Lesión fibrótica en cicatriz de mastectomía: ¿estamos ante una recidiva? / Fibrotic lesion in a mastectomy scar: is this a recurrence?

El uso de la radioterapia para el cáncer de mama ha mejorado sustancialmente las tasas de supervivencia para esta enfermedad1;sin embargo, una consecuencia de esto son las complicaciones inducidas por el tratamiento en pacientes que cada vez son máslongevas. Décadas después de la irradiación de la pared torácica, puede desarrollarse una osteomielitis inducida por la radiaciónde inicio muy tardío, causada por osteorradionecrosis2. Es una complicación sumamente infrecuente pero descrita en la literatura. (AU)

The use of radiation therapy for breast cancer has substantially improved survival rates for this disease1; however, one consequenceof this is treatment-induced complications in patients who are increasingly living longer. Decades after chest wall irradiation, verylate-onset radiation-induced osteomyelitis, caused by osteoradionecrosis, can develop2. This is a very rare but a described complication in the literature. (AU)

Evidence for the presence of a bacterial endosymbiont in the pecan scab pathogen Venturia effusa (basyonym: Fusicladium effusum).

AIMS: To determine whether Venturia effusa, the causative fungal agent of pecan scab, harbours a bacterial symbiont. METHODS AND RESULTS: Venturia effusa isolates were maintained on potato dextrose agar amended with antibiotics (chloramphenicol (100 µg ml-1 ) and tetracycline 100 (µg ml-1 )). Genomic DNA extracted from mycelia was used to target eubacterial 16S rDNA. A 1·4-kbp PCR amplified product using 16S rDNA degenerate primers was cloned, sequenced and found to have 99% identities with Actinobacteria representatives. Attempts to culture the detected bacteria apart from the fungus following agitation and fungal cell lysis were unsuccessful using standard bacteriological media under either aerobic or anaerobic conditions. Fungal structures were visualized using scanning electron microscopy and putative bacterial formations associated with the fungal mycelia were observed. Fluorescence in situ hybridization using 16S rDNA oligonucleotides illuminated spores and portions of the hyphae. CONCLUSIONS: This is the first report to provide both molecular microbiological and microscopic evidence in support of the hypothesis that V. effusa harbours endosymbiotic bacteria. SIGNIFICANCE AND IMPACT OF THE STUDY: Findings from this research contribute fundamental information regarding the biology of the fungus that may ultimately lead to identifying a target of the pathogen for use in management and/or avoidance strategies.

Repercusión de la resonancia magnética nuclear mamaria en el tratamiento final del cáncer de mama / Impact of breast magnetic resonance imaging on the final treatment of breast cancer

Objetivo: Conocer la capacidad de la resonancia magnética nuclear mamaria preoperatoria para valorar su influencia en el tratamiento final del cáncer de mama. Material y métodos: Incluimos a las pacientes diagnosticadas de carcinoma de mama infiltrante o carcinoma ductal in situ en el Hospital Nuestra Señora de Gracia de Zaragoza entre enero de 2010 y diciembre de 2013. Todas ellas tenían estudios con mamografía o ecografía y fueron operadas en el mismo centro del diagnóstico con el estudio anatomopatológico final como «prueba de oro». Resultados: En un 40% de las pacientes, la resonancia provocó un cambio del tratamiento final. En un 8% de las pacientes el cambio fue no relevante, ya que se aumentó el margen de la cirugía conservadora en 1cm como máximo. En el 32% del total de pacientes, en las que sí que consideramos que la resonancia influyó de una manera significativa en la modificación del tratamiento, el cambio más frecuentemente realizado fue de cirugía conservadora a mastectomía. Conclusiones: La resonancia nuclear magnética mamaria determina de una forma más correcta el tratamiento final del cáncer de mama con una tasa de 4,45% de falsos positivos

