MRI and endoscopic ultrasonography in the staging of gastric cancer.

OBJECTIVE: to determine the diagnostic precision of endoscopic ultrasounds (EUS) and magnetic resonance imaging (MRI) in the preoperative staging of gastric cancer. METHODS: a prospective, blind study was carried out in 17 patients diagnosed with gastric cancer (GC) using endoscopic biopsy from November 2002 to June 2003. Patients underwent preoperative MRI and EUS. The reference test used was pathology, and laparotomy for non-resectable cases. RESULTS: MRI (53%) was better than EUS in the assessment of gastric wall infiltration (35%). MRI (50%) was also superior to EUS (42%) for N staging. After pooling stages T1-T2 and T3-T4 together, results improved for both MRI (67 and 87.5%, respectively) and EUS (67 and 62.5%, respectively) (p < 0.05). N staging--lymph node invasion--results were correct in 50% for MRI as compared to EUS (42%). In classifying positive and negative lymph nodes EUS was superior to MRI (73 versus 54%). CONCLUSIONS: MRI was the best method in the assessment of gastric wall infiltration. EUS was superior to MRI for T1 staging, and in the assessment of lymph node infiltration.

Resonancia magnética y ecoendoscopia para el estadiaje del cáncer gástrico / MRI and endoscopic ultrasonography in the staging of gastric cancer

Objetivo: determinar cuál de las dos técnicas: ultrasonografíaendoscópica (USE) o resonancia magnética (RM) permite una mejorestadificación preoperatoria del cáncer gástrico (CG).Material y métodos: se diseñó un estudio prospectivo de lospacientes con CG diagnosticados de noviembre del 2002 a juniodel 2003. A los pacientes se les realizó una RM y una USE previaa la cirugía. El diagnóstico final de los pacientes se estableció medianteel estudio anatomopatológico de la pieza quirúrgica y/o laparotomía.Resultados: se incluyeron 17 pacientes. El grado de infiltracióntumoral de la pared gástrica (T) obtenida por RM se confirmóen el 53% de los casos y por USE en el 35%. Cuando se agrupabanlos estadios T1 y T2 el diagnóstico era correcto en el 67% delos casos tanto por la RM como para la EUS. Cuando se agrupabanel estadio T3 con el T4 el diagnóstico fue correcto en el87,5% de los casos por RM y en el 62,5% por EUS (p < 0,05). Elgrado de infiltración tumoral de los ganglios (N) por RM obtuvoconfirmación en el 50% de los casos y por USE en el 42%. Al clasificarlos ganglios en positivos (N1, N2 y N3) y negativos (N0) laUSE fue superior a la RM (73 vs. 54%).Conclusiones: la infiltración tumoral del CG en la pared gástricafue mejor valorada con la RM. La USE era mejor que la RMpara valorar el estadio T1 y la infiltración tumoral de adenopatías

Objective: to determine the diagnostic precision of endoscopicultrasounds (EUS) and magnetic resonance imaging (MRI) in thepreoperative staging of gastric cancer.Methods: a prospective, blind study was carried out in 17 patientsdiagnosed with gastric cancer (GC) using endoscopic biopsyfrom November 2002 to June 2003. Patients underwent preoperativeMRI and EUS. The reference test used was pathology, andlaparotomy for non-resectable cases.Results: MRI (53%) was better than EUS in the assessment ofgastric wall infiltration (35%). MRI (50%) was also superior to EUS(42%) for N staging. After pooling stages T1-T2 and T3-T4 together,results improved for both MRI (67 and 87.5%, respectively)and EUS (67 and 62.5%, respectively) (p < 0.05). N staging–lymph node invasion– results were correct in 50% for MRI ascompared to EUS (42%). In classifying positive and negativelymph nodes EUS was superior to MRI (73 versus 54%).Conclusions: MRI was the best method in the assessment ofgastric wall infiltration. EUS was superior to MRI for T1 staging,and in the assessment of lymph node infiltration

Childhood maltreatment, childhood social support, and child abuse potential in a Basque sample.

The present study obtained data on childhood physical and sexual abuse in a Basque sample in order to compare abuse rates with a similar study conducted in the United States. The study also examined the relationships between childhood physical and sexual abuse, childhood social support, and abuse potential in the Basque sample. Although the overall rates of physically abusive behaviors were similar in the Basque and US samples, the rates of physical abuse sequelae (bruises/welts, cuts/scratches, dislocations, burns, and/or bone fractures) were lower in the Basque sample. In addition, while the rates of sexual abuse were similar for females, the sexual abuse rates for Basque males were more than double the rates reported for US males. As expected, a childhood history of physical and sexual abuse were directly related to child abuse potential. Childhood social support, especially father support, was inversely associated with abuse potential. An interaction between a childhood history of physical abuse and father support was found where those with a history of abuse and low levels of father support had the highest level of abuse potential and those with a history of abuse and high levels of father support had the lowest level of abuse potential.

[The hepatotrophic action of cyclosporin A in a model of hepatic ischemia in the rat]. / Estudio de la acción hepatotrófica de la ciclosporina A en un modelo de isquemia hepática en la rata.

Liver ischemia is a common surgical situation. In this study the effect of 15 minutes of warm ischemia on liver regeneration in the rat is assessed. From hepatocytic DNA content (cytophotometrically measured), the percentage of regenerating hepatocytes (PRH) and the regenerative gradient (RG) are calculated in normal livers and following different regenerative stimuli: partial hepatectomy (70%) and cyclosporine (20 mg/kg i.p.). In resting livers (both controls and CsA-treated) the PRH and the RG were not modified by ischemia. However, liver regeneration following partial hepatectomy was significantly decreased by ischemia. In the other hand, CsA has increased the PRH and the RG in the four situations analyzed: resting and regenerating liver, both normoperfused or following 15 minutes liver ischemia. It is concluded that the hepatotrophic effect of CsA is not nullified by warm liver ischemia.