Malignant Mesothelioma vs. Reactive Mesothelial Proliferations: Immunohistochemical Profile.

Aims: To examine the distribution of immunohistochemical markers GLUT-1, EMA (membrane epithelial antigen) and Ki-67 in benign and malignant mesothelial lesions. Thus, the sensitivity, specificity, positive and negative predictive value of these markers, used alone or in conjunction, was established. Study Design: Observational, retro-prospective and non-randomized study. Place and Duration of Study: Department of Pathology, Center for Medical Education and Clinical Research "Norberto Quirno" (CEMIC), between 2004 and 2011. Methodology: A total of 53 cases diagnosed as mesothelioma (n=15) or reactive mesothelial hyperplasia (n=38) were selected. Routine techniques using hematoxylineosin and immunostaining with EMA, GLUT-1, and Mib-1 were performed. Results: Mesotheliomas cohort was immunoreactive for GLUT-1 in 11/15 (73%) cases, and for EMA in 13/15 (87%) cases. The group of reactive lesions was positive for GLUT- 1 in 2/38 cases (5%), and positive for EMA in 7/38 (18%) cases. The median proliferation rate was 1% in benign lesions and 3% in mesotheliomas. The sensitivity and specificity for EMA was 87% and 82% respectively, with a positive predictive value of 65% and a negative predictive value of 94%. The sensitivity and specificity for GLUT-1 was 73% and 95% respectively, with a positive predictive value of 85% and a negative predictive value of 90%. Conclusion: EMA and GLUT-1 are sensitive and specific markers that express more frequently in mesothelioma than in benign mesothelial lesions with higher specificity in the case of GLUT-1 for the detection of malignant proliferations. In a mesothelial proliferation without invasion criteria, EMA and GLUT-1, including histopathology, may be sensitive and specific markers to define malignancy. Thus, a morphologically doubtful mesothelial proliferation with positive staining (diffuse and intense), for these antibodies could be a mesothelioma. However, the evidence of underlying tissue infiltration by mesothelial cells currently remains the gold standard for diagnosis of mesothelioma. Both markers should be included in the immunohistochemical panel to distinguish benign from malignant mesothelial lesions.

Expresión inmunohistoquímica de p53 en individuos con liquen / Immunohistochemical expression of p53 in individuals with lichen planus

Objetivo: Estimar el riesgo del potencial de malignización del liquen plano bucal analizando la expresión de la proteína p53. Materiales y metodos: Se realizó un diseño de cohorte de sujetos con diagnostico histopatológico de liquen. El desenlace fue el desarrollo de cáncer si/no. El total de individuos que cumplió con los criterios de inclusión/exclusión fue de 58. A los 58 sujetos se les realizó la determinación de p53. Resultados: Cuarenta y nueve individuos mostraron una expresión de p53 menor al 5% con una P>0,05% intrasujeto no transformado. En los 9 individuos transformados se observaron diferencias significativas entre la determinación pre y post de la proteína p53. El Riesgo Relativo fue de 188 con una significación estadística de P< 0,01. Conclusion: La expresión de la proteína p53 en los individuos con liquen apoya la hipótesis que niveles superiores al 5%constituye un factor de incremento del riesgo en la transformación maligna de esta patología. Nuestros hallazgos deberían ser corroborados en el futuro con mayor número de individuos. La determinación de la p53 mediante IHQ en individuos con liquen plano bucal podría modificar el seguimiento clínico de estos individuos. Esto permitiría un diagnóstico precoz de cualquier alteración que pueda indicar un posible cambio hacia la malignización.

Objective: To determine the risk for potential malignant transformation of oral lichen planus by analyzing protein p53 expression. Materials and methods: Cohort study of subjects with a histopathologic diagnosis of lichen. The study analyzed whether or not subjects developed cancer. A total of 58 subjects fulfilled the inclusion/exclusion criteria, and were analyzed for p53. Results: Fortynine(49) subjects showed a p53 expression <5%, with a p>0.05 among subjects undergoing no transformation. In the 9 subjects undergoing malignant transformation, significant differences were observed between pre and post p53 expression. The relative risk was 188, with a statistical significance of p< 0.01. Conclusions: Protein p53 expression in subjects with lichen supports the hypothesis that levels >5% are associated with an increased risk of malignant transformation of this condition. Should our findings be proved in a larger series in the future, the clinical follow-up of these subjects could be modified. This would allow an early diagnosis of any disorder indicative of a potential malignant transformation.

La medicina molecular: ¿es una utopía pensar en su aplicación clínica? / The molecular medicine: is it an utopia to think in it clinical application?

In order to know better the diagnostics and the physiopathology of molecular, it's necessary to incorporate molecular biology techniques to an important group of illnesses, some of them are infectious pathologies and genetic illnesses. The knowledge of human metabolic ways or the specific enzymes that can be of molecular basis of the several man pathologies, is the molecular medicine. Actually, at least exist three lines that use the molecular biology in order to understand medical problems. These main lines are: 1. hereditary illnesses, II. viral and bacteriology diagnoses, and III. identification and the studies of paternity

Control de terapia anticoagulante oral en el Hospital Clínico de la Universidad de Chile: informe preliminar / Control of oral anticoagulant therapy in the clinical hospital of Universidad de Chile: preliminar report

The data analysis of 202 patients in oral coagulant therapy, the indication of therapy, the hemorragic complications and the basis for an efficient therapy are analyzed

Prevalencia de parasitosis intestinal infantil en la comuna de Nueva Imperial - IX Región / Intestinal parasitosis prevalence in children at the Nueva Imperial community IX Región

Considerando la alta frecuencia de enteroparasitosis infantil en la IV zona biogeográfica se realizó una encuesta parasitológica entre Junio y Diciembre de 1987 a 126 niños de 1 a 14 años que concurrieron al Control de Salud en el Hospital de la Comuna de Nueva Imperial o algunas de sus Postas. En 67,4% de los menores el exámen coproparasitológico fue positivo y un 25,2% al Test de Graham. El protozoo más frecuente fue Giardia Lamblia (36,5%). Las geohelmintiasis ocupan el segundo lugar (18,2%), con incidencia similar para la ascaridiasis y la trichurasis. No hay diferencias significativas entre niños parasitados en cuanto a lugar de origen (rural o urbano)