Vascular reconstruction in a case of iliac artery infiltrating giant retroperitoneal liposarcoma

Introduction. Liposarcoma is the most common tumor type of retroperitoneal soft tissue sarcomas. Case report. A 35 year-old male with a history of smoking with hypogastric abdominal pain, abdominal fullness, constipation and weight-loss for several months. Physical examination revealed abdominal distension, increased abdominal collateral circulation and a left subcostal mass. Abdominal and pelvic CT scan showed a large, septated fat tumor measuring approximately 30cm x 31cm x 41cm in size. It was decided to perform a resection of the tumoral mass, the para-aortic adenopathy and the infiltrating component of the arterial axis plus a left nephrectomy. During the operation, we observed infiltration of the left CIA which required a block resection of the left CIA, followed by a CIA to left external iliac artery terminal-terminal (T-T) bypass using a 8mm Polyethylene Terephthalate prosthesis, internaliliac artery ligation and venous axis ligation. (AU)

Pupil inversion Mach-Zehnder interferometry for diffraction-limited optical astronomical imaging.

We present theoretical and laboratory experimental results on a robust interferometric device based on pupil inversion, or 180° rotational shearing interferometry. The image of an astronomical object degraded by the atmosphere turbulence can be restored (ideally up to the diffraction limit) by a numerical post-processing of the interferogram. Unlike previous Michelson configurations that return half of the light to the sky, the Mach-Zehnder interferometer has no fundamental losses when both outputs are used. The interferogram is formed by two overlapped images of the telescope pupil, but one of them is spatially inverted, and out of phase by π/2 only in its half. This optical operation is achieved in a robust way by inserting a refractive optical image inverter and a binary phase plate in one of the arms of the interferometer. In this way, the system has no polarization dependence or moving parts since the plate allows the object to be retrieved numerically from just one interferogram (single exposition) or a few independent interferograms. For that, several algorithms are proposed. Likewise, we include a laboratory proof-of-concept in which a diffraction-limited image is obtained in spite of presence of aberrations and photon noise.

[Mental development trajectories of a group of preterm babies from 1 to 30 months of age]. / Trayectorias de desarrollo mental de un grupo de bebes prematuros de 1 a 30 meses.

INTRODUCTION: This research falls within the category of longitudinal studies assessing the evolution of prematurely born infants with the use of standardized tests. AIMS: To analyze the trajectory of the mental development of a group of premature infants and to identify if gestational age is a significant predictor of their evolution. SUBJECTS AND METHODS: 359 prematurely born infants were assessed at three stages of their development (between 1-9 months, 10-18 months and 19-30 months of age), using the Bayley Scales of Infant DEVELOPMENT. To analyze the trajectory of the sample mental development, a linear mixed model procedure was applied. RESULTS: The trajectories of the mental development of these children conform to a model of the quadratic development curve. The results show that gestational age is a significant predictor of the initial score that explains 34% of the total interindividual variability. CONCLUSIONS: Children with lowest initial scores are those who most increase them with age, an important fact for the prediction of premature newborns future development. This fact should be taken into account regarding negative prognoses in the first year of life.

TITLE: Trayectorias de desarrollo mental de un grupo de bebes prematuros de 1 a 30 meses.Introduccion. Esta investigacion se inscribe en los estudios de corte longitudinal para evaluar la evolucion de los recien nacidos prematuros con el uso de pruebas estandarizadas. Objetivos. Analizar la trayectoria del desarrollo mental de un grupo de recien nacidos prematuros e identificar si la edad gestacional es un predictor significativo de su evolucion. Sujetos y metodos. Se evaluo a 359 recien nacidos prematuros en tres momentos de su desarrollo (entre 1 y 9 meses, entre 10 y 18 meses, y entre 19 y 30 meses de edad), utilizando las escalas Bayley de desarrollo infantil. Para analizar la trayectoria del desarrollo mental de la muestra se aplico el procedimiento de modelos lineales mixtos. Resultados. Las trayectorias del desarrollo mental de estos niños se ajustan a un modelo de la curva de desarrollo cuadratica. Los resultados muestran que la edad gestacional es un predictor significativo de la puntuacion inicial que explica el 34% del total de la variabilidad interindividual. Conclusiones. Los niños con puntuaciones iniciales mas bajas son los que mas incrementan sus puntuaciones con la edad, un dato importante de cara a la prediccion del futuro desarrollo de los prematuros y que previene sobre la realizacion de pronosticos negativos en el primer año de vida.

