Expanded criteria donors, histological scoring, and prolonged cold ischemia: impact on renal graft survival.

The use of expanded donors or kidneys with preexistent chronic damage remains controversial, but they offer the opportunity to expand the donor pool. We investigated the impact of these conditions as predictors of graft survival among a cohort of recipients with prolonged cold ischemia times and a high incidence of delayed graft function. We included 70 consecutive cadaveric kidney allografts implanted between 2001 and 2005, which had undergone an early graft biopsy. Delayed graft function was present in 84% of cases with moderate or severe preexistent chronic damage in 63% and 27% of biopsies, respectively, and acute rejection was diagnosed in 14.3% of overall cases. The graft survival was 73.3% at 48 months. Primary nonfunctioning kidneys were more frequent using kidneys from expanded compared with standard donors (20.0% vs 0.0%, P < .002). Multivariate analysis showed that only the donor condition (standard vs expanded) was independently associated with graft survival (hazard ratio: 0.12; 95% confidence interval: 0.01-0.87; P < .03). Our results suggested that the donor characteristics prevail over other variables to predict graft outcomes.

Neoplasias anexiales de la piel: Revisión histopatológica de 8 años de experiencia / Skin´s adnexal tumors: Histopathologic reviewof eight years of experience

Antecedentes: los tumores anexiales cutáneos representan un grupo heterogéneo de entidades de baja frecuencia de presentación, que puede plantear ciertas dificultades diagnósticas para el patólogo general. Métodos: se realizó un estudio retrospectivo observacional, revisándose informes cuyo diagnóstico correspondía a tumores anexiales, realizados en la institución entre los años 2000 y 2007. Se utilizó la clasificación de tumores anexiales de la WHO del consenso del año 2003 en Lyon. De dichos informes, se registraron características como género y edad, localización, histopatología, márgenes y multicentricidad, entre otras. Resultados: fueron recolectados 200 informes correspondientes a 178 pacientes, encontrándose en 13 de ellos más de un tumor. El 50% era de sexo masculino. El 47% correspondía a tumores foliculares, el 42% a tumores ecrinos y apócrinos y el 11% a tumores sebáceos. El más frecuente de los tumores foliculares fue el pilomatrixoma (67%); entre los ecrinos y apócrinos, el siringoma (24%) y de los sebáceos se destacó el carcinoma (63%). El 84,5% correspondía a tumores benignos, el 12% a malignos y el 3,5% a tumores de potencial incierto. Entre los tumores ecrinos y apócrinos, se registró un predominio del sexo femenino y en los restantes del sexo masculino. Los tumores foliculares se presentaron a edades más tempranas y los sebáceos, a edades mayores. Todos ellos se localizaron principalmente en la región cefálica. Conclusión: nuestros resultados demostraron concordancia con la literatura consultada y confirmaron la heterogeneidad de dichos tumores en su presentación como biopsias cutáneas, a pesar de su baja frecuencia.

Introduction: skin´s adnexal tumors represent a heterogeneous group of lesions of low frequency of presentation, which can cause certain diagnostic difficulties for the general pathologist. Materials and methods: a retrospective study was carried out. The reports about adnexal tumors performed in the institution between the years 2000 and 2007 were revised. The Who classification of adnexal tumors from the consensus of 2003 in Lyon was used. The gender, age, localization, histopathology, margins and other characteristics of the biopsies were revised. Results: 200 reports were revised corresponding to 178 patients. 13 of them presented more than one tumor. 50% were men. Among all the reports, 47% corresponded to follicular tumors, 42% to apocrine and eccrine tumors and 11% to sebaceous tumors. Between the follicular ones, the pilomatricomas were the most common (67%), among apocrine and eccrine ones, were the syringomas (24%) and the sebaceous carcinomas (63%) were the principal diagnostic as regard sebaceous tumors. 84.5% were benign, 12% were malignant and 3.5% were of uncertain biological potential. There was a female predominance between the apocrine and eccrine tumors. The sebaceous and follicular tumors were more common in men. The follicular ones were diagnosed in earliest ages, in contraposition with the sebaceous ones, diagnosed in advanced ages. All of these tumors were more frequent in cephalic region. Conclusions: our results showed concordance with the literature and confirmed the heterogeneity of these tumors in their presentation as skin biopsies, in despite of their low frequency.

The development of a stress survey schedule for persons with autism and other developmental disabilities.

The Stress Survey Schedule is an instrument for measuring stress in the lives of persons with autism and other developmental disabilities. Development of the survey and analysis of the underlying measurement structure of the instrument is reported in three studies. Through the use of exploratory and confirmatory analysis procedures, eight dimensions of stress were identified: Anticipation/Uncertainty, Changes and Threats, Unpleasant Events, Pleasant Events, Sensory/Personal Contact, Food Related Activity, Social/Environmental Interactions, and Ritual Related Stress. These stress dimensions are highly relevant to the problems of autism and have not been addressed by other stress surveys. The information obtained from the Stress Survey can be used to plan for strategies to reduce the stress before it occurs or results in maladaptive behavior.

