Endoscopic submucosal dissection as treatment for early gastric cancer: Experience at two centers in Lima, Peru. / Disección submucosa endoscópica como tratamiento de cáncer gástrico temprano: experiencia en 2 centros de Lima, Perú.

INTRODUCTION AND AIMS: The aim of the present study was to evaluate the feasibility of endoscopic submucosal dissection (ESD) and determine the clinical and pathologic characteristics of early gastric cancers and premalignant lesions treated with that technique at the Hospital Nacional of the Department of Health and a private clinic in Lima, Peru. MATERIAL AND METHODS: A descriptive study of all pre-malignant and malignant gastric lesions treated with ESD at the Gastroenterology Service of the Hospital Arzobispo Loayza and the Clínica Angloamericana was conducted within the time frame of January 2012 and January 2017. RESULTS: A total of 13 lesions were resected through ESD: 8 adenocarcinomas (61.53%), 3 adenomas with high-grade dysplasia (23%), and 2 adenomas with low-grade dysplasia (15.38%). Twelve lesions (92.3%) were located in the lower third of the stomach. Slightly elevated lesions (Paris classification IIa) (4 lesions, 30.76%) and mixed slightly elevated lesions with a depressed component (IIa+IIc) (4 lesions, 30.76%) predominated. The mean size of the resected specimens was 35mm. Complete resection of all lesions was achieved in 11 cases (84.6%) and en bloc resection was carried out in 11 cases (84.6%). Resection was curative in 6 cases (75%), from the total of 8 resected adenocarcinomas. One case of perforation was the only complication reported (7.6%) and it was surgically resolved. CONCLUSIONS: The feasibility and efficacy of ESD for the treatment of early gastric cancer was demonstrated at two healthcare centers in Lima, Peru. The complication rate was similar to that reported in the international medical literature.

Genotoxic and anti-genotoxic properties of Calendula officinalis extracts in rat liver cell cultures treated with diethylnitrosamine.

Calendula officinalis flower extracts are used to cure inflammatory and infectious diseases, for wound healing and even cancer with partial objective evidence of its therapeutic properties or toxic effects, many of which can be attributed to the presence of flavonols. We studied whether C. officinalis extracts induce unscheduled DNA synthesis (UDS) in rat liver cell cultures, and if these extracts can reverse diethylnitrosamine (DEN)-induced UDS. Four different flower extracts were prepared: aqueous (AE), aqueous-ethanol (AEE), ethanol (EE) and chloroform (CE). AE and AEE were evaporated to 6.72 and 4.54 mg of solid material per ml, respectively and final ethanol concentration in AEE was 0.8%. EE and CE were dried and resuspended in dimethyl sulfoxide (DMSO) to 19.2 and 10 mg of solid material per ml. Ethanol residue of EE was 0.34%. In the UDS assay in liver cell cultures, DEN at 1.25 microM produced a maximal increase of 40% (3)H-thymidine ((3)HdTT) incorporation, and both, AE and AEE showed complete reversion of the DEN effect at around 50 ng/ml and between 0.4 to 16 ng/ml, respectively. In the absence of DEN, these two polar extracts induced UDS at concentrations of 25 microg for AE and 3.7 microg/ml for AEE to 100 microg/ml in rat liver cell cultures. Concentrations producing genotoxic damage were three orders of magnitude above concentrations that conferred total protection against the DEN effect. Thus, at the lower end, ng/ml concentrations of the two polar extracts AE and AEE conferred total protection against the DEN effect and at the higher end, g/ml concentrations produced genotoxic effects. These results justify the study of C. officinalis flower extracts to obtain products with biological activity and to define their genotoxic or chemopreventive properties.

Frequency of CCR5 delta-32 mutation in human immunodeficiency virus (HIV)-seropositive and HIV-exposed seronegative individuals and in general population of Medellin, Colombia.

Repeated exposure to human immunodeficiency virus (HIV) does not always result in seroconversion. Modifications in coreceptors for HIV entrance to target cells are one of the factors that block the infection. We studied the frequency of Delta-32 mutation in ccr5 gene in Medellin, Colombia. Two hundred and eighteen individuals distributed in three different groups were analyzed for Delta-32 mutation in ccr5 gene by polymerase chain reaction (PCR): 29 HIV seropositive (SP), 39 exposed seronegative (ESN) and 150 individuals as a general population sample (GPS). The frequency of the Delta-32 mutant allele was 3.8% for ESN, 2.7% for GPS and 1.7% for SP. Only one homozygous mutant genotype (Delta-32/Delta-32) was found among the ESN (2.6%). The heterozygous genotype (ccr5/Delta-32) was found in eight GPS (5.3%), in one SP (3.4%) and in one ESN (2.6%). The differences in the allelic and genotypic frequencies among the three groups were not statistically significant. A comparison between the expected and the observed genotypic frequencies showed that these frequencies were significantly different for the ESN group, which indirectly suggests a protective effect of the mutant genotype (Delta-32/Delta-32). Since this mutant genotype explained the resistance of infection in only one of our ESN persons, different mechanisms of protection must be playing a more important role in this population.

Method for tapping the parotid gland. Studies in patients with bilateral englargement of the parotid gland.

A new biopsy method for the study of the parotid gland is proposed. 60 patients with enlarged parotid gland were studied and samples in 44 of them were obtained for investigation. There was a hematoma in the tapping area of two patients but both recoved. This new-method implies a simple procedure, without serious complications that will facilitate the development of clinical studies and further investigation of the parotid gland.

Method for tapping the parotid gland. Studies in patients with bilateral englargement of the parotid gland.

A new biopsy method for the study of the parotid gland is proposed. 60 patients with enlarged parotid gland were studied and samples in 44 of them were obtained for investigation. There was a hematoma in the tapping area of two patients but both recoved. This new-method implies a simple procedure, without serious complications that will facilitate the development of clinical studies and further investigation of the parotid gland.

Method for tapping the parotid gland. Studies in patients with bilateral englargement of the parotid gland

A new biopsy method for the study of the parotid gland is proposed. 60 patients with enlarged parotid gland were studied and samples in 44 of them were obtained for investigation. There was a hematoma in the tapping area of two patients but both recoved. This new-method implies a simple procedure, without serious complications that will facilitate the development of clinical studies and further investigation of the parotid gland.