Objective: To determine the utility of preoperative breast magnetic resonance imaging (MRI) and its influence on the final treatment of breast cancer. Material y methods: We included patients with a diagnosis of breast cancer between January 2010 and December 2013 in Nuestra Señora de Gracia Hospital in Zaragoza (Spain). All patients had undergone mammography and/or ultrasound and underwent surgery in the centre where they received their diagnosis. The final pathological study was taken as the gold standard. Results: In 40% of patients, magnetic resonance imaging led to a change in the final treatment. In 8% of the patients, the change was not relevant, because the margin of conservative surgery was increased by 1cm or less. magnetic resonance imaging significantly influenced a change of treatment in 32% of the patients, the most frequent change being a switch from conservative surgery to a mastectomy. Conclusions: Breast magnetic resonance imaging was the most useful technique in selecting the final treatment of breast cancer with a false-positive rate of 4.45%

Enfermedad granulomatosa crónica / Chronic granulomatous disease

Resumen La enfermedad granulomatosa crónica es una enfermedad genéticamente heterogénea caracterizada por infecciones bacterianas recurrentes y fúngicas que se distinguen por la formación de granulomas. Su frecuencia en Estados Unidos es de aproximadamente 1:250,000 nacidos vivos. Es causada por defectos en el fagocito nicotinamida adenina dinucleótido fosfato oxidasa (NADPH), que constituye el fagocito oxidasa (phox). Estos defectos genéticos dan como resultado la incapacidad de los fagocitos (neutrófilos, monocitos y macrófagos) para destruir ciertos microbios. El diagnóstico se realiza mediante pruebas de función de los neutrófilos, y luego el defecto exacto se determina por genotipo. Las infecciones son causadas generalmente por microorganismos catalasa-positivos. Los sitios frecuentes de infección son los pulmones, la piel, los ganglios linfáticos y el hígado. La formación de granulomas es especialmente un problema en el tubo gastrointestinal y el aparato genitourinario. La enfermedad granulomatosa crónica puede aparecer en cualquier momento desde la infancia hasta la adultez, pero la mayoría de los pacientes son diagnosticados antes de los cinco años de edad, por lo que se destaca la importancia clínica de este caso ocurrido en un adulto mayor.

Abstract Chronic granulomatous disease (CGD) is a genetically heterogeneous condition characterized by recurrent, life-threatening bacterial and fungal infections and granuloma formation. The frequency of CGD, in the United States is approximately 1:250,000 live births. CGD is caused by defects in the phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, which constitutes the phagocyte oxidase (phox). These genetic defects result in the inability of phagocytes (neutrophils, monocytes, and macrophages) to destroy certain microbes. The diagnosis is made by neutrophil function testing, and then the exact defect is determined by genotyping. Infections are generally caused by catalase-positive micro-organisms (most bacterial and all fungal pathogens are catalase positive). The frequent sites of infection are lung, skin, lymph nodes, and liver. The formation of granulomata is especially problematic in the gastrointestinal and genitourinary tracts. May present at any time from infancy to late adulthood, but the majority of patients are diagnosed as toddlers and children before the age of five years. Whereby emphasis is made on the clinical significance of this case, which occurs in an older adult.

Síndrome de Bartter como causa de polihidramnios severo. A propósito de un caso / Bartter syndrome as a cause of severe polyhydramnios. Apropos of a case

El síndrome de Bartter es una rara enfermedad congénita que afecta a los túbulos renales. Se presenta el caso de una paciente que comenzó en la semana 32 con polihidramnios severo de aparición brusca, como única manifestación de esta enfermedad, diagnosticada posnatalmente

Bartter syndrome is a rare congenital disease that affects the renal tubules. We describe the case of a patient with abrupt onset of severe polyhydramnios at 32 weeks of gestation as the only clinic manifestation of this disease, which was diagnosed postnatally

Cotton (Gossypium hirsutum L.) boll rotting bacteria vectored by the brown stink bug, Euschistus servus (Say) (Hemiptera: Pentatomidae).

