MIRAgel: the immunohistochemical expression of CD3, CD34, and CD68 in the surrounding capsule.

PurposeTo study the immunohistochemical features of the capsule tissue surrounding MIRAgel episcleral buckles.Patients and methodsThis Institutional interventional clinical cohort study examined a consecutive series of 21 referred patients who required MIRAgel removal from July 2009 to July 2013. All patients with hydrated and fragmented MIRAgel episcleral buckles were included in this study. Capsule biopsies from MIRAgel episcleral buckles were obtained from all patients. Capsule specimens of seven patients with extruded silicone bands were processed as controls. Paraffin-embedded specimens were examined using light microscopy and immunohistochemistry (via the PAP horseradish peroxidase technique) to detect the expression of CD3, CD20, CD34 and CD68, and S-100 protein.ResultsInflammation with granuloma, which was primarily related to sutures, was found in all (n=36) of the MIRAgel specimens and foreign body granulomas with multinucleated giant cells, histiocytes, and macrophages (CD68+ cells) surrounded the MIRAgel fragments. Average number of CD68+ cells was higher (P<0.001) for MIRAgel than for silicone rubber. The lymphocytic inflammatory infiltrate related to the MIRAgel fragments was CD3+ and CD20- (delayed T cell-mediated immune response). Moderate neoangiogenesis was indicated by the presence of CD34+ cells.ConclusionsThe immunohistochemical analysis revealed that the immune system is able to identify the fragments of MIRAgel (after its hydrolytic degradation) as a foreign body during a delayed T cell-mediated immune response. The phagocytosis by macrophages likely triggers and perpetuates local disease. Removal of MIRAgel explants before hydrolysis should be considered.

Valores de referencia de la proteína S100beta en población pediátrica / Serum S100Beta protein reference values in a paediatric population

INTRODUCCIÓN: La proteína S100β se ha propuesto como posible biomarcador en patología neurológica, tanto crónica como aguda. Los valores normales de esta proteína están bien definidos en adultos, no así en niños, en los que los valores séricos parecen variar con la edad. Nuestro objetivo es describir valores de referencia de S100β sérica en niños de 0 a 14 años. MATERIAL Y MÉTODOS: Estudio prospectivo en 257 niños sanos. Se establecieron 3 grupos por edad (menores de 12 meses, de 12 a 24 meses y mayores de 24 meses). RESULTADOS: Se incluyó a 179 niños y 78 niñas. La edad media ± DE fue de 5,5 ± 3,75 años. La concentración sérica media de la proteína S100β en todo el grupo fue 0,156 (0,140-0,172) μg/l. En los menores de 12 meses, la concentración sérica de S100β fue de 0,350 (0,280-0,421) μg/l; 0,165 (0,139-0,190) μg/l en el grupo entre 12 y 24 meses y 0,121 (0,109-0,133) μg/l en el grupo de niños mayores de 24 meses. Se observó una relación inversa entre la edad y la concentración sérica de S100β, que desciende conforme se incrementa la edad. No se observaron diferencias en cuanto al sexo. CONCLUSIONES: La concentración de S100β permanece estable a partir de los 2 años de edad, siendo posible establecer unos valores de referencia de S100β para mayores de 2 años. En los 2 primeros años de vida, la concentración de S100β sérica es más elevada cuanto menor es la edad del niño. No se observan diferencias en el valor de S100β sérica entre ambos sexos