Trayectorias de desarrollo mental de un grupo de bebés prematuros de 1 a 30 meses / Mental development trajectories of a group of preterm babies from 1 to 30 months of age

Introducción. Esta investigación se inscribe en los estudios de corte longitudinal para evaluar la evolución de los recién nacidos prematuros con el uso de pruebas estandarizadas. Objetivos. Analizar la trayectoria del desarrollo mental de un grupo de recién nacidos prematuros e identificar si la edad gestacional es un predictor significativo de su evolución. Sujetos y métodos. Se evaluó a 359 recién nacidos prematuros en tres momentos de su desarrollo (entre 1 y 9 meses, entre 10 y 18 meses, y entre 19 y 30 meses de edad), utilizando las escalas Bayley de desarrollo infantil. Para analizar la trayectoria del desarrollo mental de la muestra se aplicó el procedimiento de modelos lineales mixtos. Resultados. Las trayectorias del desarrollo mental de estos niños se ajustan a un modelo de la curva de desarrollo cuadrática. Los resultados muestran que la edad gestacional es un predictor significativo de la puntuación inicial que explica el 34% del total de la variabilidad interindividual. Conclusiones. Los niños con puntuaciones iniciales más bajas son los que más incrementan sus puntuaciones con la edad, un dato importante de cara a la predicción del futuro desarrollo de los prematuros y que previene sobre la realización de pronósticos negativos en el primer año de vida

Introduction. This research falls within the category of longitudinal studies assessing the evolution of prematurely born infants with the use of standardized tests. Aims. To analyze the trajectory of the mental development of a group of premature infants and to identify if gestational age is a significant predictor of their evolution. Subjects and methods. 359 prematurely born infants were assessed at three stages of their development (between 1-9 months, 10-18 months and 19-30 months of age), using the Bayley Scales of Infant Development. To analyze the trajectory of the sample mental development, a linear mixed model procedure was applied. Results. The trajectories of the mental development of these children conform to a model of the quadratic development curve. The results show that gestational age is a significant predictor of the initial score that explains 34% of the total interindividual variability. Conclusions. Children with lowest initial scores are those who most increase them with age, an important fact for the prediction of premature newborns future development. This fact should be taken into account regarding negative prognoses in the first year of life

Las diferentes manifestaciones de la aspergilosis pulmonar. Hallazgos en tomografía computarizada multidetector / The different manifestations of pulmonary aspergillosis: Multidetector computed tomography findings

La aspergilosis pulmonar es una infección micótica causada la mayoría de las veces por la inhalación de esporas de Aspergillus fumigatus. Sin embargo, al hablar de aspergilosis, en realidad nos referimos a un abanico de manifestaciones clínicas y radiológicas que dependen directamente del estado del sistema inmune del paciente, de la existencia de enfermedad pulmonar previa y de la virulencia del organismo. Son 4 los tipos de aspergilosis pulmonar (aspergiloma, aspergilosis broncopulmonar alérgica, aspergilosis necrosante crónica y aspergilosis invasiva), cada uno con hallazgos radiológicos distintos. En este artículo revisamos el espectro de signos de la aspergilosis pulmonar en la tomografía computarizada multidetector y los correlacionamos con los síntomas y la respuesta inmune del paciente. Se abordarán asimismo los principales diagnósticos diferenciales (AU)

Pulmonary aspergillosis is a fungal infection usually caused by inhaling Aspergillus fumigatus spores. However, when we talk about aspergillosis, we normally refer to the spectrum of clinical and radiological findings that depend directly on the patient's immune status, on the prior existence of lung disease, and on the virulence of the infective organism. There are four types of pulmonary aspergillosis (aspergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing pulmonary aspergillosis, and invasive aspergillosis), and each type has its own distinct radiologic findings. We review the signs of pulmonary aspergillosis on multidetector computed tomography and we correlate them with patients’ symptoms and immune responses. Likewise, we discuss the differential diagnoses (AU)

[The different manifestations of pulmonary aspergillosis: multidetector computed tomography findings]. / Las diferentes manifestaciones de la aspergilosis pulmonar. Hallazgos en tomografía computarizada multidetector.

