Effect of dual modification with citric acid combined with ultrasonication on hydrolysis kinetics, morphology and structure of corn starch dispersions.

Corn starch dispersions (CSD) were hydrolyzed with citric acid and compared with CSD co-treated with citric acid combined with ultrasonication for 1 to 18 days, which are designated as single modification (CSD-SM) and dual modification (CSD-DM), respectively. The logistic functions monitor the dynamics of the hydrolysis advance (%) of the CSD-SM and CSD-DM as a function of time, where the zones most vulnerable to the single-treatment and/or co-treatment of the corn starch granules (CSG) are the amorphous or disordered regions. The characterization results of CSD-DM suggest that the structural changes caused by dual modification affected the morphology, sequence, and microstructure of the CSG. The heterogeneous changes caused by the dual modification changed the configuration of the CSG, generating a kind of destemming of the amorphous lamellae (depolymerization), an increase in the percentage of relative crystallinity of the CSD-DM and an active rearrangement of the intralamellar chains that promoted the relative amount of double helix for 18 days of double modification. The synergistic effect of the dual modification for CSD by the sequential combination of a chemical treatment followed by a physical one improved the hydrolyzed advance by 12 %, the relative crystallinity by 10 %, and the promotion of double helices by 25 % during 18 days of co-treatment.

[Seroprevalence of Toxoplasma gondii in students with occupational risk]. / Seroprevalencia de Toxoplasma gondii en estudiantes con riesgo ocupacional.

BACKGROUND: Toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world's most common parasites. The zoonotic infection usually occurs by eating undercooked contaminated meat or by contact with contaminated cat feces. A few studies of toxoplasmosis in healthy and immuno-compromised persons were done in Chile, but investigations related to occupational risk groups, such as Veterinary Medicine students were not studied. AIM: Determine the seroprevalence for T. gondii in Veterinary Medicine students at a university located in the center-south of the country, and evaluated to association with intrinsic variables. METHODS: Peripheral blood samples were taken from 74 veterinary students from a university in south-central Chile. Immunoassay with sequential chemiluminescent was used as diagnostic technique. RESULTS: Of the total number of students, 16 were seropositive, which is equivalent to 21.6%, the largest number of seropositive students was female (75%), they were in the age range between 24 and 26 years of age (43.7%), all consumed meat and vegetables (100%) and collected pet cat feces without protection 50 (68,7%). CONCLUSIONS: The results obtained show the presence of antibodies against T. gondii in Veterinary Medicine students. To the authors' knowledge, it is the first serological study for toxoplasmosis performed in university students of Veterinary Medicine in Chile.

Seroprevalencia de Toxoplasma gondii en estudiantes con riesgo ocupacional / Seroprevalence of Toxoplasma gondii in students with occupational risk

INTRODUCCIÓN: La toxoplasmosis es una enfermedad zoonótica cuyo contagio se produce por vía oral por ingestión de quistes al consumir carne contaminada o al tener contacto con heces de felinos contaminadas con ooquistes. Con menor frecuencia, se adquiere por transmisión vertical o por trasplante de órganos infectados. En Chile, existen estudios serológicos en personas sanas e inmunodeprimidas, pero no en grupos de riesgo ocupacional, como son los estudiantes de Medicina Veterinaria. OBJETIVO: Determinar la seroprevalencia para T. gondii en estudiantes de Medicina Veterinaria de una universidad ubicada en el centro-sur del país, y ver su asociación con variable intrínsecas. MÉTODOS. Se tomaron muestras de sangre a 74 estudiantes de una universidad del centro-sur de Chile. Se determinó la presencia de anticuerpos específicos clase IgG contra Toxoplasma gondii mediante la técnica de inmunoanálisis por quimioluminiscencia en fase solida secuencial. RESULTADOS. Del total de alumnos, 16 fueron seropositivos lo que equivale a 21,6%, el mayor número de estudiantes seropositivos fue de sexo femenino (75%), se encontraban en el rango etario entre 24 y 26 años de edad (43,7%), todos consumían carne y verduras (100%) y realizaban la recolección de heces de gatos sin protección 50 (68,7%). CONCLUSIONES. Los resultados obtenidos demuestran la presencia de anticuerpos contra T. gondii en alumnos de Medicina Veterinaria. Según el conocimiento de los autores, es el primer estudio serológico para toxoplasmosis realizado en estudiantes universitarios de Medicina Veterinaria en Chile.