INTRODUCTION: S100β protein has been proposed as a potential biomarker for both chronic and acute neurological disorders. Reference values of this protein are well defined in adults but not in children, in whom serum levels appear to vary with age. Reference values for serum S100β in children from 0 to 14 years are presented. MATERIALS AND METHODS: A prospective study was conducted on 257 healthy children, who were divided into three age groups (under 12 months, 12 to 24 months and over 24 months). RESULTS: The study included179 boys and 78 girls, with a mean age of 5.5 (3.75) years. The mean serum concentration of protein S100β was 0.156 (0.140-0.172) μg/l. In children under 12 months, serum S100β concentration was 0.350 (0.280-0.421) μg/l; 0.165 (0.139-0.190) μg/l in the group between 12 and 24 months and 0.121 (0.109-0.133) μg/l in children older than 24 months. An inverse relationship was observed between age and serum S100β, which declines as age increases. No differences were observed between sexes. CONCLUSIONS: The concentration of S100β remains stable after two years of age, being possible to establish a baseline of S100β for over two years. During the first two years of life, S100β serum concentration is higher, the lower the age of the child. No differences in serum S100β levels between sexes are observed

[Serum S100ß protein reference values in a paediatric population]. / Valores de referencia de la proteína S100ß en población pediátrica.

INTRODUCTION: S100ß protein has been proposed as a potential biomarker for both chronic and acute neurological disorders. Reference values of this protein are well defined in adults but not in children, in whom serum levels appear to vary with age. Reference values for serum S100ß in children from 0 to 14 years are presented. MATERIALS AND METHODS: A prospective study was conducted on 257 healthy children, who were divided into three age groups (under 12 months, 12 to 24 months and over 24 months). RESULTS: The study included179 boys and 78 girls, with a mean age of 5.5 (3.75) years. The mean serum concentration of protein S100ß was 0.156 (0.140-0.172) µg/l. In children under 12 months, serum S100ß concentration was 0.350 (0.280-0.421) µg/l; 0.165 (0.139-0.190) µg/l in the group between 12 and 24 months and 0.121 (0.109-0.133) µg/l in children older than 24 months. An inverse relationship was observed between age and serum S100ß, which declines as age increases. No differences were observed between sexes. CONCLUSIONS: The concentration of S100ß remains stable after two years of age, being possible to establish a baseline of S100ß for over two years. During the first two years of life, S100ß serum concentration is higher, the lower the age of the child. No differences in serum S100ß levels between sexes are observed.

Polymorphisms in HIF-1 alpha affect presence of lymph node metastasis and can influence tumor size in squamous-cell carcinoma of the glottic larynx

BACKGROUND: HIF-1alpha plays a key role in the development and progression of cancer. Its polymorphic variants C1772T and G1790A have been associated with greater susceptibility to cancer and increased tumor progression. METHODS: We determined the distribution of these polymorphisms among 121 patients with glottic cancer and 154 healthy volunteers by PCR-RFLP. We also analyzed the relationship between the presence of these polymorphisms and various clinicopathologic variables. RESULTS: Advanced tumors (T3-T4) were associated with the TT variant (p = 0.036), which was present in 75 % of T4 tumors (p = 0.008). Among patients with nodal metastasis (N+), 41.7 and 22 % were carrying the TT and GA variants, respectively, compared with 9.4 and 2 % of the patients with no metastasis (N0), (p = 0.006 and p = 0.032). CONCLUSIONS: The presence of the TT and GA variants were associated with lymph node metastasis, while the presence of the TT variant can be associated with larger tumor size (AU)

Polymorphisms in HIF-1alpha affect presence of lymph node metastasis and can influence tumor size in squamous-cell carcinoma of the glottic larynx.

BACKGROUND: HIF-1alpha plays a key role in the development and progression of cancer. Its polymorphic variants C1772T and G1790A have been associated with greater susceptibility to cancer and increased tumor progression. METHODS: We determined the distribution of these polymorphisms among 121 patients with glottic cancer and 154 healthy volunteers by PCR-RFLP. We also analyzed the relationship between the presence of these polymorphisms and various clinicopathologic variables. RESULTS: Advanced tumors (T3-T4) were associated with the TT variant (p = 0.036), which was present in 75 % of T4 tumors (p = 0.008). Among patients with nodal metastasis (N+), 41.7 and 22 % were carrying the TT and GA variants, respectively, compared with 9.4 and 2 % of the patients with no metastasis (N0), (p = 0.006 and p = 0.032). CONCLUSIONS: The presence of the TT and GA variants were associated with lymph node metastasis, while the presence of the TT variant can be associated with larger tumor size.

