The interrelationship between tubular and papillary sectors of tubulo-villous colorectal adenomas: comparative morphometric analysis and evaluation of cell proliferation.

In a series of 100 colorectal adenomas, 23 tubulo-villous adenomas were individualized through the identification of papillae as structures persisting for more than 100 microm in serial sections with a connective axis lined with epithelial cells. In these adenomas, the tubular and villous areas with the highest dysplasia were selected, and a morphometric analysis was undertaken to assess the Index of Structural Atypia, the Nucleo-Glandular Index, and the Nuclear Stratification Index. The AgNor count and the proliferating cell nuclear antigen (PCNA) Label Index (LI) also were performed. The overall mean of each of these indexes was significantly higher in the villous sector than in the tubular one (P < .001). In 16 cases, the semi-objective method of dysplasia gradation showed a superior degree in the papillary sector, whereas it showed an equal degree in the remaining seven lesions. The AgNOR count was significantly different in all cases, with higher values in villous sectors (P < .05). With the exception of one case, this was confirmed by the PCNA LI. The Stratification Index showed significantly different values in 20 cases, whereas the other morphometric indexes showed a less discriminatory result. Our findings objectively show that the degree of dysplasia in tubulo-villous adenomas should be analyzed in the villous sector. The existence of heterogeneous cellular populations has been confirmed both in the structural organization of cells and in some basic parameters such as the cell proliferation rate in colorectal adenomas. Our findings suggest that the occurrence of villous architectural growth is a secondary event in a tubular adenoma. Enhanced cellular proliferation of the villous area allows the progressive substitution of tubular structures.

[Multicenter study for the evaluation of the reproducibility in the measurement of rectal sensorial threshold]. / Estudio multicéntrico para la evaluación de la reproducibilidad en la medición del umbral sensorial a la distensión rectal.

A simple way to evaluate the rectal sensorial threshold has been the sloped distention of a rectal balloon, as a way to obtain the required volume to induce desire to defecate (VDE) and pain (VTM). Six medical groups belonging to the Argentine Motility Circle, studied in 14 patients (7M, 7F age 51 +/- 10.1) the VDE and VTM. The measurements were repeated in the same subjects with intervals longer than 24 Hs. The estimate of precision established a coefficient of variation (CV) for VDE of 10.23% (2CV = 20.46%). And so Reproducibility was found to be not acceptable. The CV for VMT was 1.44 (2CV = 2.88%) this could be considered a very good reproducibility. In conclusion, the VTM appears to be a reproducible measurement suitable for clinical and pharmacological studies of the rectal sensorial perception.

Estudio multicéntrico para la evaluación de la reproducibilidad en la medición del umbral sensorial a la distensión rectal. / [Multicenter study for the evaluation of the reproducibility in the measurement of rectal sensorial threshold]

A simple way to evaluate the rectal sensorial threshold has been the sloped distention of a rectal balloon, as a way to obtain the required volume to induce desire to defecate (VDE) and pain (VTM). Six medical groups belonging to the Argentine Motility Circle, studied in 14 patients (7M, 7F age 51 +/- 10.1) the VDE and VTM. The measurements were repeated in the same subjects with intervals longer than 24 Hs. The estimate of precision established a coefficient of variation (CV) for VDE of 10.23

(2CV = 20.46

). And so Reproducibility was found to be not acceptable. The CV for VMT was 1.44 (2CV = 2.88

) this could be considered a very good reproducibility. In conclusion, the VTM appears to be a reproducible measurement suitable for clinical and pharmacological studies of the rectal sensorial perception.

[Endoscopic-pathologic correlation of rectocolonic lesions less than 10 mm]. / Correlción endoscópico-patológica de lesiones rectocolónicas menores de 10 mm.

Ninety eight rectocolonic lesions up to 10 mm in diameter found in 50 patients were analyzed. The relationship between endoscopic and pathologic diagnosis was established. Emphasis was made on the detection of adenomas based in the following: Yamada III or IV lateral vision, Yamada I and II with smooth but erythematous surface, and in pale with irregular surface lesions. The sensitivity of the method was 92% and the specificity was 72% for adenomas. Six percent of adenomas were pale, with mucous hypersecretion on histopathology, and can be mistaken for hyperplastic polyps. This mucous hypersecretion correlates with low grade dysplasia, which supposedly indicates a lower evolutive risk.

Prevalencia de litiasis vesicular en una poblacion uruguaya / Prevalence of gallbladder lithiasis in a Uruguayan population

Con el objetivo de conocer la prevalencia de L.V. en Uruguay, la proporción de sintomáticos y asintomáticos y su asociación a determinados factores de riesgo, se realizaron ecografías a 693 funcionarios del Hospital de Clínicas de Montevideo que concurrieron voluntariamente, previo llenado de un formulario. La prevalencia encontrada fue de 10,4%, de acuerdo al tamaño de la nuestra, extrapolable a la población general con una confianza del 99%. 65% de los portadores de L.V. fueron asintomáticos. Se encontró una asociación estadísticamente significativa con los siguientes factores: grupo etáreo de 31 a 50 años, obesidad leve y AP de tener hijos en caso de mujeres portadoras de la enfermedad. No fue estadísticamente significativo, pero si se comprobó una clara tendencia con los siguientes factores: sexo femenino y AF de madre portadora de L.V. Al considerar todos estos factores en conjunto, la probabilidad de tener una L.V. llegó al 19%. Se discuten los resultados y se comparan con los de publicaciones extranjeras. Se concluye que podía esbozarse un perfil del uruguayo con mayores posibilidades de tener una L.V.: mujer, entre 31 y 50 años, obesa, con hijos y cuya madre tuvo o tiene la misma enfermedad

