Distribution, Invasion History, and Ecology of Non-native Pine Bark Beetles (Coleoptera: Curculionidae: Scolytinae) in Southern South America.

The growth of international trade, coupled with an expansion of large-scale pine plantations in South America during the second half of the twentieth century, has significantly increased the opportunities for the invasion of forest insects. Bark beetles (Coleoptera: Curculionidae, Scolytinae) are a large and diverse group of insects, commonly recognized as one of the most important tree mortality agents in coniferous forests worldwide and an important group among invasive forest species. In this study, we combined data from field sampling with published records of established non-native pine bark beetles, to describe their distribution and invasion history in pine plantations across southern South America, reviewing the available information on their phenology and host range. We obtained records of established populations of six Eurasian species distributed in two major regions: the southwest region comprises plantations in Chile and the Argentine Patagonia, with four bark beetle species: Hylastes ater, Hylastes linearis, Hylurgus ligniperda, and Orthotomicus laricis; the northeastern zone includes northeastern Argentina, Uruguay, and southern Brazil, and includes three bark beetle species: Cyrtogenius luteus, H. ligniperda, and O. erosus. The establishment of non-native populations across the study area began in the 1950s, and from the 1980s onwards, there has been an exponential increase in introductions. We predict that several of these species will continue spreading across South America and that new species will continue arriving. We highlight the importance of international collaboration for early detection and management of non-native pine bark beetles.

Quantification of the effect of host patch configuration on the abundance of Bemisia tabaci in central Argentina: a multimodel inference approach.

Bemisia tabaci is a complex of species, which is considered the most common and important pest of a wide range of crops belonging to many different botanical families. In Argentina, this species is recognized as a vector of geminiviruses, and Middle East-Asia Minor 1, Mediterranean, New World and New World 2 have been found to coexist in the same area. Landscape elements, like habitat patch area and isolation, define the habitat configuration and have a direct effect on insect populations between and within host patches. In this paper, we analyse the effect of potato patch configuration on the distribution and abundance of B. tabaci. Potato patches were identified using Landsat TM5 and TM7 images, and a supervised classification was performed to quantify the spatial distribution of the patches in the whole study area. Potato patch metrics were estimated using Fragstats 4.4. Generalized linear mixed models were employed to analyse the relationship between whiteflies and landscape configuration, through a multimodel inference approach, finding that B. tabaci abundance and landscape metrics were very variable. After a multimodel selection process, we found that perimeter-to-area ratio and Euclidean distance between patches were the variables that best explained whitefly abundance in potato patches. Implications of these findings are discussed.

Impacto de la pandemia por COVID-19 en una Residencia Universitaria de Cirugía Plástica / Impact of the COVID-19 pandemic on a university-based residency program in plastic surgery

RESUMEN Antecedentes: la pandemia por COVID-19 plantea un desafío inédito en la educación quirúrgica mundial. La falta de actividad práctica, fruto de las suspensiones y restricciones, pone en jaque la capacidad de los programas de entrenamiento de ajustarse a los estándares de idoneidad requeridos para el ejercicio de la especialidad. Objetivo: comparar la actividad quirúrgica de los residentes antes y durante la cuarentena, y describir los cambios de roles asistenciales y de las tácticas para su formación. Material y métodos: observacional, descriptivo, retrospectivo. Se registraron las ciru-gías realizadas por residentes en los períodos marzo 2019-febrero 2020 (Prepandemia) y marzo 2020-febrero 2021 (Intrapandemia). Se compararon la cantidad y tipo de procedimientos, así como el año de la residencia. Se analizó también el porcentaje de variación en las consultas de consultorios externos. Resultados: se experimentó una reducción global del número de operaciones del 59% (n = 368 vs. n = 152). Los procedimientos estéticos programados disminuyeron un 64%. En cirugía reconstructiva hubo una caída del 55%: tumores de piel -64%, reconstrucción mamaria -54%, reconstrucción de miembro -40%, reconstrucción cabeza y cuello -13%. En las reconstrucciones interdisciplinarias llevadas adelante con otros Servicios se observó un comportamiento dispar. La atención ambulatoria en consultorios externos experimentó una disminución del 50% (n = 2603 vs. n = 1308) en las consultas presenciales. Conclusiones: durante la cuarentena se registró una marcada disminución en todos los tipos de actividad quirúrgica y asistencial de los residentes de cirugía plástica, lo que influirá en su formación y plantea un desafío para minimizar ese impacto.