AIM: To determine the capacity of the brown stink bug (BSB) (Euschistus servus) to transmit an infective Pantoea agglomerans strain Sc 1-R into cotton (Gossypium hirsutum) bolls. METHODS AND RESULTS: A laboratory colony of BSB was maintained on fresh green beans. Either sterile or Sc 1-R contaminated beans were offered to adult insects. Strain Sc 1-R holds rifampicin resistance (Rif(r) ). Insects were then caged with unopened greenhouse-grown bolls. After 2 days, BSB were surface sterilized, ground, and then plated on media with and without Rif. Two weeks later, seed with lint were ground and plated on media with and without Rif. Microbes were recovered on nonselective media from all BSBs and from seed/lint at concentrations reaching 10(9)  CFU g(-1) tissue. Rif(r) bacteria were recovered strictly from insects exposed to Sc1-R and from diseased seed/lint of respective bolls. CONCLUSIONS: Euschistus servus was capable of transmitting strain Sc 1-R into bolls resulting in disease. Insects not exposed to the pathogen deposited bacteria yet the nonpathogenic microbes produced insignificant damage to the boll tissue. SIGNIFICANCE AND IMPACT OF STUDY: This is the first study to concretely show the capacity of the BSB to transmit an infective P. agglomerans strain resulting in boll disease.

Síndrome de Bartter como causa de polihidramnios severo. A propósito de un caso / Bartter syndrome as a cause of severe polyhydramnios. Apropos of a case

El síndrome de Bartter es una rara enfermedad congénita que afecta a los túbulos renales. Se presenta el caso de una paciente que debutó en la semana 32 con polihidramnios severo de aparición brusca, como única manifestación de esta enfermedad, diagnosticada posnatalmente

Bartter syndrome is a rare congenital disease that affects the renal tubules. We describe the case of a patient with onset of severe polyhydramnios at 32 weeks of gestation, as the only clinic manifestation of this disease, which was diagnosed postnatally

An alternative explanation for cyanobacterial scum formation and persistence by oxygenic photosynthesis.

The cause of persistent cyanobacteria scum formation in lakes is an unresolved subject. Scum refers to the event in which cyanobacteria are at the water surface of a lake. Factors like low turbulence levels, long day-light, high water temperatures and the buoyant capacity of cyanobacterial cells play a role in the occurrence of scums. However, they do not explain why scums are observed at periods during the day when according to theory they should have disappeared into the deeper water layers. In this study, we present an alternative explanation. The hypothesis we present here is that irreversible buoyancy of cyanobacteria colonies is created by the growth of gas bubbles on or within the mucilage of the colonies. These bubbles grow under oxygen super-saturated conditions. At low wind speed and high chlorophyll levels, the dissolved oxygen (DO) produced during photosynthesis by cyanobacteria, cannot escape sufficiently fast to the atmosphere hence a DO supersaturated condition arises in the water. At this stage, growth of oxygen bubbles may occur inside or attached to the mucilage. We present results of compression experiments to support our hypothesis. In a chamber, the pressure on lake water containing a natural cyanobacteria population is increased. At 3×105 and 4×105Pa the cyanobacteria colonies were not able to float anymore and sank. This pressure is lower than the 106Pa needed to collapse all gas vacuoles inside the cyanobacteria cells (Walsby, 1994). The observed change from floating to sinking colonies due to increased water pressure suggests that gas bubbles were present inside the colonies. In lakes, these gas bubbles may lead to permanent buoyancy, i.e. a persistent scum.

¿Qué prueba de imagen determina más correctamente el tamaño tumoral en el cáncer de mama? / Which imaging test determines more corectly tumor size in breast cáncer?