Pulmonary aspergillosis is a fungal infection usually caused by inhaling Aspergillus fumigatus spores. However, when we talk about aspergillosis, we normally refer to the spectrum of clinical and radiological findings that depend directly on the patient's immune status, on the prior existence of lung disease, and on the virulence of the infective organism. There are four types of pulmonary aspergillosis (aspergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing pulmonary aspergillosis, and invasive aspergillosis), and each type has its own distinct radiologic findings. We review the signs of pulmonary aspergillosis on multidetector computed tomography and we correlate them with patients' symptoms and immune responses. Likewise, we discuss the differential diagnoses.

c-Kit identifies a subpopulation of mesenchymal stem cells in adipose tissue with higher telomerase expression and differentiation potential.

The stromal vascular fraction (SVF) of adipose tissue is an easy to obtain source of adipose tissue-derived stem cells (ADSCs). We and others have achieved significant but suboptimal therapeutic effects with ADSCs in various settings, mainly due to low rates of differentiation into specific cell types and with the downside of undesired side effects as a consequence of the undifferentiated ADSCs. These data prompted us to find new stem cell-specific markers for ADSCs and/or subpopulations with higher differentiation potential to specific lineages. We found a subpopulation of human ADSCs, marked by c-Kit positiveness, resides in a perivascular location, and shows higher proliferative activity and self-renewal capacity, higher telomerase activity and expression, higher in vitro adipogenic efficiency, a higher capacity for the maintenance of cardiac progenitors, and higher pancreatogenic and hepatogenic efficiency independently of CD105 expression. Our data suggests that the isolation of ADSC subpopulations with anti-c-Kit antibodies allows for the selection of a more homogeneous subpopulation with increased cardioprotective properties and increased adipogenic and endodermal differentiation potential, providing a useful tool for specific therapies in regenerative medicine applications.

IGFBP-3 methylation-derived deficiency mediates the resistance to cisplatin through the activation of the IGFIR/Akt pathway in non-small cell lung cancer.

Although many cancers initially respond to cisplatin (CDDP)-based chemotherapy, resistance frequently develops. Insulin-like growth factor-binding protein-3 (IGFBP-3) silencing by promoter methylation is involved in the CDDP-acquired resistance process in non-small cell lung cancer (NSCLC) patients. Our purpose is to design a translational-based profile to predict resistance in NSCLC by studying the role of IGFBP-3 in the phosphatidyl inositol 3-kinase (PI3K) signaling pathway. We have first examined the relationship between IGFBP-3 expression regulated by promoter methylation and activation of the epidermal growth factor receptor (EGFR), insulin-like growth factor-I receptor (IGFIR) and PI3K/AKT pathways in 10 human cancer cell lines and 25 NSCLC patients with known IGFBP-3 methylation status and response to CDDP. Then, to provide a helpful tool that enables clinicians to identify patients with a potential response to CDDP, we have calculated the association between our diagnostic test and the true outcome of analyzed samples in terms of cisplatin IC50; the inhibitory concentration that kills 50% of the cell population. Our results suggest that loss of IGFBP-3 expression by promoter methylation in tumor cells treated with CDDP may activate the PI3K/AKT pathway through the specific derepression of IGFIR signaling, inducing resistance to CDDP. This study also provides a predictive test for clinical practice with an accuracy and precision of 0.84 and 0.9, respectively, (P=0.0062). We present a biomarker test that could provide clinicians with a robust tool with which to decide on the use of CDDP, improving patient clinical outcomes.