BACKGROUND: Toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world's most common parasites. The zoonotic infection usually occurs by eating undercooked contaminated meat or by contact with contaminated cat feces. A few studies of toxoplasmosis in healthy and immuno-compromised persons were done in Chile, but investigations related to occupational risk groups, such as Veterinary Medicine students were not studied. AIM: Determine the seroprevalence for T. gondii in Veterinary Medicine students at a university located in the center-south of the country, and evaluated to association with intrinsic variables. METHODS: Peripheral blood samples were taken from 74 veterinary students from a university in south-central Chile. Immunoassay with sequential chemiluminescent was used as diagnostic technique. RESULTS. Of the total number of students, 16 were seropositive, which is equivalent to 21.6%, the largest number of seropositive students was female (75%), they were in the age range between 24 and 26 years of age (43.7%), all consumed meat and vegetables (100%) and collected pet cat feces without protection 50 (68,7%). CONCLUSIONS: The results obtained show the presence of antibodies against T. gondii in Veterinary Medicine students. To the authors' knowledge, it is the first serological study for toxoplasmosis performed in university students of Veterinary Medicine in Chile.

Assessment of Serum sRANKL, sRANKL/OPG Ratio, and Other Bone Turnover Markers with the Estimated 10-Year Risk of Major and Hip Osteoporotic Fractures in Rheumatoid Arthritis: A Cross-Sectional Study.

BACKGROUND: Fracture risk assessment tool (FRAX) index was developed for estimating of the 10-year risk of major or hip osteoporotic fracture. To date, there is insufficient information regarding the correlation between FRAX and serum bone turnover markers (BTMs), such as soluble ligand of receptor activator of nuclear factor-κB (sRANKL), osteoprotegerin (OPG), and other molecules related with secondary osteoporosis in rheumatoid arthritis (RA). Therefore, this study is aimed at assessing the correlation between the FRAX and serum levels of sRANKL, OPG, sRANKL/OPG ratio, Dickkopf-1 (DKK-1), and sclerostin (SOST) in RA. METHODS: Cross-sectional study included 156 postmenopausal women with RA. Bone mineral density (BMD) was measured at lumbar spine (L1-L4) and total hip using dual-energy X-ray absorptiometry (DXA). RA patients were divided into (A) RA + osteoporosis and (B) RA without osteoporosis. FRAX scores were calculated including the total hip BMD. Serum sRANKL, OPG, DKK-1, and SOST levels were measured by ELISA. Pearson tests were used for assessing the correlation between serum levels of these molecules and FRAX scores in RA. RESULTS: The RA + osteoporosis group had elevated sRANKL levels (p = 0.005), higher sRANKL/OPG ratio (p = 0.017), decreased DKK-1 (p = 0.028), and lower SOST levels (p < 0.001). Low total hip BMD correlated with high sRANKL (p = 0.001) and sRANKL/OPG ratio (p = 0.005). Total hip and lumbar spine BMD correlated with DKK-1 (p = 0.009 and p = 0.05, respectively) and SOST levels (p < 0.001 and p < 0.001, respectively). Higher sRANKL levels and sRANKL/OPG ratio correlated with estimated 10-year risk of a major osteoporotic fractures (p = 0.003 and p = 0.003, respectively) and hip fracture (p = 0.002 and p = 0.006, respectively). High serum SOST levels were associated with a low estimated 10-year risk of a major osteoporotic fracture (p = 0.003) and hip fracture (p = 0.009). CONCLUSION: High sRANKL levels and sRANKL/OPG ratio can be useful to detect a subgroup of RA patients who has an increased 10-year risk of major and hip osteoporotic fractures.