Objetivos: Determinar la capacidad de la RNM, la ecografía y la mamografía preoperatorias para evaluar la extensión de cáncer de mama, comparando el tamaño dado por la anatomía patológica definitiva con el tamaño estimado por la mamografía, la ecografía y la resonancia magnética. Material y Métodos: Incluimos a las pacientes con diagnóstico de carcinoma de mama infiltrante o carcinoma ductal in situ en el Hospital nuestra Señora de Gracia de Zaragoza entre enero 2010 y diciembre 2013. A todas ellas se les realizó estudios con mamografía y/o ecografía, así como RNM y fueron operadas en el mismo centro del diagnóstico con el estudio anatomopatológico final como "prueba de oro". Resultados: Utilizando el criterio de diferencias menor o igual a 5 mm con respecto al tamaño patológico final, la técnica de RNM tuvo mejor acuerdo con la anatomia patologica con un 90,90% de los tamaños correctamente estimado, en comparación con 54,30% de la mamografía y el 47,20% de la ecografía. Las infravaloraciones fueron más frecuentes en el caso de la mamografía y ecografía y las sobreestimaciones al usar la RNM mamaria. Conclusiones: La RNM de mama fue la técnica que mejor se correlacionó con el tamaño del tumor final dado por la histología. La mayor precisión de la resonancia magnética en comparación con la mamografía o ecografía en la evaluación del tamaño del tumor se produce independientemente de la densidad mamaria, la edad de las pacientes y con cualquier patrón histológico, pero existe una alta influencia en el caso de carcinoma in situ asociado

Objective: To determine the ability of preoperative breast MRI, mammography and ultrasound to evaluate the final tumor size of breast cancer, comparing the final pathological size withe the size estimated by mammography, ultrasound and MRI. Methods: We included patients diagnosed with carcinoma infiltrating breast or ductal carcinoma in situ in the Hospital "Nuestra Señora de Gracia" of Zaragoza, between January 2010 and December 2013. They all had studies with mammography and / or ultrasound and MRI and were operated on the center of diagnosis with the final pathological study as "gold standard". Results: Using the criterion of less than or equal to 5 mm difference with respect to pathologic size, the MRI technique was better agreement with the pathology with 90.90% of matched sizes, compared to 54.30% of matched sizes by mammography and ultrasound 47.20%. If no agreement, the undervaluation on mammography and ultrasound and MRI in breast overstatements were more frequent. Conclusions: The breast MRI was the technique that best correlated with final tumor size given by histology. The increased accuracy of MRI compared to mammography or ultrasound in the assessment of tumor size occurs in breasts of any kind (breast density) of patients with any age and with any histological pattern, but high in situ tumors associated

Ingestion of a marked bacterial pathogen of cotton conclusively demonstrates feeding by first instar southern green stink bug (Hemiptera: Pentatomidae).

Long-held dogma dictates that first instars of Nezara viridula (L.) do not feed, yet recent observations of stylet activity within a food source suggest otherwise. As a cosmopolitan pest of cotton and other high-value cash crops, confirmation of feeding by first instars may ultimately influence the knowledge on biology and management strategies for this pest. To determine whether first instars feed, newly hatched nymphs were provided sterile green beans (control) or beans infected with a rifampicin-resistant marked bacterial pathogen (Pantoea agglomerans (Ewing and Fife)) of cotton. Insects were exposed to beans for 2 d, and feeding was confirmed based on detection of marked bacteria ingested by the insect. Normal bacterial flora was detected in all insects; however, control insects did not possess the marked bacteria. Of the first instars surviving on infected beans, ≍65% possessed the marked bacteria internally. Furthermore, the frequency of insects with marked bacteria was higher in insects collected directly from the bean surface than those that were off the bean at time of collection. Densities of innate and marked bacteria were comparable (both ranging from 10(1) to 10(3)), suggesting that the marked bacteria did not exclude preexisting bacterial flora. Marked bacteria were also detected in a subset of second instars, indicating marked bacteria were retained through the molting process after ingesting bacteria as first instars. Our findings conclusively demonstrate feeding by first instars and redefine the long-held perspective of nonfeeding by first instars. These findings may necessitate changes to crop protection strategies against feeding and vectoring of plant pathogens by N. viridula.