ABSTRACT Background: The COVID-19 pandemic poses an unprecedented challenge to surgical education worldwide. The lack of hands-on activity, due to suspensions and restrictions, jeopardizes the ability of training programs to meet the competence standards required for the practice of the specialty. Objective: To compare residents' surgical activity before and during the lockdown, and describe the changes in healthcare roles and training strategies. Material and Methods: We conducted a descriptive, observational and retrospective study. The surgeries performed by residents during pre-pandemic (March 2019-February 2020) and intrapandemic (March 2020-February 2021) periods were recorded. The number and type of procedures and the year of the residency program were compared in both periods. The percent change in outpatient consultations was also analyzed. Results: The total number of plastic surgery procedures was reduced by 59% (n = 368 vs. n = 152). Scheduled cosmetic procedures decreased by 64%. Reconstructive procedures decreased by 55%: skin tumors -64%, breast reconstruction -54%, extremity reconstruction -40%, head and neck reconstruction -13%. Multidisciplinary reconstructions performed with other specialists showed different patterns. Face-to-face consultations decreased by 50% (n = 2603 vs. n = 1308). Conclusions: During the lockdown, there was a marked decrease in all the types of surgical and healthcare activities among residents in plastic surgery which will influence their training, posing a challenge to minimize this impact.

¿Tiene el páncreas divisum un rol determinante en la pancreatitis aguda? / Does Pancreas divisum have any determinant role in acute pancreatitis?

Resumen Objetivo: Las anomalías pancreáticas del desarrollo son un espectro de variaciones anatómicas, entre las que se destaca el páncreas divisum; su asociación con la pancreatitis aguda continúa siendo controversial. Materiales y métodos: En primer término se realizó una investigación no experimental de corte transversal sobre 100 piezas duodenopancreáticas cadavéricas y en segunda instancia se analizó el reporte de caso de un paciente con colestasis extrahepática y pancreatitis aguda asociadas a la portación de páncreas divisum. El objetivo fue determinar la prevalencia del sistema descompresivo pancreático. Resultados: Existe diferencia estadísticamente significativa entre las dimensiones del conducto pancreático accesorio y su relación con la permeabilidad. En cuanto a la volumetría pancreática, la sección correspondiente al tercio superior cefálico, cuello, cuerpo y cola del órgano registró una dimensión media de 21,99 cm3, mientras que la sección de los dos tercios cefálicos restantes fue de 8,17 cm3. Simultáneamente, el paciente reportado presentó cuadro clínico de pancreatitis con amilasa de 280 UI/l y lipasa de 173 UI/l asociado a colestasis. Al segundo día de internación se realizó colangiopancreatografía retrógrada endoscópica con papilotomía duodenal mayor y extracción de múltiples cálculos coledocianos, evidenciando un páncreas divisum completo. Discusión: El caso expuesto exhibe que la pancreatitis, en presencia de páncreas divisum, tendría la denominación de una pancreatitis ventral subclínica. Conclusión: El páncreas divisum sería un predictor determinante de pancreatitis aguda al perder el mecanismo descompresivo protector pancreático.

Abstract Purpose: Pancreatic developmental anomalies are a spectrum of anatomical variations, including the pancreas divisum, where its association with acute pancreatitis continues being controversial. Materials and methods: Firstly, a non-experimental cross-sectional study was carried out on one hundred cadaveric duodenpancreatic pieces, and secondly was analyzed the case report of a patient with extrahepatic cholestasis and acute pancreatitis associated with pancreas divisum. The objective was to determinate the prevalence of the decompressive pancreatic system. Results: There is a statistically significant difference between the dimensions of the accessory pancreatic duct and its relation with the permeability. In terms of pancreatic volumetry, the section corresponding to the upper third cephalic, neck, body and tail of the organ registers an average dimension of 21.99 cm3, while the section of the last two thirds cephalic was 8.17 cm3. Simultaneously, the patient reported presented a pancreatitis with amylase 280 UI/l, lipase 173 UI/l, associated with cholestasis. On the second day of hospitalization, endoscopic retrograde cholangiopancreatography was performed with a greater duodenal papillotomy and extraction of multiple common bile duct stones, evidencing a complete pancreas divisum. Discussion: The exposed case shows that pancreatitis, in presence of pancreas divisum, would have the denomination of a subclinical ventral pancreatitis. Conclusion: The pancreas divisum would be a predictor of acute pancreatitis by losing the decompressive pancreatic protective mechanism.