Intragraft expression of transforming growth factor-beta 1 by a novel quantitative reverse transcription polymerase chain reaction ELISA in long lasting kidney recipients.

BACKGROUND: Chronic allograft nephropathy (CAN) remains a major problem in clinical transplantation. It has been associated with increased transforming growth factor (TGF-beta1). Our goal was to correlate CAN and levels of TGF-beta1 by using a novel competitive quantitative for reverse transcription-polymerase chain reaction-ELISA (RT-PCR-ELISA) assay. METHODS: We studied 12 transplantation patients (posttransplant time: 36.5+/-11.2 months, range (r): 13-52) with stable creatinine and blood pressure and varied proteinuria. A Kidney biopsy was performed in all patients. Six patients with acute tubular necrosis (ATN) immediately after transplantation were used as controls. Histopathological evaluation was based on Banff working classification criteria. We designed an heterologous RNA competitor (IC) for RT-PCR-ELISA, which co-amplified with the same primer as TGF-beta1. Products were viewed on 96-well plates labeled with probes for IC at the desired sequence. RESULTS: Results were expressed as the number of TGF-beta1 copies/microg of total RNA. Six patients showed more than 1000 mg/24 hr proteinuria (2446+/-1421 mg/24 hr, r: 1200-5000) higher CAN Banff scores, and the other six presented <1,000 mg/24 hr (348+/-267 mg/24 hr, r: 114-800). This difference was significant (P=0.01). There were not significant differences in posttransplant time, creatinine, or blood pressure between groups. TGF-beta1 levels by RT-PCR-ELISA were statistically significant (6038+/-5317, r: 1239-12100 versus 177+/-119.7, r: 51-400, P=0.04). The control group showed levels of 228+/-111, r. 140-444, P=0.04) with significant difference only for the higher proteinuria group (P=0.03). CONCLUSIONS: This study showed that those patients with elevated CAN scores and higher proteinuria levels had higher TGF-beta1 intragraft expression.

[Breast carcinoma metastasis in ileum-colon and gallbladder simulating inflammatory diseases]. / Metástasis de carcinoma de mama en ileon-colon y vesicula biliar simulando enfermedades inflamatorias.

The metastasis in the extrahepatic digestive system are not very frequent and their characteristic is appearing after a long latent period, which takes 3 to 20 years, their symptoms are unspecific and appear to be inflammatory diseases or a second tumor. The most common histological subtype is the lobular carcinoma. Here we show you two cases of breast carcinoma metastasis, one in the ileum-colon and the other in the gallbladder. Both patient started showing symptoms, which led to the diagnosis was done in the surgical specimens where lobular carcinoma cells which infiltrated from the serosa to the mucosa were observed. The immunophenotype resulted to be BCA225, estrogen and progesterone positive. The treatment with radiotherapy, chemotherapy or hormonal therapy provides better life quality but the average chance of survival after the diagnosis is of a year.

Metástasis de carcinoma de mama en ileon-colon y vesicula biliar simulando enfermedades inflamatorias. / [Breast carcinoma metastasis in ileum-colon and gallbladder simulating inflammatory diseases]

The metastasis in the extrahepatic digestive system are not very frequent and their characteristic is appearing after a long latent period, which takes 3 to 20 years, their symptoms are unspecific and appear to be inflammatory diseases or a second tumor. The most common histological subtype is the lobular carcinoma. Here we show you two cases of breast carcinoma metastasis, one in the ileum-colon and the other in the gallbladder. Both patient started showing symptoms, which led to the diagnosis was done in the surgical specimens where lobular carcinoma cells which infiltrated from the serosa to the mucosa were observed. The immunophenotype resulted to be BCA225, estrogen and progesterone positive. The treatment with radiotherapy, chemotherapy or hormonal therapy provides better life quality but the average chance of survival after the diagnosis is of a year.

Serine acetyltransferase from Arabidopsis thaliana can functionally complement the cysteine requirement of a cysE mutant strain of Escherichia coli.

Serine acetyltransferase, a key enzyme in the L-cysteine biosynthetic pathway of sulfate assimilating organisms, catalyzes the formation of O-acetylserine, the immediate precursor of L-cysteine. In higher plants, it is thought that sulfur assimilation occurs primarily in leaf chloroplasts; however, serine acetyltransferase is not localized exclusively in this tissue and organelle. At least three genes for serine acetyltransferase have been identified in the higher plant Arabidopsis thaliana. Reported here is a cDNA corresponding to one of these genes, SAT1, a 1,079 bp clone with an open reading frame predicted to encode a 34-kDa protein that is able to functionally complement a serine acetyltransferase mutant strain of Escherichia coli. The predicted amino acid sequence of SAT1 shows significant homology with bacterial serine acetyltransferases. SAT1, expressed as a recombinant protein, shows serine acetyltransferase enzyme activity and cross-reacts with an antibody against the homologous E. coli enzyme. The first 40 amino acids of the SAT1 polypeptide resembles a plastid transit peptide, but the polypeptide is probably not plastid localized. Genomic DNA blot analysis of A. thaliana showed that SAT1 is a single copy gene and RNA blot analysis revealed that SAT1 is expressed in both leaves and roots.