Mastopatía diabética: lesión poco conocida que simula un cáncer de mama / Diabetic mastopathy: a little-known lesion mimicking breast carcinoma

La mastopatía diabética es una complicación poco frecuente y poco conocida de la diabetes mellitus, que puede simular un cáncer de mama. La forma más frecuente de presentación es un nódulo indoloro de consistencia pétrea y de márgenes irregulares. Los resultados de las pruebas diagnósticas de imagen son inespecíficos, siendo imprescindible para su diagnóstico el estudio anatomopatológico que pondrá de manifiesto fibrosis estromal asociada a ductitis, lobulitis y vasculitis linfocítica. Presentamos el caso de una paciente diabética tipo 1 de 33 años de evolución que consultó por un nódulo en la mama, el cual fue sometido a estudio mamográfico y ecográfico, con diagnóstico de lesión sospechosa de malignidad (BIRADS IV ). Se realizó una biopsia con aguja gruesa y el resultado anatomopatológico fue compatible con mastopatía diabética. (AU)

Diabetic mastopathy is an uncommon complication that usually occurs in patients with longstanding diabetes mellitus. This entity often presents as a palpable hard and irregular mass that mimics breast carcinoma. Imaging features are nonspecific and a histological diagnosisis required to exclude malignancy. The pathological features of diabetic mastopathy show densekeloid-like fibrosis associated with lymphocytic ductulitis, lobulitis and vasculitis. We report the case of a woman with a longstanding history of insulin-dependent diabetes mellitus and a hard, painless and irregular mass in her breast. Mammography and ultrasound examination showed a suspicious lesion (BIRADS IV). Sonographically-guided core biopsy of the mass was performed and pathological features revealed fibrosis compatible with diabetic mastopathy (AU)

Micrometástasis en el ganglio centinela del cáncer de mama. Revisión de literatura / Sentinel lymph node metatases in breast cancer. Review of literature

OBJETIVO. El resultado de micrometástasis y células tumorales aisladas como única expresión de extensión linfática de un cáncer de mama es algo relativamente frecuente. Actualmente se plantea la posibilidad de no realizar la linfadenectomía axilar tras el hallazgo histológico de una micrometástasis en la biopsia de ganglio centinela, por la baja frecuencia de afectación del resto de los ganglios axilares y el aumento significativo de morbilidad de dicha técnica. MATERIAL Y MÉTODOS. Se incluyen todas las pacientes sometidas a biopsia de ganglio centinela durante los años 2010 y 2011 en el Hospital Universitario Río Hortega de Valladolid. En todos los casos de macro y micrometástasis se realizó una linfadenectomía posterior para valorar el grado de afectación axilar. RESULTADOS. En el año 2010 se intervinieron en el HURH de Valladolid 126 casos de cáncer de mama, de los cuales 77 (65%) fueron candidatas para la realización de la biopsia de ganglio centinela, obteniéndose 47 negativos, 16 positivos para macrometástasis, 9 micrometástasis, 3 células tumorales aisladas y en 2 casos no hubo migración del trazador. En el año 2011 se operaron 140 casos de cáncer de mama, de los cuales 102 casos (73%) sometidas a biopsia de ganglio centinela, obteniéndose 77 negativos, 13 positivos para macrometástasis, 7 micrometástasis, 2 células tumorales aisladas y en 3 casos no hubo migración del trazador lo que obligó a realizar la linfadenectomía clásica. Durante estos dos años se realizó linfadenectomía posterior en todos los casos de afectación del ganglio centinela con macro y micrometástasis y no se realizó con ganglios negativos y células tumorales aisladas. En el caso de las micrometástasis no se objetivó afectación de ningún otro ganglio linfático en la disección axilar. DISCUSIÓN. Según los datos de nuestra actividad quirúrgica, la disección axilar de las pacientes con afectación del ganglio centinela por micrometástasis podría evitarse (AU)