Malformaciones arteriovenosas. Revisión y análisis estadístico de 52 MAVs tratadas durante el período de 2000-2010. Tercera parte / Arteriovenous malformations. Review and statistical analysis of 52 MAVs treated during the period 2000-2010. Third part

INTRODUCCIÓN: describir nuestra experiencia en el tratamiento de las MAVs analizando: procedimientos endovasculares utilizados, resultados postoperatorios y complicaciones asociadas, estadificación según escalas de Barthel y Rankin modificadas. MATERIAL Y MÉTODOS: la población de estudio se constituyó por 52 pacientes con MAVs la cual fue analizada y estudiada mediante examen neurológico pre y postoperatorio, TC cerebral, RM cerebral y arteriografía de 4 vasos de cuello, la totalidad fue tratada mediante cirugía convencional en nuestro Servicio durante el período comprendido entre los años 2000 a 2010. RESULTADOS: recibieron tratamiento endovascular previo a la cirugía 16 MAVs (30,76 %). Todas fueron operadas. Doce pacientes mejoraron en el postoperatorio (23,07 %), 30 pacientes (57,69%) no sufrieron modificaciones y 10 de ellos (19,23%) empeoraron durante el postoperatorio. La mortalidad fue de 7 casos (13,46 %). CONCLUSIÓN: consideramos a los procedimientos endovasculares y la radiocirugía una herramienta de indudable valor terapéutico. Creemos que el subgrupo de MAVs grados III, IV y V representa una entidad singular que las distingue del resto, como una subtipo que requiere más aun de una compleja toma de decisiones. Tuvimos las mayores complicaciones postoperatorias en MAVs grados III y IV. Nuestra mortalidad postoperatoria coincide con la bibliografía consultada

INTRODUCTION: to describe our experience in treating AVMs based on the endovascular procedures used, postoperative results and associated complications, staging according to Barthel Index and modified Rankin Scale. PATIENTS AND METHOD: we present 52 patients with AVMs which were analysed and studied by Pre and Post-Surgery Neurological exam, brain CT, Brain IRM and four Neck vessels arteriography. All the patients were treated by conventional Surgery at our Department of Neurosurgery for the 2000­2010 period. RESULTS: Sixteen patients with AVMs (30.76%) underwent endovascular treatment prior to surgery. 100% were operated. 12 patients (23.07%) improved their clinical condition in the postoperative period, 30 patients (57.69%) showed no changes, and 10 of them (19.23%) experienced deterioration during the postoperative period. There were 7 mortal cases (13.46%). CONCLUSION: we believe that endovascular procedures and radiosurgery are tools of immense therapeutic value. We also consider that the subgroup of AVMs grade III, IV and V have unique features that distinguish them among the rest as a subtype, thus requiring extreme care when making decisions. Most postoperative complications occurred with AVMs grade III and IV. The mortal cases in the postoperative period coincided with those mentioned in the bibliography consulted

Malformaciones arteriovenosas - segunda parte. revisión y análisis estadístico de 52 MAVs tratadas durante el período de 2000-2010 / Arteriovenous malformations - part two. review and statistical analysis of 52 MAVs treated during the period 2000-2010