La procalcitonina en el diagnóstico de infección postoperatoria en las artroplastias de rodilla / Procalcitonin in the diagnosis of postoperative infection in knee arthroplasty

Objetivo. La procalcitonina (PCT) es un polipéptido de 116 aminoácidos sintetizado en las células C del tiroides cuyas concentraciones se elevan en presencia de una infección bacteriana. El objetivo del trabajo es estudiar el comportamiento de las concentraciones de PCT en el postoperatorio de las artroplastias de rodilla y valorar su utilidad en el diagnóstico de procesos infecciosos y su relación con la velocidad de sedimentación globular (VSG) y la proteína C reactiva (PCR). Material y métodos. Se estudiaron las concentraciones de PCT, PCR y valores de VSG en 128 pacientes intervenidos para una artroplastia primaria de rodilla desde el preoperatorio y los tres primeros días tras la intervención para relacionar los cambios en los niveles de estos marcadores con la aparición de complicaciones. Se estudió la variación en el número de leucocitos, el número de transfusiones, la utilización de diferentes implantes y el tiempo de isquemia buscando correlación con la aparición de concentraciones de PCT > 0,5 ng/mL. Resultados. Concentraciones de PCT < 0,5 ng/mL se correspondieron con ausencia de complicaciones clínicas en el 95% de los casos mientras que concentraciones de PCT > 0,5 ng/mL se correspondieron con aparición de complicaciones clínicas en el 75% de los casos. La PCR y la VSG se incrementaron en todos los casos. Conclusiones. La dificultad para hacer el diagnóstico incuestionable de infección no permite afirmar categóricamente que una concentración de PCT > 0,5 ng/mL sea marcador exclusivo de complicación infecciosa pero su determinación parece de mayor utilidad que la de VSG y PCR (AU)

Purpose of the study: Procalcitonin (PCT) is a 116 aminoacid polipeptyde synthesized in the thyroid C-cells. Its levels rise in the presence of bacterial infection. The aim of this work was to study the evolution of PCT levels in the postoperative period of knee arthroplasty and to assess its usefulness in the diagnosis of the infection process and its relationship to Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP). Material and methods: Blood samples from 128 patients undergoing total knee arthroplasty surgery were taken one hour before surgery and 24, 48 and 72 hours after. PCT, ESR and CRP levels were measured and related to clinical complications. The number of leukocytes, blood transfusions, type of implant and minutes of ischaemia were studied and correlated to PCT concentrations above 0.5 ng/mL. Results: PCT < 0.5 ng/mL correlated with absence of clinical complications in 95% of the cases, and levels of PCT>0.5 ng/mL correlated to clinical complications in 75% of the cases. ESR and CRP increased in all of the patients in the postoperative period. Conclusions: Difficulties in establishing an unquestionable diagnosis of infection do not allow us to firmly assert that PCT levels higher than 0.5 ng/mL are exclusive of bacterial infection, but it does seem to be more useful than ESR and CRP in the management of these patients (AU)

The influence of respiration on biofeedback techniques.

This research is based on previous studies which identified a specific respiratory pattern and inhalation-exhalation ratio, with which we were able to obtain significantly greater reductions in psychophysiological activation than with other respiratory patterns. The present study aimed to check the effectiveness of this respiratory pattern in learning based on biofeedback from the electrical conductance of the skin. The results obtained demonstrated that biofeedback combined with this respiratory pattern produced a significant reduction in psychophysiological activation and improved learning through biofeedback techniques.

[Identification of individuals with insulin resistance by means of clinical measurements and routine biochemical markers. Construction of an individual risk index]. / Identificación de individuos con resistencia a la insulina mediante mediciones clínicas y marcadores bioquímicos de rutina. Construcción de un índice de riesgo individual.