AIM. The result of micrometastases and isolated tumor cells as the only expression of lymphatic spread of breast cancer is relatively frequent. The possibility of avoiding complete axillary lymphadenectomy in those patients who are only affected by micrometastasis is proposed because of the low incidence of further involvement of the remaining lymph nodes and the significant increase in morbidity of the technique. MATERIAL AND METHOD. We included all patients undergoing sentinel node biopsy during the years 2010 and 2011 at Hospital Universitario Rio Hortega. Complete axillary lymphadenectomy was performed when micro or macrometastases were found in the sentinel node, in order to determine the degree of axillary involvement.RESULTS. In 2010 126 breast cancers were operated in the HURH from Valladolid. 77 (65%) have benefited from the use of axillary sentinel node biopsy, which 47 were negative, 16 were affected by macrometastasis a, 3 isolated tumor cells and 9 by micrometastasis. In 2 cases there was no migration. In 2011, 140 breast cancer were operated in our hospital, and 102 (73%) were able to performed sentinel node biopsy. 77 were negative, 13 positive, 2 with isolated tumor cells and 7 micrometastasis. In 3 cases there was no migration. Complete axillary lymphadenectomy was performed when micro o macrometastases were found in the sentinel node. There was no other axillary lymph node involved in patient with micrometastasis. DISCUSSION. It is possible to speculate that, in the future, axillary dissection can be avoided in those patients diagnosed of micrometastasis in the sentinel node (AU)

Adenopatía axilar tumoral como manifestación de recidiva del cáncer de ovario / Axillary lymph node as manifestation of recurrent ovarian cancer

El cáncer de ovario es el tumor ginecológico que presenta mayor mortalidad. La vía de diseminación más frecuente de esta neoplasia es por vía intraperitoneal, aunque pueden aparecer metástasis a distancia por diseminación hematógena a otros órganos de la cavidad abdominal. La aparición de adenopatías axilares metastásicas de un carcinoma de ovario es un hallazgo muy infrecuente. Debe realizarse un diagnóstico diferencial con otro tipo de tumores, fundamentalmente el carcinoma mamario, ya que el tratamiento y el pronóstico resultan muy diferentes. Presentamos el caso de una mujer de 60 años sometida a un tratamiento quirúrgico y quimioterápico por un adenocarcinoma seroso de alto grado (estadio IIIC de la FIGO). Tras 15 meses de la cirugía presenta una adenopatía axilar izquierda sospechosa que se somete a PAAF con diagnóstico de metástasis de carcinoma ovárico. Al mismo tiempo presenta nuevo episodio de carcinomatosis peritoneal (AU)

Ovarian cancer is the gynecological tumor with higher mortality. The way of spread of this tumor most often is intraperitoneal, although distant metastases may occur by hematogenous via to other organs in the abdominal cavity. The appearance of metastatic axillary lymph nodes from ovarian carcinoma is a very rare finding. You should have a differential diagnosis with other tumors, mainly breast carcinoma, since treatment and prognosis is very different. We report a 60 years patient under both surgical and chemotherapy treatment for high-grade serous adenocarcinoma (FIGO stage IIIC). After 15 months of the surgery has left axillary adenopathy suspicious subjected to FNA diagnosis of metastatic ovarian carcinoma. At the same time new episode of peritoneal carcinomatosis occurs (AU)

Fármacos utilizados en reproducción asistida y riesgo de cáncer de mama / Drugs used in assisted reproduction technology and risk of breast cancer

Desde las últimas décadas se ha visto incrementado el uso de fármacos en el ámbito de la esterilidad; dicho uso ha incrementado de modo paralelo el número de los recién nacidos al año mediante técnicas de reproducción asistida en parejas estériles. Debido a la conocida hormonodependencia de algunos de los cánceres, y considerando al cáncer de mama como un clásico modelo de tumor hormono dependiente, este aumento suscita una alarma razonable por los posibles efectos carcinogénicos de dichos fármacos, ya que aumentan el valor de las hormonas gonadales endógenas. En este trabajo, se ha pretendido revisar los estudios llevados a cabo sobre este tema, para lo cual se ha realizado una búsqueda bibliográfica de los últimos15 años en Pubmed y artículos relevantes de las principales revistas científicas. Como conclusión se puede afirmar que se necesitaría un seguimiento más prolongado y un diseño correcto de los trabajos (con una potencia estadística y una población adecuadas), y puntualizar el tipo de esterilidad y el tipo de fármacos y dosis de cada caso (AU)