Objetivo: Describir nuestra experiencia en el tratamiento de las MAVs analizando: tamaño, tipo de MAV más frecuentes, relación entre aneurismas arteriales y/o venosos asociados con eventos de sangrado crisis comiciales y déficit neurológico. Material y Métodos: la población de estudio se constituyó por 52 pacientes con MAVs la cual fue analizada y estudiada mediante examen neurológico pre y postoperatorio, TC cerebral, IRM cerebral y arteriografía de 4 vasos de cuello, la totalidad fue tratada mediante cirugía convencional en nuestro servicio durante el periodo comprendido entre los años 2000 a 2010. Resultados: las MAVs más frecuentes fueron grado 2: 30,76% y grado 3: 30,76%. De la totalidad de la muestra el 50% presentaron aneurismas arteriales o venosos asociados. El 32,69% de los pacientes portadores de aneurismas sean estos arteriales o venosos debutaron con eventos vasculares hemorrágicos. Del total de las MAVs, el 59,61% debutó con sangrado, 26,92% con crisis convulsivas y el 13,46% con déficit neurológico no relacionado con crisis comiciales o eventos vasculares hemorrágicos, de estas últimas el 71,42% correspondieron al grupo comprendido por las MAVs grado III y IV. Conclusión: el evento vascular hemorrágico fue la presentación más frecuente 59,61% (31 casos). La presencia de aneurismas asociados representa un factor predisponente para dicho debut. Las crisis comiciales y el déficit neurológico siguen en orden de frecuencia al evento hemorrágico como forma de comienzo, en concordancia con la bibliografía las crisis comiciales prevalecieron en los grados II y III. Las MAVs que sangraron con mayor frecuencia fueron las grado I y V.

Purpose: To describe our experience in treating AVMs based on size, most frequent types of AVMs, the relationship between arterial and/or venous aneurysms associated with bleeding events, epileptic seizures and neurological deficit. Method: we present 52 patients with AVMs treated at our Department in the 2000 – 2010 period.Results: the most frequent AVMs were grade 2 in 30.76% of the cases and grade 3 in 30.76% of them. Of the total number of all the cases, 50% presented associated arterial or venous aneurysms. 32.69% of the patients with either arterial or venous aneurysms presented hemorrhagic vascular events as an early symptom. Of the total number of AVMs, 59.61% of the cases showed bleeding, 26.92% of them showed seizures and 13.46% showed neurological deficit not related to seizures or hemorrhagic vascular events. Of the latter group, 71.42% corresponded to AVMs grade III and IV.Conclusion: hemorrhagic vascular event was the symptom most frequently observed: 31 cases (59.61%). Associated aneurysms are predisposing factors to such events. Epileptic seizures and neurological deficit are the second most common events after hemorrhagic ones as early symptoms. We agree with the authors consulted that epileptic seizures corresponded mostly to grade II and III. The AVMs that bled more frequently were grade I and V.

Análisis de factores pronósticos en leucemia linfática crónica. Valor predictivo del inmunofenotipo, el CD23 soluble y la morfología / Predictive factors in chronic lymphocytic leukemia. Value of immunophenotype, SCD23 and morphology

En LLC se reconocen factores pronósticos útiles como la duplicación linfocitaria, el estadio clínico y el patrón de infiltración medular. Otros, como el porcentaje de células CD38+, están en estudio y requieren confirmación. El objetivo del presente trabajo fue evaluar si existe asociación entre morfología, inmunofenotipo linfocitario, CD23 soluble (SL) y sobrevida libre de eventos (SLE). Se evaluaron prospectivamente 36 pacientes sin tratamiento. Se determinaron: morfología típica, mixta y LLC-PL; inmunofenotipo linfocitario (score de Matutes); niveles plasmáticos de CD23 SL; estadio clínico, duplicación linfocitaria; ß2 microglobulina y alteraciones citogenéticas. Se consideró evento: progresión de enfermedad (necesidad de tratamiento, evolución a estadios avanzados, desarrollo de organomegalia voluminosa) y muerte por enfermedad. Mediana de seguimiento 24 meses. Resultados: estadio 0: 11/36, SLE 80 por ciento; I: 10/36 SLE 90 por ciento; II: 13/36: III y IV: 2/36. SLE >= II 37 por ciento. p= 0.023. Duplicación linfocitaria: <12m 7/31, >12m 24/31. SLE 28 por ciento vs 80 por ciento p<0.001. Citogenético: normal 13/28; anormal 15/28. SLE 92 por ciento vs 54 por ciento p=0.053. +12 positiva 7/30, negativa 23/30. SLE 65 por ciento vs 66 por ciento. ß2 microglobulina normal 9/35, elevada 26/35; SLE 100 por ciento vs 53 por ciento p=0.006. D23 SL < 350 Ul/ml 15/32, > 350 Ul/ml 17/32. SLE 92 por ciento vs 53 por ciento p=0.005. Inmunofenotipo: Score 5: 15/36, Score 4: 19/36, SLE 64 por ciento. Score 3: 2/36. p=0.516. Morfología típica 17/35, mixta 17/35. SLE 81 por ciento vs. 57 por ciento p=0.099. LLC-PL 1/35. El CD 23 SL resultó adecuado para predecir SLE, particularmente útil en estadios iniciales sin otros marcadores de actividad. La morfología y el fenotipo linfocitario, dos variables accesibles, no fueron útiles para el propósito del estudio. (AU)