Antimicrobial activity of graphite oxide doped with silver against Bacillus subtilis, Candida albicans, Escherichia coli, and Staphylococcus aureus by agar well diffusion test: Synthesis and characterization.

In the present study, graphite oxide, graphite oxide doped with 0.8 g AgNO3 named GrO-0.5Ag, and graphite oxide doped with 1.25 g AgNO3 named GrO-1.0Ag (silver-doped graphitic materials) were synthesized by the modified Hummers and chemical doping methods. Subsequently, its antimicrobial activity against Bacillus subtilis, Candida albicans, Escherichia coli, and Staphylococcus aureus microorganisms was evaluated by agar well diffusion test with 1 and 2 mg·ml-1 of material concentrations. The silver-doped graphitic materials were characterized by X-Ray Diffraction, Fourier-Transform Infrared, Raman, X-Ray Photoelectron spectroscopies, and Scanning Electron Microscopy. The GrO-0.5Ag material showed a percentage of inhibition effect of 86, 82, 48, and 45% with respect to the positive control for Staphylococcus aureus, Bacillus subtilis, Escherichia coli, and Candida albicans microorganisms, respectively. Otherwise, the GrO-1.0Ag material showed a percentage of inhibition effect of 54% with respect to the positive control for Bacillus subtilis and less than 50% for the other microorganisms. The material concentrations showed a slight change in the percentage of inhibition effect for all microorganisms. Graphite oxide functional groups, small crystal size, free silver ions, and silver carbonate formation in silver-doped graphitic materials presented a viable alternative to inhibit bacterial growth.

A consensus linkage map identifies genomic regions controlling fruit maturity and beta-carotene-associated flesh color in melon (Cucumis melo L.).

The nutritional value and yield potential of US Western Shipping melon (USWS; Cucumis melo L.) could be improved through the introgression of genes for early fruit maturity (FM) and the enhancement of the quantity of beta-carotene (QbetaC) in fruit mesocarp (i.e., flesh color). Therefore, a set of 116 F(3) families derived from the monoecious, early FM Chinese line 'Q 3-2-2' (no beta-carotene, white mesocarp) and the andromonoecious, late FM USWS line 'Top Mark' (possessing beta-carotene, orange mesocarp) were examined during 2 years in Wisconsin, USA to identify quantitative trait loci (QTL) associated with FM and QbetaC. A 171-point F(2-3) based map was constructed and used for QTL analysis. Three QTL associated with QbetaC were detected, which explained a significant portion of the observed phenotypic variation (flesh color; R (2) = 4.0-50.0%). The map position of one QTL (beta-carM.E.9.1) was uniformly aligned with one carotenoid-related gene (Orange gene), suggesting its likely role in QbetaC in this melon population and putative relationship with the melon white flesh (wf) gene. Two major (FM.6.1 and FM.11.1; R (2) >or= 20%) and one minor QTL (FM.2.1; R (2) = 8%) were found to be associated with FM. This map was then merged with a previous recombinant inbred line (RIL)-based map used to identify seven QTL associated with QbetaC in melon fruit. This consensus map [300 molecular markers (187 co-dominant melon and 14 interspecific; 10 LG)] provides a framework for the further dissection and cloning of published QTL, which will consequently lead to more effective trait introgression in melon.

Mapping of genetic loci that regulate quantity of beta-carotene in fruit of US Western Shipping melon (Cucumis melo L.).