The use of fertility drugs has greatly increased in the last few decades, leading to a parallel increase in the number of infants born as a result of assisted reproduction technology in sterile couples. However, because some tumors are hormone dependent– and considering breast cancer as a classical model of a hormone-dependent tumor – the increase in the use of this kind of drug raises reasonable doubts about possible carcinogenic adverse effects, as these agents increase endogenous gonadal hormone levels. The present article reviews the studies carried out on this subject. A literature search of articles published in the previous 15 years was performed in Pubmed and bibliographic references were retrieved from relevant articles published in the main scientific journals. We conclude that further studies with longer follow-up periods and more meticulous designs (with greater statistical power and adequate populations)are required. Such studies should specify details on the type of sterility in each patient, as well as the type of drug used and the dose (AU)

Transmission of cotton seed and boll rotting bacteria by the southern green stink bug (Nezara viridula L.).

AIMS: To determine the ability of the southern green stink bug (SGSB) (Nezara viridula L.) to transmit Pantoea agglomerans into cotton (Gossypium hirsutum) bolls. METHODS AND RESULTS: An SGSB laboratory colony was kept on fresh green beans. A P. agglomerans variant resistant to rifampicin (Rif) (strain Sc 1-R) was used as the opportunistic cotton pathogen. Adult insects were individually provided green beans that were sterilized and then soaked in either sterile water or in a suspension of strain Sc 1-R. Insects were individually caged with an unopened greenhouse-grown cotton boll. After 2 days, live SGSB were collected, surfaced sterilized, ground, serially diluted, and then plated on nonselective media and media amended with Rif. Exterior and interior evidence of feeding on bolls was recorded 2 weeks after exposure to insects. Seed and lint tissue were harvested, ground, serially diluted, and then plated on media with and without Rif. Bacteria were recovered on nonselective media from all insects, and from seed and lint with signs of insect feeding at concentrations ranging from 10(2) to 10(9) CFU g(-1) tissue. The Sc 1-R strain was isolated only from insects exposed to the marked strain and from seed and lint of respective bolls showing signs of insect feeding. Evidence of insect feeding on the exterior wall of the carpel was not always apparent (47%), whereas feeding was always observed (100%) on the interior wall in association with bacterial infections of seed and lint. CONCLUSIONS: Nezara viridula readily ingested the opportunistic P. agglomerans strain Sc 1-R and transmitted it into unopened cotton bolls. Infections by the transmitted Sc 1-R strain caused rotting of the entire locule that masked internal carpel wounds incurred by insect feeding. Bacteria were recovered from penetration points by insects not exposed to the pathogen, but locule damage was limited to the area surrounding the feeding site (c. 3 mm). SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study that demonstrates the ability of SGSB to acquire and transmit plant pathogenic bacteria into cotton bolls.

Role of Pantoea agglomerans in opportunistic bacterial seed and boll rot of cotton (Gossypium hirsutum) grown in the field.