Análisis de factores pronósticos en leucemia linfática crónica. Valor predictivo del inmunofenotipo, el CD23 soluble y la morfología / Predictive factors in chronic lymphocytic leukemia. Value of immunophenotype, SCD23 and morphology

En LLC se reconocen factores pronósticos útiles como la duplicación linfocitaria, el estadio clínico y el patrón de infiltración medular. Otros, como el porcentaje de células CD38+, están en estudio y requieren confirmación. El objetivo del presente trabajo fue evaluar si existe asociación entre morfología, inmunofenotipo linfocitario, CD23 soluble (SL) y sobrevida libre de eventos (SLE). Se evaluaron prospectivamente 36 pacientes sin tratamiento. Se determinaron: morfología típica, mixta y LLC-PL; inmunofenotipo linfocitario (score de Matutes); niveles plasmáticos de CD23 SL; estadio clínico, duplicación linfocitaria; ß2 microglobulina y alteraciones citogenéticas. Se consideró evento: progresión de enfermedad (necesidad de tratamiento, evolución a estadios avanzados, desarrollo de organomegalia voluminosa) y muerte por enfermedad. Mediana de seguimiento 24 meses. Resultados: estadio 0: 11/36, SLE 80 por ciento; I: 10/36 SLE 90 por ciento; II: 13/36: III y IV: 2/36. SLE >= II 37 por ciento. p= 0.023. Duplicación linfocitaria: <12m 7/31, >12m 24/31. SLE 28 por ciento vs 80 por ciento p<0.001. Citogenético: normal 13/28; anormal 15/28. SLE 92 por ciento vs 54 por ciento p=0.053. +12 positiva 7/30, negativa 23/30. SLE 65 por ciento vs 66 por ciento. ß2 microglobulina normal 9/35, elevada 26/35; SLE 100 por ciento vs 53 por ciento p=0.006. D23 SL < 350 Ul/ml 15/32, > 350 Ul/ml 17/32. SLE 92 por ciento vs 53 por ciento p=0.005. Inmunofenotipo: Score 5: 15/36, Score 4: 19/36, SLE 64 por ciento. Score 3: 2/36. p=0.516. Morfología típica 17/35, mixta 17/35. SLE 81 por ciento vs. 57 por ciento p=0.099. LLC-PL 1/35. El CD 23 SL resultó adecuado para predecir SLE, particularmente útil en estadios iniciales sin otros marcadores de actividad. La morfología y el fenotipo linfocitario, dos variables accesibles, no fueron útiles para el propósito del estudio.

[Evolution of chronic lymphocytic leukemia: predictive value of immunophenotype, soluble CD23 and morphology]. / Evolución de la leucemia linfática crónica. Valor predictivo del inmunofenotipo, el CD23 soluble y la morfología.