Melon (Cucumis melo L.) is highly nutritious vegetable species and an important source of beta-carotene (Vitamin A), which is an important nutrient in the human diet. A previously developed set of 81 recombinant inbred lines (RIL) derived from Group Cantalupensis US Western Shipper market type germplasm was examined in two locations [Wisconsin (WI) and California (CA), USA] over 2 years to identify quantitative trait loci (QTL) associated with quantity of beta-carotene (QbetaC) in mature fruit. A moderately saturated 256-point RIL-based map [104 SSR, 7 CAPS, 4 SNP in putative carotenoid candidate genes, 140 dominant markers and one morphological trait (a) spanning 12 linkage groups (LG)] was used for QbetaC-QTL analysis. Eight QTL were detected in this evaluation that were distributed across four LG that explained a significant portion of the associated phenotypic variation for QbetaC (R (2) = 8 to 31.0%). Broad sense heritabilities for QbetaC obtained from RIL grown in WI. and CA were 0.56 and 0.68, respectively, and 0.62 over combined locations. The consistence of QbetaC in high/low RIL within location across years was confirmed in experiments conducted over 2 years. QTL map positions were not uniformly associated with putative carotenoid genes, although one QTL (beta-car6.1) interval was located 10 cM from a beta-carotene hydroxylase gene. These results suggest that accumulation of beta-carotene in melon is under complex genetic control. This study provides the initial step for defining the genetic control of QbetaC in melon leading to the development of varieties with enhanced beta-carotene content.

Detection of QTL for yield-related traits using recombinant inbred lines derived from exotic and elite US Western Shipping melon germplasm.

The inheritance of yield-related traits in melon (Cucumis melo L.; 2n = 2x = 24) is poorly understood, and the mapping of quantitative trait loci (QTL) for such traits has not been reported. Therefore, a set of 81 recombinant inbred lines (RIL) was developed from a cross between the monoecious, highly branched line USDA 846-1 and a standard vining, andromonoecious cultivar, 'Top Mark'. The RIL, parental lines, and three control cultivars ('Esteem', 'Sol Dorado', and 'Hales Best Jumbo') were grown at Hancock, WI and El Centro, CA in 2002, and evaluated for primary branch number (PB), fruit number per plant (FN), fruit weight per plant (FW), average weight per fruit (AWF), and percentage of mature fruit per plot (PMF). A 190-point genetic map was constructed using 114 RAPD, 43 SSR, 32 AFLP markers, and one phenotypic trait. Fifteen linkage groups spanned 1,116 cM with a mean marker interval of 5.9 cM. A total of 37 QTL were detected in both locations (PB = 6, FN = 9, FW = 12, AWF = 5, and PMF = 5). QTL analyses revealed four location-independent factors for PB (pb1.1, pb1.2, pb2.3, and pb10.5), five for FN (fn1.1, fn1.2, fn1.3, fn2.4, and fn8.8), four for FW (fw5.8, fw6.10, fw8.11, and fw8.12), two for AWF (awf1.3 and awf8.5), and one for PMF (pmf10.4). The significant (P

Validación del método mispho para el diagnóstico de leucemias agudas / Mispho's diagnostic method validation for acute leukemia: premio a la mejor teis, Facultad de Bioquimica 2000

Pregunta de investigación. Cuáles son los valores de sensibilidad, especificidad y valores predictivos de las pruebas morfológicas, citoquímicas e inmunofenotipo desarrolladas en el método MISPHO para el diagnóstico de Leucemias Agudas en sujetos de ambos sexos en todo grupo etário?.Objetivos. Determinar los valores de sensibilidad especificidad y valores predictivos de las pruebas morfológicas, citoquímicas e inmunofenotipo desarrolladas en el método MISPHO para el diagnóstico de Leucemias Agudas en sujetos de ambos sexos en todo grupo etáreo. Conocer a través de estadisticas descriptivas el comportamiento de otras variables en estudio. Diseño. Test diagnóstico. Lugar. Unidad de Biología Molecular, Instituto de Genética, Fac. Medicina, UMSA. Poblacón 44 casos y 20 controles por cálculo muestral en ambos sexos y de grupos etáreos diverso y que realizaron sus exámenes hematológicos en la Unidad mencionada. Métodos. Se recolectó médula ósea para realizar las pruebas morfológica, citoquímica, inmunofenotipo y determinación de daños moleculares, se llenó una hoja de registro con datos personales, antecedentes generales y parámetros hematológicos. Se utilizó estadítica descriptiva, test de significancia, t-test, chi2, tablas de contingencia de 2x2. Resultados. Se observó que no existe asociación sexo-enfermedad con P de 0,279. No existe diferencia entre los promedios de edad de los pacientes con la enfermedad con P de 0, 652. La sensibilidad del método para el diagnóstico de leucemia linfoblástica es de 100 por ciento, especialidad 100 por ciento, valores predictivos positivos y negativos 100 por ciento. La sensibilidad del método para el diagnóstico de leucemia mieloide es de 83 por ciento, especialidad 100 por ciento, valor predictivo positivo 100 por ciento y valor predictivo negativo 90 por ciento La sensibilidad, especialidad y valores predictivos tanto negativo como positivo del método MISPHO global son del 100 por ciento. Conclusiones.Los métodos utilizados son altamente sensibles y especificos, así mismo los valores predictivos compueban que el método MISPHO es válido y aplicable para el diagnóstico de Leucemias Agudas con la aplicación de recursos minimos.

