a minor increase in LDH levels in the group treated with octreotide at the time of induction. CONCLUSIONS: Octreotide administration has almost no impact on mortality in experimental severe acute pancreatitis. Biochemical and morphometric changes are minimal. Therefore, according to the present study, the efficacy of octreotide administration is very low.

[Brigantium study. Cardiovascular risk factors in childhood and adolescence in a rural area of Galicia]. / Estudio Brigantium. Factores de riesgo cardiovascular en la niñez y adolescencia en un área rural gallega.

BACKGROUND: The aim of this study was to determine the levels of certain factors of cardiovascular risk in children and adolescents in rural areas of Gallicia. METHODS: One thousand eight children between the ages of 6 and 15 years selected from three primary schools were studied. Weight, height, blood pressure, serum levels of cholesterol and self admitted consumption of tobacco were determined in each participant. RESULTS: The patterns of body mass, blood pressure and total cholesterol selected to age and sex are very similar to those observed in a great deal of the Spanish and foreign studies. However, the absolute values do not necessarily coincide. The children studied were more obese than those reported in other studies carried out in the rest of Spain with similar values of systolic blood pressure and lower cholesterol levels. The levels of cholesterol in this study were within the range observed in other Western countries, lower than those found in other parts of Spain but much higher than the ideal quantities recommended by the WHO. Blood pressure was similar to that of a recent meta-analysis of Spanish studies but much higher than that observed in the Second American Task Force Study. With regard to the use of tobacco, this population demonstrated lower prevalences to those of other Spanish populations. From the age of 14 the consumption of cigarettes greatly increases, especially in boys. CONCLUSIONS: Obesity and blood pressure appear to be a more important potential problem than cholesterol among the cardiovascular risk factors considered in the children studied in comparison with populations of a similar age. If prevention plans on the use of tobacco are foreseen in Spain, they should be made before the age of 14 when an important number of children already smoke or have tried cigarettes.

Catamenial pneumothorax with pleural endometriosis and hemoptysis.

One case of recurrent pneumothorax, coinciding with menstruation, is documented. The ethiopathogenesis of this syndrome remains unknown, after studying the 44 cases. Their association with pleural endometriosis has only been found in nine cases. This new publication with pleural endometriosis and menstrual hemoptysis supports an endometriosis etiology. The surgical treatment of pneumothorax is effective, and a main disclosure of this syndrome would facilitate the research and enlightenment of the ethiopathogenesis.