UNLABELLED: Some prognostic factors are useful in chronic lymphocytic leukemia (CLL): lymphocyte doubling time, clinical stage and bone marrow pattern infiltration, while others, such as the percentage of CD38+ cells, are under study and require confirmation. The objective of this study was to evaluate whether there is an association between morphology, lymphocyte immunophenotype, soluble CD23 (sCD23) and progression free survival (PFS). A total of 36 non-treated patients were enrolled. We analysed prospectively: morphology (typical, mixed and PL-CLL); immunophenotypic profile (Matutes score); sCD23 plasma levels; clinical stage; lymphocyte doubling time; beta 2 microglobulin and karyotype abnormalities. Disease progression (need of treatment, progression to advanced stages, development of bulky organomegaly) and death related to disease were considered as events. Md of follow-up 24 mo. RESULTS: Stage 0: 11/36, PFS 80%; I: 10/36 PFS 90%; II: 13/36; III and IV: 2/36. SLE > or = II PFS 37%. p = 0.023. Lymphocyte doubling time < 12mo. 7/31; > 12mo. 24/31. PFS 28% vs. 80% p < 0.001. Karyotype: normal 13/28, abnormal 15/28. PFS 92% vs. 54% p = 0.053. Trisomy 12: positive 7/30, negative 23/30, PFS 66% vs. 65%. beta 2 microglobulin: normal 9/35; high 26/35. PFS 100% vs. 53% p = 0.006. sCD23 < 350 Ul/ml: 15/32; > 350 Ul/ml: 17/32. PFS 92% vs. 53% p = 0.005. Immunophenotype: Score 5: 15/36, Score 4: 19/36, PFS 64%. Score 3: 2/36. p = 0.516. Morphology: typical 17/35, mixed 17/35, PFS 81% vs. 57%, p = 0.099. PL-CLL 1/35. CONCLUSIONS: sCD23 was suitable to predict PFS, specially useful for early stages without additional markers of active disease. Morphology (excluding PL-CLL) and immunophenotype, two common tools, were not useful for the study purpose.

CD34 and CD117 are overexpressed in AML and may be valuable to detect minimal residual disease.

We estimated by quantitative flow cytometry (FC) the expression of CD13, CD33, CD34 and CD117 antigens in cells from 64 patients with acute myeloid leukaemia (AML) and 22 normal bone marrows (BMs). The method converts fluorescence intensity into number of antigen molecules per cell, measured by antibody binding capacity (ABC). The number of molecules per cell in normal BM was 9.5+/-5.7 for CD13, 7+/-2.3 for CD33, 6+/-0.7 for CD34, and 6.3+/-1.5x10(3) for CD117. AML blasts expressed 11.4+/-12.4 molecules per cell for CD13, 9.5+/-9.7 for CD33, 74+/-2328.5 for CD34 and 12.5+/-33 x 10(3) for CD117. The number of CD34 and CD117 molecules were significantly higher in AML than in normals (P<0.0001 and P<0.05, respectively) while only in a few cases, CD13 and CD33 were abnormally expressed in myeloblasts. Our results indicate that quantitative analysis of CD34 and CD117 may be useful to detect minimal residual disease (MRD) and could be tested in a future to monitor therapy in AML.

New challenges and old problems: end of life care and the dilemma of prognostic accuracy.

Dignity of the natural end of life for everybody is one of the new great challenges of medicine and social care for the beginning 21st century. However, many end of life care providing doctors are confused about how to categorize the help they give. One of the central problems is predicting the life expectancy of an individual patient. Difficulties in this field can become ethical dilemmas when physicians are obliged to predict accurately a patient's prognosis as the basis for a certain care strategy. Clinical estimation of the duration of life for patients with end of life cancer needs experience and training. Education programmes in the field should include this topic much more until now. Prognosis should be based more on proven indices and less on intuition. However, there is no doubt that daily clinical practice limits the use of highly sophisticated computer-based score models. Even maximal accuracy of prognosis will not exclude the risk of errors in a great part of patients. This limits their classification in care categories too strictly defined. Health care systems should avoid models for care with standards and budgets based on prognostic estimates and the medical community should avoid claim by disciplines of certain categories of patients defined by their prognoses. What we need is a network of assistance for incurable patients with single parts defined by patients needs and not by predicted life expectancy. Separating palliative and terminal care is artificial and often in contrast to the needs of the patients.

