[Gastrointestinal bleeding caused by small bowel leiomyosarcoma]. / Hemorragia digestiva por leiomiosarcoma de intestino delgado.

The small bowel leiomyosarcoma is a infrequent tumour in the clinical practice. We report the case of a 50 year old male admitted to the hospital on two occasions for gastrointestinal bleeding. On the second occasion a push enteroscopy located in jejunum a tumour. The pathologic diagnosis was a low grade jejunal leiomyosarcoma. The patient required a surgical intervention with resection of the affected portion of the jejunum.

Immunohistochemical analysis of beta3 integrin (CD61): expression in pig tissues and human tumors.

CD61 is a membrane glycoprotein that associates with CD41 (alphaIIb) to form the heterodimeric complex gpIIb/IIIa (CD41/CD61), predominantly expressed in platelets and megakariocytes. CD61 or beta3 integrin also associates with alpha v (CD51) to form the vitronectin receptor, which is expressed in many tissues. We have used a monoclonal antibody against the porcine gpIIIa or CD61 (JM2E5) to study the distribution of this molecule in different normal pig tissues. As in humans, CD61 was broadly expressed in all tissues examined. In the kidney, strong expression of CD61 was observed in epithelial cells from renal tubules. In the testis, CD61 expression was detected in the Leydig cells. However, in liver, CD61 was weak or not detected. Many integrins are particularly involved in tumogenicity and in tumor progression mediating cell-cell interaction. Immunofluorescence experiments using cultured human tumor HeLa cells showed nuclear and cytoplasmic staining of mAb JM2E5. Immunohistochemical analysis of human tumor sections from several organs showed a heterogeneus distribution in metastatic cases from colon and breast carcinoma. However, no staining was found in metastasis from melanoma.

[Lactose malabsorption in patients with inflammatory bowel disease without activity: would it be necessary to exclude lactose products in the diet of all patients?]. / Malabsorción de lactosa en pacientes con enfermedad inflamatoria intestinal inactiva: ¿ está justificado excluir los productos lácteos a todos los pacientes?

INTRODUCTION: There are inflammatory bowel disease (IBD) patients avoid lacteal products without evidence of lactose malabsorption, probably because of incorrect patient perceptions and arbitrary advice from physicians and diet books. AIM: To evaluate the prevalence of lactose malabsorption in patients with IBP. METHOD: In 18 patients with Crohns disease and 24 with ulcerative colitis and 25 controls the prevalence of lactose intolerance, as measured by lactose breath hydrogen tests. RESULTS: Observed deficiencies of absorption of the lactose in 7 (16.6%) patients with IBP and 5 (20%) subjects control. CONCLUSIONS: Not all the patients with IBD are intolerant to the lactose by the suppression of the lacteal produts must not be generalized in the diet of these patients.

[Results of the latest generation dual-mobility cup in Spain (135 THAs followed-up for a mean of 32 months)]. / Resultados del cotilo con doble movilidad de última generación en España (135 PTC seguidas durante una media de 32 meses).

INTRODUCTION: This multi-center study (Cabuenes Hospital and Santa Lucia University Hospital) assessed the results of a retrospective and ongoing series of 135 total hip arthroplasties (THA) in which a latest generation dual-mobility cup was implanted. MATERIAL AND METHODS: A total of 135 THAs performed between 2005 and 2008 were analyzed. Mean follow-up was 32 months. The causes of surgery were: coxarthrosis in 31.8% and hip fracture in 68.1%. Mean age was 82.1 years. All patients were seen at regular follow-up visits for clinical and radiological assessments. RESULTS: The follow-up lasted over 24 months in 121 THAs (14 patients died). In the most recent follow-up, in May 2011, 119 cups did not show any loosening. Complications were as follows: 2 postoperative dislocations; 4 DVTs; 3 infections; 5 periprosthetic fractures; 2 loosened cups, and one subsided stem. The mean preoperative Harris Hip Score (HHS) was 45, 83; the mean postoperative HHS was 80.03. Only two of the 135 cups analyzed had radiographic modifications without clinical signs. Isolated cup survival at 12 months was 97.03% (87.3-99.2) with a 95% confidence interval; survival at 5 years was 96.7% (85.4-98.8). DISCUSSION: In our study, the new dual-mobility cup showed good results for the following indications: primary coxarthrosis and femur neck fractures. CONCLUSION: The complication rate in our series was similar to the one reported in other series in the literature, except for dislocation. The latter was considerably less frequent (1.48%) in our series compared to the rates reported by the classical series, especially in patients with neuromuscular or cognitive problems (one third of patients).