Leucemia neutrofílica crónica asociada a leucemia cutánea: reporte de un caso clinico / Vhronic neutrophilic leukemia asociated with leukemia cutis: case report

Se describe un caso de leucemia neutrofílica crónica asociada a leucemia de piel, en una paciente de 49 años de edad, sexo femenino, diagnosticada en julio de 2001; con presencia de 43.605/mm3 neutrófilos en sangre periférica y médula ósea hipercelular con serie granulocítica hiperplástica. el estudio histopatológico de la piel reveló infiltrado del 70 porciento de blastos tipo mieloide. Fue tratada con hidroxiurea, siendo favorable la resuesta clínica y laboratorial. el hemograma de diciembre de 2001 presentó 5.656/mm3 neutrófilos.

Leucemia Eosinofilica: reporte de un caso clínico / Eosinophilic leukemia: on pourpose of a case

Se describe un caso de leucemia eosinofilica en niñade 11 años sin alteraciones croosómicas, en fase de crisis blástica. Con cuadro clínico de compromiso gastrointestinal cutáneo, asociado a 21216 eosinófilos/mL en sangre periférica en un infiltrado del 60porciento en médula ósea.

Alteraciones en el patron de apoptosis de celulas precursoras de eritrocitos en mujeres postmenopausicas con eitrocitosis patológica de la altura / Alteration in the Apoptosis pattern of erithocytes precursors Cells of postmenopausic women with high altitude erithrocytosis

Pregunta de investigación. ¿Existe alteraciones en el patrón de apoptisis de células precursoras de eritrocitos en mujeres postmenaopausicas con ertitrocitosis patológicas de la altura?. Objetivo. Determinar la existencia de alteraciones en el patrón de apoptosis de células precursoras de eritrocitos en mujeres postmenopausicas con eritrocitosis patológica de la altura. Diseño Corte transversal. Lugar. unidad de Biologia Molecular Paolo Belli, Instituto de Genética, Facultad de Medicina, UMSA. Poblacion. dos pacinetes mujeres postmenopausicas diagnosticadas con EPA según criterio clínico- laboratoriales, sin sobrepeso ni enfermedades cardiacorrespiratorias, no fumadoras y que no recibian tratamiento hormonal. El grupo control estuvo conformado por 4 mujeres de iguales características sin EPA. Metodos. Las células nononucleadas de la médula ósea fueron separadas en medio LSD y se cultivaron en medios líquidos en presencia y ausencia de Eritropoyetina. De estos cultivos se recuperaron las células a 1, 2, 7 y 14 días de ultivo, a partir de estas células se realizaron 2 frotis para la evaluación de la apoptosis por morfologia y el remanente celular fue empleado en el anális de la formación del DNA degradado. Finalmente los resultados fueron sujeto de test de significancia. Resultados. La morfología y el DNA degraado detectaron un retardo de patrón de apoptosis, de los progenitores eritroides, en las dos pacientes con EPA estudiadas; donde el porcentaje de células apoptosis tiende a mantenerse constante en función del tiempo, en lugar de incrementarse, como ocurre en los controles (p,00). el patrón de apoptosis en los controles es EPO dependiente, observandose una diferencia significativa ente los cultivos con y sin EPO (p0,00); mientras que en los pacientes es no EPO dependiente (p0,23). Conclusiones. El patron de aptosis modificado en los pacientes es indicativo de la presencia de alteraciones en la sobrevivencia celular y el incremento de la tasa de producción de progenitores eritroides durante la deferenciación EPO dependiente, posblemente sean factores etiopatogénicos de la eritrocitosis.