INTRODUCTION: This study aimed to know the markers and routine biochemical measures that are associated to the insulin resistance (IR) and to develop an index of individual IR risk from them. SUBJECTS AND METHODS: Cross-sectional study made in Primary Health Care population of both genders between 40 and 74 years (n = 2,143). A representative sample was obtained by simple random sampling of 305 patients after excluding the diabetic subjects. Sociodemographic variables, background, examinations, routine analyses as well as fasting insulin levels were obtained. IR was considered if HOMA was higher than 2.9. A step by step logistic regression was done to obtain the best variables to predict IR. A logistic equation, categorical scale and simple additive scale from the beta coefficients was then constructed and was compared with other instruments designed to predict IR. RESULTS: IR prevalence was 25.2%. There were no differences between genders or by age. The four variables that entered the model were fasting plasma glucose, BMI, HDL cholesterol and diastolic blood pressure. The logistic model had good adjustment. The logistic equation was: IR = 1/ 1 + exp (-[-21.011) - [0.119 * fasting plasma glucose] - [0.231 * BMI] - [-0.046 * HDL cholesterol] - [0.048 * diastolic blood pressure]). The scale constructed assesses each subject between -1 and 7 points; cutoff to predict IR was established at 3.5 points, obtaining a sensitivity and specificity similar to the McAuley index and better than the triglycerides/HDL cholesterol ratio, the first model of Stern and the diagnosis of metabolic syndrome according to ATP-III. DISCUSSION: A very easy-to-use instrument has been obtained to predict IR by means of exploratory measures and routine biochemical measures, which makes it possible to select the patients at the greatest risk in order to intensify preventive actions in them.

Identificación de individuos con resistencia a la insulina mediante mediciones clínicas y marcadores bioquímicos de rutina. Construcción de un índice de riesgo individual / Identification of individuals with insulin resistance by means of clinical measurements and routine biochemical markers. Construction of an individual risk index

Introducción. El objetivo del estudio fue conocer los marcadores bioquímicos y las medidas clínicas de rutina que se asocian a la resistencia a la insulina (RI), y desarrollar a partir de ellos un índice de riesgo individual de RI. Sujetos y métodos. Estudio transversal sobre población general de ambos sexos entre 40 y 70 años (n = 2.143); se obtuvo una muestra aleatoria simple de 305 pacientes tras excluir a los diabéticos. Se recogieron variables sociodemográficas, antecedentes, exploración y analítica de rutina más insulinemia. Se consideró RI un HOMA (homeostasis model assessment) ≥ 2,9. Se practicó una regresión logística por pasos hacia adelante para obtener las mejores variables para predecir la RI, posteriormente se construyó una ecuación logística, una escala categórica y una escala aditiva simple a partir de los coeficientes beta, y se comparó ésta con otros instrumentos diseñados para predecir la RI. Resultados. La prevalencia de RI fue del 25,2%. No hubo diferencias por sexos ni por edad. Las variables que entraron en el modelo fueron: glucemia, índice de masa corporal (IMC), colesterol ligado a lipoproteínas de alta densidad (c-HDL) y presión arterial diastólica (PAD). El modelo logístico presentó un buen ajuste. La ecuación logística fue: probabilidad de RI = 1/ 1 + exp (-[-21,011] ­ [0,119 * glucemia] ­ [0,231 * IMC] ­ [-0,046 * c-HDL] ­ [0,048 * PAD]. La escala construida valora a cada sujeto entre -1 y 7 puntos; el punto de corte para predecir la RI se estableció en > 3,5 puntos, obteniéndose una sensibilidad y especificidad similares al índice de McAuley y mejores que la razón triglicéridos/c-HDL, el modelo de Stern y el diagnóstico de síndrome metabólico (SM) según el Adult Treatment Panel III (ATP-III). Discusión. Se ha obtenido un instrumento de gran sencillez de uso para predecir la RI mediante la exploración y analítica de rutina, que permite seleccionar a los pacientes de mayor riesgo para intensificar intervenciones preventiva (AU)