Serie de casos. Experiencia de un único centro en el tratamiento de fístulas aortoentéricas / A case series. Experience of a single centre in the treatment of aortoenteric fistulas

Objetivo: Analizar nuestra experiencia y resultados obtenidos en una patología infrecuente, compleja y grave como la fístula aortoentérica (FAE). Material y métodos: La patología aórtica previa y su tratamiento fueron: 4 síndromes de Leriche y 2 aneurismas de aorta y un aneurisma roto tratados con bypass aortobifemoral y dos endovascular aneurysms repair (EVAR). Otros datos recogidos fueron: factores de riesgo cardiovascular, patología y cirugía abdominal previa, la localización de FAE secundaria, periodo de tiempo hasta la FAE, evolución y recidivas. Nueve pacientes (7 hombres y 2 mujeres) con fístula secundaria aortoentérica tratados durante el periodo 2000-2010 se agruparon en función de la estabilidad hemodinámica: 3 hombres estables, 4 hombres y 2 mujeres inestables. Resultados: Las FAE secundarias aparecieron tras una media de tiempo de 85,8 meses (mediana: 104; rango: 5-204). Cuatro se trataron con bypass extra-anatómico, 3 inestables. Tres pacientes con reparación in situ, 2 inestables. Dos de forma endovascular, uno inestable. Hubo una muerte intra-quirófano, inestable, y durante los primeros 30 días fallecieron otros 4 pacientes, 3 inestables y uno estable. Los 4 pacientes que sobrevivieron sufrieron una recidiva de la FAE tras tres meses de media (intervalo: 2-5); solo dos se trataron, uno con endoprótesis y otro con bypass axilobifemoral. Conclusiones: La FAE secundaria es una complicación grave, rara y compleja, con una alta morbilidad y mortalidad. No existe un tratamiento estándar, aunque es fundamental el tratamiento urgente de la hemorragia, incluyendo la terapia endovascular, con o sin una nueva intervención para el tratamiento definitivo(AU()

Objective: To analyse our experience and results of a rare, complex and serious disease, aortoenteric fistula (AEF). Material and methods: Nine patients (seven males and two females) with secondary aortoenteric fistula treated during the period 2000-2010, were grouped according to hemodynamic stability: stable three males. Four males and two females were unstable. Previous aortic pathology and its treatment were: four Leriche syndrome, two aortic aneurysms and a ruptured aortic aneurysm treated by aortobifemoral bypass and two EVAR (endovascular aneurysms repair). Other data collected: cardiovascular risk factors, previous abdominal pathology and its surgery, the location of the secondary AEF, period of time until the appearance of AEF, evolution and recurrence. Results: The secondary AEF appeared after a mean time of 85.8 months (median 104, range 5-204). Four were treated with extra-anatomical bypass, and three were unstable. Three patients with in situ repair, two unstable. Two with endograft, one unstable. There was one death during surgery, unstable, and during the first 30 days, four patients died, 3 unstable, one stable. The four surviving patients had a recurrence of the AEF after a mean of three months (range, 2-5), only two were treated, one patient with endograft and one with axilobifemoral bypass. Conclusions: Secondary AEF is a serious, rare and complex complication, with high morbidity and mortality. No standard treatment exists, although the urgent treatment of bleeding is essential, including endovascular therapy, with or without a new intervention for definitive treatment(AU)

Ten novel mutations in the NR5A1 gene cause disordered sex development in 46,XY and ovarian insufficiency in 46,XX individuals.