Total therapeutic paracentesis (TTP) with and without intravenous albumin in the treatment of cirrhotic tense ascites: a randomized controlled trial.

We studied 35 cirrhotic patients with tense ascites assigned at random into two groups: Group I consisted of 17 patients treated by total therapeutic paracentesis (TTP) (6-15 l) plus i.v. albumin (5 g/l of fluid) and Group II consisted of 18 patients treated by TTP (5.5-15.5 l) without albumin. On 19 patients we performed a sequential assessment of cardiac output (CO), plasma renin activity (PRA) and plasma aldosterone (PA). Both groups were similar in age, sex, and etiology of cirrhosis. CO, PRA and PA values were expressed as mean changes occurring in relation to their respective baseline values. CO changes after TTP (l/min): Group I: 2.5 after 6 h and 2.2 after 12 h; Group II: 2.2 after 6 h and -0.4 after 12 h, (p < 0.05 comparing values after 12 h between the two groups). PRA changes after TTP (ng/dl/h): Group I: -7.4 after 1 h, -7.8 after 6 h and -3.2 after 24 h; Group II: -2.4 after 1 h, -0.8 after 6 h and 3.9 after 24 h (p < 0.05 comparing values between both groups after 6 and 24 h). PA changes after TTP (ng/dl): Group I: -50.5 after 1 h, -36.7 after 6 h and -34.6 after 24 h; Group II: -18.2 after 1 h, -2.2 after 6 h and 20 after 24 h, (p < 0.05 comparing values between both groups after 1 and 6 h). Complications were minimal in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Autologous adrenal medullary transplants in advanced Parkinson's disease with particular attention to the selective improvement in symptoms.

Ten patients with advanced Parkinson's disease, presenting with tremor, rigidity and akinesia had autologous adrenal medullary transplantation taken from the left adrenal gland to the head of the right caudate nucleus. Particular attention was taken to avoid prolonged exposure of the adrenal tissue before transplantation and to separate the medullary from the cortical adrenal tissues. Postoperative CT scans confirmed the correct position of the transplants. Differences between pre- and 1-year postoperative clinical conditions were statistically evaluated, with patients under medical (L-dopa) treatment and after the medication was temporarily discontinued. Performance of motor tasks was tested to differentiate slowness of movements imposed by excessive muscular tension (rigidity) from that secondary to delayed reaction time to sensory demands (akinesia). Two deaths occurred 35 and 69 day after surgery for causes not related to the surgical procedures. One of those patients had remained stable neurologically and the other had deteriorated to progressive dementia and catatonia. At autopsy, no lesions in the CNS other than those expected from the surgical procedure were evident, and histological examination failed to reveal chromaffin cells in the head of the right caudate nucleus. Evaluation of the 8 cases that survived for 1 year revealed no significant improvement in their clinical or motor task performance, when considered as a group. However, cases with mild akinesia did better than cases with moderate to advanced akinesia, suggesting that transplantation is indicated in cases with rigidity, but not in cases with 'negative' symptoms of Parkinson's disease. All cases required postoperative medication.

Monthly injectable steroid contraceptives and cervical carcinoma.