Resultados del cotilo con doble movilidad de última generación en España (135 PTC seguidas durante una media de 32 meses) / Results of the latest generation dual-mobility cup in spain (135 THAs followed-up for a mean of 32 months)

Introducción: En este estudio multicéntrico (Hospital de Cabueñes y Hospital Universitario Santa Lucía) se evalúan los resultados de una serie retrospectiva y continua de 135 PTC realizadas implantando un cotilo doble movilidad de nueva generación. Material y métodos: Se estudiaron 135 PTC intervenidas entre 2005 y 2008. El seguimiento medio fue de 32 meses. Las causas de la cirugía fueron 31.8% coxartrosis y 68.1% fracturas de cadera. La edad media era de 82.1 años. Todos los pacientes eran revisados periódicamente haciendo una valoración clínica y radiográfica. Resultados: El seguimiento pudo ser realizado durante más de 24 meses en 121 PTC (14 pacientes fallecidos). En la última revisión, mayo 2011: 119 cótilos no presentaban aflojamiento. Las complicaciones fueron: 2 luxaciones postquirúrgicas; 4 TVP; 3 infecciones PTH; 5 fracturas peri PTC; 2 aflojamientos cetilo y 1 hundimiento vástago. HHS preoperatorio medio: 45, 83 y postoperatorio medio: 80, 03. De los 135 cotilos revisados sólo dos presentaban modificaciones radiográficas sin signos clínicos. La supervivencia aislada del cótilo a los 12 meses fue 97.03% (87.3-99.2) con un intervalo de confianza del 95% y a los 5 años, un 96.7% (85.4-98.8). Discusión: En nuestro estudio el nuevo cótilo doble movilidad ha mostrado buenos resultados en las siguientes indicaciones: coxartrosis primaria y fracturas de cuello de fémur. Conclusión: Las complicaciones obtenidas en esta serie aparecen en el mismo porcentaje que en otras series de la literatura excepto para la luxación. En ésta, el porcentaje (1.48%) era mucho más pequeño que el de las series clásicas, especialmente en los pacientes con problemas neuromusculares o cognitivos (un tercio de los pacientes).

Introduction: This multi-center study (Cabueñes Hospital and Santa Lucía University Hospital) assessed the results of a retrospective and ongoing series of 135 total hip arthroplasties (THA) in which a latest generation dual-mobility cup was implanted. Material and methods: A total of 135 THAs performed between 2005 and 2008 were analyzed. Mean follow-up was 32 months. The causes of surgery were: coxarthrosis in 31.8% and hip fracture in 68.1%. Mean age was 82.1 years. All patients were seen at regular follow-up visits for clinical and radiological assessments. Results: The follow-up lasted over 24 months in 121 THAs (14 patients died). In the most recent follow-up, in May 2011, 119 cups did not show any loosening. Complications were as follows: 2 postoperative dislocations; 4 DVTs; 3 infections; 5 periprosthetic fractures; 2 loosened cups, and one subsided stem. The mean preoperative Harris Hip Score (HHS) was 45, 83; the mean postoperative HHS was 80, 03. Only two of the 135 cups analyzed had radiographic modifications without clinical signs. Isolated cup survival at 12 months was 97.03% (87.3-99.2) with a 95% confidence interval; survival at 5 years was 96.7% (85.4-98.8). Discussion: In our study, the new dual-mobility cup showed good results for the following indications: primary coxarthrosis and femur neck fractures. Conclusion: The complication rate in our series was similar to the one reported in other series in the literature, except for dislocation. The latter was considerably less frequent (1.48%) in our series compared to the rates reported by the classical series, especially in patients with neuromuscular or cognitive problems (one third of patients).