Evolución de la leucemia linfática crónica. Valor predictivo del inmunofenotipo, el CD23 soluble y la morfología. / [Evolution of chronic lymphocytic leukemia: predictive value of immunophenotype, soluble CD23 and morphology]

Some prognostic factors are useful in chronic lymphocytic leukemia (CLL): lymphocyte doubling time, clinical stage and bone marrow pattern infiltration, while others, such as the percentage of CD38+ cells, are under study and require confirmation. The objective of this study was to evaluate whether there is an association between morphology, lymphocyte immunophenotype, soluble CD23 (sCD23) and progression free survival (PFS). A total of 36 non-treated patients were enrolled. We analysed prospectively: morphology (typical, mixed and PL-CLL); immunophenotypic profile (Matutes score); sCD23 plasma levels; clinical stage; lymphocyte doubling time; beta 2 microglobulin and karyotype abnormalities. Disease progression (need of treatment, progression to advanced stages, development of bulky organomegaly) and death related to disease were considered as events. Md of follow-up 24 mo. RESULTS: Stage 0: 11/36, PFS 80

; I: 10/36 PFS 90

; II: 13/36; III and IV: 2/36. SLE > or = II PFS 37

. p = 0.023. Lymphocyte doubling time < 12mo. 7/31; > 12mo. 24/31. PFS 28

vs. 80

p < 0.001. Karyotype: normal 13/28, abnormal 15/28. PFS 92

vs. 54

p = 0.053. Trisomy 12: positive 7/30, negative 23/30, PFS 66

vs. 65

. beta 2 microglobulin: normal 9/35; high 26/35. PFS 100

vs. 53

p = 0.006. sCD23 < 350 Ul/ml: 15/32; > 350 Ul/ml: 17/32. PFS 92

vs. 53

p = 0.005. Immunophenotype: Score 5: 15/36, Score 4: 19/36, PFS 64

. Score 3: 2/36. p = 0.516. Morphology: typical 17/35, mixed 17/35, PFS 81

vs. 57

, p = 0.099. PL-CLL 1/35. CONCLUSIONS: sCD23 was suitable to predict PFS, specially useful for early stages without additional markers of active disease. Morphology (excluding PL-CLL) and immunophenotype, two common tools, were not useful for the study purpose.

Evolucion de la leucemia linfatica cronica: valor predictivo del inmunofenotipo, el CD23 soluble y la morfologia / Evolution of chronic lymphocytic leukemia: predictive value of immunophenotype, soluble CD23 and morphology

Some prognostic factors are useful in chronic lymphocytic leukemia (CLL): lymphocyte doubling time, clinical stage and bone marrow pattern infiltration, while others, such as the percentage of CD38+ cells, are under study and require confirmation. The objective of this study was to evaluate whether there is an association between morphology, lymphocyte immunophenotype, soluble CD23 (sCD23) and progression free survival (PFS). A total of 36 non-treated patients were enrolled. We analysed prospectively: morphology (typical, mixed and PL-CLL); immunophenotypic profile (Matutes score); sCD23 plasma levels; clinical stage; lymphocyte doubling time; beta 2 microglobulin and karyotype abnormalities. Disease progression (need of treatment, progression to advanced stages, development of bulky organomegaly) and death related to disease were considered as events. Md of follow-up 24 mo. RESULTS: Stage 0: 11/36, PFS 80%; I: 10/36 PFS 90%; II: 13/36; III and IV: 2/36. SLE > or = II PFS 37%. p = 0.023. Lymphocyte doubling time < 12mo. 7/31; > 12mo. 24/31. PFS 28% vs. 80% p < 0.001. Karyotype: normal 13/28, abnormal 15/28. PFS 92% vs. 54% p = 0.053. Trisomy 12: positive 7/30, negative 23/30, PFS 66% vs. 65%. beta 2 microglobulin: normal 9/35; high 26/35. PFS 100% vs. 53% p = 0.006. sCD23 < 350 Ul/ml: 15/32; > 350 Ul/ml: 17/32. PFS 92% vs. 53% p = 0.005. Immunophenotype: Score 5: 15/36, Score 4: 19/36, PFS 64%. Score 3: 2/36. p = 0.516. Morphology: typical 17/35, mixed 17/35, PFS 81% vs. 57%, p = 0.099. PL-CLL 1/35. CONCLUSIONS: sCD23 was suitable to predict PFS, specially useful for early stages without additional markers of active disease. Morphology (excluding PL-CLL) and immunophenotype, two common tools, were not useful for the study purpose (AU)