The World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives is a large multinational hospital-based case-control study of steroid contraceptives and gynecologic, hepatobiliary, and mammary neoplasms. Monthly injectable steroid contraceptives which contained the long-acting progestogen dihydroxyprogesterone acetofenide plus a shorter-acting estrogen (usually estradiol enanthate) were used by women in two of the countries (Chile and Mexico) from which data were collected. In preliminary analyses of data from Chile (1979-1983), a strong association was observed between use of these products and invasive cervical cancer. Therefore, three additional data sets from these two countries were analyzed in further detail for this report. Analyses of additional data from Chile on invasive cervical cancer (1983-1985) and cervical carcinoma in situ (1979-1986) and of data on invasive cervical cancer from Mexico (1979-1986) failed to confirm the initially observed association. The original finding was probably due to chance, but a causal interpretation cannot be confidently ruled out, and additional studies are warranted.

Pelvic exenteration for carcinoma of the cervix: analysis of 252 cases.

We present the results of 252 pelvic exenterations for primary and recurrent carcinoma of the cervix at the Hospital General de Mexico, a tertiary-care institution for the indigent. Emphasis is placed on the morbidity and mortality of the procedure in relation to patient selection. In underdeveloped countries, where early detection of cervical cancer is a rare event, pelvic exenteration must continue in the armamentarium of physicians; it can be associated with gains in the quality of life, with long-term survival, with effective rehabilitation, and possibly with cures.

High-altitude paragangliomas diagnostic and therapeutic considerations.

Forty-one cervical paragangliomas that occurred in 40 patients born and living in Mexico City, Mexico, were studied. Tumors were most common in women (38/40); were unilateral (39/40), without a side preference; were of the nonhereditary type; and were not malignant. Tumor imaging with radionucleaide angiographic scanning was noninvasive, innocuous, and reliable for screening, whereas selective carotid angiography allowed for definitive diagnosis and clinical stratification of patients. Surgical resection was performed in 29 patients; in 23 cases, en bloc resection was accomplished without a vascular compromise, whereas in 4 patients, a portion of the external carotid artery had to be ligated and resected. Two other patients required a vascular graft to restore blood flow to the internal carotid. Seven patients had postoperative transient cranial nerve palsies, and one had an incomplete hemiplegia. Permanent nerve damage occurred in seven patients. It was concluded that high-altitude paragangliomas are hyperplastic growths that result from adaptation to hypoxia. They are rarely true neoplasm and, in general, are not associated with functional loss. In view of this and of the high morbidity rate associated with surgical removal, it was recommended that these patients be referred to research centers where efforts toward the elucidation of the etiology and pathophysiology of these tumors can be carried out. Surgery should be reserved for symptomatic cases or cases in which the diagnosis remains in doubt. The decision to operate must weigh the following factors: The tumor's benign nature, its slow growth rate, the technical difficulties associated with its resection, the high postoperative morbidity rate, and the general condition of the patient.

Neoplasias epiteliales malignas del ovario. Analisis de 242 casos. / Malignant epithelial neoplasms of the ovary. Analysis of 242 cases

Se presenta un estudio clinico y terapeutico de un grupo de pacientes con neoplasias epiteliales malignas del ovario revisadas en un lapso de 15 anos, destacandose la mayor frecuencia observada entre los 40 y los 60 anos, y la baja fertilidad encontrada en el 40% de ellas. Se llevan a cabo consideraciones terapeuticas y se analizan los factores que en una o en otra forma intervienieron en el prognostico de los 200 casos tratados durante este lapso, haciendose notar que el 37% de los casos evoluciono 30 meses como promedio sin evidencia clinica de cancer (67% de las etapas I, 29% de las II, 22% de las III y 6% de las IV). Desde el punto de vista pronostico, se resaltan los mejores resultados obtenidos en el grupo que recibio un tratamiento integral y multidisciplinario, en aquellas pacientes tratadas con panhisterectomia y omentectomia mas radioterapia externa al abdomen y a la pelvis, y en quienes recibieron un tratamiento combinado con quimioterapia.tratamiento combinado con quimioterapia