CONTEXT: Steroidogenic factor-1 (SF-1/NR5A1) is a nuclear receptor that regulates adrenal and reproductive development and function. NR5A1 mutations have been detected in 46,XY individuals with disorders of sexual development (DSD) but apparently normal adrenal function and in 46,XX women with normal sexual development yet primary ovarian insufficiency (POI). OBJECTIVE: A group of 100 46,XY DSD and two POI was studied for NR5A1 mutations and their impact. DESIGN: Clinical, biochemical, histological, genetic, and functional characteristics of the patients with NR5A1 mutations are reported. SETTING: Patients were referred from different centers in Spain, Switzerland, and Turkey. Histological and genetic studies were performed in Barcelona, Spain. In vitro studies were performed in Bern, Switzerland. PATIENTS: A total of 65 Spanish and 35 Turkish patients with 46,XY DSD and two Swiss 46,XX patients with POI were investigated. MAIN OUTCOME: Ten novel heterozygote NR5A1 mutations were detected and characterized (five missense, one nonsense, three frameshift mutations, and one duplication). RESULTS: The novel NR5A1 mutations were tested in vitro by promoter transactivation assays showing grossly reduced activity for mutations in the DNA binding domain and variably reduced activity for other mutations. Dominant negative effect of the mutations was excluded. We found high variability and thus no apparent genotype-structure-function-phenotype correlation. Histological studies of testes revealed vacuolization of Leydig cells due to fat accumulation. CONCLUSIONS: SF-1/NR5A1 mutations are frequently found in 46,XY DSD individuals (9%) and manifest with a broad phenotype. Testes histology is characteristic for fat accumulation and degeneration over time, similar to findings observed in patients with lipoid congenital adrenal hyperplasia (due to StAR mutations). Genotype-structure-function-phenotype correlation remains elusive.

Differences in questing tick species distribution between Atlantic and continental climate regions in Spain.

Climate and vegetation in Spain vary from north to south, affecting tick distribution and consequently the presence of tick-borne diseases. The aim of this study was to investigate throughout a 2-yr study the distribution of the different exophilic questing tick species present in 18 areas: eight located in central and 10 in northern Spain. The same methodology was used in both areas, sampling vegetation on a monthly basis by blanket dragging for 20- to 30-min intervals. A total of 12 species belonging to the genera Ixodes, Haemaphysalis, Rhipicephalus, Dermacentor, and Hyalomma was identified. Differences in species distribution and prevalence were dramatically different. The most frequent and abundant species in northern Spain were Ixodes ricinus (67% of adult ticks) and Haemaphysalis punctata (8%), whereas Hyalomma lusitanicum (86%) and Dermacentor marginatus (12%) were the most abundant in central Spain. There were important differences in the monthly seasonal patterns for the different tick species. These results highlight important differences in tick distribution in neighboring areas and underline the need for ongoing surveillance programs to monitor tick population dynamics and the prevalence of tick-borne pathogens.

Hipertensión pulmonar: aportación de la TCMD al diagnóstico de sus distintos tipos / Pulmonary hypertension: The contribution of MDCT to the diagnosis of its different types

La hipertensión pulmonar (HP) es una enfermedad caracterizada por la progresiva afectación de los vasos pulmonares, lo que produce aumento de las resistencias vasculares y, como consecuencia, fallo ventricular derecho. La lesión vascular es el factor común a un amplio abanico de patologías y su resultado, la HP, un cuadro clínico grave de mal pronóstico, que agrava el curso normal de las enfermedades a las que se asocia (EPOC, colagenosis, sarcoidosis, cardiopatías congénitas o adquiridas…). El interés por diagnosticarla lo más precozmente posible se debe a que, actualmente, se dispone de fármacos que mejoran la calidad de vida y han disminuido la mortalidad de estos pacientes y que existen posibilidades quirúrgicas para algunos tipos de hipertensión como la tromboembólica crónica o la asociada a algunas cardiopatías congénitas con cortocircuitos izquierda-derecha. Ante una sospecha clínica de HP los métodos de imagen son los que confirman el diagnóstico, sugieren una causa, ayudan a seleccionar el tratamiento más adecuado y monitorizan la respuesta. En la actual revisión del tema se presenta la aportación de los diferentes métodos de imagen para el diagnóstico de la enfermedad, haciendo especial hincapié en la TC multidetector (TCMD), que ofrece la posibilidad de estudiar con una sola adquisición todos los órganos torácicos. Se revisan los signos radiológicos de HP y se establecen los criterios radiológicos actuales para etiquetar el tipo de hipertensión, según la clasificación de Dana Point, basados en el estudio de las alteraciones del parénquima pulmonar, mediastino, espacios pleurales y pericardio y en el estudio de las cámaras cardíacas (AU)