AIMS: To investigate the aetiology of seed and boll rot of cotton grown in South Carolina (SC). METHODS AND RESULTS: Bacteria were isolated from diseased locules of cotton bolls collected in a field in SC, USA and tested for the ability to cause comparable disease symptoms in greenhouse grown cotton fruit. Spontaneously generated rifampicin-resistant (Rif(r)) mutants of the isolates were used in confirmatory pathogenicity tests. Resistance to the antibiotic was both stable and effective in differentiating between an inoculated Rif(r) strain, rifampicin-sensitive contaminants and/or endophytes. A series of inoculation methods was tested at various boll developmental stages and at different fruiting nodes on the plant. Field disease symptoms were reproduced by inoculating bolls at 2 weeks postanthesis with bacterial suspensions ranging from 10(3) to 10(6) CFU ml(-1). Pathogenic isolates were categorized as Pantoea agglomerans on the basis of phenotype testing, fatty acid profiling (similarity index = 0.94), and 16s ribosomal DNA sequence analysis (99% nucleotide identity). CONCLUSIONS: Pantoea agglomerans isolates from field-collected immature, diseased cotton caused comparable infection symptoms in greenhouse produced cotton fruit. SIGNIFICANCE AND IMPACT OF THE STUDY: In 1999, significant yield losses in SC cotton resulted from a previously unobserved seed and boll rot that has since been reported in other southeastern states. This study demonstrated a role of P. agglomerans in producing opportunistic bacterial seed and boll rot of cotton.

Adenocarcinoma primario de vagina / Primary adenocarcinoma of the vagina

El carcinoma primario de vagina es un tumormuy infrecuente. Más del 90% son tumoresde células escamosas, que deben ser diferenciadosdel 5% de adenocarcinomas, ya que éstosúltimos tienen un peor pronóstico, con mayortendencia de recidiva local y a distancia. Eladenocarcinoma primario de células claras conpatrón papilar de vagina es extremadamenteraro dentro de estas neoplasias, por lo que presentamosel caso de una paciente con este tipode patrón histológico y recurrencia tras el tratamientocon cirugía y radioterapia.El pronóstico de estos tumores depende principalmentedel estadio de la enfermedad, localizacióny extensión de la lesión y éstos son losprincipales factores a considerar para plantearlas alternativas terapéuticas. Dada la baja frecuenciade esta enfermedad, no existe un protocolode tratamiento unánime. En general, la cirugíao la radioterapia son eficaces en estadiosiniciales, mientras que la radioterapia es el tratamientoprincipal en estadios avanzados. Tampocoexiste consenso de actuación frente a loscasos de recidiva tumoral local

Primary carcinoma of the vagina is an uncommom tumor. More than 90% are squamous cell carcinomas and should be distinguised from 5% of adenocarcinomas which have a poor prognosis, with more tendency to local and metastatic recurrence. Primary clear cell adenocarcinoma with papillary pattern is an extremely rare case of these tumors so we present a case with this unusual histologic pattern and recurrence after surgical and radiation therapy treatment. Prognosis depends primarily on the stage of the disease, the localitation and extension of the lesion and these are the main factors to consider to plain the therapeutic alternatives. Due to the low frecuency of the disease, there is no generally accepted treatment protocol; surgery or radiation therapy is high effective in early stages, while radiation therapy is the primary treatment of more advanced stages. There is no consensus about the local recurrences treatment either

[Disseminated acute encephalomyelitis in children]. / Encefalomielitis aguda diseminada en niños.

INTRODUCTION: Disseminated acute encephalomyelitis (DAE) is an autoimmune inflammatory condition, usually monophasic with gradual resolution, polysymptomatic, usually in relation to a virus, bacteria or immunizations but may also occur in the absence of any obvious infection. OBJECTIVE: To describe DAE, its aetiology, clinical features, diagnosis and treatment. Also to analyze these aspects with regard to a series of 13 children with DAE. RESULTS: The clinical condition started with fever in 61% of the patients. The commonest neurological findings were sensory deterioration, convulsions and motor disorders (paresias). The cerebrospinal fluid was abnormal in four patients. MR showed hyperintense lesions of multifocal distribution, predominantly in the subcortical white matter. All patients were treated with intravenous methylprednisolone at a dose of 20 30 mg/kg. Clinical follow up showed complete recovery in 11/13 patients and mild sequelae in two cases. CONCLUSIONS: Diagnosis of DAE is based on suggestive clinical data and MR findings. MR is very sensitive in detecting demyelinating lesions and is the method of choice for confirmation of the diagnosis. DAE is characterized by a satisfactory clinical course with simultaneous resolution of the demyelinating lesions.