Introduction. This study aimed to know the markers and routine biochemical measures that are associated to the insulin resistance (IR) and to develop an index of individual IR risk from them. Subjects and methods. Cross-sectional study made in Primary Health Care population of both genders between 40 and 74 years (n = 2,143). A representative sample was obtained by simple random sampling of 305 patients after excluding the diabetic subjects. Sociodemographic variables, background, examinations, routine analyses as well as fasting insulin levels were obtained. IR was considered if HOMA was higher than 2.9. A step by step logistic regression was done to obtain the best variables to predict IR. A logistic equation, categorical scale and simple additive scale from the beta coefficients was then constructed and was compared with other instruments designed to predict IR. Results. IR prevalence was 25.2%. There were no differences between genders or by age. The four variables that entered the model were fasting plasma glucose, BMI, HDL cholesterol and diastolic blood pressure. The logistic model had good adjustment. The logistic equation was: IR = 1/ 1 + exp (-[-21.011) ­ [0.119 * fasting plasma glucose] ­ [0.231 * BMI] ­ [-0.046 * HDL cholesterol] ­ [0.048 * diastolic blood pressure]). The scale constructed assesses each subject between -1 and 7 points; cutoff to predict IR was established at 3.5 points, obtaining a sensitivity and specificity similar to the McAuley index and better than the triglycerides/HDL cholesterol ratio, the first model of Stern and the diagnosis of metabolic syndrome according to ATP-III. Discussion. A very easy-to-use instrument has been obtained to predict IR by means of exploratory measures and routine biochemical measures, which makes it possible to select the patients at the greatest risk in order to intensify preventive actions in them (AU)

La cuestión de la transferencia en la psicosis / The question of transference in psychosis

El objetivo que persigue este trabajo es analizar, mostrar y valorar el controvertido problema de la transferencia en la psicosis. El recorrido crítico que hemos realizado, limitado obviamente por el espacio, está jalonado por referencias conceptuales de diversos autores, en las que hemos apoyado, con el mayor rigor posible, las conclusiones que en el texto se vierten. Se aborda, primordialmente, la polémica cuestión de la transferencia del enfermo psicótico y los mecanismos de proyección y de negación, ligados íntimamente a ella, así como la viabilidad del análisis con este tipo de pacientes. Por último, no hemos podido eludir la tentación de esbozar una aproximación teórica acerca del posible abordaje analítico de la psicosis, a tenor, claro está, de las conclusiones expuestas (AU)

Myxoma of the jaws. Report of three cases.

Odontogenic myxoma is a locally aggressive, uncommon benign tumour which arises from mesenchymal tissues normally present in developing teeth. The most frequent locations of odontogenic myxoma are the posterior regions of the mandible, as well as the condylar region. Since odontogenic myxomas are not associated with any specific clinical or radiological sign, a histopathological examination of the specimen is required for confirmation of the primary diagnosis. We report three cases of myxoma diagnosed during the last 18 years. Two of them were located in atypical regions of the mandible and one was located in the maxilla. Presence of a slow-growing swelling associated with expansion of the bone plates raised suspicion of a tumour in two cases, while in the third patient the myxoma was an incidental finding during radiological examination. Due to the unspecific nature of these lesions, in every case a histopathological examination of the surgical specimen was required for diagnostic confirmation. In one of the three reported cases, we shall underline the need to follow a correct diagnostic work-up of all radiolucent lesions of the jaws, in order to avoid contraindicated therapeutic procedures.

