Carcinoma de mama en hombres: reporte de cuatro casos y revisión de la literatura / Breast neoplasms in men: report of four cases and literature revision

El carcinoma de mama en el hombre es infrecuente y representa el 1 por ciento de todos los cánceres de mama, De un total de 603 pacientes con carcinoma de mama en los últimos 6 años en el Hospital Universitario de Caracas tratamos en conjunto cuatro pacientes masculinos, que representaron el 0,66 por ciento. Sus edades variaron entre 25 y 73 años. De los factores de riesgo enunciados, dos de ellos presentaron ginecomastia y uno alcoholismo. En todos los casos el tumor se presentó retroareolar y con la misma histología (carcinoma ductal infiltrante). A todos se les practicó mastectomía radical modificada tipo Madden, seguida de radioterapia y tamoxifén, en tres de ellos se asocio quimioterapia. El carcinoma de mama en el hombre, es similar al de la mujer, sin embargo se presenta en pacientes más viejos y estadios más avanzados. Los factores pronósticos más fuertes son: tamaño del tumor, tiempo de aparición de los síntomas hasta su tratamiento y los ganglios asilares. El tratamiento sugerido es las mastectomía radical modificada, seguida de radioterapia. Los tumores responden muy bien a la hormonoterapia y puede usarse la quimioterapia

Effect of blood pH on pulmonary artery pressure, left atrial pressure and fluid filtration rate in isolated rabbit lung.

To determine the effects of pH changes on Pulmonary Artery Pressure (PAP), 18 isolated rabbit lung preparations, perfused with autologous blood mixture and constant PaCO2 have been studied. Each preparation was studied under 3 conditions: Baseline: 30 minutes equilibration period. Acidosis: pH was decreased by 0.2 N HCl infusion, the ventilatory rate was changed and different CO2 mixtures were used to maintain the PCO2 within the initial parameters. Compensated Acidosis (CA): pH was returned to normal values by 0.7 N NaHCO3 infusion maintaining PCO2 in its initial values. The decrease in pH (acidosis) from 7.36 +/- 0.05 to 7.18 +/- 0.06 at constant PCO2, generated a significant increase in PAP (13.6 +/- 3.2 cm H2O to 18.8 +/- 5.2 cm H2O, p < 0.01). The pH increase (CA) from 7.18 +/- 0.06 to 7.40 +/- 0.09 caused the PAP to decrease (18.8 +/- 5.2 cm H2O to 15.9 +/- 4.2 cm H2O); the fluid filtration rate remained unchanged during the whole experiment. It is concluded that blood pH changes at constant PCO2 result in significant changes of PAP. Acidemia produces pulmonary vasoconstriction, which may be a contributing factor in the genesis of pulmonary hypertension in clinical conditions with increased hydrogen ion concentration [H+].

[Colonic polyps. Experience at a clinical center in Caracas]. / Polipos del colon. Experiencia en un centro clínico de Caracas.

After six years experience in the anatomopathological study and having checked 33.452 histological cases 772 corresponded to colon tumoral pathology. It was then decided to proceed with the epidemiological analysis of the polyps, it's anatomical distribution according to sex and age, it's histolopathological characteristics and the possible relationship with malignant transformation. We found a clear predominance mainly of adenomatosic neoplasic polyps, followed by hyperplasic polyps. 65% of the patients were male and more than half of the cases were between the ages of 50 and 70. Coincitentally, 86% of the atypical polyps were found within this age group.

[Colonic tumors: experience at a clinical center in Caracas]. / Tumores de colon: experiencia en un centro clínico de Caracas.

During a period of six years, 33.452 histopathological studies were reviewed among which were found 285 cases with malignant neoplasm of the colon. 69% of the patients were between fifty and sixty years of age. The diagnosis of colonic adenocarcinoma was positive in 90.17% of the cases. 58.9% of the tumors were localized in the rectum and sigmoid. The remaining 41.06% of the tumors were not subject to rectosigmoidoscopy. The epidemiological analysis was made. Most of the patients were found with locally advanced cancer with a predominance of poor differentiated tumours, which represents a complex challenge to the surgeon.

[Adenosquamous carcinoma of the colon. Report of 2 cases and review of the literature]. / Carcinoma adenoescamoso de colon. Reporte de dos casos y revisión de la literatura.

The adenosquamous carcinoma of colon is an uncommon neoplasia, it only represents 0.1% of all carcinomas of colon. We report two new cases, that are added to the 39 reported in the medical literature. The pathogenesis and the biologic behavior of this variety are revised.

[Effect of the administration of intralipid on liquid filtration rate and pressure of the pulmonary artery in isolated lung of rabbits]. / Efecto de la administración de Intralipid en la tasa de filtración de líquido y en la presión de la arteria pulmonar en el pulmón aislado de conejo.

INTRODUCTION: We study the effect on Intralipid on pulmonary circulation. METHODS: A 10% infusion of Intralipid was administered at a dose of 0.5/kg in 14 isolated rabbit lungs in which constant blood flow infusion was carried out principally in zone 3. The liquid filtration rate (LFR) and the mean pressure of the pulmonary artery were measured. RESULTS: A constant increase of mean pressure of the pulmonary artery was observed following the infusion (from 12.32 +/- 3.66 cm of H2O to 39.92 +/- 07.68 cmH2O (p < 0.01) which was associated to a significant increase in the rate of liquid filtration (from 0.018 +/- 0.01 g/min to 0.198 +/- 0.04 g/min; p < 0.01). CONCLUSIONS: The administration of Intralipid produces a statistically significant increase of mean pressure of the pulmonary artery and the rate of liquid filtration. This is probably caused by vasoconstriction due to metabolic changes produced by Intralipid on pulmonary circulation.

[Juvenile dermatomyositis. Clinical and epidemiologic experience]. / Dermatomiositis juvenil. Experiencia clínica y epidemiológica.

27 cases with a diagnosis of Juvenile Dermatomyositis were studied from a total of 1307 patients who suffered from connective tissue diseases; 19 of which met the diagnosis criteria of Bohan and Peters. Females were the most frequently affected. 52.63% of the cases presented the first symptoms between 5 and 9 years of age. Skin lesions, debility in inferior extremities and fever were the most frequent motives of consultation. The Aldolase and LDH were the muscular enzymes whose values increased in the majority of the cases. The electromyography was more sensible than the muscular biopsy in the diagnosis of the disease. We suggest that the epidemiologic and clinical characteristics found in our study should be taken into account for further accurate diagnosis of Juvenile Dermatomyositis in Venezuela.