Prevalencia de litiasis vesicular en una poblacion uruguaya / Prevalence of gallbladder lithiasis in a Uruguayan population

Con el objetivo de conocer la prevalencia de L.V. en Uruguay, la proporción de sintomáticos y asintomáticos y su asociación a determinados factores de riesgo, se realizaron ecografías a 693 funcionarios del Hospital de Clínicas de Montevideo que concurrieron voluntariamente, previo llenado de un formulario. La prevalencia encontrada fue de 10,4%, de acuerdo al tamaño de la nuestra, extrapolable a la población general con una confianza del 99%. 65% de los portadores de L.V. fueron asintomáticos. Se encontró una asociación estadísticamente significativa con los siguientes factores: grupo etáreo de 31 a 50 años, obesidad leve y AP de tener hijos en caso de mujeres portadoras de la enfermedad. No fue estadísticamente significativo, pero si se comprobó una clara tendencia con los siguientes factores: sexo femenino y AF de madre portadora de L.V. Al considerar todos estos factores en conjunto, la probabilidad de tener una L.V. llegó al 19%. Se discuten los resultados y se comparan con los de publicaciones extranjeras. Se concluye que podía esbozarse un perfil del uruguayo con mayores posibilidades de tener una L.V.: mujer, entre 31 y 50 años, obesa, con hijos y cuya madre tuvo o tiene la misma enfermedad (AU)

[Prevalence of gallbladder lithiasis in a Uruguayan population]. / Prevalencia de litiasis vesicular en una población uruguaya.

Ultrasound examinations were carried out in 693 volunteers from the health care personnel of the Hospital de Clinicas of Montevideo, with the aim of studying the prevalence of gallbladder gallstones in Uruguay, the proportion of symptomatic and asymptomatic people and its association to some definite risk factors. The prevalence found was 10.4%, which, according to the sample's size, is representative of the general population with a confidence of 99%. Sixty five per cent of gallstones carriers were asymptomatic. A statistically significant association with the following factors was found: people between 31 and 50 years old, slight obesity, and, for women, to have children. A marked tendency with the following factors was found, though it was not statistically significant: female sex, and a familiar history of mother carrying gallstones. Considering all these factors as a whole, the probability of having gallstones reached 19%. Results are discussed and compared with those of foreign publications. It is concluded that uruguayan people with more possibilities of having gallstones are: women between 31 and 50 years old, obese, with children, and whose mother has or had the same disease.

Prevalencia de litiasis vesicular en una población uruguaya. / [Prevalence of gallbladder lithiasis in a Uruguayan population]

Ultrasound examinations were carried out in 693 volunteers from the health care personnel of the Hospital de Clinicas of Montevideo, with the aim of studying the prevalence of gallbladder gallstones in Uruguay, the proportion of symptomatic and asymptomatic people and its association to some definite risk factors. The prevalence found was 10.4

, which, according to the samples size, is representative of the general population with a confidence of 99

. Sixty five per cent of gallstones carriers were asymptomatic. A statistically significant association with the following factors was found: people between 31 and 50 years old, slight obesity, and, for women, to have children. A marked tendency with the following factors was found, though it was not statistically significant: female sex, and a familiar history of mother carrying gallstones. Considering all these factors as a whole, the probability of having gallstones reached 19

. Results are discussed and compared with those of foreign publications. It is concluded that uruguayan people with more possibilities of having gallstones are: women between 31 and 50 years old, obese, with children, and whose mother has or had the same disease.

Prevalencia de litiasis vesicular en una población uruguaya. / [Prevalence of gallbladder lithiasis in a Uruguayan population]

Ultrasound examinations were carried out in 693 volunteers from the health care personnel of the Hospital de Clinicas of Montevideo, with the aim of studying the prevalence of gallbladder gallstones in Uruguay, the proportion of symptomatic and asymptomatic people and its association to some definite risk factors. The prevalence found was 10.4

, which, according to the samples size, is representative of the general population with a confidence of 99

. Sixty five per cent of gallstones carriers were asymptomatic. A statistically significant association with the following factors was found: people between 31 and 50 years old, slight obesity, and, for women, to have children. A marked tendency with the following factors was found, though it was not statistically significant: female sex, and a familiar history of mother carrying gallstones. Considering all these factors as a whole, the probability of having gallstones reached 19

. Results are discussed and compared with those of foreign publications. It is concluded that uruguayan people with more possibilities of having gallstones are: women between 31 and 50 years old, obese, with children, and whose mother has or had the same disease.

[Hepato-splenic hemangiosarcoma: presentation of a clinical case]. / Hemangiosarcoma hepato-esplénico: aportación de un caso clínico.

A 65-year-old farmer who had used arsenic as a plaguicide for many years developed a hepatosplenic hemangiosarcoma with metastasis in the colonic serosa, mesentery and omental. The tumor was complicated with intraabdominal hemorrhage originated by spontaneous intraperitoneal rupture. The echographic and post-mortem findings are presented. This is the first case of hepatic hemangiosarcoma reported in Uruguay.