Mixoma de los maxilares. A propósito de tres casos / Myxoma of the jaws. Report of three cases

El mixoma odontogénico es un tumor benigno poco frecuente, con agresividad local, que se origina a partir de los tejidos mesenquimales de los dientes en desarrollo. Su localización preferente son las zonas posteriores de la mandíbula, así como el área condilar. Clínica y radiográficamente no muestra signos de especificidad, por lo que en su diagnóstico es necesario el estudio histopatológico del tejido para confirmar la tumoración.Presentamos tres casos de mixomas recogidos en los últimos 18 años, dos localizados en zonas atípicas mandibulares y uno en la maxilar. La presencia de un crecimiento lento, con expansión de la cortical ósea en do permitió s casos permitio sospechar la presencia del tumor, y el tercer caso constituye un hallazgo casual durante la exploración radiográfica. En todas las ocasiones ha sido necesario el estudio histopatológico de la pieza quirúrgica para confirmar el diagnóstico dada la inespecificida de la lesión; en uno de ellos llamamos la atención sobre la necesidad de realizar un correcto protocolo diagnóstico de las lesiones radiotransparentes de los maxilares, a efectos de evitar procedimientos terapéuticos contraindicados (AU)

Analysis and characterization of hematopoietic progenitor cells from fetal bone marrow, adult bone marrow, peripheral blood, and cord blood.

Hematopoietic stem cell transplantation has been increasingly used to replace a defective hematopoietic system and to treat various genetic defects as well as malignant diseases. However, the limitations of conventional bone marrow transplantation have stimulated an intense interest in exploring the use of alternative sources of hematopoietic stem cells, including peripheral blood mononuclear cells (PBMC) and cord blood (CB). A major investigative effort of our laboratory has been focused on evaluating fetal bone marrow (FBM) for transplantation. The current study compares and characterizes the functional and phenotypic characteristics of FBM, CB, adult bone marrow (ABM), and PBMC by clonogenicity assays, immunogenicity, and the quantification of progenitor cells. There was a striking difference in the proportion of CD34+ cells in FBM, ABM, PBMC, and CB (24.6%, 2.1%, 0.5%, and 2.0%, respectively). The clonogenic potential, as measured by colony forming unit in culture (CFU-C) assay, was significantly higher in FBM when compared with ABM, PBMC, and CB (202.5, 73.5, 40.8, and 65.5 colonies/10(5) cells, respectively). There was a significant decrease in proliferative responsiveness in mixed lymphocyte reaction (MLR) assay of FBM and CB compared with ABM and PBMC. These observations indicate that each source of hematopoietic stem cells has different intrinsic properties closely correlated with ontogenetic age that is a vital determinant for phenotypic characteristics, lineage commitments, immunogenicity, and proliferative potentials.

Computer-assisted analysis of methylation status of individual interphase nuclei in human cultured cells.

This paper demonstrates that (a) differences in the methylation levels of interphase nuclei can be measured on a cell-by-cell basis, (b) the binding sites of beta-satellite DNA and 5-methylcytosine (5MeC)-rich regions can be localised in interphase nuclei and metaphase chromosomes by sequential in situ hybridization and indirect immunolabelling, and (c) quantitative differences in the relative extensions of beta-satellite DNA and anti-5MeC antibody binding areas can also be measured. This goal was achieved by indirect immunolabelling by anti-5MeC antibodies (Reynaud et al.: Cancer Lett. 61:255-262, 1991) of control and 5-azacytidine-treated human cell cultures. A quantitative analysis of the number, total, and mean areas of labelled heterochromatic regions and the optical densities of euchromatin and heterochromatin was performed for the cells on microscope slides. Dedicated software was used to select and measure the areas of cytological interest. In additional experiments, DAPI-stained slides from control cultures were sequentially treated by in situ hybridization with beta-satellite DNA probe and indirect immunofluorescent labelling with anti-5MeC antibodies. Fluorescent signals of probe and antibodies were pseudocoloured and merged on digital images. The relative locations of probe- and antibody-positive areas were analysed on metaphases and nuclei, and their extensions were quantified in interphase nuclei. Our results show that (a) our analysis can successfully detect different levels of DNA methylation within individual nuclei, (b) in metaphase chromosomes the antibody binding sites are mostly coincident with the hybridisation sites, and (c) in interphase nuclei a quite different picture is consistently observed.