Pulmonary hypertension is characterized by progressive involvement of the pulmonary vessels that leads to increased vascular resistance and consequently to right ventricular failure. Vascular lesions are a common factor in a wide spectrum of diseases, and their result, pulmonary hypertension, is a severe clinical condition with a poor prognosis that worsens the normal course of the diseases to which it is associated (COPD, collagen disease, sarcoidosis, and congenital or acquired heart disease). It is important for pulmonary hypertension to be diagnosed as early as possible because nowadays drugs can reduce mortality and improve the quality of life; furthermore, some types of pulmonary hypertension (e.g., chronic thromboembolism and those associated with some congenital heart diseases like left-to-right shunt) can be treated surgically. In cases of suspected pulmonary hypertension, imaging methods can confirm the diagnosis, suggest a cause, help choose the most appropriate treatment, and monitor the response to treatment. This review describes the approach to pulmonary hypertension using different imaging techniques; special emphasis is given to the role of multidetector CT (MDCT), which makes it possible to study all the organs in the thorax in a single acquisition. We review the radiological signs of pulmonary hypertension and the current (Dana Point) radiological criteria for classifying the type of hypertension based on alterations in the lung parenchyma, mediastinum, pleural spaces, and pericardium, as well as on the study of the chambers of the heart (AU)

[Pulmonary hypertension: the contribution of MDCT to the diagnosis of its different types]. / Hipertensión pulmonar: aportación de la TCMD al diagnóstico de sus distintos tipos.

Pulmonary hypertension is characterized by progressive involvement of the pulmonary vessels that leads to increased vascular resistance and consequently to right ventricular failure. Vascular lesions are a common factor in a wide spectrum of diseases, and their result, pulmonary hypertension, is a severe clinical condition with a poor prognosis that worsens the normal course of the diseases to which it is associated (COPD, collagen disease, sarcoidosis, and congenital or acquired heart disease). It is important for pulmonary hypertension to be diagnosed as early as possible because nowadays drugs can reduce mortality and improve the quality of life; furthermore, some types of pulmonary hypertension (e.g., chronic thromboembolism and those associated with some congenital heart diseases like left-to-right shunt) can be treated surgically. In cases of suspected pulmonary hypertension, imaging methods can confirm the diagnosis, suggest a cause, help choose the most appropriate treatment, and monitor the response to treatment. This review describes the approach to pulmonary hypertension using different imaging techniques; special emphasis is given to the role of multidetector CT (MDCT), which makes it possible to study all the organs in the thorax in a single acquisition. We review the radiological signs of pulmonary hypertension and the current (Dana Point) radiological criteria for classifying the type of hypertension based on alterations in the lung parenchyma, mediastinum, pleural spaces, and pericardium, as well as on the study of the chambers of the heart.

Cardiopatías congénitas en el adulto. Aportaciones de la tomografía computarizada multidetector / Congenital heart disease in adults: the contribution of multidetector CT

Las cardiopatías congénitas (CC) constituyen actualmente una enfermedad no infrecuente en el adulto. Generalmente el paciente está diagnosticado previamente y el estudio se solicita como seguimiento o por complicaciones de la anomalía o de su corrección quirúrgica. Clásicamente, estos pacientes se estudiaban con ecocardiografía y cateterismo cardíaco, pero el abordaje ha cambiado con la tomografía computarizada multidetector (TCMD) y la resonancia magnética, ya que permiten una excelente demostración anatómica de las anomalías cardíacas y de su corrección quirúrgica. Pretendemos resaltar la importancia de la TCMD como método complementario en el estudio de las CC descubiertas en el adulto o en las corregidas quirúrgicamente en la infancia y seguidas posteriormente. Cuando existen anomalías vasculares extracardíacas o tras la realización de cirugía paliativa, la TCMD muestra detalles anatómicos difíciles o imposibles de valorar con ecocardiografía. También resaltamos la frecuente asociación de hipertensión pulmonar con CC que pueden debutar en la edad adulta (AU)