Evolucion de la leucemia linfatica cronica: valor predictivo del inmunofenotipo, el CD23 soluble y la morfologia / Evolution of chronic lymphocytic leukemia: predictive value of immunophenotype, soluble CD23 and morphology

Some prognostic factors are useful in chronic lymphocytic leukemia (CLL): lymphocyte doubling time, clinical stage and bone marrow pattern infiltration, while others, such as the percentage of CD38+ cells, are under study and require confirmation. The objective of this study was to evaluate whether there is an association between morphology, lymphocyte immunophenotype, soluble CD23 (sCD23) and progression free survival (PFS). A total of 36 non-treated patients were enrolled. We analysed prospectively: morphology (typical, mixed and PL-CLL); immunophenotypic profile (Matutes score); sCD23 plasma levels; clinical stage; lymphocyte doubling time; beta 2 microglobulin and karyotype abnormalities. Disease progression (need of treatment, progression to advanced stages, development of bulky organomegaly) and death related to disease were considered as events. Md of follow-up 24 mo. RESULTS: Stage 0: 11/36, PFS 80%; I: 10/36 PFS 90%; II: 13/36; III and IV: 2/36. SLE > or = II PFS 37%. p = 0.023. Lymphocyte doubling time < 12mo. 7/31; > 12mo. 24/31. PFS 28% vs. 80% p < 0.001. Karyotype: normal 13/28, abnormal 15/28. PFS 92% vs. 54% p = 0.053. Trisomy 12: positive 7/30, negative 23/30, PFS 66% vs. 65%. beta 2 microglobulin: normal 9/35; high 26/35. PFS 100% vs. 53% p = 0.006. sCD23 < 350 Ul/ml: 15/32; > 350 Ul/ml: 17/32. PFS 92% vs. 53% p = 0.005. Immunophenotype: Score 5: 15/36, Score 4: 19/36, PFS 64%. Score 3: 2/36. p = 0.516. Morphology: typical 17/35, mixed 17/35, PFS 81% vs. 57%, p = 0.099. PL-CLL 1/35. CONCLUSIONS: sCD23 was suitable to predict PFS, specially useful for early stages without additional markers of active disease. Morphology (excluding PL-CLL) and immunophenotype, two common tools, were not useful for the study purpose

The synthetic potential of phthalimide SET photochemistry.

The authors' studies in the area of phthalimide photochemistry are discussed in the context of the development of new methods for N-heterocycle synthesis. Emphasis is given to reactions which are initiated by both intermolecular and intramolecular SET from silicon-containing electron donors to excited states of phthalimides and related maleimides and conjugated imides. The photoaddition and photocyclization processes which ensue follow mechanistic pathways, in which efficient desilylation of initially formed radical cation occurs to generate radical pair and biradical intermediates that serve as precursors of the products. Several examples that demonstrate the preparative potential of these reactions are presented. These are taken from the authors' investigations of (1) phthalimido-alkylsilane photocyclization reactions, (2) azomethine ylide-forming excited-state processes of N-(trimethylsilylmethyl)phthalimide, and (3) photoaddition and photocyclization reactions of phthalimide alpha-silyl ether, thioether, amine, and amide systems.

Applications of phthalimide photochemistry to macrocyclic polyether, polythioether, and polyamide synthesis.

Irradiation of phthalimides which contain N-linked omega-trimethylsilylmethyl-substituted polyether, polythioether, and polysulfonamide chains results in efficient production of the corresponding macrocyclic polyether, polythioether, and polysulfonamide products. These photocyclization reactions follow sequential single electron transfer (SET)-desilylation pathways. Only in the cases of phthalimides, bearing mixed ether-thioether N-substituents, do these excited-state cyclization reactions proceed with lower degrees of regioselectivity. This is a result of competitive desilylation and alpha-to-sulfur deprotonation reactions of the zwitterionic diradical intermediates formed by initial SET.