Congenital heart disease is relatively common among adults. Patients’ conditions have generally been diagnosed previously and imaging tests are requested for follow-up or for complications of the anomaly or of its surgical correction. Classically, these patients were studied with echocardiography and cardiac catheterization, but multidetector CT and magnetic resonance imaging have changed the approach because these techniques show the anatomy of heart defects and their correction very clearly. We emphasize the importance of multidetector CT as a complementary technique for the study of congenital heart disease that is newly discovered in adults or for the follow-up of congenital heart disease that was surgically corrected during childhood. When vascular anomalies are present outside the heart or after palliative surgery, multidetector CT shows anatomical details that are difficult or impossible to see with echocardiography. We also emphasize the frequent association between pulmonary hypertension and congenital heart disease that can debut in adults (AU)

[Congenital heart disease in adults: the contribution of multidetector CT]. / Cardiopatías congénitas en el adulto. Aportaciones de la tomografía computarizada multidetector.

Congenital heart disease is relatively common among adults. Patients' conditions have generally been diagnosed previously and imaging tests are requested for follow-up or for complications of the anomaly or of its surgical correction. Classically, these patients were studied with echocardiography and cardiac catheterization, but multidetector CT and magnetic resonance imaging have changed the approach because these techniques show the anatomy of heart defects and their correction very clearly. We emphasize the importance of multidetector CT as a complementary technique for the study of congenital heart disease that is newly discovered in adults or for the follow-up of congenital heart disease that was surgically corrected during childhood. When vascular anomalies are present outside the heart or after palliative surgery, multidetector CT shows anatomical details that are difficult or impossible to see with echocardiography. We also emphasize the frequent association between pulmonary hypertension and congenital heart disease that can debut in adults.

IGFBP-3 hypermethylation-derived deficiency mediates cisplatin resistance in non-small-cell lung cancer.

Cisplatin-based chemotherapy is the paradigm of non-small-cell lung cancer (NSCLC) treatment; however, it also induces de novo DNA-hypermethylation, a process that may be involved in the development of drug-resistant phenotypes by inactivating genes required for drug-cytotoxicity. By using an expression microarray analysis, we aimed to identify those genes reactivated in a set of two cisplatin (CDDP) resistant and sensitive NSCLC cell lines after epigenetic treatment. Gene expression, promoter methylation and CDDP-chemoresponse were further analyzed in three matched sets of sensitive/resistant cell lines, 23 human cancer cell lines and 36 NSCLC specimens. Results revealed specific silencing by promoter hypermethylation of IGFBP-3 in CDDP resistant cells, whereas IGFBP-3 siRNA interference, induced resistance to CDDP in sensitive cells (P<0.001). In addition, we found a strong correlation between methylation status and CDDP response in tumor specimens (P<0.001). Thus, stage I patients, whose tumors harbor an unmethylated promoter, had a trend towards increased disease-free survival (DFS). We report that a loss of IGFBP-3 expression, mediated by promoter-hypermethylation, results in a reduction of tumor cell sensitivity to cisplatin in NSCLC. Basal methylation status of IGFBP-3 before treatment may be a clinical biomarker and a predictor of the chemotherapy outcome, helping to identify patients who are most likely to benefit from CDDP therapy alone or in combination with epigenetic treatment.

Detection of Coxiella burnetii in ticks collected from Central Spain.

A total of 1482 adult ticks collected from vegetation and animals in central Spain in 2003-2005 were tested for the presence of Coxiella burnetii by polymerase chain reaction and subsequent reverse line blot hybridization (PCR-RLB). C. burnetii was identified in 7.7% of questing ticks (80/1039) and 3.4% of ticks collected from animals (15/443) belonging to four species: Hyalomma lusitanicum, Dermacentor marginatus, Rhiphicephalus sanguineus, and R. pusillus. These findings show an active role of ticks in maintaining C. burnetii in wild and peridomestic cycles in central Spain.